Ranjith Kumar Chikine

Abstract

Aim: The aim of the study is to estimate the glycated hemoglobin (HbA1c) in Boric acid affinity method, (Nycocard reader II) compare and correlate these values with those values of DCCT standardized method, High Performance Liquid Chromatography (D-10, Biorad). As well as to check the boric acid affinity may or not work as an alternative to the costly high performance liquid chromatography method for glycated hemoglobin. Materials and Methods: People visit the clinical laboratory of S.V.S medical college for their HbA1c, to know their glycemic status. A total of40 subjects were included in this cross sectional study irrespective of their glycemic condition after exclusion criteria. Subjects with either anaemia (Haemoglobin less or equal 10% was considered as anaemia)or underlying abnormal haemoglobinopathies or addiction of alcohol or opiates or medication on salicylates and those not willing to give consent were not included. HbA1c levels were measured by both the techniques on the same blood sample of individual participants. Results: The mean SD age of the study group was 52 17.16 years. The HbA1c values of individuals by HPLC method were between 4.7% - 14.3% were taken in this study. Their whole blood HbA1c levels estimated by HPLC and boric acid affinity in terms of mean SD were 7.57 2.64 and 7.67 2.48 respectively. This difference was not statistically significant which indicates no value differences in these two methods under standard conditions and trained techniques. A highly positive correlation was established between these two methods as 0.98, which was statistically significant (p Bablok regression analysis demonstrated similar performance of HPLC and BAA methods for estimating HbA1c with Intercept close to zero and slope close to one. The precision of the boric acid affinity method is not better than HPLC, but it is within IFCC suggested limits. Conclusion: The study revealed that the Boric acid affinity and the HPLC methods show very strong correlation and good agreement. Boric acid affinity performed acceptable precision. Though the HPLC method is established as the gold standard for estimation of HbA1c, Boric acid affinity method can serve as an alternative and suitable in minimal facility laboratories as it is cheaper and easier to analyse. Keywords: Glycated Haemoglobin (HbA1c), High performance liquid, chromatography (HPLC), Boric acid affinity (BAA), Precision study.

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Abstract

Background: Individuals have the chance to get exposed to organophosphates either at domestic, or industrial spheres. Organophosphate poisoning is a worldwide problem. Organophosphate insecticides inhibit Cholinesterase enzymatic activity. Chlorpyrifos, Phorate 10% granules and Monocrotophos are insecticides and pesticides commonly used in India by farmers. Aim: The present study aims at determining the effect oforganophosphate compounds on thyroid profile in individuals exposed to acute poisoning. Materials and Methods: In this study, those individuals who were acutely presented at the emergency department, SVS Medical College, Mahabubnagar, with a history of intentional or accidental intake of either chlorpyrifos or Phorate 10% granules or Monocrotophos (Organophosphorus compounds) were taken as cases. Intake of these compounds was confirmed by analyzing serum cholinesterase levels. Those patients having a serum cholinesterase levels value below 4000 U/L were included in this study. Simultaneously, the sample was analyzed for thyroid profile that includes Total triiodothyronine (TT3), Total tetraiodothyronine (TT4) and Thyroid stimulating hormone (TSH). Reanalyzing of thyroid profile was done after a time gap of one month from the day of discharge from hospital after recovery. Results: Total T3, Total T4 and TSH values showed statistically significant change (p-value between the acute poisoning phase and one month follow up phase of after recovery. Conclusion: Total T4 values are significantly higher in acute organophosphorus poisoned phase mimicking thyrotoxicosis, and return to normal biological reference range after recovery, whereas TSH values in acute opiates poisoned phase were significant lower than that of recovery phase. Keywords: Organophosphorus compounds (OPC), Total triiodothyronine(TT3), Total tetraiodothyronine(TT4), Thyroid stimulating hormone (TSH), Cholinesterase enzyme.

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