Risk profile in asymptomatic first degree relatives of Coronary Artery Disease (CAD) patients.

Aim: Cardiovascular disease is on the rise and is expected to be a leading cause of death and disability worldwide. Identification of risk in asymptomatic individual in higher risk group could help to plan individual patient’s management. Positive family history is one of the risk factors and screening at this level may help in determining individual therapy. Studies have shown relation of positive family history but are lacking in this part of world, so we considered it worthwhile to assess FRS in asymptomatic sibling of CAD Patients Materials and methods: 75 volunteers were enrolled in the study and they underwent Bruce treadmill exercise protocol after their initial evaluation, these volunteers than also underwent biochemical test – Fasting blood sugar and lipid profile. These volunteers were divided into two groups based upon their Treadmill test results. Results: 31 out of 75 volunteers were TMT positive and they were kept in one group. These volunteers differed significantly (p<0.05) in higher age, fasting blood sugar and Low density lipoprotein level (LDL). This group also had a significantly lower metabolic equivalents and higher Framingham Risk Score. Conclusion: Our study showed that positive family history is associated with a higher Framingham risk score in asymptomatic volunteers.

Safety and Efficacy of Add on Modafinil to Selective Serotonin Reuptake Inhibitors in Major Depressive Disorder.

Aim: Despite the efficacy of selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depression, a significant number of patients show partial or no remission of symptoms. Although antidepressant medications are effective, they have a delayed onset of therapeutic effect. Modafinil is a novel psychostimulant that may be helpful in treating patients with residual symptoms of depression. The efficacy of modafinil as add-on therapy to SSRIs in depressed patients in Indian population is lacking; hence this study was designed to study the efficacy and safety of Modafinil as add-on therapy to SSRI in depressed patient in Indian Population.Methods: In an open, randomized study, 50 patients diagnosed with major depressive disorder (MDD) were divided into two groups. In Group A (n = 25) patients received conventional SSRIs with low dose Modafinil for 8 weeks. In Group B (n = 25) patients received conventional SSRIs for 8 weeks. Patients were evaluated at baseline and then at the end of 2, 4, 6, and 8 weeks. Results: There was significant improvement in Hamilton depression rating scale (HDRS), Epworth Sleepiness Scale (ESS), Fatigue severity Scale (FSS) and Clinical Global Improvement – severity (CGI-S) Scale (p < 0.05) in both groups. Modafinil in low dose as add on therapy showed more decrease in scores, had earlier onset of action, as compared to conventional treatment (p < 0.05). No serious adverse event was reported in either of the groups. Conclusion: Low dose Modafinil as add-on therapy had shown better efficacy, earlier onset of action as compared to conventional treatment in MDD in Indian patients.