INTRODUCTION: Objectives: The recent research aims to detect ceramide and meteorin-like proteins as potential markers for identifying type 2 diabetes and monitoring its progression.
METHODS: A cross-sectional study included three groups: type 2 diabetes without hypertension, type 2 diabetes with hypertension, and healthy control groups. Serum ceramide, meteorin-like protein, insulin, fasting blood glucose, lipid profile, and hemoglobin A1c levels were measured.
RESULTS: Higher concentrations of ceramide, fasting blood glucose, hemoglobin A1c, and the homeostatic model assessment of insulin resistance were observed in both type 2 diabetes groups compared to the healthy control group. In the type 2 diabetes group with hypertension, total cholesterol was elevated compared to the other study groups; however, the concentration of low/very-low-density lipoprotein was statistically higher than in the healthy control group. Serum meteorin-like protein was statistically lower in the type 2 diabetes group with hypertension than in the other study groups and positively correlated with fasting blood glucose in type 2 diabetes with hypertension. The ceramide level showed a significant positive correlation with meteorin-like protein across all study groups and with systolic blood pressure in the type 2 diabetes group with hypertension. In type 2 diabetes without hypertension, ceramide negatively correlated with the homeostatic model assessment of insulin resistance and fasting blood glucose.
DISCUSSION AND CONCLUSION: Elevated ceramide levels could accelerate type 2 diabetes progression. Meteorin-like protein levels were lower in type 2 diabetes with hypertension and higher in type 2 diabetes without hypertension. It positively correlated with fasting blood glucose in type 2 diabetes with hypertension, suggesting that meteorin-like protein may play a potential role in glycemic and blood pressure control.

INTRODUCTION: In this study, ASO and RF immunoturbidimetric assays determined on the Roche Cobas analyzer were evaluated against an immunonephelometric method
METHODS: ASO and RF assays were performed with the immunonephelometric method using the Beckman Coulter Immage 800 analyzer and the immunoturbidimetric method using the Cobas c501 analyzer. Precision values of both assays were calculated using internal quality control (IQC) samples provided by the test manufacturers. In addition, to assess bias, IQC and external quality control (EQA) data were used. Method comparison studies were performed using serum specimens randomly selected from routine hospital orders.
RESULTS: Both assays demonstrated good precision for ASO, with precision values of 3.2% CV in the immunoturbidimetric assay and 5.0% CV in the immunonephelometric assay. Although the immunoturbidimetric assay for RF showed good precision, the precision of RF exceeded the desired limits in the immunonephelometric assay. Bias obtained from EQA data was excellent in both ASO and RF for the immunoturbidimetric assay. The Passing–Bablok regression equation was obtained as y=1.65x - 20, r=0.98 for ASO, and as y=1.02x - 10.9, r=0.85 for RF.
DISCUSSION AND CONCLUSION: In conclusion, ASO and RF tests on the Cobas analyzer are suitable for routine use because they meet the requirements for accuracy and precision. The imprecision of the RF assay should be improved, especially for the immunonephelometric assay.

INTRODUCTION: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age, often characterized by insulin resistance, hyperandrogenism, and metabolic disturbances. This study aimed to investigate the relationship between serum irisin levels, a myokine involved in energy regulation, and insulin resistance in women with PCOS.
METHODS: A prospective study was conducted with 90 women diagnosed with PCOS, divided into two groups: 45 with insulin resistance and 45 without. Insulin resistance was evaluated using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Serum irisin levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA). Statistical analyses, including correlation and regression tests, were used to assess the relationships between serum irisin levels and various metabolic and hormonal parameters.
RESULTS: No significant difference in serum irisin levels was found between PCOS patients with insulin resistance (3.66±2.69 ng/mL) and those without insulin resistance (2.77±1.72 ng/mL) (p=0.065). Weak correlations were identified between serum irisin levels and insulin, HOMA-IR, free testosterone, and total testosterone levels. Significant positive correlations were observed with insulin (p<0.001) and HOMA-IR (p=0.008), while negative correlations were found with free testosterone (p=0.029) and total testosterone (p=0.013). Additionally, no significant differences in serum irisin levels were detected between patients with and without metabolic syndrome.
DISCUSSION AND CONCLUSION: Although weak correlations between serum irisin levels and insulin resistance markers were observed, no significant difference was found between PCOS patients with and without insulin resistance. These findings suggest that serum irisin may not be a key factor in the pathophysiology of PCOS related to insulin resistance. Larger studies are needed to further explore the role of irisin in PCOS and its potential as a therapeutic target.

INTRODUCTION: Glioblastoma multiforme (GBM) has long been one of the most common and particularly invasive malignant gliomas. High-grade gliomas are highly prone to relapse and associated with poor prognosis. This study tests the hypothesis that hyper-thermal conditions could influence TAU and CD-44 protein expression by increasing temperature in glioblastoma cancer cell line culture.
METHODS: AMGM cancer cells were cultured and maintained under normal growth conditions, then separated into two groups: one group was cultured at 37°C, and the other at 40°C. After 24 hours of growth, cells underwent immunocytochemistry (ICC) to visualize the localization of TAU and CD-44 markers.
RESULTS: The results show that fewer AMGM cells remained stable enough to grow at 40°C; these cells lost their fusiform shape and became spherical compared to cells grown under normal conditions. Additionally, an increase in microenvironmental temperature significantly affected TAU protein expression in the nucleus of AMGM cells, with a 71.4% increase at 40°C. In contrast, the expression of CD-44, typically expressed on the cell membrane of AMGM cells, decreased by 42.9% at 40°C.
DISCUSSION AND CONCLUSION: Changes in the microenvironment may affect glioblastoma cell line development by influencing the cancer stem cell marker CD-44 and the microtubule-stabilizing protein TAU. These markers could serve as potential targets for the treatment and prevention of glioblastoma.

INTRODUCTION: This study aims to calculate the measurement uncertainty values of prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, and fibrinogen tests according to ISO/TS 20914 and Nordtest 2017 guidelines and to compare these values with the total allowable error (TEa%) and maximum expanded allowable measurement uncertainty (MAU) values established by international organizations.
METHODS: Normal and pathological level internal quality control data for PT, APTT, D-dimer, and fibrinogen tests performed on the Sysmex CS2100 device between January and May 2024 were obtained from the Laboratory Information System. External quality control data for October 2023 and September 2024 were sourced from the external quality control system. Measurement uncertainty was calculated following ISO/TS 20914 and Nordtest 2017 guidelines.
RESULTS: According to the ISO/TS 20914 guideline, the measurement uncertainty values for PT, APTT, D-dimer, and fibrinogen tests were 10.42%, 3.49%, 4.81%, and 19.10%, respectively. According to the Nordtest guideline, the measurement uncertainty values were 10.44%, 12.64%, 17.94%, and 21.69%, respectively.
DISCUSSION AND CONCLUSION: Based on the ISO/TS 20914 guideline, it was observed that the measurement uncertainty values for all coagulation tests met the TEa% analytical targets. According to the Nordtest guideline, all tests except fibrinogen met these targets. When evaluated against the MAU criterion, it was determined that D-dimer met the targeted quality specification according to both guidelines; however, the measurement uncertainty values for PT, APTT, and fibrinogen exceeded the allowed targets. Standardization of the measurement uncertainty calculation model and the determination of analytical targets based on laboratory priorities can ensure reliable monitoring of analytical performance.

INTRODUCTION: This study aimed to assess the diagnostic accuracy of the fecal occult blood test (FOBT), fecal calprotectin (FC), and the combination of these markers in patients with suspected inflammatory bowel disease (IBD). Additionally, FC levels were compared between patients monitored for IBD and those newly diagnosed with IBD.
METHODS: Conducted at Gazi University Application and Research Hospital, this retrospective study reviewed demographic, clinical, colonoscopy reports, and laboratory data (FC and FOBT) of IBD patients. The final analysis included 153 patients with suspected IBD to evaluate the diagnostic accuracy of FOBT, FC, and their combination. FC was analyzed using the Quantum Blue® fCAL extended test. The ROC curve was drawn to determine the diagnostic ability of FC, and the area under the curve (AUC) was calculated. Sensitivity, specificity, and predictive values were determined for FC and FOBT.
RESULTS: The AUC was determined as 0.827 (95% CI: 0.742–0.913) for FC (p<0.001). FC showed a sensitivity of 85.7%, specificity of 62.4%, positive predictive value (PPV) of 30.6%, and negative predictive value (NPV) of 95.8%. FOBT had a sensitivity of 81.3%, specificity of 78.1%, PPV of 30.2%, and NPV of 97.3%. The combination of FOBT and FC, with positivity in at least one of the tests, had a sensitivity of 93.8%, specificity of 63.5%, PPV of 23.1%, and NPV of 98.9%. The combined use of FOBT and FC demonstrated higher diagnostic accuracy than either test alone.
DISCUSSION AND CONCLUSION: The combination of FOBT and FC provides superior diagnostic accuracy for identifying suspected IBD
patients compared to each test alone. This combined approach could serve as a cost-effective strategy to avoid unnecessary invasive procedures.

INTRODUCTION: Following the release of an informational bulletin, Roche Diagnostics adopted a more restrictive hemolysis index (100 HI) for the release of serum lipase results on all Cobas systems. This study aimed to evaluate the interference threshold for serum lipase hemolysis on Cobas C501/311/701/Integra 400 systems using a total allowable error set by the Royal College of Pathologists of Australasia (RCPA).
METHODS: To assess the influence of hemolysis on lipase, the parameter was quantified in serum pools spiked with escalating concentrations of a hemolysis interferent. The lipase assay was performed using the colorimetric lipase method (LIPC), and the HI was determined by absorbance measurements of diluted samples in accordance with the system protocol.
RESULTS: The Cobas Integra 400 and Cobas C311 showed the greatest interference of lipase with hemolysis (≤300 HI). The Cobas C501 and C701 demonstrated less sensitivity to hemolysis (≤1300 HI).
DISCUSSION AND CONCLUSION: The results of this study demonstrate that interference limits may vary between different Roche systems, even when the same reagent is used. Our study indicated that the lipase hemolysis threshold (100 HI) currently set by the manufacturer was excessively restrictive. This finding highlights the necessity of verifying manufacturers' information bulletins to provide better medical care.

Alpha thalassemia is one of the most common genetic diseases in the world. This disease is prevalent in various parts of the world, such as India, the Middle East, Africa, and many other countries. Several clinical conditions can result from mutations. In the condition where only one of the alpha globin genes is expressed, hemoglobin H disease (Hb H) occurs. Alpha thalassemia trait and silent carrier are milder forms of the disease, caused by the deletion of one and two alpha globin genes, respectively. Several mutations result in the deletion of alpha-globin. Seven common deletional mutations include -α4.2, -α3.7, -(α)20.5, --MED, --SEA, --Fil, and --THAI. The deletional mutations -α4.2 and -α3.7 remove only one of the alpha globin genes, while others remove both α1 and α2 globin genes from the gene cluster. Nowadays, laboratories identify these mutations using the Gap PCR method and other advanced methods. In addition to these mutations, some deletional mutations are found only in certain families or certain regions.

The recent release of the 2024 revised guidelines for the Competency Based Medical Education (CBME) curriculum by the National Medical Commission (NMC) marks a pivotal moment in the evolution of medical education in India. Building upon the foundation established in 2019, this revised curriculum introduces critical advancements designed to align medical training with contemporary global standards. These updates not only enhance the educational experience but also ensure that future medical professionals are equipped with the knowledge, skills, and competencies necessary to thrive in modern healthcare environments. This article focuses on the significant changes within the biochemistry curriculum, highlighting its importance and the shift towards integrating clinical relevance, innovative teaching methodologies, and robust assessment strategies. Educators are encouraged to prioritize tailoring their teaching approaches according to these expected standards. The article also provides strategies for incorporating these changes
into teaching methodologies, offering educators evidence-informed guidance.

INTRODUCTION:
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