Role of ALAD and VDR genotypes on the association of low blood lead level with serum uric acid and blood pressure in automobile paint workers of Karachi, Pakistan

Lead is an environmental pollutant having nephrotoxic effects even at low level. Its continuous exposure is associated with increased serum uric acid level that resulting in renal insufficiency. This research was conducted to see the effects of delta-aminolevulinic acid dehydratase [ALAD] and vitamin D receptor [VDR] genotypes on biochemical parameters and blood pressure [BP] of automobile workers having low blood lead level [BLL] with continuous lead exposure. Automobile paints workers with ALAD 1-2 genotype showed the positive association of BLL with diastolic BP [p<0.05] whereas, a genotypic combination ofALAD -2IVDR BB showed the negative association of serum uric acid with BLL [p<0.05]. Similarly negative effects of VDR BB genotype [p<0.01] and ALAD 1-2 genotype [p<0.05] were observed in the association of serum uric acid with BLL at the mean age >30 years. This suggests that automobile paint workers having ALAD 1-2 genotypes are at the risk of increased diastolic BP. The research also foretells that combination of ALAD -2IVDR BB may play a significant role against lead induced nephrotoxicity at low BLL with continuous lead exposure

Comparative analysis of vitamin B 12 levels and effects of its deficiency in selected adult population diagnosed with various clinical conditions

Back ground: vitamin B12 deficiency has been associated with various clinical conditions and co-morbidities however none of the individual symptom, or group of symptoms could be ascertaining directly to its declined status. Mostly older population is affected and documented causes of deficiency are hematologic or neurological, followed by gastrointestinal and a possible altered vascular symptoms

Aim: the present prospective observational study was initiated to compare analytical levels of vitamin B12 and evaluation of underlying clinical condition and symptoms associated with possible vitamin B12 deficiencies. Materials and Methods: The study was prospective observational and carried out for the assessment period of 1st January 2000 till 30th Dec 2010. After two years of assessment, 290 patients [males, n = 156 and females, n = 134] were inducted in the study and finalized during the period 1st January 2002 to 30th December 2009. Age ranges were from 16 to 70 years, and categorized in two groups as > 60 yrs. and < 60 years. Several blood parameters [serum folate, B12, CBC, LDH, creatinine, Hb] were analyzed by standardized methods on automated analyzers

Results and Conclusion: vitamin B12 deficiency was found to be more prevalent in females and when compared with other groups the percentage increased up to 58.20% in individuals with vitamin B12 <150 pg/ml. The most common condition was malnourishment followed by anemia [n = 75; 46.01 %] and weakness [n = 55, 33. 74%] as the more frequent clinical findings. Other clinical conditions were neuropsychiatric, whereas less frequent findings were paresthesia and gastrointestinal symptoms. Moreover, hypertension was more prevalent in vitamin B12 deficient individuals followed by diabetes, dementia, stroke, ischemic heart disease and Parkinson's disease

Short title: vitamin B12 deficiency in clinical conditions

Evaluation of Carcino-embryonic antigen [CEA] and diagnostic significance in adult patients suffering from Colorectal Carcinoma [CRC] and GIT malignancies

Carcinoembryonic antigen [CEA] is a classic tumor marker for CRC, and has been used to monitor CRC recurrence and as a prognostic factor for CRC patients. The CEA molecule is an onco-development human tumor marker and bears the cluster differentiation designation of CD66e. It has a molecular weight of 180 kDa. Due to considerable clinical merit of CEA for diagnosis, prognosis and treatment, a study was carried out to assess its levels in patients suspected of or diagnosed with GIT cancers, with special reference to colorectal carcinoma [CRC]. A total of 106 patients, 71 [66.98%] males and 35 [33.01%] females, were included in the study with age range of 46 to 79 years. Out of 71 males, 33 [46.47%] have malignant conditions and exhibited elevated levels of CEA whereas 38 have non-malignant complications with normal or non-significant CEA concentrations. The malignant conditions in males [n = 33] are sub-grouped and were determined to be pancreatic [n = 2, 6.06%], gastric [n = 10, 30.30%], colorectal [n = 18, 54.54%] and hepatic [n = 3, 9.09%] cancers. Furthermore, in female group of 35 patients, 15 [42.85%] were diagnosed with malignant condition of pancreatic [n = 1; 6.66%], gastric [n = 5; 33.33%], colorectal [n = 7; 46.66%] and hepatic [n = 2; 13.335] cancers and exhibited elevated levels of CEA. In present study all malignant conditions, either metastasizing or not, showed significantly elevated levels of CEA. In male-malignant cancer patents' groups, average CEA values were 102.20 40 ng/ml, 298.40 21 ng/ml, 451.65 16 ng/ml and 176.10 5 ng/ml for pancreatic, gastric, colorectal and hepatic cancers, respectively. Similarly in females elevated levels of CEA were noted in pancreatic [99 ng/ml], gastric [169.25 22 ng/ml] CRC [441.15 16 ng/ml] and hepatic [128.54 20 ng/ml]. At present, serial CEA-monitoring is considered the best non-invasive technique for detecting CRC and its recurrence. It is also substantiated that intensive follow-up CEA assays facilitate the identification of treatable recurrence at an early stage

Estimation of Total, Bio-available and Free Testosterone levels in various age groups of men

In recent years several studies recommended the estimation of total as well as bio-available and free testosterone levels to assess the variations provided by the measurements and thus developing the foundation for interpreting hormone status in all groups of men. Therefore present study documents the current testosterone status i.e. total, free and bio-available, including sex hormone binding globulin [SHBG] in variable age groups of men [n = 78] between 14 years to 65 years. They were grouped as male aged 14-24 yrs [young] [n = 24], 25-35 yrs [adult] [n = 20], 36-50 yrs [middle aged] [n.= 29] and 51-65 yrs [older] [n - 15]. Scrum total testosterone and SHBG were measured by Electro Chemiluminescence's [ECL] technology whereas bio-available and free testosterones were calculated from pre-described calculation methods. Total testosterone levels are comparable to each other in adult and middle age groups, however significantly differ [P < 0.001] among older and younger group. Moreover, highest level of significant difference in free testosterone values were obtained for younger men in comparison with middle age group [P< 0.001] and moderate level of significance was noted when same was compared with adult and middle aged groups [P < 0.05]. The assessment of data was gave similar outcome for bio-available testosterone as well; accept when older group was compared with middle aged men, which was found to be non-significant, in conclusion, the levels of total, free, bio-available testosterone and SHBG were compared with their normal ranges and noted to be match-able with their respective age groups accordingly

Diagnostic utility and Assessment of C - reactive protein [CRP] in patients with community acquired pneumonia

It has been researched and agreed upon that pneumonia elicits a powerful inflammatory response with the release of inflammatory mediators or biomarkers, such as acute-phase proteins, inteleukin-6 and C-reactive protein [CRP] from activated mononuclear phagocyte cells. It is also known and recommended that the early analysis of serum concentrations of CRP is a significant tool for the diagnosis and monitoring of different acute inflammatory processes. Community-acquired pneumonia [CAP] is documented to be the major cause of death in the western world and effects increasing number of population annually. In present study we have investigated the suggested usefulness of serum CRP levels in patients with CAP at the time of diagnosis and compared it with CRP of healthy controls. One hundred and seventy one [n = 171] patients were included in the study and classified according to presence of pathogens/ etiology in individual capacity as well as in combination with other organisms. All microbiological assays were performed according to standardized procedures, whereas CRP was measured in serum samples by an automated turbid metric method with normal reference of

Diagnostic importance of C-reactive protein [CRP] analysis in tuberculosis pleural effusions

One of the acute-phase biomarkers that have recently been investigated for its clinical utility in tuberculosis pleural effusion is C-reactive protein [CRP] which has already been commonly used as a marker of inflammation and tissue injury. Therefore, the present study was undertaken to analyze the viability of CRP as a diagnostic aid for tuberculosis in lymphocytic pleural effusions. Fifty two [n = 52] patients with lymphocytic pleural effusion with definite diagnosis of a disease condition, were taken into the test group and classified into no tuberculosis [n = 28] group and tuberculosis pleurisy group where sputum culture was positive for Mycobacterium tuberculosis in pleural effusion [n = 24]. CRP in pleural fluid was analyzed by automated turbid metric immunoassay method as per description of the manufacturer and normal reference value in serum is