Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Archana Dambal

"Journal of clinical and diagnostic research is a welcome change in publishing practices. It aims to reach out to the grass-root level researchers who do not lack in experience, clinical material and ideas, but lack in their knowledge in English language and statistics. The journal achieves it's aim by supporting in these exact domains.
It also gives due credit to all research designs like descriptive and qualitative studies while many journals ignore these important study designs. The rigorous review process does not allow any compromise in quality
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Dr. Archana Dambal
Department of General Medicine,
Belgaum Institute of Medical Sciences,Belgaum, Karnataka,INDIA,
On 30 Nov 2018




Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2010 | Month : October | Volume : 4 | Issue : 5 | Page : 3176 - 3180

Plasma Protein Thiols, Malondialdehyde, Phosphodiesterase and RBC Acetylcholinesterase in Patients with Intrauterine Growth Restriction

*PRABHU K, #KUMAR P, °BHAT P, *RAO A, *MOHAN S, *SHARMA S

*Department of Biochemistry, #Department of Reproductive Medicine, Kasturba Medical College Manipal, Manipal University, India. °Department of Obstetrics and Gynecology, TMA Pai Rotary Hospital, Manipal University, Udupi. 2571927, Ph: 0820 2922326 (O)

Correspondence Address :
Dr.Krishnananda Prabhu, Associate Professor, Department of Biochemistry Kastutrba Medical College, Manipal, Manipal University, India -576104. E mail: krishnakunj2000@yahoo.com
Fax: 910820 2571927

Abstract

Introduction: Intrauterine growth restriction (IUGR) is a term which is used to describe a condition in which the foetus is smaller than expected, for the number of weeks of pregnancy. One of the main reasons for this condition is that the foetus is not receiving the necessary nutrients, blood and oxygen which are needed for the growth and development of its organs and tissues. Nitric oxide (NO) which acts through cyclic GMP (cGMP), plays an important role in the pathophysiology of the vascular system. So, phosphodiesterase (PDE) activity may play a role in pre-eclampsia and endothelial dysfunction. Another compound that maintains the vascular tone is acetylcholine (Ach). It exerts its effect at neuromuscular junctions and is involved with muscle contraction. The oxidant status of the cell modulates angiogenesis, which is critical for embryonic growth.
Aim: To estimate plasma phosphodiesterase, protein thiols, malondialdehyde (MDA) and RBC acetylcholinesterase (AchE) in normal pregnant women who were in their 28-36th weeks of gestation and to compare their respective levels of these parameters in pregnant women who were diagnosed with IUGR in the same time period of their gestation.
Results and Discussion: We found a significant decrease in PDE (p < 0.05) and a marginal decrease in AchE activities in patients with IUGR as compared to the controls. Both protein thiols and MDA were found to be marginally elevated in IUGR patients, thus indicating an increased turnover of Reactive Oxygen Species (ROS). Our study shows that the pathophysiology of IUGR is multifactorial and a large scale study in this matter is required to further substantiate our findings.
Key Messages:The foetoplacental circulation plays a key role in the growth and the development of the foetus. Both acetylcholinesterase and phosphodiesterase may play key roles in the growth and development of a foetus. If a definitive marker can be found in this regard, it will be of immense help to mankind. Any attempt to find such markers is worth rewarding.

Keywords

Intrauterine growth restriction; Acetylcholinesterase; Antioxidants; Phosphodiesterase

How to cite this article :

PRABHU K, KUMAR P, BHAT P, RAO A, MOHAN S, SHARMA S. PLASMA PROTEIN THIOLS, MALONDIALDEHYDE, PHOSPHODIESTERASE AND RBC ACETYLCHOLINESTERASE IN PATIENTS WITH INTRAUTERINE GROWTH RESTRICTION. Journal of Clinical and Diagnostic Research [serial online] 2010 October [cited: 2019 Aug 18 ]; 4:3176-3180. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2010&month=October&volume=4&issue=5&page=3176-3180&id=985

Introduction
Intrauterine growth restriction (IUGR) is a term which is used to describe a condition in which the foetus is smaller than expected for the number of weeks of pregnancy. A foetus with IUGR often has an estimated foetal weight which is less than the 10th percentile. There are several causes for IUGR which can be maternal, genetic, foetal, placental, etc. In all, one of the main reasons is that the foetus is not receiving the necessary nutrients, blood and oxygen which are needed for the growth and development of its organs and tissues. This abnormality prevents its cells and tissues from growing or it causes the cells to decrease in size.
Several factors are important in the maintenance of the vascular tone in the placenta. Nitric oxide plays an important role in several physiological and pathological processes, especially in the pathophysiology of the vascular system. Nitric oxide is thought to cause dilation of the placental vasculature, which is important for the blood supply of the developing foetus (1). Nitric oxide acts through the second messenger cGMP. Cyclic nucleotide accumulation has been implicated in the dilatation of the intact tonic spiral arteries of the uterus and in the relaxation of the myometrium (2),(3). So, PDE activity which is responsible for the cleaving and inactivation of these cyclic nucleotides may play a role in pre-eclampsia and endothelial dysfunction (4),(5).
Another compound that maintains the vascular tone is acetylcholine. It exerts its effect at neuromuscular junctions and is involved with muscle contraction. Acetylcholine and butyrylcholine are involved in many non cholinergic functions such as cell proliferation, cellular adhesions, fertility, foetal growth, apoptosis, etc (6),(7),(8). Human studies have shown that pyridostigmine (cholinesterase inhibitor) which is given along with infertility treatment, resulted in higher levels of growth hormone and growth factors in the follicular fluid, which resulted in higher rates of ovulation and a higher rate of pregnancy (9). Accidental exposure to pesticides (containing cholinesterase inhibitors) in a selected population resulted in a decreased incidence of low birth weight babies and a decreased incidence of abortions as compared to unexposed females in the same population, thus further indicating the role for acetylcholine in foetal growth and development (10).
Reactive oxygen species affect multiple physiological processes from oocyte maturation to fertilization, embryo development and pregnancy. The oxidant status of the cell modulates angiogenesis, which is critical for follicular growth, corpus luteum formation, endometrial differentiation and embryonic growth. The serial measurement of oxidative stress biomarkers in longitudinal studies may help to delineate the aetiology of some of the disorders in female reproduction such as preeclampsia, preterm labour, intrauterine growth retardation, etc (11),(12),(13),(14),(15). It has been reported that during pregnancy which is complicated with IUGR, malondialdehyde (MDA) concentration in the amniotic fluid was found to be almost three times more than that in normal pregnancy.
So, we sought to estimate plasma PDE, protein thiols, MDA and RBC AchE in normal pregnant women who were in their 28-36th weeks of gestation and to compare their respective levels of these parameters in pregnant women who were diagnosed with IUGR in the same time period of their gestation.

Material and Methods

The Institutional Ethics Committee gave the clearance to carry out this study. Seventeen pregnant women with IUGR (ultrasoundconfirmed), in the 28th-36th weeks of gestation, visiting Kasturba Medical College Hospital, Manipal and at Udupi TMA Pai Hospital in Karnataka, were the test subjects. Ten pregnant women, in the 28th-36th weeks of gestation with no complications, served as the controls.

Specimen
2ml of blood was collected in EDTA vacutainers.
Haemoglobin was estimated in 20 µl of the whole blood by Drabkin’s method.
The remaining blood in the vacutainer was centrifuged to separate the blood cells and plasma and the plasma was used for the estimation of protein thiols, malondialdehyde and phosphodiesterase. The seperated blood cells were washed thrice with saline and then 100µl of the washed cells were haemolysed by diluting with distilled water (1: 50). 20µl of the haemolysate was used for the assay of acetylcholinesterase.

Acetylcholinesterase (AchE) assay
The enzyme activity was typically measured by using acetylthiocholine ester as a substrate.
Acetylthiocholine thiocholine
+ acetate
Thiocholine + dithiobisnitrobenzoate 5-thio-2—nitrobenzoate (yellow colour)
The catalytic activity was measured by following the increase in the intensity of the yellow colour spectrophotometrically at 412 nm (mec: 1.361x mmol -1x mm -1). The assay was carried out at 37oC. The values of the acetylcholinesterase activity were expressed in IU/gr/ltr of haemoglobin (16).

Phosphodiesterase Assay
The hydrolysis of p-nitrophenyl phosphate results in a yellow colour due to the liberation of p-nitrophenylate at alkaline pH, which was read at 400nm at 37oC (mec: 17, 600 Mol -1x cm -1) (17).

Protein Thiols
Ellman’s reagent or dithiobisnitrobenzoate (DTNB) readily undergoes a thiol-disulphide interchange reaction in the presence of free thiol. The 2- nitro 5 - thiobenzoate di-anion has a relatively intense absorbance at 412nm (mec: 13600 M-1 cm-1), which can be used to assess thiols (18).

Malondialdehyde
MDA levels were estimated by the thiobarbituric acid (TBA) reaction. TBA reacts with MDA to form an MDA-TBA2 complex which is pink coloured. The pink coloured complex was brought to room temperature and was measured spectrophotometrically at 532nm (mec: 1.56 x 10 5 Mol -1x cm -1) (19),(20).

Results

Our studies have shown a significantly decreased activity of PDE (p < 0.05) in the IUGR cases as compared to that of the healthy controls (Table/Fig 1) . We found increased plasma protein thiols and increased plasma MDA levels, both indicating an increased turnover of free radicals (Table/Fig 1).

(Table 1) Comparison of variables between normal pregnant women and patients with IUGR of same gestational period.


*All test results were statistically analyzed by non parametric Mann Whitney Test.
† MDA = Molndialdehyde

Discussion

Both menstruation and pregnancy are inflammatory conditions that cause a degree of physiological ischaemia-reperfusion (21). The contractility of the uterine smooth muscle is essential for the cyclic shedding of the endometrial lining and also for the expulsion of the foetus during parturition (22).
Acetylcholine is a neurotransmitter which is involved in muscle contraction and in the maintaining of the vascular muscle tone. This compound is hydrolyzed by AchE which may be an indication of the activity of the neurotransmitter. As mentioned above, acetylcholine and butyrylcholine are involved in many non cholinergic functions and they may have a role in foetal growth and development (5),(6),(7),(8),(9). Our studies have shown a decrease in the AchE activity in IUGR patients as compared to normal pregnant cases, thus indicating its probable role in the female reproductive system and foetal growth.
Isoforms of the PDE family are shown to be involved in smooth muscle contraction and inflammation. PDE4 inhibitors have been shown to prevent inflammation-induced preterm delivery by countering hypoxaemic foetoplacental vasoconstriction, thus improving foetal oxygenation and nutrition (23).
The inactivation of cGMP is brought about by the enzyme, PDE. The activity of PDE may be an indication of the amount of available active cGMP and therefore, it can relate indirectly to the nitric oxide activity and therefore, to vascular maintenance.
Our studies have shown a significantly decreased activity of PDE (p < 0.05) in the IUGR cases as compared to the healthy controls [Table. 1], which probably indicate an increased turnover, leading to decreased cGMP levels which are required to maintain foetoplacental vasculature which leads to IUGR.


Pregnancy itself may predispose to increased oxidative stress, mostly because of the increased oxygen requirements and mitochondria-rich placenta (24) . Studies have shown that during advanced pregnancy, a derangement of the oxidative balance can lead to improper activation of inflammatory changes, thus triggering premature labour as well as other complications (25),(26). We found increased plasma protein thiols and increased plasma MDA levels, both indicating an increased turnover of free radicals [Table. 1].
Our study shows that the pathophysiology of IUGR is multifactorial and that a large scale study in this matter is required to further substantiate our findings.

References

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Teran E, Chedraui P, Vivero S, Villena F, Duchicela F, Nacevilla L. Plasma and placental nitric oxide levels in women with and without pre-eclampsia living at different altitudes. Int J Gynaecol Obstet. 2009 Feb; 104(2):140-2.
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Schmitz T, Souil E, Hervé R, Nicco C, Batteux F, Germain G, Cabrol D, Evain-Brion D, Leroy MJ, Méhats C. PDE4 inhibition prevents preterm delivery induced by an intrauterine inflammation. J Immunol. 2007 Jan 15; 178(2):1115-21.
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Downing JW, Ramasubramanian R, Johnson RF, Minzter BH, Paschall RL, Sundell HW, Engelhardt B, Lewis R. Hypothesis: selective phosphodiesterase-5 inhibition improves outcome in preeclampsia. Med Hypotheses. 2004; 63(6):1057-64.
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Pinheiro da Costa BE, Scocco C, Poli de Figueiredo CE, Guimarães JA. Increased serum phosphodiesterase activity in women with pre-eclampsia. BJOG. 2006 May; 113(5):577-9.
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Méhats C, Schmitz T, Breuiller-Fouché M, Leroy MJ, Cabrol D. Should phosphodiesterase 5 selective inhibitors be used for uterine relaxation? Am J Obstet Gynecol. 2006 Jul; 195(1):184-5.
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Barbosa M, Rios O, Velásquez M, Villalobos J, Ehrmanns J. Acetylcholinesterase and butyrylcholinesterase histochemical activities and tumor cell growth in several brain tumors. Surg Neurol. 2001 Feb; 55(2):106-12.
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Soreq H, Zakut H. Amplification of butyrylcholinesterase and acetylcholinesterase genes in normal and tumor tissues: putative relationship to organophosphorous poisoning. Pharm Res. 1990 Jan; 7(1):1-7.
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Patocka J, Strunecká A, Rípová D. Cholinesterases and their importance in the etiology, diagnosis and therapy of Alzheimer's disease. Cesk Fysiol. 2001 Feb; 50(1):4-10.
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Tables and Figures
[Table / Fig - 1]
JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com