The correlation of cardiovascular risk factors and angiographic findings with serum vitamin D levels in patients undergoing coronary angiography

Background: Studies regarding correlation of various conventional risks factors for Coronary Artery Disease (CAD) are many. Keeping in mind the scarcity of studies regarding Vit-D Deficiency (VDD), a new risk factor in CAD, present study was conducted to correlate Vit-D level with conventional risk factors and Coronary Angiography (CAG).Methods: Hundred adult patients admitted to Medicine and Cardiology undergoing CAG with suspected or established CAD were kept in study. Patients having renal, hepatic, parathyroid disease, osteomalacia and patients taking drugs interfering with Vitamin D (Vit-D) metabolism were excluded. After detailed history and thorough clinical examination, routine investigations and 25-(OH) D level was estimated. Subsequently patients underwent CAG. Statistical analysis by Mann Whitey test and Chi-square Test was done and inference was drawn.Results: 100 patients in different age groups had hypertension (HTN) in 53, diabetics mellitus (DM) 39, dyslipidemia 62, smokers 38 and family history of CAD 19. CAG showed normal coronaries in 4, Single Vessel Disease (SVD) in 30, double vessel diseases (DVD) 43 and triple vessel disease (TVD) 22. Vit-D level <20ng/ml i.e. Vit-D deficiency (VDD) in 68, 20-30ng/ml i.e. Vit-D insufficiency (VDI) in 22 and >30ng/ml (normal) in 10. VDD was profound in 51-60 and 61-70 years age groups. Statistical correlation of VDD was not significant with conventional risk factors, but statistically significant correlation of VDD was observed with dyslipidemia and CAG findings in our study.Conclusions: Like earlier studies we observed significant correlation of Vit-D levels with CAD. Though dyslipidemia was significantly correlated with VDD, correlation of other conventional risk factors like age, sex, HTN, DM, smoking and family history was not found. We conclude from this study presence of significant association of VDD with severe CAD. DVD and TVD by CAG were common with low Vit-D levels.

Perioperative challenges in management of a deaf and dumb patient posted for high‑risk cardiac surgery.

Perioperative management of deaf and dumb patients can be a challenging task. For smooth postoperative recovery, proper care should begin in the preoperative period. Understanding the patients’ needs and training him to follow the instructions requires to involve a communication specialist. Judicious use of sedatives and analgesics is essential to keep the patient pain‑free and comfortable. Postoperatively, the patient should be kept awake, enough to understand the internal need of the body and to make a meaningful response to external stimuli. Adequate preoperative planning and coordinated team efforts with involvement of specialists can help in delivering better postoperative care.

Intractable hyperkalemia due to nicorandil induced potassium channel syndrome.

Nicorandil is a commonly used antianginal agent, which has both nitrate‑like and ATP‑sensitive potassium (KATP) channel activator properties. Activation of potassium channels by nicorandil causes expulsion of potassium ions into the extracellular space leading to membrane hyperpolarization, closure of voltage‑gated calcium channels and finally vasodilatation. However, on the other hand, being an activator of KATP channel, it can expel K+ ions out of the cells and can cause hyperkalemia. Here, we report a case of nicorandil induced hyperkalemia unresponsive to medical treatment in a patient with diabetic nephropathy.

Cardiac surgery in a patient with immunological thrombocytopenic purpura: Complications and precautions.

Immune thrombocytopenic purpura (ITP) patients are at high-risk for bleeding complications during and after cardiac surgeries involving cardiopulmonary bypass. We report a patient with ITP with severe coronary artery disease and mitral valve regurgitation who underwent uncomplicated coronary artery bypass grafting and mitral valve replacement. Three weeks later, the patient was readmitted in a very low general condition with signs of pericardial tamponade. We describe our experience of managing the case.

Edwardsiellosis in fish: a brief review.

Edwardsiellosis is one of the most important bacterial diseases in fish. Scientific work on this disease started more than forty years ago and numerous workers around the world are continually adding to the knowledge of the disease. In spite of this, not a single article that reviews the enormous scientific data thus generated is available in the English language. This article briefly discusses some of the recent research on edwardsiellosis, describing the pathogen's interaction with the host and environment, its pathogenesis and pathology as well as diagnostic, preventive and control measures.

Estimation of salt iodine in Pondicherry District.

A cross sectional survey was conducted in 2005 among 358 school children from 8 communities in the district of Pondicherry to assess the iodine content of salt at consumer level. School children were asked to bring salt consumed at their houses and 290 salt samples could finally be analysed. Only 26.2% of the population in the district were found to consume salt with more than 15 ppm iodine. Consumption of non-iodised salt was more in rural areas (96.4%) as compared to urban areas (71.3%). 39 salt samples from different retail shops in Pondicherry showed a mean value of 35.6+/-10.7 ppm.

A p53-like protein from a freshwater mollusc Lamellidens corrianus.

p53 is the most frequently mutated protein in human cancers and the accumulation of its high levels is a potential novel marker for malignancy. Recently, its homologues such as p63 and p73 have been reported in human, mice and fish. Environmentally induced alterations in p53 protein have been reported to contribute to pathogenesis of leukemia in soft-shell clam Mya arenaria inhabiting polluted water, suggesting that p53 proteins can also be used as pollution markers. In the present study, the presence of p53 protein or its homologues was investigated in tissues of bivalve molluscs Lamellidens corrianus that are predominant in the freshwater riverine environment and are well suited to act as test organisms for evaluation of habitat degradation. The molluscs were collected live from the river Ganga at three sampling sites viz., Kanpur, Allahabad and Varanasi and different tissues (foot, gill and mantle) were collected. Proteins were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). On immunoblot analysis, a 45 kDa protein (p45) was recognized by the monoclonal anti-p53 antibody in the molluscan tissues. The p45 showed immunoreactivity in all the three tissues of molluscs collected at Kanpur, in foot and gill tissues in those collected at Allahabad, and in foot tissue only, in those collected at Varanasi. Since monoclonal anti-p53 recognizes a denaturation-resistant epitope on the p53 (53 kDa) nuclear protein and does not react with other cellular proteins, the molluscan p45 is a p53-homologue or p53-like protein. Further, the differential expression of p45 in the different organs might serve as a useful biomarker that would help in establishing pollution gradient for environmental monitoring in the large aquatic ecosystems.

Effect of paper mill effluent on germination of green gram (Phaseolus aureus Roxb.) and growth behaviour of it's seedlings.

Effect of paper mill effluents on Phaseolus aureus Roxb was studied. The effluent significantly inhibited germination of root and shoot length. The bio-chemical injury does not appear spontaneously but with the increase in effluent treatment there is reduction in observed biochemical parameters (chlorophyll, protein, amino acid, nuclic acids and carbohydrate) which are negatively correlated. The shoots of the seedlings were found to be resistant; whereas roots of the seedlings were susceptible to paper mill effluent treatment.

Bleeding complication during coumarin therapy due to amiodarone and azithromycin.

A patient with mechanical heart valves developed bleeding, after the introduction of amiodarone and azithromycin. Though the anticoagulant effect could be neutralized, the patient succumbed to heart failure. Any new drug prescribed to patients on anticoagulant must be assessed for its potential for interaction and warrants frequent prothrombin time testing.

Hypohaptoglobinaemia as a biochemical and epidemiological marker of falciparum malaria.

OBJECTIVES: The study was conducted in two parts to find out the usefulness of hypohaptoglobinemia (Hpo) as a biochemical and epidemiological marker of malaria. Part-I study was conducted in a Medical College Hospital to find out Hpo in malaria and the time required for normalization of Hpo. Part-II study was undertaken in two endemic areas of malaria to find out the prevalence of Hpo and haptoglobin index (HI) throughout the year along with other indicators of malaria. METHODS: In Part-I study, 172 patients of malaria constituting 58, 52 and 62 patients of cerebral malaria, uncomplicated falciparum malaria and vivax malaria, respectively were enrolled. Along with routine haematological and biochemical investigations, haptoglobin (Hp) estimation was done by endoplate haptoglobin test kit on admission and at 15 days interval for 3 months. In Part-II study Hp was estimated is 305 subjects in two endemic areas of malaria. HI, parasitic index, slide positivity rate (SPR), slide falciparum rate (SFR) were estimated throughout the year and HI was compared with these epidemiological markers. RESULTS: Hpo was present in 102 (92.7%) cases of falciparum malaria which was significantly more than vivax malaria and non-malarial fever. The normalisation of Hpo took about a month or more. The incidence of Hpo was 32.1% is endemic and 4.7% in nonendemic area of malaria. The HI varied between 12.4 to 25.2% throughout the year and was found to be a better marker than other classical markers of malaria. CONCLUSION: Hypohaptoglobinemia may be considered as a useful indirect indicator of falciparum malaria. HI can be used as an epidemiological maker which is better than classical markers of malaria used at present.

Mitoxantrone, mitomycin-C, methotrexate combination chemotherapy with radiotherapy and/or surgery in stage III (T4B, NO-2, M0) breast cancer.

Results of primary surgery with or without locoregional radiotherapy (LRRT) are poor in stage III (T4b, NO-2, M0) breast cancer. Combination of mitoxantrone, mitomycin-c and methotrexate (MMM) has been reported to be as efficacious as doxorubicin based protocols with advantages of reduced nausea, vomiting, alopecia and cardiotoxicity. We tested MMM chemotherapy with LRRT and surgery in locally advanced breast cancer (LABC) with a view to assess response, survival, breast conservation, cost and toxicity. Fifty two previously untreated patients were given Mitoxantrone: 8 mg/m sq by infusion on days 1 and 21, Mitomycin-C: 8 mg/m sq by infusion on day 1 and Methotrexate: 35 mg/m sq i.v. on days 1 and 21. Cycles were repeated every 42 days. After 3 cycles LRRT was given if lump reduced to less than 2 cms. Otherwise patients were subjected to modified radical mastectomy (MRM) or radical mastectomy (RM). Following this 3 more cycles of chemotherapy were given. Patients with soft tissue, skin or heavy nodal involvement also received LRRT. Tamoxifen 20 mg daily was prescribed at the end of chemotherapy to postmenopausal patients. Complete/partial responses were seen in 5 and 26 patients, respectively after chemotherapy giving an overall response of 59.5%. Twenty four patients each had LRRT and MRM/RM. Responses could be significantly enhanced by LRRT/and or surgery. Nineteen out of 25 relapses were at distant sites. Breast conservation was achieved in 24/52 (46%) patients. Three year disease free and overall survival was 54% and 65%, respectively. There was 1 toxic death. Severe prolonged myelosuppresion was seen in those who also received LRRT. Mucositis, alopecia, nausea and vomiting were minor problems. Overall, combination was less expensive than doxorubicin based protocols.

Attachment of spermatozoa to in vitro matured bovine oocytes in TCM-199 and MEM media.

Investigation was undertaken to study the efficacy of TCM 199 and MEM media in the process of oocyte maturation and fertilization after harvesting the oocytes from slaughtered cow and heifer ovaries by aspiration and mincing techniques. Out of 354 number of ovaries, mincing method could yield 1.35 (50.98%) of good quality oocytes per ovary as comparison to 0.61 (55.45%) by aspiration method. The TCM 199 and MEM could record the maturation of 85.71% and 60.26% of oocytes and the rate of sperm penetration was higher in TCM 199 matured oocytes (97.21%) as compared to MEM matured ones (74.46%). The staining of oocytes by aceto-orcein stain was also employed.

Mammotrope heterogeneity in the pituitary gland of European ferret, M ustela putorius Juro: An immunoelectron-microscopic study.

Employing the superimposition technique of electron-microscopic immunocytochemistry ultrastructural heterogeneity of the mammοtropes in the pituitary gland of the European ferret, Mustela putorius furo, was studied. On the basis of the size of their secretory granules, the mammotropes were classified into three subtypes, type-I, type-II and type-Ill, which may correspond to different developmental or physiological states of a single cell type. Simultaneous study of mammotropes and somatotropes in several pairs of serial semithin sections demonstrated the occasional occurrence of bihormonal somatomammotropes/ mammosomatotropes which may represent a transitional stage of the progenitor stem-somatotrope during its differentiation into mammotrope; alternatively it may be a functional intermediate during the cross-transformation of somatotrope into mammotrope or vice versa.

Monitoring of temephos (abate) application as a cyclopicide under the guineaworm eradication programme in India.

Temephos application in unsafe water sources at a dose of 1ppm, which started in 1986, is an important activity of the guineaworm eradication programme in India. During March 1989, monitoring of temephos application was carried out in six villages in each of the five guineaworm endemic districts: Kurnool (Andhra Pradesh), Gulbarga (Karnataka), Dhar (Madhya Pradesh), Thane (Maharashtra) and Jhalawar (Rajasthan), selected for the study. Out of 62 unsafe water sources targeted in the sampled villages for temephos treatment, 43 were treated during 1989 in the five districts (coverage 69.35 per cent). Out of these 43 treated sources 79.1 per cent were free of cyclops and the rest 20.93 per cent showed a variable cyclops count. 117 adult cyclops identified from these sources included Mesocyclops byalinus (82) and M. leuckarti (35). People's perception of utility of chemical treatment of water sources varied from negligibly low to moderate levels. Those areas which received timely application of temephos during the preceding year, al sharp decline in the number of cases in 1989 was observed. However, in those villages where no temephos was applied or where application was started as late as April or May, there was no impact on prevalence of the disease.