Exploring the Role of Serum Hydrogen Sulphide (H2S) Levels in Manic Depressive Psychosis in Terms of Its Association, Diagnostic Ability, and Severity Prediction: Findings From a Tertiary Care Center in North Bengal.

INTRODUCTION: Manic depressive psychosis (MDP) or bipolar disorder, a prevalent psychiatric condition globally and in the Indian population, has been attributed to various pathological mechanisms. Hydrogen sulphide (H2S), a member of the gasotransmitter family, may be linked to the development of bipolar disorder because it plays a crucial role in maintaining proper neuronal function in terms of excitability, plasticity, and homeostatic functions. There is very little data regarding the role of the gasotransmitter H2S in MDP in terms of its association, diagnostic ability, and severity prediction, which led us to conduct this study among MDP patients in the Sub-Himalayan region of West Bengal. METHODS: This was an observational case-control study performed in the Department of Biochemistry, North Bengal Medical College and Hospital, Siliguri, West Bengal, India, from January 2022 to December 2022. Fifty diagnosed MDP patients and 50 healthy age- and sex-matched control subjects satisfying the inclusion and exclusion criteria were studied. The H2S level in the blood was assayed using the standardised spectrophotometric methylene blue method. The severity of depression was assessed by Hamilton Depression Rating Scale (HAM-D) scoring. RESULTS: Of the 50 MDP patients, 45 (90%) were in the depressive phase, and five (10%) were in the manic phase. Of the 45 depressive patients, eight (17.8%) had mild depression, 12 (26.7%) had moderate depression, 19 (42.2%) had severe depression, and six (13.3%) had very severe depression. The mean H2S level in MDP patients (41.98±18.88 µmol/l) was significantly (P<0.05) lower than that in control subjects (99.20± 15.20 µmol/l). It was also observed that the mean H2S level in MDP patients decreased with the duration of the disease but was not statistically significant. The mean H2S levels in the different depression severity groups were found to be significantly different (P<0.001). Receiver operating characteristic (ROC) curve analysis revealed that a cut-off value of H2S <78.5 µmol/l was associated with MDP, with a sensitivity of 96% and a specificity of 88%, and a cut-off value of H2S < 53 µmol/l predicted the severity of depression with a sensitivity of 89.3% and a specificity of 76.5%. CONCLUSION: The significant association of the gasotransmitter H2S in MDP patients and its role as a diagnostic and severity predictive marker can help us to employ proper measures for better management of MDP and improving quality of life.

Prostate-Specific Antigen Density: A Measurement to Differentiate Benign Hypertrophy of Prostate from Prostate Carcinoma.

Background Determination of isolated prostate-specific antigen (PSA) in asymptomatic individuals has not demonstrated sufficient sensitivity and specificity to be useful in the routine evaluation of prostate disease. To enhance the accuracy of serum PSA we have used a proportion of serum PSA and prostate volume, which we refer to as prostate-specific antigen density (PSAD). Prostate volume in this study was calculated using transrectal ultrasonography (TRUS). Materials and Methods A total of 106 patients with prostatic disease clinically confined to the prostate glands were evaluated. Results and Observation The mean PSAD for prostate cancer was 0.15 ± 0.01 while that for benign hypertrophy of the prostate (BPH) was 0.11 ± 0.02 ( p < 0.05). Significant difference ( p < 0.05) was noted in the prostate volume in these two groups with the mean prostate volume measured by TRUS in the BPH to be 53.85 ± 9.71 mL compared with 58.14 ± 7.48 mL in the carcinoma. PSA density of 0.13 ng/mL can be used as a cutoff for the individual in our set-up who should go for prostate biopsy with sensitivity and specificity of over 90%. Conclusion These results suggest that PSAD may be useful in distinguishing BPH and prostate cancer.

A Study of Inflammatory Status in Nephropathy Patients with History of Type-II Diabetes Mellitus Undergoing Haemodialysis.

INTRODUCTION AND OBJECTIVE: Diabetic nephropathy is one of the leading cause of chronic kidney failure. Local vascular inflammation is increased in diabetes mellitus (DM), which results in higher burden of microvascular and macrovascular complications. The present study was carried out to assess the importance of inflammatory status in nephropathy patients with Type-II DM. METHODOLOGY: Eighty diagnosed cases of type II DM who had end stage renal disease (Nephropathy Stage-5) were selected for the study, they were further divided equally into 2 sub-categories; Group I (patients who were undergoing haemodialysis) and Group II (patients who were not undergoing haemodialysis). The control group comprised of 40 individuals who were age and sex matched healthy individuals. Inflammatory status was assessed by estimating serum C-reactive protein (CRP) and serum albumin. RESULTS: A significant increase in serum CRP and a significant decrease in serum albumin were seen in test group- I and test group-2 as compared to controls. There was a positive correlation between serum albumin and GFR with r=0.904 in the Test Group-I and r=0.946 in Test Group-II. A negative correlation was observed between serum CRP and GFR r= -0.597 in Test Group-I and with r= -0.6231 in Test Group-II. Also, the correlation between CRP and albumin showed a negative trend with r= -0.848 in Test Group-I and with r= -0.78 in Test Group-II. CONCLUSION: Microinflammation is a common finding in haemodialysis patients who have a history of nephropathy with Type-II diabetes mellitus. With a proper knowledge on factors which lead to this microinflammation, we can employ preventive strategies for a better management of Type-II diabetic nephropathy patients and thereby, for improving their survival.