A study of the effect of tamoxifen on serum lipoprotein profiles in premenopausal and postmenopausal women with breast carcinoma and associated risk of cardiovascular disease.

To examine the effect of tamoxifen on serum lipoprotein profiles of premenopausal and postmenopausal patients of breast carcinoma (without and with cardiovascular disease) we performed a short term evaluation of serum lipoprotein profiles of 38 pre and 42 post menopausal subjects of breast carcinoma (without and with cardiovascular disease) at baseline and after 3 and 6 months of tamoxifen therapy. The serum lipoprotein profiles of premenopausal patients of breast carcinoma, both without and with cardiovascular disease, showed no significant variation, after 3 and 6 months of tamoxifen treatment than the corresponding baseline values of premenopausal subjects. However, in postmenopausal subjects of breast carcinoma (both without and with cardiovascular disease), serum TC, Apo-B, and Lp (a) were significantly decreased and serum TG, HDL and Apo A1 were significantly elevated, after 3 and 6 months of tamoxifen treatment, than the corresponding baseline values of postmenopausal subjects. Also, the comparison of the results of the present study for pre and postmenopausal patients of breast cancer revealed that the administration of tamoxifen, as an adjuvant therapy for breast cancer, is estrogenic and beneficial for postmenopausal patients of breast carcinoma (both without and with the risk of cardiovascular disease) as the drug minimises the risk of cardivascular disease by bringing significant improvement in serum lipoprotein profiles of the patients. But the drug fails to bring any significant beneficial effect on serum lipoproteins of hyperiipoproteinemic patients of breast cancer.

A comparative of the effect of tamoxifen on serum lipid and lipoprotein profile in premenopausal & postmenopausal women with breast carcinoma & associated risk of vascular complication.

To examine the effect of tamoxifen on serum lipid and lipoprotein profile of premenopausal and postmenopausal patients of breast carcinoma (with and without vascular disease) we performed a short term evaluation of serum lipid and lipoprotein profile of 38 pre and 42 post menopausal subjects of breast carcinoma (with and without vascular disease) at baseline and during 3 and 6 months of tamoxifen therapy. The lipid & Lp profile of premenopausal patients of Breast carcinoma without vascular disease showed no significant variation after 3 and 6 months of tamoxifen treatment than the corresponding baseline values, but in premenopausal subjects of breast cancer with vascular disease and post menopausal subjects of breast carcinoma (both with and without vascular disease), Serum TC, Apo-B and Lp (a) were significantly decreased and serum HDL and Apo A-I were elevated significantly, However serum TG remain unaltered in premenopausal patients of breast carcinoma with vascular disease but found to be elevated significantly in postmenopausal subjects of breast cancer, both, with and without vascular disease, after 3 and 6 months of tamoxifen treatment, than the corresponding baseline values. Also, the comparison of the results of the present study for pre and postmenopausal patients of breast cancer revealed that the administration of tamoxifen, as adjuvant therapy for breast cancer, is beneficial for postmenopausal patients of breast carcinoma with vascular disease as the drug minimises the risk of vascular disease by bringing significant improvement in serum lipid and Lp profiles of the patients but does not have any significant beneficial effect on familial hyperlipidemic patients of breast cancer.

Chlamydial and gonococcal serology in women with tubal infertility.

Sera from 81 infertile women with tubal pathology and 40 controls were tested for the presence of antibodies against Chlamydia trachomatis & Neisserria gonorrhoeae. Indirect immunoperoxidase test (Ipazyme kit) & Enzyme linked immuno sorbent assay (ELISA kit) were used for detection of chlamydial & gonococcal antibodies respectively. Antibodies to Ch. trachomatis were found in 74.07% of the infertile women and 5% in control group. Only a very low prevalence (4.93%) of antibodies to N. gonorrhoeae was found is infertile women as compared to nil in control group. Antibodies detection is a sensitive, specific and noninvasive test for diagnosing infertility.

Observation of lipid profile and lipoproteins in viral hepatitis and hepatic coma.

Lipid profile and lipoprotein levels were estimated in 35 patients of viral hepatitis, 15 patients of viral hepatitis with coma and in age and sex match 35 healthy controls. The values were compared in different groups. Levels of triglycerides were significantly raised (145.00 +/- 30.70 mg/dl) in viral hepatitis as compared to viral hepatitis with coma (111.40 +/- 16.80 mg/dl) which were similar to controls (110.8 +/- 20.6 mg/dl). Patients who recovered had higher levels of triglycerides (136.0 +/- 30.8 mg/dl) as compared to those who expired (110 +/- 15.72 mg/dl). Total serum cholesterol remained statistically unaltered in both groups. HDLc was significantly decreased in both groups, viral hepatitis (2.23 +/- 6.7 mg/dl) and viral hepatitis with coma (16.52 +/- 2.27 mg/dl) in comparison to controls (62.21 +/- 18.04 mg/dl). The levels were much lower in patients with coma than without coma. Furthermore the values were still lower in patients who expired (15.82 +/- 2.27 mg/dl) than in patients who recovered (24.13 +/- 7 mg/dl). The levels of LDLc were significantly raised in both groups, as compared with each other and in relation to mortality. VLDLc levels were significantly decreased in patients of viral hepatitis (22.13 +/- 5.8 mg/dl) as well as on viral hepatitis with coma (21.89 +/- 4.3 mg/dl). However, no significant difference was observed when compared with each other and in relation to mortality. Thus it may be concluded that isolated low value of HDLc in viral hepatitis may be used as a prognostic indicator.

Plasma lipoproteins in cortical and lacunar infarction.

Plasma lipoproteins in 30 patients of cortical infarction and 20 patients of lacunar infarction were estimated to study the relation of plasma lipids to the risk for ischaemic stroke by comparing clinical and biochemical characteristics of survivors. No significant differences were observed in the concentrations of total cholesterol, triglycerides, low density lipoproteins, very low density lipoproteins in both the groups. However patients with lacunar infarction had higher concentrations of high density lipoproteins as compared to patients with cortical infarction. These data suggest that previously demonstrated differences in HDL concentration between patients with ischaemic stroke and control subjects without stroke may be true for patients with cortical infarction but not for patients of lacunar infarction.

A study of nerve conduction velocity in patients on diphenylhydantoin therapy.

Peripheral nerve conduction studies were performed in 30 epileptics, treated with DPH and results were compared with age and sex matched controls. There was significant reduction in the amplitude of sensory nerve action potential of median (26.65 +/- 14.71 mu v) and superficial radial nerve (25.65 +/- 10.08 mu v) (p < 0.001) in DPH treated group as compared to controls, (median nerve 42.64 +/- 15.93 uv and superficial radial nerve 40.72 +/- 24.74 mu v). The results suggest that DPH causes a subclinical distal axonal neuropathy in therapeutic dosage.

Serum cholesterol and its components (high, low & very low density lipoproteins) in children of patients of myocardial infarction.

Total serum cholesterol and its components high density lipoprotein, low density lipoprotein and very low density lipoprotein were estimated in serum of 409 children (212 males and 197 females) of 189 patients with myocardial infarction (MI). The patients were divided into 2 groups--1. having MI before the age of 40 years and 2. having it after 40 years. Three hundred and nine children were of parents belonging to group 1 and 100 children were of parents from group 2. Lipid patterns of these children were compared. Comparison was also carried out in subgroups made as per the age and sex of the parents. It was concluded that the disease is more likely to transfer from young patients to their children. Both paternal as well as maternal effects exist in young patients of MI but the paternal effect is dominant. In children of parents having myocardial infarct at a latter age, maternal effect is predominant. The lipid patterns of male and female case-children were also compared with the respective controls. More significant differences in the levels were observed in male case-children indicating that the disease is more likely to transfer in male case-children.

Comparison of sodium valproate and phenytoin as single drug treatment in generalised and partial epilepsy.

Ninety four patients of generalised and partial epilepsy were randomly assigned to treatment with sodium valproate (49 cases) or phenytoin (45 cases). Serum levels were monitored. Cases were evaluated after 4, 12, 24 weeks of treatment. Both drugs were found to be equally effective in controlling generalised seizures. However, valproate is better in partial seizures. No correlation could be established. Side effects were minor with both the drugs.

Serum iron and total iron binding capacity in leprosy patients.

Serum Iron and total Iron binding capacity was estimated by Ramsay's Method in 40 leprosy patients having different types of leprosy and 20 normal subjects serving as controls. Significantly low serum Iron and total Iron binding capacity were observed in lepromatous leprosy patients.

Valproate sodium in epilepsy. A clinical trial including monitoring of drug levels.

Sodium valproate was used as monotherapy in 90 cases with epilepsy who had at least one fit per week, irrespective of the type of seizures. The effect of the drug was evaluated on the basis of change in seizure frequency. Serum valproic acid levels were estimated by homogenous enzyme immunoassay. All the patients with absence (5/5) and myoclonic (3/3) seizures and 80% (42/53) of cases with generalized tonic-clonic seizures, became seizure free. Six of ten patients with only tonic seizures became seizure free. An average daily dose of 19.6 mg/kg provided a mean valproic acid level of 81.4 micrograms/ml in all seizure free patients. No correlation could be established between valproate dose and serum levels. Mild transient side effects were noted. No haematologic abnormality or hepatotoxicity was observed. Valproate sodium effectively controlled seizures in a majority of patients with partial seizures. Serum level monitoring helps to establish an optimal dose to keep the patient seizure free. No correlation could be established between side effects and serum levels.

Lipid profile in smokers.

In this study we observed that all the lipids except HDL cholesterol were higher in heavy smokers and those making for longer duration. HDL cholesterol was lower in smokers than nonsmokers. The changes in lipid profile were similar in cigarette and bidi smokers.

Study of serum zinc level in leprosy.

Serum Zinc level was estimated in different types of leprosy by 'Dithiazone extraction' method in 75 leprosy patients comprising 15 each of Tuberculoid-Tuberculoid (TT); Borderline Tuberculoid (BT); Borderline Borderline (BB); Borderline Lepromatous (BL) and Lepromatous Lepromatous (LL). These findings were evaluated in comparison to 15 normal subjects serving as controls. Serum zinc level was observed to be significantly low in all types of leprosy except tuberculoid leprosy (TT). No significant difference was observed in serum zinc levels before and after 90 days of dapsone Therapy. The findings of our study are of considerable importance as zinc deficiency can be one of the factors involved in non-specific suppression of cell mediated Immunity (CMI) in lepromatous leprosy.

Significance of serum phosphohexose isomerase, hexokinase and aldolase in carcinoma ovary.

The serum phosphohexose isomerase (PHI), aldolase and hexokinase activities have been determined in 36 patients of carcinoma ovary with different clinical stages and in 25 healthy normal female subjects. The serum PHI and hexokinase levels were significantly elevated (P less than .001) in all the stages of malignancy while serum aldolase was significantly elevated only in stages III and IV of malignancy. The enzyme levels showed statistically significant response to therapy in stage II patients. The mean values in patients with progression of the disease were not significantly different.