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

Evaluation of vitamin B12 and folic acid deficiencies in selective middle aged and elderly male and female patients

Significant prevalence of vitamin B12 and folate deficiencies supported by biochemical evidence has been reported in the world. It was indicated that these biochemical evidences are associated with prevalence of anaemia in elderly. The major reasons of vitamin deficiencies, especially that of B-12, was reported to be inadequate dietary intake and, in the elderly, malabsorption of the vitamin from food. Vitamin deficiencies especially that of B-12 are usually diagnosed on the basis of serum or plasma vitamin concentrations. Due to dilemma of management and diagnoses of mal-nutrition and vitamin deficiencies in elderly population, the present study was undertaken to ascertain vitamin B12, folate and RBC folate status in selected middle aged and elderly male and female patients. A total of 132 patients [period March 2004 to November 2007], were selected according to gender and age. For males [n = 72]; age groups were 50-60, 61-70, 71-80 yrs and greater than 80 yrs and for females [n = 60]; age groups were 52-61, 62-69, 70-79 and greater than 80 yrs. The results clearly depicts that elderly patients in both gender between the age groups of 71 and greater than 80 had significantly low vitamin concentrations [p < 0.001] than the middle age groups of 61 to 70 [P < 0.01]. Correspondingly, their hemoglobin levels were also relates to the overall picture of either normal or low concentrations of vitamins in all groups. In males the lowest concentration of 3.5 ng/ml for folate, Vitamin B12 of 228 pg/ml and 168 ng/ml for RBC folate were observed in > 80 years group preceded by 6.2 ng/ml, 278 pg/ml and 170 ng/ml respectively, in 71 to 80 years group, whereas in females, the observations were 2.5 ng/ml for folate, 220 pg/ml for B12 and 110 ng/ml for RBC folate concentrations in > 80 years age group of patients. In conclusion few management strategies were suggested for therapy of vitamin deficient older patients

Assessment of lipoprotein abnormalities in diabetic and non-diabetic patients with hyperlipidemia

Background: Hyperlipoproteinaemia is a metabolic abnormal condition and is largely regulated by Apolipoproteins types and subtypes. Moreover, lipoprotein abnormalities contribute significantly to the risk of developing cardio vascular disease and diabetes. Additionally, abnormal glycemic state, lipid and lipoprotein abnormalities have also been shown to contribute in early atherosclerosis

Objectives: Our present study evaluates the status of apolipo-protein A and B in hyperlipidemic patients with both diabetic and non-diabetic conditions

Methods: Study period was May 2006 to Dec 2007. 63 patients of both gender [males = 36, females = 27] sub-grouped as n = 46 non-diabetic hyperlipidemic [NDHL] and n = 17 diabetic hyperlipidemic [DHL] patients were included in the study. All parameters were determined with standard methods on IVD instruments with recommended pathological and normal controls

Results: Total cholesterol and Apo B was noted to be significantly higher in DHL than NDHL patients. Moreover, levels of Apo B was higher than Apo A in both DHL and NDHL groups when compared with Healthy group. Elevated levels of triglyceride and total cholesterol in both DHL and NDHL groups depicts a strong hyperlipidemic state

Conclusion: Conclusion were drawn from present study that diabetes and hyperlipidemia are important risk factors, in addition to the fact that higher levels of Apo B and A and that of higher Apo B than Apo A are indicative of dyslipidemic state and thus significant parameters for assessing the prevailing conditions and extent of risk for developing coronary heart disease [CHD] and atherosclerosis

Diagnostic importance of neuron specific enolase [NSE] in pleural effusion from patients with malign

Background: Several past and recent investigations have focused on the detection and use of reliable tumor markers, such as CEA, NSE and CYFRA 21-1 in pleural fluids, as a less invasive replacement method. Some studies have dealt with the NSE levels of pleural fluid in diseases such as NSCLC, SCLC and benign pulmonary disease such as tuberculosis

Aim: Therefore the present study was undertaken to assess NSE levels in serum and pleural fluid of patients with pulmonary cancer and to compare the data with NSE levels of tuberculosis pleurisy to determine its diagnostic utility and efficacy

Materials and Methods: Pleural fluids were obtained from 13 patients with carcinomatous pleurisy due to SCLC, 6 patients with carcinomatous pleurisy due to non-small cell lung cancer, and 29 patients with tuberculosis pleurisy for comparison purpose. Determination of NSE levels was performed by ECL technology according to the manufacturerAEuro[™]s instructions

Results: NSE results of cytology-positive SCLC were significantly elevated [P<0.001] when compared with those of cytology-negative SCLC, NSCLC and tuberculosis. Pleural effusion of all 29 tuberculosis patients and two NSCLC patients showed moderate significance [P<0.05 and P<0.01, respectively] as compared to SCLC patients

Conclusion: It is concluded that determination of pleural fluid NSE levels seems to be an effective means to differentiate carcinomatous pleurisy due to SCLC from that of due to NSCLC, tuberculosis pleurisy and cytology-negative pleural effusions in SCLC. However, it is suggested that further studies with larger group of patients is needed to strengthen diagnostic specificity and sensitivity

Assessment of hyperlactatemia and acidosis in patients with cardiac dysfunctions

Background: It has been postulated that hyperlactatemia is not the only cause of acidosis in cardiac dysfunction and there are other factors such as un-measured anions also that significantly participate in its development

Aim: The present study is designed to determine different components of metabolic acidosis in cardiac dysfunctions and cardiac arrest patients in order to assess the degree to which lactate is responsible for the acidosis

Methods and Materials: Forty two patients with out-of-hospital cardiac dysfunctions and cardiac arrest, admitted to the hospital were included in present study. All arterial blood gases and plasma biochemical parameters were estimated by standard methods on automated analyzers. Modified [by Figge and colleagues] form of Stewart's quantitative biophysical methods including formula for apparent strong ion difference AEurooeSIDaAEuro and strong ionic gap AEurooeSIGAEuro were used to evaluate un-measured and measured ions

Results: The mean age of patients were 57.2 years and included 33 [78.6%] males and 9 [21.4%] females. Except for sodium, ionized calcium and SIDa, all variables were significantly different between the two groups. Patients with cardiac dysfunctions and arrest were also hyperkalemic, hypochloremic and hyperlactatemic. The anion gap and SIG were also higher in patients with cardiac arrest. Lactate was the strongest determinant of academia

Conclusion: It was concluded that lactate accounts for only less than 50% of the metabolic acidosis and consequent acidemia seen in such patients and that an increase in unmeasured anions and phosphate also accounts for major portion of acidemia

Carcinoembryonic antigen [CEA]: discovery, function, chemistry and diagnostic significance

The CEA molecule is an onco-development human tumor marker, bearing the cluster differentiation designation of CD66e, a subtype of CD66 group of CEA family. It has a molecular weight of 180 kDa. This antigen was demonstrated in primary tumor of the pancreas and liver, followed by the study of its presence in 1[st] two Trimesters of gestation. Therefore, the component was designated as Carcinoembryonic Antigen of the human digestive system and subsequently abbreviated as CEA. It became one of the significant entities to diagnose and monitor solid tumor and the response to therapy, especially in GIT cancer. Due to an immense importance of CEA in present day diagnostic and health services, this article reviews the important discovery of CEA by Dr. Phil Gold, its biology, function, chemistry and the clinical role of CEA in categories of cancer screening, diagnosis, prognostic indicator and as a monitoring tool for treatment

Determination of urinary protein to creatinine ratio as a predictor of renal insuffeciency and end-stage renal disease

Renal failure occurs as a consequence of the loss of important homeostatic regulation that the kidneys provide. Moreover, end-stage renal disease [ESRD] and the resulting uremic syndrome may caused by a wide variety of factors such as chronic glomerulonephritis, chronic pyelonephritis, immunological diseases, hypertension, and toxic and ischemic damage to kidneys. It is reported that in patients with various renal diseases, reducing urinary protein excretion [proteinuria] slows the rate of decline in the glomerular filtration rate [GFR]. Analyses have also shown a strong correlation between the degree of proteinuria and the rate of progression of renal failure. It has been observed 'that in patients with chronic proteinuric nephropathies, the ratio of protein to creatinine predicted the rate of decline in GFR and the progression to ESRD. Several research studies have suggested that patients with a urinary protein: creatinine [P:C] ratio of less than 1.0 had slow pace of renal anomalies with no ESRD where as those with a ratio of 1.0 or greater than 1.0 had decrease in GFR and a higher risk of ESRD. The presented study includes the data of assessment of urinary: creatinine ratio in patients with renal disease such as ARF, CRF. It was observed that those with P:C ratio greater than 1.0 were undergoing dialysis and a decline in renal functions relates to rise in P:C ratio and subsequent manifestation of ESRD

Determination of cancer antigen ca 15-3, in breast carcinoma

In breast carcinoma, carbohydrate antigen 15-3 [CA 15-3], a mucin component, is the most important and commonly used tumor marker. It is a transmembrane glycoprotein containing a large extracellular domain of 69 amino acids. Several studies suggested that its evaluation could provide valuable clinical information. Assessment of CA 15-3 can also be useful during treatment of Breast cancer as well as to detect recurrence following primary treatment. CA 15-3 is a breast-cancer-associated antigen defined by reactivity with two monoclonal antibodies, DF3 [raised against a membrane-enriched fraction of human breast cancer] and 115D8 [raised against antigens of human milk fat globule membrane]. The main clinical application of CA 15-3 suggested being in monitoring the response to the treatment and gives reliable information on the recurrence of the disease. The aim of present study is to assess CA 15-3 in patients with breast carcinoma and its usefulness in monitoring and therapy. Serum samples of female patients [n = 56] suspected of or diagnosed with breast carcinoma were analyzed for CA 15-3. Significantly elevated levels were noted in most of the patients and correlated with their malignant tumor status and clinical conditions. It is concluded that CA 15-3 is currently the most widely used circulating cancer marker for breast carcinom·a. CA 15-3 can provide useful information regarding successfulness when comparing pre-operative and post-operative values. In our study, breast carcin9ma patients showed decrease in CA 15-3 levels post-operatively [although most of them still above normal reference range], depicting successfully of treatment and intervention, in addition to suggesting that CA 15-3 concentrations can also provide prognostic information. Furthermore, serial concentrations analyses have the potential both to detect recurrences pre-clinically and to monitor the treatment of metastases breast carcinoma

Assessment of carcino-embryonic antigen [CEA] in patients with colorectal carcinoma [CRC]

The CEA molecule is an onco-development human tumor marker and bears the cluster differentiation designation of CD66e. Tt has a molecular weight of 180 kDa. CEA is one of the significant entities to diagnose and monitor solid tumor and the response to therapy, in GTT cancers, especially CRC. Due to substantial clinical importance of CEA for diagnosis, prognosis and treatment, a study was carried out to assess its levels in patients suspected off or diagnosed with GIT cancers, with special reference to colorectal carcinoma [CRC]. A total 86 patients, 70 [81.39%] males and 16 [18.60%] females, were included in the study with age range of 36 to 81 years. Out of 70 males, 23 [32.80%] have malignant conditions and exhibited elevated levels of CEA [66 ng/ml to 230 ng/ml; mean = 18958 ng/ml], whereas 47 have non-malignant complications with normal or non-significant [> 10 ng/ml but < 20 ng/ml] CEA concentrations. Malignant conditions were determined to be pancreatic [13.04%], gastric [26.08%], colorectal [43.47%] and hepatic [17.39%] cancers. In female group, 10 [62.50%] were diagnosed with malignant condition of pancreatic [10%], gastric [10%] and colorectal [70%] cancers with significantly elevated levels of CEA. 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