Optical Coherence Tomography Identifies Visual Pathway Involvement Earlier than Visual Function Tests in Children with MRI-Verified Optic Pathway Gliomas

This study investigates whether optical coherence tomography (OCT) could add useful information in the examination of children with optic pathway glioma (OPG) at high risk of developing vision loss. For this purpose, the relationship between ganglion cell-inner plexiform layer (GC-IPL) thickness and visual function, evaluated with tests of visual acuity (VA) and visual field (VF), as well as tumor site according to magnetic resonance imaging (MRI), were examined in a geographically defined group of children with OPG. Methods: Children aged <18 years with OPG underwent ophthalmic examination including VA, VF (Zeiss HFA perimetry) and OCT imaging (Zeiss Cirrus HD-OCT). Results: Out of 51 patients included, 45 provided 77 eyes with MRI-verified OPG, and 19 patients provided 25 eyes without OPG. Significant correlations were found between GC-IPL, VF and VA (p < 0.001). The GC-IPL pattern loss corresponded in 95% to VF defects and in 92% to MRI findings. Conclusions: Our study indicates that GC-IPL measures could serve as an early marker of vision-threatening changes related to OPG and as a valuable link between MRI and visual function tests. Thinning of GC-IPL and differences in topography between eyes are strong indicators of and predictive of vision loss related to OPG.

Effect of Folic Acid Conjugated Silver Nanoparticles in Treatment of RA like Adjuvant Arthritis in Rats.

Objective: Nanomedicine has become one of the promising research areas, opening new horizons in disease diagnosis and treatment. Recent years have witnessed a surge in the development of nanomedicine for combating rheumatoid arthritis (RA), the most common autoimmune arthritis. RA is characterized by progressive inflammation and persistent synovitis, leading to joint destruction, functional incapability, and ultimately disability. Although there has been a tremendous evolution in disease assess­ment and treatment, many patients still fail to attain remission. Therefore, developing new drugs that specifically target inflamed joints and simultaneously attenuate other possible damages to healthy tissues is indispensable. This study was done to evaluate the potential of folic acid conjugated silver nanoparticles (FA-AgNPs) as RA therapy.Methods: In the CFA-arthritic rat model, FA-AgNPs & methotrexate were administered for 8 consecutive weeks. Therapeutic efficacy was evaluated by measuring paw volume, ESR, CRP, TNF-α, and IL-6 levels. For safety concerns, CBC, liver, and renal function tests were evaluated. Joints histological assessment was also carried out.Results: FA-AgNPs significantly reduced paw volume, paw weight, ESR, CRP, RF, TNF-α, and IL-6 levels compared with arthritic non-treated rats, demonstrating good anti-inflammatory activity. Likewise, histology of tarsal joints depicted comparatively lesser inflammatory cellular infiltration and diminished cartilage erosions. Methotrexate displayed comparable results. In contrast to methotrexate, FA-AgNPs showed normal CBC & significantly improved liver and renal function tests. Conclusion: FA-AgNPs exhibited substantial anti-arthritic activity. This notable anti-arthritic potential of FA-AgNPs was as good as the current standard treatment of MTX with higher biosafety.

In pursuit of incorporation of markers of oxidative stress in traditional biochemical panels in clinical Chemistry: A risk assessment step in diagnosis and biotherapy

Chemical pathology (clinical chemistry/biochemistry) is the branch of laboratory medicine concerned with the detection of alterations in the chemical constituents and biochemical mechanisms, which ensure health, culminating in disease. The disease itself is a pattern of response to some insult or injury resulting in a disturbed function or structure. It is often difficult to ascertain precisely the point of transition from health to a disease state. Pathological changes, including metabolic and molecular perturbations, with the potential to progress to clinical disease, are also present in healthy populations, noteworthy are the reactive oxygen species such as hydroxyl radicals with the propensity to cause oxidative DNA damage. Biochemical profiles or panels such as liver function tests, renal function tests, bone profile, lipid profile, acid-base, and critical care have served as biomarkers employed in indicating the presence of or measuring the progress of the disease, as well as the effect of treatment. Oxidative stress, an imbalance between bio-available antioxidants and reactive species, is now widely recognized as accompanying most pathological states. Hence, the exclusion of antioxidant components in biochemical profiles appears a grave oversight. Basic components of the antioxidant system, glutathione (GSH), zinc, uric acid, ascorbic acid, and α-tocopherol, may be selected for incorporation. GSH is particularly important; as a scavenger for damaging oxidative intermediates in cells, it promises to be a good predictor of disease progression and prognosis. Including the antioxidant component into traditional profiles may aid physicians in more confidently ruling out disease, enabling further investigations, and/or reassuring patients. It is proposed that redefining the traditional profiles in chemical pathology by incorporating the indexes of the antioxidant system promises considerable improvement in the risk assessment process, in disease detection and recognition of the threshold of clinical concern in disease management and biotherapy.

Pathological and radiological irregularities in patients with chronic kidney disease - An observational study

Background: Chronic kidney disease (CKD) encompasses a spectrum of different pathophysiologic processes associated with abnormal renal function and progressive decline in glomerular filtration rate (GFR). Aims and Objectives: The objectives of the study are 1) to assess basic tests and kidney function tests in patients with CKD, (2) to assess coagulation profile, sugar levels, and platelets levels in patients of CKD, (3) to do the urine analysis in patients with CKD, and (4) to assess GFR among the study population. Materials and Methods: After taking the informed consent, detailed history was taken and clinical examination of patient was done. Pathological tests such as hemogram, renal function tests, liver function tests, coagulation profile, blood sugar levels, urine routine, and microscopy were performed. Ultrasonography of abdomen and pelvis was done. Correlation was done between severity of sepsis and mortality in patients. Results: Anemia was moderate (7–8.9 g/dl) in 38%, mild (9–10.9 g/dl) in 31%, while severe (<6.9) in 29 patients, that is, 29%. Thrombocytopenia was present in 58% of patients. Mean serum albumin in patients was 2.67±0.551 mg/dl; serum globulin was 3.89±0.345 mg/dl. Mean blood sugar of study subjects was 127.41±61.387 mg/dl fasting, 199.67±114.827 mg/dl post-prandial, and mean glycated hemoglobin was 5.63 ± 1.668. On ultrasound acute pyelonephritis, 25 (25%) was the most common finding. Conclusion: Correlation of clinical findings with pathological and radiological findings is very important in patients with CKD. Severity of sepsis directly correlates with mortality of patients.

Alterations of liver function tests in diabetic obese and nonobese individuals

Introduction and Aim: India has emerged as the diabetes capital in Southeast Asia having around 74 million with diabetes, with a prevalence of 9.8% in 18–99 years of age. In type 2 diabetes mellitus, triglycerides get deposited in liver thus altering its structure and function, which is the feature of nonalcoholic fatty liver disease. This study was undertaken to study the alterations in liver function tests in obese and nonobese diabetic individuals. Materials and Methods: The Department of Biochemistry at Sri Ramachandra Institute of Higher Education and Research was chosen to conduct the retrospective study on 200 diabetic individuals from September 2019 to February 2020. The data obtained were serum liver function tests, HbA1c, plasma glucose and lipid profile. Before the study ethics approval was obtained from the Institutional Ethics Committee for studies involving human participants. The obtained data were subjected to statistical analysis using SPSS version 16 and a P value less than 0.05 was considered statistically significant. Results: Transaminases and ALP were significantly altered in obese diabetics; were positively correlated with bilirubin. TGL was negatively correlated with AST/ALT ratio. Conclusion: Liver enzymes and bilirubin were altered in obese diabetics. Measurement of liver function biomarkers are cost effective diagnostic markers of non-alcoholic fatty liver disease.

Are Changes in Thyroid Hormones Associated with Mortality in Non-Thyroidal Illness Syndrome?

Introduction: Non-thyroidal illness syndrome (NTIS) can be defined as afunctional impairment of the hypothalamic-pituitary-thyroid axis accompanied by signs of non-thyroidal disease with changes in thyroid stimulating hormone (TSH), free T3 (fT3) and free T4 (fT4) levels. NTIS and thyroid hormone levels in this syndrome are thought to be related with mortality. This study was performed to evaluate the relationship between hormone levels and mortality in this syndrome. Methods: The 5-year mortality data of patients who were hospitalized in the first 6 months of 2014 and whose thyroid hormone levels could be checked twice within 5 years were evaluated. In our study conducted with 405 patients whose thyroid function tests was repeated, the follow-up period was 5 years. Biochemical parameters including thyroid function tests were sent from all patients. NTIS was defined as a condition in patients with low fT3 levels (<2.5 pg/mL) and TSH levels within the normal range (0.38-5.33 mIU / L). Results: 128 patients died, and the number of surviving patients was 277 during the follow-up period. Positive acute phase reactants such as CRP, sedimentation, ferritin was high and albumin (negative acute phase reactant) and fT3 levels were low in patients who died. In addition, these changes in biochemical values were statistically significant. The mortality rate was increased in patients with low fT3 and high fT4 levels. In the follow-up period, changes in TSH levels were not significantly associated with mortality. Conclusion: Both the decrease in fT3 levels and the increase in fT4 levels can be used as predictors and independent risk factors for long-term mortality risk in chronically ill and hospitalized patients with NTIS.