Pacing Indications and Modes in Bradyarrhythmia Patients: Gender Related Differences.

Gender differences are increasingly recognized in cardiology. It is also well known that women have higher complications and a higher mortality related to coronary procedures. In arrhythmias, gender-specific variations in the electrophysiological structure of the heart or hormonal effects may explain some of the gender differences. The aim of this study was to evaluate gender differences according to their risk factors, indications and modes of pacing. A total of 267 patients who had pacemaker implantation for bradyarrhythmia indications were enrolled in our study. A pre-designed questionnaire was filled to record their baseline characteristics, clinical indications and mode of pacing. Out of 267 patients 190 were male and 77 were female. Data was analyzed with SPSS 16.0 software (SPSS, Chicago, IL, USA) The pacemaker implantation requirement was 31% significantly lower among males compared with females who were hypertensive (RR=0.69, 95%CI=0.58-0.82, p=0.0001) and 1.57 times (RR=1.57, 95%CI=1.32-1.87, p=0.0001) significantly higher among male patients than females who were the tobacco user in any form. The single chamber requirement was 1.41 times significantly (RR=1.41, 95%CI=1.16-1.71, p=0.0001) higher in males than females. The risk analysis showed that complete heart blockage (p= 0.02) and sick sinus syndrome (p= 0.01) were significantly higher in males as compared with females. In conclusion male patients had more CHB, sick sinus syndrome and syncope as primary pacemaker indication, compared with female patients. Smoking was the most prominent risk factor in male and hypertension in female and most importantly there were significant gender differences in indications leading to pacing.

Influence of APOA5 (rs662799 and rs3135506) gene polymorphism in acute myocardial infarction patients and its association with basic coronary artery disease risk factors.

The aim of this study was to examine the allele and genotype of APOA5 -1131T/C (rs662799) and APOA5-56C/G (rs3135506) gene in acute myocardial (AMI) case and control subjects. 304 case and 304 controls were enrolled in this study. DNA was extracted using salting out method followed by polymerase chain reaction amplification and restriction endonuclease digestion (using MseI for -1131T/C and Taq1 for -56C/G). Digested PCR products were identified using agarose gel electrophoresis and stained with ethidium bromide. There was a strong association between APOA5 -1131T/C (TC vs. TT, OR= 1.58 and CC vs. TT OR= 2.43) and APOA5 -56C/G (CG vs. CC, OR= 1.64 and GG vs. CC, OR= 2.44) polymorphisms with AMI. Out of the six potential risk factors for coronary artery disease, only smoking, diabetes and hypertension were found to be associated with APOA5 gene and increased the risk of AMI. Smoking was the most prominent risk factor for both the genes. Other risk factors like history of dyslipidemia, obesity and family history of coronary artery disease did not reveal any potential association with the candidate gene. Our data demonstrate that both the SNPs in the APOA5 gene (-1131T/C, and -56C/G) were strongly associated with AMI in north Indian population.

Antidiabetic activity of heart wood of Pterocarpus marsupium Roxb. and analysis of phytoconstituents.

The crude powder, ethanolic extract and aqueous, chloroform, hexane and n-butanol soluble fractions of ethanolic extract of heart wood of P. marsupium showed marked improvement on oral glucose tolerance post sucrose load in normal rats. All these fractions except aqueous fraction showed improvement on oral glucose tolerance post sucrose load on streptozotocin (STZ)-induced diabetic rats. The crude powder, ethanolic extract and hexane and n-butanol fractions showed marked decline in blood glucose level on STZ-induced diabetic rats. The ethanolic extract (100 mg/kg body weight) when given to STZ-induced diabetic rats for 10 consecutive days declined blood glucose, improved OGTT and increased their serum insulin levels. The ethanolic extract also showed marked improvement on oral glucose tolerance on high fat-low dosed STZ-induced diabetic rats and neonatally STZ treated rats. The ethanolic extract of P. marsupium also showed marked antidyslipidemic effects on high fat diet fed Syrian golden hamsters. Altered renal and hepatic function markers and serum insulin levels of high fat diet fed-low dosed STZ-treated diabetic rats were also found towards normalization when these animals were treated with ethanolic extract of P. marsupium for 28 consecutive days. The four out of five phenolic C-glycosides isolated from n-butanol fraction of ethanolic extract of P. marsupium enhanced glucose uptake by skeletal muscle cells (C2C12) in a dose dependent manner. It may primarily be concluded that phenolic-C-glycosides present in P. marsupium heart wood are the phytoconstituents responsible for the antihyperglycemic activity and validate the claim of antidiabetic activity of heart wood of P. marsupium.

Suicide: an Indian perspective.

Suicide, as an issue, has attracted the attention of society since time immemorial. Its situation in India and the socio-demographic variables have been discussed along with management profile. The education of physicians and general practitioners in suicide prevention has been stressed.