Paraoxonase in Nervous System

The paraoxonase (PON) family consists of—PON1, PON2 and PON3 which are anti-oxidative, any dysfunction in their action, has been suggested to play a role in the pathobiology of diseases having a chronic inflammatory component. PON1 is the most studied which has paraoxonase, arylesterase, thiolactonase, and anti-oxidant actions. Studies have shown the association between lowered PON1 activity and increased incidence of ischemic stroke, dementia, Parkinson disease, multiple sclerosis, and amyotrophic lateral sclerosis. It may occur due to increased oxidative stress and/or prolonged exposure to organophosphates, and reduced capacity of the body to counter these stresses due to reduced PON1 function. PON2 has arylesterase, lactonase, and antioxidant properties. Under-expression of PON2 is associated with Parkinson Disease and Amyotrophic Lateral Sclerosis, and over-expression with tumors with glioblastoma. Various mechanisms have been proposed for the role of PON2 in the pathobiology of the said diseases. PON3 is least studied. The PON family, to some extent, interacts with acetylcholine esterase (AChE), as both share the same locus, and PONs degrade the inhibitors of AChE, especially the organophosphates. This could probably have significant role in the development of Parkinson disease and the prognosis of the treatment of Alzheimer disease by AChE inhibitors

Reference intervals for estimated CBC parameters in cord blood: An Indian Scenario

Accurate reference intervals established in healthy subjects are essential for appropriate interpretation of laboratory test results and to assist clinicians in diagnosis, monitoring, and treatment of disease. These values are affected by key covariates including age, sex, race, geographical location and dietary pattern. Reference intervals are defined as “limiting values within which a specified percentage (usually 95%) of apparently healthy individuals’ results would fall” i.e. usually the 2.5th and 97.5th percentiles of the test result distribution in the reference (healthy) population

Histopathological Spectrum of Appendicular Lesions: A Cross-sectional Study

Introduction: Multiple pathologies, ranging from non neoplastic to neoplastic tumours that may or may not obstruct the lumen, might result in appendicitis. Uncommon neoplastic appendix lesions show diverse morphologies, resembling adenomas to colorectal carcinoma. Identifying these traits is vital to differentiate them from non neoplastic mucinous lesions, as they require varied management approaches, including followup and chemotherapy. Aim: To assess the histopathological patterns in patients undergoing appendicectomy and to study the detailed morphological features of different non neoplastic and neoplastic lesions. Materials and Methods: This cross-sectional study was conducted in western part of Maharashtra for 3 years. It involved surgically removed specimens of appendix received for histopathological evaluation of the appendix from January 2019 to December 2022. A detailed gross examination of the appendicectomy specimens was carried out. Data were analysed using Statistical Package for the Social Sciences (SPSS) software, version 22.0. Categorical data such as sex, clinical presentation, gross presentation of the appendix, and histopathological findings were presented as n (%), whereas quantitative data such as age were presented as mean±SD. A p-value<0.05 was considered statistically significant. Results: A total of 716 patients were included in this study. The median age of the patients was 25.0 years. The majority of the population belonged to the 21-45 years age group, with 406 (56.7%) patients. The number of males were higher 236 (32.9%) than females 170 (23.4%). The number of patients with inflammatory or non neoplastic lesions was higher than those with neoplastic lesions, with 709 (99.02%) and 7 (0.98%) respectively. The highest number of patients had chronic appendicitis (284;39.66%), followed by acute on chronic appendicitis (216;30.16%) and acute appendicitis (188; 26.25%). Conclusion: In cases of appendicitis, histopathological examination of the appendix should be performed as it provides crucial clinical information in addition to operative findings. Hence, it is a benchmark in diagnosing acute appendicitis

Homocysteine, Carotid Intima Media Thickness and NIHSS Score: Clinical Relevance in Indian Stroke Patientspatients

Background: Stroke is one of the leading causes of mortality and morbidity worldwide accounting for 85% of global deaths from stroke. This study aimed to evaluate the role of homocysteine (HCY) in modulating various stroke parameters and its with carotid intima-media thickness (IMT). Methods: 78 patients of radiology-confirmed acute ischemic stroke were recruited for this study and National Institutes of Health Stroke Scale (NIHSS) score was evaluated upon admission. Blood samples were tested for serum HCY, fasting blood glucose (FBG) and lipid profile. Ultrasonography of neck ascertained IMT of Common (CCA) and Internal carotid artery (ICA). Results: Average age of male and female subjects was 57.88 ± 13.97 & 59.16 ± 13.62 years respectively. 71.93% of stroke patients were hyperhomocysteinemic (HHcyc) and 24.36% were hyperlipidemic. Patients with NIHSS ≥ 5 had higher low-density lipoprotein cholesterol (LDLC) than those with NIHSS < 5. HCY cutoff of ≥ 15 μmol/L had 91.7% sensitivity & 66.7% specificity for predicting. HHcyc state was associated with increased ICA IMT. HHcyc state was best predicted by ICA IMT with which it is positively correlated (P-Value = 0.012). Conclusion: HHcyc state holds a good predictive value for severity of stroke. We also came to a conclusion that ICA IMT measurement may also reduce the need for a homocysteine test as it predicts higher HCY levels; this will reduce the burden on resources. We suggest that evaluating HCY and ICA IMT should be made part of the standard protocol for management of stroke