Case report on an infant presenting with hypoglycemia,and milky serum

A 4-month-old male baby who presented in a moribund condition with seizures was found to have hepatomegaly,hypoglycemia and milky serum.Serum triglycerides were markedly elevated(3168 mg/dL) with cholesterol being 257 mg/dL and high density lipoprotein levels were low(19 mg/dL).The possibility of glycogen storage disease type Ⅰ was considered in the diagnosis.Infants with glycogen storage disease type Ⅰ may present like sepsis.The association of hepatomegaly, hypoglycemia and abnormal lipid profile stated above should alert the physician to consider glycogen storage disease type Ⅰ in the diagnosis.

Can antioxidants predispose to cancer recurrence?

Objective:To measure and compare pre- and post-treatment levels of serum total glutathione -S-transferase(GST) in stageⅣcervical cancer patients and erythrocytic glutathione(GSH) and malondialdehyde(MDA) and plasma ceruloplasmin(CP) and total GST in stageⅣoral cancer patients and to correlate with the response to treatment during a two year follow-up period in respective cancer groups.Methods:Thirty-four biopsy-proven stageⅣoral cancer and cervical cancer patients(n=17 in each group) who underwent same mode of treatment were chosen for this study.Erythrocytic MDA and GSH,CP and serum total GST were measured in all patients before the onset of treatment,and the GST level was only measured in cervical cancer patients after radiotherapy.The levels were compared with their respective prognosis in 2 years.Results:Oral cancer patients with higher pretreatment levels of GSH,CP and GST came with cancer recurrence within 2 years after the onset of treatment.Cervical cancer patients with higher post radiotherapy levels of serum total GST had higher recurrence tate.Conclusions: This study indicates there may be a role for these antioxidant parameters namely GST,GSH,CP in assessment of long term survival and prognosis of cancer patients.

Neutrophil-lymphocyte ratio in pregnancy-associated maternal complications: A review

Pregnancy associated diseases/disorders are associated with significant maternal and neonatal morbidities and mortalities.Devising/validating cost effective and easily accessible predictive,diagnostic and risk stratification markers are critical to the management and improved outcome in these diseases.Inflammation forms the backbone of most of the routinely encountered maternal complications of pregnancy.Hematological markers can be considered as a direct reflection of the systemic inflammatory milieu.Recently,the neutrophil lymphocyte ratio has been explored for its potential to assess the severity of inflammation and thus the severity of the underlying disorder.The neutrophil-lymphocyte ratio has gained scientific attention as a potential prognostic/predictive marker of acute as well as chronic inflammatory diseases including gynecological and reproductive disorders.This present study reviews the mechanistic role of neutrophils and lymphocytes in fueling or propagating the inflammatory cascades in the three most common maternal complications of pregnancy and the evidence of clinical importance of the neutrophil to lymphocyte ratio in predicting,diagnosing,and prognosticating pregnancy-associated complications.

A study of the effect of antioxidant status on the outcome of malignant gliomas

Objective:To explore the relationship of the effect of antioxidant status of patients with malignant gliomas at the time of their admission to a tertiary care hospital and the clinical condition after a post operative follow up over a period of two years.Methods: Several antioxidant enzymes like erythrocytic glutathione reductase,glutathione peroxidase,catalase,superoxide dismutase,plasma ceruloplasmin,antioxidant vitamins A,E and C and lipid peroxidation products like erythrocytic thiobarbituric acid reacting substances and plasma conjugated dienes were analyzed both in controls and glioma patients.Results: It was observed that patients who exhibited an overall higher turnover of antioxidants presented with recurrence.Conclusion: Free radical toxicity may adversely affect the outcome of such cancer patients.

Can glucose preservatives be avoided in blood samples?

Objective:To evaluate the effect of cooling of whole blood samples without an anticoagulant and glucose preservative on glucose and other commonly measured clinical analytes by serial measurements over a three hour period. Methods: Thirty healthy adult volunteers about 20-50 years old,from Kasturba Medical College,Manipal (2008) were the participants. After obtaining informed consent from each participant,blood was collected (2 mL each) in three vacutainers-one without the use of an anticoagulant and glucose preservative,one with sodium fluoride-potassium oxalate and the other with disodium ethylene diamine tetraacetic (EDTA). Automatic analyzer Hitachi was used to measure glucose and other common clinical laboratory analytes,every hour for three hours. Results: The refrigerated samples without an anticoagulant and preservative,showed slightly lower values of glucose as compared to fluorinated samples but difference between these groups was not statistically significant (P value> 0.05).Also cooling had no effect on other analytes except potassium.Conclusion: Fluoride preservative as a regular practice for glucose samples can be avoided if the samples can be processed quickly as fluoriated samples also show a marginal fall in glucose values.

Prediction modelling in the early detection of neonatal sepsis

Background Prediction modelling can greatly assist the health-care professionals in the management of diseases,thus sparking interest in neonatal sepsis diagnosis.The main objective of the study was to provide a complete picture of performance of prediction models for early detection of neonatal sepsis.Methods PubMed,Scopus,CINAHL databases were searched and articles which used various prediction modelling measures for the early detection of neonatal sepsis were comprehended.Data extraction was carried out based on Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies checklist.Extricate data consisted of objective,study design,patient characteristics,type of statistical model,predictors,outcome,sample size and location.Prediction model Risk of Bias Assessment Tool was applied to gauge the risk of bias of the articles.Results An aggregate of ten studies were included in the review among which eight studies had applied logistic regression to build a prediction model,while the remaining two had applied artificial intelligence.Potential predictors like neonatal fever,birth weight,foetal morbidity and gender,cervicovaginitis and maternal age were identified for the early detection of neonatal sepsis.Moreover,birth weight,endotracheal intubation,thyroid hypofunction and umbilical venous catheter were promising factors for predicting late-onset sepsis;while gestational age,intrapartum temperature and antibiotics treatment were utilised as budding prognosticators for early-onset sepsis detection.Conclusion Prediction modelling approaches were able to recognise promising maternal,neonatal and laboratory predictors in the rapid detection of early and late neonatal sepsis and thus,can be considered as a novel way for clinician decisionmaking towards the disease diagnosis if not used alone,in the years to come.

A comparative study to evaluate the effect of limited access dressing on diabetic ulcers

Aim:Emerging evidence favors the important role of antioxidants,matrix metalloproteinases(MMPs),and nitric oxide(NO)in the healing of diabetic wounds.There is a lack of substantial evidence regarding the effects of negative pressure on antioxidants,MMPs and NO in chronic wounds associated with diabetes.Methods:A total of 55 type 2 diabetic patients with leg ulcers were divided into 2 groups:a limited access dressing(LAD)group(n=27)and a conventional dressing group(n=28).Levels of hydroxyproline,total protein,MMP-2 and MMP-9,NO and antioxidants including reduced glutathione(GSH)and the oxidative biomarker malondialdehyde(MDA)were measured in the granulation tissue at days 0 and 10.Changes in levels between the LAD and conventional groups were determined by the Student’s t-test.Results:After 10 days of treatment,the LAD vs.conventional dressing group showed increase in the levels of hydroxyproline(mean±standard deviation=55.2±25.1 vs.29.2±1,P<0.05),total protein(12.8±6.5 vs.8.34±3.2,P<0.05),NO(1.13±0.52 vs.0.66±0.43,P<0.05),GSH(7.0±2.4 vs.6.6±2.2,P<0.05)and decrease in MMP-2(0.47±0.33 vs.0.62±0.30,P<0.05),MMP-9(0.32±0.20 vs.0.53±0.39,P<0.05)and MDA(6.8±2.3 vs.10.4±3.4,P<0.05).Conclusion:When compared to conventional dressings,LAD induces biochemical changes by significantly increasing the levels of hydroxyproline,total protein,NO and antioxidants levels,and significantly reducing MMPs(MMP-2 and MMP-9)and an oxidative biomarker in diabetic wounds.These biochemical changes are thought to favor diabetic wound healing.