Activities of serum Ada, GGT and alp in carcinoma breast-a case control study for diagnostic and prognostic significance.

AIM: To assess the clinical utility of Serum adenosine deaminase, gamma glutamyl transferase and alkaline phosphatase in carcinoma breast patients for diagnostic and prognostic purpose. MATERIALS AND METHODS: Thirty clinically and histopathologically confirmed female patients of the age group of 30-65 years served as cases and 30 normal healthy females in the same age group served as controls. The parameters were estimated by standard biochemical methods. RESULTS: The activities of serum ADA, GGT and ALP were significantly increased in carcinoma breast patients when compared to controls. When all the 4 stages of carcinoma breast were compared with controls ADA and GGT were increased significantly. Whereas ALP showed a significant increase only in stage II, III and IV. Interstage comparison yielded a steady and progressive increase in the activities of these enzymes from stage I-IV. CONCLUSION: The study concludes that enzyme markers like serum ADA and GGT could be sensitive, specific and cost effective biomarkers for diagnosing carcinoma breast and for monitoring its progression. Serum ALP level can be used as important biomarker for detecting metastasis and for differentiation of carcinoma breast with and without metastasis.

GAP-REACH: a checklist to assess comprehensive reporting of race, ethnicity, and culture in psychiatric publications.

Growing awareness of health and health care disparities highlights the importance of including information about race, ethnicity, and culture (REC) in health research. Reporting of REC factors in research publications, however, is notoriously imprecise and unsystematic. This article describes the development of a checklist to assess the comprehensiveness and the applicability of REC factor reporting in psychiatric research publications. The 16-item GAP-REACH checklist was developed through a rigorous process of expert consensus, empirical content analysis in a sample of publications (N = 1205), and interrater reliability (IRR) assessment (N = 30). The items assess each section in the conventional structure of a health research article. Data from the assessment may be considered on an item-by-item basis or as a total score ranging from 0% to 100%. The final checklist has excellent IRR (κ = 0.91). The GAP-REACH may be used by multiple research stakeholders to assess the scope of REC reporting in a research article.

Relationship between serum lithium, salivary lithium, and urinary lithium in patients on lithium therapy.

Lithium carbonate is used in the treatment of both psychiatric and nonpsychiatric disorders. The aim of this study was to explore the relationship between serum lithium, salivary lithium, and urinary lithium. Blood, saliva, and urine samples were collected from 50 patients, and estimation of serum, salivary, and urine lithium was done using an atomic absorption spectrophotometer. Mean serum lithium was 0.75 ± 0.25 mEq/L, mean salivary lithium was 1.91 ± 0.80 mEq/L, and mean urine lithium was 7.16 ± 4.84 mEq/L. A significant direct correlation was found between serum lithium and salivary lithium (r = 0.695, p < 0.001). This correlation was higher in females (r = 0.770, p < 0.001) when compared to males (r = 0.665, p < 0.001). Even though a significant correlation was found between serum and salivary lithium levels, more studies are needed in this domain to establish salivary therapeutic monitoring as a feasible option for patients on lithium carbonate therapy.

Oxidative stress and enzymatic antioxidant status in rheumatoid arthritis: a case control study.

BACKGROUND AND OBJECTIVES: Rheumatoid arthritis (RA) is a chronic multisystem disease of unknown cause. Formation of reactive oxygen species and lipid peroxides as a result of disease activity may play an important role. Oxidative stress and decreased antioxidant status are the hallmarks in patients of RA as observed in recent years. The objectives of the study was to determine oxidative stress by measuring malondialdehyde and enzymatic antioxidant status by estimating superoxide dismutase and glutathione reductase in patients of RA and then comparing with healthy individuals. MATERIALS AND METHODS: The present study comprises of 40 RA cases who were clinically diagnosed and confirmed by laboratory tests, attending KLE Society's Dr. Prabhakar Kore Hospital and Research Centre, Belgaum. Southern India attached to J. N. Medical College. between September 2007 to August 2008. All the patients were in the age group of 40-60 years including both the sexes. Biochemical parameters like malondialdehyde, enzymatic antioxidants like superoxide dismutase and glutathione reductase were estimated in cases (40) and controls (40). RESULTS: The mean level of blood malondialdehyde (in nmol/ml) in controls was 6.19 +/- 0.96 and 11.48 +/- 0.76 in cases. The mean level of superoxide dismutase (IU/g of Hb) in controls was 948.32 +/- 99.88 and 443.68 +/- 111.69 in the cases. The mean glutathione reductase level (in IU/g of Hb) in controls was 8.91 +/- 1.04 and 2.96 +/- 0.79 in the cases. CONCLUSIONS: This study revealed that there was an increased oxidative stress and a decreased antioxidant defense in patients with rheumatoid arthritis.

Markers of renal function tests.

BACKGROUND: The markers of renal function test assess the normal functioning of kidneys. These markers may be radioactive and non radioactive. They indicate the glomerular filtration rate, concentrating and diluting capacity of kidneys (tubular function). If there is an increase or decrease in the valves of these markers it indicates dysfunction of kidney. AIM: The aim of this review is to compare and analyze the present and newer markers of renal function tests which help in diagnosis of clinical disorders. MATERIAL #ENTITYSTARTX00026; METHODS: An extensive literature survey was done aiming to compare and compile renal function tests makers required in diagnosis of diseases. RESULTS: Creatinine, urea, uric acid and electrolytes are makers for routine analysis whereas several studies have confirmed and consolidated the usefulness of markers such as cystatin C and ß-Trace Protein. CONCLUSION: We conclude that further investigation is necessary to define these biomarkers in terms of usefulness in assessing renal function.

Effect of ferrous sulphate on aspartate and alanine aminotransferases of brain of Tilapia mossambica.

Iron in the form of ferrous sulphate coming from sources such as mines, writing inks, blue pigments, dyeing industries, photography, medicine, deodorizers, disinfectants, fungicides and molluscides, etc. contributes in elevating ferrous sulphate of water bodies. The present study investigated the action of ferrous sulphate on the local fish Tilapia mossambica. Tilapia exposed to 0.001 g/L ferrous sulphate for 30 days showed reduction of cytosolic AST and ALT activities of cerebral cortex by 35.4% and 29.1%, respectively, while exposure to 0.01% ferrous sulphate promoted 49.2% and 38.4% reduction of AST and ALT activities. Similarly mitochondrial AST and ALT activities reduced by 50% and 34.8%, respectively, on exposure to 0.001 g/L ferrous sulphate while 0.01 g/L ferrous sulphate promoted 51% and 47.8% reductions of AST and ALT activities at the end of 30 days, suggesting interference in the glutamate and protein metabolism of Tilapia brain.

A review on laboratory liver function tests.

Laboratory liver tests are broadly defined as tests useful in the evaluation and treatment of patients with hepatic dysfunction. The liver carries out metabolism of carbohydrate, protein and fats. Some of the enzymes and the end products of the metabolic pathway which are very sensitive for the abnormality occurred may be considered as biochemical marker of liver dysfunction. Some of the biochemical markers such as serum bilirubin, alanine amino transferase, aspartate amino transferase, ratio of aminotransferases, alkaline phosphatase, gamma glutamyl transferase, 5' nucleotidase, ceruloplasmin, α-fetoprotein are considered in this article. An isolated or conjugated alteration of biochemical markers of liver damage in patients can challenge the clinicians during the diagnosis of disease related to liver directly or with some other organs. The term "liver chemistry tests" is a frequently used but poorly defined phrase that encompasses the numerous serum chemistries that can be assayed to assess hepatic function and/or injury.

Aspartate aminotransferase and alanine aminotransferase activities of rat brain during crush syndrome.

Crush syndrome develops due to muscle crush injury often found in patients extricated from prolonged compression after disasters. It leads to rhabdomyolysis, kidney failure and hypovolemic shock, followed by decreased blood supply, to tissue under compression and general body parts including brain. In the present study, experimental model of crush syndrome in albino rats was induced by, 2h of compression followed by 48 h of decompression, of femoral muscle tissue. Aspartate and alanine aminotransferase activities of rat brain regions during crush syndrome were investigated. After exposure to 2h compression in comparison to normal/control levels, both cytosolic AST and ALT activities reduced. Cytosolic AST activity reduced by 31.2%, 26.1% and 19.4% in olfactory lobes, cerebral cortex and cerebellum, respectively, whereas cytosolic ALT activity decreased by 51.1%, 52.4%, 47.4% and 36.9% in olfactory lobes, cerebral cortex, cerebellum and medulla oblongata, respectively.

Analysis of headache management in a busy emergency room in the United States.

OBJECTIVES: To analyze the demographics, diagnosis, and treatment patterns in patients with headache-seeking treatment in one of the busiest emergency rooms (ER) of an academic medical center in the USA. BACKGROUND: The past decade has seen tremendous improvement in acute and preventive management of headaches. However, there are very few data on how headache patients are managed by ER doctors. METHODS: Retrospective analysis of 100 charts chosen at random for patients with a discharge diagnosis of headache (according to ICD-9 codes) from the University of Southern California + Los Angeles County Hospital ER. RESULTS: The majority of patients were female (74%) and Hispanic (76%) with an age range of 15-68 years. The most common ER diagnoses were migraine (42%) and headache not otherwise specified (headache NOS - 42%). Fifty-one percent of patients received a head computerized tomography; 9% received a lumbar puncture. Medications most frequently used for acute treatment, whether migraine or headache NOS, were narcotics (25%), followed by antiemetics (24%), nonsteroidal anti-inflammatory drugs (19%), and acetaminophen (17%). Only 5% of migraine patients received migraine-specific triptans in the ER (2% overall). Thirty-one percent of migraineurs were given a prescription for a triptan upon discharge from the ER (17% of all patients). Eighteen percent of patients were admitted to the hospital with secondary headache. The final diagnosis in the ER matched the diagnosis of the neurologist in 79% of cases with a moderate degree of agreement. CONCLUSION: Narcotics remain the medications most often chosen for treatment of all acute headaches (including migraine) in the ER. There is very little use of migraine-specific medications in the ER. In addition, neurology consults are underutilized even in an academic setting in the ER. The data suggest a lack of clear standards of care for diagnosis and treatment of headache, especially migraines. Specific guidelines for headache management should be established keeping in mind the unique setting of the ER.

Taking a patient safety approach to an integration of two hospitals.

BACKGROUND: Consolidation of inpatient care between two acute care medical centers brings many challenges, including an increased risk of an untoward event during patient transfer and impaired hospital performance during the postintegration period. When the Jesse Brown Department of Veterans Affairs (VA) Medical Center in Chicago integrated two acute medical-surgical inpatient facilities, the challenges intrinsic to simultaneously integrating acute medical-surgical programs and academic training programs necessitated a novel approach. STRATEGIES USED: Several patient safety-related tools were used for the safe transfer of patients and for sustaining hospital performance after integration. These tools included Failure Mode and Effects Analysis (FMEA) of the move process, process action teams to bridge the differences in standard nursing unit operation, and an integration score card to monitor and evaluate the impact of the integration on organization performance. RESULTS: Patient care was not disrupted except for a transient reduction in elective surgical procedures during the week before the move. Postintegration data indicated reduced operating room cancellations, sustained inpatient capacity and access, and comparable findings in patient falls and methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci infections. CONCLUSION: The impact of several patient safety tools and interventions was reflected in the fact that performance remained constant or improved for the predefined measures of access and quality.

Residential instability: a perspective on system imbalance.

In an exploration of residential instability and recidivism in chronic mental patients, 215 psychiatric admissions were followed for a year after the initial episode. In addition to an unusually high incidence of residential mobility, a relationship between mobility and number of hospitalizations was evident, as were isolation, disruptive family situations, and homelessness. The needed response of the mental health system is discussed.