Iron status in chronic kidney disease patients

Background: In developing countries, chronic kidney disease (CKD) associated with anaemia is one of the major public health problems. With the progression of the disease, development of haematological abnormalities including iron deficiency increases. Renal anaemia may further increase the morbidity in these patients. Therefore, earlier detection and correction of anaemia may be helpful in preventing the progression of the diseases and its other adverse outcomes.Methods: The present study was designed to observe the iron status in diagnosed CKD patients (pre-dialysis). For this purpose, 50 adult diagnosed CKD subjects who were not on any haematinics were randomly selected from the Departments of Medicine and Nephrology in a tertiary care hospital in Assam, India. 50 age and sex matched healthy controls were also included.  Haemoglobin concentration, serum iron, TIBC, transferrin saturation (TSAT) and serum creatinine were estimated by standard laboratory techniques. Statistical data were analyzed by using SPSS 21.Results: All the CKD subjects were anaemic with haemoglobin concentration below 11g/dl and 48% of them showed moderate degree of anaemia. Their serum creatinine level were >3mg/dl.  The primary aetiologies of CKD were diabetes (44%) and hypertension (36%). Serum creatinine and total iron binding capacity (TIBC) were significantly (P 3 mg/dl, iron deficiency anaemia may be present.

Perception of first year MBBS students on objective structured practical examination as an assessment tool in biochemistry

Background: It is an undeniable fact that assessment drives learning. It is documented that traditional practical examination has several drawbacks. Further, the subjectivity also affects the correlation negatively between marks awarded by different examiners and therefore on the performance of an equivalent candidate. The objective of objective structured practical examination (OSPE) is to reduce the chances of examiner bias and assess the students’ skills. Aim was to introduce objective structured practical examination (OSPE) as a method of assessment of practical skills in Biochemistry and to determine the perception of students’ regarding OSPE. Methods: It is a qualitative, observational study conducted at Department of Biochemistry, Assam Medical College, Assam, India. The first Professional MBBS students were evaluated by using OSPE to assess their practical perspective in Biochemistry. A pre-validated questionnaire-based on a 5-point Likert scale and descriptive type on various components of the OSPE was administered to get the feedback. Statistical analysis used: Microsoft Excel and GraphPad Prism 8 software were applied. Results: Most of the students favoured OSPE as an assessment tool. About 82% of students agreed that OSPE helps to score better; 62.3% stated that OSPE eliminates bias in exams; 91.6% supported OSPE to be incorporated as a formative assessment. Conclusions: The study favours OSPE as a reliable assessment tool for practical examination in biochemistry. OSPE is more objective and eliminates examiner bias and helps to evaluate all three learning domains - cognitive, psychomotor and affective domains

Association of hyperuricemia and renal involvement in type 2 diabetes mellitus

Background: Hyperuricemia maybe an independent risk factor for renal dysfunction in diabetic patients. On the other hand, albuminuria is considered as an indicator for early stages of diabetic nephropathy. The aim of our study was to find out any association between hyperuricemia and simple renal function tests to detect early renal involvement in type 2 diabetes mellitus for its early treatment and prevention for diabetic nephropathy.Methods: This hospital based cross-sectional study was conducted in 265 patients coming to medicine OPD and IPD in a tertiary care hospital in Assam, India. The subjects included were patients complaining of signs and symptoms of gout with or without Type 2 diabetes mellitus. The subjects were divided into two groups A and B, with and without type 2 diabetes respectively. They were selected randomly under the age group of 20 - 70 years old of both genders. Tests performed were serum uric acid, serum creatinine, blood urea, microalbuminuria, FBS and HbA1c estimated by standard methods.Results: In both diabetic and non-diabetic group, serum uric acid correlated positively and significantly with serum creatinine (>1.3mg/dl), blood urea (>40mg/dl) and microalbuminuria (p0.05) in both the group. In non-diabetics, males were 6.95 times likely to have hyperuricemia than females.Conclusions: Hyperuricemia may be associated with early onset or incipient nephropathy in both diabetes and non- diabetic patient

Iron status in chronic kidney disease patients

Background: In developing countries, chronic kidney disease (CKD) associated with anaemia is one of the major public health problems. With the progression of the disease, development of haematological abnormalities including iron deficiency increases. Renal anaemia may further increase the morbidity in these patients. Therefore, earlier detection and correction of anaemia may be helpful in preventing the progression of the diseases and its other adverse outcomes. Methods: The present study was designed to observe the iron status in diagnosed CKD patients (pre-dialysis). For this purpose, 50 adult diagnosed CKD subjects who were not on any haematinics were randomly selected from the Departments of Medicine and Nephrology in a tertiary care hospital in Assam, India. 50 age and sex matched healthy controls were also included. Haemoglobin concentration, serum iron, TIBC, transferrin saturation (TSAT) and serum creatinine were estimated by standard laboratory techniques. Statistical data were analyzed by using SPSS 21. Results: All the CKD subjects were anaemic with haemoglobin concentration below 11g/dl and 48% of them showed moderate degree of anaemia. Their serum creatinine level were >3mg/dl. The primary aetiologies of CKD were diabetes (44%) and hypertension (36%). Serum creatinine and total iron binding capacity (TIBC) were significantly (P <0.05) raised in CKD patients while serum iron was significantly lower in CKD subjects than in the control group. 26% of them had iron deficiency anaemia (TSAT <20%). Conclusions: Anaemia is one of the commonest and earliest manifestations in CKD patients. With serum creatinine >3 mg/dl, iron deficiency anaemia may be present. [Int J Res Med Sci 2016; 4(8.000): 3229-3234

Serum small extracellular vesicles proteome of tuberculosis patients demonstrated deregulated immune response

Purpose: Detailed understanding of host pathogen interaction in tuberculosis is an important avenue for identifying novel therapeutic targets. Small extracellular vesicles (EVs) like exosomes that are rich in proteins, nucleic acids and lipids, act as messengers and may show altered composition in disease conditions. Experimental design: In this case control study, small EVs are isolated from serum of 58 subjects (all male, 33 (15–70) in years) including drug naïve active tuberculosis (ATB: n = 22), non-tuberculosis (NTB: n = 18), and healthy subjects (n = 18). Serum small EVs proteome analysis is carried out using isobaric tag for relative and absolute quantification (iTRAQ) experiments and an independent sample (n = 36) is used for validation. Results: A set of 132 and 68 proteins are identified in iTRAQ-I (ATB/Healthy) and iTRAQ-II (ATB/NTB) experiments, respectively. Four proteins (KYAT3, SERPINA1, HP, and APOC3) show deregulation (log2-fold change &gt; ±0.48, p &lt; 0.05) in ATB with respect to healthy controls and Western blot data corroborated mass spectrometry findings. Conclusions and clinical relevance: These important proteins, involved in neutrophil degranulation, plasma heme scavenging, kynurenine, and lipid metabolism, show deregulation in ATB patients. Identification of such a protein panel in circulating small EVs besides providing novel insights into their role in tuberculosis may prove to be useful targets to develop host-directed therapeutic intervention