INTRODUCTION: Vitamin D is essential for optimal musculoskeletal function and athletic performance. While the prevalence of serum 25(OH)D levels below 20.00 ng/mL exceeds 70% in the general population of South Asian countries, research on vitamin D status in athletes from Asian countries, including India, remains limited. This study examines the extent of low serum cholecalciferol levels among Indian athletes and investigates the impact of gender and sport type (indoor vs. outdoor) on serum vitamin D levels.
METHODS: Upon receiving consent, 331 athletes (male=243, female=88) who competed in various sporting events were recruited. A serum assay was undertaken to measure vitamin D, calcium, and parathyroid hormone. Serum 25(OH)D levels were categorized using the guidelines provided by the Endocrine Society Clinical Practices Guidelines. Statistical analysis was done using IBM SPSS 20.
RESULTS: The study reported an average serum vitamin D level of 17.76±6.93 ng/mL. Only 8.2% of athletes had sufficient
serum 25(OH)D, while 54.4% were deficient. The mean serum 25(OH)D level was significantly lower in female athletes compared to male athletes (15.72±5.92 ng/mL vs. 20.72±7.73 ng/mL, p<0.001), with females having a 4.32 times higher risk of vitamin D deficiency. Additionally, indoor athletes had lower mean serum 25(OH)D levels than outdoor athletes (49.24% vs. 74.63%, p<0.001), increasing their risk of deficiency by 3.03 times.
DISCUSSION AND CONCLUSION: The rate of low serum cholecalciferol levels is high among athletes. Females and athletes partaking in indoor sports were at a higher risk for having lower vitamin D. Biannual serum assessments of those at risk for developing deficiency could help to better assess the situation.

INTRODUCTION: Despite the advances and huge efforts in determination of efficient therapy options for diffuse large B cell lymphoma (DLCBL), various issues, including resistance and toxicity, are among the main concerns. Additional contributor to the poor prognosis is genomic complexity of DLBCL, where high number of mutations are associated with the DLBCL pathogenesis. Epigenetic regulations expand the complexity of gene expression process by various mechanisms, including histone deacetylation and DNA methylation, without altering the DNA sequence.
METHODS: Present study focused on analysis of genes involved in epigenetic regulations in DLBCL by using computational approaches, including sequence and structure-based predictions. C-bioportal database was used to find mutations, which are further analyzed by structural bioinformatic tools, including PredictSNP, SNPs&GO, AlphaMissense and DynaMut servers.
RESULTS: Our results showed that mutations R1446H/C and Y1503F/D of CREBBP, L415P, H1451Y, Y1467D of EP300 and Y641N/F of EZH2 proteins are among most common mutations in DLBCL, with the mutations mostly being putative drivers and having a negative impact on the sequence and structure of the proteins.
DISCUSSION AND CONCLUSION: The understanding of correlation of identified mutations in our study and DLBCL pathogenesis could contribute to the enhanced prediction, diagnosis and treatment of DLBCL. Identification of critical epigenetic mutations might enhance the efficiency and development of epigenetic drugs, further leading to better and more effective targeted therapies. However, further in-vitro and in-vivo investigations are required to verify our findings based on computational methods.

INTRODUCTION: The limitation of internal quality control (IQC) based on daily running of commercially available QC material is that it is non-commutable and errors cannot be detected in between the scheduled runs. This study was carried out with the objective of finding the utility of patient based real time quality control (PBRTQC) in overcoming these limitations.
METHODS: This observational descriptive study was carried out in the clinical chemistry laboratory of a tertiary care hospital between July 2023 to December 2023. PBRTQC was initiated in the laboratory by using Average of Normal (AoN) approach for serum sodium and potassium. Patients’ sample-based reference mean (RPM) and standard deviation (RPSD) were calculated from the previous six months’ data using reference intervals as truncation limits. For the next 2000 samples, the mean was calculated for each block of 20 samples (x̄) and designated as x̄1, x̄2, x̄3... These block means were plotted on the LJ chart and alarms were raised on the violation of predefined control rules. These alarms were investigated and necessary corrective measures were implied in the laboratory.
RESULTS: RPM±RPSD for sodium was 139.23±3.72 mEq/L and potassium was 4.26±0.45 mEq/L. The scheduled IQC was within range during the study. Alarms were raised for x̄13, x̄28, x̄29, x̄30, x̄35, x̄36, x̄55, x̄74 and x̄96. The workup of these alarms revealed instrument calibration error in most of the cases. However, analysis of x̄35 and x̄36 revealed delayed transport, improper temperature maintenance and partial hemolysis. All responsible personnel were given training regarding sample transport procedure. Using real time monitoring, we were able to detect errors which would have otherwise gone unnoticed by conventional IQC.
DISCUSSION AND CONCLUSION: PBRTQC permits stringent quality control in analytical as well as preanalytical phase of testing procedure, even during the intervals between scheduled IQC runs. Successful implementation of PBRTQC will provide additional confidence in reporting laboratory results.

INTRODUCTION: Serum protein electrophoresis is a low-cost and low-sensitivity technique used for screening monoclonal gammopathies with capillary protein electrophoresis. Immunofixation electrophoresis, on the other hand, is a highly sensitive technique used in the diagnosis, treatment, and follow-up of monoclonal gammopathies in patients with peak or abnormal patterns in serum protein electrophoresis scans; however, it is also more expensive. In monoclonal gammopathies, excessive production of immunoglobulins, known as monoclonal bands, is observed as sharp bands in immunofixation electrophoresis. In this study, we aimed to highlight the contribution of serum protein electrophoresis and immunofixation electrophoresis in detecting monoclonal bands in laboratory reports and their role in the early diagnosis and follow-up of patients.
METHODS: In this study, 781 serum protein electrophoresis and 144 immunofixation electrophoresis analysis reports were retrospectively evaluated. Of the 52 patients with deterioration in their SPE, 10 patients with SUD detected in their IFE were included in the study. The serum samples of the patients were analyzed using the Minicap Flex Piercing and Hydrasys 2 Scan Focusing analysis devices (Sebia, France).
RESULTS: Among serum protein electrophoresis patterns, pathology (peak or distortion) was detected in 196 cases. Of these, peak was detected in 144 cases in SPE, while distortion was observed in 52 cases. For the evaluation of the disturbed electrophoretic patterns, immunofixation electrophoresis was recommended in the reports. Following clinical evaluation by the treating physician, immunofixation electrophoresis was performed for 26 patients. Monoclonal band was observed in 10 (38.5%) of these patients who underwent IFE study.
DISCUSSION AND CONCLUSION: In our retrospective study, it was found that the frequency of monoclonal bands was high in patients with abnormal serum protein electrophoresis patterns where immunofixation electrophoresis was recommended. This underscores the importance of serum protein electrophoresis as a screening tool in the early diagnosis and follow-up of monoclonal gammopathies.

INTRODUCTION: Persistent overactivation of inflammatory responses has been associated with various neurodegenerative disorders, including Alzheimer disease. This study aimed to investigate whether parameters derived from complete blood count, such as white blood cell populations, platelet counts, and hemogram-derived parameters like platelet-lymphocyte ratio, immature granulocyte-lymphocyte ratio, systemic immune-inflammation index, and platelet-neutrophil ratio, which can be easily detected without additional cost, could have diagnostic value in the pathogenesis of Alzheimer disease. Additionally, the co-occurrence rates of Alzheimer disease with other diseases (such as Parkinson disease, anxiety, diabetes mellitus, cancer, osteoporosis and kidney disease) were analyzed.
METHODS: Complete blood count data of 231 patients diagnosed with Alzheimer disease after pre-screening were retrospectively reviewed. Complete blood count parameters were generated using hemogram device data. Platelet-lymphocyte ratio, immature granulocyte-lymphocyte ratio, systemic immune-inflammation index, and platelet-neutrophil ratio were calculated using neutrophil, lymphocyte, and platelet counts. 593 patients diagnosed with Alzheimer disease during pre-screening were retrospectively screened again and Alzheimer disease comorbidities were analyzed.
RESULTS: The immature granulocyte, immature granulocyte %, immature granulocyte-lymphocyte ratio values were found to be statistically significantly higher in Alzheimer's patients compared to the control group. However, the receiver operating characteristic analysis did not provide sufficient discrimination. The diseases accompanying Alzheimer disease were determined and the numbers found were expressed as percentages. The most common diseases were anxiety disorder, vitamin D deficiency and hypertension, respectively. The comorbidity with Parkinson disease was found to be 13.8%.
DISCUSSION AND CONCLUSION: Since immature granulocyte, immature granulocyte %, immature granulocyte-lymphocyte ratio values, which do not require extra cost and can be easily detected with complete blood count, were determined to have discriminatory value in some diseases, we hope that our study will guide future research.

INTRODUCTION: The most prevalent endocrine condition in the world today is diabetes mellitus (DM). In addition to the recognized markers for assessing glycemic control and insulin resistance (IR), easily available, accurate, and repeatable markers are required. In order to assess the use of the triglyceride (TG), HDL cholesterol ratio (THR) as a marker for insulin resistance and glycemic management, our study was conducted.
METHODS: We looked back at the TG, fasting serum glucose (FSG), and Fasting Insulin levels of 953 samples that were concurrently evaluated in our Faculty of Medicine Hospital Laboratory from March 2023 to August 2023. In terms of their homeostasis model assessment-estimated insulin resistance (HOMA-IR) values, the patients were split into two groups: those with good glycemic control and those with poor glycemic control. The THR's capacity to distinguish between good and poor glycemic control was assessed using ROC analysis. The accepted level of statistical significance was p<0.05. Additionally, a multivariate logistic regression analysis was conducted.
RESULTS: The mean age was 40.83±16.78 years. All the patients had significant differences (p<0.001) in gender, FSG, HOMA-IR, FI, TG, and THR based on glycemic control, except age (p=0.613). In pairwise correlation, THR had moderate negative correlation (r=-0.555, p<0.001) with HDL, while strong positive correlation with TG (r=0.959, p<0.001). THR had the high selectivity and positive predictive value (PPV) with a cutoff value of ≥2.64 (AUC: 0,72, Se: 65%, Sp: 70% (p<0.001: 95% CI: 0,66-0,78)). Men are 2.247 times more likely than women to have poor glycemic control (p=0.022). Poor glycemic control risk rised by 1.045 times with age, and by 1.056 times with glucose (p=0.007).
DISCUSSION AND CONCLUSION: Based on the current results, we think that the THR may be a useful marker of glycemic control and IR.

INTRODUCTION: Drug addictions are chronic complicated disorders characterized by the repeated and irresistible intake of specific drugs that produce transient bliss. Methamphetamine, an amphetamine derivative, is an addictive psycho-stimulant substance used all over the world, especially in South East Asia. Chronic Methamphetamine consumption not only causes dependence but also frequently promotes psychotic symptoms, auditory hallucinations, and paranoid delusions, which are similar to the positive symptoms of schizophrenia. This study looked at the genetic variation of the GRIA1 and GRIA3 genes to see if they were associated with methamphetamine addiction in Iraqi males.
METHODS: A total of 150 male participants were enrolled in this case-control study (100 methamphetamine-dependent and 50 control), ages between 20 to 45 years. GRIA1 (rs2195450) and GRIA3 (rs3761555) polymorphism detection was achieved by using high-resolution melting (HRM) real-time PCR analysis.
RESULTS: The findings of the current study showed a highly significant difference in genotype distribution and allele frequency of rs2195450 SNP between the methamphetamine-dependent and the control groups, according to GA genotype and A allele, and in rs3761555 based on CC genotype and C allele, displaying a positive association with addiction.
DISCUSSION AND CONCLUSION: According to the result of present study GA and CC genotypes have a positive correlation with disease these could be considered as a risk factor that makes people more susceptible to methamphetamine addiction.

INTRODUCTION: Fucosidosis is a rare lysosomal storage disorder caused by mutations in the FUCA1 gene leading to a deficiency in α-L-fucosidase. This study aimed to investigate the pathogenic missense mutations in the FUCA1 gene and their effects on protein stability using various bioinformatics tools.
METHODS: Initially, 438 missense mutations were retrieved from the NCBI database, of which 43 mutations were identified by SIFT. The impact of these mutations on protein stability was assessed using I-MUTANT2.0 and MUPRO. Additionally, protein flexibility was analyzed using MEDUSA.
RESULTS: Among the 43 mutations, SIFT predicted 20 mutations as "deleterious". PANTHER database predicted 21 mutations as "probably damaging" and 4 mutations as "possibly damaging", PolyPhen-2 tool identified 14 mutations as "probably damaging", and 6 mutations as "possibly damaging", PHD-SNP tool predicted 21 mutations as "disease-related", PROVEAN tool predicted 27 mutations as "deleterious", PMUT tool predicted 18 mutations as "disease-related", and SNP&GO tool predicted 24 mutations as "disease-related". Nine mutations (R173Q, W145R, W188C, R36C, R162Q, R308H, R162W, G425R, A368T) were commonly predicted by all the seven tools. The impact of these mutations on protein stability was assessed using I-MUTANT2.0 and MUPRO tools. The I-MUTANT2.0 tool indicated that all nine mutations result in a decrease in protein stability. Similarly, MUPRO tool showed that eight of the nine mutations decrease protein stability, and one mutation, G425R, was found to increase protein stability. Additionally, protein flexibility was analyzed using MEDUSA tool, which revealed that the positions of all 9 SNPs were rigid, except R36C and G425R which were flexible.
DISCUSSION AND CONCLUSION: We hope that these findings could contribute to understanding the molecular basis of diseases associated with FUCA1 gene mutations. However, Experimental validation is recommended to confirm these results and guide future therapeutic strategies.

INTRODUCTION: Urinary tract infections (UTIs) are common and often lead to unnecessary urine culture testing, increasing costs and delaying treatment. This study aims to develop a machine learning (ML) model using urinalysis and hemogram data to predict urine culture positivity and reduce unnecessary testing.
METHODS: We retrospectively analyzed data from 12,433 patients who underwent urinalysis, urine culture, complete blood count, and CRP testing. After preprocessing and exclusion criteria, data were split into training, test, and validation sets. H2O AutoML was employed to develop and evaluate various ML algorithms.
RESULTS: The gradient boosting model demonstrated an AUC-ROC of 0.822 with high sensitivity (73.8%) and negative predictive value (90.4%), making it reliable in ruling out negative cases. Urinary leukocytes, nitrite, and bacterial count were identified as top predictors.
DISCUSSION AND CONCLUSION: ML-based models can improve diagnostic accuracy and reduce unnecessary urine cultures. These models have the potential to be integrated into clinical workflows to enhance cost-effectiveness and minimize empirical antibiotic use.

INTRODUCTION: This study aimed to evaluate whether serum nuclear factor-kappa B (NF-κB) and adiponectin levels can provide insight into disease progression and serve as potential biomarkers for predicting disease severity in patients with acute pancreatitis (AP).
METHODS: A total of 49 patients diagnosed with AP and admitted to the Emergency Department of Gaziosmanpaþa Training and Research Hospital were enrolled. An age-matched control group of 49 healthy individuals without AP was also included. Serum levels of NF-κB and adiponectin were measured and compared between groups.
RESULTS: Patients with AP exhibited significantly elevated serum NF-κB levels and reduced adiponectin levels compared to the control group (both p<0.001). A strong negative correlation was observed between adiponectin and NF-κB levels in the AP group (r=–0.865, p<0.05). Receiver operating characteristic (ROC) analysis determined the optimal cut-off value for adiponectin as 3.4, with a sensitivity and specificity of 1.000. The optimal cut-off for NF-κB was 1.8, with a sensitivity of 1.000 and specificity of 0.96.
DISCUSSION AND CONCLUSION: The findings suggest that serum NF-κB and adiponectin levels may be valuable biomarkers for assessing disease severity in AP. Their combined use or integration with existing scoring systems could enhance prognostic accuracy. Further experimental and clinical studies are necessary to evaluate the therapeutic potential of adiponectin and to validate these biomarkers for routine clinical use.

INTRODUCTION: Considering the recommendations of literature, it was important to note the potential for differences in pre- and post-analytical storage conditions at room temperature between total and free prostate-specific antigen. The aim of our study was to establish whether it would be appropriate to align the pre- and post-analytical times for the determination of free prostate-specific antigen (fPSA) with those for total prostate-specific antigen (tPSA).
METHODS: Two blood samples were taken from 48 male patients aged 60 to 84. One specimen was centrifuged within one hour of collection. Each sample was tested immediately for total and free PSA. The second blood sample was kept at room temperature for 12 hours before being tested and then reanalyzed 24 hours after blood sampling. Serum specimens were analyzed on the Roche Cobas E801.
RESULTS: There were no notable alterations in any PSA forms (p=0.866 and 0.971) or calculated ratios (Kappa=1) for the blood sample that was stored at room temperature for 12 hours prior to processing. Furthermore, all forms of PSA demonstrated stability (p=0.956 and 0.901), and fPSA/tPSA ratios showed good agreement in serum for up to 24 hours at room temperature (Kappa=1).
DISCUSSION AND CONCLUSION: It would be beneficial to extend the pre- and post-analysis times of fPSA to align them with those of tPSA. Following the elevated tPSA discovery, investigating fPSA could be more streamlined, offering an improved patient management solution.