Metabolic Syndrome and the Frequency of Occurrence of Its Components in Urban South Indian Population.

Aims: To study the frequency of occurrence of the components of Metabolic Syndrome [MetS] among MetS patients in urban south Indian population, with a view to suggest preventive measures. Study Design: Descriptive hospital based study. Place and Duration of Study: This study was done at a tertiary care teaching institution at Kozhikode, which is an urban area in south India, between September 2007 and February 2008. Methodology: Subjects aged 20 years and above attending the general health check-up clinic (953 people) were screened and people meeting National Cholesterol Education Program Adult Treatment Panel III [NCEP ATP III] criterion for MetS (257 people) were enrolled for the study. In addition to history taking and clinical examination, relevant laboratory investigations were done. Pearson chi-square test was used for statistical analysis. A P value of <0.05 was considered as statistically significant. Results: The prevalence of MetS in the screened population was 27%, more in females (28.1%) than in males (26.4%) and was found to increase with increasing age, in both genders. The most frequently occurring component of MetS in this study was increased abdominal girth [AG]. The other components in the decreasing order of frequency were low high density lipoproteins [HDL], elevated fasting blood glucose [FBG], raised blood pressure [BP] and raised triglycerides [TG]. In males the most frequently occurring component of MetS was reduced HDL, whereas in females it was increased abdominal girth. The other components in the decreasing order of frequency in males were raised TG, increased AG, elevated FBG and raised BP, whereas in females it was low HDL, elevated FBG, raised BP and raised TG. Presence of increased abdominal girth (P<.001) and low HDL (P=.030) was significantly more in females, whereas raised TG (P<.001) was more in males. Conclusions: Increased AG, which is the most frequently occurring component of MetS in this study, is an easily measurable parameter and may be taken as a proxy indicator for the prevalence of MetS in the population. Presence of increased AG is an indicator to check for the presence of other components of MetS and to advise necessary lifestyle changes to prevent the occurrence of MetS and to reduce the cardio vascular disease (CVD) burden in the population.

Poisoning due to white seed variety of Abrus precatorius.

We report an unusual case of poisoning involving the white seed variety of Abrus precatorius that caused serious manifestations in a middle-aged male who had consumed the seeds on the advice of a folk medicine practitioner. He recovered after a prolonged duration of hospital treatment without any subsequent complications or sequelae. The case is being reported on account of its rarity.

Massive gastrointestinal bleeding in a patient with AIDS.

Cytomegalovirus enteritis can lead to gastrointestinal bleeding in patients with the acquired immune deficiency syndrome. The commonest site of involvement is the colon, followed by the stomach and terminal ileum. Most of these lesions can be diagnosed by colonoscopy or gastroscopy. We present our experience of a patient with cytomegalovirus infection involving only the proximal jejunum causing massive lower gastrointestinal bleeding. Conventional endoscopy and imaging had failed to locate the source of bleeding. Enteroscopy performed at the time of laparotomy showed an ulcerated lesion in the jejunum. Resection followed by histological examination of the resected area confirmed the diagnosis of cytomegalovirus infection. In addition to highly active antiretroviral therapy, ganciclovir was given for 14 days in a dose of 5 mg/kg twice a day and tapered over a period of 3 months. There has been no further episode of gastrointestinal bleeding over a follow up of 9 months.