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Percutaneous coronary catheterization and revascularization are commonly performed all over the world. Among various access sites for coronary interventions, most cardiologists favour the femoral approach, while the procedure via the radial artery is only performed by a limited number of operators. In this study, we aimed to assess the procedural outcome of the trans-radial coronary angiography (CAG) among the patients in a tertiary care hospital in Bangladesh. This prospective observational study was carried out among 40 patients underwent trans-radial coronary angiography. The study was conducted for a period of one year. Indication of CAG including chronic stable angina, unstable angina, non ST elevated myocardial infarction (MI) and ST elevated MI were observed. Procedural attempt, success rate and outcome with or without complications were mentioned. Out of 40 patients, 70% were male and 30% were female (M: F=2.3:1). Among the patients undergoing trans-radial CAG, 50% had dyslipidemia and HTN, 55% had family history of IHD, 52.5% were smoker and 20% had DM. Most of the patients underwent trans-radial CAG due to unstable angina (52.5%) and this was followed by ST elevated MI (30%), non ST elevated MI (10%) and chronic stable angina (7.5%).The mean procedural time was 19.85±1.3 minutes. The fluoroscopy time was 9.60±.9 minutes. The mean hemostasis time was 9.00±7.0 minutes. All patients were ready for discharge within 24 hours. Only 7.5% patients experienced spasm of radial artery during CAG. No other complications were detected. Trans-radial approach is an attractive alternative to conventional trans-femoral approach, in suitable patients at the hand of experienced operator, with appropriate hardwire and should be ready to cross over, to the femoral approach when needed. Keywords: Trans-radial coronary angiography; trans-femoral approach. DOI: 10.3329/uhj.v5i2.4553 University Heart Journal Vol.5(2) July 2009 pp.52-55

Background : Acute coronary syndrome (ACS) is the major manifestation of coronary artery disease (CAD), which is a major killer of mankind. The modifiable risk factors for CAD may have different impact on men and women, which may also differ in different population groups. Identification and control of conventional risk factors is expected to result in a decline in incidence of CAD similar to that seen in western industrialized countries. Method: A retrospective study of 232 consecutive patients admitted to Manipal Teaching Hospital, Pokhara between September 2009 to December 2010 by studying their hospital records for following conventional risk factors of CAD viz Body mass index, current cigarette smoking, hypertension, excessive alcohol use, diabetes mellitus and dyslipidemia. The results were analyzed by SPSS 16. Results : The important modifiable risk factors in order of descending frequency were high BMI, smoking, hypertension, excessive alcohol use, raised total cholesterol, raised triglyceride and diabetes mellitus. Smoking and excessive use of alcohol were seen in statistically significant higher percentage of cases in males. Our study further revealed that in females, unstable angina whereas in males ST elevation myocardial infarction (STEMI) was present in statistically significant higher number of cases. Conclusion: Our study showed a statistically significant higher incidence of smoking and excessive alcohol use as risk factors for ACS in males. It was also seen that in females unstable angina and in males STEMI was present in statistically significant higher number of cases. Keywords: Acute coronary syndrome; Coronary artery disease; gender difference; risk factor DOI: http://dx.doi.org/10.3126/njms.v1i1.5794 Nepal Journal of Medical Sciences. 2012; 1(1): 31-34

Background: Majority of the patients of coronary heart disease (CHD) in our country are above 40 years of age but a good number of patients belong to the age under 40, the most valuable and productive period of life during which they can devote themselves to uplift their family, society and country and can participate in nation building activities. 3,4 The number of young individuals falling into the spectrum of CHD is increasing everywhere However, this age trend is peculiar in relation to the western age incidence. 5 Our objective was to investigate the lipid profile and coronary angiographic pattern in young Bangladeshi patients with acute coronary syndrome and also to find out the relationship between dyslipidemia and coronary artery disease in this age group. Methods: This observational study was carried out in National Institute of Cardiovascular Diseases (NICVD) during the period of January 2000 to December 2000. A brief history was recorded on the date of admission and fasting lipid profile was done within 24 hours of admission. Other associated major risk factors were looked for and recorded accordingly. After stabilization oh the acute condition patient was prepared for coronary angiogram and informed consent was taken. Accordingly elective CAG was done. Among them total 64 patients of ACS, underwent coronary angiogram in the cath lab of NICVD, were selected randomly of which of which 32 patients were up to the age 40 years (Group- I) and 32 were above 40 years of age (Group-II). Patient of ACS of either sex having no age limitation were included without prior history of Percutaneous Coronary Intervention or Coronary Artery Bypass Graft surgery. The findings were reviewed and scrutinized carefully by two interventional cardiologists. In doubtful cases third expert reviewed the CD. If a consensus was not reached due to technical or visual error, the case wais discarded from the study. Details of CAG findings i.e. site and number of diseased vessels, location, morphology and pattern of lesion were studied and recorded accordingly. Results: The prevalence of dyslipidaemia and positive family history were more in group I than group II. Younger age group has less favorable lipid profile than older age group having raised total cholesterol in 31.3 percent cases, low HDL in 12.5 percent cases and raised LDL in 31.3 percent cases, while in older age group, it was 21.8, 25.0, 0 and 18.7 percent, respectively. CAG study of the patients showed that no vessel involvement was more common in group I than group II (21.9% vs 12.5%), but triple vessel disease was more common in group II (12.5% vs 21.8%). Single vessel and double vessel diseases were similar in both the groups. Involvement of LAD was slightly more in-group I than group II (68.8% vs 65.6%) and involvement of LCX and RCA were less in group I than group II (21.9% vs 34.3%, and 43.8% vs 78.1%, respectively). Diffuse LAD and RCA lesions were more in group II (36.4% vs 52.4% and 42.9% vs 48.0%, respectively), but diffuse LCX lesion was more in group I (42.9 vs 36.4%). Multiple irregular lesions are more common in older age group (53.1%) than younger age group (28.1%). Conclusion: The younger age group has less favorable lipid profile than older age group having raised total cholesterol, decreased HDL and raised LDL. CAG findings show that most of the lesions are present in LAD (having less impressive LVEF) as like as in older age group, but older age group has more multiple irregular lesions. Prevalence of >2 lesions in one coronary artery was more in group I (31 vs. 25%) but difference was not statistically significant. Keywords: Lipid profile, Coronary angiogram, Younger patients, Acute Coronary Syndrome. DOI: http://dx.doi.org/10.3329/cardio.v1i2.8237 Cardiovasc. j. 2009; 1(2): 183-188

1068 randomly sampled adult Bangladeshi people were studied during a period of six months from October 2004 to March 2005. It was a randomized, prospective study. Cases that fulfilled two criteria of metabolic syndrome (MetS) were evaluated to see pattern and types of MetS. Out of 1068 patients, 110 (10.3%) fulfilled the inclusion criteria. 101 (9.4%) cases were labeled as metabolic syndrome according to NCEP ATP III criteria, 09 cases had only two criteria. 40 cases were male & 70 cases were female (M:F= 1:1.8). Mean age of patients with was 44.88, ranging from the age of 20-68 years. Majority (55%) of the patients were in the age group of 30-49 years. Half of the cases had BMI 30-34.9. Mean body weight of male was 85.9 kg and of female was 78.2 kg. Mean waist circumference of male was 41.7 inches and of female 40 inches. Mean HDL for male was 38.3 mg/dL and for female is 40.2 mg/dL. Mean Triglyceride for male was 172.1 and for female was 169.3 mg/dL. Mean total cholesterol for male was 216.7 and for female was 207.6 mg/dL. Mean systolic blood pressure (SBP) for men is 162 mm Hg & diastolic blood pressure (DBP) 99 mm Hg and for female mean SBP 155 and DBP 96 mm Hg. Metabolic syndrome is more prevalent in the 3rd and 4th decade of life in both sexes. It is almost twice common in female than male. Combination of hypertension, obesity & dyslipidemia comprises nearly 40% of its presentation. 1. Professor and Head, Department of Medicine, Rajshahi Medical College. 2. Resident Physician (Medicine), Rajshahi Medical College Hospital 3. M. Phil Pharmacology (Thesis part) Student, Rajshahi Medical College. 4. Professor of Medicine, Rajshahi Medical College. 5. Research Assistant, Rajshahi Medical College Hospital. 6. Professor of Medicine, Dhaka Medical College. 7. Assistant Professor, Department of Medicine, Dhaka Medical College Correspondence : Prof. Quazi Tarikul Islam. Professor and Head. Department of Medicine, Rajshahi Medical College. E-mail: prof.tarik@gmail.com disease as well as increased mortality from cardiovascular disease and all causes.2-4 Beyond CVD and type 2 diabetes, individuals with metabolic syndrome seemingly are susceptible to other conditions, notably polycystic ovary syndrome, fatty liver, cholesterol gallstones, asthma, sleep disturbances, and some forms of cancer.5 Although there are divergent criteria for the identification of the MetS, they all tend to agree that the MetS core components include obesity, insulin resistance, dyslipidemia, and hypertension.6 The first formal definition of the MetS was put forth in 1998 by the World Health Organization (WHO).7 The European Group for the Study of Insulin Resistance (EGIR) published a separate set of criteria shortly thereafter. 8 In 2001, the NCEP: ATP III published a new set of criteria based on common clinical measurements: Waist circumference (WC), blood lipids, blood pressure, and fasting glucose Table-I.9 J MEDICINE 2009; 10 : 48-51

Introduction: The objective of the study is to find the relationship of obesity with dyslipidemia and Leptin levels. Material and Methods: The study was carried out in the Department of clinical Biochemistry, Bangalore Medical College. Cases and controls were chosen from the subjects attending the out patient department of Victoria hospital for their routine check up.The protocol of the study was to study and compare the linear relationship of obesity, dyslipidemia, CRP and Leptin levels is Non Diabetic obese persons to Non Diabetic persons with normal weight. The protocol was based on inclusion and exclusion criteria and is approved by local ethical committee Serum samples were stored at -200C for estimation of Leptin and CRP levels. The samples were thawed on one stretch for the estimation. Leptin was analyzed by DRG Leptin sand witch ELISA method by using kit from DRG Company. Results: About 8.0% of patients had elevated Total cholesterol in normal subjects when compared to 84.0% in Obese subjects, indicates that patients with obesity are 60.37 times more likely to have elevated Total cholesterol (>200 mg/dl) when compared to Normal. Patients with obesity (98.0%) are 46.23 times more likely to have elevated Triglycerides when compared to normal subjects (52.0%). Subjects in Obese groups, 76.0% had decreased HDL when compared to only 12.0% on Normal group, which 8.14 times more likely in obsess group. Subjects with obesity (80.0%) are 29.33 times more likely to have elevated LDL (>150 mg/dl) when compared to Normal subjects (12.0%). The elevated VLDL is 21.0 times more likely in obese subjects (84.0%) when compared to normal subjects (20.0%). Subjects in obese are 46.58 times more likely to have elevated LP (a) when compared to normal subjects. Conclusions: Present study has shown a strong link between obesity, dislipidemia and cardiovascular disease in accordance with other studies. The role of Leptin associated with cardiovascular disease is not well established, so prospective study should be carried out to elucidate the role of Leptin in cardio vascular disease and Diabetes to establish its role as, whether it is causative, additive risk factor or a protective factor. Leptin may play a role to prevent metabolic syndrome by its interaction with neuroendocrine systems to maintain metabolic homeostasis, similar to the role played by Insulin in homeostasis of blood sugar level. doi: 10.3329/blj.v1i1.2625 Bangladesh Liver Journal Vol.1(1) 2009 p.41-50

Context: Racial and sex differences are documented globally regarding patterns of serum lipids among diabetic patients. Differences of lipid profile of normal and diabetic subjects of the different ethnic groups of Bangladesh may differ. Objectives: To find out if there were any differences in the serum lipid and lipoprotein levels in the type 2 diabetic patients of two different races namely, Bangalee and Chakma of Bangladesh. Materials and Methods: Study population consisted of 76 (Chakma / Bangalee: 35 / 41) patients aged between 40-60 years with type 2 diabetes mellitus who were on follow-up at the Rangamati Diabetes Hospital, Chittagong Hill Tract, Bangladesh and forty (Chakma / Bangalee: 20 / 20) non-diabetic subjects of same age were randomly selected as control. Biochemical parameters analyzed include - Serum total cholesterol and triglyceride (TG), serum high-density lipoprotein (HDL), low-density lipoprotein (LDL) cholesterol and atherogenic index. Results: Dyslipidemia was found in the diabetic patients of both races and the patients had higher serum TG), atherogenic index and lower serum HDL than their normal counterpart. The Bangalee patients were found to have higher TG and lower atherogenic index compared with the Chakma patients although no racial differences found regarding total, HDL and LDL cholesterol. Also no differences were found between the lipid profiles of normal control subjects of these two races. Conclusion: Present study confirms that racial differences exist in serum lipid abnormalities between Chakma and Bangalee subjects with type 2 diabetes. Key words: Diabetes Type 2; Triglyceride; Lipoprotein; Total cholesterol; Bangalee; Chakma. DOI: 10.3329/jbs.v17i0.7116 J. bio-sci. 17: 113-116, 2009

A 59 years old gentleman with hypertension, type-2 DM, dyslipidemia and atheroschlerotic stenosing coronary artery disease had the rare blood group Oh ((Bombay phenotype). After prophylactic conservation of two units of predeposit autologous blood, myocardial revascularization was successfully accomplished with off pump coronary artery bypass surgery (OPCAB). Postoperative recovery was uneventful.Key words: Bombay phenotype; OPCAB DOI: 10.3329/uhj.v6i2.7258University Heart Journal Vol. 6, No. 2, July 2010 pp.110-113

Background: By the dawn of this modern era of science, the prime challenge of physician is cardiovascular diseases (CVD). The most important modifiable risk factors of CVDs are unhealthy diet, physical inactivity and tobacco use. The effects of unhealthy diet and physical inactivity include abnormal blood lipid and obesity. We tried to evaluate the lipid profile and obesity among the employees of Bangladesh Secretariat. Methods: This cross sectional type of descriptive study was carried out among 1000 employees of Bangladesh Secretariat in December, 2008. All classes of employees irrespective of age or sex were included. Body mass index (BMI) and fasting lipid profile were measured in each case. Socio-demographic variables and different related risk factors were also evaluated. Result: Out of 1000 employees with a male, female ratio of 4.75:1, 65% had sedentary life style.20.6% were smoker and only 0.05% had a history of taking alcohol regularly. 10.1% had a history of hyperlipidemia in first degree relatives. Only 2.1% were known cases of hyperlipidemia. BMI of 47% employees were in normal range with a mean 24.38 ± 3.14 SD. Mean fasting total cholesterol, LDL, HDL and triglyceride (TG) level was found 170.65 ± 39.37, 103.72 ± 30.9, 36.45 ± 5.93 and 169 ± 97.69 SD respectively. Abnormal fasting total cholesterol, LDL, HDL and TG were found in 17.3%, 48.5%, 75.6% and 48.5% employees respectively.  Conclusion: Dyslipidemia and obesity are two important modifiable risk factors of CVDs. Early detection and prevention of obesity and abnormal lipid profile can largely reduce morbidity and mortality and alleviate undue burden on our limited health budget.  doi:10.3329/jom.v10i3.2007 J Medicine 2009; 10 (Supplement 1): 3-6

Back ground: Reduction of coronary heart disease (CHD) risk through the modification of risk factors has a strong effect on clinical practice. The introduction of 3-hydroxy-3-methylglutaryl coenzyme-A (HMG-CoA) reductase inhibitors (statins) has significantly advanced the treatment of hypercholesterolemia and in reduction of cardiovascular events and total mortality rates. Among the available statins, Fluvastatin is a newer, synthetic, second generation, potent lipid lowering agent and widely accepted in diverse population. However the safety profile and efficacy was not assessed in Bangladeshi population, a population significantly different from Caucasian population where most studies were done. Current study aimed at evaluating the safety and efficacy of fluvastatin in the specified population. Methods: The study is an open-label, multicenter, quasi experimental study conducted among 162 adult patients suffering from hypercholesterolemia. After through baseline evaluation, the patients were given with Fluvastatin 80 mg once daily for 3 months. All the patients were assessed twice, before and after treatment. Data on demography, of relevant medical history and of physical examination were collected in the both the visit along with data on relevant lipid parameters (Total Cholesterol, LDL-C, HDL-C and TG) were collected at final visit. Safety was assessed by evaluating adverse events, as well as laboratory abnormalities, including liver aminotransferases. Results: Serum total cholesterol was found to be significantly reduced and across two assessments the reduction was 51.2 units (P.05). Out of 162 study participant 4.3% had their treatment interrupted, of which 1 (0.62%) had to cease treatment due to lack of efficacy, 1 (0.62%) experienced adverse event, 2 (1.24%) didn’t return to follow-up and 3 (1.86%) patients requested their physician to cease the treatment. Conclusion: Three month treatment with Fluvastatin XL 80 mg reduces most of lipid parameter of lipid profile (Total cholesterol, Triglyceride and LDL) significantly. The drug is found to be well tolerated with minimal adverse event during the course of treatment. Key words: Hypercholesterolemia; Dyslipidemia; Lipid lowering agent; Fluvastatin. DOI: 10.3329/cardio.v2i2.6631Cardiovasc. j. 2010; 2(2) : 147-155

Stroke in young age is relatively uncommon but has serious impact on the affected family as well as society. The causes are more diversed and differ as compared to the elderly. Overall prognosis is better than elderly but there is still significant morbidity and mortality. We studied consecutive 50 stroke patients between the age of 15-45 admitted in Mymensingh Medical College Hospital. The objective of this study was to evaluate the aetiological pattern, associated risk factors and inpatient outcome. Mean age of the patients was 35.8 ± 7.39 SD ( years ), female male ratio was 1 : 1.27. Infarction was found in 60% cases. Haemorrhage was in 40% cases. Dyslipidaemia was mostly associated risk factor in both infarction (83.3%) and in haemorrhage (75%). In 74% cases aetiology could not be identified. High prevalence of dyslipidemia as associated risk factor may indicate premature atherosclerosis. Overall in-patient mortality was12% .Mortality in haemorrhagic strokes is higher.  DOI = 10.3329/jom.v9i1.1419 J MEDICINE 2008; 9 : 10-15

Angiography of patients with typical chest pain reveals normal epicardial coronary arteries in about 15-20%. ECG changes suggestive of myocardial ischemia during exercise also can be demonstrated in this subset of the patients. Total 58 patients (42 females) with mean age 42±7 years who were undergoing coronary angiogram in the Department of Cardiology, University Cardiac Center, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2005 to December 2009 were evaluated. The patients were recruited on the basis of presence of history of chest pain, with normal resting ECG and ischemia like ECG changes during exercise stress test. 32.8% patients had hypertension and 15.5% were diabetics, 19.0% had dyslipidemia and 6.9% had family history of ischemic heart disease. All the patients were having positive exercise stress test. Angiographic findings showed luminal irregularities in 29.3% patients, 15.5% patients had luminal stenosis less than 30% and rest had normal coronary angiogram. Follow up of the patients after one and six months of angiogram was done. After one month 63.8% patients remained symptomatic and after six months 63.3% patients remained symptomatic despite maximum medical management. The pathophysiology and appropriate management of this subset of the patients still remained a challenge for physicians. Optimum management of cardiovascular risk factors is very important issue in this group of patients.Key words: Angiography; Epicardial coronary arteries; Exercise stress test; Cardiovascular risk factors. DOI: 10.3329/uhj.v6i1.7187University Heart Journal Vol.6(1) 2010 pp.27-31

Background: The perception of nonalcoholic fatty liver disease (NAFLD) as an infrequent and benign condition is swiftly altering in developing countries as there has been an upsurge in non alcoholic fatty liver disease in Asia-Pacific region. NAFLD develops across all age groups and societies and is recognized to occur in 14%–30% of the common population. The foremost risk factors for NAFLD such as central obesity, diabetes mellitus, insulin resistance, dyslipidemia, hypertension, hypertriglyceridemia are currently predominant and puts a very large population at risk of evolving hepatic steatosis in the coming decades . Material and Methods: It was a hospital based case control study carried out in the Department of Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between 1 st January 2010 and 31 st Dec 2010. The variables collected were age, gender, fasting blood glucose, total cholesterol, low density lipoproteins, triglycerides, high density lipoproteins, very low density lipoproteins, aspartate transaminase, alanine transaminase . Results: Of the 200 patients of non alcoholic fatty liver disease patients with diabetes mellitus, all the variables except triglycerides shows insignificant disparity in relation to gender. The perceptible difference was observed in mean values of triglycerides for cases of NALFD between diabetes (218.25 ± SD 73.68) and non diabetic subjects (177.54 ± SD73.45) (p=.0001). The mean values of HDL did not illustrate much difference in cases of NALFD with diabetes (41.54 ± SD2.13) and non diabetic subjects (44.24 ± SD2.05). Conclusion: Public health initiatives are undoubtedly of the essence to halt or turn around the global 'diabesity' pandemic, the causal basis of NAFLD. Management of patients with NAFLD should be aimed at treating metabolic risk factors such as hyperglycemia and hypertriglyceridemia . Successful lifestyle adaptation with increased exercise and decreased food intake is able to remove the accumulation of liver fat and can reverse insulin resistance. Key words: Hepatic steatosis; Diabetes mellitus; Risk factors; Nepal. DOI: http://dx.doi.org/10.3126/nje.v1i2.5135 Nepal Journal of Epidemiology 2011;1 (2):51-56

Diabetes mellitus (DM) increases the risk of cardiovascular events in patients with cardiovascular disease as well as in patients without any previous history of ischemic heart disease (IHD). This inordinate increase in the risk of coronary events in diabetic patients is attributed to multiple factors, including glycation and oxidation of proteins and increased prevalence of classic risk factors of coronary disease, such as hypertension, obesity, and dyslipidemia. Despite advances in the management of cardiovascular disease, a large proportion of diabetic subjects continue to have uncontrolled hyperglycemia, hypertension, and dyslipidemia. Patients with CAD and pre-diabetic states should undergo lifestyle modifications aimed at preventing DM. In patients with CAD and DM, routine use of aspirin and an angiotensin-converting en zyme inhibitor (ACE I) - unless contraindicated or not tolerated - and strict glycemic, blood pressure, and lipid control are strongly suggested. The results after revascularization in diabetic patients are usually worse compared with non-diabetic patients. Advances in PCI include the use of drug-eluting stents and adjunctive drug therapies, such as GpIIbIIIa antagonists. Glycemic control is an important determinant of outcome after revascularization in diabetic patients. In this review, some of these landmark studies are reviewed and some practical guidelines of management are suggested. Key words: Angiotensin-converting enzyme inhibitor; Coronary artery disease; diabetes mellitus; dyslipidemia. DOI: 10.3329/uhj.v5i2.4559 University Heart Journal Vol.5(2) July 2009 pp.75-78

Objective: To compare hospital outcomes of acute myocardial infarction (AMI) in patients with andwithout diabetes mellitus.Methodology: This observational cohort study was carried out in the department of Cardiology,Postgraduate Medical Institute Govt. Lady Reading Hospital Peshawar. A total of 444 patients with AMIwere studied from December 2009 to December 2011. Among these half of patients were diabetic whilerests were non-diabetic. After enrolment in the study, patients were monitored for in- hospital complicationsofAMI.Results: Most of the baseline characteristics were similar between the two groups of patients. Howeverpatients in diabetic group had more hypertension, dyslipidemia, high glucose level, less smoking, high heartrate and raised blood pressure on presentation as compared to patients in non-diabetic group. Complicationrates were significantly higher in the diabetic group as compared to non-diabetic group. Complication ratesbetween diabetic and non-diabetic groups were atrial fibrillation (AF) 14.4% V 8.1%; P=0.036 respectivelywhile ventricular tachycardia (VT) 10.8% V 13.1% ;P=0.464, ventricular fibrillation (VF) 3.2% V 4.1 %;P=0.611, advanced AV blocks 12.2%V 6.3% ;P=0.033, acute heart failure (AHF) 24.8% V 17.1% ;P=0.047,cardiogenic shock(CS) 18% V 7.2%;P=0.001, recurrent MI (Re-MI) 14.4% V 7.7%; P=0.000, acute renalfailure 9%V5%; P=0.001 and death rate 13.5 % V 8.1 %; P=0.000 respectively.Conclusion: Diabetes mellitus is associated with an increase risk of in-hospital complications afterAMI.Key words: Diabetes mellitus, hospital Outcomes,Acute Myocardial Infarction

Introduction: Down Syndrome (trisomy 21) provides an interesting natural model to study atherosclerosis, since these individuals appear to be protected from plaque formation. Methodology: We assessed the lipid levels, and superoxide dismutase (SOD) activity in 32 clinically diagnosed children of Down syndrome and 34 children matched for age and sex as controls. Results: SOD activity was found to be significantly higher (p=0.004) in children with Down Syndrome (mean=313.7 IU/ml) than in controls (mean140.2 IU/ ml). Significantly higher levels of serum triglyceride (154.7 mg/dl) and VLDL (33.9 mg/dl) were observed in Down Syndrome as compared to healthy controls (119.6 mg/dl and 23.9 mg/dl respectively; p

Background: Brain natriuretic peptide (BNP) reflects left ventricular pressure. It increases in systolic dysfunction. Our aim was to evaluate role of plasma BNP level in early diagnosis of left ventricular isolated diastolic dysfunction. Methods: We studied 60 patients (male=18, female=42) with hypertension, diabetes mellitus, ischemic heart disease, dyslipidemia. The Doppler parameters used for evaluation of diastolic dysfunction are: isovolumetric relaxation time (IVRT), Transmitral flow velocities (E/A) ratio, deceleration time (DT) & pulmonary vein Doppler findings. 49 patients (group-1) had diastolic dysfunction whereas 11 patients (group-2) had normal flow patterns. Plasma BNP level was done in all patients. Results: Mean plasma BNP levels were 40.41±6.82 pg/ml in individuals with normal filling patterns and 183.36±25.28 pg/ml in subjects with abnormal diastolic dysfunction (p

BACKGROUND: Beta thalassaemia is the most common frequent hereditary blood disorderthroughout the world. Changes in lipid levels have been seen in different types of beta thalassaemia.OBJECTIVE: The aim of study was to evaluate the lipid profile (serum cholesterol, HDL, LDL, serumtriglyceride) in beta-thalassemia major patients and to compare the lipid profile of beta-thalassemiamajor patients with healthy controlsMATERIALS AND METHODS: In the present study we included clinically diagnosed 45 patients ofbeta thalassaemia major. The levels of Cholesterol, Triglyceride, HDLc, LDLc, VLDLc, were measuredby using latest techniques in clinical biochemistry laboratory.RESULTS: Our study revealed that in thalassaemic patients lipid pattern became altered had high levelof triglyceride, low level of cholesterol and low HDL-cholesterol levels and conclude that thalassaemicpatients are at risk of coronary heart disease .CONCLUSION: Significant variations were found which confirm that lipid changes occur in Bthalassaemic patients when Total cholesterol, Serum triglycerides, Low density lipoprotein cholesterol,high density lipoprotein cholesterol levels are compared with normal healthy subjects. Multiple factorssuch as age, iron overload, hormonal changes and liver injury might cause these changes. As this studyfocus on lipid abnormalities in beta thalassaemia major, this may help clinicians in the management ofsuch patients.KEYWORDS: Total Cholesterol (TC), Triglyceride (TG), High density lipoprotein (HDL), Lowdensity lipoprotein (LDL), Beta thalassaemia major.

UNLABELLED Objective : This study aims to observe the risk factors of cardiovascular disease in patients after kidney transplantation. METHODS Total 102 patients after renal transplantation (group A) and 96 clinic examination cases (group B) were recruited. Blood pressure, blood urea nitrogen (BUN) and creatinine (Cr), blood glucose (GLU), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and apolipoprotein A-I ( apoA-I ) of the subjects were tested. These indexes were tested 3 times in group A in the 1, 2, and 3 month after kidney transplantation surgery. Electrocardiogram examination was done in the third month after kidney transplantation surgery. RESULTS There were significant differences in the incidence of hypertension, hyperglycemia and dyslipidemia between the two groups. After operation, the levels of BUN and Cr decreased significantly in 57 cases of group A without taking antihypertensive drugs (P

Background and Objectives: Diabetes mellitus, hypertension, obesity and dyslipidemia are the integral components that constitute metabolic syndrome. It has emerged as cause of substantial mortality with gender difference. To compare the gender characteristics of metabolic syndrome in subjects of type 2 diabetes mellitus. Methods: This observational comparative prospective study was conducted in medical ward of BVH Bahawalpur over period of 6 month from January 2014 to June 2014. Sample size of 100 diagnosed cases of type 2 diabetics (comprising equal number of males and females) were collected. As defined by WHO and IDF, variables of metabolic syndrome studied were BMI, hypertension, hyperglycemia and hyperlipidemia. The lipid values were interpreted in normal or high risk category by applying NCEP ATPIII criterion. Fasting sample were collected for sugar and lipid profile. Anthropometric, demographic and biochemical data was tabulated. Continuous and categorical variables were displayed as mean ± standard deviation and percentage respectively. Student ‘t’ test was use to assess the difference for the lipid profile at 5% significance level. Results: Female patients were found to be overweight, hypertensive and had uncontrolled hyperglycemia as compared to male subjects. Their systolic blood pressure was 150±25.75 and diastolic was 90±17mm/hg. The mean blood glucose concentration was 246.64±105mg/dl. In age group 35-44 years, the mean triglycerides and cholesterol levels in females were 184.54±42.05 and 192.5±34mg/dl respectively. HDL-C was 33.2±5.19mg/dl. In females with age group of 45-54 years, the mean concentration of triglycerides, total cholesterol and HDL-C were 217.75±77.6mg/dl, 190.95±14.4mg/dl and 31.75±3.8mg/dl respectively, and all were in high risk category when compared to cut off values determined by NCEP/ADA. While in females of age group 55-64 years, the values of TGs, total cholesterol and HDL-C were 204±154.11mg/dl, 200.09± 47.8 mg/dl and 33.4±4.6mg/dl respectively and again all these values were significantly raised. Conclusion: Female genders were affected in all respects. They had higher BMI, hypertension, hyperglycemia and hyperlipidemia as compared to male counterparts.

Coronary heart disease (CHD) is the cause of 7,3 million death globally in 2008. The main pathophysiology process that leads to CHD is atherosclerosis which is caused by high LDL cholesterol level. The aim of this study was to explore bay leaf and celery leaf infusion effect on reducing LDL cholesterol level in dyslipidemic rat model. The type of this study was true experimental research using wistar rat (Rattus novergicus) as the sample. The rats were induced by high fat diet and PTU for two weeks then each of the group were given either bay leaf infusion, celery leaf infusion, simvastatin (positive control), or aquadest (negative control) for a week. The measurement of LDL level used Friedewald formulation. Data was analyzed using paired sample t test and one way ANOVA. As the result there was a significance reduction on LDL level after treatment with bay leaf (p=0,013) and celery leaf infusion (p=0,035) but there was no significance difference between groups (p=0,293). It was concluded that bay leaf and celery leaf infusion could reduce the LDL level in dyslipidemic wistar rat but there was no difference on the capability of the two different leafs on reducing LDL level. Keywords: dyslipidemia, LDL, bay leaf, celery leaf, wistar rats

Type 2 diabetes mellitus is a condition in which a large part of the population has obesity, hypertension and dyslipidemia. These imbalances must cover these multiple metabolic abnormalities, which, in addition to preventing the onset of diabetes, would also be avoiding cardiovascular diseases and reducing mortality. Wounds with difficulty in healing usually do not progress through the normal healing process. Wounds often enter a state of pathological inflammation due to a prolonged, incomplete or uncoordinated wound healing process. Most chronic wounds are ulcers that are associated with ischemia, diabetes mellitus, venous disease, or pressure. Several studies have produced extensive knowledge about normal and poor wound healing. But there is still much to be learned, these studies can lead to innovative therapies that promote proper tissue repair and improve poor wound healing. Many of the biochemical changes observed in the pre-diabetic state (ie, storage of ectopic lipids, increase of acylcarnitines, increase of branched chain amino acids) are also observed in patients with rare inborn errors of fatty acids and amino acid metabolism, an interesting question is whether defects of isolated metabolic genes may confer an increased risk for T2DM. Many of the biochemical changes observed in the pre-diabetic state (ie, storage of ectopic lipids, increase of acylcarnitines, increase of branched chain amino acids) are also observed in patients with rare inborn errors of fatty acids and amino acid metabolism, an interesting question is whether defects of isolated metabolic genes may confer an increased risk for T2DM. Taking into account that diabetes is currently considered an immunological disorder and that the oxidative stress generated in DM2 is directly related to the inflammation and difficulty of healing diabetic foot ulcers (DFU).This review will discuss possible cellular and molecular mechanisms involved in wound healing in patients with T2DM.

Objective: To study the frequency of known risk factors for stroke in poor patients of Swat district. Design: prospective, descriptive hospital based study. Setting: Saidu teaching Hospital Saidu Sharif district Swat. Subjects and Methods: All poor patients admitted to the general medical ward of Saidu teaching Hospitalduring June 2005 to May 2007 were included in the study.Type of stroke was identified by C.T.scan. Risk factors for stroke and other relevant information wasrecorded on properly designed proforma. The data was analyzed on SPSS Results: Data of 134 patients, 75 male and 59 females was collected. 92 patients (70%) had cerebralinfarction, 30 patients (23%) had cerebral haemorrhage. 12 patients had normal C.T scan (non enhanced).Most patients had more than one risk factor. Hypertension was present in 61%, smoking 50%, sedentaryhabits 38%, diabetes 33%, dyslipidemia 32 %, coronary artery disease 22 %, obesity 11%, alcoholism 2%and carotid artery stenosis 5%. In hospital mortality was 20%. Eighty eight percent of patients weredependent at the time of discharge for their daily activities. Conclusion: Hypertension, smoking and diabetes are major risk factors for the development of stroke ingeneral poor population. All aims of primary and secondary prevention should address these major riskfactors. Most of the patients become dependent and it is very important to develop stroke units,physiotherapy programs and rehabilitation centers to reduce morbidity due to stroke in a poor community. Key Worlds: Stroke, Risk factors,Swat District.