Effect of Time Interval between Collection, Plasma Separation and Analysis and the Effect of Temperature on the Laboratory Results of Plasma Glucose Estimation

Introduction:In a clinical laboratory, consistency of test results cannot be solely achieved by controlling the accuracy in the analytical phase of glucose estimation alone. Considering the high chances of pre-analytical errors, due consideration has to be given for storage criteria as well.Aims: Aim is to find out the quantitative alterations and the useful time interval between collection and analysis and the effect of temperature on the laboratory results of plasma glucose.Study Design:Cross sectional study.Place and Duration of Study:Study was conducted at Department of Biochemistry, Kasturba Medical College Hospitals, Mangaluru between 2015 and 2016.Methodology:In this study, 17 apparently healthyvolunteers aged 20-30 years wereenrolled with their consent.Plasma glucose levels were estimated by glucose oxidase-peroxidase kit method in semi-autoanalyzer at different temperatures and at different time intervals after collection and at room temperature but separating plasma at different time intervals and correlating it with the initial value.Results:The mean of plasma glucose when estimated immediately after separation of plasma was 78.16 ± 13.28 mg/dL. Only when glucose was estimated within 2hrs when stored at 2-8° Celsius after plasma separation (71.57 ±12.64), non-significant difference was noted(p value –0.696) otherwise as the temperature and time interval for estimation increases, the value of glucose decreases significantly. The effect of delayed separation of plasma showed that as the time of separation increases the value of glucose decreases significantly in the sample.Conclusion:Most mistakes occur before the samples are analysed, either during sampling or preparation for analysis. Thus, proper storage temperature and time must be considered for plasma glucose estimation, if measurement cannot be done immediately

Assessment of Cardiovascular Disease Risk in Prediabetes

This study was aimed at investigating the nutrient and bioactive components of Annona muricataand Fagara zanthxoyloidefrom south-southern Nigeria. The roots and leaves of these plants were collected from communities within this region and an analysis of the phytochemical, mineral and vitamin components of these plant parts were carried out using standard methods. The results of the investigation revealed the a high presence of alkaloids (27.34 ± 0.15 and 12.98 ± 0.98), flavonoids (19.66 ± 0.04 and 3.71 ± 0.46) and phenols (15.10 ± 0.11 and 0.07 ± 0.42) in the leaves and roots of Annona muricatawhile alkaloids (35.55 ± 0.95 and 50.90 ± 0.83), tannins (28.70 ± 0.19 and 55.37 ± 0.47) and terpenoids (18.23 ± 0.08 and 41.21 ± 0.16) were observed in leaves and roots of Fagara zanthoxyloide. Mineral analysis revealed the presence of iron (20.23 ± 0.01 and 5.21 ± 0.02), calcium (3.67 ± 0.06 and 1.59 ± 0.01), copper (2.17 ± 0.011 and 0.16 ± 0.01) and magnesium (3.04 ± 0.01 and 2.18 ± 0.005) in leaves and roots of Annona muricataand iron, copper (2.53 ± 0.011and 7.38 ± 0.017) and zinc (5.16 ± 0.02 and 5.32 ± 0.011) in leaves and roots of Fagara zanthoxyloide.The leaves and roots of both plants also showed the presence of folate (26.82±0.48 and 23.47±0.03 for A. muricata and 15.82±0.18 and 20.63±0.91 for F. zanthoxyloide) and ascorbate (31.97±0.03and 26.89±0.19 for A. muricataand13.86±0.13 and 30.21±0.01for F. zanthoxyloide) in appreciable quantities while vitamins D, E and K were also observed in minute concentrations in both plant samples. These results may thus suggest that these plants from this region as a result of their rich nutrients and bioactive compositions may play a large role in alleviating the salient nutritional, physiological and medical challenges observed among people within this region.

Evaluation of the Association between Ischemia Modified Albumin (IMA), Glycemic and Lipid Status in Diabetic Nephropathy

Introduction:Hyperglycemia induced oxidative stress in Type 2 Diabetes Mellitus modifyvarious biomolecules to cause Diabetic Nephropathy (DN). IMA (Ischemia-Modified Albumin) is one such oxidative stress marker already examined in various clinical events but have not yet been evaluated in different stages of DN. Aim:To estimate and assess the relationship of IMA with glycemic status and lipid parameters in all stages of DN. Study Design: Cross-sectional study.Place and Duration of Study: Study was conducted at Department of Biochemistry,Kasturba Medical College Hospitals, Mangaluru conducted between 2014 and 2015 Materials andMethods:There were 60 type 2 diabeticcases and 30 healthy controls. Diabetic cases were further categorized into three equal groups on the basis of UACR (urine albumin-creatinine ratio), DN stage I having UACR less than 30 mg/g, DN stage II having UACR 30 to 300 mg/g, and DN stage III havingUACR ≥ 300 mg/g of creatinine. Using enzyme-linked immunosorbent assay serum IMA level was estimated whereas automated analyzers was used for serum creatinine, HbA1c, urine albumin and urine creatinine analysis.Results:Lowest level of IMA (109 ng/mL) measured in DN stage I, which was significantly different from those in DN stage II (154 ng/mL) and DN stage III (178 ng/mL). The significant positive correlation between IMA and fasting blood glucose, glycated hemoglobin were present in stage II and stage III DN. In this study significant positive correlation of serum IMA to serum total cholesterol, low density lipoprotein cholesterol and negative correlation with high density lipoprotein were revealed in all stage of DN. Conclusion:Current study postulates that early evaluation of serum IMA in diabetic patients with deranged lipid profile will provide an index of nephropathy development. This will help in prognosis and controlling complication in diabetes mellitus.

Interleukin-6 in impaired fasting glucose

Prediabetes is associated with the features of metabolic syndrome and inflammation contributing directly to the pathogenesis of cardiovascular disease (CVD). This study was conducted to explore the utility of interleukin-6 (IL-6) in determining the risk of CVD in prediabetes. It involves estimation of IL-6 & insulin along with its correlation with insulin, fasting plasma glucose (FPG), Insulin resistance (IR) and physical measurements. Eighty subjects were grouped into 40 prediabetes and 40 normoglycemic on the basis of FPG values. The mean insulin, IL-6, Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) and anthropometric measurements were found to be significantly higher (P <0.05) in prediabetes group. IL-6 had a significant correlation with fasting insulin (r = −0.413) and HOMA-IR (r = −0.413), but no correlation with FPG (r = −0.227) in the prediabetes group. IL-6 also showed a positive correlation with body mass index BMI(r = −0.339), waist circumference WC (r = −484) and waist-to-hip ratio WHR (r = −0.430). This study concludes that prediabetes is associated with inflammation, increasing the risk of CVD in these individuals.

A Comparative Study Of Retrieval Of Gall Bladder During Laparoscopic Cholecystectomy With Endobag Versus Without Endobag In Terms Of Benefits And Complications

Introduction: In laparoscopic cholecystectomy gall bladder perforation and spillage are the common complications encountered during dissection and removal of gall bladder. Gall bladder removal can be completed simply and safely when a retrieval bag is used. This trial was undertaken to compare the retrieval of gall bladder with endobag versus without endobag. A sterile latex glove was used as an endobag which is an easily available and a cheaper alternative with similar effectiveness. Aim: To compare the benefits and complications of extraction of gallbladder in an endobag v/s direct extraction through 10 mm port in laparoscopic cholecystectomy in terms of operative time, port site infection, port site pain and duration of hospital stay. Materials and Methods: This study was carried out in Department of Surgery SN Medical College Agra to compare benefits and complications of extraction of gallbladder in an Endobag versus direct extraction. A total of 100 patients with symptomatic cholelithiasis were included in the study after surgical assessment and confirming diagnosis. They were divided into two groups of 50 each by randomization. Results: In this study of 100 patients 92% were females and 8% were males. With the use of an endobag, mean operative time taken was 1 hour as compared to 1.3 hours taken in procedure without using an endobag. Mean hospital stay was of 3.45 days and only 2% patients had port site infection in cases with endobag as compared to 3.6 days and 10% patients had port site infection in cases without endobag. There was no spillage of stones and bile with the usage of endobag. Conclusion:An endobag for retrieval of gall bladder during laparoscopic cholecystectomy was found better than the direct extraction of the gall bladder. A sterile latex glove made endobag is a simple, safe and cost–effective method and can be used instead of endobag