In children, Coronavirus Disease 2019 (COVID-19) is typically mild. However, in rare cases, children are severely affected, and clinical manifestations are differed from adults. The consequence of COVID-19; Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare complication that seems like toxic shock syndrome or Kawasaki Disease (KD). The MIS-C is characterised by an inflammatory response in the body that occurs four weeks after infection with the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus. Fever, rashes, diarrhoea, red eyes, and vomiting are common early symptoms that can worsen over time. The inflammation can affect the blood vessels, heart, and other organs, leaving children critically ill and in need of immediate medical attention. Many of the children with MIS-C show positive SARS-CoV-2 serology but negative Polymerase Chain Reaction (PCR), supporting the concept that MIS-C is linked to immunological dysregulation that develops after the acute infection has passed. However, some children do have positive PCR testing. A case series of seven critically ill children with MIS-C in sequential order of admission in the Paediatric Intensive Care Unit (PICU) of tertiary care hospital is illustrated. Key findings of this syndrome include fever, epilepsy, diarrhoea, shock and variable presence of rash. In the present case series, the clinical features, laboratory findings and therapies for a cohort of seven children with MIS-C are presented. Laboratory investigations carried out at early stage of disease can be of vital importance to diagnosis of MIS-C.

The aim of this study is to compare analytical performance characteristics and also the patient results obtained from both Modified Jaffe’s kinetic and Enzymatic Trinder methods for serum creatinine so as to identify risk zone, if present, within the measurement range. Serum creatinine was measured on 206 left-over serum samples by Modified Jaffe’s kinetic and Enzymatic Trinder methods. For analytical performance comparisons, limit of detection(LOD), limit of quantification(LOQ), linearity, measuring range, intra and inter-assay CV were measured and compared. Statistical comparisons were done by Pearson‘s correlation coefficient and Bland-Altman tests. For Enzymatic Trinder and Modified Jaffe’s kinetic methods, LODs for serum creatinine were 0.01 & 0.02 mg/dl respectively; LOQs were 0.04 & 0.06 mg/dl respectively; linearity were upto 55 mg/dl & 30 mg/dl respectively. Correlation coefficient was high (r=0.99); intra and inter-assay CV measurements were acceptable. However, CV was lower for Enzymatic Trinder method. Bland-Altman plot showed that more than 95% data points lie within ± 1.96 SD limit of mean difference value (0.16). Average discrepancy (ie. bias) was 0.16 mg/dl across whole measurement range. However, at low concentrations, Modified Jaffe’s kinetic method gave higher values indicating systematic bias, thereby forming a “risk zone” in measurement range. Analytical performance requirements were met by both methods for routine use and good agreement exists between them. However, better performance was not shown by Modified Jaffe’s kinetic method at low concentrations. Such a “risk zone” needs to be identified by laboratories for accurate reporting of creatinine results.

Introduction: Breast cancer accounts for 25% of all female cancer cases in India. Although, lipids and free radicals like Nitric Oxide (NO) have been related to breast cancer, but its pathogenesis remains controversial. Aim: To estimate NO, endothelial NO Synthase (eNOS) and lipid profile in serum of breast cancer patients and also to determine their possible role in patients of breast cancer in Indian women. Material and Methods: This was a hospital-based case-control study conducted for a period of 24 months from July 2012 to June 2014 in Dr VM Government Medical College, Solapur, with a total of 100 women (50 breast cancer cases and 50 healthy age matched controls) of age group 35-65 years. Fasting venous blood samples were collected. Biochemical parameters analysed in the study were serum NO, serum eNOS, serum Total Cholesterol (TC), serum Triglycerides (TG), serum High Density Lipoprotein (HDL) and serum Low Density Lipoprotein (LDL). Results were expressed as mean±Standard Deviation (SD) and Student’s unpaired t-test was used to compare the pairs of means. Results: There was no difference in mean age between cases (49.73±8.16 years) and controls (48.23±8 years). Serum levels of NO, eNOS, TC, TG and LDL were significantly higher in cases than in controls (55.92±6.54 µmol/L v/s 49.58±6.74 µmol/L for NO; 175.4±22.92 U/mL v/s 148.6±9.77 U/mL for eNOS; 271±9.16 mg/dL v/s 177.58±6.41 mg/dL for TC; 180.70±8.48 mg/ dL v/s 107.57±8.98 mg/dL for TG ; 177.39±6.21 mg/dL v/s 98.16±8.90 mg/dL for LDL). However, serum HDL levels did not showed significant difference in case group (57.55±6.40 mg/dL) when compared with control group (57.15±5.35 mg/dL). Conclusion: The present study demonstrated that high serum levels of NO, eNOS and lipids are associated with breast cancer and thereby suggests that increased NO, eNOS and abnormal lipid profile may have a role in pathogenesis of breast cancer.

Porphyria is a relatively uncommon condition and it should be considered in patients presenting with atypical medical, psychiatric, or surgical history. Paucity of clinical recognition of porphyria often delays diagnosis and consequently treatment. Also, signs and symptoms mimic other common medical and surgical conditions. So, awareness of porphyria along with proper and accurate diagnostic tests in conjunction could be of great boon to surpass the formidable challenges put forth by porphyric patients. Here, we present a case of 24 year old woman who suffers from porphyria and ultimately dies because of inappropriateness in diagnosis on the part of physicians which is due to lack of awareness and strong clinically suspicious eye.

Aims: The aim of the study was to evaluate the status and diagnostic utility of PON1. (Paraoxonase-1) Arylesterase and nitric oxide as indicator of antioxidant status in preeclampsia. Study Design:  Analytical case control study. Place and Duration of Study: Sample: Department of obstretics and gynecology Department, G. M. C. Ambajogai, between July 2010 and July 2012. Methodology: We conducted a case-control study of 57 women with preeclampsia and 57 women with uncomplicated deliveries. We measured PON1 Arylesterase activity, Nitric oxide and lipid profile. Results: Serum levels of LDLc (low density lipoprotein cholesterol) are higher in cases than in controls and are statistically significant (p=0.023). However serum HDLc (high density lipoprotein cholesterol) levels are decreased significantly (p = 0.017). Serum PON1 Arylesterase showed significant decrease in cases152.68 KU/L versus controls 180.89 KU/L, p value=0.002.  Serum nitric oxide also showed significant decrease in cases 22.77 ± 4.792 umol/L versus controls 25.127 umol/L, p=0.010. PON1 Arylesterase activity is found to be positively correlated with serum HDL cholesterol (r = 0.449, p value< 0.001). Multivariate logistic regression analysis was done. Conclusion: Our observed results show decrease in the antioxidant PON1 Arylesterase activity point towards their role in the pathogenesis of Preeclampsia.