Evaluation of Endocrine Parameters as Predictor of Major Depressive Disorder.

BACKGROUND: The diagnosis of the disease, major depressive disorder (MDD), entirely depends on the presence of some symptoms without any biochemical parameter to support it. Depletion of dopamine though is an established feature, is not the sole causative factor of MDD. Moreover, it has very little diagnostic value due to a short half-life. Other chemical messengers like hormones have also been found to get altered due to significant over activity of hypothalamo-pituitary axis. Literature review suggests that cortisol, thyroid-stimulating hormone (TSH), and prolactin (PRL) are mostly altered in MDD, which can be utilized to diagnose the condition. MATERIALS AND METHODS: A total of 101 patients suffering from MDD along with 106 age- and sex-matched controls were included in this study. Cortisol, TSH, and PRL were assayed in all the study participants by enzyme immunoassay. Student's t-test and linear discriminant analysis were used for statistical analysis. RESULTS: All the three hormones were found to be significantly high in cases with MDD. When applied for classification purpose, the errors in training group were found to be 15% and 15.74% from test set. None of the normal population was wrongly diagnosed as a patient of depression. CONCLUSION: To the best of our knowledge, this is the first attempt to evaluate multiple biochemical parameters as diagnostic marker of MDD. The study is in progress to find out a cutoff value of the responsible parameter so that they can be optimally used to diagnose a case of MDD.

Hyperhomocysteinemia, a biochemical tool for differentiating ischemic and nonischemic central retinal vein occlusion during the early acute phase.

PURPOSE: The purpose of the study was to differentiate ischemic central retinal vein occlusion (CRVO) from nonischemic CRVO during the early acute phase using plasma homocysteine as a biochemical marker. METHODS: Fasting plasma homocysteine, serum vitamin B12, and folate levels were measured in 108 consecutive unilateral elderly adult (age >50 years) ischemic CRVO patients in the absence of local and systemic disease and compared with a total of 144 age and sex matched nonischemic CRVO patients and 120 age and sex matched healthy control subjects. RESULTS: Homocysteine level was significantly increased in the patients with ischemic CRVO in comparison with nonischemic CRVO patients (p = 0.009) and also in comparison with control subjects (p < 0.001). Analysis also showed that hyperhomocysteinemia was associated with increased incidence of ischemic CRVO (odds ratio, 18) than that for nonischemic CRVO (odds ratio, 4.5). Serum vitamin B12 and folate levels were significantly lower (p < 0.001) in CRVO patients compared to the control but were not significantly different between nonischemic and ischemic CRVO patients (p > 0.1). CONCLUSIONS: Hyperhomocysteinemia can be regarded as useful in differentiating nonischemic and ischemic CRVO during the early acute phase in absence of local and systemic disease in the elderly adult (age >50 years) population.

Establishment of Trimester-Specific Reference Intervals of Serum TSH & fT4 in a Pregnant Indian Population at North Kolkata.

Reference intervals (RIs) of serum thyroid stimulating hormone (TSH) and free thyroxine (fT4) were determined in 402 healthy pregnant women by enzyme-linked immunosorbent assay (ELISA) technique after partitioning them into three trimesters. The reference population was chosen from a study population of 610 pregnant females by applying strict inclusion and exclusion criteria. The assays were done using proper quality control measures. RIs were calculated from the central 95 % of the distribution of TSH and fT4 values located between the lower reference limit of 2.5 percentile and upper reference limit of 97.5 percentile value 0.90 confidence intervals for the upper and lower reference limits were also determined. The reference intervals for TSH were 0.25-3.35 µIU/ml for the first trimester; 0.78-4.96 µIU/ml for the second trimester and 0.89-4.6 µIU/ml for the third trimester. Similarly, the reference intervals for fT4 for first, second and third trimesters were 0.64-2.0, 0.53-2.12 and 0.64-1.98 ng/dl respectively. The values thus obtained varied from those provided by the kit literature. In comparison to our derived reference intervals, the reference data from kit manufacturer under-diagnosed both subclinical hypo- and hyper-thyroidism within our pregnant reference population.

Assessment of placental oxidative stress in pre-eclampsia.

OBJECTIVE: To study oxidative stress in placental tissue as well as in serum in pre-eclamptic women. METHODS: Fifty pre-eclamptic cases and fifty normal pregnant women were selected in the study. Thio barbituric acid reacting substances (TBARS) was measured as oxidative stress marker and superoxide dismutase (SOD) and GSH (reduced glutathione) were measured for assessment of antioxidant status in placental tissue extract and serum. RESULTS: TBARS and SOD activity were increased significantly (P < 0.001) in both placental homogenate and serum in pre-eclamptic women. Level of GSH was not altered much. CONCLUSION: Placental oxidative stress can be assessed by measuring serum oxidative stress markers and this may help in prevention of further progress of this condition.

Study of oxidative stress in obsessive compulsive disorder in response to treatment with Fluoxetine.

Oxidative stress has been found to play important role in several neuropsychiatric diseases including Obsessive Compulsive Disorder. A longitudinal case control study was conducted to evaluate the oxidative stress in 30 newly diagnosed obsessive compulsive disorder patients and same number of control patients. Serum thiobarbituric acid reacting substances, plasma ascorbate were assessed to evaluate oxidative stress and Yale Brown obsessive compulsive scale for disease severity before and after treatment with Fluoxetine at the average dosage of 40 mg/day. Improvement in Yale Brown obsessive compulsive scale score by about 43% after 12 weeks treatment was associated with significantly decreased thiobarbituric acid reacting substances and increased plasma ascorbate values (p < 0.05). The newly diagnosed obsessive compulsive disorder patients had higher serum thiobarbituric acid reacting substances as well as a lower plasma ascorbate levels than the control population. Thus, the present study suggested a significant role of oxidative stress in obsessive compulsive disorder and showed that a successful treatment with Fluoxetine not only improves the clinical scenario but also reduces the oxidative stress that may further improve the prognosis of the disease.