Hemantha Peiris

Could ochratoxin A in food commodities be the cause of chronic kidney disease in Sri Lanka

Ochratoxin A (OA) is a naturally occurring mycotoxin with nephrotoxic properties that can contaminate plant food products. OA concentrations were assessed in commonly consumed food items in the North Central Province of Sri Lanka, where chronic kidney disease is diagnosed at epidemic proportions. Ninety-eight randomly selected food samples were analysed. Mycotoxin was detected in the extract by using a MycoMonitor Ochratoxin A ELISA assay kit (Helica Biosystems Inc., USA). The levels of OA found in these food commodities were below the recommended statutory maximum limit and are unlikely to be a potential risk factor for nephropathy in the North Central Province of Sri Lanka.

The significance of serum uric acid, creatinine and urinary microprotein levels in predicting pre-eclampsia

The object of this study was to determine whether serum uric acid, serum creatinine and urinary microprotein levels could be used to identify women who might subsequently develop pre-eclampsia during pregnancy. This is a cross-sectional descriptive study performed on women attending the University antenatal clinic in Colombo South Teaching Hospital, Sri Lanka. Serum uric acid, creatinine and microproteinuria levels were determined in 256 women attending the antenatal clinic at 28 weeks of pregnancy. Subsequently they were followed-up at 2-weekly intervals until 36 weeks and weekly thereafter until delivery. At each visit blood presure was recorded and serum uric acid, creatinine and microprotein levels were determined. Fifty-nine women developed blood pressures of 140/90 mmHg or more during the study period. Serum uric acid and serum creatinine levels did not show any significant difference before the elevated blood pressures were recorded. Microprotenuria levels of more than 375 mg/l were recorded in 43 women before elevation of their blood pressure. Sixty-five woemn of 197 who remained normotensive had microproteinuria levels of more than 375 mg/l. The sensitivity and specificity of microproteinuria levels of more than 375 mg/l as a screening test for prediction of pre-eclampsia was 73% and 67%, respectively. Therefore, microproteinuria of more than 375 mg/l may be used as a cut-off value and as a screening test for the early detection of women at risk of developing pre-eclampsia. Serum uric acid and creatinine had no predictive value as a screening test for pre-eclampsia.

A study of the serum carotenoids of eight cases of hypercarotenemia in Sri Lanka

Over-consumption of absorbable carotenoids causes hypercarotenemia. Although hypercarotenemia is detected in Sri Lanka, a detailed study on this condition has not been carried out previously. Two millilitres of venous blood was drawn from hypercarotenemic patients (n=8) and examined by high-performance liquid chromatography for carotenoids and vitamin A. A common high-performance liquid chromatographic pattern in serum was shown by six of the cases with β-carotene (9.9–35.7 µg/dl), β-cryptoxanthin and monohydroxy metabolites collectively (5.3–48.5 µg/dl), and six to eight metabolites of dihydroxy, trihydroxy and polyhydroxy metabolites (22.5–282.1 µg/dl). Vitamin A levels were within the normal range (32–61 µg/dl). However, two cases identified were abnormal. The first of these showed low β-carotene (3.5 µg/dl) and no β-cryptoxanthin and monohydroxy metabolites, but normal dihydroxy, trihydroxy and polyhydroxy metabolites (128.2 µg/dl). However, the vitamin A level was high (75.2 µg/dl). The other case showed high β-carotene (212.3 µg/dl) and β-cryptoxanthin (49.3 µg/dl) but no normal monohydroxy, dihydroxy, trihydroxy and polyhydroxy metabolites. Instead there was an atypical metabolite (343.9 µg/dl). According to the present study, excessive intake of boiled, homogenized carrot and ripe papaw is the main causative factor for hypercarotenemia. Over-consumption of carotenoids-rich plant foods may be complicated in the case of individuals having defects of either the control of the 15,15′-dioxygenase activity or metabolism of carotenoids.

Serum 25-hydroxyvitamin D, serum calcium and vitamin D receptor (VDR) polymorphisms in a selected population with lumbar disc herniation—A case control study

Background Association of Vitamin D receptor (VDR) polymorphisms with lumbar disc herniation (LDH) have been identified in several ethnic groups globally. Despite abundant sunlight, vitamin D deficiency is reported in many tropical countries. As vitamin D is a key modulator for intestinal calcium absorption, low vitamin D could contribute to low serum calcium leading to abnormalities of skeletal homeostasis. Therefore, present study was aimed to study the association of serum 25-hydroxyvitamin D (25(OH)D), serum calcium and VDR polymorphisms in a selected Sri Lankan population. Materials & methods A case control study was conducted in 119 participants (cases = 51: controls = 68). Serum 25(OH)D levels were measured using ELISA. The VDR polymorphisms (Fok I and Taq I) were detected by polymerase chain reaction followed by restriction fragment length polymorphism. Results Findings indicated a significantly low (p = 0.000) 25(OH)D levels in cases (18.7±3.7 ng/mL) compared to controls(25.5±9.8 ng/mL) while 25(OH)D in both groups were below the reference range. Mean serum calcium levels in both groups were within normal reference range and was not significantly different among groups. Statistically significant association was not observed between VDR Fok I polymorphisms among cases and controls. Although Fok I polymorphism genotypes were in Hardy-Weinberg equilibrium (HWE), Taq I genotypes in controls violated HWE. Conclusion Present study confirms that insufficient serum 25(OH)D levels in cases have major contribution to LDH. VDR Fok I polymorphisms did not have any significant association with LDH in Sri Lankan ethnicity.