Search

Introduction Atherosclerosis mediated by inflammatory markers is the corner stone in the pathology of coronary artery disease (CAD). Hyperlipidemia, one of the risk factors is treated with statins. Statins also have a pleotropic role in reducing inflammation. Effect of statins on two inflammatory markers pentraxin 3(PTX 3) and high sensitivity C-reactive protein (hs-CRP) is explored in this study. Objective This article estimates the levels of serum PTX 3 and hs-CRP in CAD patients with and without statin therapy and correlates the levels with low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) in CAD patients without statin therapy. Material and Methods This was a cross-sectional study conducted on 62 patients with CAD diagnosed by coronary angiogram. They were divided into two groups. Group I were the CAD patients on statin therapy and group II were CAD patients who never had any lipid lowering drugs irrespective of their lipid values. Serum PTX3, hs-CRP, and lipid profile were estimated in these groups. Comparison between the groups was done using Student's t -test and correlation analyzed using Pearson's correlation. Results Serum PTX 3 and hs-CRP levels were higher than the reference range in both the groups. But group I showed significantly low PTX 3 levels (p -value = 0.032) compared with group II. There was a significant positive relationship between PTX 3 and LDL-c (p = 0.003) in group II. Conclusion CAD patients on statin therapy have lower vessel wall inflammation compared with patients without statin therapy. [ABSTRACT FROM AUTHOR]

Hypertriglyceridemia associated acute pancreatitis is a medical emergency and it causes significant morbidity and mortality. Here we report a case of 47 years old male with hypertriglyceridemia associated acute pancreatitis. The diagnosis was confirmed by elevated serum triglyceride levels and elevated lipase levels. Initially, Insulin infusion started with fibrates and statins but due to worsening hypertriglyceridemia and he underwent one session of plasmapheresis, following which triglyceride levels improved. Triglyceride assessment in removed plasma in plasmapheresis showed that the amount of triglyceride level reduction was 4 times the amount removed in plasmapheresis. The study showed that plasmapheresis improves insulin-related triglyceride metabolism besides removal. [ABSTRACT FROM AUTHOR]

Byline: Satyaki. Ganguly, Lopamudra. Ray, Sheela. Kuruvila, Sunil. Nanda, Kandasamy. Ravichandran Background: Psoriasis has well-known associations with individual components of metabolic syndrome such as hypertension, dyslipidemia, insulin resistance, and obesity. [...]

Background: Atherosclerosis being the keystone in the pathology of coronary artery disease (CAD) is a chronic inflammation of arterial intima mediated by various inflammatory markers. Pentraxin 3 (PTX3) and high-sensitivity C-reactive protein (hs-CRP) are the two important biomarkers of chronic inflammation that causes atherosclerosis. Aims: This study aims to investigate the association of serum PTX3 and hs-CRP with the severity of coronary stenosis in patients undergoing coronary angiogram. Subjects and Methods: A total of 80 patients who underwent elective coronary angiogram were included. Their blood sample was collected for PTX3 and hs-CRP estimation prior to angiogram. Based on the angiogram, the participants were divided into four groups based on the number of arteries affected. PTX3 was estimated using enzyme-linked immunosorbent assay and hs-CRP was assayed using latex-enhanced immunosorbent assay. Statistical Analysis Used: Kruskal--Wallis test was used to find the association of PTX3 and hs-CRP in each group and Pearson's correlation was used to correlate PTX3 and hs-CRP with the extent of stenosis. Results: The mean PTX3 and hs-CRP levels in patients with some lesions in the coronary artery were 231.5 ± 129.9 pg/mL and 2.4 ± 0.4 mg/mL, respectively. The PTX3 levels elevate gradually with the severity of stenosis with P = 0.000 which is highly significant. A strong positive correlation was observed (R = 0.7929, P < 0.00001) with PTX3 and severity of stenosis. Whereas, for hs-CRP, the correlation was weaker (R = 0.3011, P = 0.006). Conclusions: PTX3 and hs-CRP can not only predict the number of arteries affected but also can differentiate between normal coronaries and CAD which can minimize the use of angiography. [ABSTRACT FROM AUTHOR]

Membranous nephropathy constitutes 30% of adult nephrotic syndrome. Of all cases of membranous nephropathy, primary membranous nephropathy is commonest. Mercury is known to be a cause of secondary membranous nephropathy. There is no human data on the pathophysiology of mercury-related membranous nephropathy, but animal studies suggested an autoimmune mechanism behind it. There is no data to the best of our knowledge about target antigen for mercury-related membranous nephropathy. We are reporting a case of NELL-1 positive mercury-related membranous nephropathy that started resolving after stopping siddha medication and taking antiproteinuric. There was also concomitant euthyroid lymphocytic thyroiditis with anti-TPO positive, which started after exposure to siddha medication, which suggests systemic autoimmune phenomenon due to mercury exposure. [ABSTRACT FROM AUTHOR]

Aim: To assess role of vitamin D‐calcium supplementation on the metabolic profile and oxidative stress in women with Gestational Diabetes Mellitus (GDM) controlled on diet. Methods: A randomized controlled trial was conducted at a tertiary care teaching hospital. Seventy women diagnosed as GDM at 24–28 weeks of gestation, controlled on a diabetic diet, were randomized to receive either vitamin D 1000 IU and calcium 1000 mg (group A, n = 34) or vitamin D 250 IU and calcium 500 mg (group B, n = 36) daily for 6 weeks. Levels of serum 25‐hydroxy vitamin D, fasting plasma glucose (FPG), serum insulin, fasting lipid profile and total glutathione (GSH) were analyzed both prior to and after supplementation. Means, standard deviations and mean change were computed. Paired and independent t‐tests were used to determine statistical significance between the two groups. Results: Women in group A showed a significant reduction in FPG level (P‐value = 0.007), fasting serum insulin level (P‐value = 0.000), LDL (P‐value = 0.000), total cholesterol levels (P‐value = 0.000) and increase in HDL levels (P‐value = 0.000). Group B had a significant fall only in FPG after 6 weeks supplementation. A significant change in total glutathione level (P‐value = 0.000) was observed in both groups. Conclusion: Vitamin D and calcium supplementation at a dose of 1000 IU and 1000 mg, respectively, has a beneficial role in glucose metabolism, lipid metabolism and oxidative stress in GDM. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular diseases (CVDs) are major problems in India and many other developing and developed countries. As India is committed to provide universal health care for the population, there is a need to find out the prevalence and determinants of CVD risk among high-risk individuals (Diabetes and Hypertensive patients) in the remote rural area of India to deliver appropriate services, as they are considered as neglected population. Methods: We screened high-risk individuals (Hypertension and Diabetes patients) for CVD risk using WHO/ISH chart, in a remote rural area of south India, covering ten villages surrounding the Rural Health Training Centre (RHTC), in August–September 2017. After line-listing the participants from the electronic database of RHTC, screening with questionnaire and biochemical tests was done at village level as the first step. Thereafter, the participants were invited to the hospital on a particular day where electrocardiography (ECG) and echocardiography (ECHO) were done with special consultation. Results: Among the total of 303 individuals screened at the village level, 64 [21%(CI 17–25)] had a higher risk for CVD. 235 people attended the special consultation; among them, 212 underwent ECG and 88 underwent ECHO. Among those screened with ECHO, 18 had some cardiac pathologies. The relationship between CVD risk and other factors is shown in. After final adjustment, illiteracy [adjusted prevalence ratio (aPR) 1.8 (0.1–3.1)], anemia [aPR 1.8 (1–3.6)], and chronic renal diseases [aPR 1.8 (1.0–3.4)] were found to be associated with high risk for CVD among hypertension and diabetes groups. Conclusion: Cardiovascular disease risk assessment using WHO/ISH chart showed an association with poor education, anemia, and chronic kidney disease. [ABSTRACT FROM AUTHOR]

Background: As committed by India in Global Action Plan, Sustainable Development Goals and National Health Policy 2017, India has the responsibility to provide accessible, affordable noncommunicable disease care to the people. Our study aimed to find out the burden of cardiovascular risk factors among hypertension and diabetic patients, through a community-based screening, in a remote rural area of South India. Methods: A special program named "Chunampet Rural–Cardiovascular Health Assessment and Management Program" (CR-CHAMP) was launched in August and September 2017 in a Rural Health Training Center (RHTC), functioning under a private medical college in South India. In this program, participants with hypertension (HT) and diabetes (DM) were line listed from 10 remote villages, and then history, initial biochemical, hormonal, and hematological screenings were done to assess the cardiovascular diseases (CVDs) risk factors among these patients, following which special consultation was offered in RHTC. Results: Out of 415 eligible patients with HT and DM, 389 were approached; among them, 328 were willing to participate and were screened initially; among them, 235 were attended special consultation. Higher CVD risk was found in 21%. Prevalence of chronic kidney disease was 14%, deranged lipid profile was more than 50%, metabolic syndrome was 49%, anemia was 68%, abnormal waist-hip ratio was 56%, abdominal obesity was 59%, and overweight and obesity using body mass index (BMI) was 59%. Females' participation was more in our community-based screening procedure (66%) than male participation (34%). Conclusion: CR-CHAMP demonstrated feasibility and value of implementing a screening program for high-risk individuals with HT and DM for CVD risk through existing primary care in a remote rural area of South India. This will help the National Program and policymakers to plan for interventions in the remote rural area in future. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is a leading cause of mortality and morbidity worldwide, whose incidence is rapidly increasing in India. T2DM is caused by varying degrees of insulin resistance (IR) and relative insulin deficiency. Leptin, an adipokine with the primary function of regulating energy balance, is found to mediate insulin secretion and sensitivity in peripheral tissues. Hence, we aimed to determine the role of leptin in the development of IR in newly diagnosed T2DM patients. Aim: This study aims to compare the leptin levels and homeostatic model assessment-IR (HOMA-IR) levels in the study population. Material and Methods: The study included a total of sixty patients newly diagnosed with T2DM. Their fasting blood samples were collected to estimate the glucose, insulin, and leptin levels. IR was calculated using HOMA-IR formula. Statistical analysis was done by Pearson's correlation, Spearman's correlation, and One-sample Wilcoxon Signed Rank test. Results: Leptin and HOMA-IR levels were significantly high in T2DM patients (P < 0.001) when compared with reference values. Body mass index showed a significant positive correlations with insulin (r = 0.40, P < 0.01), HOMA-IR (r = 0.37, P < 0.01), and leptin levels (r = 0.90, P < 0.01). Leptin levels showed significant positive correlations with plasma insulin (r = 0.35, P < 0.01) and HOMA-IR levels (r = 0.31, P < 0.05). The correlation between leptin and HOMA-IR levels was more pronounced and significant among the obese T2DM subjects (r = 0.82, P = 0.01). Conclusion: Hyperleptinemia reflecting leptin resistance plays an important role in the development of IR in obeseT2DM patients, making leptin a possible biomarker for the same. [ABSTRACT FROM AUTHOR]

Background: One of the risk factors for the development of coronary heart disease is high low-density lipoprotein (LDL) cholesterol levels. National Cholesterol Education Program ATP III guidelines suggest drug therapy to be considered at LDLcholesterol levels >130 mg/dl. This makes accurate reporting of LDL cholesterol crucial in the management of Coronary heart disease. Estimation of LDL cholesterol by direct LDL method is accurate, but it is expensive. Hence, We compared Friedewald's calculated LDL values with direct LDL values. Aim: To evaluate the correlation of Friedewalds calculated LDL with direct LDL method. Materials and Methods: We compared LDL cholesterol measured by Friedewald's formula with direct LDL method in 248 samples between the age group of 20-70 years. Paired t-test was used to test the difference in LDL concentration obtained by a direct method and Friedewald's formula. The level of significance was taken as P < 0.05. Pearsons correlation formula was used to test the correlation between direct LDL values with Friedewald's formula. Results: There was no significant difference between the direct LDL values when compared to calculated LDL by Friedewalds formula (P = 0.140). Pearson correlation showed there exists good correlation between direct LDL versus Friedewalds formula (correlation coefficient = 0.98). The correlation between direct LDL versus Friedewalds calculated LDL was best at triglycerides values between 101 and 200 mg/dl. Conclusion: This study indicates calculated LDL by Friedewalds equation can be used instead of direct LDL in patients who cannot afford direct LDL method. [ABSTRACT FROM AUTHOR]

Background: A controversy exists regarding the association between subclinical hypothyroidism (SH) and dyslipidemia. Moreover, studies on lipid ratios and atherogenic index of plasma (AIP) in SH are rare, particularly in the Indian scenario. Aim: This study aimed to investigate abnormalities in conventional lipid profile, lipid ratios, and AIP in SH and attempted to correlate thyroid stimulating hormone (TSH) and AIP in SH. Materials and Methods: In this retrospective analysis of patient records of SH subjects and euthyroid subjects, age, free triiodothyronine, free thyroxine, TSH, total cholesterol, triglycerides, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol, lipid ratios, and AIP were compared between the two groups. The correlation of TSH and AIP in SH was studied. Spearman's correlation, Mann-Whitney U-test and logistic regression analysis were performed. Results: Triglyceride, triglyceride/HDL-C, and AIP were significantly higher in SH as compared to euthyroid group, but there was no correlation between TSH and AIP in SH. AIP emerged as the significant single factor associated with SH in multiple logistic regressions. Conclusion: The positive association of dyslipidemia and SH indicates a need for regular screening of these patients to enable early diagnosis and treatment of dyslipidemia. Even in patients who have a normal conventional lipid profile, lipid ratios, and AIP have to be calculated for better assessment of atherogenic risk. [ABSTRACT FROM AUTHOR]

The study was undertaken to study the maternal risk factors associated in the development of sepsis neonatorum (neonatal sepsis). The study was conducted in 70 neonates. Out of these 70 neonates, 27 were cases of neonatal sepsis and 43 served as controls. The maternal risk factors undertaken in the study were maternal age, parity, premature rupture of membranes (PROM), meconium stained amniotic fluid (MSAF), preeclampsia, foul smelling liquor, antepartum hemorrhage (APH), Intrapartum fever, maternal educational status. Out of these maternal factors, premature rupture of membranes (PROM), meconium stained amniotic fluid (MSAF), Intrapartum fever, Preeclampsia, foul smelling liquor showed statistically significant association with development of neonatal sepsis and maternal factors like maternal age, educational status, parity and antepartum hemorrhage (APH) were not associated with the development of neonatal sepsis. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies indicate a higher prevalence of metabolic syndrome in psoriatic patients. This study aimed to investigate the association of metabolic syndrome and its components with psoriasis. It also studied the relation between presence of metabolic syndrome and disease duration in psoriasis patients. Materials and Methods: This was a hospital-based, case control study conducted with 30 clinically diagnosed patients of chronic plaque psoriasis and 30 age- and sex-matched control subjects. Height, weight, BMI, blood pressure and waist circumference were assessed in all the subjects. Fasting levels of serum glucose, serum triglycerides and serum HDL were estimated by automated clinical chemistry analyser. Metabolic syndrome was diagnosed by the presence of at least 3 criteria of NCEP ATP III with Asian modification for waist circumference. results: Metabolic syndrome was more common in psoriatic patients than in controls but the difference was statistically insignificant (60% vs. 40%, p-value=0.12). The psoriasis group had a higher prevalence of elevated blood glucose levels and higher waist circumference compared to controls. Psoriasis patients had a higher prevalence of high triglyceride levels than controls, the difference being statistically insignificant (40% vs. 30%, p-value = 0.41). The prevalence of low HDL levels was significantly higher in cases compared to controls (86.7% vs. 60%, p-value = 0.02). There was no relation between presence of metabolic syndrome and duration of psoriasis. conclusion: Our findings suggest that metabolic syndrome as well as dyslipidaemia is commoner in psoriasis patients. This underlines the need for screening of all psoriasis patients for early diagnosis and treatment of associated metabolic syndrome to reduce the high burden of morbidity and mortality. [ABSTRACT FROM AUTHOR]

Context: Frequent incidence of early postoperative memory impairment (POMI) after cardiac surgery remains a concern because of associated morbidity, impaired quality of life, and increased health care cost.Aim: To assess the effect of preoperative statin therapy on POMI in patients undergoing off-pump coronary artery bypass (OPCAB) surgery.Setting and Design: Prospective observational study in a tertiary level hospital.Methods: Sixty patients aged 45-65 years undergoing OPCAB surgery were allocated into two groups of 30 each. Group A patients were receiving statin and Group B patients were not receiving statins. All patients underwent memory function assessment preoperatively after admission to hospital and on the 6 th postoperative day using postgraduate institute memory scale.Statistical Analysis: Appropriate tests were applied with SPSS 20 to compare both groups. The value P < 0.05 was considered statistically significant. Multiple regression analysis was performed with confounding factors to determine the effect on memory impairment.Results: Patients in Group A showed significant postoperative deterioration in 6 of the 10 functions and in Group B showed deterioration in 9 of 10 functions tested compared to preoperative scores. Intergroup comparison detected less POMI in Group A compared to Group B and was statistically significant in 8 memory functions. Multiple regression analysis detected statin as an independent factor in preventing memory impairment.Conclusions: Preoperative statin therapy attenuates the early POMI in patients undergoing OPCAB. Future long-term studies will define the efficacy of statin on POMI. [ABSTRACT FROM AUTHOR]

Background: Hepatic diseases are common among chronic kidney disease patients and liver function tests particularly serum liver enzymes play an important role in diagnosing and monitoring these patients. Serum aminotransferase levels commonly fall near the lower end of the range of the normal values in patients of chronic kidney disease (CKD). High-levels of serum alkaline phosphatase (ALP) can occur in these patients due to renal osteodystrophy. Thus, the recognition of liver damage in these patients is challenging. Aim: To compare the levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and ALP among three groups - CKD patients without end stage renal disease (ESRD), patients with ESRD and healthy controls. Materials and Methods: A retrospective, hospital-based study was carried out from 100 patients' records from each group and serum AST, ALT and ALP values were noted. Results: Our study showed that serum AST and ALT levels were significantly lower in CKD patients both without and with ESRD compared to controls. Further, these two enzyme levels were also significantly lower in CKD patients with ESRD compared to CKD patients without the condition. Serum ALP levels were significantly higher in patients with and without ESRD as compared to the controls. However, the values did not differ significantly between patients with and without ESRD. Conclusion: Levels of serum aminotransferases were low in CKD with and without ESRD and the levels become lower as the severity of CKD increases. Thus, the study established the need for separate reference ranges of serum aminotransferase in different stages of CKD. [ABSTRACT FROM AUTHOR]

This article describes a radiographic case study of a four-year-old male child with a ventricular septal defect associated with left ventricular outflow tract (LVOT) obstruction. Topics discussed include the clinical outcome of the patient, findings of the transthoracic echocardiography (TTE) done on the patient, and patient outcome. Also explored is a controversy surrounding the surgical management of LVOT obstruction.

Introduction: The introduction of a new method or new analyser is a common occurrence in clinical biochemistry laboratory. Blood gas measurements and electrolytes are often performed in Point-of-Care (POC) settings. When a new POC analyser is obtained, the performance of the analyser should be evaluated by comparison to the measurements with the reference analyser in the laboratory. Objectives: Evaluation of method performance of pH, PCO2, PO2, Na+, K+ of cobas b121 ABG analyser. Materials & Methods: The evaluation of method performance of pH, PO2, PCO2, Na+, K+ of cobas b121 ABG analyser was done by comparing the results of 50 patient samples run on cobas b121 with the results obtained from Rapid lab values (reference analyser). Correlation coefficient was calculated from the results obtained from both the analysers. Precision was calculated by running biorad ABG control samples. Results: The correlation coefficient values obtained for parameters were close to 1.0 indicating good correlation. The CV obtained for all the parameters were less than 5 indicating good precision. Conclusion: The new ABG analyser, Cobas b121 correlated well with the reference ABG analyser (Rapid Lab) and could be used to run on patient samples. [ABSTRACT FROM AUTHOR]

Body stalk anomaly or Limb Body Wall Complex (LBWC) is rare and fatal developmental polymalformation, with at least two of the following features: exencephaly and facial clefts, thoraco and/or abdominoschisis (midline defect) and limb defect with an incidence of one in14,000 to 1 in 75,000 pregnancies. A 25 year old gravida two, abortion one presented at 20 weeks of gestation with an ultrasound report showing abdominal wall defect with herniated abdominal contents floating in amniotic fluid, gross thoraco-lumbar kyphoscoliosis, multiple vertebral anomalies, right clubfoot and continous juxtaposition of fetus to placenta. Pregnancy was terminated to expell a live male abortus (250gm) with placenta. Fetal autopsy confirmed clinical and scan diagnosis of LBWC. [ABSTRACT FROM AUTHOR]

Objective: The complaints of excessive menstrual bleeding (menorrhagia) have a substantial impact on the gynaecological services and in most of the cases, no organic pathology is identified. Nonsteroidal anti-inflammatory drugs and tranexamic acid offer a simple therapy which has to be taken during menses, with reductions of 25-35% and 50% respectively in the Menstrual Blood Loss (MBL). Danazol and the gonadatrophin-releasing hormone analogues are highly effective, but their side-effects make them suitable only for a short-term use. In the present study, the role of ormeloxifene was studied in patients of DUB. Materials & Methods: The subjects were diagnosed cases of DUB. After ruling out the possible causes of the abnormal uterine bleeding, a diagnosis of DUB was made and the treatment with ormiloxifene was started. The number of cases were 35 cases. The treatment with ormeloxifene was evaluated by measuring the Hb g/dl and the endometrial thickness before and after 3 months of treatment with sevista. Ormeloxifene was given in the dosage of a 60 mg tablet twice a week for 3 months, followed by once a week for another 3 months. Observation & Results: There was a statistically significant increase in the Hb g/dl (p < 0.001) and a statistically significant decrease in the endometrial thickness (p< 0.001) after the treatment with ormeloxifene. Conclusion: Ormeloxifene can be used asa effective drug in the treatment of Dysfunctional uterine bleeding. [ABSTRACT FROM AUTHOR]

Sex hormone binding globulin (SHBG) is a liver-synthesized glycoprotein. Low SHBG levels are associated with insulin resistance (IR). Specific single nucleotide polymorphisms (SNPs) in the SHBG gene are linked to IR. Therefore, it is of interest to provide a review on the comprehensive overview for SHBG related to IR., (© 2024 Biomedical Informatics.)