Association of Lipid Profile and Uric Acid with Pre-eclampsia of Third Trimester in Nullipara Women.

BACKGROUND: Pre-eclampsia (PE) affects approximately 3% of all pregnancies worldwide, with onset of symptoms in the late second or third trimester, commonly after 32(nd) week. It is common in nulliparous women. To avoid complications it is necessary to diagnose it in advance, but the available tools are unable to clinch the diagnosis of preeclampsia effectively in majority. AIM: To find out an association of lipid profile and uric acid with PE in nullipara pregnant women in third trimester. MATERIALS AND METHODS: One hundred nulliparous pregnant women in their third trimester of 18-35 years were divided into; 50 pre-eclamptics of study group and 50 non pre-eclamptic in control group; further subdivided according to age, 18-26 and 27-35 yrs. Diagnosis was confirmed as per the standard criteria. Lipid profile and uric acid levels were estimated by Vitros 250 dry chemistry analyser. Data was analysed statistically by student t-test at p<0.01 level of significance. RESULTS: TC, LDL-c and VLDL-c levels in the study group as a whole and in the patients between 18-26 years were significant; HDL-c levels in the patients between 27-35 years were significant while TG and uric acid levels in all the three study groups were significant. CONCLUSION: Total cholesterol, LDL-c, VLDL-c, triglycerides (TGs) and uric acid levels were raised in preeclampsia and statistically significant; while HDL-c levels were raised in these patients but statistically non-significant, it can be concluded that there exists an association in lipid profile and uric acid with PE therefore dyslipidemia and raised uric acid levels are the features of PE in nullipara pregnant women in their third trimester.

Relationship of Lipid Profile and Serum Ferritin levels with Acute Myocardial Infarction.

INTRODUCTION: National Health and Nutrition Examination Survey (NHANES III), 1988-1994, first time reported a significant, positive association in iron storage and heart disease risk. Thereafter several researchers have found an association between iron overload, serum ferritin (SF) and MI. No such Indian study was available in the literature and so we decided to find out the relation of lipid profile and Serum Ferritin with myocardial infarction (MI). MATERIALS AND METHODS: Fifty indian patients of AMI (study group) and fifty indian healthy volunteers (control group) were included for the present study. Lipid profile including TC, HDL-c, LDL-c, VLDL-c & TG and SF levels were estimated in all subjects. OBSERVATIONS AND RESULTS: Mean ± SD of TC level was 250.64 ± 25.61, of HDL-c was 36.52 ± 2.86, of LDL-c was 165.69 ± 26.80, of VLDL-c was 42.35 ± 8.53 and of TG was 211.83 ± 42.65 in study group while these values were 174.46±47.68, 43.2±12.52, 98.37±41.13, 32.88±21.45 and 164.42±107.29 respectively in control group. All the parameters were found not only raised in patients of acute myocardial infarction (AMI) but were also statistically significant when compared with control group (p=<0.01). Mean ± SD of SF levels was 268.43±30.17 ng/ml in study group and 110.96±56.5 ng/ml in control group; this level was found not only raised in patients of AMI but were also statistically significant when compared with control group (p=<0.01). CONCLUSION: TC, LDL-c, VLDL-c, TG and SF levels were raised in patients of AMI and found to be statistically significant; while HDL-c levels were reduced in such patients and is also statistically significant. It can be concluded that there exists an association in lipid profile and SF with AMI therefore dyslipidemia and raised SF levels are the features of AMI.

Sensitivity, specificity, negative and positive predictive values of adenosine deaminase in patients of tubercular and non-tubercular serosal effusion in India.

BACKGROUND: In India, tuberculosis is an endemic disease. Delay in diagnosis results in poor prognosis and fast spread of the disease. The objective of the present study is to look for an effective and acceptable diagnostic test, which may be helpful to initiate early treatment to improve prognosis and reduce spread. METHODS: Three hundred and thirty patients with pleural, ascitic, meningeal and synovial effusion were selected and divided depending upon the etiology and the involvement of serosal membranes. Serosal aspirated fluid was subjected to biochemical tests and adenosine deaminase estimation. Cutoff taken is above 40 for pleural, peritoneal or synovial fluid and above 10 for CSF. RESULTS: In cases of pulmonary and extra-pulmonary disease, sensitivity was 92.80% and 94.29%; specificity 90.00% and 92.16%; positive predictive value 92.86% and 89.00%; and negative predictive value 90.00% and 95.92% respectively. CONCLUSIONS: Adenosine deaminase estimation is not only a fairly sensitive and specific test (more than 90%), helpful in differentiating tubercular from non-tubercular etiology both in pulmonary and extra-pulmonary disease, but is also simple, inexpensive and rapid. For this reason this test may help in early diagnosis, improve the prognosis and reduce spread of disease and sequlae. KEYWORDS: Adenosine deaminase; Serosal effusion; Tubercular; Non-tubercular; Pulmonary; Extra-pulmonary.

Adenosine Deaminase Levels in CSF of Tuberculous Meningitis Patients.

BACKGROUND: Tuberculosis kills five lakh patients in India every year, out of which 7-12 % are with meningeal involvement. Delay in its diagnosis and in initiation of treatment results in poor prognosis and sequlae in up to 25% of cases. The aim of the present study is to look for a simple, rapid, cost effective, non-invasive and fairly specific test in differentiating tubercular etiology from other causes. METHODS: Forty patients between the age of 6 - 24 months attending hospital with symptoms and signs of meningitis were selected and divided into two groups: tubercular and non-tubercular, depending upon the accepted criteria. CSF was drawn and ADA estimated. RESULTS: Out of 19 tubercular patients, 18 had CSF ADA at or above the cutoff value while one had below. Out of 21 non-tuberculous patients, two had ADA levels at or above the cutoff value while 19 had below this value. Results of our study indicate that ADA level estimation in CSF is not only of considerable value in the diagnosis of TBM, CSF ADA level 10 U/L as a cutoff value exhibited 94.73% sensitivity and 90.47% specificity in differentiating tuberculous from non-tuberculous meningitis; it also has 90.00% positive predictive value and 95.00% negative predictive value. CONCLUSIONS: It can be concluded that ADA estimation in CSF is not only simple, inexpensive and rapid but also fairly specific method for making a diagnosis of tuberculous etiology in TBM, especially when there is a dilemma of differentiating the tuberculous etiology from non-tuberculous ones. For this reason ADA estimation in TBM may find a place as a routine investigation. KEYWORDS: Cerebrospinal fluid; Adenosine deaminase; Tuberculous meningitis.

Role of Adenosine Deaminase Estimation in Differentiation of Tuberculous and Non-tuberculous Exudative Pleural Effusions.

BACKGROUND: Tuberculosis kills five lakh patients every year in India, commonest being pulmonary tuberculosis and is often associated with effusion. Delay in diagnosis and treatment results in poor prognosis. Several studies have suggested the role of adenosine deaminase (ADA) in the diagnosis of tuberculous pleural effusions, but false-positive results from lymphocytic effusions have also been reported. The purpose of this study is to find out the role of ADA levels in differentiation of tuberculous and non-tuberculous exudative pleural effusions of different etiologies. METHODS: Ninety-six lymphocytic pleural fluid samples were consecutively selected and divided into two groups: tuberculous (n = 56) and non-tuberculous (n = 40), depending upon the etiology [Malignancy (n = 16), Infectious diseases (n = 18), Pulmonary embolism (n = 1), Collagen vascular diseases (n = 3) and Sarcoidosis (n = 2)]. ADA was estimated in pleural fluid in all the cases. RESULTS: In all 56 samples, ADA level of tuberculous group was above diagnostic cut-off (40 U/L), while only one sample was above cut-off in non-tuberculous group (2.5%). The negative predictive value of ADA for the diagnosis of non-tuberculous etiology was 97.5% (39 of 40) lymphocytic pleural effusion patients. CONCLUSIONS: In this study, ADA levels in nontuberculous exudative pleural effusions rarely exceeded the cut-off; set for tuberculous disease. The pleural fluid ADA levels were significantly higher in tuberculous exudative pleural effusions when compared with non-tuberculous exudative pleural effusions. KEYWORDS: Adenosine deaminase; Tuberculous effusion; Pleural fluid; Exudative pleural effusions.

Malondialdehyde and Antioxidant Enzymes in Maternal and Cord Blood, and their Correlation in Normotensive and Preeclamptic Women.

BACKGROUND: An increased oxidative level and decreased antioxidant activities in the blood of preeclamptic women have been reported by us and other workers. The present study was aimed to evaluate oxidative stress in infants born to preeclamptic mothers, and to examine whether cord blood with oxygen radical disease had different total enzymatic antioxidant status than those without preeclampsia. METHODS: The present study consisted of 23 normotensive (served as control) and 23 preeclamptic mothers. We compared their oxidative and anti-oxidative system in maternal and cord blood of pair-matched mother and neonate. Their blood malondialdehyde (MDA), antioxidant enzymes were determined and compared to evaluate if pro-oxidative status of preeclampsia differs from the status in cord blood of pair-matched neonate. RESULTS: The MDA content in preeclamptic maternal plasma was significantly high (p < 0.001) compared to that of control. Interestingly, its content in preeclamptic cord blood was significantly low (p < 0.001) compared to their pair-matched maternal blood. Superoxide dismutase (SOD) activity was 8.7% higher in cord as compared to pair-matched normotensive maternal blood which was significant (p = 0.01) whereas in preeclamptic cord the level decreased significantly (p = 0.011) in comparison to pair-matched preeclamptic maternal. Glutathione peroxidase (GPx) was 16.4% higher in normotensive cord compared to maternal blood, and 7% low in preeclamptic cord compared to pair-matched maternal blood. The increase was significant (P = 0.011) in normotensive cord whereas in preeclamptic cord the decrease was insignificant (p = 0.06). Contrary to earlier reports on catalase activity, our results showed 20.97% elevation in normotensive and 16.12% increase in the preeclamptic cord blood compared to their pair-matched maternal blood. This change was significant with p = 0.01 and p = 0.017 in control and preeclamptic group respectively. CONCLUSIONS: Our results showed the significantly low MDA contents in the pair-matched cord blood and the activities of SOD, GPx and Catalase mentioned above, we conclude that the oxidative stress status is low in the blood of neonates born to preeclamptic mothers. Further studies are needed to explore strategies so that the normal levels of antioxidant vitamins are maintained to combat preeclampsia in women at high risk. KEYWORDS: Maternal; Cord blood; Malondialdehyde; Antioxidant enzymes; Glutathione peroxidase; Glutathione reductase; Superoxide dismutase; Catalase.