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BACKGROUND Disturbance of brain iron homeostasis have been linked to acute neuronal injury following cerebral ischemia. Increased body iron stores measured as serum ferritin is an acute-phase reactant involved in cellular defence against oxidative stress and it constitutes the main intracellular iron storage protein. In a healthy population, iron excess may not be a major concern; however, in persons with high oxidative stress and dyslipidaemia, iron excess may place them at greater risk. Hence this study is undertaken to find out the role of iron in acute ischemic stroke and to estimate the iron stores, measured as serum ferritin in acute ischemic stroke patients. METHODS A minimum of 180 consecutive patients above 40 years in the acute phase of ischemic stroke within 72 hours of first episode admitted to the neurology department was selected for the study. Data collection was based on Interview method by detailed questionnaire and laboratory investigations. Quantitative determination of serum ferritin was done by immunoenzymatic colorimetric method using ELISA technique. Association of risk factors like age, gender, place of residence, history of hypertension, dyslipidaemia and diabetes between cases with elevated ferritin and normal values were analysed. RESULTS In the present study incidence of stroke was more common among patients with the age group of more than 50 years and among the 180 cases, 75 % showed elevated serum ferritin levels. Association of risk factors between cases with elevated ferritin and cases with normal ferritin were studied and it shown that history of hypertension, dyslipidaemia and diabetes were statistically significant. Multiple logistic regression showed history of hypertension and dyslipidaemia that were independent predictors of elevated ferritin levels among stroke patients. CONCLUSIONS Serum Ferritin was increased in acute ischemic stroke patients. There was significant association of factors like history of hypertension, dyslipidaemia and diabetes with elevated ferritin levels. KEYWORDS Stroke, Ferritin, Oxidative Stress, Free Radicals

BACKGROUND Over the last three decades, prevalence of stroke has been high in India, while the Western countries have witnessed a downward slide. Epidemiological studies suggest that hyperhomocysteinaemia might be a potentially modifiable nonlipid risk factor associated with stroke, in addition to the long-recognized factors like hypertension, diabetes mellitus, hyperlipidaemia and smoking. Hyperhomocysteinaemia occurs due to deviation in the metabolic pathway of methionine, attributed by deficiency of vitamins, enzymes and other factors. The present study was undertaken to assess the proportion of hyperhomocysteinaemia in patients with acute ischemic stroke. We also compared the risk factors associated with stroke and serum levels of homocysteine. METHODS This is a cross sectional observational study conducted in a tertiary care hospital. The sample size was 140. Both male and female consecutive patients of age more than 18 years, with first attack of acute ischaemic stroke admitted in the Department of Neurology were selected. Baseline fasting serum samples were obtained for testing serum homocysteine levels. Statistical tests used were proportion, chi square and logistic regression. RESULTS Among 140 acute ischaemic stroke patients, total homocysteine level was raised in 83.6 % cases. The prevalence of moderate hyperhomocysteinaemia in our study was 65.4 % and intermediate hyperhomocysteinaemia was 17.9 % among stroke patients. The mean (± SD) homocysteine level was 22.75 (± 8.19). CONCLUSIONS A strong association was found between hyperhomocysteinaemia and acute ischaemic stroke. We could not find any significant correlation between total homocysteine level and most risk factors of stroke. KEYWORDS Stroke, Homocysteine, Risk Factors, Endothelial Dysfunction, Atherosclerosis, B Vitamins

BACKGROUND Magnesium has been implicated as a key molecule in several mechanisms of migraine pathogenesis. Central neuronal hyperexcitability is suggested to be the pivotal physiological disturbance predisposing to migraine. In this study, the role of serum magnesium in defining the physiologic threshold for migraine and modulating the various mechanisms of migraine genesis was searched for. MATERIALS AND METHODS The study enrolled adult migraine patients of age 18 to 40 years (41 females and 29 males) with and without aura and healthy controls of the same age group. Serum magnesium levels measured in the interictal period (between attacks) in cases were compared with the results from controls. Serum calcium levels were also measured and compared in both groups. Design- Case-control study. RESULTS Serum magnesium was found to be significantly low among cases with migraine compared to controls. Serum magnesium levels showed inverse correlation with frequency of migraine attacks, implying the role of a decreased serum magnesium level in defining the susceptibility to migraine. Results also showed an association between serum magnesium and calcium levels. Serum calcium was found to be low when serum magnesium was low. CONCLUSION Magnesium has a fundamental role in establishing the threshold for migraine headaches.