Evaluation of protein: creatinine ratio on random urine samples in assessment of proteinuria

Background: Significant proteinuria (>300mg/day) may indicate the presence of important renal disease. Quantitative estimation of urinary protein over 24 hours is the gold standard test for detection of proteinuria. However, 24 hours urine collection method is inconvenient and cumbersome to patients. The present study was undertaken to determine diagnostic accuracy of random urine protein: creatinine ratio for the diagnosis of proteinuria among patients with renal diseases.Methods: The prospective study was done in 200 nephropathy cases. The 24 hours urinary protein test used as gold standard test and compared with their random urine sample protein: creatinine ratio (cut off >0.3). The data analyzed for sensitivity, specificity and accuracy of random urine sample protein: creatinine ratio test.Results: Random urine sample protein: creatinine ratio test showed sensitivity, specificity and accuracy of 95.6%, 94.4% and 95.5% respectivelyConclusions: The convenient and accurate protein: creatinine ratio method on random urine samples is reliable method for estimation and screening the proteinuria cases over quantification of proteinuria by collection of 24 hours urine samples and hence, a wider application of this method is recommended

Evaluation of hemoglobin estimation with non-cyanide alkaline haematin D- 575 method

Background: Anemia is serious cause for concern in the world as it impacts on psychological and physical development, behavior and work performance. There are various methods recommended for estimation of hemoglobin for detection of anemia. Each method has its advantages and disadvantages. Aims and objectives of the present study were to compare conventional Hemoglobinocynide (HiCN) method containing potassium ferricyanide and potassium or sodium cyanide with non- cyanide alkaline haematin Method for hemoglobin estimation.Methods: The prospective study was conducted to evaluate the performance of two methods - HiCN method with Drabkin’s reagent and non- cyanide alkaline haematin method with AHD 575 reagent, for hemoglobin determination utilizing 201 blood samples. The data statistically analyzed by using coefficient of variation (CV), linear regression and mean differences.Results: A good correlation was observed for hemoglobin estimation between the HiCN method and non-cyanide alkaline haematin Method with AHD 575 reagent. The correlation coefficient of r= 0.9998 was statistically significant.Conclusions: It was concluded that both methods are accurate and precise, however the toxic and biohazardous effects of potassium ferricyanide and sodium cyanide in HiCN method can be prevented by using alkaline haematin method with AHD 575 reagent

Analysis of cerebrospinal fluid adenosine deaminase levels in meningitis

Background: A precise etiological diagnosis of meningitis is required so that appropriate therapy can be started at the earliest. Due to inconsistent clinical presentations and the lack of a rapid, sensitive and specific test, tuberculous meningitis (TBM) is particularly difficult to diagnose. The present study was done to analyze the utility of adenosine deaminase (ADA) activity in CSF for differentiating TBM from other forms of meningitis.Methods: In our study, ADA activity measured in 26 TBM, 15 pyogenic meningitis (PM) and 10 aseptic/viral meningitis (AM) cases. A cut-off ADA level of 10 IU/L was used for differentiation of TBM cases from other meningitis cases.Results: The mean ADA levels in CSF were highest in TBM patients as compared to PM and AM. The sensitivity, specificity and accuracy of ADA were 96.15%, 92% and 94.11% respectively for detection TBM cases from non-tuberculous meningitis cases.Conclusions: Since ADA test is simple, rapid and inexpensive, it can be used as rapid diagnostic test for differential diagnosis of CSF and confirmation of TBM cases.              

Utility of peripheral blood smear in platelet count estimation

Background: There are several methods of platelet count used in hematology laboratory. These methods are manual counting, automated hematology analyzer counting, platelet count estimation by peripheral blood smear (PBS) method etc. Many diseases such as dengue, malaria, pregnancy induced hypertension etc. may leads to severe thrombocytopenia. Timely and precise diagnosis of platelet count plays very crucial role in critical care management of thrombocytopenia cases. The present study was undertaken to estimate platelet counts by PBS method and correlate them with results from automated hematology analyzer method.Methods: Study included one hundred randomly collected blood samples in EDTA anticoagulant vacutainer tubes. Each blood sample was processed for platelet count estimation with automated hematology analyzer and Leishman’s stained PBS examination. The statistical analysis was done by using Pearson's correlation test to access the agreement between both the methods.Results: The Pearson's correlation test showed significant positive correlation for platelet count estimation between both the methods. (r =0.9789).Conclusions: Platelet count estimation by PBS method is reliable and statistically significant when compared to hematology analyzer method. PBS platelet estimation method can be taken as early and rapid procedure for platelet assessment in critical severe thrombocytopenia cases. This method is simple, cheaper and can be done in rural hospital setup where automation is not available

Comparative utility of biochemical markers for differentialdiagnosis of ascites

Background: Ascites is pathological accumulation of free fluid in the peritoneal cavity. Appropriate management for ascites depends upon diagnosis of its etiology. Based on total protein concentration of ascitic fluid, earlier ascites was classified as transudate and exudate. The present study was designed to compare the utility of total protein, lactate dehydrogenase (LDH) and serum ascites albumin gradient (SAAG) to categorise ascitic fluids as either exudate or transudate.Methods: This prospective study comprised of 110 adult patients with ascites whose diagnosis was established by clinical examination and appropriate investigations. Biochemical analysis of ascitic fluid and serum was done with protein, albumin and LDH. The usefulness of each biochemical parameters was statistically evaluated in terms of sensitivity, specificity, accuracy, PPV and NPV.Results: In this endeavour, the SAAG and fluid LDH did showed a clear advantage over the fluid protein which is traditional existing biochemical parameter for differential diagnosis of ascitic fluid into transudate and exudate.Conclusions: The SAAG had more discriminatory power than fluid protein parameter and hence should replace fluid protein test in diagnostic separation of ascites into transudate and exudate.

Evaluation of micro-ESR method with Westergren method for determination of erythrocyte sedimentation rate

Background: Erythrocyte sedimentation rate (ESR) test provides valuable information in screening, diagnosis, as well as monitoring disease activity and therapeutic response in numerous health conditions. The most commonly used method for determination of ESR is Westergren method, which is time-consuming and requires a large amount of blood sample. There are several other methods, like Micro-ESR method which overcome the limitations of conventional Westergren method, hence the present study was performed to compare results of Westergren method with Micro-ESR method for determination of ESR.Methods: In the present study, blood samples from 100 patients were processed for ESR determination by Westergren method and Micro-ESR method. The results obtained were compared using Pearson’s correlation test.Results: The Westergren method was the reference method and the Micro-ESR method was testing method. The comparison was done between Micro- ESR method results (X-axis) and results of Westergren method (Y-axis). The slope of the regression line using linear regression was 1.010 with a y-intercept of -0.788. Statistical analysis demonstrated significant correlation of results of Micro-ESR method with Westergren method (r = 0.9977).Conclusions: Micro-ESR is a reliable and precise method for ESR measurement. The Micro- ESR method is simple to perform and requires very small volume of blood (0.2ml) as compared to conventional Westergren method. It can be potential useful tool in performing ESR determination especially for the patients with limitation of blood availability as pediatric patients and very old patients.

Utility of urinary gram stain as a diagnostic method for urinary tract infection

Background: Urinary tract infection (UTI) is one of the most common infections in humans. Timely diagnosis and treatment are necessary to reduce the complications from UTI. Urine culture is still the gold standard diagnostic test for UTI, however it is costly and time consuming. The present study was conducted to compare the utility of urinary gram stain, microscopy of centrifuged urine sample and urine culture for the diagnosis of UTI.Methods: 100 urine samples were processed for gram stain, culture and microscopy. Urinary gram stain findings were correlated with microscopy and culture results. Using urine culture as gold standard, the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of urinary gram stain were assessed for the diagnosis of UTI.Results: The accuracy of urinary gram stain for detection of UTI was 97%.Conclusions: Urinary gram stain is a reliable diagnostic test for early detection of UTI

Sacrospinous ligament fixation for prevention and treatment of vaginal vault prolapse: a retrospective study of 45 cases

Background: To assess intraoperative and postoperative complications and to evaluate recurrence of vault prolapse in women who have undergone unilateral (left) Sacrospinous ligament fixation.Methods: Between January 2007 and January 2015, 45 women (mean age 56.5 years, range 35 to 78 years) underwent vaginal unilateral (left) Sacrospinous ligament fixation at Shree Dharmasthala Manjunatheshwara (SDM) College of Medical Sciences, Dharwad, India. 15 patients had prior hysterectomy. Concomitant hysterectomy and Sacrospinous ligament fixation was performed in 30 patients. Sacrospinous ligament fixation was combined with additional procedures like Trans-Obturator tape (TOT) insertion in 2 (4.6%) patients.Results: All patients were analyzed for intraoperative and postoperative complications. 1 patient had Urinary tract infection (n=1, 2.2%), 1 patient had haemorrhage requiring blood transfusion (n=1, 2.2%). The mean follow up was for 15 months (range 6 months to 24 months). 1 patient (2.2%) had asymptomatic recurrent cystocele and 1 patient (2.2%) had dyspareunia. No recurrence of vault prolapse was noted.Conclusions: Sacrospinous ligament fixation is a simple, effective and safe procedure for treatment and prevention of vault prolapse with least complications and recurrence rates.

A comparative study of platelet profile in gestational diabetes mellitus versus healthy pregnancies: A cross sectional study

BACKGROUND: Gestational diabetes mellitus is defined as any degree of glucose intolerance with its onset or first recognition during pregnancy. Early diagnosis of this complication and appropriate treatment aimed at tight control over maternal glucose levels may positively influence the perinatal outcome. There are studies, which suggest platelets play a role in the pathogenesis of gestational diabetes mellitus. Altered platelet morphology and function (higher MPV) have been reported in patients with diabetes mellitus. These changes may be associated with increased risk of vascular disease and venous thromboembolism. Although normal pregnancy may result in the activation of primary hemostasis and coagulation, these issues have not been widely investigated in gestational diabetes. AIM AND OBJECTIVE: The present study was designed to compare and assess the demographic and laboratory findings in healthy pregnant women and Gestational diabetes mellitus patients. The aim of this study is to compare the various blood parameters especially platelet indices in gestational diabetes and normal pregnant women and to investigate whether there is a statistically significant difference in these parameters between gestational diabetes mellitus patients and in patients with healthy pregnancies .The objective of this study is to highlight the value of inflammatory markers in predicting gestational diabetes mellitus (GDM). This study also evaluates the relationship between blood glucose levels and mean platelet volume. Correlation of blood glucose against Various parameters like HBA1C, Platelet count, mean platelet volume ,Platelet distribution width are also studied and results analysed. MATERIALS AND METHODS: A cross sectional study was performed on 200 pregnant women in their second/third trimester.: 100 cases with newly diagnosed gestational diabetes and 100 euglycemic healthy controls. GDM was diagnosed using the one step 2 hr OGTT values. The two groups were compared in terms of demographic and platelet parameters derived from complete blood counts using the automated CBC coulter machine. STATISTICAL ANALYSIS: Data was collected and Statistical analysis was performed using student t test, Mann Whitney test and pearson corelation RESULTS: The mean platelet volume in control group and GDM group was 7.77+-0.52 fl and 11.13 +-0.48 fl respectively. The MPV was significantly higher in GDM group when compared to healthy pregnancies. (P<0.001).HBA1C and BMI values were also significantly higher in GDM group. Though the platelet count in GDM was higher the difference was not significant (p=0.435). Platelet distribution width values were similar in both groups. The mean platelet volume was linearly correlated with glucose values (correlation coefficient -0.923). CONCLUSION: Platelet volume is a marker of platelet activation and function and is measured using the MPV. Measurement of the MPV and other platelet-related parameters is a simple procedure, available in most hospital laboratories. Platelet-related indices and their determination are inexpensive and routinely ordered markers, the significance of which is often ignored. They may be useful in screening for gestational diabetes as an adjunct to oral glucose tolerance test. These parameters can also be used as an adjunct to monitor the disease after starting treatment since alterations in MPV occur much before changes in blood glucose .The role of changes in these parameters in the hemostatic system during diabetic pregnancy and the possible clinical relevance concerning the risk for thrombosis calls for further studies

Ashoka [Saraca Asoca (Roxb.) Willd.] : A Salubrious Plant

Over the centuries, plants have been known to be a potential source of therapeutics. A comprehensive review of medicinal plants and its diversified action in mitigating the diseases is essential to be documented for serving mankind. Saraca asoca (Roxb.) willd. Belonging to the family Caesalpinioideae is a rain-forest tree, prized for its beautiful foliage and fragrant flowers. It’s found wild along streams and in the shades of evergreen forests. All most all parts of the plant are considered as pharmacologically important especially bark and flower. Bark is generally adulterated part of the plant with the bark of other plants like Polyalthia longifolia, Bauhinia variegata and Shorea robusta. It mainly contains tannin and catechin in substantial amount and widely used as uterine tonic, Antimenorrhagia, Analgesic, Anti-pyretic, Anthelmintic, Dermatoprotective and anti-diabetic. The current article highlights about review of Ashoka and its microscopical features