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

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Department of General Medicine,
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On 30 Nov 2018




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National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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On Sep 2018




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Lucknow
On Sep 2018




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On Aug 2018




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




Dr. Mamta Gupta,
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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.
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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.
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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 : 2011 | Month : February | Volume : 5 | Issue : 1 | Page : 70 - 73

Evaluation of Serum Selenium Level in Patients With Uncomplicated Diabetes Mellitus, Raipur, India

USHA JOSHI,PD RAUT*,SK AGRAWAL,PK PATRA,BK MAHESHWARI,MANU APURB,DHIRHE TC.

*Department of Pharmacology, Pt. J.N.M. Medical College Raipur & Dr. B.R.A.M. hospital Raipur (C.G.), 492001, INDIA

Correspondence Address :
Dr Presenjit Daulat Raut (09039267377)
Asst. Prof. (Pharmacology)
Pt.JNM Medical College, Raipur, CG-492001 India

Abstract

Objective-Free radicals have important role in the pathogenesis of diabetes mellitus. In diabetes, free radical production is increased whereas capacity of antioxidant system is reduced. This study was, therefore designed to determine and evaluate the serum selenium level in patient with uncomplicated diabetes mellitus and a control group of non-diabetic individuals.
Study design- Hospital based non randomized, multistage, stratified, cross-sectional comparative study.
Material and Method- 50 uncomplicated diabetic patients (23 male, 27 female) with mean age of 49.10±6.48 years were enrolled in the study. Control group was composed of 50 healthy individual (22 male, 28 female) with mean age of 52.74 ±7.5 years. Serum selenium level was determined by using Hydride generation atomic absorption spectrometry in diabetic patients and controls.
Result – Mean serum- selenium concentration measured in uncomplicated diabetic patients (51.9±8.23 µg/lit) were significantly lower than those determined in control group (130.66±37.18 µg/lit) (p< 0.05).There was significant decrease in mean serum selenium level with increasing age. (p<0.05).No significant differences in serum selenium levels were found in relation to the sex of the patient (p> 0.05).
Conclusion- The result of this comparative evaluation confirms the relation between low serum selenium and diabetes. Significant reduction in selenium levels are indicators of metabolic response to oxidative stress in patient with diabetes. Hence, selenium can be used in diabetic patient to prevent the late complications.
The present study indicates that since it is a hospital based study, the same study should be conducted in general population (community based) to further evaluate the effect of serum-selenium in diabetes.

How to cite this article :

USHA JOSHI, PD RAUT, SK AGRAWAL, PK PATRA, BK MAHESHWARI, MANU APURB, et al.. EVALUATION OF SERUM SELENIUM LEVEL IN PATIENTS WITH UNCOMPLICATED DIABETES MELLITUS, RAIPUR, INDIA . Journal of Clinical and Diagnostic Research [serial online] 2011 February [cited: 2019 Aug 22 ]; 5:70-73. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2011&month=February&volume=5&issue=1&page=70-73&id=1134

INTRODUCTION Diabetes mellitus is a disorder with late complications including cardiovascular disease, nephropathy, neuropathy, retinopathy which affect severely the quality of life (1). Recent report indicates that free radicals have important roles in pathogenesis of diabetes and a relationship between oxidative stress and secondary complications of diabetes exists (2), (3).

Diabetes is highly prevalent affecting approximately 150 million people worldwide and this number is expected to be 300 million in the year 2025 with the greatest number of cases being expected in China and India (4).

Oxidative stress in person with diabetes is also related to decreased antioxidant defense (5). Since free radical production is increased whereas capacity of antioxidant system is reduced in diabetes, it has been proposed that diabetic patients may require more antioxidants compared to healthy individuals (6),(7).

All aerobic organisms possess some sort of antioxidant defense, with enzymatic and non-enzymatic constituents (8). Selenium is a trace element that is found in the soil and is absorbed in the food chain. The body needs small amount of it for healthy metabolism. It is an antioxidant and stop cells being damage by oxygen. Selenium is a cofactor for enzyme glutathione peroxidase. Glutathione peroxidase (catalyses the decomposition of reactive oxygen species) is a selenium-dependent enzyme. The substrate, for enzyme glutathione peroxidase is reduced glutathione, which is a specific H donor for reduction of H2O2, lipid and non-lipid H2O2 and protect the membrane lipid and haemoglobin against oxidation by peroxides (9).

Selenium modulates the cellular response and protects against oxidative stress and the production of reactive oxygen species. (10) In addition, selenium has effect on preventing decomposition, absorption and biological activity of  – tocopherol. (11), (12) Selenium and Vitamin E act as complementing each others function against oxidative stress (13), (14). Recommended daily intake of selenium in adult is 55µg/day (15).

Studies over serum selenium in diabetic population are rather limited. Therefore the present study was designed to determine and evaluate the serum selenium level in uncomplicated diabetic patients and healthy subjects so that early detection of complications, timely and appropriate interventions can be done to decrease the late complications of diabetes mellitus.

Material and Methods

1) Selection of patients:
The present study was carried out on a group of 50 serum sample from patient with uncomplicated diabetes mellitus attending the OPD / ward of medicine department in B.R.A.M. hospital, Raipur (C.G.)

The inclusion criteria for the selection of uncomplicated diabetic patients were; diabetic patient of the age between 40-70 years at the time of study, not having any complication of diabetes like diabetes neuropathy, diabetes nephropathy, diabetes retinopathy etc.

Exclusion criteria were as follows-patients with age below 40 and above 70 years, patients having any complications of diabetes mellitus, pregnant patients, patient taking multi-vitamin and anti-oxidant preparation (containing selenium).
2) Selection of controls: 50 subjects were randomly selected from hospital with age group between 40-70 years, and is non-diabetic according to 1999 WHO diagnostic criteria for diabetes.
3) Study design: it is a hospital based non randomized, multistage, stratified, cross-sectional comparative study.
4) Sample collection: after an overnight fast, venous blood samples were collected aseptically from the diabetic patients and controls via venepuncture.The blood was then centrifuged at 3000 rpm for 10 minutes to obtain serum, taking all precaution to avoid haemolysis. Serum was then frozen at -20’C until analysis.
5) Serum Selenium Estimation: Serum selenium was determined by atomic absorption spectrophotometer. A Chemito 201 atomic absorption spectrophotometer equipped with a hydride generation system and a hollow cathode lamp for selenium operating at 12mA intensity was employed.

Reduction of the selenium compounds present on the sample was carried out using 3/. NaBH4 in 1/. NaOH solution. Atomization was performed using an air-acetylene flame. Absorbance was measured using 195 nm wavelength and 1.0 nm slit width. Serum selenium estimation was measured after obtaining the calibration graph. The reading obtained are converted from parts per million to µg/ lit of selenium in all the samples obtained from uncomplicated diabetic patient and controls.
STATISTICAL ANALYSIS
The results obtained from atomic absorption spectrometer were expressed as mean± SD. Data’s were compared using chi-square test. The difference were considered to be significant when P < 0.05. Statistical analysis was done using SPSS for windows statistical software, version 8.0.

Results

50 uncomplicated diabetic patients & 50 normal healthy individuals were selected according to inclusion criteria. In the diabetic group, mean age is 49.10±6.48 years,while in control group, mean age is 52.74 ± 7.5 years. In diabetic group, 46٪ were male and 54٪ were female, while in control group 44٪ were male and 56٪ were female.(Table/Fig 1) After collection of blood sample, the serum selenium concentration was estimated in all the three groups by Hydride Generator Atomic Absorption Spectrophotometer (HGAAS).The mean serum selenium concentration in diabetic group and in control group was 51.9 ± 8.23 µg/lit and130.66 ± 37.18 µg/lit. There was a significant decrease in mean serum selenium level in diabetic group in comparison to control (P<0.05). The mean serum selenium concentration in diabetic patient in age group 41-50, 51-60yr and 61-70 yr is 57.11±7.05 µg/lit, 45.79±3.43µg/lit and 42.00 ±1.73 µg/lit respectively (Table/Fig 2). In control group, the mean serum selenium level in the age group 41-50yr, 51-60yr and 61-70yr is 171.17±23.49µg/lit, 117.82±14.70µg/lit and 86.00±8.94µg/l respectively. There was a significant decrease in the mean serum selenium levels in both the groups with increasing age. There was a significant decrease in the mean serum selenium level in 51-60 years age group when compared with 41-50 years age group (p<0.05) and in 61-70 years age group when compared with 51-60 years age group (p<0.05)(Table/Fig 3). There was no significant difference in the mean serum selenium level between males and females in the diabetic and control group (p>0.05)(Table/Fig 4).

Discussion

In the present study 50 diabetic patient and 50 controls were analyzed. We determined a significant decrease in serum selenium level of diabetic patients compare to control. The mean serum selenium concentration for the control group in the present study was 130.66  37.18 g/liter.

Similar observations were cited in the following studies:
In the Nutritional Prevention of Cancer (NPC) Trial, a selenium level of 80 ng/ ml is considered the minimum level of plasma selenium necessary in the blood stream for maximum production of selenoproteins (glutathione peroxidase, thioredoxin reductase, etc.).(16) Safaralizadeh R et al. (10) evaluated the serum concentration of selenium in 184 healthy individuals living in Tehran by hydride generator flame atomic absorption spectrometry. In adults the mean serum selenium was 100.6 ± 13 μg/lit. Navarro M et al. (17) evaluated the serum selenium concentration in 130 healthy individuals living in Spain. The mean selenium concentration in serum was 74.9μg/lit.

Cunha SD et al. (18) evaluated the serum level of selenium in healthy volunteers living in the city Rio de Janeiro. The mean serum selenium level was 73.18 ± 9.9 μg/lit. Karatas F et al. (19) found the mean serum selenium concentration of the control group to be 85.81 ± 10.84μg/lit. Nsonwu AC et al. (20) found that mean serum selenium concentration of control group in his study was 0.28  0.24 mg/lit.

In India, there are some selected reports of serum selenium concentration of healthy adults. The mean serum selenium concentration reported by Mahalingum et al.(21) is 72 ± 4 µg/lit, Srikumar et al.(22) is 125 ± 19 µg/lit., Yadav et al.(23) is 117 ± 16 µg/lit and by Gambhir and Lali et al. (24) is 133 ± 39 µg/lit.

The mean serum selenium in the study for uncomplicated diabetes mellitus) was 51.9 ± 08.23 µg/liter, which was significantly lower than the control group (p<0.05)

Karatas F et al.(19) estimated the mean serum selenium to be 67.17 ± 11.88 μg/lit, which was significantly lower than the control group (85.81 ± 10.84 g/lit) (p<0.05). Findings of several studies demonstrated that overproduction of peroxides along with emaciation of antioxidant defense system cause oxidative damage and these events in Type 2 diabetic patients are observed earlier before diabetic complications developed (25). Ruiz C et al (1998)(26) also found that the mean plasma selenium concentration in diabetic patients was significantly lower than controls (p<0.01). Diplock et al(27) reported that when diabetic complications are developed, an increase in oxidative damage and subsequently emaciation of antioxidant defense system are observed. In diabetes, there occur glycation of glutathione peroxidase and consequently functional changes of the antioxidant enzymes. Thus decreasing antioxidant status of this selenium dependent enzyme leads to more free radical production and more complication of diabetes.

Decline in physiological functions with age may influence absorption, metabolism and excretion of micronutrients Serum selenium level were significantly lower in the age group of 55-75 years than those of the age group of 40-54 years (p<0.05) in the diabetic population (20),(28),(29).
In our study, There was no significant difference in the mean serum selenium level between males and females (p>0.05).

Navarro M et al (17) found that the mean serum selenium concentration in healthy individuals did not vary significantly in relation to the sex of the subject. Significant reductions in selenium levels are indicators of metabolic response to oxidative stress in patients with diabetes.

Although glucose itself can initiate oxidative stress, deficiency of essential trace element such as selenium may exacerbate this oxidative stress in diabetic rats (30).

Conclusion

Although the results of this comparative evaluation after the collection of data and its analysis confirm the relation between serum selenium with diabetes and its complications, the result and conclusion drawn can be extrapolated to general population (community based) with suitable representative samples to further evaluate the effect of serum-selenium in diabetes.

Acknowledgement

We thank the department of Biochemistry and department of medicine Pt.J.N.M.Medical College, Raipur, for their wonderful technical support.

References

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Maxwell SRJ, Thomason H, Sandler D, Leguen C, Baxter MA, Thorpe GHG: Antioxidant status in patients with uncomplicated insulin dependent and non insulin depedent diabetes mellitus: Eur J Clin Inv:1997,27:484-490.
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Cheesman KH and Slater TF: Introduction to free radical biochemistry. Br Med Bull.1993,49(3): 481-493.
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Langenstroer P, and Pıeper GM: Regulation of Spontaneous EDRF rebase in diabetic rat aorta by oxygen free radical. Am J Physiol.1992,263:257-265.
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