Background: Need for undertaking prostate biopsies for detection of prostate cancer is often decided on the basis of serum levels of prostate specific antigen (PSA). Aim: To evaluate the case detection rate of prostate cancer among patients presenting with lower urinary tract symptoms (LUTS) on the basis of PSA levels and to assess the scope of prostate biopsy in these patients. Setting and Design: A retrospective study from a tertiary care center. Materials and Methods: The clinical and histopathological data of 922 patients presenting with LUTS in the last five years was obtained from the medical record section. They had been screened for prostate cancer using PSA and /or digital rectal examination examination followed by confirmation with prostate biopsy. Statistical Analysis Used: Detection rate and receiver operating characteristic curve were performed using SPSS 16 and Medcalc softwares. Results: The detection rate of prostate cancer according to the PSA levels was 0.6%, 2.3%, 2.5%, 34.1% and 54.9% in the PSA range of 0-4, 4-10, 10-20, 20-50 and <50 ng/ml, respectively. Maximum prostate cancer cases were detected beyond a PSA value of 20 ng/ml whereas no significant difference in the detection rate was observed in the PSA range of 0-4, 4-10 and 10-20 ng/ml. Conclusion: A low detection rate of prostate cancer observed in the PSA range of 4-20 ng/ml in LUTS patients indicates the need for use of higher cutoff values of PSA in such cases. Therefore we recommend a cutoff of 20 ng/ml of PSA for evaluation of detection rate of prostate cancer among patients presenting with LUTS.

Insulin resistance (IR) is hallmark of metabolic syndrome. It is important to identify IR as it is the early stage before development of diabetes mellitus. The standard method to measure insulin resistance is the euglycemic clamp technique, which is laborious. Hence, a number of surrogate measures like homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI) and triglyceride/high density lipoprotein cholesterol (TG/HDL-C) ratio have been developed. Both of the former involve calculations, while TG/HDL ratio may be readily available for clinicians. Therefore, this study was undertaken to assess whether TG/HDL-C ratio serves as a better predictive marker of IR. Objectives: The aim of the present study was to evaluate the triglyceride/HDL-C ratio as a surrogate marker of IR in metabolic syndrome patients. Materials and methods: Total 110 patients were recruited in the study after obtaining informed written consent. They were divided into two groups. Group I included healthy controls (n = 50) and subjects with metabolic syndrome (MS) (n = 60) as per NCEP ATP III criteria were included in group II. Anthropometric measurements and biochemical analysis was performed in all subjects. Results: There was statistically significant difference in anthropometric, glycemic and lipid parameters in control and study group (p < 0.0001). The regression model between HOMA-IR and TG/HDL-C ratio showed was positive correlation (r = 0.29, p = 0.01) while between QUICKI and TG/HDL-C ratio showed negative correlation (r =-0.37, p = 0.002). Conclusion: We report in our study that TG/HDL-C can be adopted in routine laboratory practice as a surrogate marker for prediction of insulin resistance. So that patients with metabolic syndrome may be beneficial at an early stage.

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Tubular damage is a complication associated with nephrotic syndrome and increased levels of urinary enzymes are of significant value in detection of the same. The aim of our study was to evaluate the use of urinary lysozyme and trehalase as markers of tubular dysfunction in nephrotic syndrome. This study assessed 35 nephrotic syndrome patients and 30 healthy controls matched for age and sex. Urine samples were examined at pretreatment and post treatment (8 weeks) stages for proteinuria, lysozyme and trehalase. At pretreatmant stage there was significant increase in urinary lysozyme and trehalase as compared to controls (p<0.001). A good correlation was observed between degree of proteinuria and urinary lysozyme (p<0.001;r=0.80) and trehalase (p<0.001; r=0.74). At the end of 8 weeks of treatment, the patients showed significant decrease in their urinary lysozyme and trehalase activity (p<0.001) but no correlation with degree of proteinuria was observed. Our results indicate that enzymes like lysozyme and trehalase can be used as markers of tubular dysfunction.