Medical Laboratory Technology Journal
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Coagulation Profile In Diabetes Mellitus And Its Association with Microvascular Complications in Uncontrolled and Controlled Diabetes at Edo Specialist Hospital, Benin-City, South-South, Nigeria
Diabetes mellitus induces coagulopathies by glycating haemoglobin, prothrombin, fibrinogen, and other proteins involved in the clotting mechanism. Shortened PTTK and PT represent a hypercoagulable state related to an elevated thrombotic risk and a negative cardiovascular effect, both of which can lead to the onset and progression of microvascular and macrovascular problems. The study aims to compare the coagulation profile in diabetes-related microvascular complications in clients with uncontrolled and controlled diabetes at an Edo specialty hospital in Benin City. A hospital-based case-control study was carried out at ESH in Benin City. Two hundred eighty individuals were recruited for the study, including 215 diabetes patients (55 type I diabetes, 160 type II diabetes, and 65 non-diabetics) attending the outpatient department of ESH in Benin City. Blood was drawn for coagulation and biochemical assays. Diabetes patients had significantly lower levels of PT and PTTK compared to non-diabetes controls (p<0.05). Fibrinogen and D-dimer levels were considerably higher (p<0.05). The PTTK level was much lower in type 2 diabetes than in type 1 diabetes, and there was a significant difference in platelet count between type 1 and type 2 diabetes. Female diabetes patients had lower levels of PTTK and PT than male diabetic patients. Furthermore, in diabetes with complications, the levels of PTTK and platelet count were lower (p0.05). It was discovered that insulin treatment decreased platelet count, whereas sulfonylurea increased fibrinogen levels in people with diabetes. Diabetes may increase the risk of clotting, as indicated by shorter PTTK, PT, and higher fibrinogen and D-dimer levels compared to controls. The coagulation profile should be evaluated as a regular screening test in diabetes patients to reduce the incidence and prevalence of vascular burden and to improve quality of life
Correlation of Parasitaemia and Anemia in Mice Infected with Plasmodium berghei ANKA
Malaria is an infectious disease caused by protozoa of the genus Plasmodium and transmitted through the bite of a female Anopheles mosquito. Plasmodium berghei ANKA is a species of rodent malaria parasite that is commonly used to study malaria pathology and the immune system against infections. Parasitaemia in malaria is the figure of malaria pathology due to some numbers of parasite-infected erythrocytes present in the peripheral blood. Hemoglobin (HGB) and hematocrit (HCT) levels are the parameters of anemia and some hematological changes caused by malaria infection. This study aimed to determine the correlation between parasitemia and anemia in BABL/c mice infected with Plasmodium berghei ANKA. Two uninfected and infected mice groups were compared for parasitemia, HGB, and HCT levels. Analysis statistics showed a significant difference in HGB and HCT between uninfected and infected groups. Pearson correlation analysis showed no significant correlation between parasitemia and HGB and HCT levels in infected mice. Anemia in mice infected with Plasmodium berghei ANKA can occur when parasitemia is even low; the higher parasitemia worsens the hamatological condition. Parasitemia plays a role independently in the severity of anemia. Plasmodium berghei infection in mice is useful for studying malaria anemia
HLA-DQB1*05:02 Allele Association with Anti-Tuberculosis Drug Induced Liver Injury: A Single-Hospital Based Study in Jakarta, Indonesia
Past studies have delved into the genetic factors underlying anti-tuberculosis drug-induced liver injury (AT-DILI), primarily concentrating on polymorphisms in genes responsible for drug-metabolizing enzymes. However, the immune system's potential impact on drug adverse effects, specifically through genes such as HLA, has received limited attention. Previous research has notably revealed an association between HLA-DQB1*05 and AT-DILI, specifically the prevalence of the HLA-DQB*05:02 allele in AT-DILI patients. In light of this, our study aimed to investigate a potential link between HLA-DQB1*05:02 alleles and AT-DILI. In this study, we included 51 AT-DILI cases and 59 controls belonging to the Javanese ethnic group. The HLA-DQB1*05:02 genotypes were determined using a customized PCR-based typing method, and the results were further confirmed by analyzing five samples via the Luminex assay. Our findings revealed a significant association between HLA-DQA1*05: 02 and the risk of AT-DILI (P = 0.022; OR (95% CI) = 6.11 (1.25-29.74)). Moreover, the consistent results obtained from the Luminex assay validated the reliability of the custom PCR-based genotyping approach. This preliminary study sheds light on the relationship between the HLA-DQB1*05:02 allele and AT-DILI within the Indonesian population. Furthermore, our study demonstrates the dependability of custom PCR-based genotyping in detecting HLA-DQB1*05:02 alleles. Nevertheless, further research is imperative to corroborate and expand upon our findings
The Emergence of Mupirocin Resistance among Staphylococcus aureus in a Tertiary Care Hospital in South India: The Necessity for Routine Susceptibility Testing
Methicillin-resistant Staphylococcus aureus (MRSA) is difficult to treat, causing considerable morbidity and mortality. Nasal carriage of MRSA can occur both in healthcare workers and patients. Mupirocin is used as a topical agent for the eradication of such isolates. The present study aims to study the prevalence of mupirocin resistance among the MRSA and MSSA (Methicillin-sensitive Staphylococcus aureus) isolates. A total of 148 Staphylococcus aureus isolates were tested. Antibiotic susceptibility testing was done by Kirby Bauer disc diffusion method for amoxicillin, penicillin, cotrimoxazole, clindamycin, mupirocin(5 µg and 200 µg discs for low and high-level resistance), erythromycin, gentamicin and linezolid. MRSA isolates were detected by cefoxitin disc diffusion and Mec A detection by PCR (Polymerase Chain Reaction). MRSA was detected among 44 (29.7%) of the isolates. Among MSSA, good susceptibility was observed for cotrimoxazole 89 (85.5%) and clindamycin 92 (88.4%). An overall mupirocin resistance of 12(8.1%) was observed, with high-level resistance at 4 (2.7%) and low-level resistance at 8 (5.4%).The mupirocin resistance pattern between MRSA and MSSA was not statistically significant (p=0.1833). The emergence of mupirocin resistance highlights the necessity for creating cognizance among clinicians before prescribing mupirocin. In eradicating nasal carriage of MRSA, all the isolates should always be tested for mupirocin susceptibility to prevent the selection and spread of drug-resistant isolates
Identıfıcatıon of KRAS Mutatıons in Colorectal Carcınoma Patıents at Dr. M. Djamıl Hospıtal, West Sumatra-Indonesıa
Kirsten rat sarcoma viral oncogene (KRAS) gene mutations lead to abnormal activation of the RAS signalling pathway and have been associated with poor prognosis and resistance to some therapeutics. This study aimed to identify mutation characteristics of the KRAS genes codon 12 and 13 in colorectal cancer patients in West Sumatra. KRAS mutations were analyzed in 20 DNA of colorectal cancer patients' tissue samples by using polymerase chain reaction (PCR) with specific primer and direct sequencing analysis. Our findings showed five samples (25%) with mutated KRAS at codons 12 and 13 (including three samples with GGT→GAT, one sample with GGT→GTT in codon 12, and one sample with GGC→GAC in codon 13). In conclusion, we found two variations of amino acid changes at codon 12 (G12D and G12V) and one at codon 13 (G13D). More research with many samples is required to obtain conclusive data on the relationship between these gene mutations and colorectal cancer response to therapy and prognosis
Profile and Role of Serum Hypothalamic-Pituitary-Testicular-Axis Hormones on Sexual Function of Older Men with Type-2 Diabetes
Little information is available on the complex endocrinology of sexual dysfunction, which is frequently associated with ageing and diabetes. We wanted to examine the serum profile of hypothalamic-pituitary-testicular-axis (HPTA) hormones and how they relate to sexual function in older men with type-2 diabetes. This study included 74 participants (44 type-2 diabetics and 30 healthy controls). The enzyme-linked immunosorbent assay (ELISA) method was used to measure serum levels of total testosterone (Te), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin (PRL). Compared to controls, diabetic patients had significantly higher FSH and PRL levels but lower Te levels. Testosterone was found to be significantly correlated with sexual intercourse frequency (p<0.01), erectile function, and libido (p< 0.001). We discovered significant (p < 0.001) relationships between libido, penile erection, and FSH, as well as between PRL and libido (p< 0.05). When compared to the other hormones, testosterone had the strongest associations with the frequency of sexual intercourse (p< 0.05), libido (p< 0.05), and penile erection (p< 0.01). Our findings indicated that HPTA hormones might have a significant influence on sexual functions in type-2 diabetic patients, with Te being the most important HPTA hormone influencing sexual functions in diabetic patients. This study, therefore, helps to clarify the complex endocrinology and physiology of the sexual dysfunction frequently observed in older men with type-2 diabetes and also supports the use of testosterone replacement therapy in older diabetic adults
Condition Optimization for The Analysis of Risperidone and 9-0H-Risperidone by High-Performance Liquid Chromatography
Risperidone (RIS) is one of the most widely used atypical antipsychotics for treating schizophrenia in hospitals. RIS is metabolized by the liver and produces the primary active metabolite 9-OH-Risperidone (9-OHR). In the process of RIS metabolism, it is suspected that there are gene polymorphisms that cause variations in patient responses. Analysis of RIS and 9-OHR levels in the patient's blood can help to explain the various responses. High-Performance Liquid Chromatography (HPLC) is the most popular method to analyze RIS and 9-OHR, but many deficiencies were found in the chromatograms in the previous study. This research aims to obtain optimal conditions of the analysis prior to method validation. Condition optimization by optimizing the wavelength, composition of the mobile phase, pH, flow rate, and particle size of the stationary phase. The results showed that the wavelength was 279 nm, the mobile phase was 0.05 M KH2PO4 pH 3.7: acetonitrile (94:6, v/v) plus 0.3% triethylamine, and the flow rate was 1.2 ml/min in the stationary phase (LiChroCART® RP 18; 250x4 mm; 10 µm) being the optimal condition. This method is suggested to continue method validation for analyzing RIS and 9-OHR in the serum or plasma
Survival and Clinicopathological Features of Cervical Carcinoma Patients with Radiation Therapy
Cervical cancer has a high incidence with a low survival rate. The clinicopathological profile and risk factors cause this. Most cervical cancer sufferers are late in realizing this, contributing to the severity suffered. Radiation has a very important role because it is a therapy that can be done in cervical cancer patients who have experienced an advanced level of severity. This study aims to determine the survival and influence of the clinicopathological and risk factors of radiation patients as a consideration in selecting effective therapy to increase the survival rate of cervical cancer patients. The benefit of this research is to help evaluate cervical cancer management procedures with radiation therapy applied in many hospitals in Indonesia to increase the success of therapy for cervical cancer. An analytical observational study with a retrospective cohort type using medical record data with samples of all patients diagnosed with cervical cancer who received radiation therapy from January to December 2017. Samples in this study were 111 patients. This study revealed that the five-year survival rate of cervical cancer patients was only 53.1%. There was an influence on the clinicopathological stage (p<0.000), histopathology (p<0.000), lymph node status (p<0.000), degree of differentiation (p<0.001), and risk factors for age (p<0.038), parity (p<0.001), education (0.022), marital status (0.001), contraceptive use (p<0.000), and BMI (p<0.000) which resulted in a log-rank p-value <0.05, so it was concluded that there was an effect between these variables on cervical carcinoma survival rate. Multivariate, it was found that radiation, histopathology, lymph node status, contraception, and BMI had a significant effect (p<0.005) on the survival rate of cervical cancer patients. The results of this study indicate that the survival rate of cervical cancer patients is still low, and there is a clinicopathological and risk factors that influence the survival rate of cervical cancer patients
Effect of Papaya Leaf Extract Gel (Carica papaya) on Incision Wound Healing in Rattus norvegicus
Carica papaya is one kind of herbal plant that can help the wound healing process. Scientifically, the leaves of papaya are proven to have anti-inflammatory effects. Flavonoid, alkaloid, tannin, and saponin compounds in papaya leaves have antimicrobial and antioxidant properties to accelerate the re-epithelization and cell migration needed for wound healing. This research aims to determine the effect of papaya leaf extract gel (Carica papaya) on the healing of incision wounds in Rattus norvegicus based on changes in wound morphology (signs of redness, edema, pus, granulation, moisture, and wound length). This research used female Rattus norvegicus aged 12-16 weeks weighing 180-200 grams, divided into five groups (NaCl 0,9%, povidone-iodine, papaya leaf extract gel with concentrations of 10%, 20%, and 30%). Incision wounds on the back of the rat with a length of 2 cm and depth of 1 cm. The normality test used the Shapiro-Wilk test, and the homogeneity test used the Levene test. The research data were not normally distributed nor homogeneous, so they were analyzed using the Kruskal Wallis and Mann-Whitney tests. The results showed that the extract of papaya leaves with concentrations of 10%, 20%, and 30% had significant differences in positive and negative control groups in the wound healing process with the differences in redness (p=0.038), granulation tissue (p=0.039), moistures (0,48), and wound length (p=0,049). It can be concluded that papaya leaf extract gel (Carica papaya) is effective in accelerating the healing process of incision wounds in Rattus norwegicus at concentrations of 10%, 20%, and 30%, so for further research, it is hoped that a histopathological examination can be carried out so that changes that occur in collagen, neutrophile cells, monocytes, and lymphocytes are seen
Effect of Hematologic Values in Determining the Resolution of Subacute Thyroiditis and Long-Term Hypothyroidism Risk
Subacute thyroiditis (SAT), which can be considered a disease with infectious signs and parameters, can affect humans and lead to permanent hypothyroidism. Haematological parameters play an essential role in SAT; these parameters begin to normalise after the thyrotoxic phase; however, there is still a gap in knowledge about how these parameters play a role in SAT prognosis. Therefore, we wanted to investigate haematological parameters and their impact on treatment response and recovery phase in patients with SAT. 51 SAT patients and 44 healthy controls were included in the study. ESR, CRP, NLR and MPV were recorded at the diagnosis and after resolution. The changes in these parameters were compared to determine the resolution phase. The ratio of permanent hypothyroidism after one year was studied, and its relevance with these parameters at the time of diagnosis was explored. 36 of 51 SAT patients were female in the study (70.5%). The mean age was 45.53 ± 11.46 years. In the acute phase, WBC, Neutrophil, platelet, ESR, N/L, and P/L were significantly higher (p<0.05). In the recovery phase, MPV and lymphocyte count were significantly higher (p: 0.002 and p=0.002). WBC, CRP, and ESR had the highest AUC values in ROC analysis (0.990, 0.959, 0.907, p<0.05). P/L and N/L ratios also had higher ratios for the acute phase (0.807, 0.98, p<0.05, respectively). Δ ESR, Δ CRP, Δ N/L, and Δ P/L had the highest AUC for the recovery phase (AUC= 0.990, 0.899, 0889,0.800, p<0.5, respectively). Permanent hypothyroidism after one year was 9/42 (21.4%). In addition to ESR and CRP, NLR, PLR and MPV were also successfully used to estimate SAT activity and response to treatment. Moreover, a decrease in NLR and PLR and an increase in MPV were associated with the treatment response and resolution phase. However, these parameters did not determine the long-term risk of hypothyroidism