Study of Prognostic Association of C-Reactive Protein (A Biomarker) with Clinically Important Predictors of Outcome in Stable and Unstable COPD Patients.

Background: COPD is characterized by persistent airflow limitation that is progressive and is associated with enhanced chronic inflammatory response in the airways to noxious particles or gases. It has both systemic and pulmonary effects. Since COPD deaths estimated to increase by 30% in next 10 years, cost of treatment will be a heavy burden on global economy. The costs are proportional to pulmonary and extra pulmonary components of the disease. Methods: In this study, we examined 100 patients of COPD, out of which 80 were stable and 20 were unstable. Results: CRP levels were found to be increased in cases more than in controls (13.55+10.83 vs. 2.07+0.82 mg/lit, p<0.001), the levels being higher in unstable patients than in stable patients (33.78+7.74 vs. 8.50+1.81 mg/lit, p<0.001). We also submitted the patients to MMRC dyspnoea scale and found that CRP is positively correlated with MMRC dyspnoea scale (r=0.638, p<0.001) and was inversely correlated with 6- minute walk distance (r= -0.364, p<0.001). There was a significant positive correlation of CRP with BODE index (r=0.780, p<0.001). Conclusion: The study is valuable in detecting the severity of COPD cases both in stable and unstable conditions and to forecast the future morbidity and mortality outcome of such cases.

Pulmonary haemorrhage syndrome associated with dengue haemorrhagic fever.

Dengue fever is a major public health problem in India. Dengue haemorrhagic fever (DHF), a more serious form of disease, occurs when a person previously infected with dengue is reinfected with a different serotype. Besides common manifestations pleural effusion, pneumonitis, haemoptysis and pulmonary haemorrhage have rarely been seen. We report a case of 30 years old male, who developed pulmonary haemorrhage, haemoptysis requiring blood transfusion. Serology was consistent with the diagnosis of dengue haemorrhagic fever.

Thyroid hormone profile in obese subjects--a clinical study.

Fifty obese subjects with body weight above 120% of the ideal weight for that height or body mass index greater than 27.8 kg/m2 in men or 27.3 kg/m2 in women were studied for thyroid hormone profile. Nearly three-fourths obese subjects had body mass index of 30-40 kg/m2. Eighty-six per cent subjects were clinically and biochemically euthyroid. Fourteen per cent of the subjects had hypothyroidism; out of them, 8% were clinically and biochemically hypothyroid while 6% were only biochemically hypothyroid. None of the hypothyroid subjects had morbid obesity (greater than 40 kg/m2 body mass index). Duration of obesity in hypothyroid subjects was less than 10 years in nearly three-fourths of cases.

A study of the influence of insulin resistance on left ventricular mass in hypertensive patients.

OBJECTIVES: To study the influence of insulin resistance on the left ventricular mass in hypertensive subjects. MATERIAL AND METHODS: Thirty patients having uncomplicated essential hypertension were included in the study. Post-oral glucose load serum insulin level (2 hrs) was determined and this was used as a marker for insulin resistance. Two D-echocardiography was performed and left ventricular mass and left ventricular mass index were calculated. RESULT: Out of the 30 patients 18 were males and 12 were females. Eight were obese while the remaining 22 were non-obese. The patients were 27 to 70 years old. The mean age, height and weight were 54.83 +/- 9.46 years, 159.07 +/- 8.81 cm and 58.38 +/- 11.03 kg, respectively. The post oral glucose load serum insulin levels in the study ranged from 57.65 to 210.81 microU/ml. The left ventricular mass and left ventricular mass index ranged from 42.58 to 310.8 g (mean 196.60 +/- 65.13 g) and 42.74 to 185.59 g/m2 (mean 118.71 +/- 37.75 g/m2), respectively. The correlation coefficient ('r' value) between post oral glucose load serum insulin levels and left ventricular mass and left ventricular mass index were calculated. CONCLUSION: A strong positive correlation was observed between the post oral glucose load serum insulin levels and left ventricular mass ('r' = +0.750). A strong positive correlation between post oral glucose load serum insulin levels and left ventricular mass index ('r' = +0.757) was also observed. These correlations were found to be statistically highly significant (p < 0.01). This association was demonstrated independently of age, anthropometric measurements, systolic and diastolic blood pressure levels. Thus, in patients with essential hypertension, hyperinsulinemia (insulin resistance) has a role in promoting left ventricular hypertrophy.