Monitoring of bone fractured healing using biochemical markers among patients attending federal teaching hospital abakaliki and bone setter home in onueke ebonyi state, Nigeria

The monitoring of bone fractured healing using Alkaline phosphatase, calcium ion and inorganic phosphate was evaluated among patients with fractured bone in two different centers, Alex Ekwueme Federal University Teaching Hospital Abakaliki and Bone Setters Home, Onueke, Ezza in Ebonyi State between August 2017 and September 2018. : A total of 90 adults patients from 18 years to 78 years were examined using phenolphthalein monophosphate colorimetric end point method. Out of the 90 patients, 30 were healthy normal subjects, another 30 were patients in AE-FUTHA while the remaining 30 patients were in bone setter home. : Patients without bone fracture had the least mean serum level of alkaline phosphatase, 28.5 ± 9.0µl followed by those admitted in bone setter home with a mean serum level of 38.2±17.9µl while patients admitted in AE-FUTHA had the highest mean serum level of 41.4±6.5µl (P<0.05). The mean serum level of calcium was significantly higher 10.9± 2.6mg/dl in healthy normal patients compared to mean serum level of 9.2 ± 3.3mg/dl and 7.4 ± 1.3mg/dl for patients admitted in AE-FUTHA and bone setter home respectively. The mean serum level of inorganic phosphate indicate that patients admitted in bone setter home had the highest mean of 4.1 ± 1.0mg/dl followed by patients admitted in AE-FUTHA 3.4 ± 0.2mg/dl while that of healthy normal individuals had the least mean serum level of 3.2 ± 0.5mg/dl. : Out of the three parameters examined, alkaline phosphatase test was more precise, reliable and patient doctor friendly; hence it can be used as a veritable tool to monitor the process of bone fracture healing effectively.

Assessment of Plasma Vitronectin as Diagnostic and Prognostic Marker of Hepatocellular Carcinoma in Patients with Hepatitis C Virus Cirrhosis

Background: hepatitis C is an inflammatory liver disease caused by the hepatitis C infection (HCV), and without treatment, almost 50% will progress to liver cirrhosis. Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer and the fourth leading cause of cancer-related mortality. Aim of the study: the objective of this study was to evaluate the serum level of vitronectin (VTN) compared to AFP and determine their role as diagnostic and prognostic markers of HCV-related liver diseases. Subject and Methods: this study involved 52 HCV patients from which 26 patients were cirrhotic, and 26 patients had HCC (on top of hepatitis C virus-related cirrhosis) plus 10 healthy people as a control group. It was carried out in Gastroenterology and Hepatology Unit, Internal Medicine Department, Zagazig University Hospitals, Egypt. All individuals in this study were subjected to physical examination, full history taking, liver function tests, assessment of serum levels of Vitronectin (VTN) and alpha-fetoprotein (AFP) before and after the intervention within three months. Results: serum level of vitronectin increased significantly in cirrhosis patients and HCC patients than controls (p = 0.0041), (p < 0.001), respectively, and in HCC than cirrhosis patients (p < 0.001). Significant positive correlations were observed between levels of serum VTN and AFP in all HCV patients as well as cirrhotic patients (p < 0.001, p = 0.011, respectively). On the contrary, VTN and AFP didn’t show a significant correlation in HCC patients’ group. Moreover, the median serum level of VTN decreased significantly after treatment in patients with HCC (p < 0.001). At cut-off 38.5 ng/mL for AFP it shows sensitivity 80.8%, specificity 76.9% to differentiate HCC from cirrhosis cases. While VTN shows 84.6% sensitivity, 96.2% specificity at cut-off 26.5 μg/mL. Regarding clinicopathological characteristics and VTN levels, half of patients were stage B, 63.9% had tumor size >3 cm, 84.6% had more than one focal lesion. Conclusions: these results may allow one to speculate a potential role of Vitronectin in diagnosis and prognosis of HCC on top of cirrhosis related to HCV infection in addition to AFP and US and CT.

A comparative study: rural versus urban children as regard exposure to organophosphorus pesticides using cholinesterase enzyme activity

Background The uncontrolled long-term exposure to organophosphorus (OP) pesticides is hazardous to health especially in children. The present study aimed to determine the acetyl cholinesterase enzyme serum level in exposure and non-exposure children groups, to explore other clinical and laboratory outcomes of organophosphorus pesticides exposure on children living in rural versus urban areas, and to establish the hemotoxic alterations as a result of the exposure. A ninety clinically free children—forty-five from rural areas and forty-five children from urban areas—were assessed, and the clinical and laboratory effects of their exposure to organophosphorus pesticides were evaluated via measuring acetyl cholinesterase (AChE) enzyme activity. Results Significant differences between the two areas of residence were found in weight %, visits to the field, eating vegetables without washing, presence of insecticides at home, and previous organophosphorus pesticides toxicity of the patients and their families. Eye, respiratory, cardiac, nervous, muscle, gastrointestinal, and urinary symptoms were more common in the rural residence group which shows more exposure to pesticides. The mean level of the AChE enzyme was less in the rural residence group than the other one, and it showed significant correlations with the anemia indicating parameters. A weak positive correlation was found with platelets count. Conclusions Chronic organophosphorus toxicity that is more prevalent in rural areas may result in many transient neglected symptoms, unrevealed acetyl cholinesterase (AChE) enzyme deficiency, anemia, and thrombocytopenia. Acetyl cholinesterase enzyme serum level can be used as a screening test for organophosphorus pesticides exposure.

Low Serum Iron Status Is Associated With Low Incidence of Coronary Artery Disease In Women

Background: Disorders of iron metabolism has been implicated in cardiovascular disease. However, the association of serum ferritin and coronary artery disease (CAD) remains inconsistent. Here, we investigated the associations of serum iron metabolism with the incidence of CAD, the severity of coronary artery stenosis, metabolic biomarkers, and 1-year restenosis after coronary artery revascularization. Methods: A total of 643 CAD patients and 643 healthy controls were enrolled to assess the associations of serum iron status with the presence of CAD, the severity of CAD, and 1-year rehospitalization after revasculation. Serum iron metabolism and other metabolic markers were measured in all subjects. All statistical analyses were analyzed using SPSS22.0 software and STATA statistical package.Results: Serum level of iron metabolism markers, including serum iron, ferritin, unsaturated transferrin iron binding capacity (UIBC), Total iron binding capacity (TIBC) levels, in CAD groups was significantly higher than the control group (P<0.001). UIBC and TIBC were negatively correlated with ferritin in both sexes. Serum level of iron (OR=0.806, 95% CI (0.687-0.944), UIBC (OR=0.919, 95% CI (0.852-0.992), and TIBC (OR=0.864, 95% CI (0.787-0.95) were found to have a protective role for CAD in women (P<0.05, Table 3). The OR for ferritin was significant in the both sexes (OR=1.029, 95% CI (1.002-1.058) in men, OR=1.02, 95% CI (1.005-1.034) in women, P<0.05). Conclusion: Low Serum level of iron, UIBC, TIBC and ferritin levels were found to have a protective role for CAD in women, but not in men. Elevated serum ferritin is independently and positively associated with CAD in men and women.

Elevated Levels of IL-33, IL-17 and IL-25 Indicate the Progression from Chronicity to Hepatocellular Carcinoma in Hepatitis C Virus Patients

Hepatitis C virus (HCV) is one of the most epidemic viral infections in the world. Three-quarters of individuals infected with HCV become chronic. As a consequence of persistent inflammation, a considerable percentage of chronic patients progress to liver fibrosis, cirrhosis, and finally hepatocellular carcinoma. Cytokines, which are particularly produced from T-helper cells, play a crucial role in immune protection against HCV and the progression of the disease as well. In this study, the role of interleukins IL-33, IL-17, and IL-25 in HCV patients and progression of disease from chronicity to hepatocellular carcinoma will be characterized in order to use them as biomarkers of disease progression. The serum levels of the tested interleukins were measured in patients suffering from chronic hepatitis C (CHC), hepatocellular carcinoma (HCC), and healthy controls (C), and their levels were correlated to the degree of liver fibrosis, liver fibrosis markers and viral load. In contrast to the IL-25 serum level, which increased in patients suffering from HCC only, the serum levels of both IL-33 and IL-17 increased significantly in those patients suffering from CHC and HCC. In addition, IL-33 serum level was found to increase by liver fibrosis progression and viral load, in contrast to both IL-17 and IL-25. Current results indicate a significant role of IL-33 in liver inflammation and fibrosis progress in CHC, whereas IL-17 and IL-25 may be used as biomarkers for the development of hepatocellular carcinoma.

Đánh giá nồng độ lactate và procalcitonin ở bệnh nhân Covid-19

TÓM TẮT Đặt vấn đề: Bệnh COVID-19 đa dạng từ không có triệu chứng đến có các triệu chứng nhẹ cho đến viêm phổi nặng, hội chứng suy hô hấp cấp tiến triển (ARDS), nhiễm khuẩn huyết suy đa tạng và tử vong. Người cao tuổi, người có bệnh mạn tính sẽ có nguy cơ diễn biến nặng nhiều hơn. Nghiên cứu này nhằm xác định nồng độ lactate và PCT ở những bệnh nhân Covid-19 và xét mối liên quan giữa lactate và PCT trên bệnh nhân Covid-19. Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang trên 126 bệnh nhân được chẩn đoán nhiễm Sars-Cov-2 bằng xét nghiệm RT PCR. Kết quả: Tuổi trung bình 55,98 ± 17,1 tuổi (4 - 98 tuổi). Bệnh nhân > 60 tuổi chiếm tỉ lệ cao nhất (42,8%). Trung vị PCT: 3,6 (95%CI:3,21 - 3,75) ng/ml; trung vị lactate 1,5 (95%CI:1,21 - 1,91) mmol/L; lactate có tương quan thuận và yếu với procalcitonin với r = 0,241; p < 0,001. Nồng độ procalcitonin > 0,1 ng/ml; lactate > 2 mmol/l ở bệnh nhân Covid-19 chiếm tỷ lệ cao với 89,7% và 39,7%. Kết luận: Chỉ điểm procalcitonin, lactate tăng cao ở bệnh nhân Covid-19. ABSTRACT ASSESSMENT OF SERUM LEVEL OF LACTATE AND PROCALCITONIN IN COVID-19 PATIENTS Background: Sars-CoV-2 has been identified as the cause of acute respiratory infections in Wuhan city, Hubei province, China, and has since spread worldwide. Sars-CoV-2 is capable of aerosol transmission in enclosed, crowded, and poorly ventilated spaces. COVID-19 illness ranges from asymptomatic to mild symptoms to severe pneumonia, acute respiratory distress syndrome (ARDS), sepsis, multiple organ failure, and death. This study aims to determine lactate and PCT levels in Covid-19 patients and examine the relationship between lactate and PCT in Covid-19 patients. Methods: A cross-sectional study was performed on 126 patients diagnosed with Sars-Cov-2 infection by RT-PCR. Results: Mean age was 55.98 ± 17.1 years (range: 4-98 years). Patients more than 60 years old were accounted for the highest rate (42.8%). Median PCT: 3.6 (95%CI:3.21 - 3.75) ng/ml; median lactate 1.5 (95%CI:1.21 - 1,91) mmol/L; lactate has a positive and weak correlation with procalcitonin with r = 0.241; p < 0.001. Procalcitonin concentration > 0.1 ng/ml; lactate > 2 mmol/l in patients with Covid-19 accounted for a high rate with 89.7% and 39.7%. Conclusion: Serum level of procalcitonin and lactate raise highly in Covid-19 patients. Keywords: Covid-19, procalcitonin, lactate.