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Diagnostic utility of procalcitonin in Early diagnosis of neonatal sepsis in a Tertiary care center: a cross Sectional study

2025-04-24T14:42:31Z

Title: Diagnostic utility of procalcitonin in Early diagnosis of neonatal sepsis in a Tertiary care center: a cross Sectional study Authors: REG NO: BC0121001 Abstract: Background. Neonatal septicaemia is the leading cause of neonatal mortality and morbidity in Developing countries like india. Neonatal sepsis diagnosis is a challenge because of its Nonspecific presentation together with low sensitivity of the time-consuming bacterial Cultures. So, many sepsis markers, like procalcitonin (pct) and high sensitive creactive Protein (hs-crp), are emerging to improve its diagnosis. Objective. •estimation of procalcitonin, hs-crp and blood culture in neonatal sepsis Patients. •correlation of procalcitonin, hs-crp with automated blood culture, Gestational age and mode of delivery

Estimation Of Fructosamine And Glycated Hemoglobin In Newly Diagnosed Subclinical Hypothyroid, Clinical Hypo And Hyperthyroid Patients Without Diabetes Mellitus:A One Year Cross Sectional Study

2021-04-04T09:55:49Z

Title: Estimation Of Fructosamine And Glycated Hemoglobin In Newly Diagnosed Subclinical Hypothyroid, Clinical Hypo And Hyperthyroid Patients Without Diabetes Mellitus:A One Year Cross Sectional Study Authors: Dr.Sangamma Sajjan, BC0115001 Abstract: Thyroid disease is the most common endocrine disorder encountered in clinical practice,it can present as hypo, hyper or subclinical hypothyroidism. Circulating sugars, primarily glucose and fructose when they come in contact with proteins and lipids cause damaging reactions and forming compounds called Advanced Glycation End Products (AGEs).Fructosamine and Glycated Hemoglobin (HbA1c) known AGEs are useful indicators to measure the peripheral metabolic function in patients with thyroid disorder. We have undertaken this study to evaluate and correlate the role of Glycated Hemoglobin and Fructosamine in thyroid disorders. Materials And Methods This one year cross sectional study was done from January 2016 to December 2016 attending medicine (Endocrinology) Outpatient Department of KLE’S Dr Prabhakar Kore Hospital and Medical Research Centre, Belagavi. Newly diagnosed Subclinical hypothyroid,Clinical hypo and hyperthyroid patients were part of the study,along with age matched healthy individuals.The study consists of 110 subjects (80 cases+30 controls) who were included after obtaining informed and written consent.Suspected cases after clinical examination underwent TSH,T3,T4 investigations by Chemiluminescence method .After the confirmation of diagnosis,all the cases were asked to come in fasting state on the day of their choice and the FPG,Glycated Hemoglobin and Fructosamine assays were done.If FPG levels were more than reference interval (70-100 mg/dl) then those were excluded from the study. The study was conducted in four groups.30 participants in control or euthyroid group,20 patients in Subclinical Hypothyroid group,Clinical hypothyroid and hyperthyroid group which consisted of 30 patients each,of either age and sex aged 20-60 years. Results were tabulated and subjected to appropriate statistical analyses. Results: In subclinical hypothyroid group the mean FPG (88.80±2.59),HbA1c (5.32±0.38) and Fructosamine values (485±40.16) were high when compared with the controls by one way ANOVA.Pair wise comparison of FPG (p=0.009),HbA1c (p=0.001) and Fructosamine levels (p=0.001) with controls by Tukeys multiple Post-hoc Bonferroni test showed statistically significant difference. There was a positive significant correlation between FPG and HbA1c (r=0.4704) ,while there was no significant correlation between FPG and Fructosamine (r=0.1317) levels by Karl Pearson’s correlation coefficient method. In clinical hypothyroid group the mean FPG (89.23±4.44), HbA1c (5.44±0.14) and Fructosamine (576.77±37.33) levels were high when compared with the controls by one way ANOVA. Pair wise comparison of FPG ( p=0.001),HbA1c (p=0.001) and Fructosamine levels (p=0.001) with controls by Tukeys multiple Post-hoc Bonferroni test showed statistically significant difference. There was a positive significant correlation between FPG and HbA1c (r=0.466) and FPG and Fructosamine (r=0.421) levels by Karl Pearson’s correlation coefficient method. In clinical hyperthyroid group the mean FPG (93.67±0.92) and HbA1c (5.53±0.24) and low Fructosamine (269.43±7.90) levels when compared with the controls by one way ANOVA. Pair wise comparison of FPG (p=0.001), HbA1c (p=0.001) and Fructosamine levels (p=0.001) with controls by Tukeys multiple Post-hoc Bonferroni test showed statistically significant difference.There was a positive significant correlation between FPG and HbA1c (r=0.406) and negative correlation between FPG and Fructosamine (r=-0.437) ) levels by Karl Pearson’s correlation coefficient method. Interpretation and conclusion: In the present study Subclinical hypothyroid ,Clinical hypothyroid and Clinical hyperthyroid groups had higher levels of FPG when compared with the Controls.HbA1c and Fructosamine levels were higher in Subclinical hypothyroid and Clinical hypothyroid groups when compared with the Controls.However in clinical hyperthyroid group FPG and HbA1c levels were higher while Fructosamine levels were low when compared with the Controls which was statistically significant. The severity, prevalence and pathogenesis of abnormalities of carbohydrate metabolism in thyroid disorders are incompletely defined. To study the effect of thyroid hormones on glucose metabolism in non diabetic patients is an area for extensive research.Glycated Hemoglobin and Fructosamine could be useful indicators to measure the peripheral metabolic functions in patients with thyroid disorder. Hence we suggest HbA1c and Fructosamine could be included in the thyroid work up of the patients.

Estimation Of Ischemia Modified Albumin In Acute Stroke With And Without Diabetes Mellitus: A One Year Cross Sectional Study

2021-04-04T09:54:00Z

Title: Estimation Of Ischemia Modified Albumin In Acute Stroke With And Without Diabetes Mellitus: A One Year Cross Sectional Study Authors: Dr.Jayaraj G Gudi, BC0114001 Abstract: Background and Objectives: Stroke is a leading cause of mortality and morbidity all over the world. Diabetes Mellitus is frequently associated with it. Currently the diagnosis of stroke is mainly based on neuro imaging techniques which are not devoid of limitations. Thus the alternate approach would be using biomarkers to support the clinical diagnosis of acute stroke. Ischemia Modified Albumin is one such marker of ischemia approved by FDA of US. Primary objective of the present study was to estimate and compare the IMA levels in ‘Stroke with DM’, ‘Stroke without DM’ and ‘Healthy Control’ groups. Secondary objective was to assess the diagnostic efficacy of the IMA in both the patient groups. Materials and methods: This one year cross sectional study included 90 subjects of either sex, of which 30 cases of acute stroke with diabetes, 30 cases of acute stroke without diabetes and 30 normal healthy controls after obtaining informed and written consent. Blood sample was collected from stroke patients soon after the clinical diagnosis and included in the study after radiological confirmation of acute stroke. Blood sample from healthy volunteers attending the blood bank was taken as controls. IMA was estimated using Albumin Cobalt Binding test using a spectrophotometer. Results of IMA were expressed in absorbance units (ABSU). Serum albumin was also estimated in all the subjects involved in the study. Results were tabulated and subjected to appropriate statistical analyses. Results: Mean IMA values were high in ‘Stroke with DM’ (0.23± 0.03) and ‘Stroke without DM’ (0.21 ± 0.03) groups when compared with the ‘Controls’ (0.16 ± 0.03). There was a statistically significant difference between the three groups when compared by ANOVA (p <0.001). Comparison of IMA values of three groups with each other by Post-hoc Bonferroni test showed statistically significant difference between ‘Stroke with DM’ and ‘Controls’(p <0.001), ‘Stroke without DM’ and ‘Controls’(p <0.001). However the difference in mean IMA levels between ‘Stroke with DM’ and ‘Stroke without DM’ was not significant statistically (p= 0.116). There was no significant correlation between serum albumin and IMA in all the three groups (p>0.05). In ‘Stroke with DM’ group, area under the ROC curve was 0.968 and at a cut off of 0.196 ABSU, sensitivity was 90% and specificity was 87%. In ‘Stroke without DM’ group, area under the ROC curve was 0.917 and at a cut off of 0.192 ABSU, sensitivity was 87% and specificity was 83%. Interpretation and conclusion: Ischemia Modified Albumin levels were found to be significantly higher in ‘Stroke with DM’ and ‘Stroke without DM’ patients than healthy controls. Though there was no statistically significant difference in IMA levels between the two groups, ‘Stroke with DM’ patients had higher IMA levels than ‘Stroke without DM’ patients. ROC analysis showed higher AUC for IMA in ‘Stroke with DM’ than ‘Stroke without DM’ group. In both the groups IMA was found to be having excellent diagnostic efficacy for the diagnosis of acute stroke. According to the present study there was no significant correlation of serum albumin with IMA levels in both stroke patients and controls. Hence we suggest that estimation of IMA could serve as an aid in the diagnosis of acute stroke in patients both with and without DM. Albumin cobalt binding test can be used for the estimation of IMA, which is a simple and cost-effective method.

Measurement of cholesterol and triglycerides in fresh serum and dried serum after storage at different time intervals

2021-04-04T09:51:36Z

Title: Measurement of cholesterol and triglycerides in fresh serum and dried serum after storage at different time intervals Authors: Dr.Resma Chennashetti, BC0112001 Abstract: Background and Objectives: Non-communicable diseases (NCD) including cardiovascular diseases, diabetes, obesity, cancers, and chronic lung diseases, are growing concerns in developing countries. In a large country such as India, screening for NCD at remote corners of the country is difficult because of limited resources and technical capacity. Measurement in a good quality central laboratory would be ideal, but the cost and safety of chilled sample transportation are concerns. Transportation of samples in the form of dried blood/serum would circumvent the need for blood processing, storage, and shipment at ultralow temperatures. The collection of dried blood/serum spots on filter paper offers a powerful tool in screening programs. Dried serum spot technology offers several advantages over conventional serum assays; as it does not require separation of serum by centrifugation and allows convenient shipment of samples at low cost. Serum spot assays therefore allow a quick and convenient assessment of patients presenting cardiometabolic health risks. . In the present study, the stability of cholesterol and triglycerides in serum dried on filter paper at room temperature for different time intervals is studied. Materials and methods: 100 Samples of Patients coming to the lab for lipid investigations were selected. Blood collected by venipuncture into tubes without anticoagulant was used. Replicates of serum were spotted onto 3M Whatman paper and left at room temp for an hour for drying. Filter discs were transferred to a plastic bag, sealed and stored at room temp for different time periods . Dried blood spots were cut out with scissors and analysed on 7, 14, 21, 28 and 35 days in a Erba semiautoanalyser using commercially available kit. Results Cholesterol values in the 100 samples analyzed ranged from 102 mg/dl to 314 mg/dl.. The mean +/- standard deviation (SD) cholesterol values obtained from fresh serum was 148.33+/-30.68 mg/dl and the mean cholesterol values from corresponding dried serum was 147.86+/-30.67 mg/dl on the same day of drying and subsequently 147.59+/-30.47 (day 7) , 147.3+/-30.52 ( day14) , 146.74+/-30.62 (day 21) , 146.45+/-30.69 (day 28) and 146.41+/-30.66 (day 35). Triglyceride values in the 100 samples ranged from 86 mg/dl to 168 mg/dl. The mean +/- standard deviation (SD) triglyceride values obtained from fresh serum was 113.18 + 18.77 mg/dl and the mean cholesterol values from corresponding dried serum was 112.78 + 18.62 mg/dl on the same day of drying and subsequently 112.52 + 18.63 (day 7) , 112.35 + 18.64 ( day14) , 111.87 + 18.70 (day 21) , 111.63 + 18.72 (day 28) and 111.49 + 18.80 (day 35). A Intra class correlation coefficient of 0.98 for cholesterol and 0.99 for triglycerides was evident between dried serum spots and fresh serum. Bland–Altman plots suggest that the difference in values obtained by the two methods were within the 2 SD limits for most of the samples for Cholesterol and for Triglycerides. Less than 5% of the values were outside the 2 SD limits. Interpretation and conclusion: The comparable values between dried serum spots and serum assays supports the usage of dried blood spot sample collection method as an alternative when conventional venous blood draw facilities are not available or accessible. However, precision and accuracy of the results can be improved by opting standard spotting methods and proper storage. The stability, efficient recovery, and excellent correlation with fresh serum samples makes the dried blood spot assay reliable and convenient method for screening modifiable risk factors of CVD like cholesterol and Triglycerides.