Implication for health policy/practice/research/medical education:As urolithiasis patients are at a constant inflammatory insult caused by the calculi, the levels of inflammatory markers can be used to monitor the success of treatment. Vitamin D and anti-inflammatory agents may be used in the management of nephrolithiasis patients. Please cite this paper as: Introduction:Hypercalciuria plays an important role in the pathogenesis of renal calculi. The role of vitamin D, parathyroid hormone (PTH), inflammatory markers highly sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in the development of renal calculi has not well defined. Objectives: To assess the serum levels of vitamin D, PTH, hs-CRP and IL-6, urinary and serum calcium and phosphorus levels in patients with renal calculi and to compare these parameters with healthy controls Patients and methods: It was a cross-sectional study. About 41 confirmed renal calculi patients and 41 age and sex matched controls were recruited. Patients with malignancies, hyperparathyroidism, chronic disease, and patients taking vitamin D supplementations were excluded. Serum levels of 25(OH) vitamin D, i-PTH, hs-CRP, IL-6, calcium and phosphorous, 24 hours urine levels of calcium and phosphorus were estimated Results: There was a statistical significant difference in the serum levels of 25(OH) vitamin D (12.26 vs 19.61 ng/mL), i-PTH (75.5 vs. 33.5 pg/mL), hsCRP (5117.05 vs. 1721.87 ng/mL), IL-6 (13.49 vs. 1.47 pg/mL) calcium (11.5 vs. 9.4 mg/dL) and urinary calcium (370.5 vs. 342 mg/d) and phosphorous levels (1172 vs. 1432 mg/d) between the cases and the control. There was negative correlation between the levels of i-PTH and vitamin D (r = -0.765) and positive correlation between i-PTH and hsCRP, IL-6, Serum calcium and urine calcium (r = 0.353, 0.340, 0.522, 0.501 respectively) Conclusion: There was vitamin D inadequacy and increased levels of PTH, IL-6 and C-reactive protein, calcium in patients with renal calculi when compared with healthy controls.
BACKGROUND Alcoholic Liver Disease (ALD) is a spectrum of disorders ranging from simple steatosis to steatohepatitis and cirrhosis. Various non-invasive markers have been validated as reliable prognostic markers of fibrosis in Chronic Viral Hepatitis and Non-Alcoholic Fatty Liver Disease but their utility in ALD is least evaluated. This study aims to compare the fibrosis scores in ALD patients with non-alcoholic healthy controls. METHODS The non-invasive scores of fibrosis namely AST/ALT ratio, BARD score, APRI and FIB-4 were calculated in 30 ALD cases and 30 age matched controls. Alcohol drinking pattern was evaluated using the AUDIT questionnaire. The difference in the fibrosis scores between cases and controls were calculated using independent student's t test. All statistical analysis were done using SPSS software v 20.0 and p value <0.05 was considered statistically significant. RESULTS All the non-invasive scores of fibrosis viz. AST/ALT ratio, BARD score, APRI and FIB-4 were significantly high in ALD cases compared to controls. All the cases had AST/ALT ratio more than >1, 76% of them had BARD score >2, 97% had APRI score >1 and 73% had FIB-4 score >3.25 denoting the presence of significant fibrosis in ALD patients. AUDIT score correlates with all the non-invasive fibrosis scores except AST/ALT ratio. There is significant correlation between FIB-4 score and APRI score (r= 0.962, p=<0.001) and between FIB-4 score and AST/ALT ratio (r= 0.500 p= 0.005). CONCLUSIONS The non-invasive fibrosis markers are significantly high in ALD cases. APRI, FIB4 and BARD score positively correlate with alcohol drinking pattern. Hence these scores derived from routine lab investigations could be used as cost effective tools to assess the severity of fibrosis in ALD patients.
Objective Lipemia is an important cause of preanalytical errors in laboratory results. They affect the specimen integrity and trustworthiness of laboratory results. The present study was to assess the impact of lipemia on routine clinical chemistry analytes. Methods Anonymous leftover serum samples with normal levels of routine biochemical parameters were pooled. Twenty such pooled serum samples were used for the study. The samples were spiked with commercially available intralipid solution (20%) to produce lipemic concentrations of 0, 400 (mild, 20 μL), 1,000 (moderate, 50 μL), and 2,000 mg/dL (severe, 100 μL). Glucose, renal function test, electrolytes, and liver function test were estimated in all the samples. Baseline data without the effect of interference was considered as true value and percentage bias for the spiked samples was calculated. Interference was considered significant if the interference bias percentage exceeded 10%. Result Parameters like glucose, urea, creatinine, direct bilirubin, sodium, potassium, and chloride showed negative interference at mild and moderate lipemic concentration and positive interference at severe lipemic concentration. Parameters like aspartate transaminase (AST) and alanine transaminase (ALT) showed negative interference at mild and positive interference at moderate and severe lipemic concentration. Whereas uric acid, total protein, albumin, total bilirubin, alkaline phosphatase, gamma-glutamyl transferase, calcium, magnesium, and phosphorous showed positive interference at all concentrations. Significant interference (> 10%) was shown for magnesium (mild lipemia), albumin, direct bilirubin, ALT, and AST at moderate lipemic concentration. All parameters showed significant interference at severe lipemic concentration. Conclusion All the study parameters are affected by lipemic interference at varying levels. Laboratory-specific data regarding lipemic interference at various concentrations on the clinical biochemistry parameters is needed.
Introduction and aim: The Government of India has endorsed COVID-19 vaccination for pregnant and lactating mothers. However, the vaccine acceptance rate among this target group is not satisfactory. The study aimed to assess the awareness level, acceptance rate, and hesitancy for COVID-19 vaccination among pregnant and lactating mothers attending government health care centers and to identify the psycho-social factors associated with vaccine hesitancy. Materials and methods: A government facility-based cross-sectional study was conducted in various government primary and secondary health care centers in Karaikal for a period of six months. After Institutional Ethics Committee (IEC) clearance, a semi-structured questionnaire was used to collect the data from 904 pregnant and lactating mothers. Bivariate and multivariate logistic regression were employed. Results: Despite a high awareness level (87%), vaccine hesitancy was high (55%) among the study participants. In multivariate analysis, age > 30 years, primi mothers, lactating mothers with < 6 months old children, unawareness, and recent COVID-19 infection were significantly associated with vaccine hesitancy. Fear of side effects for baby and mother following vaccination and family pressure were the prime reasons for vaccine hesitancy. Conclusion: Despite sufficient awareness about the eligibility for COVID-19 vaccination, the acceptance rate was low. There is a dire need to motivate the higher age group, primigravidas, and lactating mothers at the community level to get rid of their fear factors related to vaccination.
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