Search results for: pituitary
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 42

Search results for: pituitary

42 Trans-Sphenoidal Approach to Pituitary Tumors: Analysis of 568 Cases Over a Decade

Authors: Sandeep Mohindra

Abstract:

Since 2013, the authors have operated on 568 cases of pituitary tumors through the trans-sphenoidal route, using the binostril approach. The distribution included 486 cases of non-functioning pituitary tumors, 24 cases of Growth hormone(GH) secreting tumors(acromegaly), and 28 cases of adrenocorticotrophic(ACTH) secreting tumors(Cushing's Disease). The authors utilized neuro-navigation for 18 cases, and all belonged to the functional tumor category. Complications included ICA injury in 2 cases, fatal meningitis in 5 cases, while CSF leak required repair in 28 cases. Satisfactory excision was noted in 512 cases, while recurrence/residual required repeat surgery in 32 cases. Authors conclude that trans sphenoidal route remains the best and optimal way of managing sellar tumors, especially pituitary adenomas.

Keywords: pituitary, adenoma, trans-sphenoidal, endonasal, neuronavigation

Procedia PDF Downloads 58
41 Comparative Effects of Homoplastic and Synthetic Pituitary Extracts on Induced Breeding of Heterobranchus longifilis (Valenciennes, 1840) in Indoor Hatchery Tanks in Owerri South East Nigeria

Authors: I. R. Keke, C. S. Nwigwe, O. S. Nwanjo, A. S. Egeruoh

Abstract:

An experiment was carried out at Urban Farm and Fisheries Nigeria Ltd, Owerri Imo State South East Nigeria between February and June 2014 to induce Brood stock of Heterobranchus longifilis (mean wt 1.3kg) in concrete tanks (1.0 x 2.0 x 1.5m) in dimension using a synthetic hormone (Ovaprim) and pituitary extract from Heterobranchus longifilis. Brood stock males were selected as pituitary donors and their weights matched those of females to be injected at 1ml/kg body weight of Fish. Ovaprim, was injected at 0.5ml/kg body weight of female fish. A latency period of 12 hours was allowed after injection of the Brood stock females before stripping the egg and incubation at 23 °C. While incubating the eggs, samples were drawn and the rate of fertilization was determined. Hatching occurred within 33 hours and hatchability rate (%) was determined by counting the active hatchings. The result showed that Ovaprim injected Brood stock eggs fertilized up to 80% while the pituitary from the Heterobranchus longifilis had low fertilization and hatching success 20%. Ovaprim is imported and costly, so more effort is required to enhance the procedures for homoplastic hypophysation.

Keywords: heterobranchus longifilis, ovaprim, hypophysation, latency period, pituitary

Procedia PDF Downloads 205
40 LGR5 and Downstream Intracellular Signaling Proteins Play Critical Roles in the Cell Proliferation of Neuroblastoma, Meningioma and Pituitary Adenoma

Authors: Jin Hwan Cheong, Mina Hwang, Myung Hoon Han, Je Il Ryu, Young ha Oh, Seong Ho Koh, Wu Duck Won, Byung Jin Ha

Abstract:

Leucine-rich repeat-containing G-protein coupled receptor 5 (LGR5) has been reported to play critical roles in the proliferation of various cancer cells. However, the roles of LGR5 in brain tumors and the specific intracellular signaling proteins directly associated with it remain unknown. Expression of LGR5 was first measured in normal brain tissue, meningioma, and pituitary adenoma of humans. To identify the downstream signaling pathways of LGR5, siRNA-mediated knockdown of LGR5 was performed in SH-SY5Y neuroblastoma cells followed by proteomics analysis with 2-dimensional polyacrylamide gel electrophoresis (2D-PAGE). In addition, the expression of LGR5-associated proteins was evaluated in LGR5-inꠓhibited neuroblastoma cells and in human normal brain, meningioma, and pituitary adenoma tissue. Proteomics analysis showed 12 protein spots were significantly different in expression level (more than two-fold change) and subsequently identified by peptide mass fingerprinting. A protein association network was constructed from the 12 identified proteins altered by LGR5 knockdown. Direct and indirect interactions were identified among the 12 proteins. HSP 90-beta was one of the proteins whose expression was altered by LGR5 knockdown. Likewise, we observed decreased expression of proteins in the hnRNP subfamily following LGR5 knockdown. In addition, we have for the first time identified significantly higher hnRNP family expression in meningioma and pituitary adenoma compared to normal brain tissue. Taken together, LGR5 and its downstream sigꠓnaling play critical roles in neuroblastoma and brain tumors such as meningioma and pituitary adenoma.

Keywords: LGR5, neuroblastoma, meningioma, pituitary adenoma, hnRNP

Procedia PDF Downloads 48
39 Rathke’s Cleft Cyst Presenting as Unilateral Visual Field Defect

Authors: Ritesh Verma, Manisha Rathi, Chand Singh Dhull, Sumit Sachdeva, Jitender Phogat

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A Rathke's cleft cyst is a benign growth found on the pituitary gland in the brain, specifically a fluid-filled cyst in the posterior portion of the anterior pituitary gland. It occurs when the Rathke's pouch does not develop properly and ranges in size from 2 to 40mm in diameter. A 38-year-old male presented to the outpatient department with loss of vision in the inferior quadrant of the left eye since 15 days. Visual acuity was 6/6 in the right eye and 6/9 in the left eye. Visual field analysis by HFA-24-2 revealed an inferior field defect extending to the supero-temporal quadrant in the left eye. MRI brain and orbit was advised to the patient and it revealed a well defined cystic pituitary adenoma indenting left optic nerve near optic chiasm consistent with the diagnosis of Rathke’s cleft cyst (RCC). The patient was referred to neurosurgery department for further management. Symptoms vary greatly between individuals having RCCs. RCCs can be non-functioning, functioning, or both. Besides headaches, neurocognitive deficits are almost always present but have a high rate of immediate reversal if the cyst is properly treated or drained.

Keywords: pituitary tumors, rathke’s cleft cyst, visual field defects, vision loss

Procedia PDF Downloads 195
38 Endoscopic Pituitary Surgery: Learning Curve and Nasal Quality of Life

Authors: Martin Dupuy, Solange Grunenwald, Pierre-Louis Colombo, Laurence Mahieu, Pomone Richard, Philippe Bartoli

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Endonasal endoscopic trans-sphenoidal surgery for pituitary tumours has become a mainstay of treatment over the last two decades. Although it is generally accepted that there is no significant difference between endoscopic versus microscopic approach for surgical outcomes (endocrine and ophthalmologic status), nasal morbidity seems to the benefit of endoscopic procedures. Minimally invasive endoscopic surgery needs an operative learning curve to achieve surgeon’s efficiency. This learning curve is now well known for surgical outcomes and complications rate, however, few data are available for nasal morbidity. The aim of our series is to document operative experience and nasal quality of life after (NQOL) endoscopic trans-sphenoidal surgery. The prospective pituitary surgical cohort consisted of 525 consecutives patients referred to our Skull Base Diseases Department. Endoscopic procedures were performed by a single neurosurgeon using an uninostril approach. NQOL was evaluated using the Sino-Nasal Test (SNOT-22), the Anterior Base Nasal Inventory (ASBNI) and the Skull Base Inventory Score (SBIS). Data were collected before surgery during hospital stay and 3 months after the surgery. The seventy first patients were compared to the latest 70 patients. There was no significant difference between comparison score before versus after surgery for SNOT-22, ASBNI and SBIS during the single surgeon’s learning curve. Our series demonstrates that in our institution there is no statistically significant learning curve for NQOL after uninostril endoscopic pituitary surgery. A careful progression through sinonasal structures with very limited mucosal incision is associated with minimal morbidity and preserves nasal function. Conservative and minimal invasive approach could be achieved early during learning curve.

Keywords: pituitary surgery, quality of life, minimal invasive surgery, learning curve, pituitary tumours, skull base surgery, endoscopic surgery

Procedia PDF Downloads 117
37 Uncommon Presentation of Iscahemic Heart Disease with Sheehan’s Syndrome at Mid-Level Private Hospital of Bangladesh and Its Management- A Case Report

Authors: Nazmul Haque, Syeda Tasnuva Maria

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Sheehan's Syndrome (SS), also known as postpartum hypopituitarism, is a rare but potentially serious condition resulting from ischemic necrosis of the pituitary gland, often occurring during or after childbirth. This syndrome is characterized by hypopituitarism, leading to deficiencies in various hormones produced by the pituitary gland. The primary cause is typically severe postpartum hemorrhage, leading to inadequate blood supply and subsequent necrosis of the pituitary tissue. This chronic hypopituitarism sometimes plays the role of premature atherosclerosis, which may lead to cardiovascular disease. This abstract provides a comprehensive overview of Sheehan's Syndrome with ischaemic heart disease, encompassing its pathophysiology, clinical manifestations, and current management strategies. The disorder presents a wide spectrum of symptoms, including chest pain, fatigue, amenorrhea, lactation failure, hypothyroidism, and adrenal insufficiency. Timely diagnosis is crucial, as delayed recognition can lead to complications and long-term health consequences. We herein report a patient complaining of chronic fatigue symptoms, aggressiveness, chest pain, and breathlessness with repeated LOC that were diagnosed with SS with IHD. The patient was treated with antiplatelet, antianginal, steroids, and hormone replacement with marked improvement in his overall condition.

Keywords: ischaemic heart disease, Sheehan's syndrome, post-partum haemorrhage, pituitary gland

Procedia PDF Downloads 44
36 Stability Analysis for an Extended Model of the Hypothalamus-Pituitary-Thyroid Axis

Authors: Beata Jackowska-Zduniak

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We formulate and analyze a mathematical model describing dynamics of the hypothalamus-pituitary-thyroid homoeostatic mechanism in endocrine system. We introduce to this system two types of couplings and delay. In our model, feedback controls the secretion of thyroid hormones and delay reflects time lags required for transportation of the hormones. The influence of delayed feedback on the stability behaviour of the system is discussed. Analytical results are illustrated by numerical examples of the model dynamics. This system of equations describes normal activity of the thyroid and also a couple of types of malfunctions (e.g. hyperthyroidism).

Keywords: mathematical modeling, ordinary differential equations, endocrine system, delay differential equation

Procedia PDF Downloads 331
35 Induced Breeding of Neolissochilus hexagonolepis Using Pituitary and Synthetic Hormone under the Agro-Climatic Condition of Meghalaya, India

Authors: Lydia Booney Jyrwa, Rabindra Nath Bhuyan

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Chocolate Mahseer (Neolissochilus hexagonolepis) is one of the Mahseer species inhabiting the North-eastern region of India and is a native species to the state of Meghalaya since it can adapt and grow well under the agro climatic conditions of the region. The natural population of this fish has been declining over the years from this part of the country. The natural population of this fish has been declining over the years from this part of the country. The fish is considered as one of the endangered species of the Mahseer group, which is having tremendous scope for culture, sports and tourism. But non-availability of quality seed is a hindrance for the culture of this fish. Thus induced breeding of the fish by hormonal administration with pituitary gland and synthetic hormones is the only reliable method to procure the pure seed of the fish. Chocolate Mahseer was successfully bred at the Hatchery Complex, St. Anthony’s College, Shillong, Meghalaya by using pituitary extract and synthetic hormone viz. ovaprim, ovatide and gonopro-FH. The dose standardized is @ 4mg/kg body weight to both male and female as 1st dose and @ 7.9 mg/kg body weight only to female as 2nd dose for pituitary extract and single dose @ 0.8 ml/kg body weight to female and @ 0.3 ml/kg body weight to male of both ovaprim and ovatide, while a single dose @ 0.9 ml/kg body weight to female and @ 0.3 ml/kg body weight to male of gonopro-FH. The doses are standardized after a series of trial and error experiment performed. The fecundity of the fish was 3500 eggs/ kg body weight. The final hatching percentage achieved was 60%. The survival rate of hatchling was 50% up to fry stage. The use of synthetic hormone and positive response of the fish to the hormone will go in long way for production of quality seed of the fish which in turn help in culture of the species as the fish can be a very good candidate species for the culture in the state. This study will also help in the ranching of the fish in the natural habitat leading to conservation of the species. However, the study should be continued further for the large scale production of seeds.

Keywords: chocolate mahseer, induced breeding, pituitary extract, synthetic hormone

Procedia PDF Downloads 233
34 Concepts of Instrumentation Scheme for Thought Transfer

Authors: Rai Sachindra Prasad

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Thought is physical force. This has been well recognized but hardly translated visually or otherwise in the sense of its transfer from one individual to another. In the present world of chaos and disorder with yawning gaps between right and wrong thinking individuals, if it is possible to transfer the right thoughts to replace the wrong ones it would indeed be a great achievement in the present situation of the world which is torn with violence with dangerous thoughts of individuals. Moreover, such a possibility would completely remove the barrier of language between two persons, which at times proves to be a great obstacle in realizing a desired purpose. If a proper instrumentation scheme containing appropriate transducers and electronics is designed and implemented to realize this thought ransfer phenomenon, this would prove to be extremely useful when properly used. Considering the advancements already made in recording the nerve impulses in the brain, which are electrical events of very short durations that move along the axon, it is conceivable that this may be used to good effect in implementing the scheme. In such a proposition one shoud consider the roles played by pineal body, pituitary gland and ‘association’ areas. Pioneer students of brain have thought that associations or connections between sensory input and motor output were made in these areas. It is currently believed that rather than being regions of simple sensory-motor connections, the association areas process and integrate sensory information relayed to them from the primary sensory areas of the cortex and from the thalamus, after the information has been processed, it may be sent to motor areas to be acted upon. Again, even though the role played by pineal body is not known fully to neurologists its interconnection with pituitary gland is a matter of great significance to the ‘Rishis’ and; Seers’ s described in Vedas and Puranas- the ancient Holy books of Hindus. If the pineal body is activated through meditation it would control the pituitary gland thereby the individual’s thoughts and acts. Thus, if thoughts can be picked up by special transducers, these can be connected to suitable electronics circuitry to amplify the signals. These signals in the form of electromagnetic waves can then be transmitted using modems for long distance transmission and eventually received by or passed on to a subject of interest through another set of electronics circuit and devices.

Keywords: modems, pituitary gland, pineal body, thought transfer

Procedia PDF Downloads 367
33 Effect of Resistance Exercise on Hypothalamic-Pituitary-Gonadal Axis

Authors: Alireza Barari, Saeed Shirali, Ahmad Abdi

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Abstract: Introduction: Physical activity may be related to male reproductive function by affecting on thehypothalamic-pituitary-gonadal(HPG) axis. Our aim was to determine the effects of 6 weeks resistance exercise on reproductive hormones, HPG axis. The hypothalamic-pituitary-gonadal (HPG) axis refers tothe effects of endocrine glands in three-level including (i) the hypothalamic releasing hormone GnRH, which is synthesized in in a small heterogenous neuronal population and released in a pulsatile fashion, (ii) the anterior pituitary hormones, follicle-stimulating hormone(FSH) and luteinizing hormone (LH) and (iii) the gonadal hormones, which include both steroid such as testosterone (T), estradiol and progesterone and peptide hormones (such as inhibin). Hormonal changes that create a more anabolic environment have been suggested to contribute to the adaptation to strength exercise. Physical activity has an extensive impact on male reproductive function depending upon the intensity and duration of the exercise and the fitness level of the individual. However, strenuous exercise represents a physical stress and inflammation changed that challenges homeostasis. Materials and methods: Sixteen male volunteered were included in a 6-week control period followed by 6 weeks of resistance training (leg press, lat pull, chest press, squat, seatedrow, abdominal crunch, shoulder press, biceps curl and triceps press down) four times per week. intensity of training loading was 60%-75% of one maximum repetition. Participants performed 3 sets of 10 repetitions. Rest periods were two min between exercises and sets. Start with warm up exercises include: The muscles relax and stretch the body, which was for 10 minutes. Body composition, VO2max and the circulating level of free testosterone (fT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone binding globulin (SHBG) and inhibin B measured prior and post 6-week intervention. The hormonal levels of each serum sample were measured using commercially available ELISA kits. Analysis of anthropometrical data and hormonal level were compared using the independent samples t- test in both groups and using SPSS (version 19). P ≤ 0.05 was considered statistically significant. Results: For muscle strength, both lower- and upper-body strength were increased significantly. Aerobic fitness level improved in trained participant from 39.4 ± 5.6 to 41.9 ± 5.3 (P = 0.002). fT concentration rise progressively in the trained group and was significantly greater than those in the control group (P = 0.000). By the end of the 6-week resistance training, serum SHBG significantly increased in the trained group compared with the control group (P = 0.013). In response to resistance training, LH, FSH and inhibin B were not significantly changed. Discussion: According to our finfings, 6 weeks of resistance training induce fat loss without any changes in body weight and BMI. A decline of 25.3% in percentage of body fat with statiscally same weight was due to increase in muscle mass that happened during resistance exercise periods . Six weeks of resistance training resulted in significant improvement in BF%, VO2max and increasing strength and the level of fT and SHBG.

Keywords: resistance, hypothalamic, pituitary, gonadal axis

Procedia PDF Downloads 395
32 Effect of Visnagin on Altered Steroidogenesis and Spermatogenesis, and Testicular Injury Induced by the Heavy Metal Lead

Authors: Saleh N. Maodaa

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Background: Lead (Pb) is an environmental pollutant causing serious health problems, including impairment of reproduction. Visnagin (VIS) is a furanochromone with promising antioxidant and anti-inflammatory effects; however, its protective efficacy against Pb toxicity has not been investigated. Objective: This study evaluated the protective effect of VIS on Pb reproductive toxicity, impaired steroidogenesis and spermatogenesis, oxidative stress and inflammation. Methods: Rats received VIS (30 or 60 mg/kg) and 50 mg/kg lead acetate for 3 weeks, and blood and testes samples were collected. Results: Pb intoxication impaired the pituitary-testicular axis (PTA), manifested by the decreased serum levels of gonadotropins and testosterone. Pb decreased sperm count, motility and viability, increased sperm abnormalities, and downregulated the steroidogenesis markers StAR, CYP17A1, 3β-HSD and 17β-HSD in the testis of rats. VIS significantly increased serum gonadotropins and testosterone, alleviated sperm parameters and upregulated steroidogenesis. In addition, VIS decreased pro-inflammatory cytokines, testicular lipid peroxidation and DNA fragmentation, downregulated Bax, and enhanced antioxidants and Bcl-2 Conclusion: These results demonstrate the protective effect of VIS against Pb reproductive toxicity in rats. VIS improved serum gonadotropins and testosterone, enhanced steroidogenesis and spermatogenesis, and attenuated oxidative injury, inflammation and apoptosis. Therefore, VIS is a promising candidate for the protection against Pb-induced reproduction impairment.

Keywords: pituitary-gonadal axis, cytokines, DNA damage, apoptosis

Procedia PDF Downloads 91
31 Case Presentation Ectopic Cushing's Syndrome Secondary to Thymic Neuroendocrine Tumors Secreting ACTH

Authors: Hasan Frookh Jamal

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This is a case of a 36-year-old Bahraini gentleman diagnosed to have Cushing's Syndrome with a large anterior mediastinal mass. He was sent abroad to the Speciality hospital in Jordan, where he underwent diagnostic video-assisted thoracoscopy, partial thymectomy and pericardial fat excision. Histopathology of the mass was reported to be an Atypical carcinoid tumor with a low Ki67 proliferation index of 5%, the mitotic activity of 4 MF/10HPF and pathological stage classification(pTNM): pT1aN1. MRI of the pituitary gland showed an ill-defined non-enhancing focus of about 3mm on the Rt side of the pituitary on coronal images, with a similar but smaller one on the left side, which could be due to enhancing pattern rather than a real lesion as reported. The patient underwent Ga68 Dotate PET/CT scan post-operatively, which showed multiple somatostatin receptor-positive lesions seen within the tail, body and head of the pancreas and positive somatostatin receptor lymph nodes located between the pancreatic head and IVC. There was no uptake detected at the anterior mediastinum nor at the site of thymic mass resection. There was no evidence of any positive somatostatin uptake at the soft tissue or lymph nodes. The patient underwent IPSS, which proved that the source is, in fact, an ectopic source of ACTH secretion. Unfortunately, the patient's serum cortisol remained elevated after surgery and failed to be suppressed by 1 mg ODST and by 2 days LLDST with a high ACTH value. The patient was started on Osilodrostat for treatment of hypercortisolism for the time being and his future treatment plan with Lutetium-177 Dotate therapy vs. bilateral adrenalectomy is to be considered in an MDT meeting.

Keywords: cushing syndrome, neuroendocrine tumur, carcinoid tumor, Thymoma

Procedia PDF Downloads 80
30 Dependence of Androgen Status in Men with Primary Hypothyroidism on Duration and Condition of Compensation

Authors: Krytskyy T.

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Introduction: The role of androgen deficiency in men as a factor in the pathogenesis of many somatic diseases is unmistakable. The interaction of thyroid and sex hormones with hypothyroidism in men is still the subject of discussions. The purpose of the study is to assess the androgen status of men with primary hypothyroidism, depending on its duration and the state of compensation. Materials and methods: 45 men with primary hypothyroidism aged 35 to 60 years, as well as 25 healthy men, who formed a control group, were under supervision. A selection of men for examination was conducted in the process of outpatient and in-patient treatment at the endocrinology department of the University Hospital in Ternopil. The functional state of the pituitary-gonadal system was evaluated in order to characterize the androgen status of patients. The concentration of follicle stimulating hormone, luteinizing hormone, prolactin, thyroid-stimulating hormone was determined in blood with the help of enzyme-linked method. Also, the content of hormones: total testosterone, linking sex hormones globulin were determined. Results: Reduced total testosterone (TT) content was found in 42.2% of patients with hypothyroidism. Herewith in 17.8% of patients, blood TT levels were lower than 8.0 nmol / L, and in 11 (24.4%) men, the rate was in the range of 8.0 to 12.0 nmol / L. Based on the results of the determination of the content of free testosterone (FT), the frequency of laboratory hypogonadism in men with hypothyroidism was higher than the results of the determination of TT. The degree of compensation of hypothyroidism probably did not affect the average levels of gonadotropic and sex hormones. Conclusions: Reduced total testosterone content was found in 42.2% of patients with primary hypothyroidism. Herewith, in 17.8% of patients blood TT levels were lower than 8.0 nmol / L, which is a sign of absolute deficiency of testosterone, and in 24.4% of men the rate ranged from 8.0 to 12.0 nmol / l , indicating partial androgen deficiency. Linking sex hormones globulin levels were believed to be lower in 46.7% of patients with hypothyroidism compared to control group. The average levels of E2 in the examined patients did not significantly differ from the mean of control group. FSH, LH, and prolactin levels in men with hypothyroidism were within the normal age limits and probably did not differ from those of control group. The degree of compensation of hypothyroidism probably did not affect the average levels of gonadotropic and sex hormones. The mean LH content in the blood was significantly increased in men with a duration of hypothyroidism up to 5 years and did not differ from that of the control group and in men with a duration of hypothyroidism over 5 years. In men with hypothyroidism, a probable reduction in T / LH coefficient is found. The obtained data may indicate a combined lesion of the central and peripheral parts of the pituitary-gonadal system in men with hypothyroidism.

Keywords: androgenic status, hypothyroidism, testosterone, linking sex hormones globulin

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29 Distribution of Putative Dopaminergic Neurons and Identification of D2 Receptors in the Brain of Fish

Authors: Shweta Dhindhwal

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Dopamine is an essential neurotransmitter in the central nervous system of all vertebrates and plays an important role in many processes such as motor function, learning and behavior, and sensory activity. One of the important functions of dopamine is release of pituitary hormones. It is synthesized from the amino acid tyrosine. Two types of dopamine receptors, D1-like and D2-like, have been reported in fish. The dopamine containing neurons are located in the olfactory bulbs, the ventral regions of the pre-optic area and tuberal hypothalamus. Distribution of the dopaminergic system has not been studied in the murrel, Channa punctatus. The present study deals with identification of D2 receptors in the brain of murrel. A phylogenetic tree has been constructed using partial sequence of D2 receptor. Distribution of putative dopaminergic neurons in the brain has been investigated. Also, formalin induced hypertrophy of neurosecretory cells in murrel has been studied.

Keywords: dopamine, fish, pre-optic area, murrel

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28 A Study on How Domestic Cats' Nutritional Behavior is Affected by Adjustment Stress

Authors: Maria Magdy Danial Riad

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The hypothalamic-pituitary-adrenal axis is activated by the adaptation stress, and this might result in the alteration of certain behavioral signs. The primary purpose of this paper is the adaptive stress effect on dietary behavior, which is directly correlated with changes in plasma cortisol levels. Physiological factors have a role in systems of adaptation and stress. Objectives: Ten clinically healthy cats were included in the study, and they were all kept in the same setting. Methods: On days 1, 5, 9, and 10 of the stay, each cat's behavior was observed through ethograms, and the serum cortisol levels were also measured at the same time. Significant behavioral changes in terms of nutrition were seen on the first day, with 50% of the participants not feeding and all participants not watering. Toward the study's conclusion, between days 5 and 9, there were no longer any discernible changes in the dietary habits, which might be attributed to the adaptation to the new living conditions. Cortisol variations in serological levels were consistent with behavioral changes; in 50% of the participants under observation, there was a substantial increase in values (p<0.05), which gradually declined as the study came to an end.

Keywords: domestic cats, ewes, nutritional behavior, adjustment stress, plasma cortisol levels

Procedia PDF Downloads 32
27 Erectile Dysfunction in A Middle Aged Man 6 Years After Bariatric Surgery: A Case Report

Authors: Thaminda Liyanage, Chamila Shamika Kurukulasuriya

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Introduction: Morbid obesity has been successfully treated with bariatric surgery for over 60 years. Although operative procedures have improved and associated complications have reduced substantially, surgery still carries the risk of post-operative malabsorption, malnutrition and a range of gastrointestinal disorders. Overweight by itself can impair libido in both sexes and cause erectile dysfunction in males by inducing a state of hypogonadotropic hypogonadism, proportional to the degree of obesity. Impact of weight reduction on libido and sexual activity remains controversial, however it is broadly accepted that weight loss improves sexual drive. Zinc deficiency, subsequent to malabsorption, may lead to impaired testosterone synthesis in men while excessive and/or rapid weight loss in females may result in reversible amenorrhoea leading to sub-fertility. Methods: We describe a 37 year old male, 6 years post Roux-en-Y gastric bypass surgery, who presented with erectile dysfunction, loss of libido, worsening fatigue and generalized weakness for 4 months. He also complained of constipation and frequent muscle cramps but denied having headache, vomiting or visual disturbances. Patient had lost 38 kg of body weight post gastric bypass surgery over four years {135kg (BMI 42.6 kg/m2) to 97 kg (BMI 30.6 kg/m2)} and the weight had been stable for past two years. He had no recognised co-morbidities at the time of the surgery and noted marked improvement in general wellbeing, physical fitness and psychological confident post surgery, up until four months before presentation. Clinical examination revealed dry pale skin with normal body hair distribution, no thyroid nodules or goitre, normal size testicles and normal neurological examination with no visual field defects or diplopia. He had low serum testosterone, follicular stimulating hormone (FSH), luteinizing hormone (LH), T3, T4, thyroid stimulating hormone (TSH), insulin like growth factor 1 (IGF-1) and 24-hour urine cortisol levels. Serum cortisol demonstrated an appropriate rise to ACTH stimulation test but growth hormone (GH) failed increase on insulin tolerance test. Other biochemical and haematological studies were normal, except for low zinc and folate with minimally raised liver enzymes. MRI scan of the head confirmed a solid pituitary mass with no mass effect on optic chiasm. Results: In this patient clinical, biochemical and radiological findings were consistent with anterior pituitary dysfunction. However, there were no features of raised intracranial pressure or neurological compromise. He was commenced on appropriate home replacement therapy and referred for neurosurgical evaluation. Patient reported marked improvement in his symptoms, specially libido and erectile dysfunction, on subsequent follow up visits. Conclusion: Sexual dysfunction coupled with non specific constitutional symptoms has multiple aetiologies. Clinical symptoms out of proportion to nutritional deficiencies post bariatric surgery should be thoroughly investigated. Close long term follow up is crucial for overall success.

Keywords: obesity, bariatric surgery, erectile dysfunction, loss of libido

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26 Drastic Improvement in Vision Following Surgical Excision of Juvenile Nasopharyngeal Angiofibroma with Compressive Optic Neuropathy

Authors: Sweta Das

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This case report is a 15-year-old male who presented with painless unilateral vision loss from left optic nerve compression due to juvenile nasopharyngeal angiofibroma. JNA is a rare, benign neoplasm that causes intracranial and intraorbital bone destruction and extends aggressively into surrounding soft tissues. It accounts for <1% of all head and neck tumors, is predominantly found in pediatric males and tends to affect indigenous population disproportionately. The most common presenting symptom for JNA is epistaxis and nasal obstruction. However, it can invade orbit, chiasm and pituitary gland, causing loss of vision and field. Visual acuity and function near normalized following surgical excision. Optometry plays an important role in the diagnosis and co-management of JNA with optic nerve compression by closely monitoring afferent optic nerve function and structure, and extraocular motility. Visual function and acuity in patients with short-term compressive neuropathy may drastically improve following surgical resection as this case demonstrates.

Keywords: orbital mass, painless monocular vision loss, compressive optic neuropathy, pediatric tumor

Procedia PDF Downloads 54
25 Breeding Biology and Induced Breeding Status of Freshwater Mud Eel, Monopterus cuchia

Authors: Faruque Miah, Hafij Ali, Enaya Jannat, Tanmoy Modok Shuvra, M. Niamul Naser

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In this study, breeding biology and induced breeding of freshwater mud eel, Monopterus cuchia was observed during the experimental period from February to June, 2013. Breeding biology of freshwater mud eel, Monopterus cuchia was considered in terms of gonadosomatic index, length-weight relationship of gonad, ova diameter and fecundity. The ova diameter was recorded from 0.3 mm to 4.30 mm and the individual fecundity was recorded from 155 to 1495 while relative fecundity was found from 2.64 to 12.45. The fecundity related to body weight and length of fish was also discussed. A peak of GSI was observed 2.14±0.2 in male and 5.1 ±1.09 in female. Induced breeding of freshwater mud eel, Monopterus cuchia was also practiced with different doses of different inducing agents like pituitary gland (PG), human chorionic gonadotropin (HCG), Gonadotropin releasing hormone (GnRH) and Ovuline-a synthetic hormone in different environmental conditions. However, it was observed that the artificial breeding of freshwater mud eel, Monopterus cuchia was not yet succeeded through inducing agents in captive conditions, rather the inducing agent showed negative impacts on fecundity and ovarian tissues. It was seen that mature eggs in the oviduct were reduced, absorbed and some eggs were found in spoiled condition.

Keywords: breeding biology, induced breeding, Monopterus cuchia, human chorionic gonadotropin

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24 Brain Tumor Detection and Classification Using Pre-Trained Deep Learning Models

Authors: Aditya Karade, Sharada Falane, Dhananjay Deshmukh, Vijaykumar Mantri

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Brain tumors pose a significant challenge in healthcare due to their complex nature and impact on patient outcomes. The application of deep learning (DL) algorithms in medical imaging have shown promise in accurate and efficient brain tumour detection. This paper explores the performance of various pre-trained DL models ResNet50, Xception, InceptionV3, EfficientNetB0, DenseNet121, NASNetMobile, VGG19, VGG16, and MobileNet on a brain tumour dataset sourced from Figshare. The dataset consists of MRI scans categorizing different types of brain tumours, including meningioma, pituitary, glioma, and no tumour. The study involves a comprehensive evaluation of these models’ accuracy and effectiveness in classifying brain tumour images. Data preprocessing, augmentation, and finetuning techniques are employed to optimize model performance. Among the evaluated deep learning models for brain tumour detection, ResNet50 emerges as the top performer with an accuracy of 98.86%. Following closely is Xception, exhibiting a strong accuracy of 97.33%. These models showcase robust capabilities in accurately classifying brain tumour images. On the other end of the spectrum, VGG16 trails with the lowest accuracy at 89.02%.

Keywords: brain tumour, MRI image, detecting and classifying tumour, pre-trained models, transfer learning, image segmentation, data augmentation

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23 Influence of 50 Hz, 1m Tesla Electromagnetic Fields on Serum Male Sex Hormones of Male Rats

Authors: Randa M. Mostafa, Y. Moustafa

Abstract:

During our daily life, we are continuously exposed to the extremely low frequency electromagnetic fields (ELF-EMFs) generated by electric appliances. The possible relation between exposure to (ELF-MFs) and adverse health effects has attracted and passed through long debate sessions. Extremely low frequency is a term used to describe radiation frequencies below 300 Hertz (Hz).It is very important for public health because of the widespread use of electrical power at 50-60 Hz in most countries. This study set out to investigate the impact of chronic exposure of male rats to 50- Hz, 1 mTesla (ELF-EMF) of over periods of 1, 2, and 4 weeks on concentration of serum FSH, LH, and testosterone hormones. 60 male albino rats were divided into 6 groups and were continuously exposed to 50-Hz, 1 m Tesla (ELF-EMF) generated by magnetic field chamber for periods of 1, 2, and 4 weeks. For each experimental point, sham treated group was used as a control. Assay of serum testosterone LH, and FSHwere performed. Serum testosterone showed no significant changes. FSH showed significant increase than sham exposed group after 1 week of field exposure. LH showed significant increase than sham exposed group only after 4 weeks of field exposure. A future detailed molecular studies must be carried out to figure out and may be able to explain the possible interactions between ELF-EMF and hypothalamic-pituitary gonadal axis.

Keywords: extremely low frequency electromagnetic fields, testosterone, follicular stimulating hormone, LH

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22 Administration of Lactobacillus plantarum PS128 Improves Animal Behavior and Monoamine Neurotransmission in Germ-Free Mice

Authors: Liu Wei-Hsien, Chuang Hsiao-Li, Huang Yen-Te, Wu Chien-Chen, Chou Geng-Ting, Tsai Ying-Chieh

Abstract:

Intestinal microflora play an important role in communication along the gut-brain axis. Probiotics, defined as live bacteria or bacterial products, confer a significant health benefit to the host. Here we administered Lactobacillus plantarum PS128 (PS128) to the germ-free (GF) mouse to investigate the impact of the gut-brain axis on emotional behavior. Administration of live PS128 significantly increased the total distance traveled in the open field test; it decreased the time spent in the closed arm and increased the time spent and total entries into the open arm in the elevated plus maze. In contrast, heat-killed PS128 caused no significant changes in the GF mice. Treatment with live PS128 significantly increased levels of both serotonin and dopamine in the striatum, but not in the prefrontal cortex or hippocampus. However, live PS128 did not alter pro- or anti-inflammatory cytokine production by mitogen-stimulated splenocytes. The above data indicate that the normalization of emotional behavior correlated with monoamine neurotransmission, but not with immune activity. Our findings suggest that daily intake of the probiotic PS128 could ameliorate neuropsychiatric disorders such as anxiety and excessive psychological stress.

Keywords: dopamine, hypothalamic-pituitary-adrenal axis, intestinal microflora, serotonin

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21 Utility of Optical Coherence Tomography (OCT) and Visual Field Assessment in Neurosurgical Patients

Authors: Ana Ferreira, Ines Costa, Patricia Polónia, Josué Pereira, Olinda Faria, Pedro Alberto Silva

Abstract:

Introduction: Optical coherence tomography (OCT) and visual field tools are pivotal in evaluating neurological deficits and predicting potential visual improvement following surgical decompression in neurosurgical patients. Despite their clinical significance, a comprehensive understanding of their utility in this context is lacking in the literature. This study aims to elucidate the applications of OCT and visual field assessment, delineating distinct patterns of visual deficit presentations within the studied cohort. Methods: This retrospective analysis considered all adult patients who underwent a single surgery for pituitary adenoma or anterior skull base meningioma with optic nerve involvement, coupled with neuro-ophthalmology evaluation, between July 2020 and January 2023. A minimum follow-up period of 6 months was deemed essential. Results: A total of 24 patients, with a median age of 61, were included in the analysis. Three primary patterns emerged: 1) Low visual field involvement with compromised OCT, 2) High visual field involvement with relatively unaffected OCT, and 3) Significant compromise observed in both OCT and visual fields. Conclusion: This study delineates various findings in OCT and visual field assessments with illustrative examples. Based on the current findings, a prospective cohort will be systematically collected to further investigate and validate these patterns and their prognostic significance, enhancing our understanding of the utility of OCT and visual fields in neurosurgical patients.

Keywords: OCT, neurosurgery, visual field, optic nerve

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20 Cognitive Functioning and Cortisol Suppression in Major Depression in a Long-Term Perspective

Authors: Pia Berner Hansson, Robert Murison Anders Lund, Hammar Åsa

Abstract:

Major Depressive Disorder (MDD) is often associated with high levels of stress and disturbances in the Hypothalamic Pituitary Adrenal (HPA) system, yielding high levels of cortisol, in addition to cognitive dysfunction. Previous studies in this patient group have shown a relationship between cortisol profile and cognitive functioning in the acute phase of MDD and that the patients had significantly less suppression after dexamethasone administration. However, few studies have investigated this relationship over time and in phases of symptom reduction. The aim of the present study was to examine the relationships between cortisol levels after the Dexamethasone Suppression Test (DST) and cognitive function in a long term perspective in MDD patients. Patients meeting the DSM-IV criteria for a MDD were included in the study and tested in symptom reduction. A control group was included. Cortisol was measured in saliva collected with Salivette sampling devices. Saliva samples were collected 4 times during a 24 hours period over two consecutive days: at awakening, after 45 minutes, after 7 hours and at 11 pm. Dexamethasone (1.0 mg) was given on Day 1 at 11 pm. The neuropsychological test battery consisted of standardized tests measuring memory and Executive Functioning (EF). Cortisol levels did not differ significantly between patients and controls on Day 1 or Day 2. Both groups showed significant suppression after Dexamethasone. There were no correlations between cortisol levels or suppression after Dexamethasone and cognitive measures. The results indicate that the HPA-axis functioning normalizes in phases of symptom reduction in MDD patients and that there no relation between cortisol profile and cognitive functioning in memory or EF.

Keywords: depression, MDD, cortisol, suppression, cognitive functioning

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19 The Fabrication of Stress Sensing Based on Artificial Antibodies to Cortisol by Molecular Imprinted Polymer

Authors: Supannika Klangphukhiew, Roongnapa Srichana, Rina Patramanon

Abstract:

Cortisol has been used as a well-known commercial stress biomarker. A homeostasis response to psychological stress is indicated by an increased level of cortisol produced in hypothalamus-pituitary-adrenal (HPA) axis. Chronic psychological stress contributing to the high level of cortisol relates to several health problems. In this study, the cortisol biosensor was fabricated that mimicked the natural receptors. The artificial antibodies were prepared using molecular imprinted polymer technique that can imitate the performance of natural anti-cortisol antibody with high stability. Cortisol-molecular imprinted polymer (cortisol-MIP) was obtained using the multi-step swelling and polymerization protocol with cortisol as a target molecule combining methacrylic acid:acrylamide (2:1) with bisacryloyl-1,2-dihydroxy-1,2-ethylenediamine and ethylenedioxy-N-methylamphetamine as cross-linkers. Cortisol-MIP was integrated to the sensor. It was coated on the disposable screen-printed carbon electrode (SPCE) for portable electrochemical analysis. The physical properties of Cortisol-MIP were characterized by means of electron microscope techniques. The binding characteristics were evaluated via covalent patterns changing in FTIR spectra which were related to voltammetry response. The performance of cortisol-MIP modified SPCE was investigated in terms of detection range, high selectivity with a detection limit of 1.28 ng/ml. The disposable cortisol biosensor represented an application of MIP technique to recognize steroids according to their structures with feasibility and cost-effectiveness that can be developed to use in point-of-care.

Keywords: stress biomarker, cortisol, molecular imprinted polymer, screen-printed carbon electrode

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18 Melatonin Rescue Fungicide Induced Behavioral and Reproductive Abnormalities through Changes of Dopaminergic Activity in the Brain of Catfish, Mystus cavasisu

Authors: Muhammad Badruzzaman, Alif Hasan, Md. Shahjahan

Abstract:

Propiconazole is a triazole fungicide extensively used in agriculture which can harm to non-target organisms in aquatic environment through runoff. Chronic exposure to environmental pesticides turn to behavioral impairment in vertebrates including teleosts. However, the potential effect of this fungicide on neurobehavioral impairment and release from it in vertebrates has not been fully explored. In this work, we examined the role of melatonin to rescue fungicide induced neurobehavioral and reproductive alternation and its connection with changes in dopaminergic activity in the brain of Mystus cavasius. After fish were exposed to water containing propiconazole at 0, 0.1, 5, and 250 µg/L for 3 days, significant increases of DA, 3,4-dihydroxyphenylacetic acid (DOPAC; a DA metabolite), and their ratio (DOPAC/DA) were observed in whole brain at 250 µg/L concentration. When fish were treated with propiconazole at 250 µg/L for 3 days, there was a significant elevation of DA, DOPAC and DOPAC/DA in diencephalon and pituitary, and only DA in the telencephalon, compared with control fish. Besides, it induced a reduction in extracellular serotonin and had an anxiolytic-like effect, supported by a decrease in cortisol production. Increased locomotor activity, anxiety and aggressiveness, decreased gonadosomatic index with few vitellogenic oocytes in ovaries after propiconazole treatment. When fish were treated with melatonin, D1 (SCH-23390) or D2 (Haloperidol) dopamine receptor antagonists and combined of melatonin and D1/D2 receptor antagonist and was observed melatonin + D2 receptor antagonist rescued fungicide induced all behavioral changes in fish. These results indicate that propiconazole increases locomotor activity, anxiety and aggressiveness and decreases reproductive activity, which was rescued by combined treatment of melatonin and dopamine receptor antagonist.

Keywords: behavior, catfish, dopamine, fungicide, melatonin

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17 Effect of Oxytocin on Cytosolic Calcium Concentration of Alpha and Beta Cells in Pancreas

Authors: Rauza Sukma Rita, Katsuya Dezaki, Yuko Maejima, Toshihiko Yada

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Oxytocin is a nine-amino acid peptide synthesized in the paraventricular nucleus (PVN) and supraoptic nucleus (SON) of the hypothalamus. Oxytocin promotes contraction of the uterus during birth and milk ejection during breast feeding. Although oxytocin receptors are found predominantly in the breasts and uterus of females, many tissues and organs express oxytocin receptors, including the pituitary, heart, kidney, thymus, vascular endothelium, adipocytes, osteoblasts, adrenal gland, pancreatic islets, and many cell lines. On the other hand, in pancreatic islets, oxytocin receptors are expressed in both α-cells and β-cells with stronger expression in α- cells. However, to our knowledge there are no reports yet about the effect of oxytocin on cytosolic calcium reaction on α and β-cell. This study aims to investigate the effect of oxytocin on α-cells and β-cells and its oscillation pattern. Islet of Langerhans from wild type mice were isolated by collagenase digestion. Isolated and dissociated single cells either α-cells or β-cells on coverslips were mounted in an open chamber and superfused in HKRB. Cytosolic concentration ([Ca2+]i) in single cells were measured by fura-2 microfluorimetry. After measurement of [Ca2+]i, α-cells were identified by subsequent immunocytochemical staining using an anti-glucagon antiserum. In β-cells, the [Ca2+]i increase in response to oxytocin was observed only under 8.3 mM glucose condition, whereas in α-cells, [Ca2+]i an increase induced by oxytocin was observed in both 2.8 mM and 8.3 mM glucose. The oscillation incidence was induced more frequently in β-cells compared to α-cells. In conclusion, the present study demonstrated that oxytocin directly interacts with both α-cells and β-cells and induces increase of [Ca2+]i and its specific patterns.

Keywords: α-cells, β-cells, cytosolic calcium concentration, oscillation, oxytocin

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16 Associations and Interactions of Delivery Mode and Antibiotic Exposure with Infant Cortisol Level: A Correlational Study

Authors: Samarpreet Singh, Gerald Giesbrecht

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Both c-section and antibiotic exposure are linked to gut microbiota imbalance in infants. Such disturbance is associated with the Hypothalamic-Pituitary-Adrenal (HPA) axis function. However, the literature only has contradicting evidence for the association between c-sections and the HPA axis. Therefore, this study aims to test if the mode of delivery and antibiotics exposure is associated with the HPA axis. Also, whether exposure to both interacts with the HPA-axis. It was hypothesized that associations and interactions would be observed. Secondary data analysis was used for this co-relational study. Data for the mode of delivery and antibiotics exposure variables were documented from hospital records or self-questionnaires. In addition, cortisol levels (Area under the curve with respect to increasing (AUCi) and Area under the curve with respect to ground (AUCg)) were based on saliva collected from three months old during the infant’s visit to the lab and after drawing blood. One-way and between-subject ANOVA analyses were run on data. No significant association between delivery mode and infant cortisol level was found, AUCi and AUCg, p > .05. Only the infant’s AUCg was found to be significantly higher if there were antibiotics exposure at delivery (p = .001) or their mothers were exposed during pregnancy (p < .05). Infants born by c-section and exposed to antibiotics at three months had higher AUCi than those born vaginally, p < .02. These results imply that antibiotic exposure before three months is associated with an infant’s stress response. The association might increase if antibiotic exposure occurs three months after a c-section birth. However, more robust and causal evidence in future studies is needed, given a variable group’s statistically weak sample size. Nevertheless, the results of this study still highlight the unintended consequences of antibiotic exposure during delivery and pregnancy.

Keywords: HPA-axis, antibiotics, c-section, gut-microbiota, development, stress

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15 Detection of MspI Polymorphism and SNP of GH Gene in Some Camel Breeds Reared in Egypt

Authors: Sekena H. Abd El-Aziem, Heba A. M. Abd El-Kader, Sally S. Alam, Othman E. Othman

Abstract:

Growth hormone (GH) is an anabolic hormone synthesized and secreted by the somatotroph cells of the anterior lobe of the pituitary gland in a circadian and pulsatile manner, the pattern of which plays an important role in postnatal longitudinal growth and development, tissue growth, lactation, reproduction as well as protein, lipid and carbohydrate metabolism. The aim of this study was to detect the genetic polymorphism of GH gene in five camel breeds reared in Egypt; Sudany, Somali, Mowaled, Maghrabi and Falahy, using PCR-RFLP technique. Also this work aimed to identify the single nucleotide polymorphism between different genotypes detected in these camel breeds. The amplified fragment of camel GH at 613-bp was digested with the restriction enzyme MspI and the result revealed the presence of three different genotypes; CC, CT and TT in tested breeds and significant differences were recorded in the genotype frequencies between these camel breeds. The result showed that the Maghrabi breed that is classified as a dual purpose camels had higher frequency for allele C (0.75) than those in the other tested four breeds. The sequence analysis declared the presence of a SNP (C→T) at position 264 in the amplified fragment which is responsible for the destruction of the restriction site C^CGG and consequently the appearance of two different alleles C and T. The nucleotide sequences of camel GH alleles T and C were submitted to nucleotide sequences database NCBI/Bankit/GenBank and have accession numbers: KP143517 and KP143518, respectively. It is concluded that only one SNP C→T was detected in GH gene among the five tested camel breeds reared in Egypt and this nucleotide substitution can be used as a marker for the genetic biodiversity between camel breeds reared in Egypt. Also, due to the possible association between allele C and higher growth rate, we can used it in MAS for camels and enter the camels possess this allele in breeding program as a way for enhancement of growth trait in camel breeds reared in Egypt.

Keywords: camel breeds in Egypt, GH, PCR-RFLP, SNPs

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14 Postoperative Budesonide Nasal Irrigation vs Normal Saline Irrigation for Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis

Authors: Rakan Hassan M. Alzahrani, Ziyad Alzahrani, Bader Bashrahil, Abdulrahman Elyasi, Abdullah a Ghaddaf, Rayan Alzahrani, Mohammed Alkathlan, Nawaf Alghamdi, Dakheelallah Almutairi

Abstract:

Background: Corticosteroid irrigations, which regularly involve the off-label use of budesonide mixed with normal saline in high volume Sino-nasal irrigations, have been more commonly used in the management of post-operative chronic rhinosinusitis (CRS). Objective: This article attempted to measure the efficacy of post-operative budesonide nasal irrigation compared to normal saline-alone nasal irrigation in the management of chronic rhinosinusitis (CRS) through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The databases PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched by two independent authors. Only RCTs comparing budesonide irrigation to normal saline alone irrigation for CRS with or without polyposis after functional endoscopic sinus surgery (FESS) were eligible. A random effect analysis model of the reported CRS-related quality of life (QOL) measures and the objective endoscopic assessment scales of the disease was done. Results: Only 6 RCTs met the eligibility criteria, with a total number of participants of 356. Compared to normal saline irrigation, budesonide nasal irrigation showed statically significant improvements in both the CRS-related quality of life (QOL) and the endoscopic findings (MD= -4.22 confidence interval [CI]: -5.63, -2.82 [P < 0.00001]), (SMD= -0.50 confidence interval [CI]: -0.93, -0.06 [P < 0.03]) respectively. Conclusion: Both intervention arms showed improvements in CRS-related QOL and endoscopic findings in post-FESS chronic rhinosinusitis with or without polyposis. However, budesonide irrigation seems to have a slight edge over conventional normal saline irrigation with no reported serious side effects, including hypothalamic-pituitary-adrenal (HPA) axis suppression.

Keywords: Budesonide, chronic rhinosinusitis, corticosteroids, nasal irrigation, normal saline

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13 Revalidation and Hormonization of Existing IFCC Standardized Hepatic, Cardiac, and Thyroid Function Tests by Precison Optimization and External Quality Assurance Programs

Authors: Junaid Mahmood Alam

Abstract:

Revalidating and harmonizing clinical chemistry analytical principles and optimizing methods through quality control programs and assessments is the preeminent means to attain optimal outcome within the clinical laboratory services. Present study reports revalidation of our existing IFCC regularized analytical methods, particularly hepatic and thyroid function tests, by optimization of precision analyses and processing through external and internal quality assessments and regression determination. Parametric components of hepatic (Bilirubin ALT, γGT, ALP), cardiac (LDH, AST, Trop I) and thyroid/pituitary (T3, T4, TSH, FT3, FT4) function tests were used to validate analytical techniques on automated chemistry and immunological analyzers namely Hitachi 912, Cobas 6000 e601, Cobas c501, Cobas e411 with UV kinetic, colorimetric dry chemistry principles and Electro-Chemiluminescence immunoassay (ECLi) techniques. Process of validation and revalidation was completed with evaluating and assessing the precision analyzed Preci-control data of various instruments plotting against each other with regression analyses R2. Results showed that: Revalidation and optimization of respective parameters that were accredited through CAP, CLSI and NEQAPP assessments depicted 99.0% to 99.8% optimization, in addition to the methodology and instruments used for analyses. Regression R2 analysis of BilT was 0.996, whereas that of ALT, ALP, γGT, LDH, AST, Trop I, T3, T4, TSH, FT3, and FT4 exhibited R2 0.998, 0.997, 0.993, 0.967, 0.970, 0.980, 0.976, 0.996, 0.997, 0.997, and R2 0.990, respectively. This confirmed marked harmonization of analytical methods and instrumentations thus revalidating optimized precision standardization as per IFCC recommended guidelines. It is concluded that practices of revalidating and harmonizing the existing or any new services should be followed by all clinical laboratories, especially those associated with tertiary care hospital. This is will ensure deliverance of standardized, proficiency tested, optimized services for prompt and better patient care that will guarantee maximum patients’ confidence.

Keywords: revalidation, standardized, IFCC, CAP, harmonized

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