Effect of aluminium on lipid profile and atherogenic index in prepubertal and young adult female rats: A pilot study

Objectives: Exposure of aluminium (Al) to mankind is inescapable, and its dyslipidaemic impact is a possible contributing factor to health hazards like cardiovascular diseases. The health effects due to the metalloestrogenic property of the metal need imperative consideration. The current experimental work was undertaken to explore Al-induced dyslipidaemia due to its metalloestrogenic property. Materials and Methods: To fulfil this objective, prepubertal (PP) and young adult (YA) female Wistar rats were intraperitoneally administered to two doses of Al [5 and 10 mg/Kg body weight (BW)] once daily for 2 weeks. After the completion of the acute exposure protocol, plasma and hepatic tissue lipid profiles were estimated. Analysis of variance was carried out by the Kruskal–Wallis test and the differences between the groups were analysed by Mann–Whitney U post hoc test Results: Increased triglyceride, total cholesterol, low-density lipoprotein (LDL) cholesterol and very-LDL cholesterol in plasma were found in YAs treated with both doses of Al in a dose-dependent manner. Similar changes were not present in PP female rats. Decreased levels of lipid levels were observed in the case of hepatic lipid profile. Conclusion: The study ushers light towards the dyslipidaemic alterations in experimental female rats after acute Al exposure. Impacts of Al on the growth and organosomatic index during the vital developmental days were significantly decided by the pubertal status of the female rats. The results of this study indicate the impact of puberty on the Al-induced modifications in lipid profile parameters and cardiovascular risk factors.

PREVALENCE AND PATTERN OF DYSLIPIDEMIA AND ITS ASSOCIATED FACTORS IN CHRONIC KIDNEY DISEASE PATIENTS

A study of Lipid profile in CKD patient is subject of interest due to impact on the individual and society as dyslipidaemia is one of the traditional risk factors for CVD which is responsible for most of the morbidity & mortality in CKD patient. And its study can lead to therapeutical result affecting both short term and long-term outcomes. To identify and analyse lipid AIMS & OBJECTIVE - alteration in CKD patients and study the correlation between renal function and lipid abnormalities in CKD Our study is hospital METHODS – based descriptive observational study for duration of 18 months. Study included 100 patients RESULTS – in which mean age was 51.88 and male to female ratio of 1.5:1. Prevalence of Lipid Profile abnormalities seen as HDL decreased in 100% patient and Cholesterol, LDL, Triglyceride increased in 40%, 24%, 64% patients respectively Dyslipidaemia is common among pa CONCLUSION - tients with CKD and predominant lipid profile abnormalities were reduced HDL and elevated Triglycerides. Hence regular monitoring of lipid profile should be done in patients of CKD

Efficacy and safety of Saroglitazar and Fenofibrate in the treatment of diabetic dyslipidaemia: A pilot study

Objectives: Diabetic dyslipidaemia (DD) is characterised by hypertriglyceridaemia and elevated or normal levels of low-density lipoprotein cholesterol and decreased levels of high-density lipoprotein cholesterol with Type 2 diabetes mellitus. Statins and anti-diabetic medication are coprescribed for optimal control. Materials and Methods: The objective of the study was to compare the safety and efficacy of Saroglitazar 4-mg and Fenofibrate 200 mg in combination with low dose Atorvastatin (10 mg) in patients with DD. Run-in period of 4 weeks for life-style and diet modification followed by 12 weeks of treatment with saroglitazar or fenofibrate and low dose of atorvastatin was followed. Primary outcome of this study was an absolute change in serum triglyceride level at baseline and end of treatment period (12 weeks). Secondary outcome was changed from baseline lipid profile, fasting blood glucose and glycosylated haemoglobin (HbA1c) at the end of treatment period. Safety assessment was also done during the duration of study. Results: Forty patients of DD were randomly divided into two groups. One group received Saroglitazar 4 mg along with Atorvastatin 10 mg. Patients in second group received Fenofibrate 200 mg along with Atorvastatin 10 mg. Improvement in deranged lipid levels in both the groups was observed and this difference in improvement statistically was not found to be significant. We also observed that Saroglitazar significantly improves glycaemic profile by decreasing fasting blood sugar levels and HbA1c (P = 0.01, P < 0.01). Adverse events reported during this study were mild and none of the patients reported serious adverse events. Conclusion: Saroglitazar could be a potential drug to control both hyperglycaemia and dyslipidaemia in patients with DD.

Effect of Nyctanthes arbor-tristis on cardiovascular parameters and metabolic syndrome in fructose-induced hypertensive rats

Objectives: We investigated the effects of methanolic extract of Nyctanthes arbor-tristis (MNAT) 100, 200 and 400 mg/kg/day post-operative for 6 weeks on ECG, basal mean arterial blood pressure (MABP), heart rate, respiratory rate, vascular reactivity, antioxidant activities of enzyme superoxide dismutase (SOD) and catalase (CAT), levels of thiobarbituric acid reactive substances (TBARS), serum levels of leptin, adiponectin, glucose, triglycerides, cholesterol, uric acid, insulin, sodium and potassium in fructose-fed rats. Materials and Methods: A high-fructose-diet (fructose 10%, w/v) ad libitum for 6 weeks was used to induce hypertension in male Wistar rats (150–200 g). Sixty albino Wistar rats were randomly divided into a group of six, each group containing 10 animals. Group I was considered as normal control which received chow pellets and normal drinking water ad libitum for 6 weeks. Group II received fructose (10%) solution instead of normal drinking water for 6 weeks. Group III received fructose (10%) solution instead of drinking water ad libitum and MNAT at a dose of 100 mg/kg post-operative for 6 weeks. Group IV received fructose (10%) solution instead of drinking water ad libitum and MNAT at a dose of 200 mg/kg post-operative for 6 weeks. Group V received fructose (10%) solution instead of drinking water ad libitum and MNAT at a dose of 400 mg/kg post-operative for 6 weeks. Group VI received fructose (10%) solution instead of drinking water ad libitum and enalapril at a dose of 10 mg/kg post-operative for 6 weeks. Physiological parameters, ECG, heart rate, respiratory rate and blood pressure vascular reactivity to various drugs were measured and recorded by the invasive method. The antioxidant activities of enzyme SOD and CAT, levels of TBARS, along with serum levels of leptin, adiponectin, glucose, triglycerides, cholesterol, uric acid, insulin, sodium and potassium were measured. Cumulative concentrationresponse curve (CCRC) of Ang II and acetylcholine (Ach) was recorded. Results: MNAT treatment decreased MABP and altered vascular reactivity to various catecholamines. The activities of SOD and CAT enzymes exhibited a considerable increase and the levels of TBARS in the liver were reduced by MNAT treatment. MNAT has shown decrease in the plasma level of triglycerides, cholesterol, insulin and sodium while increase in plasma adiponectin and potassium levels. The CCRC of Ang II was shifted towards the right by MNAT treatment using an isolated strip of rat ascending colon. MNAT treatment increased the contractile characteristics of the rat ascending colon in the CCRC of ACh as compared to the fructose-treated group. MNAT treatment reduced fructose-induced tissue damage due to the consequence of metabolic syndrome (MetS). MNAT is rich in flavonoids and, therefore, has powerful antioxidant properties. The findings show that by battling oxidative stress caused by fructose (10%) and reducing Ang II activity, MNAT may be able to prevent the development of high blood pressure caused by fructose. Conclusion: MNAT has antihypertensive action and reverses MetS in the fructose-induced hypertensive rat model.

STUDY ON RELATIONSHIP BETWEEN OBESITY & LIPID PROFILE IN NORMAL POPULATION OF CENTRAL UTTAR PRADESH

INTRODUCTION: Obesity is generally considered to play a key role in the metabolic syndrome, including hypertension. Metabolic syndrome is defined as a cluster of as a combination of obesity, insulin resistance, hyperinsulinemia, dyslipidaemia and hypertension. Other measures of obesity apart from Body Mass Index (BMI) are Waist Circumference (WC) and Height Weight Ratio (HWtR) and are efficient risk factors for prediction of CVD in children. BMI is calculated as person's weight (kg) 2 divided by height in meters (m ). Correlation between BMI and lipid profile were studi MATERIAL & METHODS: ed in a sample of 270 people (154 males & 116 females). In our study, we found that Mean total cholest RESULT: erol of Group I and Group II patients was 163.88±50.17 mg/dl and 184.02±36.31 mg/dl respectively. Total mean total cholesterol of the patients was 173.95±44.86 mg/dl. Triglycerides in Group I and Group II patients was 152.84±58.82 mg/dl and 157.28±73.29 mg/dl respectively. Total mean total cholesterol of the patients was 155.06±66.37 mg/dl. HDL in Group I and Group II patients was 48.55±16.76 and 47.03±9.06 respectively. Total mean total cholesterol of the patients was 47.79±13.47 mg/dl. The mean LDL of Group I and Group II patients was 85.04±36.13 mg/dl and 113.1926±24.35 mg/dl respectively. Total mean LDL of the patients was 99.11±33.83 mg/dl. Total Chol CONCLUSION: esterol and LDL of the studied patients have shown significant correlation in both groups (p<0.05). Triglycerides and HDL of the studied patients have shown non-significant correlation in both groups. (p>0.05)

Evaluation of Dyslipidaemia among Different Age Groups in Urban South Indians

The significant reason for morbidity and mortality in industrialised countries is coronary artery disease. Globally, it is considered as one of the major public health problems. There is emerging evidence of premature coronary artery disease occurring in Asian Indians at least 10 years earlier as compared to other ethnic groups. The most important atherosclerotic risk factor is dyslipidaemia. Recent studies have reported that Total Cholesterol (TC), Low Density Lipoproteins (LDL), Triglycerides (TG) levels have increased among young urban population over a 20-year period. Hence, this study was carried out to find out the prevalence of dyslipidaemia among different age groups in urban South Indian population. METHODSThis study is a descriptive cross-sectional study conducted among patients visiting the OPD of Department of General Medicine. The study subjects were divided into 3 groups as per age as 18 - 40 years, 41 - 60 years and > 60 years by involving 1989 subjects of whom 532 were in 18 - 40 years age group, 522 were in 41 - 60 years age group and 935 were over 60 years of age. In this study, fasting serum lipid profile was estimated. RESULTSThe study revealed higher prevalence of dyslipidaemia in the group < 60 years. Statistically significant difference in mean was found with cholesterol, LDL, and triglycerides in the age group of 18 - 40 years and more than 60 years. Statistically significant difference was not found between 18 – 40 years and 40 - 60 years for HDL. Mean serum cholesterol was high in the age group 18 – 40 years. The highest mean triglycerides were found in the age group of 41 - 60 years. The highest mean HDL levels were found in the above 60 years age group. CONCLUSIONHigher percentage of dyslipidaemia was found in the age groups less than 60 years. It is also the need of the hour to devise comprehensive strategy for awareness programme for periodically screening of all age groups.

Metabolic syndrome in south Indian population with skin tags: a hospital-based case control study

Background: Metabolic syndrome is a constellation of several clinical and laboratory cardiovascular risk factors that have been linked with numerous medical and dermatologic conditions. Recent evidence suggests a strong association between skin tags and insulin resistance and obesity, yet there is a paucity of data on relation of skin tags with metabolic syndrome as a whole. Aim of the study was to evaluate the strength of association between skin tags and metabolic syndrome.Methods: 70 patients with skin tags and an equal number of age and gender matched controls were enrolled in a hospital-based case control study. Anthropometric measures, blood pressure, fasting glucose, high density lipoprotein cholesterol and triglycerides were measured. Metabolic syndrome was diagnosed by the presence of 3 or more of the south Asian modified national cholesterol education program’s adult panel III criteria. Statistical analysis was performed using chi square test, and odds ratio was calculated. P≤0.05 were considered significant.Results: Metabolic syndrome was significantly more common in patients with skin tags than in controls (70% vs. 26%, p<0.001). Triglycerides and waist circumference values were significantly increased in cases as compared to controls (p<0.05).  There was no statistically significant difference in the high-density lipoprotein levels, fasting blood glucose levels and presence of hypertension among cases and controls.Conclusion: Skin tags when present in multiple could be an early warning sign for Metabolic syndrome. They serve a cutaneous marker to initiate early detection and intervention of at-risk patients for cardiovascular disorders.

Clinical Application of Fasting and Post-Prandial Lipid Profile in Patients of Chronic Kidney Disease.

Dyslipidemia is a traditional risk factor for cerebrovascular disease and cardiovascular disease (CVD). CKD is associated with dyslipidemia. Patients with CKD will be more prone to the CVD and cerebrovascular disease as compared to normal healthy individuals. Thus, it is important to cover the postprandial lipid profile for better assessment and treatment of dyslipidemia. We wanted to study the postprandial lipid profile in patients of CKD. MethodsThis is a case control study conducted in Acharya Vinoba Bhave Rural Hospital (AVBRH) Sawangi (Meghe), Wardha, Maharashtra, between September 2016 and September 2018. In this study, we enrolled 150 cases and 75 controls. ResultsFasting lipid profile in CKD patients was higher as compared to controls and was found to have similar post-prandial lipid profile. When we compared the fasting and post-prandial lipid profile in patients with CKD, we found that a substantial difference existed. We found a considerable difference in the fasting and post-prandial lipid profiles even in the controls. ConclusionsPatients with CKD and diabetes mellitus had a significant increase in the total cholesterol, triglycerides, low density lipoprotein and very low-density lipoprotein in the fasting and post-prandial state. In clinical practice, the implementation of standardized methodologies and biomarker profiles would allow for the early and reliable detection of those at risk.

Study of Lipid Profile in Metabolic Syndrome Patients

Background: Metabolic syndrome is a group of metabolic abnormalities in which the chance of developing cardiovascular disease, diabetes mellitus, chronic kidney disease are high.Aim:It aims at studying the lipid abnormalities in metabolic syndrome patients.Methods: Total of 100 metabolic syndrome patients were selected for study over a period of 1year. These patients were selected based on the criteria for metabolic syndrome as established by National Cholesterol Education Program (NCEP) adult Treatment Panel III (ATP III). Demographic data were taken and biochemical parameters were estimated by standard guideline. Results:Total cholesterol is significantly higher in very high risk(272.1 ± 8.591) compared to high risk (241.2 ± 3.901) and moderate risk (231.5 ± 4.498). TGL is significantly higher in very high risk (263.9 ± 13.70) compared to high risk (202.1 ± 6.531) and moderate risk (183.7 ± 7.650). HDL is almost same in very highrisk (43.09 ± 1.533), high risk (40.44 ± 0.996) and moderate risk (42.53 ± 1.088). LDL is significantly higher in very high risk (177.9 ± 4.255) and high risk (169.4 ± 3.190) compared to moderate risk (155.7 ± 3.098). VLDL is significantly higher in very high risk (52.78 ± 2.739) compared to high risk (40.43 ± 1.306) and moderate risk (36.73 ± 1.530). CHO: HDL is significantly higher in very high risk (6.648 ± 0.366) compared to moderate risk (5.560 ± 0.207). High risk (6.060 ± 0.156) is not significantly different from very high risk and moderate risk. Thus TC, TGL, LDL, VLDL, and CHO: HDL is significant as p value < 0.05 while HDL did not have any significance as p value > 0.05.Conclusion: In this study, high prevalence of dyslipidaemia is seen. So, timely diagnosis and treatment will help in detecting dyslipidaemia patients in future

Thyroid Dysfunction in Metabolic Syndrome Patients in a Tertiary Care Hospital.

Metabolic syndrome is a prevalent non-communicable disease in the present era. It manifests as obesity, impaired fasting blood glucose, dyslipidaemia, and hypertension. Hypothyroidism causes hypertension, dyslipidaemia, and impaired carbohydrates metabolism, which are all components of metabolic syndrome. The cardiovascular system is very sensitive to thyroid hormones. METHODSA cross sectional study was conducted from October 2017 to March 2019 in adult population aged 18 years and above, with features of Metabolic syndrome diagnosed according to National Cholesterol Education Programme Adult Treatment Panel – III (NCEP ATP III) criteria. Study was conducted in the department of general medicine, GSL Medical College and General hospital, Rajahmundry, Andhra Pradesh. RESULTSIn a total of 134 patients with metabolic syndrome, 39 were male (29.2%) and 95 were female (70.8%). The mean age of the study population was 54.63 ± 10.9 years. The prevalence of thyroid dysfunction in the present study is 28.4%. In the present study, metabolic syndrome is found to be significantly (p=0.032) associated with thyroid dysfunction. CONCLUSIONSBoth hypothyroidism and hyperthyroidism are associated with cardiovascular manifestations. Hypothyroidism and subclinical hypothyroidism cause cardiovascular manifestations along with metabolic changes. Investigating the thyroid function status may be considered as a part of screening in patients with metabolic syndrome.

Gender Differences in Risk Factors of Ischemic Stroke Patients in a Tertiary Care Centre in North India

Every year, more than 33 million people worldwide experience an acute stroke. ischemic stroke is caused by loss of blood supply to brain tissues due to sudden occlusion of arterial system by an embolus or a thrombus. Non-modifiable risk factors are age, sex & genetic factors whereas modifiable ones include hypertension, diabetes, smoking, tobacco chewing, dyslipidaemia, obesity, cardiac disease etc. Aim of the present study is to evaluate & compare the presence of various risk factors of ischemic stroke among males & females.METHODSThe study was conducted at BRD Medical College, Gorakhpur, during the academic year 2019-2020. All patients with ischemic stroke on CT Head & age >18 years were included in this cross-sectional study. Detailed history including age, addictions, comorbidities (diabetes, hypertension), previous stroke history & compliance to treatment was taken. A short neurological & laboratory examination was performed in each patient.RESULTSIn this study, a total of 100 patients was included out of which 57 were male & 43 were female. The mean age of stroke was 64.82 years [males-65.62 years, females-63.5 years]. The most common risk factors responsible for ischemic stroke was hypertension- 52% [males- 50.4%, females- 53.57%]. Other risk factors were diabetes- 28% [males- 29%, females- 25.6%], cardiac disease-13% [males-8.8%, females-18.6%], dyslipidaemia-12.3% in males & none of females. Smoking & tobacco chewing were more common among males (54.4% each). Dyslipidaemia & tobacco use was significantly associated with ischemic stroke in male patients.CONCLUSIONSThere is increasing incidence of acute ischemic stroke which is directly related to modifiable risk factors like dyslipidaemia, smoking & tobacco use in male patients. Advanced age is strongly related to acute stroke in both males & females. Hypertension is the commonest risk factor overall for ischemic stroke.

Comparison of risk profile in pre-menopausal and post-menopausal women with acute coronary syndrome

Background: The physiological changes associated with menopause are responsible for increase in cardiovascular disease after menopause. BMI, physical inactivity, metabolic syndrome, hypertension and diabetes mellitus increase in post-menopausal women which are all powerful predictors of cardiovascular events. The risk factor profile between pre-menopausal and post-menopausal women presenting with acute coronary syndrome was thus studied.Methods: This study was a prospective cross-sectional hospital based study and was conducted in the Department of Medicine and Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana wherein 50 pre-menopausal women and 50 post- menopausal women who presented with acute coronary syndrome were enrolled. The risk factor profile and angiography findings amongst the 2 groups were compared.Results: There was no difference in the incidence of Diabetes Mellitus and Hypertension among the pre & post-menopausal groups. The prevalence of family history of cardiovascular disease was higher in the pre-menopausal group. The post-menopausal women showed a significant decrease in physical activity due to sedentary lifestyle. Both the groups had high BMI and increased waist circumference. Lipid parameters did not show any significant difference between the two groups. However, pre-menopausal women had higher LDL-C and triglyceride levels and lower HDL-C levels. On analysis of the angiographic findings in diabetics and non-diabetics, of both the groups diabetes mellitus was much higher in subjects presenting with triple vessel disease suggesting extensive atherosclerosis.Conclusions: study showed physical inactivity as an important cardiovascular risk factor in post-menopausal women. Obesity is an important risk factor for coronary artery disease in both pre- and post-menopausal women.

Multimodal HIIT is more efficient than moderate continuous training for management of body composition, lipid profile and glucose metabolism in the diabetic elderly / El entrenamiento multimodal es más eficiente que el entrenamiento continuo moderado para el manejo de la composición corporal, el perfil de lípidos y el metabolismo de la glucosa en adultos mayores diabéticos

The exercise could play a central role to the fat management and glucose metabolism what can be a critical role in the health status of diabetic people, but the high intense exercise remains with controversial data about their effects. To identify the effect of the multimodal high-intensity interval training on body composition, lipid profile, and glucose metabolism in elderly diabetics. Methods: Elderly diabetic individuals (n = 48) were randomly divided in a Sedentary Control (SC) group, a Moderate-Intensity Continuous Training (MICT) group, and a High-Intensity Interval Training (HIIT) group. MICT and HITT were conducted over 60 days, 3x per week, with 40 minutes of exercise. Blood was collected prior to intervention, at four, and at eight weeks subsequently to assess glucose metabolism and lipid profiles. Body composition was determined before and after the intervention period. To verify the normality Kolmogorov-Smirnov statistical test was performed, followed by student "t" test or two-way ANOVA with Bonferroni's post hoc test with significance of 5 % the Cohen's f test to indicate the magnitude of the differences. HIIT significantly lowered cholesterol and triglyceride levels, and significantly lowered blood glucose and glycosylated haemoglobin levels (p<0.05). MICT and HIIT significantly increased levels of high-density lipoprotein, decreased total body mass and body mass index. HIIT resulted in significantly smaller waist circumferences, waist-to-hip ratios, and weight-to-height ratios over 60 days of training. HIIT is more effective than MICT for improving lipid and glycaemic profiles, decreasing body fat, and improving fat distribution elderly diabetics.

El ejercicio podría desempeñar un papel central en el manejo de la grasa y el metabolismo de la glucosa, lo que puede ser un papel crítico en el estado de salud de las personas diabéticas, pero el ejercicio intenso intenso sigue teniendo datos controvertidos sobre sus efectos. El objetivo del estudio fue identificar el efecto del entrenamiento multimodal de intervalos de alta intensidad sobre la composición corporal, el perfil lipídico y el metabolismo de la glucosa en diabéticos de edad avanzada. Los individuos diabéticos de edad avanzada (n = 48) se dividieron aleatoriamente en un grupo de control sedentario (SC), un grupo de entrenamiento continuo de intensidad moderada (MICT) y un grupo de entrenamiento de intervalos de alta intensidad (HIIT). MICT y HITT se realizaron durante 60 días, 3 veces por semana, con 40 minutos de ejercicio. Se recogió sangre antes de la intervención, a las cuatro y a las ocho semanas posteriormente para evaluar el metabolismo de la glucosa y los perfiles de lípidos. La composición corporal se determinó antes y después del período de intervención. Para verificar la normalidad se realizó la prueba estadística de Kolmogorov-Smirnov, seguida de la prueba "t" de Student o ANOVA de dos vías con la prueba post hoc de Bonferroni con una significancia del 5 % de la prueba f de Cohen, indicando las diferencias. HIIT redujo significativamente los niveles de colesterol y triglicéridos, además de reducir de manera importante los niveles de glucosa en la sangre y la hemoglobina glicosilada (p <0.05). MICT y HIIT aumentaron significativamente los niveles de lipoproteína de alta densidad, disminuyeron la masa corporal total y el índice de masa corporal. HIIT resultó en circunferencias de cintura significativamente más pequeñas, relaciones cintura-cadera y relaciones peso-altura durante 60 días de entrenamiento. HIIT es más efectivo que MICT para mejorar los perfiles de lípidos y glucémicos, disminuir la grasa corporal y mejorar la distribución de grasa en los diabéticos de edad avanzada.

Importance of carotid intimal medial thickness measurement in patients with coronary artery disease

Background: Prevalence of CAD in urban India is about double that of rural India and about 4-fold higher than in United States. Mortality related to CAD is high in Indian Population. Early diagnosis can prevent the CAD related morbidity and mortality. Aims and objectives is to study and compare the CIMT among the patients with CAD and asymptomatic control group.Methods: Hundred patients with CAD were studied for the CIMT and compared with age and sex matched asymptomatic control subjects in Department of Medicine of G. R. Medical College, Gwalior for one year from 2012 to 2013. Details on history, risk factors and presenting symptoms were recorded for all. High resolution B mode ultrasonography was performed to assess CIMT of carotid arteries.Results: CAD was more prevalent among males (78%) having mean age of 56.82±8.91 years. Majority of CAD patients had dyslipidemia (42%) followed by hypertension (21%), diabetes (13%) and smoking (17%). Majority of the CAD patients had chest pain (98%) followed by breathlessness (54%) and sweating (12%) as the most common presenting symptom. Mean CIMT was significantly more among the CAD patients (0.76±0.34) as compared to those without it (0.63±0.22) (p<0.001).Conclusions: CIMT was found to be more in CAD as compared to asymptomatic control subjects. CIMT can be an important tool for assessing CAD and atherosclerosis.

Gestational diabetes mellitus causes dyslipidemia in late trimester: mini review

The incidence of gestational diabetes mellitus (GDM) is increasing rapidly worldwide. Many women with gestational diabetes mellitus are likely to have type 2 diabetes. With the extensive management protocol for GDM we are able to obtain a good glycaemic control but still excess morbidity prevails among GDM pregnancy compared to normal pregnancy. This may be due to the dysfunction of lipid metabolism. Changes in carbohydrate and lipid metabolism occur during pregnancy to ensure a continuous supply of nutrients to the growing fetus despite intermittent maternal food intake. Exaggerated reduction in insulin sensitivity in the peripheral tissues combined with peripheral adipose tissue lipolysis in GDM pregnancy than normal pregnancy results in increased maternal lipoprotein concentrations and elevated lipoprotein triglyceride content. An altered lipid profile on the maternal side would modulate the quantity and quality of lipids being transferred to the fetus. Hypertriacylglycerolemia in gestational diabetes mellitus has been related to a significant risk of having neonates that are large for gestational age and it is considered as a major cause of preeclampsia in the late gestational age. So, the recent researchers emphasize on targeting lipid metabolism in pregnant women with GDM to avoid the adverse outcomes of pregnancy.

Widespread use of anti-retroviral therapy elevated the prevalence of dyslipidemia in HIV-infected Chinese patients

With the widespread use of high-efficiency antiretroviral therapy (HAART), the life expectancy of HIV-infected patients has been significantly extended. However, the metabolic complications among HIV-infected patients treated with HAART have become the most common problem in the world. It is very important to explore the incidence of dyslipidaemia and studies on the role of potential risk factors in HIV-infected Chinese patients treated with HAART are sparse. Therefore, we designed current study, to investigate the effects of therapeutic intervention and continuous information support on the lifestyle of HIV/AIDS patients with dyslipidaemia. Three hundred and six HIV/AIDS patients admitted to the AIDS clinic in Beijing from January 2016 to January 2017 were recruited and assigned into two groups: the treatment group (n=64) and the control group (n=64). The median age of the participants was 38.8±11.0 years (range 20-75 years). The prevalence of dyslipidemia in control and treatment group was (59/64) 92.2% and (53/64) 82.8%, respectively. In this study, low HDL-cholesterol (HDLC) led to abnormalities 47/64 (73.3%) in the control group and 35/64 (54.7%) in HAART-treatment group. Additionally, HAART group showed higher triglyceride, total cholesterol, and low-density lipoprotein (246.1±171.8, 1.73±1.61 mmol/L, 4.46±1.1 mmol/L, 2.54±0.74 mmol/L). In multivariate analysis, gender, marital status, high BMI, dietary habits and physical activity were potential risk factors for dyslipidemia in HIV-infected Chinese patients. In this study, we reported high prevalence dyslipidemiain two HIV infected groups. We suggest that the appropriate diagnosis should be performed for analyzing the metabolic complications in HIV-infected Chinese patients. Further studies are very important to understand the role of potential risk factors in metabolic complications.

The impact of intravenous thrombolysis in acute ischemic stroke in National Medical College, Kolkata: initial experience

Background: Acute ischemic stroke is a potentially treatable condition, if left untreated, lead to mortality and morbidity. This study was conducted to study clinical profile of patients with acute ischemic stroke receiving intravenous thrombolysis (r-TPA-alteplase) and to measure the outcome of thrombolysis.Methods: Retrospective observational study of 54 patients who underwent thrombolysis for acute ischemic stroke at National Medical College, Kolkata over a period of one year.Results: There was statistically significant improvement in NIHSS (p value-0.000) after intravenous thrombolysis.Conclusions: IV thrombolysis is feasible for AIS in governmental hospital in India.

Prevalence of cardiovascular risk factors among municipality workers in Chitradurga, South India

Background: Cardiovascular disease (CVD) is the single largest cause for mortality and morbidity in the world. In India, non-communicable diseases (NCDs) were responsible for 53% of deaths and 44% of disability adjusted life years lost. Appropriate assessment and management of cardiovascular risk is vital to prevent fatal and non-fatal heart attacks and strokes and to improve health outcomes in individuals at high risk of cardiovascular events. Diabetes mellitus (DM) and HT are common diseases in adulthood, pre-disposing to many cardiovascular complications, posing a major public health challenge.This study aims to assess the prevalence of cardiovascular risk factors such as diabetes, HT, smoking, alcohol intake, dyslipidaemia and obesity among Municipality workers.Methods: A cross-sectional study was carried out between Jan 2019-June 2019 among 100 Municipality workers in Chitradurga, South India. Socio-demographic details and some of the risk factors such as alcohol intake and smoking history were obtained using a pre-tested, structured questionnaire. Blood pressure & waist circumference were measured by standard methods. Fasting blood sugar & lipid profile were measured.Results: Mean age of study participants was 38.03 years (SD ± 10.9). Out of the study subjects, 21% were known diabetic and 22% were known hypertensive. 34% of the participants had cholesterol level higher than the desirable level of 200 mg/dL. Around 72% had a history of alcohol consumption and 13% had a history of tobacco smoking during the last 1 month. The prevalence of overweight based on BMI (BMI >23) is higher among Municipality workers (56%) compared to the general population (35.4%).Conclusions: Burden of cardiovascular risk factors such as diabetes and HT were high among Municipality Workers of Chitradurga.

The Association of Cardiac Troponin I Level on Admission with the Angiographic Severity of Coronary Artery Disease in Acute STEMI Patients

Objective: In this study our main goal is to find out theassociation of cardiac troponin I level on admission with theangiographic severity of coronary artery disease in acuteSTEMI patients.Method: This cross-sectional observational study was done inthe NICVD, Dhaka from October 2010 to September 2011. Atotal of 100 consecutive patients were included. Studypopulations were sub-divided into two groups on the basis ofcTn I level. In group I cTn I level ≥20ng/ml and in group II cTnI level <20ng/ml. 50 patients were included in group I and 50patients were included in group II.Results: Most of the patients presented with more than 4hours chest pain which was 68% vs. 60% patients in group Iand group II respectively. Where mean heart rate was higher ingroup I than group II (83.08.4 vs. 78.210.6). It wasstatistically significant (p=0.01) in student-test. Vessel score 2and 3 together formed the main bulk of the patients (68%) ingroup I, while vessel score 0 and 1 were frequently common ingroup II (80%). In group I there was no patient with vesselscore 0, in group II 12(24%) patients had vessel score 0 (5patients had normal coronaries and 7 patients had insignificantlesions, p-value from Chi square test).Conclusion: From our study we can say that, estimation ofserum cardiac troponin I might facilitate the triage of patientswith acute myocardial infarction by clinicians and moreaggressive approach to promote myocardial reperfusion mightbe warranted in the patients with high cardiac troponin I level.

Comparative study of efficacy and safety of omega 3 fatty acids and fenofibrate with background atorvastatin therapy in patients of atherogenic dyslipidaemia

Background: Trials of atorvastatin combined either with fenofibrate or with omega-3 fatty acids (O3FA) have shown promising results in atherogenic dyslipidemia but there are very few studies where both these TGs lowering agents have been compared with each other. This study was conducted to compare efficacy and safety of these two agents on lipid profile of patients of atherogenic dyslipidaemia on background statin therapy and also to monitor effects of these interventions on serum uric acid (SUA) levels.Methods: About 90 patients of dyslipidemia were randomised to 3 groups and received O3FA (2000 mg), fenofibrate (80 mg) or dietary restrictions, each with atorvastatin (20 mg) in background for a period of 90 days. Total cholesterol (TC), HDL-C,TGs, LDL-C, SGOT and SGPT levels were done at baseline, 6 weeks and 12 weeks. Other parameters (SUA and BMI) were done at baseline and 12 weeks.Results: Both group 1 (O3FA) and group 2 (fenofibrate) showed highly significant fall in TG levels (p <0.001) in comparison to group 3 (dietary restrictions) whereas comparative TG reduction between groups 1 and group 2 was not significant. Group 2 also showed significant fall in LDL-C levels (p <0.01) in comparison to group 3. LDL-C reduction, TG reduction and SUA reduction was more in group 2 compared to group 1 followed by group 3. No significant difference was observed in the incidence of adverse effects in three study groups.Conclusions: Combination of fenofibrate and atorvastatin was more effective than that of omega-3 fatty acid and atorvastatin, in lowering serum TG and LDL-C levels. There was a significant reduction in SUA levels in all three groups, but combination of fenofibrate and atorvastatin again showed better outcomes. With respect to the safety, all the 3 groups were comparable. O3FA, however, may be a good alternative to fibrates in patients not tolerating latter.