To study the renal function in term newborns with perinatal asphyxia including urinary excretion ... more To study the renal function in term newborns with perinatal asphyxia including urinary excretion of β2 microglobulin (β2M). This case control study included 50 term newborn babies with perinatal asphyxia and 50 normal babies as matched controls. In all cases, asphyxia grading (using Apgar score) and Hypoxic ischemic encephalopathy (HIE) staging (Sarnat and Sarnat) were done. Blood and urinary parameters (including β2M) for renal function were done in all and Fractional excretion of sodium (FENa) and Renal failure index (RFI) were calculated. The renal parameters were compared within subgroups as well as controls using analysis of variance test and the independent samples t test. Acute kidney Injury (AKI) was noted in 56 % of cases (24 % prerenal and 32 % intrinsic type). All 9 babies who died had AKI. Serum parameters like urea, creatinine, sodium and potassium had better correlation with the renal function as compared to urine parameters. All individual urine parameters except β2M showed wide variations. FENa, RFI and urinary β2M increased with increasing severity of asphyxia and HIE staging. AKI is common in term babies with perinatal asphyxia. FENa and RFI are useful parameters for assessing the renal function and urinary β2M is a good biomarker for diagnosis and prognosis of acute tubular injury in term babies with perinatal asphyxia.
Objectives: The present study was conducted to evaluate the effect of Team Idea Mapping (TIM) ses... more Objectives: The present study was conducted to evaluate the effect of Team Idea Mapping (TIM) sessions on the problem solving skills of postgraduate (PG) students of Biochemistry, as deduced from retro-pre self-efficacy questionnaire. Materials and Methods: The study was conducted enrolling students pursuing PG-MD course in Medical Biochemistry in a premier medical college. First TIM session was preceded by sensitization of PG students and departmental faculty. In total, four TIM sessions were conducted. Retro-pre self efficacy questionnaire was administered 3 months after the last session. Feedback from the students was collected immediately after last session and satisfaction index was also calculated. Results: The satisfaction index was highest (100) for items stating that TIM sessions promoted interactivity and participatory behaviorand lowest (78) for item stating that TIM sessions promoted reflective behavior respectively. The students expressed enhanced self-efficacy in understanding Biochemistry concepts, clinical application of Biochemistry, problem solving skills in Biochemistry, interpreting laboratory reports, participation in group works and clarifying problems with peers and seniors. However, the sessions were not as effective in instilling technical skills like trouble shooting for analyzer breakdowns. Conclusion: TIM is an effective tool for instilling problem solving skills in medical PG students, additionally fortifying their attitude to work in groups.
Caudate nucleus (CN) plays a role in neural-immune interactions and dopamine is an important neur... more Caudate nucleus (CN) plays a role in neural-immune interactions and dopamine is an important neurotransmitter in it. Hence, the effect of injection of dopamine and spiperone, a dopamine antagonist into the nucleus and lesion of caudate nucleus on humoral immunity was evaluated in albino rats. Dopamine injection into caudate nucleus at a dose of 4 microg/rat/day for 6 days was found to significantly attenuate antibody response following primary immunization of rats with sheep red blood cells (SRBC), decreased the spleen and body weight ratio and total globulin levels. Bilateral lesion of caudate nucleus also had similar effects whereas injection of spiperone (4 microg/rat/day for 6 days) into caudate nucleus enhanced the primary antibody response. The observed changes following dopamine or dopamine antagonist into caudate nucleus indicate that dopaminergic pathway of caudate nucleus negatively modulates humoral immunity in rats.
Patients with a traumatic or non-traumatic acute abdominal conditions often have equivocal findin... more Patients with a traumatic or non-traumatic acute abdominal conditions often have equivocal findings regarding the need for surgery. Ultrasound and computed tomography, though useful, have limitations and not always available in peripheral hospitals. Diagnostic peritoneal lavage (DPL) was investigated as an aid to decision-making in such patients. After preliminary X-ray and ultrasound, DPL was performed in 50 patients with an equivocal acute abdomen (18 trauma, 32 non-trauma). It was found that overall sensitivity, specificity, accuracy, and positive and negative predictive values were high for patients with trauma. All the above parameters except specificity and negative predictive value (NPV) were also found to be high for the non-trauma group. DPL was found to be a bedside investigation, which helped in taking the decision to operate on patients with both traumatic and non-traumatic acute abdomen.
Introduction: The increased prevalence of upper normal limit of TSH and raised anti-thyroperoxida... more Introduction: The increased prevalence of upper normal limit of TSH and raised anti-thyroperoxidase antibody titer indicate, relatively more frequent occurrence of compensated thyroid function in infertile women. This finding necessitates considering such cases for a thorough investigation of pituitary-thyroid axis. In addition, as some patients may exhibit the clinical picture of hypothyroidism despite normal TSH and free thyroxin (FT4) concentrations, this hospital-based study was undertaken to review the impact of thyroid status on the menstrual function and fertility of the subjects. Materials and methods: In this study, we investigated 160 women with primary infertility who attended the Biochemistry department, Maulana Azad Medical College (MAMC), New Delhi for hormonal evaluations. Eighty fertile women with similar age and socioeconomic status were enrolled as the controls. The association between thyroid dysfunction and levels of serum prolactin, LH and FSH as their menstrual status were reviewed. Results: The majority of the infertile and fertile women were euthyroid. In infertile group, the crude prevalence of hypothyroidism was slightly higher in the infertile group in comparison with that of the general population. There was a positive correlation between serum TSH and prolactin levels in the infertile subjects. Menstrual disorders (mainly oligomenorrhea), were reported by about 60% of the infertile women. Hyperprolactinemia was depicted in 41% of the infertile women while it was only 15% in the control group. The infertile women with hypothyroidism had significantly higher prolactin levels when compared to the subjects with hyper- or euthyroidism. There was a significant association between abnormal menstrual patterns and anovulatory cycles, as observed on endometrial examination of infertile subjects with raised serum prolactin levels. Conclusion: There is a greater propensity for thyroid disorder in infertile women than the fertile ones. There is also a higher prevalence of hyperprolactinemia in infertile patients.
Matrix metalloproteinases (MMPs), particularly MMP-2 and MMP-9, have been reported as putative tu... more Matrix metalloproteinases (MMPs), particularly MMP-2 and MMP-9, have been reported as putative tumor markers because of their involvement in cancer invasion and metastasis. The aim of our study was to elucidate the possible role of MMP-2 and -9 as serum prognostic biomarker for breast cancer classification and correlate it with the clinicopathological variables. Our study consisted of 60 females with primary breast cancer, 40 cases of benign breast disease and 60 healthy female volunteers as controls. The serum MMP-2 and -9 levels were quantitatively measured by ELISA technique. A significantly raised MMP-2 and MMP-9 levels were observed in breast cancer patients. Significant rise in serum MMP-9 concentration was found in patients presenting with metastasis as well as in those cases who presented with a duration of less than 1year. ROC analyses depicted a serum cutoff value of 315ng/mL for MMP-9 to discriminate the breast cancer patients from the control group. Our results suggest that serum MMP-9 level is a better marker than serum MMP-2 in predicting the breast cancer development and progression.
The effect of truncal vagotomy on gallbladder function and on the incidence of lithogenesis has r... more The effect of truncal vagotomy on gallbladder function and on the incidence of lithogenesis has remained controversial. A prospective and retrospective investigational study was undertaken to evaluate the effect of truncal vagotomy and gastrojejunostomy on gallbladder function. The study included a total of 76 patients and 77 controls. In Group I (Prospective group), 32 consecutive patients with chronic duodenal ulcer and gastric outlet obstruction undergoing truncal vagotomy and gastrojejunostomy were included. Group II included 25 age and gender matched controls (prospective group). Group III included 44 patients who had undergone truncal vagotomy and gastrojejunostomy 3 years or more prior to presentation (Retrospective group) and Group IV included 52 age and gender matched controls for the retrospective group. The patients in the prospective groups were followed up for a period of 1 year. An alkaline tide test was done in the prospective and retrospective group to assess for the completeness of vagotomy. Gallbladder contractile response to fatty meal and the presence of stones and sludge were noted in all the four groups by ultrasonography. There were 30 patients in the prospective group and 40 in the retrospective group after excluding patients with incomplete vagotomy. On ultrasound examination, there was no significant difference in the gallbladder volume and contractility of the study group when compared with the controls. Gallbladder sludge was found in 16 to 25% of patients in the prospective group (group I) during follow up, where as similar finding was documented in 8% of the matched control (group II (P>0.1). However, in the retrospective (group III) 10% (4 out of 40) had calculi and 20% of patients demonstrated sludge which was significantly higher when compared with the controls (p = 0.001). Truncal vagotomy and gastrojejunostomy did not affect gallbladder contractility, but it might predispose to the formation of sludge and subsequent calculi in a proportion of patients in long term.
ABSTRACT Contrast-induced acute kidney injury (AKI) is diagnosed by estimating serum creatinine a... more ABSTRACT Contrast-induced acute kidney injury (AKI) is diagnosed by estimating serum creatinine at 48-72h after diagnostic or interventional coronary angiography. It is too late for an early intervention. Neutrophil gelatinase associated lipocalin (NGAL) and cystatin C are novel markers of AKI. We determined the optimum cut off level of NGAL and cystatin C in early diagnosis and prediction of AKI in patients undergoing coronary angiography followed by angioplasty. In a nested case control study, serum NGAL, cystatin C by ELISA and serum creatinine by Jaffe's kinetic method were estimated at 0, 4, 24 and 48h of coronary angiography followed by angioplasty in 30 cases who developed contrast-induced AKI and 30 subjects who did not develop AKI. eGFR was estimated for both cases and controls by the MDRD equation. ROC was used to determine optimum cut-off. Serum NGAL increased sharply at 4h after the procedure and then gradually declined to near normal level at 48h in AKI cases. The rise in cystatin C peaked at 24h and then declined but remained high till 48h. In controls, they remained static. Optimum cut-off of serum NGAL and cystatin C was 155.2ng/ml and 0.517mg/l respectively at 4h and 89.5ng/ml and 0.99mg/l respectively at 24h of angiography. Odds ratio for hypertensives to develop AKI was 3.57 (CI: 1.2-11.1, P=0.03). Serum NGAL and cystatin C may act as early markers of contrast-induced AKI in patients undergoing percutaneous coronary intervention. Patients with hypertension are susceptible to develop contrast-induced AKI.
Health Care Workers (HCWs) of diagnostic laboratory handling COVID positive samples are at risk a... more Health Care Workers (HCWs) of diagnostic laboratory handling COVID positive samples are at risk and need to take protective measures. Many protective materials were not available when the pandemic reached India forcing laboratory managers to take innovative measures to protect the laboratory staffs. We made face shields from OHP sheets and substitute of biosafety cabinets from cardboard boxes fitted with hypochlorite spraying devices. Here we present if these two in-house developed safety devices when incorporated in standard operating procedure (SOP) of laboratory safety were effective in clinical biochemistry laboratory of dedicated COVID hospitals. We assessed contamination of laboratory surfaces (n=6) and rate of SARS-nCov-2 positivity from their nasal and throat swab by RT-PCR among laboratory personnel (n=18) after 14 days of their use along with other routine safety devices like use of gloves, surgical masks, OT gowns etc. These HCWs were checked regularly for signs and sympt...
To study the renal function in term newborns with perinatal asphyxia including urinary excretion ... more To study the renal function in term newborns with perinatal asphyxia including urinary excretion of β2 microglobulin (β2M). This case control study included 50 term newborn babies with perinatal asphyxia and 50 normal babies as matched controls. In all cases, asphyxia grading (using Apgar score) and Hypoxic ischemic encephalopathy (HIE) staging (Sarnat and Sarnat) were done. Blood and urinary parameters (including β2M) for renal function were done in all and Fractional excretion of sodium (FENa) and Renal failure index (RFI) were calculated. The renal parameters were compared within subgroups as well as controls using analysis of variance test and the independent samples t test. Acute kidney Injury (AKI) was noted in 56 % of cases (24 % prerenal and 32 % intrinsic type). All 9 babies who died had AKI. Serum parameters like urea, creatinine, sodium and potassium had better correlation with the renal function as compared to urine parameters. All individual urine parameters except β2M showed wide variations. FENa, RFI and urinary β2M increased with increasing severity of asphyxia and HIE staging. AKI is common in term babies with perinatal asphyxia. FENa and RFI are useful parameters for assessing the renal function and urinary β2M is a good biomarker for diagnosis and prognosis of acute tubular injury in term babies with perinatal asphyxia.
Objectives: The present study was conducted to evaluate the effect of Team Idea Mapping (TIM) ses... more Objectives: The present study was conducted to evaluate the effect of Team Idea Mapping (TIM) sessions on the problem solving skills of postgraduate (PG) students of Biochemistry, as deduced from retro-pre self-efficacy questionnaire. Materials and Methods: The study was conducted enrolling students pursuing PG-MD course in Medical Biochemistry in a premier medical college. First TIM session was preceded by sensitization of PG students and departmental faculty. In total, four TIM sessions were conducted. Retro-pre self efficacy questionnaire was administered 3 months after the last session. Feedback from the students was collected immediately after last session and satisfaction index was also calculated. Results: The satisfaction index was highest (100) for items stating that TIM sessions promoted interactivity and participatory behaviorand lowest (78) for item stating that TIM sessions promoted reflective behavior respectively. The students expressed enhanced self-efficacy in understanding Biochemistry concepts, clinical application of Biochemistry, problem solving skills in Biochemistry, interpreting laboratory reports, participation in group works and clarifying problems with peers and seniors. However, the sessions were not as effective in instilling technical skills like trouble shooting for analyzer breakdowns. Conclusion: TIM is an effective tool for instilling problem solving skills in medical PG students, additionally fortifying their attitude to work in groups.
Caudate nucleus (CN) plays a role in neural-immune interactions and dopamine is an important neur... more Caudate nucleus (CN) plays a role in neural-immune interactions and dopamine is an important neurotransmitter in it. Hence, the effect of injection of dopamine and spiperone, a dopamine antagonist into the nucleus and lesion of caudate nucleus on humoral immunity was evaluated in albino rats. Dopamine injection into caudate nucleus at a dose of 4 microg/rat/day for 6 days was found to significantly attenuate antibody response following primary immunization of rats with sheep red blood cells (SRBC), decreased the spleen and body weight ratio and total globulin levels. Bilateral lesion of caudate nucleus also had similar effects whereas injection of spiperone (4 microg/rat/day for 6 days) into caudate nucleus enhanced the primary antibody response. The observed changes following dopamine or dopamine antagonist into caudate nucleus indicate that dopaminergic pathway of caudate nucleus negatively modulates humoral immunity in rats.
Patients with a traumatic or non-traumatic acute abdominal conditions often have equivocal findin... more Patients with a traumatic or non-traumatic acute abdominal conditions often have equivocal findings regarding the need for surgery. Ultrasound and computed tomography, though useful, have limitations and not always available in peripheral hospitals. Diagnostic peritoneal lavage (DPL) was investigated as an aid to decision-making in such patients. After preliminary X-ray and ultrasound, DPL was performed in 50 patients with an equivocal acute abdomen (18 trauma, 32 non-trauma). It was found that overall sensitivity, specificity, accuracy, and positive and negative predictive values were high for patients with trauma. All the above parameters except specificity and negative predictive value (NPV) were also found to be high for the non-trauma group. DPL was found to be a bedside investigation, which helped in taking the decision to operate on patients with both traumatic and non-traumatic acute abdomen.
Introduction: The increased prevalence of upper normal limit of TSH and raised anti-thyroperoxida... more Introduction: The increased prevalence of upper normal limit of TSH and raised anti-thyroperoxidase antibody titer indicate, relatively more frequent occurrence of compensated thyroid function in infertile women. This finding necessitates considering such cases for a thorough investigation of pituitary-thyroid axis. In addition, as some patients may exhibit the clinical picture of hypothyroidism despite normal TSH and free thyroxin (FT4) concentrations, this hospital-based study was undertaken to review the impact of thyroid status on the menstrual function and fertility of the subjects. Materials and methods: In this study, we investigated 160 women with primary infertility who attended the Biochemistry department, Maulana Azad Medical College (MAMC), New Delhi for hormonal evaluations. Eighty fertile women with similar age and socioeconomic status were enrolled as the controls. The association between thyroid dysfunction and levels of serum prolactin, LH and FSH as their menstrual status were reviewed. Results: The majority of the infertile and fertile women were euthyroid. In infertile group, the crude prevalence of hypothyroidism was slightly higher in the infertile group in comparison with that of the general population. There was a positive correlation between serum TSH and prolactin levels in the infertile subjects. Menstrual disorders (mainly oligomenorrhea), were reported by about 60% of the infertile women. Hyperprolactinemia was depicted in 41% of the infertile women while it was only 15% in the control group. The infertile women with hypothyroidism had significantly higher prolactin levels when compared to the subjects with hyper- or euthyroidism. There was a significant association between abnormal menstrual patterns and anovulatory cycles, as observed on endometrial examination of infertile subjects with raised serum prolactin levels. Conclusion: There is a greater propensity for thyroid disorder in infertile women than the fertile ones. There is also a higher prevalence of hyperprolactinemia in infertile patients.
Matrix metalloproteinases (MMPs), particularly MMP-2 and MMP-9, have been reported as putative tu... more Matrix metalloproteinases (MMPs), particularly MMP-2 and MMP-9, have been reported as putative tumor markers because of their involvement in cancer invasion and metastasis. The aim of our study was to elucidate the possible role of MMP-2 and -9 as serum prognostic biomarker for breast cancer classification and correlate it with the clinicopathological variables. Our study consisted of 60 females with primary breast cancer, 40 cases of benign breast disease and 60 healthy female volunteers as controls. The serum MMP-2 and -9 levels were quantitatively measured by ELISA technique. A significantly raised MMP-2 and MMP-9 levels were observed in breast cancer patients. Significant rise in serum MMP-9 concentration was found in patients presenting with metastasis as well as in those cases who presented with a duration of less than 1year. ROC analyses depicted a serum cutoff value of 315ng/mL for MMP-9 to discriminate the breast cancer patients from the control group. Our results suggest that serum MMP-9 level is a better marker than serum MMP-2 in predicting the breast cancer development and progression.
The effect of truncal vagotomy on gallbladder function and on the incidence of lithogenesis has r... more The effect of truncal vagotomy on gallbladder function and on the incidence of lithogenesis has remained controversial. A prospective and retrospective investigational study was undertaken to evaluate the effect of truncal vagotomy and gastrojejunostomy on gallbladder function. The study included a total of 76 patients and 77 controls. In Group I (Prospective group), 32 consecutive patients with chronic duodenal ulcer and gastric outlet obstruction undergoing truncal vagotomy and gastrojejunostomy were included. Group II included 25 age and gender matched controls (prospective group). Group III included 44 patients who had undergone truncal vagotomy and gastrojejunostomy 3 years or more prior to presentation (Retrospective group) and Group IV included 52 age and gender matched controls for the retrospective group. The patients in the prospective groups were followed up for a period of 1 year. An alkaline tide test was done in the prospective and retrospective group to assess for the completeness of vagotomy. Gallbladder contractile response to fatty meal and the presence of stones and sludge were noted in all the four groups by ultrasonography. There were 30 patients in the prospective group and 40 in the retrospective group after excluding patients with incomplete vagotomy. On ultrasound examination, there was no significant difference in the gallbladder volume and contractility of the study group when compared with the controls. Gallbladder sludge was found in 16 to 25% of patients in the prospective group (group I) during follow up, where as similar finding was documented in 8% of the matched control (group II (P>0.1). However, in the retrospective (group III) 10% (4 out of 40) had calculi and 20% of patients demonstrated sludge which was significantly higher when compared with the controls (p = 0.001). Truncal vagotomy and gastrojejunostomy did not affect gallbladder contractility, but it might predispose to the formation of sludge and subsequent calculi in a proportion of patients in long term.
ABSTRACT Contrast-induced acute kidney injury (AKI) is diagnosed by estimating serum creatinine a... more ABSTRACT Contrast-induced acute kidney injury (AKI) is diagnosed by estimating serum creatinine at 48-72h after diagnostic or interventional coronary angiography. It is too late for an early intervention. Neutrophil gelatinase associated lipocalin (NGAL) and cystatin C are novel markers of AKI. We determined the optimum cut off level of NGAL and cystatin C in early diagnosis and prediction of AKI in patients undergoing coronary angiography followed by angioplasty. In a nested case control study, serum NGAL, cystatin C by ELISA and serum creatinine by Jaffe's kinetic method were estimated at 0, 4, 24 and 48h of coronary angiography followed by angioplasty in 30 cases who developed contrast-induced AKI and 30 subjects who did not develop AKI. eGFR was estimated for both cases and controls by the MDRD equation. ROC was used to determine optimum cut-off. Serum NGAL increased sharply at 4h after the procedure and then gradually declined to near normal level at 48h in AKI cases. The rise in cystatin C peaked at 24h and then declined but remained high till 48h. In controls, they remained static. Optimum cut-off of serum NGAL and cystatin C was 155.2ng/ml and 0.517mg/l respectively at 4h and 89.5ng/ml and 0.99mg/l respectively at 24h of angiography. Odds ratio for hypertensives to develop AKI was 3.57 (CI: 1.2-11.1, P=0.03). Serum NGAL and cystatin C may act as early markers of contrast-induced AKI in patients undergoing percutaneous coronary intervention. Patients with hypertension are susceptible to develop contrast-induced AKI.
Health Care Workers (HCWs) of diagnostic laboratory handling COVID positive samples are at risk a... more Health Care Workers (HCWs) of diagnostic laboratory handling COVID positive samples are at risk and need to take protective measures. Many protective materials were not available when the pandemic reached India forcing laboratory managers to take innovative measures to protect the laboratory staffs. We made face shields from OHP sheets and substitute of biosafety cabinets from cardboard boxes fitted with hypochlorite spraying devices. Here we present if these two in-house developed safety devices when incorporated in standard operating procedure (SOP) of laboratory safety were effective in clinical biochemistry laboratory of dedicated COVID hospitals. We assessed contamination of laboratory surfaces (n=6) and rate of SARS-nCov-2 positivity from their nasal and throat swab by RT-PCR among laboratory personnel (n=18) after 14 days of their use along with other routine safety devices like use of gloves, surgical masks, OT gowns etc. These HCWs were checked regularly for signs and sympt...
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