ABSTRACT
Introduction: Minimal Change Nephrotic Syndrome is the most common type of nephrotic syndrome accounting for 85% of cases. It is the most common primary or idiopathic type of nephrotic syndrome in children. It occurs between 1 to 12 years of age, but most commonly 2 to 6 years. Even though the majority of cases show remission of nephrotic syndrome, the hypocalcemia due to Glucocorticoids are very severe. It reduces the bone mineralization and reducing the bone mineral content and thereby reducing bone density. Aim of the study: To assess the reduction in bone mineral density among children who have completed the first course of steroid therapy for nephrotic syndrome by measuring biochemical markers of bone. Materials and methods: This study was done to find out the reduction in the Bone mineral density among children who completed steroid therapy for nephrotic syndrome, by using bone biochemical markers. This study also helped to assess the side- effect of Glucocorticoids on bone density and to prevent bone demineralization and pathological fractures in children. Results: The results showed there was a reduction in the serum calcium values among children with MCNS. This implied hypocalcemia among children due to GCs and the P value is significant <0.001. This represented the corrected calcium levels among the children after drug effect. It implied the D. Sampath Kumar, S. Prasanna, P. Sakthi Seethalakshmi. To assess the reduction in bone mineral density among children who completed steroid therapy for nephrotic syndrome. IAIM, 2018; 5(2): 94-104. Page 95 overall the corrected calcium levels at low levels with MEAN=8.34 mg%. The P value was <0.024 Significant. The total proteins were normal among children after completing the glucocorticoid therapy. The P value was <0.001 and was significant. Mean = 5.68. Standard Deviation (SD) = 0.28. The serum phosphorus was almost normal among remission MCNS Children and at higher levels among defaulters, SDNS and SRNS. Conclusion: Glucocorticoids is the drug of choice and standard therapy for Minimal Change Nephrotic Syndrome (MCNS), but the drug-induced hypocalcemia and hypovitaminosis D are assessed by our study. Added to the above, the disease itself characterized by hypocalcemia and hypovitaminosis D. So, all children should undergo this assessment to prevent growth failure and pathological fractures. Nutritional supplements are recommended for the quality of life among children.
ABSTRACT
The endothelium plays a key role in haemostatic balance. Endothelial progenitor cells (EPCs) are involved in the maintenance of endothelial haemostasis and in the process of blood vessel formation. Cardiovascular disease (CVD) is associated with reduced numbers and dysfunction of endothelial cells (ECs) and EPCs. Inhibition of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-Co-A) reductase helps in restoring of EPCs and improvement of vascular function. This review underlines the pleiotropic effects of atorvastatin on ECs and EPCs.
ABSTRACT
Coronary atherosclerosis is the most frequent cause of ischemic heart disease. The composition and vulnerability of the atherosclerotic plaque determines the development of acute coronary syndromes. In this study, 224 advanced atherosclerotic plaques were identified from the main coronary arterial branches of 10 autopsy heart specimens. The plaques were classified by American heart association (AHA) and modified American heart association classification. Vulnerability of the plaques and factors influencing vulnerability were assessed. Vulnerable plaques were mostly of Type IV category of AHA classification and of thin cap fibroatheroma type by modified American heart association classification. Inflammation was more frequent and was of a higher grade in vulnerable plaques. Calcification was predominantly of mild grade.
Subject(s)
Autopsy , Calcinosis/pathology , Coronary Artery Disease/classification , Humans , India , Inflammation/pathology , Myocardial Ischemia/etiology , Prognosis , Prospective StudiesABSTRACT
BACKGROUND: The site of occlusion of left anterior descending coronary artery is important in acute anterior myocardial infarction because, proximal occlusion is associated with less favorable outcome and prognosis. The present study attempted to evaluate the electrocardiographic correlate of the location of the site of the left anterior descending coronary artery occlusion with respect to first septal perforator and/or the first diagonal branch. METHODS AND RESULTS: The study included 50 patients with a first acute anterior myocardial infarction. The electrocardiogram with the most pronounced ST segment deviation before the start of reperfusion therapy was evaluated and correlated with the left anterior descending occlusion site as determined by coronary angiography. ST segment elevation in lead aVR, ST segment depression in lead V5 and ST segment elevation in V1>2.5 mm strongly predicted left anterior descending occlusion proximal to first septal, whereas abnormal Q wave in V4-6 was associated with occlusion distal to first septal. Abnormal Q wave in lead aVL was associated with occlusion proximal to first diagonal, whereas ST depression in lead aVL was suggestive of occlusion distal to first diagonal branch. For both first septal and first diagonal, ST segment depression > or =1 mm in inferior leads strongly predicted proximal left anterior descending artery occlusion, whereas absence of ST segment depression in inferior leads predicted occlusion distal to first septal and first diagonal. All the patients were followed during their in-hospital stay (median of 7 days), during which four patients in the proximal to first septal and first diagonal group and one patient in the distal to first septal and first diagonal group died (p < or = 0.001). CONCLUSIONS: In acute myocardial infarction electrocardiogram is useful to predict the left anterior descending occlusion site in relation to its major side branches and such localization has prognostic significance.