Journal of Biochemistry and Biophysics

Aim of the Study: The aim of the study is to present a case of leptospirosis in pregnancy with uncommon presentation. Introduction: Leptospirosis is a zoonotic disease and has varied manifestation with overlapping features of malaria, hepatitis, typhoid and dengue. Leptospirosis is uncommon and difficult to diagnose due to its non-specific clinical presentation. Case description: A 26-year-old multigravida with 28 weeks of gestation, presented to the obstetrics outpatient department of our hospital with the chief complaints of high grade fever associated with chills, myalgia, nausea and vomiting. She also complained of having giddiness. She gave history of having oliguria and passage of dark colored urine. Following investigations were carried out: blood glucose, Liver function tests included serum total and direct bilirubin, AST, ALT, total protein and albumin, renal function tests included BUN and creatinine and C- reactive protein as inflammatory marker. Laboratory findings included high serum AST, ALT, total and direct Bilirubin, BUN, S. Creatinine, C- reactive protein and leukocytosis. Hemoglobin, S. total protein, albumin and random blood sugar were reported low. Urine analysis was positive for proteinuria. Peripheral smear was negative for malaria. Serological tests were negative for typhoid, hepatitisand dengue. Serological test was positive for antibodies (IgM) to leptospira at titer of 1:1,000. Diagnosis of leptospirosis was confirmed and management was carried out for the same. Conclusion: Since leptospirosis often presents with symptoms which overlap with the clinical features of malaria, dengue, hepatitis, enteric fever, therefore these conditions can be considered in the differential diagnosis of leptospirosis in pre exposure cases associated with pregnancy. Clinical Significance: Due to its nonspecific presentation, its diagnosis can be overlooked. It is important to have a high index of suspicion, for early diagnosis of the disease and start treatment, so as to avoid complications especially in pregnant women.

Keywords: Hyperbilirubinemia, leptospirosis, pregnancy, proteinuria.

Guillain-Barré syndrome (GBS) is referred to a rare condition in which a person’s self-immune system attacks his own peripheral nerves. The disease was first detected by the French physician Jean-Baptiste Octave Landry in 1859. After this during 1916, Georges Guillain, Jean Alexandre Barré, and André Strohl also confirmed the disease onset in some soldiers. The disease can affect the people of all ages but more common in adult males. The disease has recovery, if treated. In case of severity which is rare can lead to total paralysis. Guillain-Barré syndromecan adversely affect the nerves that control muscle movement, transmit pain, temperature, feeling the touch sensations. Muscle weaknesses, loss of sensation in the legs and/or arms are the resultant symptoms may arise in the patient suffering from GBS. The symptoms will start in the legs and further spread to face and arms. In GBS 20–30% peoples may experience the chest muscle affected and difficulty in breathing. Sometimes the swallow and speak abilities also get affected. Most of peoples recover fully from GBS, but some people have long-term nerve damage. 3–5% of GBS patients may die from complications, which include paralysis of the muscles that control breathing, blood infection, lung clots or cardiac arrest. As per the National Health Portal web site information the cause of GBS is unknown. It sometimes linked with triggering by an infectious illness like gastrointestinal infection or a lung infection. Some countries from Europe and Asia have also reported familial occurrence of GBS. According to World Health Organization (WHO) overall incidence of GBS is 0.4 to 4.0 people per 100000 per year.1

Keywords: Autoimmune disease; Guillain-Barré syndrome (GBS); Systemic lupus erythematous; World health organization (WHO).

During process of digestion, proteins are broken down in into amino acids. Mainly the proteins contain 22 standard amino acids and several non-standard amino acids. We possess synthetic pathways for only 11 amino acids out of 22 standard amino acids. The remaining ones must be obtained from diet and hence they are referred to as essential amino acids. During day to day protein turnover most of amino acids used in protein synthesis were not from food but obtained through endogenous protein breakdown. The amino acid degradation occurs in Liver, Muscles and Kidneys. The liver being the major site of degradation while for some specific ones Muscles and Kidneys are the sites. During the amino acid degradation the nitrogen is removed from the carbon skeleton and transferred to the alpha-ketoglutarate which results into Glutamate. The carbon skeletons are converted into intermediates of mainstream carbon oxidation pathways via specific adapter pathways. Surplus nitrogen is removed from glutamate, and excreted in urea. In the degradation process, the amino acids are converted into the intermediates of the citric acid cycle to pyruvate which in turn can serve as precursors for gluconeogenesis, can be referred as glucogenic amino acids. Those amino acids which yield acetoacetate are termed as ketogenic.1 Phenylketonuria (PKU) is a metabolic disorder occurring since birth which results into decreased metabolism of the amino acid phenylalanine.2 It is observed that the untreated, PKU can develop intellectual disability, seizures, behavioral problems, and mental disorders.3 It may also result in a musty smell and lighter skin. A baby born to a mother who has poorly treated PKU may have heart problems, a small head, and low birth weight.2 Present review study will compare the prevalence of disease in the countries with special focus to India.

Keywords: Amino acids; Phenylketonuria (PKU); Metabolism; Phenylalanine.

Benign prostatic hyperplasia (BPH) is the most common pathology of the prostate gland in men. Raised levels of PSA are seen in different pathological conditions involving the prostate. PAP levels are altered in inflammatory, infectious or abnormal growth of the prostate tissue. Serum calcium and magnesium levels were also found to be altered in prostate cancer and BPH. The present study was carried out to study the levels of PSA, Prostatic Acid Phosphatase (PAP), calcium, and magnesium in serum of patients with BPH and to evaluate the relationship between them as well.

Keywords: Benign prostatic hyperplasia (BPH); Prostatic Acid Phosphatase (PAP); Serum.