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Introduction: The overall magnitude of the frequency of G6PD deficiency ranges between 0 to 10 percent in the Indian population. This prospective study was planned to estimate the prevalence of G6PD deficiency in newborn population born in a tertiary care centre in Eastern India. Methods: This prospective observational study was undertaken among all consecutively delivered neonates born in a tertiary care teaching hospital of Eastern India, between Apr 2016 and Oct 2017. Prematurity less than 32 weeks and perinatal asphyxia requiring extensive resuscitation were excluded from the study. Umbilical cord blood samples were collected in a EDTA containers, drawn from the placental side of the umbilical cord incised while severing it at the time of birth. The G6PD levels were estimated quantitatively based on ultraviolet (UV) method by quantitative sphectrophotometric assay using ILab 650 fully automated analyzer. All babies wherein the cord blood G6PD levels was less than 6.95 mU/g of Hb was taken as deficient. Results: Mean (SD) of G6PD at birth was 12.56 (3.45) mU/g of Hb. Out of 1037 neonates, five were found to be G6PD deficient. There was increased incidence of neonatal jaundice requiring phototherapy in G6 PD deficient neonates, and it was statistically significant. Conclusion: The prevalence of G6PD deficiency was 0.48% in term and late preterm neonates as assessed quantitatively in cord blood

Systemic lupus erythematosus (SLE) is an autoimmune disorder with multifactorial etiology involving vital organs like the heart and causing rare complications like cardiac tamponade which are indeed difficult to manage especially in a setting of macrophage activation syndrome (MAS) with flare. A case of 25-year-old female with flare having high.grade fever and breathlessness on exertion to begin with. Subsequently, she developed pericardial effusion leading to cardiac tamponade and was managed with pericardiocentesis. With the rising ferritin levels, raised triglycerides, and cytopenia, she was diagnosed as MAS, along with reactivation of tuberculosis. She was discharged on oral steroids and anti-tubercular therapy with regular follow-up. Clinical suspicion, keeping in mind, the rarest complications such as cardiac tamponade, and timely employability of biochemical tests can help in early diagnosis of MAS and can lead to early therapeutic intervention in SLE patients preventing fatal outcomes.

Kit lot change in clinical biochemistry labs leads to variations in patient results. This study planned to identify variations during 60 reagent lot changes in our laboratory during the period from June 2018 to May 2019.A statistical analysis was performed to identify the difference between patient samples results variations and QC results. The long term drift was analyzed using a regression test.There was a significant difference between the patient and QC results in 16.7% of reagent lot changes. Moreover, the extent of variation in QC results was 3.3%. No long-term drift was seen in three analytes which were studied using regression analysis.Our results showed that, during reagent kit lot change, along with QC material, the patient samples should also be run in order to identify the variation. However, this practice is presently ignored by most of the laboratories. There was no accumulated effect in our laboratory due to reagent kit lot change.Promena setova reagenasa u biohemijskim laboratorijama na klinikama dovodi do varijacija u rezultatima pacijenata. Plan ovog istraživanja je bio da identifikuje varijacije u toku šezdeset promena setova reagenasa u našoj laboratoriji u periodu od juna 2018. godine do maja 2019. godine.Izvršena je statistička analiza kako bi se identifikovala razlika između varijacija u rezultatima pacijenata i rezultata kontrole kvaliteta (QC). Dugoročne promene su analizirane pomoću regresijskih testova.Otkrivena je značajna razlika u rezultatima pacijenata i kontrole kvaliteta u 16,7% promena setova reagenasa. Takođe, opseg varijacije u rezultatima kontrole kvaliteta bio je 3,3%. Nisu pronađene dugoročne promene u tri analita koja su analizirana regresijskim testovima.Naši rezultati ukazuju na to da bi prilikom zamene setova reagenasa, pored materijala za kontrolu kvaliteta, trebalo testirati i uzorke pacijenata kako bi se identifikovale varijacije. Međutim, većina laboratorija ovaj postupak ne primenjuje. Nije pronađen dugoročni uticaj usled nagomilavanja varijacija prilikom promene setova reagenasa u našoj laboratoriji.

The current COVID-19 pandemic has not only greatly burdened healthcare system globally but also exposed the medical and paramedical staff to risk of infection. Although the major mode of transmission of this highly infectious disease is via close contact with an infected person i.e., droplet infection due to coughing/sneezing and aerosol generation, few research articles have shown presence of SARS-CoV-2 in blood and serum. This poses a potential risk to health care professionals who are handling these samples. Once the suspected/confirmed case of COVID-19 is admitted in the hospital setting, it requires a battery of clinical chemistry investigations. Laboratory has a vital and indispensable role to play in the management of COVID-19 patients as several biochemical markers are used for prognostication as well as monitoring and guiding treatment in the critical patients. Hence, this evaluation was undertaken to have protocols based on robust recommendations and guidelines to be followed while handling the potentially infective samples in the clinical laboratories in order to ensure safety of the staff. However, these recommendations are based on the limited and rapidly evolving knowledge available at the moment and hence need to be reviewed periodically.

COVID-19 caused by SARS-CoV-2 became a pandemic affecting the health and economy of the world. Although it was known that this virus uses ACE2 protein along with TMPRSS2 to enter the host cell, the methylation pattern and gene expression of ACE2 and TMPRSS2 genes are not explored in saliva samples of patients infected with COVID-19. The study aimed to quantify promoter methylation of ACE2 and TMPRSS2 along with its mRNA expression in saliva samples of COVID-19 patients in order to understand the regulatory mechanism of these genes in SARS-CoV-2 infection. Saliva samples were collected from thirty male patients with SARS-CoV-2 infection and thirty age-matched healthy control male subjects. Q MS PCR and qRT PCR was performed to quantify the promoter DNA methylation and mRNA expression of ACE2 and TMPRSS2 respectively. Our study didn’t find any significant difference between methylation and expression of these two genes in cases compared to control subjects. However there was significant positive correlation between DNA methylation of ACE2 and its gene expression. Among cases, the sample collected ≥7 days after appearance of symptoms showed higher amount of methylation in both ACE2 and TMPRSS2 genes when compared to sample collected before 7 days. In conclusion, we found that ACE2 and TMPRSS2 methylation plays a role in COVID-19.

Introduction: Subclinical hypothyroidism refers to thyroid hormone deficiency in patients who have no apparent clinical features. Both iron deficiency anemia and subclinical hypothyroidism, due to their high prevalence and close interrelation, are significant clinical problems. Aims and Objectives: Association of subclinical hypothyroidism and disordered iron metabolism was studied so that better management of iron deficiency could be advised in these patients. Materials and Methods: 150 newly diagnosed subclinical hypothyroid patients and 150 healthy euthyroid controls were included. Total T3, total T4, TSH, iron, TIBC, transferrin and ferritin were measured. Data was analysed by student‘t’ test and Person’s formula. Results: Mean total T3, total T4, iron, TIBC, transferrin and ferritin values of study group were lower than that of control group (p < 0.05). Mean TSH values of study group was higher than that of control group (p < 0.05). Total T4 and T3 were positively correlated with transferrin (p < 0.05). The patients of subclinical hypothyroidism had altered iron metabolism. Conclusion: Decreased iron profile in subclinical hypothyroidism was significantly high. It was suggestive to regularly investigate iron profile for early detection and its early management in case of subclinical hypothyroidism. Keywords: Subclinical Hypothyroidism, Serum Iron, TIBC, Ferritin, Transferrin

Introduction: Cardiovascular diseases are the most prevalent cause of mortality and morbidity in both developed as well as developing countries. Coronary artery disease (CAD) is usually due to atherosclerosis of large and medium sized arteries. Dyslipidemia and hyperglycemia have been found to be the important contributing factors. Aims and objectives: Present study is done to know the pattern of dyslipidemia and blood glucose status as per National Cholesterol Education Program – Adult treatment panel III (NCEP-ATP III) guidelines and American Diabetes Association (ADA) criteria respectively in young doctors and to sensitize the importance of its implication and to take timely preventive measures. Material and methods: This is a retrospective observational study conducted in a tertiary care hospital. The study group comprised of 173 young doctors from all over India, between age 25 to 29 years who reported to lab for routine medical investigations. The study group included 118 males and 55 females. Serum lipid profile and plasma glucose for 173 subjects were analyzed. Results: In our study 71.7% of total study group had impaired range of plasma glucose values and 10.4% had diabetic range plasma glucose.5.78% of total subjects had Triglyceride (TG) level more than 200 mg/dL.11.56% had total cholesterol (TC) level >240 mg/dL. 45.66% of total subjects had Low density lipoprotein cholesterol (LDLc) more than 130 mg/dL. 37.2% of males had high density lipoprotein cholesterol (HDLc) less than 40 mg/dL. 40% of females had HDLc less than 50 mg/dL. Thereby implying that even apparently healthy young medical professionals are at increased risk of metabolic disorders like diabetes and dyslipidemia. Conclusion: This study revealed higher prevalence of hyperglycemia and dyslipidemia in apparently healthy medical professionals suggesting higher risk for metabolic disorders like coronary artery disease and diabetes mellitus. The study indicates the need for physical exercise, change in dietary pattern and regular monitoring of biochemical indicators of metabolic diseases. Keywords: Dyslipidemia, Impaired fasting glucose, young, doctors, diabetes

Introduction: Diabetes mellitus (DM) is a metabolic disorder occurring due to either defect in the secretion of insulin or defect in the action of insulin characterized by hyperglycemia. Hyperglycemia causes oxidative stress due to increased production of mitochondrial Reactive oxygen species (ROS) in T2DM. Ceruloplasmin (Cp) acts as an antioxidant through its ferroxidase activity. There is an association between the raised serum Cp levels and elevated plasma glucose levels in Type-2 Diabetes mellitus (T2DM) patients. Aim and objectives: The aim of this study is to evaluate the correlation between the fasting plasma glucose (FPG), 2hour plasma glucose (2hPG), and serum Cp level in T2DM patients as compared to non diabetics. Materials and methods: 165 cases of T2DM were recruited along with the 40 healthy age and sex matched controls. The blood samples were analyzed for serum Cp and FPG and 2hPG after 75-gram oral glucose. Results: The serum Cp levels of the patient group with T2DM were significantly higher than the control group (p = 0.000). There was a significant positive association between serum Cp level and 2hPG level of the patient population (r = 0.283, p = 0.000), but there was no significant correlation found between serum Cp levels and fasting plasma glucose levels in patients (r = 0.146, p =0.061). Similar findings were seen in the sub group analysis. Conclusion: Our study concludes a significant positive correlation between serum Cp and 2hPG levels in T2DM patients. Hence Cp levels may be considered as a part of the routine diagnostic panel to assess diabetes mellitus. Keywords: Serum Ceruloplasmin, Type-2 Diabetes Mellitus, Fasting plasma glucose, 2hour plasma glucose

Introduction: Patients of Diabetes mellitus type 2 are known to have high levels of BUN and Serum creatinine levels as compared to non-diabetics. There is an association between the raised BUN, serum creatinine levels and poor glycemic controls, subsequently leading to complications like nephropathy in Diabetic patients. Aim and objectives: The aim of this study is to assess the BUN, Serum creatinine levels in relation to fasting plasma glucose (FPG) and 2-hour post plasma glucose (2h-PG) status in diabetic patients as compared to non-diabetics. Materials and methods: 215 cases of Diabetes Mellitus were recruited along with the 100 age and sex matched controls who were healthy and non-diabetic and their blood samples were analyzed for BUN and FPG and 2-h-PG after 75-gram oral glucose in National Accreditation Board for testing and calibration Laboratories (NABL) certified laboratory. Results: In our study we have found that there is a significant association of FPG, 2h-PG, BUN and serum creatinine in diabetic cases as compared to non-diabetic controls. There also exists a significant positive correlation between mean BUN (12.3 ± 5.9mg/dL) and mean FPG (159.72 ± 71.60 mg/dL) and mean 2h-PG (222.76 ± 100.86 mg/dL) levels. Conclusion: BUN and serum creatinine are the markers in diabetes patients to assess the diabetic nephropathy. Serum BUN may be preferred over serum creatinine in assessing early renal impairment due to positive correlation with fasting and post prandial glycemic levels. Keywords: BUN, Nephropathy, FPG, 2h-PG, Diabetic complications.

Introduction: Magnesium (Mg) is the second most abundant intracellular cation, and is vital for a multitude of cellular functions and enzymes. Derangement of Mg homeostasis often leads to various diseases such as, Diabetes Mellitus (DM) and Insulin Resistance (IR), hypertension, atherosclerosis and depression. In pregnancy particularly, hypomagnesaemia has been associated with preterm delivery and low birth weight. Aim: To measure maternal and cord blood Mg levels at delivery to calculate the prevalence of hypomagnesaemia in pregnancy, and to correlate Mg levels with other maternal and foetal variables at birth. Materials and Methods: This cross-sectional correlational study was conducted in a 1000- bedded tertiary care centre in Northern India, and consisted of 110 pregnant women admitted for delivery. Maternal and cord blood was obtained at birth and analysed for serum Mg levels. The normality of continuous data was assessed by the Shapiro-Wilk test. Pearson’s correlation analysis was used to determine the relationship between continuous variables. Comparison of means of different groups was done by using unpaired t-test. A p-value

Introduction: In order to maintain a strict control over the results generated in clinical chemistry laboratories, a number of procedures are followed to maintain the quality of results. The procedures followed in order to compare the performances between different laboratories are known as External Quality Assessment (EQA). Separate EQA programmes for different analysers are recommended as the methods and principles may be different for them. Aim: To compare the performance of EQA results from Dimension EXL 200 and VITROS® 4600 analysers from two consecutive years and to analyse differences, if any. Materials and Methods: The clinical chemistry laboratory of this tertiary care hospital is enrolled in EQA with CMC Vellore. The lab has Dimension EXL 200 and VITROS® 4600 analysers. The results from two different EQA cycles of 2016 (Dimension EXL 200) and 2017 (VITROS® 4600) have been for analysed and compared. The Variable Index Score (VIS) and Standard Deviation Index (SDI) from these reports were analysed. Results: The data for 2016 for Dimension EXL 200 had 15 parameters in the EQA while VITROS® 4600 had 20 parameters in the EQA list. There were some parameters that were not common and hence have not been compared. The overall VIS for the Dimension had 07 parameters (46.7%) VIS (200) ‘not acceptable’ category. The overall VIS for the VITROS® 4600 had 15 parameters (75%) with VIS (

Introduction: India is presently facing an epidemic of diabetes mellitus and the risks of chronic complications from the disease are associated with the duration of the disease as well as the degree of hyperglycaemia. Diabetic retinopathy is a known microvascular complication of diabetes mellitus and is the most common cause of blindness in the western countries. Apolipoproteins are the protein component of lipoproteins. Apart from acting as structural proteins, they also act as cofactors to various enzymes. Aim: To measure the levels of serum apolipoproteins and glycated haemoglobin in cases of diabetic retinopathy and to assess their association with the stages of diabetic retinopathy. Material and Methods: The 135 diabetic cases [with (110) and without (125) retinopathy] attending the Ophthalmology OPD of this tertiary care hospital were included in the present study. Following retinoscopy, the patients were classified as Non-Proliferative Diabetic Retinopathy (NPDR) (n=75) and Proliferative Diabetic Retinopathy (PDR) (n=35). The controls (n=100) were age and sex matched patients who did not have diabetes. The cases and controls were assessed for HbA1c, total cholesterol, triglycerides, HDL cholesterol, Apo A-I and Apo B-100. Results: The HbA1c was found to be higher in diabetics without retinopathy (7.02%) as compared to controls (5.58%) (p

Melanotic Neuroectodermal Tumour of Infancy (MNTI) is an uncommon neoplasm found predominantly in infants, with around 220 cases reported so far in world literature. 92% of the reported cases have been found in children less than one year of age and 82% of cases have been within the first 6 months of infancy [1, 2, 3]. This tumour has a predilection for the craniofacial region and is most frequently found in the maxilla (72%) followed by cranial vault (12%), mandible (5%) and brain (4%) [4, 5]. The remainder of the sites where the lesion has been reported are epididymis, mediastinum, ovaries and few isolated cases in the thigh, foot, scapula, cheek and zygoma. The earlier uncertainty on the origin of the tumour resulted in a variety of terms [6, 7] for the lesion. Krompecher (1918) who first reported this neoplasm referred to it as congenital melanocarcinoma. The other names proposed have been melanotic progonoma, pigmented ameloblastoma, retinal anlage tumour, melanotic epithelial odontoma, and pigmented congenital epulis [8]. Borello and Gorlin in 1966 referred to the tumour as melanotic neuroectodermal tumour of infancy and suggested neural crest origin on the basis of high excretion of vanillyl mandelic acid [9] by the patients which is characteristic of tumours of neural crest origin, namely pheochromocytoma, neuroblastoma and ganglioneuroblastoma [10, 11]. The neural crest origin has further been established from the support received on the basis of immunohistochemical, ultrastructural and biochemical analysis. MNTI is a locally aggressive benign lesion with a recurrence rate of 15%. About 16 cases of malignant variants (6-7%) reported, have been from CNS. Keeping in mind the locally aggressive behaviour of this neoplasm, its tendency for recurrence and the highly proliferative nature of its constituent cells, the management proposed for this lesion is early surgery in the form of either enucleation with aggressive curettage or enbloc resection, depending upon the extent, proximity of the lesion to vital anatomic structures and the histopathological report.