ABSTRACT
The evaluation of coronary artery disease (CAD) concerning the metabolic status and body mass index (BMI) is poorlystudied. This study was designed to observe the relationship between insulin resistance (IR) and the severity of CADon the basis of the metabolic and phenotypic status in stable-angina patients. A cross-sectional study was conductedon 532 patients with stable angina and coronary angiogram was done to diagnose the CAD for all. Determination ofmetabolic obesity was done using the National Cholesterol Education Program-Adult Treatment Panel III criteria.Phenotypic obesity was defined as BMI ≥ 25 kg/m2. Homeostasis model assessment IR in correlation with the severityof CAD was measured using SYNTAX (TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for theTreatment of Narrowed Arteries) Score. The average age of the patients was 57.58 ± 10.40 years, and 69.4% weremales. Out of 532 subjects, 51.3% were hypertensive, 14.5% were smokers, 29.1% consumed alcohol, 49.3% weremetabolically obese, and 50% were phenotypically obese. Increase in IR increased the risk of severity of CAD inmetabolically obese subjects (OR = 2.51, p = 0.048). In the phenotypically obese group, the relationship between IRand the severity of CAD was not statistically significant (OR = −2.19, p = 0.08). The study concludes that the increasedIR increases the risk of severity of CAD in metabolically obese subjects.
ABSTRACT
Background & objectives: Short chain acyl coenzyme A dehydrogenase deficiency (SCADD) is a rare autosomal recessive inborn error of mitochondrial fatty acid β oxidation. The energy producing fatty acid oxidation pathway is affected at the first step due to deficiency of short chain acyl coA dehydrogenase and is manifested as lethargy, metabolic acidosis and hypoglycaemia. We report a case ofeight day old male neonate born to 32 year old female by caesarean delivery diagnosed with SCADD. Investigations: Blood investigations of haematology, serum electrolytes, and enzymes levels were done. Metabolic screening for TSH, galactosaemia, blood ammonia was also conducted. Results: Serum sample revealed elevated acyl carnitine levels and urine analysis for organic acid showed slightly elevated Methyl malonic acid. The neonate was mechanically ventilated and metabolic acidosis was corrected with 8.4 % sodium bicarbonate andintravenous dextrose. Carnitor syrup 5ml/500mg was started once daily and the neonate improved in general activity along with weight gain. Conclusion: Neonatal screening by biochemical method facilitates earlier diagnosis and, along with effective management prevents morbidity and prolongs survival.
ABSTRACT
Angiogenesis is a hallmark of wound healing, the menstrual cycle, cancer, and various ischemic and inflammatory diseases. A rich variety of pro and anti-angiogenic molecules have already been identified. Vascular endothelial growth factor (VEGF) is an interesting inducer of angiogenesis and lymphangiogenesis, because it is a highly specific mitogen for endothelial cells. Signal transduction involves binding to tyrosine kinase receptors and results in endothelial cell proliferation, migration, and new vessel formation. In this article, the role of VEGF and other growth factors in the pathology of dysfunctional uterine bleeding is reviewed. We also discuss the role of VEGF expression and interaction with extracellular matrix that lead to possible inhibition or stimulation of Angiogenic factor on endometrium of dysfunctional uterine bleeding patients.
ABSTRACT
Background: In fluorosis endemic area, the amount of fluoride transferred to the fetus is significant in determining the early onset of fluorosis. The role played by placenta in transporting fluoride and other ions which are present in high concentrations in the local drinking water is studied. Aims & Objectives: The aim of the present study is to decipher the role of placenta in transport of fluoride to the fetus and to analyze the placental binding & distribution of fluoride, calcium and magnesium within the placenta. Materials & Methods: 200 healthy pregnant women aged between 17- 28 yrs were inducted in the study. All the women had a normal & uneventful delivery. The maternal blood, cord blood & placenta were collected immediately after delivery. The placenta was divided into 3 parts- the maternal side, fetal side & the peripheral. Separate tissue extracts were prepared from each site and analyzed. Fluoride, calcium and magnesium were quantified from the samples. Results: The average drinking water fluoride was 1.64±0.49ppm and ground water fluoride was 10.94±2.09ppm. Fluoride concentration of placenta on the maternal side was 1.62±0.787 ppm and in the periphery it was2.54±1.54 ppm (p<0.001) while that of the fetal side of placenta was1.41±0.776 ppm. Maternal and cord blood fluoride levels were1.21±0.79ppm and 0.45±0.304 ppm respectively (p<0.001). The concentrations of calcium in the maternal blood and cord blood were 9.67±1.53mg% and 9.89±1.89 mg% respectively (P<0. 5). The levels of calcium in the placenta were 8.79±1.36 mg%, 9.68±1.69 mg%, 13.87±3.32 mg% respectively on the maternal surface, fetal surface and periphery (p<0.001). The magnesium concentration on the peripheral part of placenta was twofold higher than that of the maternal serum and cord serum (p<0.001) indicating a significant accumulation of magnesium on the peripheral parts of the placenta. However, the differences in the magnesium concentrations of the placenta on the maternal and fetal surfaces with that of the maternal and cord blood sera were found to be insignificant. Conclusion: The results show that, Fluoride, Calcium and Magnesium accumulate in placenta, with the highest concentration being in the marginal part. The placenta therefore acts as a barrier to the transport of fluoride ions and protects against early fluorosis.
ABSTRACT
Fluoride (F) is known to cross the placenta from the maternal blood to the growing fetus. However, there are few studies on the role of placenta in conditions of high F intake in fluorosis endemic area. The present study is the first of its kind carried out in Nalgonda district, an endemic fluorosis area of Andhra Pradesh, India with an average ground and drinking water F of 10.94+2.09 ppm and 4.4+1.6 ppm respectively. The aim of the study is to determine the role of placenta in the transport of F from the maternal blood to the fetus in fluorosis endemic area. 200 healthy pregnant women aged 17-36 years were inducted in the study. All the women had normal and uneventful delivery. Samples collected were maternal blood, cord blood & placenta. The placenta was divided into three parts- peripheral, maternal and fetal surfaces. Placental extracts were obtained and stored at -20° C until processed. F concentrations of the newborn were well within the normal reference range despite high maternal F concentrations (1.62±0.78 ppm). Placental F concentration on the peripheral side (2.54±1.55 ppm) was two fold higher than the maternal serum F (1.62±0.78 ppm; p< 0.001) and six fold higher than the cord F (0.45±0.35 ppm; p< 0.001). Placental F on the maternal (1.62±0.78 ppm) and fetal surfaces (1.41±0.77 ppm) were three fold higher than that of cord blood (p<0.001). On the peripheral part of placenta F was found to be 1.5 times higher than maternal and fetal surfaces. Thus, it can be deduced that placenta does accumulate F especially in the peripheral part when women are exposed to relatively high F concentrations in water and food. The study also suggests that placenta can act as a backstop or guard for the passage of F to the fetus; thus protecting the developing fetus against neonatal fluoride complications.