ISSN  2587-2362  |  E-ISSN  2618-642X
International Journal of Medical Biochemistry - Int J Med Biochem : 5 (2)
Volume: 5  Issue: 2 - 2022
1.Front Matter 2022-2

Pages I - VI

2.Monocyte to high-density lipoprotein and derived neutrophil to lymphocyte ratio in patients with acute pancreatitis are associated with the severity of the disease
Erdinc Gulumsek, Fatih Yesildal, Begum Seyda Avci, Ismail Yigitdol, Beytullah Aktaş, Banu Kara, Adnan Tas, Mevlut Koc, Akkan Avci, Hilmi Erdem Sumbul
doi: 10.14744/ijmb.2022.20981  Pages 77 - 83
INTRODUCTION: We aimed to compare the severity of the disease with derived neutrophil to lymphocyte ratio (DNLR) and monocyte to high-density lipoprotein ratio (MHR) in patients with acute pancreatitis (AP).
METHODS: This retrospective study included 52 patients with Ranson 0, 57 patients with Ranson I, 39 patients with Ranson II, 36 patients with Ranson III–IV, and 20 healthy controls as the control group with similar demographic characteristics to the patient groups. Demographic characteristics, mortality, etiology, and laboratory data of the patients were evaluated from their previous records.
RESULTS: The study data were compared in five groups as control and Ranson 0, I, II, III–IV according to their AP stage. MHR values were 9.62±4.25 in the control group and 13.4±5.18, 14.2±4.22, 19.4±10.5, 31.7±26.3 in Ranson 0, I, II, III–IV, respectively (p<0.001). DNLR was 1.33±0.45 in the control group and 3.48±2.68, 3.71±2.31, 4.43±2.84, 4.62±3.46 in Ranson 0, I, II, III–IV, respectively (p<0.001). MHR and DNLR values were significantly different in patients with AP.
DISCUSSION AND CONCLUSION: The levels of MHR and DNLR evaluated during the follow-up of patients with AP are low-cost and easy to access parameters that may help the clinician in determining the severity of the disease.

3.Performance of a multi-criteria algorithm based on urinalysis in predicting negative urine culture results
Didem Barlak Keti, Sabahattin Muhtaroğlu, Pınar Sağıroğlu
doi: 10.14744/ijmb.2022.89421  Pages 84 - 88
INTRODUCTION: Urinalysis by automated urine analyzer, including microscopy and dipstick test, is easy, rapid, and inexpensive. Among these parameters, leukocyte count (WBC) or leukocyte esterase (LE) has relatively sufficient sensitivity in urinary tract infection (UTI) detection. Urine culture is accepted as the gold standard for the diagnosis of UTI. Unnecessary culture requests constitute the majority of the microbiology laboratory workload. This study aimed to evaluate the performance of a multi-criteria algorithm by using urinalysis in predicting negative urine cultures.
METHODS: During a 2-week period, randomly selected 600 urine samples that reached the microbiology laboratory for urine culture were subjected to chemical and microscopic urinalysis without waiting. Urinalysis was performed using Iris iQ200 (Iris Diagnostics, Chatsworth, USA). LE >25 μL-1, nitrite positive, and WBC >5 per HPF were accepted as abnormal/positive. The sensitivity and specificity were also calculated by Receiver operating characteristic analysis at alternative threshold values for all small particles. A multi-criteria algorithm based on these urine parameters was developed, and its performance was evaluated by determining specificity, sensitivity, negative predictive value (NPV), and positive predictive value.
RESULTS: Multi-criteria algorithm based on urinalysis gave false-negative results for only 3 (0.5%) samples. This algorithm had 98.9% NPV and eliminated 47.4% of urine samples from the culture workflow.
DISCUSSION AND CONCLUSION: This algorithm may reduce unnecessary culture requests and more effective use of time and resources.

4.Circulating sTWEAK and its scavenger receptor sCD163 concentrations in patients with Behçet’s disease
Fulya Balaban Yücesan, Asım Örem, Deniz Aksu Arıca, Burak Akşan, Serap Özer Yaman, Buket Akcan, Birgül Kural, Sevgi Bahadır
doi: 10.14744/ijmb.2022.98700  Pages 89 - 95
INTRODUCTION: Behçet’s disease (BD) is a chronic multisystemic inflammatory disorder and is associated with many inflammatory processes. The present study aimed to examine the serum levels of proinflammatory cytokine soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and its scavenger receptor soluble cluster of differentiation 163 (sCD163) simultaneously in patients with BD by considering their relationships with disease activity.
METHODS: The study group included 53 patients with BD (29 females and 24 males) and 30 healthy individuals. Patients with a lesion or active organ involvement were defined as active (n=39) and those without were identified as inactive (n=14). Serum sTWEAK and sCD163 concentrations were determined by enzyme-linked immunosorbent assay.
RESULTS: Serum sTWEAK and sCD163 levels were significantly increased in patients with BD compared with the healthy group (p=0.016 and p=0.003, respectively). Concentrations of these two molecules were also higher in active and inactive BD than the healthy individuals (p=0.043 for sTWEAK and p=0.010 for sCD163). Receiver operating characteristic curve analysis revealed that serum sCD163 and sTWEAK levels had a discriminating ability between patients with BD and healthy controls with area under the curve values of 0.706 and 0.661, respectively.
DISCUSSION AND CONCLUSION: It was concluded that circulating sTWEAK and its scavenger receptor sCD163 levels were increased in BD, significantly predicted the disease, and might be significant molecules to assess inflammation.

5.Effects of electronic cigarettes on oxidative stress markers in the rat kidney tissues
Kübra Doğan, Hüseyin Saygin, Yücel Yalman
doi: 10.14744/ijmb.2022.40427  Pages 96 - 100
INTRODUCTION: Electronic cigarettes (e-cigarettes) are an alternative to traditional cigarettes. Although numerous studies have been conducted regarding the effects of traditional cigarettes on oxidative stress biomarkers in the kidney, there are only a few studies on the effects of e-cigarettes.
METHODS: A total of 24 male Wistar albino rats were separated into three groups: Group 1 was treated with traditional cigarettes, Group 2 with e cigarettes, and Group 3 formed the control group. Kidney homogenates and plasma samples were obtained, and the glutathione peroxidase, protein carbonyl, superoxide dismutase (SOD), catalase (CAT), lipid hydroperoxide (LPO), and symmetric dimethylarginine (SDMA) levels were examined.
RESULTS: Higher plasma SDMA levels were determined in Group 1 and Group 2 compared with Group 3 (<0.0001). Higher SOD activity was found in Group 1 compared with Group 2 (p=0.0094). Lower CAT activity was found in Group 1 compared with both Group 2 (p=0.0035) and Group 3 (p<0.0001). Higher LPO levels were determined in the traditional cigarette smoking group compared with the control group (p=0.028), and no statistically significant difference was found between the e-cigarette and the control groups.
DISCUSSION AND CONCLUSION: E-cigarettes and traditional cigarettes are associated with the dysregulation of particular oxidative stress markers in the kidney. However, e-cigarettes have less effect on some oxidative stress markers than traditional cigarettes. Long-term use of traditional cigarettes and e cigarettes causes oxidative stress, which may lead to renal tissue damage and diminished kidney function.

6.Intra-day changes in the levels of biochemistry parameters
Abdullah Arpacı, Serdar Doğan, Bahar Ünlü Gül, Berna Kuş, Emre Dirican
doi: 10.14744/ijmb.2022.54227  Pages 101 - 108
INTRODUCTION: People mostly live in the nonfasting state during a normal 24-h cycle. This study aims to compare the levels of 18 biochemical parameters during different hours of the day.
METHODS: A total of 18 biochemical tests of patients who visited outpatient clinics only once between January 1, 2010, and December 31, 2019, were evaluated at the Hatay Mustafa Kemal University (HMKU) Central Laboratory by using hospital database information. The tests are albumin (Alb), aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), alkaline phosphatase (ALP), amylase, blood urea nitrogen (BUN), calcium (Ca), total cholesterol (TC), creatine kinase (CK), creatinine (Cr), gamma-glutamyltransferase (GGT), glucose, high-density lipoprotein cholesterol (HDL-C), inorganic phosphorus (Pi), iron (Fe), total protein (TP), triglyceride (TG), and lipase. The blood samples of the patient were divided into eight groups according to their collection time as follows: (a) 07: 00-07: 59, (b) 08: 00-08: 59, (c)
09: 00-09: 59, (d) 10: 00-10: 59, (e) 11: 00-11: 59, (f ) 12: 00-13: 59, (g) 14: 00-14: 59, and (h) 15: 00-17: 00.
RESULTS: A statistically significant difference was found between the groups in terms of all parameters except amylase, GGT, and TP (p<0.05). The effect size refers to the minimum amount of difference that is clinically significant. According to the effect size values, there was no significant difference between time groups in the following parameters: Alb, ALT, AST, Pi, Ca, TC, Cr, Fe, glucose, BUN, lipase, TG, ALP, HDL-C, and CK (ʈ<0.30).
DISCUSSION AND CONCLUSION: When considering all of the results, nonfasting screening would not only be acceptable but also make physiologic sense.

7.Evaluation of oxidative stress in gout disease; thiol-disulfide homeostasis and ischemia-modified albumin levels
Ahmet Rıfat Balık, Ahmet Omma, Sevinç Can Sandıkçı, Çiğdem Yücel, Murat Kızılgün, Zeynep Büşra Balık, Esra Fırat Oğuz, Salim Neselioglu, Özcan Erel
doi: 10.14744/ijmb.2022.52714  Pages 109 - 115
INTRODUCTION: Gout is a common and easily treated disease characterized by the accumulation of monosodium urate crystals in both joints and other tissues. Monosodium urate crystals are the main stimulants for initiating and maintaining an inflammatory response. Oxidative stress is also an early change in gout pathogenesis together with inflammation. This study aimed to investigate the presence of oxidative stress in gout together with thiol–disulfide homeostasis and ischemia-modified albumin (IMA) levels. We aimed to compare these parameters with inflammation marker C-reactive protein (CRP) and high-sensitivity C-reactive protein (hsCRP).
METHODS: Levels of native thiol, total thiol, disulfide, IMA, CRP, and hsCRP were detected in patients with gout (n=50) and healthy subjects (n=50). Student’s t-test and the Mann-Whitney U test were used for istatistical analysis.
RESULTS: Native thiol, total thiol, and index 3 (native thiol/total thiol×100) were significantly lower in the patient group, while disulfide, index 1 (disulfide/native thiol×100), index 2 disulfide/total thiol×100), IMA, CRP, and hsCRP were significantly higher. In addition, elevation in native thiol, total thiol, and disulfide levels was detected as disease duration increased.
DISCUSSION AND CONCLUSION: The present study has shown the role of oxidant damage in gout disease. Additional studies are needed to identify sources of oxidative stress in gout.

8.Comparison of Diagon Coag XL and Cobas t 511 analyzers
Berrak Güven, Ismail Benice, Murat Can
doi: 10.14744/ijmb.2022.40316  Pages 116 - 119
INTRODUCTION: We compared prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and Ddimer test results measured using the Diagon Coag XL coagulation analyzer with Cobas t 511 analyzer.
METHODS: Imprecision studies were performed for the PT, aPTT, fibrinogen, and D-dimer tests used by the Diagon Coag XL analyzer. For the comparison study, we used the leftover citrated plasma from patient samples after routine analysis with Cobas t 511. All of the results were analyzed using the correlation coefficient and Passing–Bablok regression analysis.
RESULTS: Total coefficient of variation obtained for all tests were within the criteria for acceptance. The method comparison study showed a good correlation between the results obtained on Diagon Coag XL and Cobas t 511 analyzers, except for aPTT test. The correlation coefficients obtained were 0.98 for PT, INR, and D-dimer, 0.95 for fibrinogen, and 0.80 for aPTT.
DISCUSSION AND CONCLUSION: For PT, aPTT, fibrinogen, and D-dimer tests, Diagon Coag XL analyzer is suitable for monitoring the coagulation system, and it can be used in clinical laboratories. However, the precision values of tests stated by the manufacturer must be verified.

9.Sigma metric evaluation with different TEa targets in clinical biochemistry
Şeniz Korkmaz
doi: 10.14744/ijmb.2022.81300  Pages 120 - 124
INTRODUCTION: The aim of this study was to evaluate the analytical performances of various clinical biochemistry analytes by the sigma metrics method according to different total allowable error (TEa) targets and to determine the causes of errors that lead to low sigma score by using Quality Goal Index (QGI).
METHODS: The study was carried out in the Central Laboratory of Bursa Karacabey State Hospital. Twelve analytes that were studied on the Roche Cobas c 501 autoanalyzer were included in the study. Internal (level 1 and 2) and external quality control data for the period March August 2020 were obtained retrospectively. The TEa targets were obtained from the Clinical Laboratory Improvement of 2019 (CLIA 2019), biological variation database (BVD), Rili-BAEK, and Turkish data. QGI was calculated for analytes with sigma score <3 according to CLIA.
RESULTS: According to the TEa goals of four different guides, different sigma scores were obtained. Three parameters with sigma scores <3 were determined according to TEa targets of CLIA, 8 according to BVD, and 6 according to Rili-BAEK, while there were no parameters with sigma score <3 according to the TEa targets of Turkey. Number of parameters with sigma scores >6 were 7, 10, 6, and 18 according to TEa targets of CLIA, BVD, Rili-BAEK, and Turkey, respectively. When QGI was calculated, it was found that there was inaccuracy problem for albumin and chlorine L1 and imprecision for chlorine L2.
DISCUSSION AND CONCLUSION: Laboratories should determine the appropriate TEa targets and use the sigma metrics method and QGI as a quality improvement tool. In the light of the obtained data, necessary quality improvements should be made, and the reliability of the results should be increased.

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