Vitamin D, Bone Mineral Density and Serum IGF-1 Level in Non-ambulatory Children With Cerebral Palsy.

OBJECTIVES: To compare serum 25-hydroxy vitamin D (25-OHD) status, bone mineral density and Insulin-like growth factor (IGF-1) level among children with cerebral palsy (CP) aged 1 to 8 years with age- and gender-matched controls. METHODS: A cross-sectional study enrolled 30 children in each group: CP with epilepsy, CP without epilepsy, and healthy controls. Bone mineral density (BMD), serum 25-OHD levels, and serum insulin like growth factor (IGF)-1 levels were measured. RESULTS: z-scores of BMD [-1.80 (1.03), -2.12 (0.85) vs -1.40 (0.90); P<0.01], 25-OHD levels [19.26 (8.28), 20.59 (8.92) Vs 26.79 (12.76) ng/mL; P<0.01] and IGF-1 levels [20.90 (6.42), 23.37 (8.11) vs 31.77 (11.21) ng/mL; P<0.01] were significantly low among children with CP with epilepsy, CP without epilepsy when compared to controls. CONCLUSIONS: Children with CP with or without comorbid epilepsy were prone to vitamin D deficiency, low bone mineral density and growth hormone axis suppression with low IGF-1 levels.

Evaluating the association between maternal vitamin D deficiency and preeclampsia among Indian gravidas.

OBJECTIVE: The association between vitamin D deficiency and devastating preeclampsia is still debated. In this present study, our aim is to evaluate whether a statistically significant association exists between vitamin D deficiency and preeclampsia in Indian gravidas. As to the best of our knowledge, no study of this context with such a large sample size is done in the Indian population till now. METHOD: A case-control study was performed in the year 2015-2019 where we enrolled 1000 pregnant women with preeclampsia admitted either in labor or for induction of labor in the study group and 1000 pregnant women without preeclampsia either in labor or admitted for induction of labor at term gestation in the control group. Serum 25-hydroxyvitamin D [25 (OH)] D levels of both the groups were measured through the radioimmunoassay method and analyzed. In both the groups, samples were collected equally across all the seasons of the year to avoid confounding by seasonal variation of vitamin D. Primary outcome measures the association of vitamin D deficiency and preeclampsia. While secondary outcome measures the correlation between levels of vitamin D deficiency with the severity of preeclampsia. RESULT: A significantly low mean vitamin D level was seen in preeclamptic women (11.0 ± 7.1 ng /ml) compared to normotensive (31.4 ± 1.7 ng/ml) with p < .001. We observed approximately 11 fold increased odds of having preeclampsia in vitamin D deficient women (OR: 11.308; 95 % CI 7.5982-14.0097). Moreover, we observed that as vitamin D level decreases, the severity of preeclampsia increases (p < .001). CONCLUSION: Compared with normotensive women, preeclamptic women had a significantly low level of vitamin D, suggesting a significant association between vitamin D deficiency and preeclampsia.

Chemoradiation in locally advanced Ca Cx: Effect on NGAL levels.

INTRODUCTION: Neutrophil gelatinase-associated lipocalin (NGAL) has been reported to be unregulated in many cancers and to suppress tumor suppressor genes like p53 leading to cell proliferation. Studies to report its relationship with carcinoma cervix (Ca Cx) are still scant. MATERIALS AND METHODS: Serum NGAL levels were analyzed in 30 patients of histopathologically proven locally advanced Ca Cx at the time of diagnosis and 3 weeks after standard chemoradiation by enzyme-linked immunosorbent assay. These patients underwent either brachytherapy or supplementary external beam radiotherapy (EBRT) depending on the response of treatment. The results were analyzed statistically by applying Student's paired t-test. RESULTS: No statistically significant difference (P > 0.05) was observed in patients of Ca Cx before and after treatment or when compared stage wise, histopathological grade wise, or response wise. But the levels were found to increase when duration of treatment was ≥8 weeks (P = 0.040) and to decrease significantly when duration of treatment was <8 weeks (P = 0.0052). The NGAL levels also increased significantly after treatment in patients who received EBRT and supplementary radiotherapy (P = 0.019) while the pre- and post-treatment difference in NGAL levels was not statistically significant in patients who received EBRT + intracavitary brachytherapy (P > 0.05). CONCLUSION: As the duration as well as modality of treatment is quite important in Ca Cx, shorter duration associated with better results and lower NGAL levels, NGAL might prove to be a useful biomarker although further studies are needed to support the claim.

Cross-sectional study of the prevalence of polycystic ovary syndrome in rural and urban populations.

OBJECTIVE: To assess the prevalence and risk factor profile of polycystic ovary syndrome (PCOS) in Haryana, India. METHODS: A large-scale cross-sectional study was conducted among women of reproductive age in Haryana between December 2015 and May 2017. A random multi-stage stratified sampling method was adopted. PCOS screening was based on questionnaires. Blood samples for hormonal analysis were collected from those with probable and definitive PCOS cases. Women with menstrual irregularities (MI), hyperandrogenism (HA), and polycystic ovaries (PCO) (Rotterdam criteria) were included. Females with thyroid disease, hyperprolactinemia, and adrenal hyperplasia were excluded. RESULTS: Among total 2400 women screened, 94 (4.21%) had PCOS. The PCOS phenotypes were 30% clinical HA (hirsutism, H), 64% biochemical HA, 35% PCO, 16% H+MI, 10% MI+PCO, 52% MI+HA, 14% PCO+H, and 19% PCO+H+HA. Overall, 67 (71%) of the women with PCOS resided in urban regions and 27 (29%) in rural regions. CONCLUSION: Among the women with PCOS, a considerably higher proportion resided in urban regions of Haryana. The difference may be attributed to lifestyle and dietary factors. Ignoring PCOS may put women at risk of serious long-term health consequences that are difficult to manage. Lifestyle changes and continuous surveys should be promoted for better management.

Assessment of quality control system by sigma metrics and quality goal index ratio: A roadmap towards preparation for NABL.

AIM: To study sigma metrics and quality goal index ratio (QGI). METHODS: The retrospective study was conducted at the Clinical Biochemistry Laboratory, PGIMS, Rohtak, which recently became a National Accreditation Board for Testing and Calibration of Laboratories accredited lab as per the International Organization for Standardization 15189:2012 and provides service to a > 1700-bed tertiary care hospital. Data of 16 analytes was extracted over a period of one year from January 2017 to December 2017 for calculation of precision, accuracy, sigma metrics, total error, and QGI. RESULTS: The average coefficient of variation ranged from 2.12% (albumin) to 5.42% (creatinine) for level 2 internal quality control and 2% (albumin) to 3.62% (high density lipoprotein-cholesterol) for level 3 internal quality control. Average coefficient of variation of all the parameters was below 5%, reflecting very good precision. The sigma metrics for level 2 indicated that 11 (68.5%) of the 16 parameters fall short of meeting Six Sigma quality performance. Of these, five failed to meet minimum sigma quality performance with metrics less than 3, and another six just met minimal acceptable performance with sigma metrics between 3 and 6. For level 3, the data collected indicated eight (50%) of the parameters did not achieve Six Sigma quality performance, out of which three had metrics less than 3, and five had metrics between 3 and 6. QGI ratio indicated that the main problem was inaccuracy in the case of total cholesterol, aspartate transaminase, and alanine transaminase (QGI > 1.2), imprecision in the case of urea (QGI < 0.8), and both imprecision and inaccuracy for glucose. CONCLUSION: On the basis of sigma metrics and QGI, it may be concluded that the Clinical Biochemistry Laboratory, PGIMS, Rohtak was able to achieve satisfactory results with world class performance for many analytes one year preceding the accreditation by the National Accreditation Board for Testing and Calibration of Laboratories. Aspartate transaminase and alanine transaminase required strict external quality assurance scheme monitoring and modification in quality control procedure as their QGI ratio showed inaccuracy.

Healing of Apical Periodontitis after Nonsurgical Treatment in Patients with Type 2 Diabetes.

INTRODUCTION: The purpose of this prospective study was to compare the success of primary root canal treatment between type 2 diabetic and nondiabetic patients and to investigate the effect of periapical healing on glycated hemoglobin (HbA1c) in type 2 diabetic patients with apical periodontitis. METHODS: Sixty mandibular molars with necrotic pulps and apical radiolucency (size ≥ 2 mm × 2 mm) were included in the study. Based on the HbA1c levels, patients were divided into 2 groups: type 2 diabetic (HbA1c ≥6.5%) and nondiabetic (HbA1c <6.5%). Forty-six teeth were evaluated at the 12-month follow-up time period. The primary outcome measure was the change in apical bone density as determined by the periapical index. RESULTS: Both the diabetic and nondiabetic group depicted a significant reduction in the periapical score after endodontic treatment at the 12-month follow-up (P < .05). Significantly less periapical healing was observed in the diabetic group (43%) compared with the nondiabetic group (80%) at the 12-month follow-up (P < .05). HbA1c levels in the diabetic group increased at each follow-up after endodontic treatment. CONCLUSIONS: Diabetes mellitus may have a negative impact on the outcome of endodontic treatment in terms of periapical healing. Nonsurgical endodontic treatment did not improve HbA1c levels in patients with type 2 diabetes.

Levels of neutrophil gelatinase-assosciated lipocalin in patients with head and neck squamous cell carcinoma in Indian population from Haryana state.

AIM: To study the levels of neutrophil gelatinase associated lipocalin (NGAL) in head and neck squamous cell carcinoma (HNSCC). METHODS: This was a non randomized case control study conducted at Department of Biochemistry, in collaboration with Regional Cancer Center over a period of one year. The study population included 50 adult newly diagnosed HNSCC patients reporting in outpatient department at Regional Cancer Center and compared with 50 healthy controls. NGAL was estimated by ELISA technique. Student t test and χ2 test were applied for comparison of means of study groups. Correlations between groups were analyzed using Pearson correlation coefficient (r) formula. RESULTS: Patients with HNSCC exhibited significantly increased levels of NGAL (P < 0.05) as compared to healthy controls (978.88 ± 261.39 ng/mL vs 34.83 ± 7.59 ng/mL). Out of 50, 26 patients (52%) were in stage IV, 21 (42%) in stage III, 1 (2%) patient in stage II and 2 (4%) patients were in stage I. Metastasis was absent in 98% patients and mean NGAL levels were highest in these patients but P value was not significant. Mean NGAL levels were highest in stage IV [1041.54 ± 222.15 ng/mL (stage IV) vs 1040 ± 0.00 ng/mL (stage I); 900 ± 0.00 ng/mL (stage II) and 1031.90 ± 202.55 ng/mL (stage III)] and χ2 test was highly significant (P < 0.001). Thirty-six patients (72%) were having moderately differentiated HNSCC and mean NGAL levels were maximum in patients with well differentiated HNSCC (1164 ± 315.64 ng/mL vs 1013.33 ± 161.19 ng/mL in moderately differentiated and 890 ± 11.55 ng/mL in poorly differentiated) and the results were also highly significant (P < 0.001, χ2 test). CONCLUSION: The present work demonstrates a potential role of NGAL as cancer biomarker and its use in monitoring the HNSCC progression.

Biomarkers in Preeclamptic Women with Normoglycemia and Hyperglycemia.

The present study was planned to assess IGF-1, leptin and cholinesterase levels in maternal blood of both normoglycaemics and hyperglycaemics preeclampsia. Twenty five normotensive pregnant women at the time of delivery were selected in as group I and sub grouped according to blood glucose less than or more than 85 mg/dL as I A (<85mg/dL) and I B (>85mg/dL). Study group (group II, n=25) comprised of preeclamptic women and was further divided into group II A (<85mg/dL) and group II B (>85mg/dL). Routine biochemical investigations along with IGF-1, leptin and cholinesterase levels were analyzed in maternal and cord blood of preeclamptic and normotensive pregnant women. Serum IGF-1 levels were significantly lower in preeclamptic women and more so in those with hyperglycemia. Cord blood IGF-1 levels were nearly doubled in hyperglycemic preeclamptics as compared to normoglycemic preeclamptics. Leptin levels were higher in preeclamptic women and more in hyperglycemic preeclamptics. Cholinesterase levels were lowered in preeclamptic mothers and higher in hyperglycemics. Cord blood cholinesterase levels were reduced in preeclamptics, more so in hyperglycaemics as compared to group I. Diet recommendation, avoidance of excessive weight gain and healthy life style, exercise and nutritional interventions may be beneficial in these women.

Chemotherapy: Impact on Anti-Müllerian Hormone Levels in Breast Carcinoma.

INTRODUCTION: Anti-Mullerian Hormone (AMH) is a glycoprotein of the transforming growth factor-ß (TGF-ß) family that seems to reflect the continuous non-cyclical growth of small follicles and can be considered an indirect index of the size of the resting primordial follicle pool. Accordingly, AMH represents a marker of Ovarian Reserve (OR) and is particularly useful in demonstrating ovarian tissue damage induced by chemotherapy. AIM: To evaluate and compare the levels of AMH in Breast Carcinoma patients before and after chemotherapy with age matched healthy controls and to assess whether AMH as a biochemical marker of the OR might improve prediction of chemotherapy related outcomes in these patients. MATERIALS AND METHODS: The present study was conducted in the Department of Biochemistry in collaboration with Department of Radiotherapy, Pt. B.D. Sharma, University of Health Sciences, Rohtak between June 2013 and June 2014. The subjects were divided into two groups. A total of 30 female patients of confirmed diagnosis of breast carcinoma were enrolled in the study group (Group I). The enrolled breast cancer cases were further divided into subgroups (Group-IA=Prechemotherapy & Group-IB= Postchemotherapy). Thirty healthy age matched female volunteers were enrolled as controls (Group II). Serum levels of AMH were determined by the ultrasensitive anti-müllerian hormone/ müllerian inhibiting substance (US AMH/MIS) Enzyme Linked Immuno Sorbent Assay (ELISA). RESULTS: There was a significant decrease in serum AMH levels in the both study group-IA and study group-IB as compared to control group-II (p<0.05 and p<0.001 respectively). The prechemotherapy (group-IA) serum AMH levels dropped significantly after chemotherapy (group-IB) (p<0.001). CONCLUSION: AMH levels declined after chemotherapy indicates direct chemotherapy induced damage to the granulosa cells and growing follicles, reflecting decrease ovarian reserve and fertility.

Evaluation of cord blood ischemia modified albumin in normal pregnancies and pre-eclampsia.

OBJECTIVE: Pre-eclampsia is associated with ischemia and increased oxidative stress, which may lead to modification of plasma albumin to ischemia modified albumin (IMA). METHODS: IMA levels were estimated in cord blood of 30 newborns born to pre-eclamptic mothers and compared with 30 normal newborns. IMA was estimated colorimetrically and the results were compared statistically. RESULTS: The levels of IMA were found to be significantly higher (p < 0.001) in newborns born to pre-eclamptic mothers (0.835 ± 0.02 ABSU) as compared to those born to normal mothers (0.325 ± 0.01 ABSU). CONCLUSION: IMA may act as a marker of ischemia and oxidative stress in newborns delivered to pre-eclamptic mothers.

Impact of iron deficiency anemia on chronic periodontitis and superoxide dismutase activity: a cross-sectional study.

PURPOSE: Both chronic periodontitis (CP) and iron deficiency anemia (IDA) induce oxidative stress in the body and cause an imbalance between reactive oxygen species and antioxidants, such as superoxide dismutase (SOD). This study explored the SOD enzyme activity of saliva and serum in CP patients with and without IDA and analyzed the impact of IDA on CP. METHODS: A total of 82 patients were divided into four groups: control group (CG, 22), periodontally healthy IDA patients (IDA-PH, 20), CP patients (CP, 20), and IDA patients with CP (IDA-CP, 20). After clinical measurements and samplings, serum and salivary SOD levels were determined using an SOD assay kit. RESULTS: IDA-CP patients exhibited a higher gingival index, bleeding on probing, probing pocket depth, and percentage (%) of sites with a clinical attachment loss (CAL) of ≥6 mm (P<0.008) than CP patients. The mean salivary and serum SOD levels were significantly lower in the IDA-PH, CP, and IDA-CP patients than in the CG group (P<0.008). A significant positive correlation between salivary and serum SOD activity was observed in IDA (P<0.05). Furthermore, serum and salivary SOD levels were significantly and negatively correlated with all periodontal parameters including the percentage of sites with CAL of 4-5 and ≥6 mm (P<0.05) except the significant correlation between salivary SOD activity and mean CAL and the percentage of sites with CAL of 4-5 mm (P>0.05) in these patients. CONCLUSIONS: Within the limits of this study, it may be suggested that IDA patients with chronic periodontitis have more periodontal breakdowns than patients with chronic periodontitis. Serum and salivary SOD activity levels were lower in the IDA-PH, CP and IDA-CP groups than in the CG. Iron deficiency anemia influenced the serum SOD activity but did not seem to affect the salivary SOD activity in these patients.

Status of leptin in MBCR-ABL p210 positive chronic myeloid leukemia patients before and after imatinib therapy: a conflicting scenario.

BACKGROUND: Chronic myelogenous leukemia (CML), a myeoloproliferative disorder, is characterized by the presence of the fusion gene BCR-ABL in hematopoietic cells. Leptin, considered a link between cancer and obesity, has been reported to be actively involved in hemopoiesis and pathophysiology of CML. There are few and conflicting reports about the status of serum leptin levels and recently alteration in leptin has been reported due to imatinib mesylate. METHODS: Leptin and CRP were estimated in 30 (male: 20; female: 10) newly diagnosed and confirmed MBCR- ABL p210 positive CML patients before and after 3 months of therapy by commercial enzyme linked immunosorbent assays. Leptin levels were compared with 30 (male: 20; female: 10) age matched healthy controls accounting for the differences due BMI and gender. RESULTS: Leptin/BMI ratio was significantly raised in both male and female chronic phase patients as compared to controls (p < 0.001, p = 0.048) and accelerated phase patients as compared to controls (males, p < 0.001; females, p < 0.001). The normal gender difference and dependence on BMI was lost in patients. In patients, who failed to achieve hematological baseline, leptin/BMI was higher only in male patients (p = 0.012). Leptin/BMI also correlat- ed with TLC and blast percentage (TLC, R2 = 0.412, p = 0.001; Blast %, R2 = 0.408, p < 0.001). There was no correlation between leptin and CRP levels. Levels decreased significantly after complete hematological remission in both males and females (p = 0.001, p = 0.028). Levels after 3 months of imatinib therapy were significantly higher than controls in all patients not in remission (males, p < 0.001; females, p = 0.018) but only in male patients in re- mission (p = 0.002). CONCLUSIONS: Leptin levels were increased in CML patients. The findings suggest a possible role of leptin in patho- genesis of CML or disease progression independent of inflammatory state or reactionary rise. Imatinib itself may increase leptin levels, and, as leptin plays an active role in the pathophysiology of CML, this conflicting scenario needs further investigation. Alterations in leptin need to be investigated cautiously accounting for confounding and differences due to BMI and gender.

Comparative evaluation of serum fluoride levels in patients with and without chronic abdominal pain.

BACKGROUND: Fluorosis ranks high among the major environmental health problems in India. Non-ulcer dyspeptic complaints are common in humans and it is a known fact that fluoride in drinking water, food and other items can cause these symptoms. METHODS: Fifty adult outpatients (mean age: 35.2±12.7 y) with chronic abdominal pain of unexplained origin were tested for their serum, urinary, and drinking water fluoride (F) concentrations. These concentrations were compared with those of 50 asymptomatic outpatients (mean age: 37.4±11.5 y) and analysed statistically. RESULTS: Serum F concentrations were higher than normal in 62% of the study group I and in 42% of the control group II with a mean of 0.065±0.03 ppm (range: 0.010-0.421) in the former and 0.023±0.028 ppm in the latter. Statistical analysis of the data by Student's t-test (unpaired) revealed a significant correlation (p<0.05) between chronic abdominal pain and elevated serum F. Urinary fluoride concentrations in group I were 0.87±1.67 (0.01-3.7) ppm. Seventy-three percent of the patients examined for urinary fluoride concentrations were having higher values than normal, whereas 27% patients had normal range urinary fluoride concentrations despite raised serum fluoride concentrations. CONCLUSIONS: In the cases of chronic pain abdomen, chronic fluoride ingestion from drinking water and other sources can be the cause and should be evaluated in patients in which other parameters are normal.

Effect of imatinib on male reproductive hormones in BCR-ABL positive CML patients: A preliminary report.

Multiple animal studies, few clinical case reports and one study have observed decreased testosterone production and gynaecomastia as adverse effect of imatinib therapy. We have prospectively studied testosterone, LH and FSH levels at baseline and at 6 months of imatinib treatment in 34 newly diagnosed male BCR-ABL positive CML patients. While none of the patients had gynaecomastia at 6 months, the proportion of patients with low testosterone level increased significantly from 11.8% at baseline to 58.8% (p < 0.001) and those with high LH and FSH increased significantly from 26.4% and 23.5% to 82.4% and 76.4%, respectively (p < 0.001 and p < 0.001). Serum testosterone levels decreased significantly (p = 0.002) and serum LH and FSH levels increased significantly at 6 months of imatinib therapy (p = 0.001 and p = 0.003) in comparison to baseline levels. The findings document the effect of imatinib on testosterone levels in adult CML patients much before than reported earlier.

Immunocontraceptives: How far from reality?

Despite high expectations of safer, effective, economical, longer acting contraceptives, to date, there are no licensed contraceptive vaccines available in the market. Nevertheless, a role for vaccines undoubtedly exists as an aid to birth spacing and as a nonsurgical means of generating sterility. The research concerned in the area so far has been successful on the feline population, with room still for exhaustive studies on humans. The future of contraceptive vaccines holds great promise in terms of comfort, price, efficacy, rare complications, and possibly nonselective action on animal populations as well as on humans. This brief review deals with the basic aspects of immunocontraceptives along with the efforts done so far. There is a need for further research in aspects involving the rate of evolution of contraception resistance based on genetics, resistance phenotypes, or cross generation effects. Gonadotropin-releasing hormone and luteinizing-hormone have not been investigated in humans, as both reported impotency in animals; the follicle-stimulating hormone has been shown to cause oligospermia; zona pellucida has also not been studied in humans as it causes irreversible oophoritis, while the sperm has the potential for success in humans based on the data from immunoreproductive studies. Even as the position of the human chorionic gonadotropin vaccine looks hopeful, research on other possible targets continue with an eventual aim of discovering a vaccine that is more immunogenically effective.

Correlation of 2 hour, 4 hour, 8 hour and 12 hour urine protein with 24 hour urinary protein in preeclampsia.

OBJECTIVE: To find shortest and reliable time period of urine collection for determination of proteinuria. MATERIALS AND METHODS: It is a prospective study carried out on 125 pregnant women with preeclampsia after 20 weeks of gestation having urine albumin >1 using dipstick test. Urine was collected in five different time intervals in colors labeled containers with the assistance of nursing staff; the total collection time was 24 hours. Total urine protein of two-hour, four-hour, eight-hour, 12-hour and 24-hour urine was measured and compared with 24-hour collection. Data was analyzed using the Pearson correlation coefficient. RESULTS: There was significant correlation (p value < 0.01) in two, four, eight and 12-hour urine protein with 24-urine protein, with correlation coefficient of 0.97, 0.97, 0.96 and 0.97, respectively. When a cut off value of 25 mg, 50 mg. 100 mg, and 150 mg for urine protein were used for 2-hour, 4-hours, 8-hour and 12-hour urine collection, a sensitivity of 92.45%, 95.28%, 91.51%, and 96.23% and a specificity of 68.42%, 94.74%, 84.21% and 84.21% were obtained, respectively. CONCLUSION: Two-hour urine proteins can be used for assessment of proteinuria in preeclampsia instead of gold standard 24-hour urine collection for early diagnosis and better patient compliance.

Microalbuminuria and C-reactive protein as a predictor of coronary artery disease in patients of acute chest pain.

Microalbuminuria is a risk factor for cardiovascular disease. It is gaining importance as a marker of atherogenic milieu and indicates the target organ damage and can be a valuable tool in screening and identification of patients with cardiovascular disease. Markers of inflammation, such as C-reactive protein (CRP), were found to be related to cardiovascular disease (CVD) events in patients with chest pain. In addition, recent studies have shown that, in the case of atherosclerosis, increased levels of CRP, reflects inflammatory condition of vessel wall. In the present study, CRP and microalbuminuria were estimated in patients of acute chest pain. The patients were divided into two study groups (gp-1 patients of chest pain with CVD and gp-2 patients of chest pain of causes other than CVD) along with one healthy control group. It was found that microalbuminuria was higher in CVD patients (RR = 6.250,95% CI 2.346-16.45,P < 0.05) and also CRP was much higher in CVD patients (RR = 13.667,95% CI 4.528-41.253, P < 0.05) as compared to other two groups. Sensitivity, specificity and positive predictive value of CRP and microalbuminuria were also higher in gp-1 (CVD) patients as compared to other two groups. Therefore, CRP and microalbuminuria can be used as important biomarkers in screening CVD.

Glycohemoglobin levels with severity of periodontitis in non-diabetic population.

BACKGROUND: Periodontal disease is closely related to type 2 diabetes and is an important complication of diabetes. There are few studies about the relationship the glycohemoglobin levels with severity of periodontitis in non-diabetic population. We therefore planned this study to evaluate the glycohemoglobin levels with severity of periodontitis in non-diabetic population. METHODS: This study was conducted on 50 age and gender matched subjects in each of the three groups (according to the grades of mobility in periodontitis), a total of 150 non-diabetic periodontitis patients (Grade 1, Grade 2, and Grade 3 mobility) and 50 non-diabetic periodontitis patients with Grade 0 mobility (controls), in collaboration with the Department of Periodontics of Dental College and Department of Biochemistry, PGIMS, Rohtak, Haryana. After obtaining informed consent, fasting venous blood samples of all the non-diabetic periodontitis patients of all grades were collected aseptically for HbA1c, plasma glucose, and serum C-reactive protein (CRP) estimation. RESULTS: A total of 150 non-diabetic periodontitis patients (Grade 1, Grade 2, and Grade 3 mobility) and 50 age and gender matched controls participated in the study. There was no significant difference in fasting plasma glucose and postprandial plasma glucose in non-diabetic periodontitis patients with Grade 1, Grade 2, and Grade 3 mobility as compared to controls, non-diabetic periodontitis patients with Grade 1 mobility as compared to Grade 2, non-diabetic periodontitis patients with Grade 1 mobility as compared to Grade 3 and non-diabetic periodontitis patients with Grade 2 mobility as compared to Grade 3. Glycohemoglobin and serum C-reactive protein levels were significantly increased in non-diabetic periodontitis patients with Grade 1, Grade 2, and Grade 3 mobility as compared to controls, non-diabetic periodontitis patients with Grade 1 mobility as compared to Grade 3 and non-diabetic periodontitis patients with Grade 2 mobility as compared to Grade 3. The difference of serum C-reactive protein levels were significant. However, glycohemoglobin levels were non-significant between non-diabetic periodontitis patients with Grade 1 and Grade 2 mobility. CONCLUSIONS: The evidence of association between periodontitis and increased glycohemoglobin increases attention to the diagnosis and treatment of periodontitis, consequently improving the patient's oral health and prevention of occurrence in future diabetes. An understanding of these correlations is important to allow dental health care providers to inform patients with periodontitis of their increased risks and to counsel such patients to seek additional medical assessment or intervention as indicated.

Antioxidant Enzymes and Lipid Peroxidation in Type 2 Diabetes Mellitus Patients with and without Nephropathy.

BACKGROUND: Oxidative stress has been considered to be a pathogenic factor of diabetic complications including nephropathy. There are many controversies and limited studies regarding the antioxidant enzymes in diabetic nephropathy. AIM: This study was to evaluate the levels of antioxidant enzymes and lipid peroxidation in Type-2 Diabetes Mellitus (DM) patients with and without nephropathy. MATERIALS AND METHODS: The study included 90 age and sex matched subjects. Blood samples of all subjects were analyzed for all biochemical and oxidative stress parameters. RESULTS: The malondialdehyde (MDA) levels and catalase (CAT) activity were significantly increased and reduced glutathione (GSH) levels and activities of glutathione peroxidase (GPx) and glutathione reductase (GR) were significantly decreased in Type-2 DM with and without nephropathy as compared to controls and also in Type-2 DM with nephropathy as compared to Type-2 DM without nephropathy. There were an excellent positive correlation of glycohemoglobin (HbA1c) with MDA and a good negative correlation of GPx with GSH in controls. There were positive correlations of GR, CAT, and superoxide dismutase (SOD) with MDA in Type-2 diabetes patients with nephropathy. CONCLUSIONS: Intensity of oxidative stress in Type-2 diabetic patients with nephropathy is greater when compared with Type-2 diabetic patients without nephropathy as compared to the controls.

The ominous link between obesity and abdominal adiposity with diabetes and diabetic dyslipidemia in diabetic population of developing country.

BACKGROUND: Individuals with obesity and abdominal adiposity are at higher risk for hyperinsulinaemia, insulin resistance, and diabetes. This study was, therefore, designed to evaluate the association of both generalized and regional obesity with metabolic variables and biochemical indices. METHODS: 200 confirmed patients of type-2diabetes of either gender were studied. RESULTS: A statistically significant degree of dyslipidemia was depicted in obese class-II subjects; however, females had a lower degree of dyslipidemia as compared to male subjects with statistically significant results only for HDL-C. Further, multiple logistic regression analysis revealed that BMI is a stronger predictor of FPG and HbA1c as compared to WHR. CONCLUSIONS: Higher plasma glucose levels were depicted at a lower BMI, which turned out to be stronger predictor of glycemic control as compared to WHR. Moreover, BMI, WHR and male gender was significantly correlated with the metabolic parameters and even much more pronounced association with BMI.