Serum levels of visfatin and interleukin-6 in non-obese versus obese men with coronary artery disease

Objective: To evaluate and compare the serum levels of visfatin, interleukin-6 and lipid profile in non-obese and obese male patients with coronary artery disease

Study Design: Observational, comparative study

Place and Duration of Study: Punjab Institute of Cardiology and Lahore General Hospital, Lahore, from July to December 2013

Methodology: The participants included 20 non-obese group I with coronary artery disease [CAD] and 20 obese males group II with coronary artery disease [angiographically confirmed]. All the participants were in the age group of 35 - 55 years being non-smokers and non-diabetic. Serum visfatin and interleukin-6 levels were analysed by Enzyme Linked Immunosorbent Assay [ELISA]. Lipid profile was also evaluated. Results were compared with T-test and Mann Whitney U test. The values were considered significant at 0.05 level of significance

Results: Serum visfatin 9.05 versus 3.9 ng/ml and interleukin-6 12.80 versus 0.60 pg/ml levels were significantly [p-value < 0.001 of both] raised in the obese CAD group as compared to non-obese with CAD. Lipid profile also showed raised levels of total serum cholesterol, low density lipoproteins, triglycerides, very low density lipoproteins and low levels of high density lipoproteins in obese group

Conclusion: Significantly raised levels of serum visfatin and interleukin-6 indicate adipose tissue as an imperative source of these adipocytokines involved in inflammation in CAD. Altered lipid profile also seen in obese patients with CAD

Relationship of serum resistin and lipid profile in type 2 diabetics

Background: Resistin an adipocyte derived factor has cysteinc-rich C-terminal domain and has emerged as controversial link between obesity and type 2 diabetes mellitus [T2DM] in different studies and leads to dyslipidernia. This study was designed to determine and compare serum resistin, LDL and HDL levels in non-obese and obese type 2 diabetics

Methods: It was a cross-sectional analytical study in which eighty diabetic patients were recruited and were divided into two groups non-obese and obese on the basis of body mass index [BMI] and waist circumference [WC] [BMI 23, WC <90 Cm in group I and BMI >25, WC >90 Cm in group II]. Serum resistin was measured by commercially available ELISA Kit. Serum LDL and HDL levels were measured by direct quantitative measurement

Results: Higher serum resistin and LDL, and lower serum HDL levels were recorded in obese diabetics compared to non-obese diabetics. Significant positive correlation of serum resistin with LDL and negative correlation between serum resistin and HDL was present in all type 2 diabetics

Conclusions: The positive correlation of serum resistin with serum LDL and negative correlation with serum HDL suggests serum resistin to be a link between obesity and T213M and it may be responsible for altering lipid profile

Epicardial pacing: time related efficacy of electrodes following cardiac surgery

Placement of epicardial wires on the right atrial and right ventricle surfaces is a routine practice in cardiac surgery. These pacing electrodes are used for invasive pacing of the myocardium for a variety of emergent and elective conditions postoperatively. There is uncertainty in actual practice about the optimum time for their removal, and practice varies widely between different institutions. To determine the time related efficacy of these pacing electrodes after cardiac surgery, to find out the optimum time of their removal. July 2008 to October 2008. 47 patients those underwent coronary artery bypass surgery were prospectively enrolled and evaluated with standard 12 lead ECG and ventricle pacing threshold immediately after surgery and on the 5[th] postoperative day. The patients were divided into two subgroups according to their left ventricle ejection fraction [> 40% verses < 40%]. There was significant difference in the effective pacing threshold in group 1 and 2 on immediate post operative period and on day 5. [P = 0.002 and P = 0.02 respectively] The sensing threshold immediately after operation and on 5[th] post operative day also differed significantly [P = 0.009 in group 1 and 0.02 in group 2] The effective VVI pacing was lost in 17 patients [40.5%] on the 5[th] post operative day and comparison of effective pacing threshold in the two groups showed no significant difference during the same period of time [P = NS]. Ventrculo-ventrical inhibition. The epicardial pacing wires have little usefulness after the fifth postoperative day and should be removed by this time. In addition postoperative pacing threshold was not affected by the decreased left ventricular function

Evaluation of risk factors in antenatal care

A cross-sectional study was conducted on a sample of 198 pregnant woman attending the antenatal clinic. Lady Aitchison Hospital Lahore, to determine the incidence of high risk pregnancy and to demonstrate the risk factors. The scoring system developed by Fortney and Whitehorne was used. The subjects with scores 0-2 were considered at low risk, those with score 3 or more were categorised as high risk Our results revealed that high risk pregnant women constituted 58% of the study population. The most frequently encountered risk factors were bad obstetrical history [52.5%]. anaemia [43.4%]. high gravidity [32%]. and high panty [20 7%] Stepwise logistic regression analysis Indicated that obstetrical history and panty were major predictors of total variation in the score. The use of objective risk scoring is recommended for identification of high risk pregnant women