Niranjan Gopal

Biosensors in clinical chemistry: An overview

Biosensors are small devices that employ biological/biochemical reactions for detecting target analytes. Basically, the device consists of a biocatalyst and a transducer. The biocatalyst may be a cell, tissue, enzyme or even an oligonucleotide. The transducers are mainly amperometric, potentiometric or optical. The classification of biosensors is based on (a) the nature of the recognition event or (b) the intimacy between the biocatalyst and the transducer. Bioaffinity and biocatalytic devices are examples for the former and the first, whereas second and third generation instruments are examples for the latter. Cell-based biosensors utilizing immobilized cells, tissues as also enzyme immunosensors and DNA biosensors find variegated uses in diagnostics. Enzyme nanoparticle-based biosensors make use of small particles in the nanometer scale and are currently making a mark in laboratory medicine. Nanotechnology can help in optimizing the diagnostic biochips, which would facilitate sensitive, rapid, accurate and precise bedside monitoring. Biosensors render themselves as capable diagnostic tools as they meet most of the above-mentioned criteria.

Planning an objective and need based curriculum: the logistics with reference to the undergraduate medical education in biochemistry.

PURPOSE The medical education is recently being transformed into several domains in order to adapt to the need and the value based academics which is required for the quality doctors who serve the community. Presently, the biochemistry curricula for the graduate students of medicine have been questioned by as many experts, because of their multiple lacunae. In this review, we would like to highlight the scenario which is related to the existing biochemistry curricula for graduate medical students, which have been followed in several medical schools and universities and we also hope to share our ideas for implementing objective and pragmatic curricula. Evidence based research, wherein the articles which are related to innovative teaching-learning tools are collected and the pros and cons which are related to the different methods analyzed in biochemistry point of view. CONCLUSION Rapid changes in the content of the curriculum may not be required, but a gradual introduction of the novel approach and the methods of teaching biochemistry can be adopted into the curriculum.

Study of Twenty One Cases of Red Cell Exchange in a Tertiary Care Hospital in Southern India.

INTRODUCTION Red Cell Exchange (RCE) is removal of a patients red blood cells while replacing with donor red blood cells either manually or using automated systems. RCE is beneficial in patients with Sickle Cell Disease (SCD) either during sickling crisis or prior to major surgical procedures to bring down the sickling percentage as high sickling percentage during prolonged anaesthesia may lead to vaso-occlusive crisis. It is also employed in patients infested with malaria and babesiosis where parasitic index remain high despite medical management. RCE is also tried as an adjuvant therapy in certain poisons like nitrobenzene and carbon monoxide when first line management fails. AIM To study the effectiveness, clinical outcome, challenges and complications of RCE in various clinical scenario and to understand how this procedure can be effectively utilized in the management of patients in Indian scenario. MATERIALS AND METHODS This retro prospective study was conducted in tertiary care center in southern India which analyzed 21 RCE procedures performed on patients with different clinical conditions. Of the 21 RCE performed, 18 procedures were performed on patients with case of sickle cell disease, Two procedures were performed on patients infested with severe falciparum malaria and one procedure was performed on a patient with nitrobenzene poisoning. All procedures were performed using Spectra Optia(®) Apheresis System - Terumo BCT. RESULTS All the 18 patients who underwent the RCE for sickle cell anaemia were admitted for hemi-arthroplasty for avascular necrosis of the head of femur. The average initial HbS levels were between 73-85% and post RCE it was brought down to 22-29% and was achieved in a single sitting in all the cases. Among the two patients infested with severe falciparum malaria, RCE helped in reducing the infestation rate. In case of nitrobenzene poisoning, RCE helped in improvement of oxygen saturation and patient showed significant improvement. CONCLUSION RCE is an safe and clinically effective therapeutic modality with very minimal to nil side effects. RCE is possibly underutilized therapy in developing world like India due to various reasons like inadequate awareness/ technical expertise, lack of equipments and facilities to identify the clinical conditions per se etc.

Association of Salivary Osteopontin Levels with Glycaemic Status and Microalbuminuria - in Patients with Type 2 Diabetes Mellitus

INTRODUCTION The monitoring of glycaemic status in patients with T2DM is mainly through blood tests (Fasting plasma glucose and HbA1c), which are invasive and involves painful pricks. This leads to poor patient compliance and soon could lead to various micro and macro vascular complications, which hamper the quality of life. There are no sensitive and specific markers to predict these complications at the earliest. Sialochemistry has recently gained attention for monitoring chronic diseases. Osteopontin is a phospho-glycoprotein molecule, elevated in many inflammatory conditions. AIM The aim of the study was to evaluate the role of serum and salivary osteopontin in Type 2 Diabetes mellitus (T2DM). MATERIALS AND METHODS In this case-control study, we recruited 33 cases of T2DM and 31 age and gender matched healthy controls. Body Mass Index (BMI), Waist/Hip Ratio (WHR), Waist Circumference (WC) and blood pressure was recorded. Fasting Plasma Glucose (FPG), salivary glucose, HbA1c, microalbuminuria, systolic BP, serum and salivary osteopontin levels were estimated. RESULTS FPG, salivary glucose, HbA1c, microalbuminuria, systolic BP, BMI, waist / hip ratio serum and salivary osteopontin levels were significantly high in T2DM cases compared to control subjects. Serum and salivary osteopontin levels were significantly correlated with HbA1c and microalbuminuria in T2DM cases. CONCLUSION Serum and salivary osteopontin levels are significantly elevated in subjects with T2DM and are associated with glycaemic control and microalbuminuria.