Mingma Sherpa

Serum malondialdehyde level: Surrogate stress marker in the Sikkimese diabetics

Background: The pbreakdown of phospholipids lead to accumulation of malondialdehyde (MDA) that is preferred as a surrogate marker of oxidative stress in diabetics. Objective: To compare serum MDA levels along with other biochemical parameters between type 2 diabetic patients with and without complications. Materials and Methods: This cross-sectional study was carried out in the Department of Biochemistry of a tertiary care teaching hospital in Sikkim on 60 type 2 diabetics and compared with 100 non-diabetic participants. The un-hemolyzed blood samples were used for estimation of biochemical parameters; MDA was estimated in serum by using trichloroacetic acid (TCA) and 1% thiobarbituric acid (TBA). Whole blood was used for estimation of glycated hemoglobin. The comparison of different parameters between cases and control was calculated by using Students t test. Results: In the study and control groups, no significant difference was noted with regard to independent variables. The fasting and postprandial serum glucose along with glycated hemoglobin from whole blood and the lipid profile differed significantly between the study and control groups. Overall, tmean serum MDA level in the study group was significantly higher thanin the controls. Male sex, addiction to tobacco (smoking and smokeless inclusive), longer duration of diabetes (≥5 years), and presence of complications (both microvascular and macrovascular) significantly increased the MDA level. Conclusion: To sum up, the serum MDA level was observed to be significantly high in diabetics with and without complication along with other parameters.

Serum nitric oxide status in patients with type 2 diabetes mellitus in Sikkim

Background: Serum nitric oxide (NO) has emerged as a fundamental signal associated with the endothelial dysfunction in type 2 diabetes. Aims: To compare serum nitric oxide level among type 2 diabetic patients along with other biochemical parameters and to compare it with that of normal population in Sikkim. Settings and Design: This prospective study was carried out in the Biochemistry Department in a tertiary care teaching hospital in Sikkim on 50 type 2 diabetics compared to 100 non-diabetics. Materials and Methods: The un-hemolyzed blood sample was collected for estimation of biochemical parameters. Griess reaction was used for indirect assay of stable decomposition products in serum(serum nitrite and nitrate levels) as an index of NO generation. The comparison of different parameters between cases and control was done by using Students t-test. Results: There was significant difference when age- and sex-matched cases and controls were compared in regard to waist circumference and body mass index. The values of fasting and postprandial serum glucose, and lipid profile between study group and control group differed significantly. The mean serum level of NO in the study and control group was 43.83 ± 11.3 μmoles/L and 58.85 ± 12.8 μmoles/L respectively, and this difference was statistically significant. Conclusion: To sum up, serum NO was observed significantly low in diabetic participants as compared to control, along with difference in other biochemical parameters.

Correlation of the Osteogenic Protein-1 (OP-1) with Age, Cartilage metabolic Markers and Antioxidants in the Osteoarthritic Patients of Sikkim

BACKGROUND Age and oxidative stress have been implicated as the main causes of the cartilage damage in osteoarthritis (OA). The osteogenic protein-1(OP-1), a member of the bone morphogenetic family (BMP), plays a major role in cartilage repair. AIM To correlate the OP-1 in the synovial fluid with the age and antioxidants like superoxide dismutase (SOD), glutathione peroxidase (GPx) and uric acid (UA) in the blood and with the cartilage metabolic markers like hyaluronic acid (HA) and keratan sulphate (KS) in the synovial fluid of osteoarthritic patients. METHOD Seventy five osteoarthritic patients were taken up for the study. Heparinized blood samples were collected for the estimation of SOD, GPx and UA. Synovial fluid was aspirated for the estimation of HA, KS and OP-1. OP-1 was estimated by using a polyclonal antibody (anti-OP-1) which was produced against OP-1 in the mouse ascitic fluid by sandwich ELISA. RESULT Age and UA showed a significant correlation with OP-1. On the other hand, the correlations between OP-1 and the antioxidants (SOD and GPx) and the cartilage metabolic markers (HA and KS) were insignificant in osteoarthritic patients. CONCLUSION The study suggests about the important role of OP-1 in cartilage aging and degeneration, which may help us in understanding the potential for the therapeutic interventions in the treatment of cartilage degenerative processes.

Correlation of cartilage metabolic markers & antioxidants with the severity of knee osteoarthritis

Osteoarthritis is characterized by the degeneration of articular cartilage. Cartilage metabolic markers have been explored as possible markers for osteoarthritis, and osteogenic protein -1 (OP-1) has emerged out to play a major role in cartilage repair. Oxidative stress has been implicated as a mediator of cartilage damage in patients with osteoarthritis. The aim of this study was to correlate the cartilage metabolic markers and antioxidants with the severity of knee osteoarthritis.

Large gastric ulcer: Result of foreign body-induced giant cell reaction

A granuloma is an organized and compact mass of mature mononuclear phagocytes. Granulomas are reported to form in various organs and sites of the body. Granulomas in stomach are rarely encountered. Foreign body granulomas are formed as a result of reaction of the tissues to a foreign body which is immunologically inert. Food granuloma is type of foreign body granuloma which is formed in response to food particles like vegetable matters or cereals. These granulomas can be distinguished from other types of granulomas with ease because of their characteristic morphologic features. We report the case of a 29-year-old male who developed a large gastric ulcer as a result of foreign body-induced giant cell reaction, which was probably of vegetative origin. He was treated with the regimen for Helicobacter pylori , rabeprazole and sucralfate. This treatment resulted in partial healing of the ulcer with persistence of food granuloma; hence, the patient was referred for surgery.

Kimura's disease: A diagnostic challenge experienced with cytology of postauricular swelling with histopathological relevance.

Kimuras disease is a rare, chronic inflammatory disorder of unknown cause. It is endemic in Asia, affecting more number of males than females, with a ratio of 3:1. The typical clinical manifestations include a triad of painless unilateral cervical lymphadenopathy or subcutaneous masses predominantly in the head and neck region, blood and tissue eosinophilia, and an elevated serum immunoglobulin E (IgE) levels. Variable conditions both benign and malignant may mimic Kimuras disease both clinically and on fine needle aspirates. The confirmatory diagnosis is established only by histopathological examination. We report a case of Kimuras disease in a patient who underwent multiple investigations in view of her past history and family history of pulmonary Kochs. Fine needle aspiration cytology (FNAC) was performed thrice with consistently similar result of reactive lymphadenitis with numerous histiocytes and eosinophilia. The final diagnosis of Kimuras disease could finally be established only on histopathological examination.

Sclerosing Lobular Hyperplasia- Correlation between Cytomorphological and Histological Findings

Sclerosing lobular hyperplasia of the mammary gland is an uncommmon benign lesion which is mainly seen in adolescents and young women. The breast lobules are enlarged due to ductal and acinar proliferations but they have normal architecture. There is extensive fibrosis of the intralobular stroma, and to a lesser degree, of the interlobular parenchyma. Patients generally complain of a palpable, painless/slightly tender and well-defined lump in breast. Fine-needle aspiration cytology of sclerosing lobular hyperplasia is non diagnostic with features similar to fibroadneoma except for the absence of stromal fragments. In order to reach a definitive diagnosis, a histopathologic evaluation is needed. However, a distinction between the two benign entities is of no clinical significance.We are describing a case of sclerosing lobular hyperplasia that occurred in the left breast of a 26-year-old lady.

Koch's Disease Presenting as an Isolated Testicular Mass- An Unusual Occurance

Isolated testicular tuberculosis (TB) is rarely seen. A 72-year-old, farmer presented with complaints of discharging sinus from scrotum along with pain and swelling. The patient had no sign of tuberculosis. On examination a hard mass arising from the left testis was noted along with a discharging fistula on the overlying scrotal skin. Chest x-ray and ultrasound examination of the abdomen were within normal limits. After assessing the testicular mass, an informed consent was taken thereafter left orchiectomy and fistulectomy performed. Histopathological examination revealed caseating granulomas along with numerous Langhans giant cells consistent with tuberculous orchitis. The patient received anti-TB treatment for six months. The rare involvement of testis by tuberculosis needs to be mentioned.