Serum Leptin levels in newly diagnosed Epileptic Patients.

Objectives: To compare leptin levels in newly-diagnosed treatment-naive epileptic patients and healthy controls. METHODS: This case-control study was conducted from January 10 to September 15, 2022, at the Dow University of Health Sciences, Karachi, and comprised newly-diagnosed epileptic patients age 12-35years who had no comorbidity. The subjects were enrolled from the Neurology out-patient department of Civil Hospital, Karachi. Healthy individuals matched for age, gender and body mass index were also enrolled as controls. Blood samples were collected between 8am and 10am for the evaluation of serum leptin levels using enzyme-linked immunosorbent assay. Data was analysed using SPSS 26. RESULTS: Of the 100 subjects, 64(64%) were males and 36(36%) were females. There were 50(50%) cases with mean age 19.34±5.65 years, and 50(50%) controls with mean age 19.76±5.67 (p=0.614). 100% of 50 individuals in control group did not have any family history of epilepsy,while 18% of cases (9) reported a positive family history. Mean leptin level in cases was 31.03±19.37 compared to 5.25±4.03 in the controls (p<0.05). CONCLUSIONS: Serum leptin levels were elevated in newly-diagnosed epileptic patients compared to healthy controls.

Classification accuracy of serum Apo A-I and S100B for the diagnosis of mild traumatic brain injury and prediction of abnormal initial head computed tomography scan.

The objective of the current study was to determine the classification accuracy of serum S100B and apolipoprotein (apoA-I) for mild traumatic brain injury (mTBI) and abnormal initial head computed tomography (CT) scan, and to identify ethnic, racial, age, and sex variation in classification accuracy. We performed a prospective, multi-centered study of 787 patients with mTBI who presented to the emergency department within 6 h of injury and 467 controls who presented to the outpatient laboratory for routine blood work. Serum was analyzed for S100B and apoA-I. The outcomes were disease status (mTBI or control) and initial head CT scan. At cutoff values defined by 90% of controls, the specificity for mTBI using S100B (0.899 [95% confidence interval (CI): 0.78-0.92]) was similar to that using apoA-I (0.902 [0.87-0.93]), and the sensitivity using S100B (0.252 [0.22-0.28]) was similar to that using apoA-I (0.249 [0.22-0.28]). The area under the receiver operating characteristic curve (AUC) for the combination of S100B and apoA-I (0.738, 95% CI: 0.71, 0.77), however, was significantly higher than the AUC for S100B alone (0.709, 95% CI: 0.68, 0.74, p=0.001) and higher than the AUC for apoA-I alone (0.645, 95% CI: 0.61, 0.68, p<0.0001). The AUC for prediction of abnormal initial head CT scan using S100B was 0.694 (95%CI: 0.62, 0.77) and not significant for apoA-I. At a S100B cutoff of <0.060 µg/L, the sensitivity for abnormal head CT was 98%, and 22.9% of CT scans could have been avoided. There was significant age and race-related variation in the accuracy of S100B for the diagnosis of mTBI. The combined use of serum S100B and apoA-I maximizes classification accuracy for mTBI, but only S100B is needed to classify abnormal head CT scan. Because of significant subgroup variation in classification accuracy, age and race need to be considered when using S100B to classify subjects for mTBI.

Serum hyaluronic acid as a marker of hepatic fibrosis.

OBJECTIVES: To determine the serum hyaluronic acid (HA) levels as biochemical marker of hepatic fibrosis and cirrhosis and correlate it with the degree of hepatic fibrosis and cirrhosis. DESIGN: Comparative cross-sectional study. PLACE AND DURATION OF STUDY: The Armed Forces Institute of Pathology, Rawalpindi from September 2003 to August 2004. PATIENTS AND METHODS: This study was performed on 100 patients of chronic liver disease whose liver biopsies had been carried out. Fifty healthy controls were also included in the study. Routine liver function tests, hepatitis serology and serum hyaluronic acid levels were carried out on patients and controls. RESULTS: Liver biopsy of 100 patients revealed that 21 were in stage 0 fibrosis, 38 in stage 1 fibrosis, 26 in stage 3 fibrosis and 15 in stage 4 fibrosis. Mean Serum HA (mean+/-SD) concentration in patients were 189+/-98 mg/L vs. 21+/-10 mg/L of healthy controls. The difference observed was statistically significant (p < 0.001). Patients in stage 4 fibrosis had significantly higher (p < 0.001) mean serum HA concentration as compared to other stages of liver fibrosis. Diagnostic accuracy of serum HA at marginally elevated level of 60 mg/L determined the sensitivity 78.4 %, specificity 80.9%, positive predicted value 93.9% and negative predicted value of 50%. CONCLUSION: Serum HA is a useful non-invasive marker of liver fibrosis. There is a strong positive correlation between serum HA levels and degree of liver fibrosis. The concentration of serum HA rises according to progression of liver fibrosis and levels are highest in patients with liver cirrhosis.