ABSTRACT
Background: Diabetes mellitus (DM) has emerged as a major healthcare problem in India. There were an estimated 40 million persons with DM in India in 2007 and this number is predicted to rise to almost 70 million by 2025. It is estimated that every fifth person with diabetes will be an Indian. The objective of the present investigation was to establish the reference range for glycated hemoglobin (HbA1C) in healthy non-diabetic subjects in our hospital laboratory and compare it with the values reported by standard laboratories. Methods: The study was conducted in the Department of Biochemistry, MMIMSR, Mullana (Ambala, Haryana). Total number of subjects was 50 (25 males, 25 females), aged 30 to 70 years. 2 ml of blood was collected from antecubital vein under aseptic conditions from each subject and put in EDTA vials. Hemolysed blood was estimated by semiautoanalyzer for HbA1C. Results: In females, the levels were 6.50 ± 0.74 % while in males the levels were 6.27 ± 0.94 %. The overall range in females was 4.8 - 7.56 % while in males it was 4.2 to 7.56 %. The values were comparable (p>0.05) with those reported by standard laboratories, e.g. Dr. Lal PathLabs (<6%), Charak diagnostic (4.5-6.3%) and Mayo Clinic (6.5-7%). Conclusion: Our laboratory levels of HbA1C are comparable with the reference range of different laboratories and hence suitable to be used as cut-offs while interpreting the results of patients with DM.
ABSTRACT
The survival rate of cancer patients has greatly increased over the last 20 years. However, to achieve this result, a considerable price has been paid in terms of the side-effects associated with the intensive anticancer treatment. Cardiotoxicity of anticancer drugs is a serious problem. It is defined, by the National Cancer Institute, as the “toxicity that affects the heart.” This definition not only includes a direct effect of the drug on the heart, but also an indirect effect due to enhancement of hemodynamic flow alterations or due to thrombotic events. Cardiotoxicity can develop in a subacute, acute, or chronic manner. The risk for such effects depends upon: cumulative dose, rate of drug administration, mediastinal radiation, advanced age, younger age, female gender, pre-existing heart disease and hypertension. Anthracyclines, such as doxorubicin (DOX), cause serious cardiac side-effects. Acute tachyarrhythmias and acute heart failure (HF) may occur after high doses, but these reactions are now rare due to changed dosage schemes (e.g. slower infusion) with the aim to prevent this. However, the sub-acute or chronic cardiac effects of anthracyclines remain a clinical problem. Clinically, anthracycline induced cardiotoxicity manifests itself as left ventricular failure, which develops insidiously over months to years after completion of the anthracycline based chemotherapy and may result in congestive HF. The mechanism of anthracyclin induced cardiotoxicity is not totally unraveled. It is likely that the decline in myocardial function is related to apoptosis of cardiac myocytes that occurs apparently at random in the myocardium. Anthracyclin induced formation of reactive oxygen species (ROS) in the presence of intracellular iron, impaired homeostasis of intracellular iron and calcium (that may facilitate the apoptosis induced by the ROS) have been put forward as mechanisms. Cardiac protection can be achieved by limitation of the cumulative dose. Further, addition of the antioxidant and iron chelator dexrazoxane to anthracycline therapy has shown to be effective in lowering the incidence of anthracycline induced cardiotoxicity.
ABSTRACT
The global burden of diabetes mellitus is expected to increase by 42% (from 51 million in year 1995 to 72 million by 2025) and by 172% (from 84 to 288 million) in the developed countries. The disease leads to many complications and one of them is electrolyte imbalance which has been an ignored subject. Amongst the electrolytes, magnesium merits special attention. The aim of the present study was to assess serum magnesium levels in Type 2 diabetics. A hospital based cross- sectional study was performed on 50 diabetic patients attending the OPD of medicine department from January 2011 to July 2011, M.M. Institute of Medical Sciences and Research, Mullana (Ambala). Thirty age-matched healthy controls were also selected for the sake of comparison. Blood was withdrawn and serum magnesium levels were estimated by colorimetric method using Xylidyl blue dye. The results were analyzed using Student's unpaired 't'test. Serum magnesium levels among normal healthy controls (n=30) ranged between 1.8-3.0 mg /dl (mean ±SD = 2.33±0.37 mg/dl), while the levels of serum magnesium in diabetic patients (n=50) ranged between 0.2-2.25 mg/dl (mean ±SD = 1.62±0.47). The difference was statistically significant (p<0.001). Levels of serum magnesium were significantly lower in diabetic patients as compared to normal healthy controls. Therefore, hypomagnesaemia is a key issue in diabetes which, if corrected, is expected to result in a better management of the disease.