Biomarkers in Clinical Medicine: Perspective from a Clinical Biochemistry Laboratory

Biomarkers have been used in clinical medicine for decades. With the rise of genomics and other advances in molecular biology, biomarkersstudies have entered a whole new era and hold promise for early diagnosis and effective treatment of many diseases. A biomarker is acharacteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes or pharmacologicresponses to therapeutic intervention. There is increasing pressure to provide cost -effective healthcare based on "best practice." Consequently,new biomarkers are only likely to be introduced into routine clinical biochemistry departments if they are supported by a strong evidence baseand if the results will improve patient management and outcome. This requires convincing evidence of the benefits of introducing the new test,ideally reflected in fewer hospital admissions, fewer additional investigations and/or fewer clinic visits. Carefully designed audit and cost-benefitstudies in relevant patient groups must demonstrate that introducing the biomarker delivers an improved and more effective clinical pathway.From the laboratory perspective, preanalytical requirements must be thoroughly investigated at an early stage. Good stability of the biomarker inrelevant physiological matrices is essential to avoid the need for special processing. This article will focus on how these biomarkers have beenused in preventive medicine-diagnosis therapeutics and prognostics as well as public health and their current status in d practice. This article alsodescribes the major uses of biomarkers in clinical investigation. Careful assessment of the validity of biomarkers is required with respect to thestage of disease. Causes of variability in the measurement of biomarkers range from the individual laboratory. Issues that affect the analysis ofbiomarkers are discussed along recommendations on how to deal with bias and confounding

A Study of Students' Attitudes towards the Use of Different Types of Audio- Visual Techniques for Biochemistry

ABSTRACT Lecture has been the most common form of teaching and learning process. Lectures delivered by using mixture of audio visual techniques are appreciated by students. The purpose of this study was to assess the student's preference regarding the use of different type's audio visual techniques for Biochemistry. Total 200 undergraduate medical students were participated in our questionnaire based study. Out of 200 students 115 (57.5%) are male and 85(42.5%) are female. In our study we found, 60 % of students preferred power point in combination with black board teaching and only 20% students' preferred power point presentation. The 15% of students favored the traditional black board teachings than projector or power point class. A very few (5 %) of students opted for the over head projector. In conclusion of our study we observed that the undergraduate medical students preferred a combination of power-point presentation along with blackboard teaching for biochemistry. It helps in both the visual and auditory senses to absorb information

Study of Lipid Profile during Late Reproductive Phase, Perimenopause and Postmenopause in North Indian Women

Background: Perimenopause or menopausal transition is the phase which preceeds menopause and is characterized with fluctuation in estrogen levels. Several studies have been done to investigate the changes in lipid profile in premenopausal and postmenopausal women. Studies regarding the changes in lipid profile during perimenopause is scanty. This study was done to study the lipid profile in reproductive or premenopausal, perimenopausal and postmenopausal women. Materials and method: A case control study was done on 60 late reproductive phase, 60 perimenopausal and 60 postmenopausal women. Total cholesterol (TC), serum triglyceride and High Density Lipoprotein – Cholesterol (HDL-C) were determined with a fasting venous blood sample. Low Density Lipoprotein – Cholesterol (LDL-C) was calculated by Friedwald’s formula. TC/HDL cholesterol ratio and LDL/HDL cholesterol ratio were calculated and compared. Data was analyzed using Statistical Package for Social Sciences (SPSS) 17.0 version (SPSS Inc., Chicago, IL, USA). Results: Statistically significant increase in the total cholesterol, serum triglyceride and HDL-C levels and LDL/HDL cholesterol ratio in the perimenopausal was observed when compared with women in late reproductive age group. LDL- C and the TC/HDL-C ratio although increased was statistically not significant. Postmenopausal women showed statistically significant increase in TC, serum TG, LDL-C, TC/HDL-C ratio and LDL/HDL-C ratio. Conclusion: Adverse changes seen in the lipid profile during postmenopause begins during the perimenopause. As the perimenopause phase is a period of varied length, it is the optimal time for lifestyle style modification and preventive intervention in order to prevent cardiovascular risk in future

Association of Serum Adiponectin Level with Dyslipidaemia in North Indian Male Population: A Case-control Study

Introduction: Adiponectin is the most abundant adipocytokines secreted from adipose tissues and circulates in considerably high concentration in human plasma. Circulating adiponectin levels are decreased in obese subjects and this decrease has been thought to play a crucial role in the early development of atherosclerosis and cardiovascular diseases. Changes in adiponectin concentration has been reported in dyslipidaemic subjects, but the evidence is controversial and no study has been conducted in north Indian population. Moreover, low molecular adiponectin seems to be linked with a worse lipid profile leading to dyslipidaemic through an association with triglyceride but the exact role of adiponectin in modulating lipid fraction is not well established. Aim: To correlate the level of serum adiponectin with lipid fractions in dyslipidaemic male subjects and also to compare them with apparently healthy individuals. Materials and Methods: This case-control study was conducted from April 2015 to November 2016 in the Biochemistry Department of Rajshree Medical Research Institute, Bareilly, Uttar Pradesh, India. A total of 70 non diabetic dyslipidaemic male subjects between the age group 35 years to 55 years were selected and all the biochemical parameters (adiponectin, fasting plasma glucose, lipid profile) were evaluated and compared with 70 apparently healthy controls. Statistical analysis was performed by licensed version of Statistical Package for Social Sciences (SPSS) 16.0 software. All the data were expressed in “mean±SD”. Student ‘t’ test was also applied to see statistical significance in adiponectin levels between dyslipidaemic subjects and healthy controls. Results: The study shows mean±SD of age in dyslipidaemic group was 43.61±4.85 years and for control group was 43.53±5.53 years. The mean±SD of BMI in dyslipidaemic group 25.72±2.43 was significantly higher than control group 23.42±1.56 with p-value <0.0001. The serum adiponectin concentration was significantly reduced in dyslipidaemic subjects 5.11±2.04 μg/mL as compared to healthy control 6.79±1.37 μg/mL with p-value <0.0001. Serum total cholesterol, triglyceride and Low Density Lipoprotein (LDL)- cholesterol were found to be negatively correlated with serum adiponectin (r= -0.89, -0.76 and -0.74) and positively correlated with High Density Lipoprotein (HDL)-cholesterol (r=0.70). Conclusion: The present study revealed that hypoadiponectinemia is associated with dyslipidaemic in men. The main observation of our present study, however, is that in dyslipidaemic subjects, lower levels of adiponectin were associated with high total cholesterol, triglyceride, LDL-cholesterol and reduced HDL cholesterol, though more extensive, multicentric, prospective research with increase sample size could obtain wider insights