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.

Pottels Equation for Estimation of Glomerular Filtration Rate.

The retrospective study was carried out to examine performance of Pottels height- independent equation compared to Schwartzs height-dependent equation to estimate glomerular filtration rate in 115 children in Indian setting. The Pottels equation performed well compared to updated Schwartz equation (R2=0.94, mean bias 0.25, 95% LOA=20.4, -19.9). The precision was better at lower range of estimated GFR.

A Study to Assess the Validity of Estimation of Serum Ostase Level in Hyperthyroid and Hypothyroid Cases.

INTRODUCTION: One of the more specific assessments of the metabolic status of bone in normal and in disease conditions is the measurement of bone specific alkaline phosphatase or ostase. The measurement of serum ostase has several advantages over the measurements of other bone parameter. Because of its relatively long half-life, in-vivo (1 to 3days), it is relatively unaffected by diurnal variation. AIM: To find the correlation of serum ostase level in hyper and hypothyroid cases and also to study the validity of routine estimation of serum ostase in hyper and hypothyroid cases so as to monitor the base level bone health on presentation. MATERIALS AND METHODS: Serum ostase level was studied in 74 patients with disorder of thyroid function. Serum ostase level, Thyroid Stimulating Hormone (TSH), FT3, FT4 levels were estimated by chemiluminescent technique. The instrument used was Beckman- coulter Access 2. A total of 39 patients were hypothyroid, 31 were hyperthyroid and 4 patients had subclinical hyperthyroidism. RESULTS: The serum ostase level was found to be elevated above 40 µg/L in 26 of the cases and above 16 µg/L but below 40µg/L in 5 cases of hyperthyroidism along with decrease in Bone Mineral Density (BMD). Serum ostase level was found to be directly proportional to the serum FT3 level (Normal range of serum ostase is 8-16 µg/L). CONCLUSION: From this study, an inference can be drawn that a routine estimation of serum ostase level in hyperthyroid cases will help in proper monitoring of decrease bone turnover as indicated by increase serum ostase level. Besides, the estimation of serum ostase level in hyperthyroid cases it is found to be valid in this study, which can turn to be an important guiding parameter to the treating physician to formulate necessary protocols and guidelines for prophylaxis, treatment and to monitor the response to therapy in cases of reduced bone turnover related to hyperthyroid state.

Presence of Concurrent Derangements of Liver Function Tests in Type 2 Diabetes and Their Relationship with Glycemic Status: A Retrospective Observational Study from Meghalaya.

BACKGROUND AND OBJECTIVES: The liver plays a pivotal role in carbohydrate metabolism. Therefore, functional state of the liver in patients with diabetes is of interest. The objectives of the current study were to (i) identify co-existent biochemical derangements of liver function tests (LFTs) in type 2 diabetes and (ii) determine the association between liver function parameters and glycemic status in type 2 diabetics from Shillong, Meghalaya. MATERIALS AND METHODS: Data from 320 type 2 diabetes patients were screened retrospectively for abnormalities in LFTs. Relationship of fasting serum glucose was assessed with the following tests in the LFT panel: Total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and albumin. Correlation coefficient was computed between individual LFT and fasting glucose status. These bivariate analyses were supplemented by multivariate linear regression analyses. RESULTS: 71.25% subjects had an abnormality in at least one LFT. Elevated ALT (46.8%) and elevated ALP (48.5%) were the most common abnormality in males and females, respectively. ALP correlated positively with fasting glucose in both sexes. AST, ALT, and ALP were found to be independent determinants of glycemic status. CONCLUSION: Derangements in liver function are widely co-existent in type 2 diabetics from Shillong. Deranged liver enzymes are associated with glycemic status. Screening for liver dysfunction in diabetics and subsequent workup may lead to the identification of hepatic co-morbidities and better management.

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.