There is a mushrooming interest in the anti-carcinogenic property of vitamin D. However, many researches reported a conflicting result in the association of vitamin D levels to certain types of cancer. This study was designed to assess the association between vitamin D and vitamin D receptor (VDR) expression with breast cancer. This case-control study, carried out at Hospital Universiti Sains Malaysia, Kelantan, involved 69 newly diagnosed breast cancer patients and 73 healthy volunteers. Serum 25(OH)D was taken and compared between 2 groups. VDR expression in patients’ breast tissue samples was determined by immunohistochemical staining method using anti-VDR antibody. 85.5% of breast cancer patients and 97.3% of healthy control were vitamin D insufficient with a mean (SD) of 13.36 (6.96) ng/mL and 13.05 (3.71) ng/mL, respectively, and the difference was not statistically significant. VDR expression showed cytoplasmic positivity in 75.4% of breast cancer tissue, followed by both cytoplasmic and nuclear positivity in 21.5% and complete absence in 3%. There was no significant association between VDR expression and hormone receptor status. In conclusion, there was a high prevalence of vitamin D deficiency among breast cancer and healthy volunteers in our study. There was no significant association between breast cancer and vitamin D. The VDR expression in breast cancer cells showed high cytoplasmic localization.

Insulin resistance increases the risk of developing diabetes, and the degree of resistance influences the glycemic control of patients with diabetes. Numerous researchers have focused on improving insulin sensitivity in order to prevent diabetes-related complications and other chronic diseases. Several studies have also linked vitamin D levels to insulin secretion and resistance, given that both vitamin D and its receptor complex play important roles in regulating pancreatic β-cells. It has been suggested that vitamin D supplementation improves vitamin D levels, but further research is needed to confirm this as neither insulin function nor glycemic control improves when vitamin D levels increase. Magnesium is a cofactor for many enzymes. Although the role of magnesium in the management of diabetes has long been evaluated, it has not yet been determined whether magnesium supplements improve insulin function. However, several researchers have found that patients with good glycemic control have high magnesium levels. Magnesium is closely related to vitamin D and is necessary for the transport and activation of vitamin D in humans. Combined supplementation with vitamin D and magnesium improves glycemic control in patients with diabetes.

Thyroglobulin (Tg) is a precursor for thyroid hormone, specifically synthesized by thyroid follicular cells upon stimulation by the thyroid stimulating hormone (TSH). Damage to the thyroid cells caused by benign or malignant thyroid diseases cause the release of Tg into circulation. Differentiated thyroid cancer (DTC) is the most common endocrine malignancy, which has an excellent prognosis if detected and treated early. This review describes the clinical and laboratory aspects of Tg and AntiTg measurement in the management of DTC. The serum Tg measurement has been used in the pre- and post-operative management of DTC. The clinical significance of Tg and the role its low level can play in the diagnosis and monitoring of DTC as well as in the prediction of its recurrence must be understood. DTC may lead to the production of a different Tg with novel immunogenic cancer epitopes that can induce TgAb synthesis. The preoperative TgAb level has shown a high predictive value for DTC, while postoperative serum TgAb can be used for the detection of disease persistence and recurrence. Despite the importance of TgAb level in DTC management, the presence of TgAb interferes with the analysis of Tg measurement, thus limiting its clinical utility. There is no established value regarding at which level TgAb interferes with Tg measurement. Available methods in measuring Tg and TgAb should emphasize the lower and upper limits of their detection, especially for postoperative monitoring and early disease recurrence detection. The accurate measurement of serum Tg and TgAb is pertinent to the follow-up of DTC patients, and any suspicious results must be interpreted in accordance with clinical findings in view of a present possible assay interference.

Background: Glycosylated hemoglobin (HbA1c) serves as a crucial biomarker for the diagnosis and monitoring of diabetes. It can be measured via different methods. Interference during analysis can potentially arise from various factors, including rare occurrences such as hyperleukocytosis. Case presentation: Here, we present the case of a 54-year-old male patient with a 20-year history of type 2 diabetes mellitus who complained of prolonged lethargy, epigastric discomfort, and constitutional symptoms of malignancy. Further investigation revealed a diagnosis of T-cell prolymphocytic leukemia accompanied by hyperleukocytosis, indicated by a white cell count of 574.60 x 109/L with predominant lymphocytes. Chemotherapy and tumor lysis syndrome prophylaxis were initiated. During diabetic monitoring, analysis of HbA1c using capillary electrophoresis revealed an absent HbA1c peak; this has not previously been observed. To address this finding, the sample underwent repeated saline washing and centrifugation. Subsequent analysis demonstrated an improvement, with a well-fractionated HbA1c peak present at 8.7% (71 mmol/mol). Various factors can interfere with HbA1c analysis. Drug and hemoglobin variant interference was ruled out following the recovery of the peak post saline washing. The accelerated migration speed of the sample caused by interfering substances in the plasma was postulated to result in a profile shift, leading to the non-recognition of HbA1c fractions. Conclusion: By implementing the important step of washing out interfering molecules, the shift was eliminated, allowing for a true HbA1c level measurement. The appearance of an HbA1c peak post saline wash suggests the presence of endogenous substances that interfere with the assay's analytical method.

This is a case report of a 47-year old man with an unknown medical illness, presented with neurological deficits typical of clinical stroke. The Magnetic Resonance Imaging (MRI) findings were an acute left middle cerebral artery (MCA) territory infarction and an incidental finding of a sellar mass likely pituitary origin. The pituitary hormones showed markedly hyperprolactinaemia with the level of 21146 ng/ml (n 4.04 – 15.2 ng/ml), low Follicle-stimulating hormone (FSH) with a level of 0.929 IU/L (n 1.5-12.4 IU/L), and low luteinizing hormone (LH) with a level of 1.11 IU/L (n 1.7-8.6 IU/L). Other investigations of serum cortisol, growth hormone (GH), thyroid-stimulating hormone (TSH), platelet count and coagulation profiles were normal. The patient was treated conservatively in the ward for acute ischaemic stroke and later was started on dopamine agonist cabergoline for hyperprolactinaemia.