Linking IL-6 and hsCRP among Indian patients with myocardial infarction.

The association between serum interleukin-6 (IL-6) and highly sensitive C - reactive protein (hsCRP) as predictors of the risk factors for Myocardial Infarction. The study included a total of 50 patients with Myocardial Infarction, aged between 25 to 74 years. The levels of hsCRP were measured using the immunoturbidimetry method, while Interleukin 6 was estimated using the sandwich ELISA method. Statistical analysis was conducted using SPSS version 21.0, with p values calculated using Quartile ratio, ANOVA unpaired t-test, and Kaplan-Meier Curve Method. A p-value of less than 0.05 was considered statistically significant. All participants underwent a questionnaire, physical examination, medical history assessment, and laboratory tests. The results of the study showed that there was a significant correlation between IL-6 and hsCRP levels in the Quartile groups, as well as with lipid profiles. The Kaplan-Meier method also demonstrated a significant association between IL-6 and hsCRP levels in participants. The comparison of biomarkers further supported these findings. Thus, data shows that elevated levels of hsCRP and IL-6 could serve as valuable diagnostic markers for predicting Acute Myocardial Infarction. Our study strongly suggests that IL-6 could be a powerful marker in evaluating the Myocardial Infarction.

Study of Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency and Genotype Polymorphism of G6PD B and G6PD (A+/A-) in Patients Treated for Plasmodium vivax Malaria in a Tertiary Care Hospital in North East India.

Introduction Glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency is the most common enzymopathy in humans, and its distribution has been historically described to be closely associated with that of malaria. North East India provides optimal conditions for transmission of malaria and bears a considerable burden of Plasmodium vivax (P. vivax) malaria. Primaquine, a mainstay in the treatment of vivax malaria, may trigger episodes of acute hemolysis in patients with G6PD deficiency. The present study sought to delineate the frequency and genotypes of G6PD deficiency among patients suffering from vivax malaria infections.  Methods Blood specimens from 80 individuals diagnosed with vivax malaria underwent enzyme assay for G6PD deficiency. Samples with deficient phenotype underwent isolation of DNA using a genomic DNA isolation kit (Qiagen India Pvt. Ltd., New Delhi, India). The genomic DNA underwent amplification, serial denaturation, annealing, extension, final extension followed by digestion with restriction endonucleases Nla III and Fok I. The digested products were subjected to horizontal agarose electrophoresis for the separation of digested fragments. Samples without nucleotide 376 adenine→guanine (A→G) mutation were classified as G6PD B. Those with the mutation were further classified into G6PD A(+) and G6PD A(-) based on the presence of Nla III site. Results Twenty-seven out of 80 individuals (33.75%) with P. vivax malaria were found to have G6PD deficiency, of which a majority (n=24) had G6PD B genotype. Three individuals had Asparagine→Aspartic Acid mutation at position 376 (A→G), of which G6PD A(+) and G6PD A(-) were present in two and one cases, respectively. Conclusion G6PD deficiency was noted in about a third of patients with vivax malaria. Since primaquine therapy is contraindicated in this group of patients, there is a rationale for looking into screening patients with vivax malaria from the region prior to primaquine therapy. Further large scale studies may substantiate this and help in better genotypic and geographic characterization of G6PD deficiency in the region.

Alcohol Used as Disinfectant before Venipuncture does not Lead to Sample Haemolysis or Sample Dilution.

INTRODUCTION: Sample haemolysis is often the leading cause of sample rejections in clinical laboratory. Isopropyl alcohol or ethyl alcohol, used as disinfectant during sample collection is often considered an important cause of sample haemolysis or sample dilution; although there is a paucity of scientific documentation verifying the same. AIM: To verify whether avoidance to wipe out alcohol from the venipuncture site, before sample collection leads to sample haemolysis; or leads to sample dilution. MATERIALS AND METHODS: This was a prospective randomized study, where every second patient coming to the phlebotomist during the study period, in the age group of 20 to 50 years, was considered for the study. A total of 60 patients were considered for the study. For unbiased comparison sample were collected from both left upper limb (alcohol dry) and right upper limb (alcohol wet) of all the patients. Visual inspection for haemolysis was done, and serum potassium (K), Calcium (Ca), Lactate Dehydrogenase (LDH), Aspartate transaminase (AST), Alanine transaminase (ALT), Alkaline phosphatase (ALKP) and Glucose were estimated in both the set. Also experiences of patients in both limb collections were considered. RESULTS: On visual inspection none of the sample was haemolysed. 51.67% of the patients experienced same level of discomfort in both limbs (alcohol dry and alcohol wet) during venipuncture. While 28.3% experienced burning sensation in alcohol wet limb, another 20% experienced a more soothing sensation in the alcohol wet limb during venipuncture. There is no statistically significant difference in the measured value of serum K, LDH, Ca, AST, ALT and ALKP and Glucose between the two sets of sample - alcohol dry and alcohol wet. CONCLUSION: The study concludes that avoidance to wipe alcohol before venipuncture does not lead to sample haemolysis or sample dilution. Also most patient experienced same or more soothing sensation in alcohol wet limb. Therefore sample can be collected without a waiting period for alcohol to dry off, thereby preventing haemoconcentration and decreasing sample collection time.

Interpreting the Laboratory Reports for Vit D.

Importance for Vit D estimation has increased in the recent years due to its link to various diseases. Measurements of Vit D by different diagnostic laboratories is however not uniform. There is variation pertaining to assay methodology and also variation in the measurement of different metabolites of Vit D. There are also various confounders which influence Vit D assays and which in most instances are overlooked. Also a matter of concern regarding Vit D assays is the lack of assay standardisation. These factors contribute to the variation in the reports generated by the diagnostic laboratories. Therefore interpretation of Vit D reports needs proper understanding of these interfering factors and further reports need to be correlated substantially with the clinical findings.