Estradiol and lipid levels in men with acute myocardial infarction

Background: The incidence of myocardial infarction (MI) is more common in men when compared with women and women after menopause are at high risk of MI. This gender difference in CVD risk might be because of the difference in the circulating estrogen levels in men and women. Dyslipidemia is also one of the major causes of MI. The present study was aimed to estimate the levels of serum estradiol and serum lipids in newly diagnosed male MI cases and to find out any correlation between these two.Methods: The study was conducted on 50 newly diagnosed MI admitted in Cardiology department Narayana general hospital and Medical College, Nellore. Only males were included in the study. Fifty age and sex-matched healthy individuals were selected as controls. Lipid levels are estimated by endpoint colorimetric assay (HUMANSTAR kit) and estradiol was estimated by Chemiluminance immune assay (CLIA).Results: Significantly raised levels of estradiol (p-value <0.0001) and low HDL cholesterol (p-value =0.0085) levels were noticed among the cases compared to controls. No significant correlation was observed between estradiol and lipoproteins (HDL and LDL).Conclusions: The results of the present study in acute MI compared to controls show hyper estrogenemia in Male MI cases, which may be the underlying cause for thrombosis in acute MI. Decreased levels of HDL cholesterol are observed in the MI cases which are known to increase the risk of Atherosclerosis. No significant correlation were noticed between Estradiol and HDL cholesterol in men with acute MI.

Alterations of serum high sensitive C reactive protein and lipid levels in newly diagnosed myocardial infarction subjects

Background: Acute Myocardial Infarction (AMI) is one of the major causes of mortality in the world. Atherosclerosis leading to AMI is the most common and severe clinical manifestation observed. Dyslipidemia is one of main traditional risk factor for MI, but in more than 50% of CHD events dyslipidemia was absent.  Atherosclerosis is considered as both a chronic inflammatory condition and a disorder of lipid metabolism. The present study was aimed to estimate the levels of serum lipids (total cholesterol, LDL cholesterol, HDL cholesterol) and hs-CRP an inflammatory marker in newly diagnosed AMI cases and to find out any correlation between these two.Methods: The study was conducted on 50 newly diagnosed myocardial infarction cases, admitted in Cardiology Department Narayana Medical College, Nellore. Both the sexes were included. Fifty age and sex matched healthy individuals were selected as controls. Lipid levels are estimated by end point colorimetric assay (HUMANSTAR kit) and hs-CRP was estimated by immunofluorescence technique (Boditechkit).Results: Significant raised levels of hs-CRP (p value <0.0001) and low HDL cholesterol (p value =0.0085) levels among the cases was noticed. A significant positive correlation was observed between LDL cholesterol and hsCRP (r=0.109, p=0.040). A non-significant positive correlation between hsCRP and HDL cholesterol  (r=0.291, p=0.453) was observed.Conclusions: The results of the study implicate the role of inflammatory component in causing atherosclerosis or coronary artery disease rather than dyslipidaemias alone to be attributed for atherogenesis. Concomitantly HDL cholesterol levels were found to be low in cases that results from the inflammatory component in atherogenesis.

The changing face of CSVT: Time to rethink and intervene

Background: Thrombosis of the cerebral venous sinuses (CSVT) is not an uncommon form of stroke. Usually affects young individuals. Aim: To compare the clinical profile of Cerebral venous thrombosis patients. Materials and methods: It was an observational study, comparing the epidemiological and etiological profile of patients with CVT during two time periods Results: This study group consisted of 130 patients, 63 patients in cohort 1 (2013/14), and 67 Patients in cohort 2 (2015-2016), were male noted in 27% and female were noted in 73% in cohort 1 (2013-14. In cohort 2 (2015-2016) male were noted in 39% and female were 61%.The data in rural were 81.5% and urban were 18.5% in cohort 1 and in cohort 2, Rural were noted in 66% and urban 34%.Common risk factors were postpartum status 31 were noted in cohort 1 and 18 were noted in cohort 2. In MRI brain Parenchymal changes cohort 1 consisted 51 and cohort 2 consisted 38. Headache was the common clinical presentation in the patients and next followed by altered sensorium. Time of onset of symptoms in the both cohorts was at 6-10 days in most of the patients, risk factor associated in both cohorts was postpartum status. Conclusion: CSVT is a multi-factorial condition with gender-related specific causes. Fifty years ago, CSVT was a mortal condition, but with the introduction of neuroimaging, the mortality rates have become minimal. CSVT is effective and economical.

Correlation Between Lipid Peroxidation Product- Malondialdehyde (MDA) and Reduced Glutathione (GSH) in Preeclampsia.

Pregnancy is a stressful condition in which many physiological and metabolic functions are altered to considerable extent and hypertension is the most commonest problem encountered during pregnancy, complicating 5-10% of pregnancies. Recent reports suggest that free radical induced endothelial damage as an important factor in the pathogenesis of preeclampsia. Such cell injury might in turn is counteracted by the action of several in vivo antioxidants. But because of increased lipid peroxidation and increased demand of antioxidants , increased oxidative stress is suspected. The present study was undertaken to determine serum malondialdehyde (MDA) and RBC reduced glutathione (GSH) levels in clinically diagnosed preeclamptic women (n=30) and compared with that of normotensive pregnant women and to find out any association between the two parameters. Serum MDA levels were significantly elevated (p value<0.000) and RBC reduced GSH levels were significantly decreased ( p value <0.000) compared to that of normotensive pregnant women. A statistically significant negative correlation was observed between serum MDA and RBC reduced GSH (p value <0.003) in preeclamptic cases.

Alterations of Serum Uric Acid Concetrations in Preeclampsia.

Hypertensive disorders during pregnancy increase maternal and fetal risk. Preeclampsia is characterised by hypertension and proteinuria. Increased uric acid is a key clinical feature of preeclampsia; higher levels correlate with significant maternal and fetal morbidity and mortality. The present study was undertaken to estimate serum uric acid , the end product of purine catabolism, in clinically diagnosed preeclamptic women (n=30) and the values were compared with that of normotensive pregnant women (n=30) ,aged 18-30yrs. All of them were in their third trimester and primigravida. Serum uric acid levels were measured by spectrophotometry. We observed that serum uric acid levels were increased significantly when compared with that of normotensive pregnant women (p value < 0.000).

Lipid Peroxidation in Preeclampsia.

Hypertension in pregnancy is a leading cause of both maternal and fetal mortality and morbidity. Preeclampsia is characterised by hypertension and proteinuria. Lipid peroxidation is an important factor in the pathophysiology of Preeclampsia. The present study was undertaken to determine Serum Malondialdehyde (MDA) levels , a product of lipid peroxidation , in clinically diagnosed Preeclamptic women(n=30) and the values were compared with that of Normotensive pregnant women (n=30) aged between 18-30yrs. All of them were in their third trimester and were primigravida. Serum MDA was estimated by TBARS (thiobarbituric acid reactive substances) method. We observed that Serum MDA levels were significantly increased in Preeclamptic women (p <0.000) as compared to that of Normotensive pregnant women . Increased levels of lipid peroxiation product - MDA may contribute to the pathophysiology of Preeclampsia.

Gestational diabetes mellitus: An overview.

The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance occurring for the first time during pregnancy. The prevalence of GDM varies in direct proportion to the prevalence of Type 2 diabetes for a given ethnic group or population. It is crucial to detect women with GDM as the condition is associated with diverse range of adverse maternal and neonatal outcomes. In addition, having a history of GDM puts the mother at risk for the development of Type 2 diabetes mellitus or recurrent GDM. Various screening guidelines have been introduced depending upon the suitability of test to the population characteristics, cost and screening accuracy. Still there are lots of controversies to which test to be used, when should the screening be done and who should be screened. However, recognizing GDM is becomimg a major health challenge for clinicians, and treating it results in lowering of both maternal and fetal complications. Also, clinicians must followup women with GDM postpartum so that the prevalence of Type 2 diabetes may start declining.

Elevated percentage of perforin positive cells in active pulmonary tuberculosis.

BACKGROUND & OBJECTIVES: Perforin is one of the major effector molecules of cytotoxic cells associated with killing of cells harbouring intracellular bacterial infection. The precise role of perforin positive cells in tuberculosis still remains controversial. The present study was done to determine the number of circulating CD4(+) and CD8(+) perforin positive cells to assess the level of cytotoxic response against Mycobacterium tuberculosis in patients with pulmonary tuberculosis. METHODS: Intracellular perforin and surface CD4 and CD8 staining of peripheral blood lymphocytes was done using specific monoclonal antibodies and enumerated using flowcytometry. RESULTS: A significantly decreased total lymphocytes (P<0.01), CD4 (P<0.001) and CD8 (P<0.01) lymphocyte counts in PTB patients was observed compared to normal healthy individuals (NHS). Intracellular perforin staining showed significantly elevated percentages of total (P<0.05) and CD8 (P<0.01) perforin positive cells in PTB patients compared to NHS. However, the absolute counts of total, CD4 and CD8 cells positive for perforin were similar in patients and NHS. INTERPRETATION & CONCLUSION: Our results suggest that during active stage of pulmonary tuberculosis there was an increased percentage of CD8 cells positive for perforin, irrespective of their absolute counts. Further, CD8(+) perforin positive cells may have increased cytolytic activity against M. tuberculosis in active pulmonary tuberculosis.