Urine albumin test (urine protein)

Urine albumin test is used to measure albumin level in the urine. Urine albumin is a protein found in urine. There are three types of urine albumin tests;

1. dipstick urine albumin test with random urine sample
2. urine albumin test with 24 hour urine collection
3. ultra-sensitive dipstick urine albumin test

urine albumin test kit

Normal urine albumin level with dipstick urine albumin test is 0 to 8 mg/dL whereas the urine albumin test value of 24 hour urine collection is 150 mg per 24 hours. But this urine albumin normal result could vary with the laboratory therefore local reference value should be considered.

Dipstick urine albumin test can give false positive results if;

urine pH 7
concentrated urine
urine contaminated with blood

Dipstick urine albumin test can give false negative results if globulin and Bence Jones proteins are high.

Dilute urine may obscure proteinuria on dipstick examination, and proteinuria that is not predominantly albumin will be missed. This is particularly important for the detection of Bence Jones proteins in the urine of patients with multiple myeloma.

There is an ultra-sensitive dipstick urine albumin test available to measure microalbuminuria (urine albumin 30 to 300 mg/d). this urine albumin test is important to detect diabetic nephropathy earlier.

Magnitude of the urine albumin test value depends on the mechanism of renal damage.

Following are the other protein present in urine other than albumin; Tamm-Horsfall, IgA, and urokinase, 2-microglobulin, apoproteins, enzymes, and peptide hormones

Following drugs can affect the urine albumin test result;

• Acetazolamide
• Aminoglycosides
• Amphotericin B
• Cephalosporins
• Colistin
• Griseofulvin
• Lithium
• Methicillin
• Nafcillin

Following conditions can give abnormal urine albumin test result;

• Amyloidosis
• Bacterial pyelonephritis
• Bladder tumor
• Congestive heart failure
• Diabetic nephropathy
• Glomerulonephritis
• Goodpasture syndrome
• Heavy metal poisoning
• Lupus erythematosus
• Malignant hypertension
• Multiple myeloma
• Nephrotic syndrome
• Nephrotoxic drug therapy
• Polycystic kidney disease
• Preeclampsia

pictures/images of salmonella

an electron microscopic view of salmonella

a salmonella culture plate

a salmonella culture

salmonella typhimurium

Typhoid fever and standard agglutination (SAT or Widal) test

Typhoid fever is a form of enteric fever caused by Salmonella typhi, Salmonella paratyphi A or B. this is a febrile illness and it is common in developing countries due to the poor sanitary facilities. Route of infection is the feco-oral. Fever, constipation or diarrhea and headache are the common clinical features of typhoid fever.

electron microscopic view of salmonella

Blood culture and serology to detect antibodies to O and H antigen of the organisms are the main laboratory tests performed.

The serological tests which is done to detect antibody to O and H antigens of Salmonella typhi, Salmonella paratyphi A or B is called standard agglutination (SAT or Widal) test. A rise in antibody titre ( 4 fold over a period of 7-10 days) is diagnostic of typhoid fever.

Lengthen patient’s stay in hospital, test sera not tested in parallel on same run, background titre in endemic areas are the diagnostic problems of standard agglutination (SAT or Widal) test.

Skin, soft tissue and wound infections and treatment

Skin, soft tissue and wound infections are one of the commonest infections in surgical practice. Normal intact skin provides the external surface of the body with a protective coat. Daily exfoliation of the superficial layers of the skin and other non-specific defenses of the skin keep bacteria levels down. However, different sites in the skin and areas of skin have microbes (bacteria and fungi) living harmoniously with human host.

Break in surface of the skin, contamination of exposed tissues, multiplications of bacteria, virulence of the bacteria, wound environment and antibiotics are the factors which determine the nature of wound infections.

Common bacteria which cause Skin, soft tissue and wound infections are two types;

1. primary pathogens ( Staphylococcus aureus, group A hemolytic streptococci)
2. opportunistic pathogens ( gram negative bacilli including pseudomonas, anaerobic streptococci)

Treatment for Skin, soft tissue and wound infections

1. asses the patient
2. local treatment (pus draining, surgery)
3. appropriate antibiotics

G6PD (Glucose-6-phosphate dehydrogenase) enzyme test for G6PD deficiency

G6PD (Glucose-6-phosphate dehydrogenase) enzyme test is performed in suspected G6PD (Glucose-6-phosphate dehydrogenase) enzyme deficiency.

The direct test for G6PD (Glucose-6-phosphate dehydrogenase) enzyme deficiency is known as Beutler test or fluorescent spot test, which is a rapid test.

G6PD (Glucose-6-phosphate dehydrogenase) is an enzyme which is found in cytosol of cells. G6PD (Glucose-6-phosphate dehydrogenase) enzyme catalyzes a reaction in pentose phosphate pathway 9an energy producing pathway). Therefore G6PD (Glucose-6-phosphate dehydrogenase) enzyme is essential for the energy production. NADPH (nicotinamide adenine dinucleotide phosphate) is a byproduct of this pathway. NADPH is essential for the maintenance of the glutathione level in the cells in order to protect cells against oxidation. This is particulary important for the red blood cells.

There can be a genetic disorder where G6PD (Glucose-6-phosphate dehydrogenase) enzyme production is absent or reduced. Therefore these people have a high risk of hemolysis of red blood cells by oxidation. These patients present with features of anemia, yellowish discoloration of eyes, red colored urine after ingestion of drugs or ayurvedic medicine. In this situation, G6PD (Glucose-6-phosphate dehydrogenase) enzyme deficiency should be suspected.

Glucose-6-phosphate dehydrogenase deficiency is an X-linked recessive hereditary disease characterised by abnormally low levels of glucose-6-phosphate dehydrogenase.

Serum bilirubin test

Serum bilirubin test

Serum bilirubin test is an investigation to detect diseases of liver, gall bladder and blood. Serum Bilirubin is the main bile pigment that is formed from the breakdown of heme in red blood cells as old red blood cell will undergo degradation in the spleen and result bilirubin. Hemoglobin in the red blood cell will be converted into serum bilirubin through several steps.Serum bilirubin will be carried into liver where it is conjugated to make it more water soluble. Therefore in the blood, two types of bilirubin can be found; unconjugated bilirubin and conjugated bilirubin. Each serum bilirubin test will need to detect different diseases. if serum bilirubin level is high, bilirubin may appear in urine.

Normal total serum bilirubin test level is 0.2-1.9 mg/dl. Conjugated serum bilirubin level is about 0-0.3 mg/dl.

Following conditions can give rise to elevated serum bilirubin test;

* Hemolysis
* Gilbert's syndromme
* Drugs (antipsychotic, some sex hormones)
* Hepatitis
* Chemotherapy
* Biliary stricture
* Neonatal hyperbilirubinaemia
* Crigler-Najjar syndrome
* Dubin-Johnson syndrome


To use the serum bilirubin test result, other test like liver function tests (especially the enzymes alanine transaminase, aspartate transaminase, gamma-glutamyl transpeptidase, alkaline phosphatase) should also be performed.

SERUM BILIRUBIN MOLECULE

Normal bacterial flora of the skin

Normal bacterial flora of the skin consists of several bacteria. The predominant bacterium of the normal flora of the skin is staphylococcus epidermidis, which is non pathogen on the skin but can cause diseases when it reaches certain sites such as artificial heart valves and prosthetic joints. It is found on the skin much more frequently than other organisms. Other members of the normal flora of the skin are staphylococcus aureus, propionibacterium, peptococcus and yeast, though it is not a bacterium. It is considered as a member of the normal flora of the skin. There are about 10000-100000 organisms/square cm of skin. Most of them are located superficially in the stratum corneum, but some are found in the hair follicles and act as a reservoir to replenish the superficial flora of the skin ahter hand washing. The yeast, candida albicans, is also a member of the normal flora of the skin. It can enter a person’s blood stream when needle pierce the skin.

electrone microscopic view of Staphylococcus epidermidis, a member of normal flora of the skin

LDH (Lactate dehydrogenase) enzyme test

Lactate dehydrogenase is an enzyme which is found in several tissues such as heart muscles, skeletal musles, kidney and red blood cells. LDH (Lactate dehydrogenase) enzyme has five isoforms.

• LDH-1 (4H) - in the heart
• LDH-2 (3H1M) - in the reticuloendothelial system
• LDH-3 (2H2M) - in the lungs
• LDH-4 (1H3M) - in the kidneys
• LDH-5 (4M) - in the liver and striated muscle

3D view of LDH (Lactate dehydrogenase) enzyme

LDH (Lactate dehydrogenase) enzyme test is an important enzyme test to detect/diagnose diseases of heart(myocardial infarction), liver, kidneys, etc.

LDH (Lactate dehydrogenase) enzyme test can also be performed in following conditions as well;

• Anemia of vitamin B-12 deficiency
• Megaloblastic anemia
• Pernicious anemia

Normal LDH (Lactate dehydrogenase) enzyme test is ranging from 105 to 333 IU/L.

LDH (Lactate dehydrogenase) enzyme test can be high in following conditions;

• Blood flow deficiency (ischemia)
• Cerebrovascular accident (such as a stroke)
• Heart attack
• Hemolytic anemia
• Infectious mononucleosis
• Liver disease (for example, hepatitis)
• Low blood pressure
• Muscle injury
• Muscular dystrophy
• New abnormal tissue formation (usually cancer)
• Pancreatitis
• Tissue death

CRP (C-reactive protein) test

C-reactive protein (CRP) is an acute phase protein. This C - reactive protein is found in blood. C-reactive protein (CRP) is synthesized by the liver and adipose (fat) cells.
CRP (C-reactive protein) test is done in several diseases such as inflammatory bowel disease, arthritis, autoimmune diseases, pelvic inflammatory diseases and coronary heart diseases. CRP is used mainly as a marker of inflammation. Apart from liver failure, there are few known factors that interfere with CRP production.

Normal CRP (C-reactive protein) test level is less than 5-6 mg/l.

Following conditions give rise to high level of CRP (C-reactive protein) test level;

• Cancer
• Connective tissue disease
• Heart attack
• Infection
• Inflammatory bowel disease (IBD)
• Lupus
• Pneumococcal pneumonia
• Rheumatoid arthritis
• Rheumatic fever
• Tuberculosis

Heart diseases and CRP (C-reactive protein) test

There are evidences suggestive of that people with high level of CRP (C-reactive protein) test are at high risk of diabetes, hypertension and heart attack. Therefore this test can be used as a prediction of those diseases.

pictures(images) of large roundworms (Ascaris lumbricoides)

Amylase enzyme test

Amylase is an enzyme which found in human saliva. But it is mainly produced by the pancreas therefore amylase is considered as a pancreatic enzyme. Amylase enzyme involves in the digestion of carbohydrates.

human salivary amylase molecule

There are three types of amylases are found

1. alpha-amylase
2. beta-amylase
3. gamma amylase

Amylase enzyme test is done to diagnose or to detect several diseases such as pancreatitis. Since it is a production of pancreas, amylase enzyme test is used to diagnose or monitor the pancreatic conditions.

Amylase enzyme test is done usingeither urine or blood.

Normal amylase enzyme test is ranging from 40 to 140 U/L.

High amylase enzyme test can be found in following conditions;

• Acute pancreatitis
• Cancer of the pancreas, ovaries, or lungs
• Cholecystitis
• Gallbladder attack resulting from disease
• Infection of the salivary glands (such as mumps) or an obstruction
• Intestinal obstruction
• Macroamylasemia
• Pancreatic or bile duct obstruction
• Perforated ulcer
• Tubal pregnancy (may be ruptured)
• Viral gastroenteritis

Low amylase enzyme test can be found in following conditions;

• Damage to the pancreas
• Kidney disease
• Pancreatic cancer
• Toxemia of pregnancy

Uses (applications) of diatoms

Diatoms are algae and they are capable of photosynthesis. They can be found in almost everywhere in the world especially in aquatic environments. Even though they are considered as non motile, they are capable of limited movements. Since they depend on photosynthesis for their energy, they are restricted in environment where sunlight is available. They have a skeleton composed of silicon. Two forms of diatoms are existing; benthic and planktic. The dimensions of diatoms are measured in microns. The length of diatoms range from 20 to 200 microns but they can grow up to few millimeters. They have an economical value as they are used to produce filters, paints and toothpaste.

Uses (applications) of diatoms

1.industrial uses

Because of the heavy silica in diatom cell walls, dead cells tend to sink to the ocean floor, forming large deposits of diatomaceous earth that may be collected for industrial or paleontological uses. In a strict sense, diatomaceous earth should be considered fossil fuel, because it is made up literally of millions of tiny preserved skeletons.Areolae are the secret to the success of old diatom tests in most of their industrial uses. This fine structure traps particles in fluids when used as a filter, or traps an insulating layer of air in more terrestrial uses.

2. As a filter:

syrups, alcoholic and nonalcoholic drinks, medicines, solvents and chemicals,
paper, paint , ceramics, and detergent.

3. As Insulation:

high-temperature insulation, including fire doors; sound insulation.

4. As a Mild Abrasive:

the oldest use of diatomaceous earth. Metal polish and toothpaste. I can't find a toothpaste that is using diatomaceous earth any more; Tom's of Maine is switched to calcium carbonate.

5. For Optical Image Quality:

another very old use of diatoms. Because of a regular, gridlike patterning of areolae in some species, diatoms may be used to measure the resolving power and contrast of light microscopes.

6. use as a bioindicators

Diatoms are a class of algae that are increasingly being used as bioindicators for environmental monitoring. These single-celled organisms reproduce quickly and are sensitive to a number of environmental pressures including changes in salinity, metals, pH, saprobrity, turbidity, current strength, water depth, substrate availability and so forth.

7. forensic uses

Alkaline phosphatase (ALP) enzyme test

Alkaline phosphatase (ALP) is an enzyme. Alkaline phosphatase (ALP) enzyme can be found in many tissues of the human body such as liver, bile duct, kidney, bone, and the placenta. This enzyme can also be found in several bacteria such as Escherichia coli. This enzyme is found in different forms, isoenzymes in human body. .

Alkaline phosphatase (ALP) enzyme test is useful to diagnose several diseases such as Cholestasis, cholecystitis, cholangitis, Paget's disease and osteosarcoma.

Normal Alkaline phosphatase (ALP) enzyme test is ranging from 20 to 140 IU/L.

High Alkaline phosphatase (ALP) enzyme test levels are found in following conditions;

1. liver diseases

• Cholestasis
• cholecystitis
• cholangitis
• cirrhosis
• hepatitis
• fatty liver
• liver tumor
• liver metastases

2. drug intoxication

• verapamil
• carbamazepine
• phenytoin
• erythromycin
• allopurinol
• ranitidine

3. Bone diseases

• Paget's disease
• osteosarcoma

4. other conditions

• prostatic cancer
• Fractured bone
• Multiple myeloma

Low Alkaline phosphatase (ALP) enzyme test levels are found in following conditions;

• Hypophosphatasia
• Postmenopausa
• Men with recent heart surgery
• malnutrition
• Pernicious anemia
• Chronic myelogenous leukemia

BREAST FEEDING IN SOUTH ASIA

Breast feeding is most fundamental for the life. Irrespective of the place where you live it is very important for the development of the early childhood period .There is a variation in the breast feeding in different part of the world in the terms of quality and quantity wise. Studying on this variation may provide important clues regarding differences in development and growth in early childhood in different areas of the world.

Feeding is the commonest way of introducing germs to children. Therefore exclusive breast feeding reduces the risk of infections. This is especially relevant to the developing countries like South Asian countries where the environment is highly contaminated.

The establishment of feeding practices that are comfortable and satisfying for both the mother and the infant is important for the emotional well-being of both mother and infant and It ensures adequate nutrient intakes for the infant. Maternal feelings are readily transmitted to the infant and are a major determinant of the emotional development of the infant. Thus, mothers who are tense, anxious, irritable, easily upset, or emotionally labile are more likely to experience a difficult feeding relationship. However, appropriate guidance and support from an empathetic and experienced relative, friend, lactation consultant, or physician can increase such a mother’s confidence, which, in turn, makes her more relaxed and increases the likelihood of establishing successful feeding practices, not only during infancy but throughout childhood and beyond.

Feedings should be started as soon as possible after birth, depending on the infant’s ability to tolerate oral nutrition. This not only maintains normal metabolism during the transition from fetal to extrauterine life but also promotes maternal-infant bonding. Most infants can start breast-feeding shortly after birth, almost always within 4–6? Hr. Therefore, mothers who wish to initiate breast-feeding in the delivery room and continue to do so on a demand basis should be supported in doing so. However, if any question about the infant’s tolerance of feeding arises, feedings should be withheld until the infant is carefully evaluated. It if appears that feedings must be withheld for several hours, parenteral fluids should be administered.

Health/medical benefits/important of antioxidants

What is an antioxidant? An antioxidant is a chemical compound or a molecule which has an ability to slow down/prevent the oxidation of other molecule/chemical compound. There is an electron exchange from a substance to an oxidizing agent in oxidation, which can result free radicals. Free radicals can set a chain reaction which lead to cell damage. Antioxidants terminate these chain reactions by removing free radical intermediates, and inhibit other oxidation reactions by being oxidized themselves.

structure of an antioxidant (vitamin C)

There are two types of antioxidants;

1. Internal antioxidants: antioxidants or antioxidant system found in human body such as glutathione system and enzymes such as catalase, superoxide dismutase and various peroxidases.
2. External antioxidants: antioxidants which are taken from outside the body (vitamin C, and vitamin E )

Health/medical benefits/important of antioxidants

1. A treatment form of brain injury as antioxidants capable of preventing the lipid peroxidation, which occur in some forms of brain injuries.

• superoxide dismutase mimetics
• sodium thiopental
• propofol
• NXY-059
• ebselen

1. People who eat more vegetables and fruits have a low risk of heart diseases and neurological diseases.
2. Protection against some cancers.
3. protection against macular degeneration
4. antioxidant supplements do not appear to increase life expectancy

Hookworms (NECATOR AMERICANUS & ANCHYLOSTOMA DUODENALE)

The parasite is widely distributed in the tropics and sub-tropics. In cold climates with suitable microclimates (such as in coal mines) the parasite may be found. Two species infect humans. Necator americanus is the species found in South Asia, Africa, pacific and in North and South America whereas Ancylostoma duodenale is the main hookworm of Eastern Europe, North Africa, India, Northern China and Japan. Both species can be found together in South East Asia, the pacific and West Africa.

an adult hookworm

The worms measure 1-2cm in length. The head ends of the worm are sharply bent backwards like a hook. In the case of N. americanus the buccal cavity bears a pair of ventral cutting plates used in biting the mucosa for feeding. A. duodenale is larger with the head end bending backwards smoothly. The buccal cavity has two pairs of curved teeth. In both species, the tail end of the male is flattened and expanded to form the copulatory bursa.

The hookworms inhabit the small intestine of humans. Unlike Ascaris it is attached to the mucosa of the intestine of the intestine with the buccal capsule.
In the acute infection the initial sings and symptoms are due to the penetration and migration of larvae in the skin. At the site of entry, a transient dermatitis with intense pruritus can result. This condition is called ‘ground itch’. The lesions may get secondarily infected. The lung migratory phase of hookworms is short and the pulmonary symptoms are either assent or minimum

This is done by demonstrating characteristic eggs in the faeces. The eggs can be cultured into infective larval stage to distinguish between Necator and Ancylostoma.

Avoidance of indiscriminate defaecation and use of footwear help in prevention. Provision of hygienic latrines, chemotherapy of infected people and health education are important in control of the infection.

Hookworm infection can be eradicated with several safe and highly effective antihelmintic drugs, including albendazole (400 mg once), mebandazole (500 mg once), and pyrantel pamoate (11 mg/kg for 3 days). Mild iron-deficiency anemia can often be treated with oral iron alone. Severe hookworm disease with protein loss and malabsorption necessitates nutritional support and oral iron replacement along with
deworming.

The large round worm (ASCARIS LUMBRICOIDES)

The worm has a world wide distribution but prevalence is high in warmer climates in tropical region where personal and environmental sanitation are poor. It is prevalent in countries like India, Nepal, Pakistan and Sri Lanka.Adult female worms are 20-40 cm in length while the adult male worms measure 15-30 cm. The tail end of male is curved. The worms are found free in the lumen of the small intestine

an adult round worm

The fertilized female lays about 200.000 eggs per day. The eggs are oval in shape (65*45µm). The egg has an outer mammilated, ailbuminous coat that appears brown due to bile pigments. Some eggs may be decorticated (with outer coat missing). A certain portion of eggs (15%) is unfertilized and appear longer and rectangular (90*40µm) with no embryo. The embryo is unsegmented when eggs are passed in faeces.
The eggs develop further in soil with the first moult taking place (within the egg) to form the 1st stage larva in about 7 days. With the second moult the infective 2nd stage larva is formed inside the egg in 2-3 weeks under optimal conditions of development such as moist, warm (25-30 ºC) clay type soil. The infective eggs can remain viable in suitable soil for long periods of time.

When ingested the eggs hatch in the upper part of the small intestine liberating the larvae which penetrate the intestinal mucosa to enter the blood stream (or the lymphatics). The larvae are carried into the lungs via the liver and the heart. The larvae develop further in the lungs moulting twice (5th and 7th days). They penetrate the alveolar walls to move along the bronchioles, bronchi and trachea and are swallowed. On reaching the small intestine they mature into males and females. The time taken for an egg to develop into a mature is about 60 days. Adult worms may live up to 2 years.
Many infected persons remain asymptomatic. However the presence of a small number of worms may lead to complications. The pathogenesis and clinical features can be categorized into; pulmonary ascariasis: intestinal ascariasis: complications of ascariasis and allergy to Ascaris species
The simplest diagnostic method is the demonstration of characteristic eggs in the faeces.

Vegetable that are usually eaten raw or undercooked should be washed thoroughly. Fruits fallen under trees should be washed before eating. Washing of hands after working with soil helps in the prevention.Prevention of indiscriminate defaecation, provision of sanitary latrines, elimination of parasite reservoir by worm treatment and health education are important

What is the normal flora of the vagina?

The vaginal flora of adult women consists primarily of lactobacillus species. Lactobacilli are responsible for producing the acid that keeps the pH of the adult women’s vagina low. Before puberty and after menopause, when estrogen levels are low, lactobacilli are rare and the vaginal ph is high. Lactobacilli appear to prevent the growth of potential pathogens, since their suppression by antibiotics can lead to overgrowth Candida albicans.

Lactobacilli (commenest organism found in vagina)

The vagina is located close to the anus and can be colonized by members of the fecal flora. For example women who are prone to recurrent urinary tract infections harbor organisms such as Escherichia coli and Enterobacter in the introitus. About 15-20% of women of child bearing age carry group B streptococci in the vagina. This organism is an important cause of sepsis and meningitis in the newborn and is acquired during passage through the birth canal. The vagina is colonized by Staphylococcus aureus in approximately 55 of women, which predisposes them to toxic shock syndrome.

Urine in the bladder is sterile in the healthy person, but during passage through the outermost portion of the urethra it often becomes contaminated with Staphylococcus epidermidis, coliforms, diphtheroids and nonhemolytic streptococci. The area around the urethra of women and uncircumcised men contains secretions that carry Mycobacterium smegmatis, an acid-fast organism.

Organism	Location
Acinetobacter spp	Anterior urethra, Vagina
Bacteroides spp	External Genitalia
Bifidobacterium spp	Vagina
Candida albicans	Anterior Urethra, External Genitalia, Vagina
Clostridium spp	Vagina
Corynebacterium spp	Anterior Urethra, External Genitalia, Vagina
Enterobacteriaceae	Anterior Urethra, External Genitalia, Vagina
Streptococcus viridans	Anterior Urethra, External Genitalia, Vagina
Eikenella corrodens	General Distribution
Streptococcus anginosus	General Distribution
Staphylococcus aureus	Perineum
Gardnerella vaginalis	Female Reproductive System
Mycoplasma hominis	Cervix, Vagina
Mobiluncus curtisii	Vagina

AST test & AST enzyme test /SGOT enzyme test

AST (SGOT) test or AST (SGOT) enzyme test is one of the basic investigations/ tests done in order to find out the liver damage. AST (SGOT) stands for Aspartate aminotransferase (SGOT- serum glutamic oxaloacetic transaminase), which is primarily found in the mitochondria of liver cells (hepatocytes). The enzyme ratio between mitochondria and cytoplasm is 80% to 20%. Since it is a mitochondrial enzyme, it is a good indicator of high degree liver cell damage such as hepatic necrosis. Other conditions which can give rise to elevated AST (SGOT) test or AST (SGOT) enzyme test are myocardial infarction, muscle injury and congestive cardiac failure as the AST (SGOT) enzyme is also found in heart, muscles, kidney, red blood cells and brain.

3D view of AST (SGOT) enzyme

The AST (SGOT) test or AST (SGOT) enzyme test is a very sensitive indicator of liver cell injury such as hepatitis. AST (SGOT) can be found in serum of normal healthy individuals in low concentration. AST level up to 300 U/L can be considered as normal. If the AST (SGOT) enzyme level is over or around 1000 U/L, it will certainly indicate liver cell injury such as viral hepatitis, ischemeic liver injury (prolonged hypotension or acute heart failure), toxic or drug induced liver injury. Pattern of the AST (SGOT) enzyme changes and comparison of AST (SGOT) enzyme with ALT (SGPT) enzyme is more important than the single AST (SGOT) enzyme test value. Usually ALT (SGPT) enzyme is higher or equal to the AST (SGOT) enzyme level. This will indicated mild to moderate damage to the liver. An AST (SGOT) enzyme to ALT (SGPT) enzyme ratio > 3:1 is highly suggestive of alcoholic liver disease. The AST in alcoholic liver disease is rarely _300 U/L and the ALT (SGPT) is often normal. The aminotransferases are usually not greatly elevated in obstructive jaundice. One notable exception occurs during the acute phase of biliary obstruction caused by the passage of a gallstone into the common bile duct. In this setting, the aminotransferases can briefly be in the 1000 to 2000 U/L range. However, aminotransferase levels decrease quickly, and the liver function tests rapidly evolve into one typical of cholestasis. AST (SGOT) enzyme level fluctuates between 100 U/L to 1000 U/l in autoimmune hepatitis. AST (SGOT) enzyme is increased by 2 to seven folds in alcoholic fatty liver.

Health benefits of fish oil

What is fish oil?

Fish oil is the oil extracted from fish. mackerel, lake trout, flounder, albacore tuna and salmon are the commonest fish which used to extract fish oil.


Constituents of fish oil

The main constituents of fish oil are omega-3 fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) and precursors to eicosanoids. Each of these components has specific action in human body. These components of fish oil are essential for the human being. Since some fish which used produce fish oil are predators, therefore there can be toxic substances such as mercury, dioxin, PCBs and chlordane found in their body. This is a drawback of fish oil. Omega 3 fatty acid is the main component of fish oil.

Sources of fish oil

• Cod liver oil
• Oily fish (mackerel, lake trout, flounder, albacore tuna and salmon)
• Commercial products

Health benefits of fish oil

When talk about the health benefits of fish oil, there are many. There are lots of cardiovascular benefits, circulatory benefits, metabolic benefits, cancer prevention benefits, etc.

1. Omega 3 fatty acids help to cholesterol level in the circulation. EPA and DHA involve in this regulation.
2. EPA and DHA have an anti-inflammatory effects and positive effect on body composition.
3. Some studies have shown that fish oil are responsible for the neuronal growth of the frontal cortex of the brain which is the main part determining the personal behavior.
4. Reduce the risk of depression, and especially suicidal risk (Eicosapentaenoic acid).
5. Some studies have shown that omega 3 fatty acid has a neuroprotective action in Parkinson's disease and Alzheimer's disease.
6. Omega-3 fatty acids could also help delay or prevent the onset of schizophrenia.
7. 7. The American Heart Association recommends the consumption of 1g of fish oil daily, preferably by eating fish, for patients with coronary heart disease.
8. hypertriglyceridemia, secondary cardiovascular disease prevention and high blood pressure are really benefited by the consumption of fish oil (omega-3 fatty acids).
9. Fish oil has an anticancer effect especially in prostate cancer and breast cancer.

Vitamin F (foods, sources, toxicity, doses,benefits,deficiency)

What is vitamin F? This is a frequently asking question as the term produces confusion. Vitamin F is another term for the essential fatty acids (EFA) such as linoleic and alpha linoleic acids. Fatty acids such as omega-3 from omega-6 were originally designated as Vitamin F when they were discovered as essential nutrients in 1923.

linoleic acid structure

Sources of vitamin f

Some of the food sources of ω-3 and ω-6 fatty acids are fish and shellfish, flaxseed (linseed), hemp oil, soya oil, canola (rapeseed) oil, chia seeds, pumpkin seeds, sunflower seeds, leafy vegetables, and walnuts.

Toxicity of vitamin f

This is almost unheard.

Benefits of vitamin f

Omega 3 fatty acids help to reduce or modify the risks of following conditions.

• coronary heart disease
• varicose veinsblood
• pressure
• arthritis
• depression
• stroke

there are increasing evidences that suggest omega 3 has an anti cancer effects against breast, colon and prostate cancer.

Negative health effects of vitamin F

Excessive amount of omega 6 fatty acids can increase the risk of following conditions.
prothrombotic,
proinflammatory and
proconstrictive

vitamin F deficiencies

signs characterized of vitamin F deficiency occur in hypophysectomised rats. It was known that vitamin F modulate hypothalamic function by stimulating GH releasing from pituitary.

Food allergy elimination diet

What is food allergy eliminating diet? How do you prepare a food allergy eliminating diet? These are the common questions arise when discuss about food allergy eliminating diet. In simpler terms, food allergy elimination diet is a form of diet, which does not contain any agent which can give rise to an allergy. But this is not an easy task as any component of the food can give rise to allergy. But fortunately there are common items such as meat, tomato which are capable of making some one allergic.

Food allergies are more common in infants and young children, possibly due to immaturity of the digestive or immune systems. Cow’s milk allergy is the commonest type and this is not surprising, considering the enormous antigenic load to which artificially fed infants are subjected. The risk is minimized by exclusive breast feeding as long as possible. The antigen may, however, be transmitted in breast milk from the diet of mother. Substitute for cow’s milk, such as goat milk or soya milk are given when allergic symptoms and signs appear. Some infants then become hypersensitive to the new protein. Most individuals, both young and old who suffer from food allergy are hypersensitive to number of different foods. Some of them may also be susceptible to other types of allergies as well. The term atopy is used to denote such generalized hypersensitivity to foreign substances from the environment and it is genetic in origin.

As there are thousands of different food allergies, it is essential to identify the exact type of food which give rise to allergy. Then the subject can avoid that food item. Then such a diet can be called food allergy elimination diet. Commonest food allergies are Dairy allergy,Egg allergy,Peanut allergy,Tree nut allergy,Seafood allergy,Shellfish allergy,Soy allergy and Wheat allergy.

Food allergy tests are Skin prick testing, Blood tests (for evaluating IgE-mediated food allergies) and Food challenges. The mainstay of treatment for food allergy is avoidance of the foods that have been identified as allergens.



Key words
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Dietary habits (diet) and cancers

Dietary habits (diet) and cancers is a popular topic among dietician, oncologist and general public as well. It is true that there is significant relationship between cancers and dietary habits, both in negative and positive aspects.

There is great variation in the incidence of different types of cancer from country to country, which suggests that environmental factors play an important role in their development. Such factors probably account for about 90% of cancers in man. If this be so, once the risk factor is identified, it should be possible to reduce the incidence by suitable manipulation of the environment.

Diet can influence cancer in several ways. A carcinogen in food could produce a direct effect. Intestinal bacteria may produce carcinogens from components of diet or of the bile. Diet and nutritional status of the patient may influence the development of cancer, once induced. Lastly malnutrition resulting from advanced cancer may be the immediate cause of death.

Potential carcinogens in foods may be those naturally present, or food additives or contaminants such as aflatoxin.

Dietary fibers help weight reduction

Do dietary fibers help weight reduction? Obviously the answer is true. As obesity is one of the major health problems that people face today, we need to find an answer this matter. There are several answers available for this obesity question. Dietary fiber is the one of them.

Dietary fiber was initially defined as the skeletal remains of plant cells in the diet that are resistant to hydrolysis by the digestive enzyme of humans. The definition was later extended to include all polysaccharides and lignin in the diet that are not digested by the endogenous secretions, so as to embrace polysaccharides in some food additives.

The next question is “how do dietary fibers help in weight reduction”? There are several mechanisms available to explain the methods by which dietary fibers help in weight reduction.

Dietary fibers affect gut’s normal function (physiology). Dietary fiber acts in the small intestine in three main physical forms: soluble chains; insoluble macro molecular assemblies; as a swollen, sponge like net work. Dietary fiber helps to regulate four central aspects of digestive process: nutrient absorption; sterol metabolism; caecal fermentation; stool weight. Different fibers may affect each of these processes in different ways.

Dietary fibers modulate the absorption of carbohydrates in the small intestine by several means: delay gastric emptying; binding with carbohydrates. Therefore amount of carbohydrates, a major source of energy get into the circulation is less therefore it helps in weight reduction. But the exact mode of action of dietary fibers is less well understood. It may interfere with enzyme access to carbohydrates substrates.

Other method by which dietary fibers help in weight reduction is that dietary fibers form bulk so even though you eat a lot, the effective amount of diet which can give rise to energy thus weight gaining is minimal.

Cranial Electrotherapy Stimulation (CES)

Cranial Electrotherapy Stimulation is a treatment modality employed in psychiatric field. Anxiety, depression, insomnia and drug addictions are the main disorders treated by this method. The activity between nerves are carried out by an electric current therefore by changing that electric current can change the function of the brain. This is the assumption on which cranial electrotherapy stimulation (CES) works. The focused brain is is the hypothalamic region. A meta-analysis has not shown CES to be effective in treatment of anxiety. Most users report a decrease in anxiety during treatment, and many other reports a decrease in anxiety as much as two days later. Some users report a euphoric feeling; they report that their bodies feel "lighter", their thinking is clearer, and that they are more creative. Some users require five to ten treatments to achieve any effect. CES was originally developed in the Soviet Union in 1949, it's primary focus being the treatment of sleep disorders, hence it's initial designation as "electrosleep." Treatment of insomnia, however, has been overshadowed by psychiatric application for depression and anxiety.

Indian medicine (Ayurvedic system of medicine)

The history of Indian medicine goes back to Vedic times and the earliest references are available in the Rig Veda (2000-1500BC). Later three more books, the Yagur Veda, the Sama Veda and Atharva Veda were added. The origin of Vedic age is not established for certain. The Vedas were in Sanskrit, the language of the Aryans. When the letter entered the north Indian plains, the non-Aryan Indus valley civilization was in existence (3000 to 2500 BC). Subject matter that could be gleaned from later literature (especially the Bhaisajya Sukta of the Atharva Veda, 800BC) and traditional practices were codified and systematized and came to know as Ayurveda (the science of life, ayus = life, veda = to know), which may denote either a science in the knowledge of which life exists, or which helps man to enjoy a longer duration of life.tradition was, and still is, quoted as an unquestioned and unquestionable authority, and the belief that this system of medicine originated from brahma-the creator- himself.

There are two ancient theses (somhitas) on Ayurveda, one buy a physician, Caraka (800BC) and the other by a surgeon, Susrutha (600BC). According to the Susrutha somhita, ayurveda originally formed a part of Atharva veda, rtung together into a hundred thousands slokas (stanzas) by the self begotten brahma even before the creation of man. He later thought of the short duration of human life on earth and the failing character of human memory and deemed it prudent to divide Ayurveda into eight branches. Salya tantra (surgery) is the oldest of these, as is to be expected. Wounds inflicted during wars between gods and demons had to be treated.

Eight specialized branches of Ayurveda

1. Kaya-cikitsa (internal medicine including genitor-urinary)
2. Shalkaya (otorhinolaryngology and ophthalmology)
3. Kaumara Britya (management of children)
4. Bhutha vidya (bacteriology and psychiatry)
5. salakya or salya (surgery)
6. Agoda/visagara/vairodhika/prasamuna (toxicology)
7. rasayana (geriatrics, science of rejuvenation)
8. Vajhikarana (science of aphrodisiacs)

Food irradiation

One of the relatively new promising methods of curtailing food losses is food irradiation. Irradiation is a physical process for treating foods and may be compared with heating or freezing of food for preservation.

The process involves the use of two types of ionizing irradiation:

1. Gamma rays emitted by radioisotopes such as cobalt or cesium. These are electromagnetic radiations differing from x-rays and the sun’s rays only in wavelength.
2. Electron rays produced by accelerators. These are corpuscular radiations consisting of electrically charged particles, produced by accelerators similar to beta rays emanating from certain isotopes.

No uranium or other fissionable material and no source of neutrons are used in food irradiation. Due to high cost of cesium, cobalt is the source more commonly used. It has been used commercially and sterilizing medical and surgical items for over 3o years. The effects of food irradiation are no more deleterious to health than other food processing methods now being used commercially, and the advantages are many.

The food is exposed to these radiations under conditions that maintain the radiation source completely separated from the food being irradiated. There is absolutely no contact between the radiation source and the food, the source being encapsulated in double-walled metal containers through which the gamma rays can pass, but not the isotopes. Therefore, radioactive material is not introduced into the food, and the food does not become radioactive. On the other hand, irradiation might result in certain physico-chemical changes in the food, altering not only its organoleptic properties and, therefore consumer acceptance, but also its nutrient composition. Hence, the changes occurring in the nutrient content of the food following irradiation have to be examined. Other changes, if any, in the bioavailability of nutrients in the food must be investigated, as well as the effect of these changes on the consumer, before irradiated food could be recommended for human consumption.

The irradiation can be used to delay physiological process in fruits and vegetables which would otherwise lead to changes such as sprouting of potatoes, onions, yams, or the over-ripening of fruits. The same radiations stop cell division of microorganisms or insect larvae, thus reducing or eliminating microbial activity and insect infestation in foods.

Irradiation the food does not increase appreciably the temperature of the foodstuff (1º to 4º C, at the most), and can therefore be applied to frozen products or to viscous products (dried dates), without changing the consistency of the product. The radiations penetrate into the middle of bulky products which are already packaged. Insects and their eggs in a large fruit can be killed, as is required in plant quarantine treatment.

Safety of irradiated foods for human consumption is based on following considerations;
1. the absence of micro-organisms and microbial toxins harmful to man
2. the nutritional contribution of the irradiated food to the total diet
3. the absence of any significant amount of toxic products formed in the food as a result of irradiation.

Low dose applications9less than 1kgy, where I kgy, a kilogray, is equivalent to 100 radiation absorbed doses or rads) can prevent spoilage from sprouting during storage of potatoes, onions, and other tubers and bulbs; disinfest cereals and pulses, fresh and dried fruits, dried fish and meat and fresh pork; and delay physiological processes such as ripening in some fresh fruits and vegetables.

Doses of 1 to 10 kgy, in conjunction with refrigeration, can delay spoilage and eliminate pathogens in fresh and frozen seafood, poultry, eggs, meats and some fruits (eg. Strawberries). High doses (10-70 kgy) are used to sterilize packaged meat, poultry, seafood, prepared foods and hospital diets, and to decontaminate certain food additives and ingredients such as spices and enzyme preparations.

GAMETE

A gamete (from Ancient Greek γαμέτης; translated gamete = wife, gametes = husband) is a cell that fuses with another gamete during fertilization (conception) in organisms that reproduce sexually. In species which produce two morphologically distinct types of gametes, and in which each individual produces only one type, a female is any individual which produces the larger type of gamete—called an ovum (or egg)—and a male produces the smaller tadpole-like type—called a sperm. This is an example of anisogamy or heterogamy, the condition wherein females and males produce gametes of different sizes (this is the case in humans, the human ovum is approximately 20 times larger than the human sperm cell). In contrast, isogamy is the state of gametes from both sexes being the same size and shape, and given arbitrary designators for mating type. The name gamete was introduced by the Austrian biologist Gregor Mendel. Gametes carry half the genetic information of an individual, one chromosome of each type. In humans an ovum can only carry X chromosome (of the X and Y chromosomes) whereas a sperm can carry either an X or a Y, hence, it has been suggested that males have the control of the sex of any resulting zygote as the genotype of the sex-determining chromosomes of a male must be XY and a female XX. In other words, due to the presence of the Y chromosome exclusively in the sperm, it is that gamete alone which can determine that an offspring will be a male.

The production of gametes is termed gametogenesis, during which phase gametocytes divide by meiosis into gametes. Meiosis reduces the number of sets of chromosomes from two to one (i.e., produces haploid gametes from diploid gametocytes). Organs that produce gametes are called gonads in animals, and archegonia or antheridia in plants.

Preservation techniques of fish

Fish is extremely perishable when compared with foods of terrestrial origin. The effective biological control of the enzyme systems in live fish ceases to function when the fish is taken out of water. Three types of deteriorations are possible;

1. due to microorganisms
2. autolysis
3. chemical action 9mainly on fatty constituents)

The putrid odour of spoiled fish is often due to trimethylamine oxide which is a typical nitrogenous excretion of marine fish. Spoilage is rapid in hot, damp climates. All methods of preservations attempt to minimize bacterial, enzymic and chemical decomposition.

Salting

Dry salting and steeping in brine is used as a method of preservation, the choice depending on the size of the fish and climatic conditions. Dry salting causes coagulation of fish proteins. The purity of the salt is important in determining the quality of the salted fish. While the salt concentration influences the storage life. A variety of salted fish called “jadi” is well known for its organoleptic properties.

Drying

Fish may be dried without salting or after salting. Unsalted dried fish keeps better than the salted variety as the tendency to absorb moisture is less. But salting before drying prevents spoilage during the drying process itself. Sun drying has been described as a slow and unreliable process that could to products of inferior quality. However, many verities of sun dried fish are valued for their organoleptic and keeping qualities. Sun dried prawns have a satisfactory consumer appeal and shelf life.

Smoking

Smoke curing involves salting, drying, heat treatment and smoking. Its preservative action is due mainly to the deposition of tars and oils from the smoke in the form of minute particles containing phenolic substances with antioxidant properties, which work with vitamin C as a synergist.

Canning and freezing

Canning and freezing are elegant methods for fish preservation but are too costly to suit the economy of developing countries. Freezing requires refrigeration at very low temperature throughout the storage. If the fish is frozen slowly or frozen fish stored at too high a temperature in refrigerators, denaturation of the proteins can take place, resulting in the separation and loss, on thawing, of considerable amount of liquid containing soluble proteins. The liquid oozing out of frozen meat and fish during thawing should be used in cooking and not discarded.

HAPLOID AND MONOPLOID

The haploid number is the number of chromosomes in a gamete of an individual. This is distinct from the monoploid number which is the number of unique chromosomes in a single complete set.
In humans, the monoploid number (x) equals the haploid number (the number in a gamete, n), that is, x = n = 23. In some species (especially plants), these numbers differ. Commercial common wheat is an allopolyploid with six sets of chromosomes, two sets coming originally from each of three different species, with six copies of chromosomes in each cell. The gametes of common wheat are considered as haploid since they contain half the genetic information of somatic cells, but are not monoploid as they still contain three complete sets of chromosomes from the original three different species (n = 3x).
Most fungi and a few algae are monoploid organisms, and male bees, wasps, and ants are haploid because of the way they develop from unfertilized, haploid eggs. The Australian bulldog ant, Myrmecia pilosula, a haplodiploid species has n = 1, the lowest known (and lowest theoretically possible) n. A monoploid cell is likely to be identical to the cell it was copied from however in haploid cells one of two differing copies of the same chromosome is in the haploid set.
Plants and some algae switch between a haploid and a diploid or polyploid state, with one of the stages emphasized over the other. This is called alternation of generations. Most diploid organisms produce monoploid sex cells that can combine to form a diploid zygote, for example animals are primarily diploid but produce monoploid gametes. During meiosis, germ cell precursors have their number of chromosomes halved by randomly "choosing" one homologue, resulting in haploid germ cells (sperm and ovum).

Water soluble vitamins

Water soluble vitamins are the vitamins which can be dissolved in water therefore intake of these vitamins in excess amount will not cause serious effects as it is the case with fat soluble vitamins. Followings are the water soluble vitamins;

1. Vitamin B1 (Thiamin)
2. Vitamin B2 (Riboflavin)
3. Niacin/Nicotinic acid/Nicotinamide
4. Pantothenic acid
5. Vitamin B6 (Pyridoxine)
6. Vitamin B12 (Cyanocobalamine)
7. Folic acid
8. Vitamin H (Biotin)
9. Vitamin C (Ascorbic acids)

Water-soluble vitamins dissolve easily in water, and in general, are readily excreted from the body, to the degree that urinary output is a strong predictor of vitamin consumption. Because they are not readily stored, consistent daily intake is important. Many types of water-soluble vitamins are synthesized by bacteria.

Few important things about water soluble vitamins

• B-complex vitamins and vitamin C are water-soluble vitamins that are not stored in the body and must be replaced each day.
• These vitamins are easily destroyed or washed out during food storage and preparation.
• The B-complex group is found in a variety of foods: cereal grains, meat, poultry, eggs, fish, milk, legumes and fresh vegetables.
• Citrus fruits are good sources of vitamin C.
• Use of mega doses of vitamins is not recommended.

Vitamin K(sources/functions/effects/requirement/deficiency)

The existence of this vitamin was postulated by Henrik Dam (1928) who found that chicks maintained on diets low in lipidstend to bleed easily and their blood clots slowly.

Vitamin k exists in nature in at least two forms, vitamin K1 (phytylmenaquinone), in animal andplant tissues, and vitamin K2 (prenylmenaquinone) in microorganisms.

Human hepatic vitamin k pool is composed mainly of menaquinone rather than phylloquinone.

Absorption of vitamin k depends on bile salt secretion and pancreatic lipase activity. Absorption from solubilised preparation is 8 times that from spinach and butter and 33 times better than from spinach alone.

Sources

Vitamin K is found chiefly in leafy green vegetables such as spinach, swiss chard, and Brassica (e.g. cabbage, kale, cauliflower, broccoli, and brussels sprouts); some fruits such as avocado and kiwifruit are also high in Vitamin K.

Deficiency

Average diets are usually not lacking in vitamin K and primary vitamin K deficiency is rare in healthy adults. As previously mentioned, newborn infants are at an increased risk of deficiency. Other populations with an increased prevalence of vitamin K deficiency include individuals who suffer from liver damage or disease (i.e. Alcoholics), people with cystic fibrosis, inflammatory bowel diseases or those who have recently had abdominal surgeries.

Vitamin E(sources/functions/effects/requirement/deficiency)

Vitamin E is the generic description for a group pf lipid soluble tocol and tocotrienol derivatives possessing varying degrees of vitamin activity.

Nevertheless, vitamin E is essntialbecause it prevents damage to cell membranes by oxidant.

Sources

Corn oil, corn, peanut oil, peanut butter, rice bran oil, wheat germ oil, bananas grapes and orange are the Vitamin E rich sources.

Antioxidant effects

Vitamin e is the nature’s best antioxidant. An antioxidant may be defined as any substance, which, when present at low concentration (when compared with those of an oxidisable substrate), siginificanly delays or prevents oxidation of that substrate.

Requirement of Vitamin E

Minimum requirements are given as 5 to 10 mg alphatocopherol in infants, 10 to 15 mg for children and 15mg for adults, when the diet contains at least 0.1ppm Se, adequate amounts of sulphur containing amino acids and no more than 1.55 linoleic acid.

A daily dose of 200 to 600 mg is said to be innocuous.

Deficiency of vitamin E

Vitamin E deficiency is a very rare problem that results in damage to nerves. When vitamin E deficiency does occur, it strikes people with diseases that prevent the absorption of dietary fats and fat-soluble nutrients. Since vitamin E is a fat-soluble vitamin, it has some of the properties of fat.

When vitamin E deficiency occurs, it strikes people with diseases that prevent the absorption of dietary fats and fat-soluble nutrients. These diseases include cystic fibrosis, pancreatitis, and cholestasis (bile-flow obstruction). Bile salts, produced in the liver, are required for the absorption of fats. Cholestasis causes a decrease in the formation of bile salts and the consequent failure of the body to absorb dietary fats. For this reason, this disease may result in vitamin E deficiency. Premature infants may be at risk for vitamin E deficiency because they may be born with low tissue levels of the vitamin, and because they have a poorly developed capacity for absorbing dietary fats.

Vitamin D(sources/functions/effects/requirement/deficiency)

Sources

In foods vitamin D exists as cholecalciferol (D3) derived from dehydrocholesterol, or as ergocalciferol (D2)formed by UV irradiation of the plant sterol, egosterol. Relatively few foods provide the vitamin. Humans as well as the cow’s milk contain negligible amount of vitamin D. fish, eggs, animal liver and cheese are the food sources of vitamin D.

Synthesis in skin

Cholesterol in the skin is converted to 7-dehydricholesterol (7-DHC), which is formed in the highest concentration in the stratum spinosum and next in stratum basale, with little in the dermis. Absorption of a quantum of light in the wavelength range 250-310 nm results in cleavage of the 9,10 bond in the sterol B ring to yield pre-cholecalciferol which undergoes thermal isomerization to yield cholecalciferol and vitamin D.

In liver

D3 from the diet and skin are transported in the blood stream bound to a special alpha-globulin, the D3-binding protein (DBP), to the liver where it is hydroxylated at carbon 25, to yield 25-hydroxy D3.

Requirement of vitamin d

There is uncertainty about the magnitude of the requirement the vitamin at any age, due to the variability between individuals in the duration of exposure to sun light. Read the article on “Recommended daily allowances of some vitamins”.

The fate of dietary vitamin D apparently differs from the fate of D3 formed in skin.

Vitamin d deficiency

Deficiency of vitamin D can result from a number of factors including: inadequate intake coupled with inadequate sunlight (UVB) exposure, disorders that limit its absorption from the gastrointestinal tract, conditions that impair conversion of vitamin D into active metabolites, such as liver or kidney disorders and body characteristics such as skin color and body fat. Rarely deficiency can result from a number of hereditary disorders.Deficiency results in impaired bone mineralization, and leads to bone softening diseases including:

Rickets,
Osteomalacia
Osteoporosis

Vitamin B1/thiamine(sources/functions/effects/requirement/deficiency)

Thiamin has a pyrimidine ring and a thiazole ring joined by a methylene bridge. It dissolves readily in water, and is rapidly destroyed by heat in neutral or alkaline solution. Thiamin is absorbed from the upper part of the small intestine, maximal absorption from a single dose being about 5 mg. Bacteria in the lower gut can synthesize thiamin but this not available for absorption.

Sources

To produce 4.184 MJ of energy from food, 0.4 mg thiamin have to be provided. Therefore, if a food is being a source of thiamin, it must provide more of the vitamin than is required for obtaining the energy it is supplying. Thiamine is found in a wide variety of foods at low concentrations. Yeast and pork meat are the most highly concentrated sources of thiamine. Cereal grains, however, are the most important dietary sources of thiamine in the diet as these foods are consumed readily in most diets. Of the cereal grains, whole grains contain more thiamine than refined grains, as thiamine is found mostly in the outer layers of the grain and in the germ.

Requirement of thiamin

The requirement for thiamin is expressed per 4.184 MJ (1000kcal) ingested. Tissues become saturated when the intake is about 0.35 mg per 4.184 MJ and excess is excreted in urine.

Health benefits of essential fatty acids (EFA)

What are the essential fatty acids (EFA)

Essential fatty acids(EFA) are the fatty acids which cannot be synthesized by the human body therefore these fatty acids should be ingested otherwise there is risk of developing deficiencies. By 1940 it was established that mammals cannot synthesize linoleic and alpha-linoleic acids, which were therefore termed as essential fatty acids (EFA) and group under the generic term vitamin F. There are two families of EFAs: ω-3 (or omega-3 or n−3) and ω-6 (omega-6, n−6). Fats from each of these families are essential, as the body can convert one omega-3 to another omega-3.

Derivatives of essential fatty acids (EFA)

Linoleic and alpha-linoleic acids can be converted into longer chain members that are more unsaturated, though successive desaturations and elongations, reactions which take place with relatively low efficiency. The non-essential fatty acids, palmatic and stearic, can also be desaturated and elongated to polyunsaturated acids, some of which may substitute for polyunsaturated acids derived from EFA, in EFA deficiency.

Oxidative metabolites of the EFA containing 20 carbon atoms are known as Eicosanoids.

Essential fatty acids deficiency

Acute deficiency of EFA in children results in growth failure and increased susceptibility to infections. A chronic deficiency (a low ratio of EFA to non-essential fatty acids in the body) causes faulty structure of cell membranes and increased prevalence of chronic degenerative diseases such as atherosclerosis.

Requirement

In children, the minimal daily requirement of n-3 fatty acids has been estimated as 0.54% of total dietary energy. In adults it ranges from 0.2% (when the supply of its long chain derivatives is adequate) to 0.3%, the maximum being 0.5 to 1%, of total dietary energy. The minimal amount defined as an intake maintaining normal concentration of n-3 acids, is estimated to be 100-200 mg/day, while the optimal intake has been extrapolated to 300 to 400 mg/day.

Recommended amount

Linoleic acid 5 to 6% of total dietary energy, alpha-linoleic acid 0.5 to 1% of total dietary energy is recommended.

Food sources

Almost all the polyunsaturated fat in the human diet is from EFA. Some of the food sources of ω-3 and ω-6 fatty acids are fish and shellfish, flaxseed (linseed), hemp oil, soya oil, canola (rapeseed) oil, chia seeds, pumpkin seeds, sunflower seeds, leafy vegetables, and walnuts.

Health benefits

Following conditions can be improved with omega-3 fatty acids (fish oil)

1. varicose veins
2. hypercoaguality states
3. high blood pressure
4. heart attacks
5. rheumatoid arthritis
6. cardiac arrhythmias

Fat soluble vitamins

Fat soluble vitamins are the vitamins which are accumulated in fat/adipose tissues when taken in excess amount and these vitamins can be dissolved in oil or in melted fat. Followings are the fat soluble vitamins;

1. Vitamin A
2. Vitamin D
3. Vitamin E
4. Vitamin F
5. Vitamin K

Fat-soluble vitamins are absorbed through the intestinal tract with the help of lipids (fats). Because they are more likely to accumulate in the body, they are more likely to lead to hypervitaminosis than are water-soluble vitamins. Fat-soluble vitamin regulation is of particular significance in cystic fibrosis

Lipoproteins are complexes of lipids and proteins that are essential for the transport of cholesterol, triglycerides, and fat-soluble vitamins. Most clinical manifestations of abetalipoproteinemia result from
defects in the absorption and transport of fat-soluble vitamins.

Few importants things about fat soluble vitamins;

• Small amounts of vitamins A, D, E and K are needed to maintain good health.
• Foods that contain these vitamins will not lose them when cooked.
• The body does not need these every day and stores them in the liver when not used.
• Most people do not need vitamin supplements.
• Megadoses of vitamins A, D, E or K can be toxic and lead to health problems.

Importance of essential fatty acids (EFA) during pregnancy

Essential fatty acids (EFA) and their long chain, more unsaturated derivatives play a major role during pregnancy. They provide precursors of the prostaglandins and leukotrienes and they are important constituents of all cell membranes, especially those in the brain and in the nerves and vascular systems. During the third trimester, rapid synthesize of brain tissue occurs, and the quantitative accretion in human brain of the long chain polyunsaturated fatty acids (PUFA), arachidonic acid (AA) and Docosahexaenoic (DHA) increases steadily during gestation. DHA in human retina also increases with maturation. There is increasing evidence that DHA is essential for the normal development of brain and retina.

Recently, it has been suggested that fish oils might reduce the occurrence of obstetric complications such as premature delivery and pregnancy induced hypertension (PIH). Decreased maternal levels of linoleic acid (LA) have been observed in PIH and intra uterine growth restriction (IUGR). Fatty acids like LA and DHA may be of great importance in the diet during pregnancy.

Some studies have shown following changes in fatty acids level

1. The total amount of fatty acids increased significantly in the blood during pregnancy.
2. The relative amounts of linoleic acid do not change while that of AA decreased.
3. There was an increase in DHA indicating maternal mobilization until 18th weeks, DHA status declined thereafter.

There is a progressive increase in the DHA deficiency index in maternal blood during pregnancy, resulting in a suboptimal neonatal DHA status. The overall EFA status also declined during pregnancy. Therefore, the question arises whether the mother is able to meet the high fetal requirement for EFA under prevailing dietary conditions.

Caffeine toxicity and their effects

Caffeine is found in both tea and coffee. it stimulates central nervous system, exert a diuretic action in the kidney, stimulate heart muscles and relax smooth muscles. Caffeine has the more powerful action on the central nervous system, while theophylline has a greater action on the cardiovascular and skeletal system and is particularly effective in relaxing the bronchioles. The amount of caffeine in a cup of tea depends on the method of brewing. The pharmacologically active dose of caffeine is 200mg, and the acute fatal dose is about 10g. Those who drink more than five cups of coffee or nine cups of tea daily are regularly consuming 5% of a fatal dose. The half life of caffeine is about three hours. It is excreted quickly in urine as 1-methyluric acids.

Caffeine has been shown to increase the teratogenecity of compounds such as cycloheximide and emetine (which inhibit protein synthesize), hydroxyl-urea and flourodeoxyuridine (which inhibits DNA synthesize) and actinomycin D (Which is an inhibitor of RNA synthesize). The mechanism of this potentiative action is not known. However, as the dose given to pregnant rats in these studies varied from 75 to 150 mg/kg body weight, to achieve a lower dose level a 50kg woman would have to drink 25 cups of strong (150mg per cup) coffee per day.

Some studies suggested that very high intakes of caffeine (600mg per day) may be associated with spontaneous abortion or premature birth. Moderation in the intake coffee (3 cups per day) and reduction in the consumption of colas and other beverages is

Overview of MICROBIOLOGY

1. Basic Bacteriology

i. Comparison with other organisms
ii. Structure of bacterial cell
iii. Growth and genetics
iv. Classification of microorganisms
v. What is normal flora?
vi. How do they cause diseases?
vii. Host defenses
viii. Laboratory investigations
ix. Antibiotics
x. Vaccines against microorganisms
xi. Sterilization and disinfection
xii. Staining methods

2. Clinical bacteriology

i. Introduction
ii. Gram positive Cocci
iii. Gram negative Cocci
iv. Gram positive Rods
v. Gram negative Rods
vi. Mycobacteria
vii. Actinomycetes
viii. Mycoplasmas
ix. Spirochetes
x. Chlamydiae
xi. Rickettsiae
xii. Minor bacterial pathogens

3. Basic virology

i. Structure and replication
ii. Genetic aspects of viruses
iii. Classification of viruses
iv. Pathogenesis and host defenses
v. Laboratory investigations
vi. Antiviral drugs
vii. Vaccines against viruses

4. Clinical virology

i. DNA enveloped viruses
ii. DNA nonenveloped viruses
iii. RNA enveloped viruses
iv. RNA nonenveloped viruses
v. Hepatitis viruses
vi. Arboviruses
vii. Tumour viruses
viii. Slow viruses
ix. Prions
x. HIV
xi. Minor viral pathogens

5. Mycology

i. Basic mycology
ii. Classification

6. Parasitology
7. Immunology
8. New developments

Structure of bacterial cell

Structure of bacterial cell is varying with the species of the bacteriae. But the basic structure is same for the all bacteriae. Therefore study of this common structure will enable the ability of understanding the varying configurations of structure.

Followings are the important structures/features found in almost all the bacterial cells.

1. shape and size of bacterial cell
2. cell wall of bacterial cell
3. cytoplasmic membrane of bacterial cell
4. mesosome of bacterial cell
5. cytoplasm of bacterial cell
6. specialized structures outside the cell wall of bacterial cell
7. spores of bacteriae


Shape and size of bacterial cell

There are three basic groups of bacteriae according to the shape of the cell.

1. Cocci (round shape)
2. Bacilli (rod shape)
3. Spirochetes (spiral shape)

Other than those basic shapes, there are some bacteriae who do not have a specific shape or shape is varying. Those bacteriae are known as pleormorphic.

Bacteria size could range from about 0.2µm to 5µm. This is general measurement therefore there can be bacteriae larger/smaller.

Cell wall of bacterial cell

This is the outermost part of bacterial cell of almost all the bacteriae. There are few groups who do not possess a cell wall such as mycoplasma. Various structures could be attached to the cell wall such as capsule, flagellae. The cell consists of several layers. Followings are the component of bacterial cell wall;

Peptidoglycan
Teichoic acid
Lipid A
Polysaccharides

Cytoplasmic membrane of bacterial cell

Cytoplasmic membrane is found inside to the cell wall. It is microscopically similar to cell membrane of eukaryotic cell but the chemical composition is different. Followings are the functions of cell membrane;

1. active transport of molecules
2. energy generation
3. synthesize of component of cell wall
4. secretion of enzymes and toxins

mesosome of bacterial cell

This is an invagination of the cell membrane and it is important for the cell division.

Cytoplasm of bacterial cell

All the organelles of the bacteriae are suspended in the cytoplasm. This is somewhat similar to cytoplasm of the eukaryotic cytoplasm but chemical composition is varying. Followings are the structures found in cytoplasm;

1. ribososmes
2. granules
3. nucleid
4. plasmids
5. transposons


Specialized structures outside the cell wall

Capsule
Flagella
Pili (fimbriae)
Glycocalyx

Spores of bacterial cell

This is not a common structure for all bacterial cells. This highly specialized structure is important to pass the difficult environmental conditions. Bacillus and clostridiums are the bacteriae which produce spores.