Correlation of Friedewald's calculated low-density lipoprotein cholesterol levels with direct low-density lipoprotein cholesterol levels in a tertiary care hospital.

BACKGROUND: One of the risk factors for the development of coronary heart disease is high low-density lipoprotein (LDL) cholesterol levels. National Cholesterol Education Program ATP III guidelines suggest drug therapy to be considered at LDL-cholesterol levels >130 mg/dl. This makes accurate reporting of LDL cholesterol crucial in the management of Coronary heart disease. Estimation of LDL cholesterol by direct LDL method is accurate, but it is expensive. Hence, We compared Friedewald's calculated LDL values with direct LDL values. AIM: To evaluate the correlation of Friedewalds calculated LDL with direct LDL method. MATERIALS AND METHODS: We compared LDL cholesterol measured by Friedewald's formula with direct LDL method in 248 samples between the age group of 20-70 years. Paired t-test was used to test the difference in LDL concentration obtained by a direct method and Friedewald's formula. The level of significance was taken as P < 0.05. Pearsons correlation formula was used to test the correlation between direct LDL values with Friedewald's formula. RESULTS: There was no significant difference between the direct LDL values when compared to calculated LDL by Friedewalds formula (P = 0.140). Pearson correlation showed there exists good correlation between direct LDL versus Friedewalds formula (correlation coefficient = 0.98). The correlation between direct LDL versus Friedewalds calculated LDL was best at triglycerides values between 101 and 200 mg/dl. CONCLUSION: This study indicates calculated LDL by Friedewalds equation can be used instead of direct LDL in patients who cannot afford direct LDL method.

Is dilution important: Factitious Total Creatine Kinase in case of Rhabdomyolysis?

Factitious test reports may result in incorrect diagnosis and incorrect management. Such incorrect diagnosis can be prevented by a vigilant biochemist. We report a case of Rhabdomyolysis presenting with extremely low total Creatine Kinase (CK) levels which was factitious. Running the sample in dilution resulted in a very high value of total CK which could have been missed if the sample was not run in dilution and the diagnosis of Rhabdomyolysis could have been missed.

Agreement of arterial sodium and arterial potassium levels with venous sodium and venous potassium in patients admitted to intensive care unit.

INTRODUCTION: Electrolyte abnormalities are one of the common causes of morbidity and mortality in critically ill patients. The turnaround time for electrolyte reporting should be as low as possible. Electrolytes are measured conventionally in serum obtained from venous blood by electrolyte analyser which takes 20 to 30 min. Point of care analysers are now available where in electrolytes can be measured in arterial blood within 5 min. This study was done to study the agreement of arterial sodium and arterial potassium with venous sodium and venous potassium levels. MATERIALS AND METHODS: Venous sodium and venous potassium levels and arterial sodium and arterial potassium levels were analysed on 206 patient samples admitted to Intensive Care Unit (ICU). The venous values were compared with the arterial values for correlation. Venous sodium was compared with arterial sodium by spearman correlation. Venous potassium was compared with arterial potassium by pearson correlation. RESULTS: The mean value of arterial sodium was 134 and venous sodium was 137. The mean value of arterial potassium was 3.6 and venous potassium was 4.1. The correlation coefficient obtained for sodium was 0.787 and correlation coefficient obtained for potassium was 0.701. There was positive correlation of arterial sodium and arterial potassium with venous sodium and venous potassium indicating agreement between the parameters. CONCLUSION: Arterial sodium and arterial potassium can be used instead of venous sodium and venous potassium levels in management of critically ill patients.

Validation of Method Performance of pH, PCO2, PO2, Na(+), K(+) of Cobas b121 ABG Analyser.

INTRODUCTION: The introduction of a new method or new analyser is a common occurrence in clinical biochemistry laboratory. Blood gas measurements and electrolytes are often performed in Point-of-Care (POC) settings. When a new POC analyser is obtained, the performance of the analyser should be evaluated by comparison to the measurements with the reference analyser in the laboratory. OBJECTIVES: Evaluation of method performance of pH, PCO2, PO2, Na(+), K(+) of cobas b121 ABG analyser. MATERIALS & METHODS: The evaluation of method performance of pH, PO2, PCO2, Na(+), K(+) of cobas b121 ABG analyser was done by comparing the results of 50 patient samples run on cobas b121 with the results obtained from Rapid lab values (reference analyser). Correlation coefficient was calculated from the results obtained from both the analysers. Precision was calculated by running biorad ABG control samples. RESULTS: The correlation coefficient values obtained for parameters were close to 1.0 indicating good correlation. The CV obtained for all the parameters were less than 5 indicating good precision. CONCLUSION: The new ABG analyser, Cobas b121 correlated well with the reference ABG analyser (Rapid Lab) and could be used to run on patient samples.

Zinc protects against indomethacin-induced damage in the rat small intestine.

The clinical utility of nonsteroidal anti-inflammatory drugs (NSAIDs) is often limited by the adverse effects that they produce in the small intestine. Alterations in the composition and functions of the glycocalyx and brush border membranes of the rat small intestine have been shown to occur in response to indomethacin, an NSAID often used in the study of adverse effects of these drugs. The micronutrient, zinc, has been documented to have cytoprotective effects in the gastrointestinal tract. The aim of this study was to evaluate the potential of zinc to reduce indomethacin-induced small intestinal damage. We pre-treated rats with zinc sulphate (50 mg/kg body weight) 2h before administration of indomethacin (20 mg/kg body weight) and sacrificed the rats 1, 12 or 24h after indomethacin. The extent of small intestinal mucosal damage and the content of lipids and sugars in the mucosa were determined. Bacterial counts in the intestinal lumen and the mucosa were ascertained. Activities of matrix metalloproteinases (MMPs) and levels of metallothionein in the mucosa were also measured. Pre-treatment with zinc sulphate was found to reduce the extent of indomethacin-induced mucosal damage. It also prevented drug-induced changes in the content of lipids and sugars in the mucosa. Drug-induced increases in activities of the MMPs and bacterial counts in the intestine were also attenuated by zinc. Metallothionein levels were significantly higher in animals pre-treated with zinc. We conclude that zinc was effective in protecting against indomethacin-induced small intestinal damage and suggest that it may do so by induction of metallothionein.