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Background: The prevalence of type 2 diabetes mellitus (T2DM), a progressive metabolic disorder characterized by chronic hyperglycemia and the development of insulin resistance, has increased globally, with worrying statistics coming from children, adolescents, and young adults from developing countries like India. Here, we investigated unique circulating metabolic signatures associated with prediabetes and T2DM in an Indian cohort using NMR-based metabolomics., Materials and Methods: The study subjects included healthy volunteers (N = 101), prediabetic subjects (N = 75), and T2DM patients (N = 108). Serum metabolic profiling was performed using 1 H NMR spectroscopy and major perturbed metabolites were identified by multivariate analysis and receiver operating characteristic (ROC) modules., Results: Of the 36 aqueous abundant metabolites, 24 showed a statistically significant difference between healthy volunteers, prediabetics, and established T2DM subjects. On performing multivariate ROC curve analysis with 5 commonly dysregulated metabolites (namely, glucose, pyroglutamate, o-phosphocholine, serine, and methionine) in prediabetes and T2DM, AUC values obtained were 0.96 (95 % confidence interval (CI) = 0.93, 0.98) for T2DM; and 0.88 (95 % CI = 0.81, 0.93) for prediabetic subjects, respectively., Conclusion: We propose that the identified metabolite panel can be used in the future as a biomarker for clinical diagnosis, patient surveillance, and for predicting individuals at risk for developing diabetes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Epigenetic modification of cancer-related genes plays a role over and above their genetic alterations and contributes to the tumor initiation and progression of breast cancer. Promoter methylation of tumor suppressor genes is one such epigenetic modification, which can be potential biomarker. In this study, promoter methylation status of p16 gene was studied in blood samples of patients with breast carcinoma., Methods: Seventy-five patients, freshly diagnosed with carcinoma of breast and 20 age and sex matched healthy control subjects were recruited for the study. DNA extracted from EDTA blood sample was bisulfite converted and subjected to methylation-specific PCR to amplify the p16 promoter region., Results: Out of 75 patients, 25 (33%) patients showed hypermethylation in promoter region of p16 gene, which was statistically significant in comparison with the control group (p < 0.05). In subgroup analysis, lymph node involvement, cancer grade, and histopathological finding did not show any difference with methylation status of p16 promoter., Conclusion: Significant hypermethylation of p16 promoter region in the blood of histopathologically proven cases of breast cancer was observed suggesting promoter hypermethylation of p16 may be a possible mechanism accounting for sporadic carcinoma of breast., Competing Interests: The authors have none to declare., (© 2021 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.)

Introduction  Urea secreted in the sweat is important for skin moisture. Similarly, ocular surface moisture is maintained by the conjunctiva. Based on this, the level of urea in tear film can be used as a potential diagnostic test for dry eye disease (DED). One of the standard tests for DED is Schirmer's test (ST). The aim of this study was to compare tear film urea to values of ST. Methods  Fifty patients symptomatic for DED having ST ≤ 10 mm/5 min were enrolled in the study. Fifty age- and sex-matched asymptomatic subjects with ST > 10 mm/5 min were taken as controls. All patients were subjected to an estimation of tear film urea, collected using micropipettes, and analyzed by an Erba Chem 5 semi-autoanalyzer. Based on the ST reading as per the Dry Eye Workshop 2007 (DEWS) classification, dry eye was classified as dry eye (≤ 10 mm/5 min), severe dry eye (≤ 5 mm/5 min), and very severe dry eye (≤ 2 mm/5 min). Tear film urea values were compared with ST values that were considered standard. Statistical analysis was done using Medcalc version 19.7. A p -value ≤ 0.05 was considered significant. Results  The mean tear film urea levels in cases were (26.78 ± 5.70 mg/dL) significantly lower compared with controls (41.72 ± 6.86 mg/dL). The area under the receiver characteristic operator curve (AUC) for tear film urea in diagnosing DED was 0.936 ( p  < 0.0001) with a cutoff of ≤ 37.2 mg/dL, yielding a sensitivity of 96% and a specificity of 76%. For diagnosing severe DED, the AUC for tear film urea was 0.824 ( p  < 0.0001) with a cutoff value of ≤ 23.4 mg/dL, yielding a sensitivity of 60.8% and a specificity of 92.59%. For diagnosis of very severe DED, the AUC for tear film urea was 0.972 ( p  < 0.0001) with a cutoff value of ≤ 19.8 mg/dL, yielding a sensitivity of 100% and a specificity of 93.62%. On comparing ST values to tear film urea, the regression coefficient was 0.85 ( p  < 0.0001), suggesting a linear relationship between ST and tear film urea. Conclusion  The study demonstrates that tear film urea can be a potential diagnostic marker for DED. The study also indicates that tear film urea level is linearly related to Schirmer's test values and provides an approximate diagnostic cutoff level for the design of future large-scale studies., Competing Interests: Conflicts of Interest None declared., (The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Background Elevated serum ceruloplasmin is a biomarker for oxidative stress. Diabetes mellitus (DM) is known to be a state of oxidative stress which causes complications of DM including diabetic retinopathy (DR). The role of ceruloplasmin in DR is still unclear. Methods Ninety patients of DM were included as cases and after evaluation sub-grouped as those with no DR, non-proliferative DR (NPDR) and proliferative DR (PDR). Serum ceruloplasmin levels were tested in all cases as well as in equal numbers of age and sex-matched controls without DM. Statistical analysis was done with p<0.05 taken as significant. Results  Serum ceruloplasmin was significantly higher among cases as compared to controls (1222.82±306.15 IU/L versus 868.38±198.80 IU/L, p<0.01). There was no statistical difference between serum ceruloplasmin values in No DR, NPDR and PDR. On receiver operator characteristic curve (ROC) analysis for serum ceruloplasmin as a test for discriminating various parameters, it was seen that serum ceruloplasmin was a good test for discriminating DM from no DM (area under receiver operator characteristic {AUROC}=0.814, 95% CI=0.749-0.868, p<0.0001) with a cut point of >1093 IU/L yielding a sensitivity of 63.33% and specificity of 87.78%. Ceruloplasmin as a test was not found to significantly discriminate DR (total) from no DR, NPDR from no DR, PDR from no DR and PDR from NPDR. Conclusion Serum ceruloplasmin levels are significantly raised in patients with DM. However, serum ceruloplasmin levels do not correlate with DR severity., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Satyanarayana et al.)

Background: Repeated blood transfusions is the mainstay of treatment for beta thalassemia major patients. Multiple blood transfusions lead to significant iron overload in these patients. Iron overload causes liberation of oxygen free radicals and peroxidative lipid injury. This study has been designed to study whether thalassemics suffer from oxidative injury. It also aims to study the quantum of oxidative injury., Methods: It is a cross sectional study using cases and controls. Thirty thalassemic patients receiving multiple blood transfusions were included in this study and thirty healthy age and sex matched controls were recruited for the study. Serum ferritin levels, malondialdehyde, nitric oxide levels were estimated., Results: Levels of all the three parameters were significantly increased ( p  < 0.05) in the cases compared to controls. Mean levels of all three parameters were correlated with serum ferritin levels and number of blood transfusions in increasing order. All the parameters showed fair degree of correlation ( r  ≥ 0.25, p  ≤ 0.05)., Conclusion: Thalassemic patients receiving multiple blood transfusion suffer from iron overload which results in increased oxidative stress., (© 2018 Published by Elsevier B.V. on behalf of Director General, Armed Forces Medical Services.)

Thalassemia is a congenital hemolytic disease which is treated by repeated blood transfusion. Chronic iron overload is currently considered to be the primary cause of mortality in β-thalassemia, mainly due to the induction of left-sided cardiac failure. Iron overload results from a number of mechanisms associated with the disease itself. In addition to chronic iron overload thalassemic patients are more prone for procoagulant status which in turn lead to clinical thrombotic events. The hypercoagulable state in thalassemia is due to multiple elements, a combination of which is often the drive behind a clinical thromboembolic events. PAI-1 study was done in thalassemia major patients receiving multiple blood transfusion as a marker for procoagulant status. Total of 30 thalassemic patients on repeated blood transfusion was included in the study and total of 30 healthy age and sex matched controls were included in the study. It was also found that there was significant differences between cases and controls. The mean level of PAI 1 in controls was 3047 ± 414 pg/ml, the value in cases was 3683 ± 358 pg/ml. The level was significantly increased ( p  < 0.05) in the cases compared to controls. PAI-1 levels were also compared with the total number of blood transfusion which correlates well.

Increase in urine albumin excretion rate (AER) precede a fall in glomerular filtration rate in patients developing diabetic chronic kidney disease (CKD). Our results have shown that 7 (50 %) of diabetic and hypertensive individuals with decreased GFR do not have increased AER. In this cross-sectional study, we measured AER of 75 patients with type 2 diabetes and hypertension by immunoturbidimetric method. We correlated the results with eGFR values obtained by Cockcroft-Gault and MDRD method. The method used was not a compensated method. We measured serum creatinine by modified Jaffe's kinetic method in autoanalyzer XL-600. Analysis of data showed positive correlation between eGFR and microalbuminuria by both the methods with eGFR <60 mL/min/1.73 m(2). Pearson's correlation co-efficient (r) was 0.9 (p = 0.0001) by Cockcroft-Gault formula and 0.69 (p = 0.0063) by MDRD formula. Our results concluded that there was positive correlation between AER and eGFR <60 mL/min/1.73 m(2). We have recognized that these two parameters provide a complimentary benefit in management of cases with CKD.

To establish utility of single enzymatic marker for the diagnosis of acute pancreatitis. This is a cohort study. Tertiary care centre proven cases of acute pancreatitis (n = 50) admitted in surgery ward between December 2011 and May 2013 were included in the study. Serum amylase and lipase were performed along with many analytes. All relevant data including serum lab values and imaging were collected. All 50 patients included in the study had raised serum lipase, 42 patients had both amylase and lipase raised, 8 patients had amylase normal but lipase raised. In smaller hospitals where limited lab and radiological facilities are available, estimation of serum lipase will be a better choice over serum amylase in diagnosis of acute pancreatitis.

Serum ferroxidase and albumin levels were determined in 98 patients of tubercuiosis, of whom 49 were freshly diagnosed, sputum positive (group-I) & 49 were completely treated patients (group-II). Forty nine age and sex matched healthy individuals were taken as controls. Mean±SD of serum ferroxidase and albumin levels in controls, group-I and group-II was found to be 864.35±106.35 IU/L & 3.91±0.234 g/dL, 1603.76±222.65 IU/L & 3.24±0.518 g/dL and 1001.78±201.63 IU/L & 3.82±0.43 g/dL, respectively. Serum ferroxidase in group I was significantly higher as compared to controls and group-II (p<0.01). The decreased levels of serum albumin in group I, as compared to control and group-II was statistically significant (p<0.01). Serum ferroxidase: albumin ratio (Ferroxidase in International Unit per gram of albumin) in group I (50.47±10.36 IU/g) was significantly higher than controls (22.22±3.3 IU/g), (p<0.001) while in group II it was significantly lower (26.72±7.18 IU/g, p<0.001) than group-I and close to control values. Serum ferroxidase: albumin ratio (IU/g) can therefore be incorporated as a surrogate marker to assist in diagnosis and prognosis of pulmonary tuberculosis.

Background: The aim of this study was to assess the clinico biochemical spectrum of hypothyroidism and the relative importance of thyroid function tests, clinical symptoms and signs in thyroid dysfunction., Methods: A retrospective study was done and 1702 requisitions for screening of hypothyroidism were analysed. The clinical presentation of cases was correlated with the results of thyroid profile tests., Results: 31.5% of the 1702 cases referred had thyroid dysfunction in the form of subclinical or overt hypothyroidism. In the hypothyroid group generalized weakness, weight gain and myxoedema was common. In cases of primary infertility and depression, subclinical and overt hypothyroidism was high (40% and 45.8% respectively). The average age of females with subclinical hypothyroidism was 30.8 years, 5.4 years less than females with overt hypothyroidism., Conclusion: We conclude that hypothyroidism is common and often under-diagnosed. Therefore routine evaluation of female patients with weight gain, generalized weakness, infertility, depression and mood changes should include thyroid profile.

Biochemistry in broad terms is the study of the chemical composition of the living matter and the biochemical processes that underlie life activities during growth and maintenance. This article is an attempt to explore the metamorphosis of biochemistry from a pupa entwined in its own cocoon to a vibrantly colored phenomenon. Studies pertaining to this discipline of science began with Biochemistry interfaces with biology and chemistry even before nineteenth century with studies concerned with the chemical processes that take place within living cells. Modern biochemistry developed out of and largely came to replace what in the nineteenth and early twentieth centuries was called physiological chemistry, which dealt more with extra cellular chemistry, such as the chemistry of digestion and of body fluids. The name Biochemistry was coined in 1903 by a German chemist named Carl Neuber. However, work in this very living, aspect of chemistry had started much earlier. Claude Bernard is accredited with the Sirehood of Biochemistry. During the later part of the nineteenth century eminent scientists contributed a great deal to the elucidation of the chemistry of fats, proteins and carbohydrates. At this period some very fundamental aspects of enzymology were under close scrutiny. Study of nucleic acid is central to the knowledge of life but its fusion with biochemistry started with works of Fredrick Sanger and Har Gobind Khurana. Their experiments involved a subtle bland of enzymology and chemistry that few would have thought possible to combine. The scientists were busy removing the mist that was mitigating the light of knowledge but they still lacked an insight into the cell. In 1990's research turned to finding the structural details of cell. The field of molecular biochemistry was also progressing at an almost unstoppable speed having expanded its horizons beyond human imagination with the introduction of PCR, creating waves of appreciation from every field of medicine and then coming out of the lab to help establish better therapies for various diseases by introduction of gene therapy. Biochemistry has promises to the world of science in development of new path-breaking research and coming times would surely prove these promises to be fulfilled.