A Comparative Quantitative Assessment of Salivary Iga and Alpha Amylase in Caries Free and Caries Active Children

Objectives: The aim of the study was to assess the salivary IgA (immunoglobulin A) and alpha amylase levels in the unstimulated whole saliva samples of caries-free and caries-active children and correlate it with the caries status and age. Study design: The salivary IgA and amylase was investigated in 100 children in the range of 8–12 years divided in two groups, control group (DMFT and/or deft = 0) and study group (DMFT/deft score ≥5). The salivary IgA was measured using kit based on two-site sandwich enzyme immunoassay principle and amylase was estimated using the vitro amyl slides. Results :The mean salivary IgA and amylase levels in the saliva of the children in the control group was found to be significantly increased (p=.001 and p=.014 respectively) whereas the relationship between salivary IgA and amylase levels in the saliva of the children was found to be insignificant with the age (p=.392 and p=.306 respectively). Conclusions: The results indicated that salivary IgA and amylase levels in saliva increased significantly in caries free children and the level of salivary IgA and alpha amylase has no significant relation with the age of the children.

Evaluation of OIDx Histoplasma Urinary Antigen EIA

A sandwich enzyme immunoassay (EIA) for the detection of Histoplasma antigens (Ag) in urine, developed by Optimum Imaging Diagnostics (OIDx) was evaluated. A verification using a standardized reference panel of urine samples found sensitivity of 92%, specificity of 32% and accuracy of 51%. In this study, the OIDx Histoplasma urinary Ag EIA displayed high sensitivity, however, in non-histoplasmosis cases this EIA displayed false-positive results in 68% of specimens tested.

Serum pyridoxine, folate, cobalamin, and homocysteine levels in children presenting with vasovagal syncope

Background: Recent studies confirm the role of B vitamins deficiency and hyperhomocysteinaemia in the development of dysautonomia that has been considered to be the main factor in vasovagal syncope development. The aim of the study was to investigate serum pyridoxine, folate, cobalamin, and homocysteine levels in children presenting with vasovagal syncope and to analyse the correlation between them and main clinical parameters of syncope. Methods: We studied 40 children, ages 8–17 years with a history of vasovagal syncope and 24 healthy volunteers. The serum pyridoxine, folate, cobalamin, and homocysteine levels were measured by a quantitative sandwich enzyme immunoassay technique using a commercial kit (Monobind, USA). Twenty-four-hour Holter monitoring and 24-hour ambulatory blood pressure monitoring were conducted for all participated patients. Results: Serum pyridoxine (9.42 ± 4.87, 16.11 ± 5.53 µg/L) and cobalamin (307.48 ± 95.50, 447.28 ± 108.85 ng/L) levels were reasonably low (p < 0.05) in patients with vasovagal syncope. Although there was no significant change in folate levels between syncope and healthy children (4.00 ± 1.34, 4.71 ± 1.73 µg/L; p = 0.20), we detected low folate-level association with longer duration of syncope (r = −0.42) and post syncope (r = −0.43) symptoms (p < 0.05). Finally, there was increased serum homocysteine level (13.55 ± 5.03, 7.81 ± 1.71 µmol/L; p < 0.05) in patients with vasovagal syncope. It was positively correlated with the average PQ interval (r = 0.35, p < 0.05) and average QTc interval (r = 0.49, p < 0.05). Conclusions: The results suggested that pyridoxine, folate, cobalamin, and homocysteine may be involved in the pathogenesis of vasovagal syncope. This might provide a new approach for effective treatment of paediatric vasovagal syncope, requiring further study.

Korelasi Kadar Adiponektin dengan Kadar Glukosa Puasa pada Penyandang Obes

Akumulasi lemak tubuh abnormal dan berlebih pada obesitas menyebabkan low grade inflammation sel adiposit yang berkontribusi terhadap penurunan kadar adiponektin. Adiponektin berperan dalam metabolisme glukosa, sehingga kondisi hipoadiponektinemia dapat menyebabkan gangguan metabolisme glukosa. Tujuan: menentukan korelasi kadar adiponektin dengan kadar glukosa puasa pada penyandang obes. Metode: Penelitian ini merupakan studi analitik dengan rancangan potong-lintang terhadap 25 orang penyandang obes yang bekerja di Instalasi Laboratorium Sentral RSUP Dr. M. Djamil Padang yang memenuhi kriteria inklusi dan eksklusi. Penelitian dilakukan mulai bulan September 2018 sampai September 2019. Kadar adiponektin diperiksa dengan metode Elisa two-step sandwich enzyme immunoassay dan kadar glukosa puasa diperiksa dengan metode heksokinase. Data dianalisis dengan uji korelasi Pearson, bermakna jika p<0,05. Hasil: Subjek penelitian terdiri dari laki-laki 8 orang (32,0%) dan perempuan 17 orang (68,0%). Rerata umur adalah 33,5 (6,0) tahun dengan rentang 23-52 tahun. Rerata indeks massa tubuh adalah 34,0 (3,6) kg/m2. Rerata kadar adiponektin adalah 2,8 (1,5) μg/mL dan rerata kadar glukosa puasa adalah 92,8 (11,4) mg/dL. Uji korelasi Pearson menunjukkan korelasi negatif lemah antara log-adiponektin dengan kadar glukosa puasa dan tidak bermakna secara statistik (r= -0,217, p= 0,298). Simpulan: Tidak terdapat korelasi kadar adiponektin dengan kadar glukosa puasa pada penyandang obes.Kata kunci: adiponektin, glukosa puasa, inflamasi adiposit, obesitas

The Relation of Brain-Derived Neurotropic Factor (BDNF) Serum Level to Sub-Domain Cognitive Functions of Indonesian Schizophrenia Patients Measured by MoCA-Ina

BACKGROUND: BDNF implies to the development of abnormal nerves and neurotransmission that occurred during the changes of cognitive functions. However, in determining initial diagnosis of schizophrenia, measurements focus on the presences of positive and negative symptoms, and general psychopathological features without concerning the BDNF serum, which involves in central nervous system as the main symptom of schizophrenia. AIM: To determine the relation of BDNF serum level to cognitive functions of schizophrenia patients based on sub-domain of Montreal Cognitive Assessment Indonesia Version (MoCA-Ina) METHODS: This study was carried out based on observational analysis with cross-sectional design study. The samples were collected by non-probability sampling and consecutive sampling by recruiting 65 of male schizophrenia patients at Prof. Dr. M. Ildrem Mental Hospital, Medan, North Sumatera, Indonesia. BDNF serum levels were analysed throughout quantitative sandwich enzyme immunoassay method, while the cognitive functions were conducted by performing the MoCA-Ina, which concern to attentions and concentrations, executive function, memory, languages, visuoconstructional abilities, numerical calculation, and orientation. RESULTS: The serum level of BDNF was accounted averagely for 27161.26, with 5350.37 of standard deviation. There was positive correlation with medium strength (r = 0.4 - < 0.6) in visuospatial function, attention (r = 0.437), and memory (r = 0.413). CONCLUSION: Relation between BDNF serum level and cognitive function occurred in visuospatial, attention and memory domains based on MoCA-Ina assessment.

Hubungan Kadar Interleukin-33 Serum Dengan Derajat Keparahan Klinis Dermatitis Atopik

Pengetahuan mengenai mekanisme yang mendasari dermatitis atopik (DA) penting untuk penatalaksanaan DA selanjutnya. Pada DA, terjadi proliferasi sitokin T helper (Th)-2. Interleukin (IL)-33 diketahui menginduksi proliferasi sel Th ke arah Th2. Aktivasi sitokin Th2 ini menyebabkan gejala klinis DA. Penelitian ini bertujuan untuk mengetahui hubungan kadar IL-33 serum dengan derajat keparahan klinis DA di Rumah Sakit Umum Pusat Dr. Moh. Hoesin (RSUP MH) Palembang. Metode penelitian observasional analitik laboratorik dengan rancangan potong lintang dilakukan mulai bulan Juli sampai September 2015. Sembilan puluh delapan subjek penelitian didiagnosis DA di Divisi Alergo-Imunologi Poliklinik Dermatologi dan Venereologi (DV) RSUP MH Palembang yang memenuhi kriteria inklusi diikutsertakan sebagai subjek penelitian dengan consecutive sampling. Derajat keparahan klinis DA dinilai menggunakan indeks Severity Scoring of Atopic Dermatitis (SCORAD). Sampel darah diambil guna pemeriksaan kadar IL-33 serum cara metode teknik kuantitatif sandwich enzyme immunoassay. Kovariabel yang diikutsertakan dalam penelitian meliputi usia, jenis kelamin, pendidikan, dan pekerjaan. Hasil penelitian menunjukkan kadar IL-33 serum meningkat signifikan dengan peningkatan derajat keparahan klinis DA. Usia, jenis kelamin, pendidikan, dan pekerjaan tidak memengaruhi derajat keparahan klinis DA. Kesimpulannya ialah kadar IL-33 serum memengaruhi derajat keparahan klinis DA. Kata kunci: dermatitis atopik, kadar IL-33 serum, sitokin Th2, SCORAD

Fungal diseases of the respiratory tract

Fungal respiratory infections are important causes of morbidity and mortality in immunocompromised patients. Invasive aspergillosis remains the most common invasive fungal infection whereas other filamentous fungi, such as Fusarium spp., Mucorales, and Scedosporium spp., are increasing in frequency, particularly in neutropenic hosts. Endemic mycoses, including those due to Histoplasma capsulatum, Coccidioides spp., and Talaromyces marneffei, are increasingly prevalent in patients with cell-mediated immunodeficiencies in respective geographic regions. Culture remains the gold standard of diagnosis but has limited sensitivity and often requires invasive procedures. Non-invasive diagnostic tests, including the serum sandwich enzyme immunoassay for the detection of galactomannan, the (1→3)-β‎-D-glucan assay, and molecular amplification methods have been developed to facilitate early and accurate diagnosis. Successful therapy depends upon early initiation of antifungal agents and reversal of immunosuppression. Lipid formulations of amphotericin B and newer generation triazoles including voriconazole, posaconazole, and isavuconazole have expanded the ability to treat multi-drug resistant pathogens more effectively and with less toxicity.

Systemic Cytokine Response predicts the Outcome of Patients from Mechanical Ventilation

ABSTRACT Purpose Despite the lifesaving potential, mechanical ventilation (MV) imposes a considerable amount of mechanical stress on the lung. Pulmonary and systemic cytokine release due to inflammatory process triggered by MV may give valuable information on patient outcome. Materials and methods Thirty patients aged >18 years with acute respiratory distress who required MV were enrolled for the study. Three milliliters of the venous blood was collected immediately after the initiation of MV and at 24 hours. Serum levels of interleukin (IL)-6, IL-8 and, tumor necrosis factor-α (TNF-α) were estimated using quantitative immunometric sandwich enzyme immunoassay technique. Based on their outcome from MV, they were divided into two groups: Survivors (group I) and nonsurvivors (group II). Results Serum levels of IL-6 and IL-8 significantly increased in group II (n=13) when compared with group I (n = 17) (p < 0.0001 and p < 0.001 respectively) at 24 hours of MV. However, TNF-α did not show any significant difference between the two groups. The IL-6 >111.9 pg/mL at 24 hours of MV increases the probability of mortality by factor 2.40. An increase of IL-6 by 1 pg/mL significantly increases the relative probability of mortality by a factor of 1.004 (95% CI, 1.0003–1.0078, p = 0.0001). Conclusion Estimating the levels of IL-6 and IL-8 at 24 hours of connecting the patient to MV will help in predicting the outcome of the patient. How to cite this article Prashant A, Vishwanath P, Kotekar N, Nataraj SM, Kuruvilla C, Nagalakshmi CS, Doddamani P. Systemic Cytokine Response predicts the Outcome of Patients from Mechanical Ventilation. Indian J Med Biochem 2017;21(1):5-10.