Diagnostic value of lactate levels in acute abdomen disorders.

The supply of oxygen is limited in certain intra abdominal conditions due to direct vascular invasion or inflammatory process, resulting in high lactate levels. Aim of this study was to find the predictive value of lactate levels in the peritoneal fluid (PF) and blood of patients with acute abdomen. The study comprised of fifty patients with acute abdominal conditions, admitted in emergency ward of tertiary care hospital, thirty patients were with surgical abdomen (group I) and twenty patients with non surgical abdomen (group II). Lactate was estimated in PF and blood on Blood Gas Analyzer (NOVA, M-7). The mean lactate levels in PF were significantly higher in group I as compared to group II (14.65 ± 1.195 vs. 5.92 ± 0.97 mmol/L, p < 0.001). There was no significant difference in blood lactate levels in both the groups. When PF and blood lactate levels were compared within groups, we found that PF levels were significantly higher than blood in group I (14.65 ± 1.195 vs. 3.85 ± 0.54 mmol/L, p < 0.001) but not in group II (5.92 ± 0.97 vs. 4.36 ± 0.95 mmol/L). Diagnostic value was obtained using ROC curve. Cut off values obtained for PF lactate, difference and ratio of PF and blood lactate (≥6.4 mmol/L, ≥3.3 and ≥2.1 respectively) are at very high degree of sensitivity and specificity. So it can be useful marker of surgical emergency in patients with acute intra abdominal pathology, especially in clinically ill patients or in whom physical examination is not yielding because of neurologic disorders or unresponsiveness.

Homocysteine--risk factor for ischemic stroke?

The present study was undertaken to compare the homocysteine levels in patients of ischemic stroke with controls. Our study included 117 patients of ischemic stroke and 101 controls. The mean homocysteine levels in patients with ischemic stroke were 16.80 +/- 6.71 micromol/L while in controls it was 12.30 +/- 4.68 micromol/L, the difference being statistically significant (P < 0.01). The increased homocysteine levels in patients with ischemic stroke are independent of diabetes mellitus, age and sex. The homocysteine levels were higher in hypertensive subjects than non-hypertensive (P < 0.05).

Changes in vitamin C and vitamin E during oxidative stress in myocardial reperfusion.

Injury to the myocardial tissue due to ischemia and reperfusion occurs because of imbalance between the formation of oxidants and available antioxidants in the heart. Levels of vitamin C (ascorbic acid) and vitamin E (alpha--tocopherol) were evaluated in 52 patients of acute myocardial infarction (AMI) treated by streptokinase. They were further divided into reperfused group (39 patients) and non-reperfused group (13 patients). Twenty normal healthy subjects served as controls. Vitamin C and vitamin E were estimated in study group before and after thrombolytic therapy and in controls. Vitamin C levels were low in AMI cases as compared to controls (8.74 +/- 1.87 and 10.63 +/- 3.26 mg/L, respectively, P < 0.001). Trend of fall in vitamin C levels in the two study groups was not statistically significant. Vitamin E levels declined from 12.19 +/- 6.71 to 9.96 +/- 6.50 mg/L by 4 hours which was significant (P < 0.01) in the reperfused group, but the change in non-reperfused group (9.28 +/- 6.37 to 9.35 +/- 6.07 mg/dL by 4 hours) was non-significant. This is because of increased consumption of this antioxidant in suppressing the oxidative stress which occurs with reperfusion. Vitamin E can be proposed as a valid marker for reperfusion.

Status of lipid peroxidation and plasma iron level in bronchial asthmatic patients.

Low antioxidant levels and oxidative stress due to airway inflammation may be determinant of asthma severity. The study was conducted to find the extent of lipid peroxidation and change in the levels of plasma iron in asthmatic patients with severity of disease. Study included 155 asthmatic and 156 healthy volunteers of the age groups 18-45 of either sex. Asthmatic patients were grouped into mild, moderate and severe groups on the basis of Forced Expiratory Volume in first second percent (FEV1%). Level of plasma malondialdhyde (MDA) was used as index of lipid peroxidation. A significant increase (P<0.01) in plasma MDA and plasma iron levels was found in asthmatic subjects as compared to controls. There was maximum increase in plasma MDA and iron levels in moderate asthmatic group. A positive correlation between plasma MDA and iron (r = +0.3) has been found in asthmatic patients. An increased plasma iron levels in asthmatics may contribute to aggravate lipid peroxidation.

Serial composition of human milk in preterm and term mothers.

Human milk samples were collected from 86 mothers induced in the study on days 3, 7, 14 and 28 of lactation. The mothers were divided into three groups on the basis of gestation viz. group 1: 37-41 weeks (n=41), group II: 33-36 (n=23) and group III: <33 weeks gestation (n=22). All the samples were analysed for the estimation of fat, lactose and protein. The results obtained from the investigations were statistically analysed. The analysis of the results revealed a lower amount of fat and lactose in preterm milk as compared to term milk (p<0.01). These were found to increase in amount with increasing postnatal age (p<0.05). The protein levels were observed to be significantly higher in preterm than term milk (p<0.01). These were observed to decrease significantly with increase in postnatal age (p<0.01).

Plasma homocysteine and insulin in diabetic nephropathy: relationship to body mass index.

The data on plasma homocysteine and endogenous insulin in type 2 diabetes mellitus with nephropathy and relationship to body mass index (BMI) is particularly from the Indian subcontinent. A prospective study was carried out in 50 patients of type 2 diabetes mellitus with overt nephropathy (Group A). The results were compared with 25 diabetics without nephropathy (Group B), and 25 age and sex matched healthy controls (Group C). Microenzyme immunoassay and ELISA estimated the plasma homocysteine and insulin, respectively. The mean values of plasma homocysteine were significantly elevated in diabetic nephropathy (21.3+/-7.2 micromol/L) and diabetics without nephropathy (19.4+/-7.1) when compared to healthy control (11.5+/-2.3). The insulin levels and BMI were significantly higher in diabetics as compared to controls. There was no correlation between homocysteine and insulin, homocysteine and BMI, and homocysteine with the degree of renal failure.

Effect of immobilisation stress on lipid peroxidation and lipid profile in rabbits.

Stress is one of the basic factors in the aetiology of a number of diseases such as atherosclerosis, coronary heart disease, aging, liver disease etc. Hence this work was designed to study the effect of stress in the form of forced immobilisation stress on lipid peroxidation and lipid profile in rabbits. The study was conducted in 25 healthy rabbits of either sex. Rabbits were subjected to forced immobilisation for two hours everyday for consecutive seven days. Blood samples were collected on day 1, 3 and 7 after immobilisation period. Malondialdehyde (MDA), a marker of lipid peroxidation was estimated by TBA assay method. Lipid profile was analysed by multichannel autoanalyser. There was statistically significant increase in MDA, total cholesterol, LDL, VLDL and triglycerides with immobilisation. These findings indicate that stress in the form of forced immobilisation increases lipid peroxidation and alter lipid profile, which may be responsible for pathophysiology of various diseases.

1, 25-Dihydroxycholecalciferol (1,25-(OH)(2) D(3)) levels in osteoporosis.

In the present study primary involution osteoporosis and vitamin D levels were studied in 60 subjects including thirty controls. The biochemical analysis of serum calcium, phosphorus, ALP, albumin and vitamin D(3) (1,25-(OH)(2) D(3)) levels were significantly decreased in osteoporotic patients when compared to non-osteoporotic control group. There was a significant correlation of magnitude of sun exposure with 1,25-(OH)(2) D(3) levels. Similarly, vitamin D intake in the diet has a significant correlation with 1,25-(OH)(2) D(3) concentration. However, no correlation could be obtained between vitamin D(3) levels with increasing age. Among the biochemical markers serum calcium, phosphorus, ALP and albumin could not be correlated with 1,25-(OH)(2) D(3) levels.