Narrowing the Gap between Anion and Strong Ion: A Current Perspective | Chapter 8 | Medical Research and Its Applications Vol. 10

 

Background: A true “ion gap” does not exist in vivo which makes the anion gap a fundamental tool to evaluate acid-base disorders. The strong anion gap (SIG), which is the foundation of the Stewart acid-base method, is a term that many doctors are unaware of, despite its significance in understanding acid-base pathophysiology. It is unknown how much the anion gap and the strong ion gap differ quantitatively.

 

Aim: The present study aimed to discuss narrowing the gap between the anion gap and the strong ion gap.

 

Methods: The quantitative difference between the SIG and the albumin-corrected anion gap (AGc) was calculated at a wide range of albumin, phosphorus and pH levels.

 

Results: At an albumin level of 1-3 g/dl and pH from 6.9-7.3, the contribution difference of albumin between the AGc and the SIG was maximally -0.97 to 0.51 mEq/L. In metabolic alkalosis and hypoalbuminaemia, the AGc differed less than 2 mEq/L from the SIG. The calculated contribution of phosphorus was higher in the SIG with phosphorus levels > 2 mmol/L and could be accounted for in the anion gap with the conversion factor 1.76x[phosphorus, in mmol/L].

 

Conclusion: The SIG and the AGc were nearly identical across a wide range of values, particularly when albumin and phosphorus levels were low. The anion gap would be more precise incorporating the major components of the SIG using the equation: [Na+] - [Cl-] - [HCO3-] - 2.5x[albumin, in g/dL] – 1.76x[phosphorus, in mmol/L], with an arbitrarily set reference range of 1 + 5 mEq/L. To have a better understanding of the pathophysiology and to be more accurate, the anion gap, or perhaps a more logical term, “the ion gap” should be written to become almost identical to the SIG.

 

 

Author(s) Details

Kenrick Berend

Department of Nephrology, Curacao Medical Centre, Curacao.

Andrew L. Lundquist

Division of Nephrology, Massachusetts General Hospital, Boston, MA, United States.

 

Please see the link:- https://doi.org/10.9734/bpi/mria/v10/998

Quantification of Urine Albumin-Creatinine Ratio (uACR) by Point-of-Care Test and Its Comparison with Other Analytical Methods for Easy Detection | Chapter 9 | Medical Science: Recent Advances and Applications Vol. 7

Background: Chronic kidney disease (CKD) is a progressive condition affecting over 10% of the global population. Monitoring the urine albumin-to-creatinine ratio (uACR) is the gold standard for early detection and ongoing management of nephropathy. However, access to laboratory testing is limited in many community healthcare settings.

 

Objective: This study aimed to develop and evaluate the performance of MyACR, a simple, accurate, sensitive, and rapid point-of-care test (PoCT) device for measuring uACR, with the goal of facilitating CKD screening and monitoring in community settings.

 

Methods: MyACR uses spectrophotometric dye-binding (tetrabromophenol blue) and colourimetric Jaffe methods to quantify urinary albumin and creatinine, respectively. Urine samples were diluted 1:80 with distilled water and reacted with respective reagent mixtures. The creatinine reaction was incubated at 25°C for 30 minutes before analysis. Optical densities were measured at 625 nm (albumin) and 515 nm (creatinine). Calibration curves were established for albumin (0–60 mg/L) and creatinine (0–2 mg/dL), and analytical performance was evaluated in terms of linearity, accuracy, precision, and sensitivity. Clinical validation was conducted on urine samples from 20 CKD patients.

 

Results: Calibration curves demonstrated strong linearity, with correlation coefficients (R²) exceeding 0.997. The method demonstrated good intra- and inter-day accuracy (per cent deviation of mean value ≤ 5.42%) and precision (coefficient of variation ≤ 12.69%). The method was specific, without interference from blood components. The limits of quantification were 5 mg/L for albumin and 0.25 mg/dL for creatinine, based on spiked samples (n = 5). Comparison with hospital-based immunoassays showed a high correlation (R² > 0.98) and acceptable agreement (median %DMV = 3.48%, range: -17.05% to 21.64%).

 

Conclusion: MyACR demonstrated satisfactory analytical performance for the point-of-care measurement of uACR, offering a promising tool for early detection and monitoring of CKD in resource-limited settings. Further studies are warranted to assess its cost-effectiveness and clinical utility in large-scale, multisite community and home-based applications.

 

Author(s) Details

Nadda Muhamad
Department of Biomedicine and Health Informatics, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand

 

Napaporn Youngvises
Bangkok High Lab Co., Ltd., Bang Khen District, Bangkok 10220, Thailand.

 

Tullayakorn Plengsuriyakarn
Graduate Program in Bioclinical Sciences, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani 12120, Thailand.

 

Wanchai Meesiri
Bangkok High Lab Co., Ltd., Bang Khen District, Bangkok 10220, Thailand.

 

Wanna Chaijaroenkul
Graduate Program in Bioclinical Sciences, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani 12120, Thailand.

 

Kesara Na-Bangchang
Graduate Program in Bioclinical Sciences, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani 12120, Thailand.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v7/5796

Albumin-Globulin Ratio as a Predictor of Prognosis in Critical Illness: A Prospective Observational Study| Chapter 8 | Perspective of Recent Advances in Medical Research Vol. 5

 Background: Nutritional rank and critical ailment have an inverse connection. The immunity of the patient is improved by a good digestive state which helps in a faster improvement from critical sickness. In this study, we analyzed the part of albumin and globulin ratio as prognostic markers for the distance of ICU stay.Materials and Methods: One hundred and fifty subjects with as well ten days of stay in the ICU were contained in the study. Variables like demographic details, comorbidities, skin fold denseness, calorie intake, and albumin globulin percentage were collected. The equivalence was made 'tween the parameters and the length of wait the ICU. Results: Demographically, both groups were comparable. The correlation 'tween calorie intake and the era 1 AG ratio showed Pearson’s equivalence coefficient R = 0.6373 and a P advantage less than 0.05. It designated a strong uninterrupted relationship middle from two points the albumin-to-globulin ratio on day individual and calorie intake. The equating between the number of days of ICU stay and the era 1 AG ratio demonstrated a Pearson correlation coefficient of R = 0.871 and a p-worth less than 0.05.Conclusion: We decide that nutritional rank assessed by AGR can guide us in the management of critical subjects and reduce ICU stay, with improving endurance.

Author(s) Details:

Mirunalini Gunaseelan,
SRM Institute of Science and Technology (SRM IST), Kattangulathur, India.

Pushparani Anand,
SRM Institute of Science and Technology (SRM IST), Kattangulathur, India.

Gayathri Ramanathan,
SRM Institute of Science and Technology (SRM IST), Kattangulathur, India.

Swetha Ramani Chinnappan Kuppusamy,
SRM Institute of Science and Technology (SRM IST), Kattangulathur, India.

Please see the link here: https://stm.bookpi.org/PRAMR-V5/article/view/9144

Assessment of Albumin Status in Hypertensive Patients with or Without Cataract in Nigeria | Chapter 06 | New Horizons in Medicine and Medical Research Vol. 7

 The Eye Foundation Hospital in Itamogiri, Ijebu – Mushin in the Ijebu-East Local Government Area and the General Hospital in Ijebu-Ode in Ogun State, Nigeria, investigated albumin levels in hypertensive patients with and without cataracts. Simple random selection was used to choose 150 samples from the study area. There was no significant difference in albumin levels between the control group (MeanSD=48.128.20g/L) and test group A (MeanSD = 49.1910.19g/L), but there was a significant reduction in albumin concentration in test group B with MeanSD = 44.3511.99g/L, indicating hypertension (with cataract) had significantly lower levels of plasma albu. This shows that cataracts may have a direct impact on the serum albumin concentration of hypertension patients. Following an analysis of serum electrolyte levels, such persons should be advised to adopt a salt-restricted diet, which may assist to reduce cataract development and progression.

Author(S) Details

Z. M. Oladunjoye
Department of Medical Laboratory Techniques, Ogun State College of Health Technology, Ilese- Ijebu, Nigeria.

J. A. Quadri
Department of Nutrition and Dietetics, Ladoke Akintola University of Technology, Oyo State, Nigeria.

View Book:- https://stm.bookpi.org/NHMMR-V7/article/view/6664

Determining the Effect of Smoking on Salivary Parameters | Chapter 11 | Issues and Developments in Medicine and Medical Research Vol. 6

 Smoking is a dangerous habit that has been linked to a number of inflammatory and malignant disorders of the mouth, respiratory system, and digestive system.

The purpose of this research is to evaluate and compare the effects of smoking on the composition of entire unstimulated saliva.

Materials and Methods: A total of 186 persons were involved in the study, who were split into two groups: smokers (77 people) and non-smokers (109 people), with an average age of 33. (19-57). There are 89 men and 87 women among them. The studies are performed on unstimulated saliva collected passively according to conventional analytical requirements. Uric acid (UA), alpha-amylase (sAA), secretory IgA (sIg A), total protein (TPro), and albumin were all investigated (alb). Salivary parameters were measured using a finished kit from Thermo science and Beckman Coulter, as well as oral fluid methods from the Olympus AU 640 and Indiko Plus biochemical analyzers.

Results: In smokers, we found a significant increase in total salivary protein and albumin, as well as a decrease in UA, amylase, and sIg A, indicating a shift in saliva homeostasis and antioxidant capacity.

Conclusion: There are significant quantitative differences in saliva parameters between smokers and non-smokers, according to the findings. Smoking has a negative impact on oral homeostasis and raises the risk of inflammatory and degenerative alterations in the mouth lining.

Author(S) Details

Mariana Yordanova
Department of General Medicine and Clinical Laboratory, Medical University of Varna “Prof. Dr. Paraskev Stoyanov” Varna; Military Medical Academy, Multiprofile Hospital for Active Treatment, Varna, Bulgaria.

Nikola Shopov
Military Medical Academy, Centre of Military Medical Expertise Aero and Maritime Medicine, Sofia, Bulgaria.

View Book:- https://stm.bookpi.org/IDMMR-V6/article/view/5604