B R. Shyam Prasad

Abstract

Chronic Kidney disease is a recognized public health problem with a huge social and economical impact on the individual, family, society and country. Renal failure is a systemic disease and induces a slow and progressive decline of kidney function aggravated by various factors such as diabetes, infections, auto immune diseases and toxic chemicals. Aim: The study was aimed to estimate malondialdehyde, urea and creatinine levels in Chronic renal failure (CRF) patients. Materials and Methods: The study was conducted in the department of Biochemistry, Government medical college, Anantapuramu, Andhra Pradesh. Study subjects were divided in to 2 groups: Group - 1: healthy controls (35) with age group 35-65 years, Group -2 : CRF patients (35) age group 35 -65 years . Blood Sample was analyzed for plasma glucose, Blood urea, serum creatinine and serum Malondialdehyde. Results: The mean and standard deviation of Serum Malondialdehyde, blood urea and serum Creatinine in Chronic renal failure patients (Group-2) was higher compared to controls (Group-1) (p Significant positive correlation was observed between serum Malondialdehyde and serum creatinine. A positive correlation was observed between serum Malondialdehyde and blood urea (r= 0.40576). Significant positive correlation existed between Malondialdehyde and serum creatinine (r=0.46832). Conclusion: In our study on chronic renal failure patients and age matched healthy controls, the renal parameters – urea, creatinine and BUN were elevated. In addition Malondialdehyde was found to be significantly elevated showing a pro oxidant status in CRF patients. Keywords: Chronic Renal Failure CRF, Malondialdehyde MDA, Creatinine.

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Tuberculosis is a communicable disease with differing manifestations. It is a disease which is one of the leading causes of morbidity and mortality worldwide and a disease which is affecting economy directly and indirectly. Extra pulmonary manifestations are an area of interest to laboratory as diagnosis is often difficult and not definitive. Pleural effusion is one of the commonest extra pulmonary manifestations. Differential diagnosis is a big palindrome for pleural fluids. Aim: To test the reliability of lactate dehydrogenase of serum and pleural fluid in diagnosing tubercular effusions. Materials and Methods: Serum and Pleural fluids of tubercular and non tubercular origin were assayed for lactate dehydrogenase and studied. Results: The serum levels were sensitive and not specific and pleural fluid levels were neither sensitive nor specific. Conclusion: The lactate dehydrogena se activity may be used a tool to distinguish exudates and transudates and also the ratio of lactate dehydrogenase and adenosine deaminase may be used if any other method are not available. Keywords: Lactate dehydrogenase LDH, Pleural fluid, Pleural effusion, Tubercular pleural effusion, Abbrevations: TB tuberculosis,  LDH - lactate dehydrogenase, ADA adenosine deaminase, ROC receiver operating characteristics, NAD nicotinamide adenine dinucleotide

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Abstract

Introduction: Tuberculosis, both pulmonary and extra pulmonary pose great threat to individual health and community economy. The diagnosis of tuberculosis is currently made by a detailed medical history, clinical examination, radiological, microbiological, immunological, biochemical, molecular-biological and histological investigations. The current diagnostic methods either are relatively expensive, feasible, and insufficient or give erroneous results especially while diagnosing extra pulmonary tuberculosis. However recent trials have shown that enzymatic, evaluations in serum and pleural fluid have given excellent diagnostic results in diagnosis of extra pulmonary tuberculosis. Aim: The current study was aimed to evaluate whether analysis of adenosine deaminase enzyme in serum and pleural fluid helps in diagnosis of HIV sero negative tuberculous pleural effusion. Material and Methods: The study encompassed a total of 100 subjects of which 50 patients were known cases of tuberculous pleural effusion and remaining 50 patients served as control subjects Adenosine deaminase was estimated in serum and pleural fluids using kits and auto analyzer. Results: The results were tabled and analyzed using MEDCALC statistical software and are in favor of the study, supporting adenosine deaminase as a reliable marker in diagnosis of sero negative pleural effusions. Conclusion: The current study has indicated that promising positive results can be obtained by estimating levels of Adenosine deaminase enzyme in diagnosis of HIV sero negative pleural effusions. Further the study concludes that testing the adenosine deaminase levels in a cheaper, cost effective diagnostic tool and can be used in large community of individuals with minimal costs. Keywords: Adenosine deaminase, Extrapulmonary tuberculosis, Exudative pleural fluid HIV, seronegative.

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