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.

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.

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.

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.

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.

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.

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.

Decrease in antioxidant status of plasma and erythrocytes from geriatric population.

BACKGROUND: Ageing is associated with an accumulation of free radical damage, which leads to physiological and clinical modifications. The study aims to find out the status of lipid profile, antioxidant enzymes, malondialdehyde in geriatric population. PATIENTS/METHODS: The study was conducted on 150 subjects (75 healthy control between the ages of 20-30 years and 75 elderly subjects between ages of 50-70 years as cases). The following parameters were analyzed using the standard reference methods: lipid profile, reduced glutathione, glutathione peroxidase, glutathione reductase, catalase, superoxide dismutase and malondialdehyde. RESULTS: The present study was conducted to estimate the oxidative stress parameters in geriatric population. Highly significant increase in total cholesterol (TC), triglyceride (TG), LDL-cholesterol (LDL-C), VLDL-cholesterol (VLDL-C), malondialdehyde, catalase and decrease in high density lipoprotein cholesterol (HDL-C), reduced glutathione, glutathione peroxidase, glutathione reductase, superoxide dismutase was observed in geriatrics when compared with their younger counterparts. CONCLUSION: This study concluded that there is enhanced oxidative stress and decreased antioxidant defence in geriatrics as compared to younger subjects which could play an important role in ageing. Dyslipidemia has become one of the important risk factors for the increasing prevalence of cardiovascular diseases. There is lack of awareness on the relationship between blood lipids and the risk of cardiovascular diseases in geriatric population. The strategy of early prevention should be adopted against dyslipidemia.

Study of changes in antioxidant enzymes status in diabetic post menopausal group of women suffering from cardiovascular complications.

BACKGROUND: In type 2 diabetic patients, persistence of hyperglycemia has been reported as a cause of increased production of oxygen free radicals (FR), which leads to oxidative stress (OS) and becomes the main factor for predisposition to the cardiovascular complications in diabetes. Diabetic postmenopausal women are prone to cardiovascular disease due to reduced production of estrogen which is a potent antioxidant and prevents oxidative stress (OS) in body. The study is being aimed to find out the status of antioxidant enzymes (AOEs) and malondialdehyde (MDA) in post-menopausal diabetic women. METHODS: The study was conducted with a total of 70 cases, which included 35 Type 2 diabetic post-menopausal females (45 - 60 years) with diabetic CVD complication as the study group and 35 age matched type 2 diabetic postmenopausal females without CVD complication. RESULTS: All diabetic post menopausal females with CVD had significantly higher levels of fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), catalase (CAT), and malondialdehyde (MDA) and significantly lower levels of HDL-C, reduced glutathione (GSH), glutathione reductase (GR), glutathione peroxidase (GPx), and superoxide dismutase (SOD) as compared to the levels of control subjects. CONCLUSIONS: During menopause, reduced production of estrogen causes hypertriglyceridemia, hypercholesterolemia, and hyperlipoproteinemia whose oxidation causes the accumulation of FR in the cell, which precipitates OS. Also, type 2 diabetic subjects with CVD poor glycemic control and impaired AOEs result in increased oxidative injury by failure of protective mechanisms, which further leads to oxidative stress.

Association of insulin like growth factor-1 (IGF-1) and thyroid hormones in patients of acute leukemia.

BACKGROUND: For many years, several studies have demonstrated a relationship between insulin like growth factor-1 (IGF-1), thyroid hormones, and various malignancies. IGF-1 plays an important role in tumor proliferation in various malignancies. The relationship between IGF-1 and thyroid hormones is complex and not fully understood. Therefore we planned to evaluate the level of IGF-1 and thyroid hormones in patients of acute leukemia. METHODS: The present study included 25 patients with acute leukemia (Acute Myeloid Leukemia, n = 16; Acute Lymphoid Leukemia n = 9, mean age 28.16 years). 25 age and gender matched healthy individuals were taken as control (mean age 27.17 years). In all the subjects, serum IGF-1 was measured by enzyme linked immunosorbent assay (ELISA), serum total triiodothyronine (T3), thyroxine (T4) by radioimmunoassay (RIA), thyroid stimulating hormone (TSH) by immunoradiometric assay (IRMA), and free T3 (FT3) and free T4 (FT4) by chemilluminiscence. These tests were done before starting of chemotherapy and either 6 to 8 weeks after chemotherapy or at the time of remission, whichever was earlier. RESULTS: At the time of diagnosis, patients with acute leukemia showed a significantly increased level of IGF-1 as compared to controls (198.32 +/- 67.55 vs 160.64 +/- 45.96; p < 0.01). After 6 to 8 weeks of chemotherapy, patients with acute leukemia showed a significant decrease in the level of IGF-1 compared to the baseline values (198.32 +/- 67.55 vs 155.6 +/- 45.96; p < 0.01). Though FT3, FT4, total T3, and total T4 values in these patients were within the normal range, these values were still significantly higher compared to controls. TSH levels were significantly lower in patients at the time of presentation and the levels increased after chemotherapy. CONCLUSIONS: The estimation of IGF-1 and thyroid hormones may be helpful in assessing the disease activity and predicting the response of chemotherapy.

Diagnostic significance of adenosine deaminase, uric acid and C-reactive protein levels in patients of head and neck carcinoma.

BACKGROUND: Carcinomas are considered to be associated with increased cellular proliferation under antigenic stimulation and inflammation. Therefore, the markers of increased cellular turnover such as adenosine deaminase and uric acid were estimated quantitatively along with markers of inflammation such as C-reactive protein in squamous cell carcinoma of head and neck region. METHODS: The levels of adenosine deaminase, uric acid, and C-reactive protein were estimated in 50 patients of squamous cell carcinoma of head and neck region before starting any treatment and compared with their corresponding levels in 30 healthy age and gender matched controls. The patients were divided into four groups depending on their staging and their results were compared statistically and the coefficient of correlation was calculated using Pearson's formula. RESULTS: The levels of adenosine deaminase, uric acid, and C-reactive protein were found to be significantly higher in patients of head and neck cancers as compared to the levels in controls (p < 0.001). The levels were also observed to rise with staging. A positive correlation was observed between adenosine deaminase and uric acid (r = 0.743, p < 0.001), adenosine deaminase and C-reactive protein (r = 0.648, p < 0.001) and also between C-reactive protein and uric acid (r = 0.712, p < 0.001). CONCLUSIONS: Thus, estimation of adenosine deaminase, uric acid, and C-reactive protein can help in making the diagnosis and assessing the severity of disease in patients of head and neck carcinoma.

HbA(1c) levels in cardiovascular diseased patients without diabetes in a developing country.

BACKGROUND: High levels of glycated hemoglobin (HbA(1c)) have been associated with Coronary Vascular Diseases (CVD) in diabetic patients. Recent studies have reported no association between elevated glycated hemoglobin (HbA(1c)) and incident cardiovascular disease (CVD) among women without diabetes. There are many controversial studies on topics such as "Glycated hemoglobin levels (HbA(1c)) have been associated with cardiovascular diseases (CVD) in the non-diabetic patients". Therefore, we planned this study. METHODS: The present study was conducted on 50 age matched controls and 50 clinically diagnosed non-diabetic CVD patients of either gender. The study included 50 patients with myocardial infarction (MI) admitted to the ICCU ward of J.L.N. Medical College and Hospital, Ajmer (Rajasthan). The following information was recorded from admission sheets of non-diabetic CVD patients of either gender: history of diabetes, hypertension, and cigarette smoking; demographic indices; coronary heart disease and diabetes mellitus treatment; serum cholesterol; serum triglycerides (TG); high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C); fasting and non-fasting blood glucose levels and Glycated haemoglobin levels (HbA(1c)). Glycosylated hemoglobin (HbA(1c)) was measured by latex agglutination inhibition assay. RESULTS AND CONCLUSIONS: The HbA(1c) levels in healthy controls (n = 50) and non-diabetic CVD subjects (n = 50) observed were 4.32 +/- 0.34% and 5.80 +/- 0.20%, respectively. HbA(1c) levels in these subjects were significantly higher than controls (p < 0.001). The HbA(1c) levels in non-diabetic CVD patients are higher in comparison to controls.

Cefepime versus ceftazidime as empirical therapy for fever in neutropenic patients with haematological malignancies.

An open randomized comparative study was conducted to evaluate the efficacy of Cefepime (2 gm iv. 8 hr.) vs. ceftazidime (2 gm iv. every 8 hr.) in empirical therapy of febrile neutropenic patients. A total of 40 eligible febrile episodes were randomized to be treated with study regimen. Twenty febrile episodes were treated with cefepime and 20 were treated with ceftazidime. The two groups were comparable in terms of age, sex, height, underlying neoplasm, number of pretherapy neutrophils, duration of neutropenia. The overall therapeutic success rate of cetepime group (60%) was comparable to that of ceftazidime group (55%). The results of this study suggest that cefepime is an effective and safe agent in empirical therapy of febrile episode in neutropenic patient and its efficacy is comparable with that of ceftazidime.

Plasma tocopherol levels: a preliminary reference range.

Alpha-tocopherol level was measured spectrofluorometrically in 279 healthy volunteers to establish reliable reference values and to compare possible sex and age-related differences. In the present study, men had higher tocopherol levels than women (p<0.05) and older subjects had lower values. This study provides reference values for alpha-tocopherol that may assist it evaluating the anti-oxidant defense.

Plasma lipoperoxides: a preliminary reference range.

We measured lipoperoxides, as malonaldehyde (MDA) by thiobarbituric acid reaction in serum from 80 male and 120 female volunteers to establish reliable reference values and to compare possible sex- and age- related differences. In the present study women had higher MDA concentration in serum than do men (p<0.05) and older subjects had higher values (p<0.05). These age related results support the suggestions that lipid peroxidation increases with increasing age.

Adenosine-deaminase (ADA) activity in Psoriasis (A Preliminary Study).

Study of adenosine-deaminase activity 'in 23 patients hav-mg psoriasis compared with an equal number of healthy controls revealed significantly high ADA-activity in the psotiatic patients.