Assessment of nutritional status in hyperthyroidism patients.

Introduction: Hyperthyroidism often referred to as overactive thyroid, is a type of thyrotoxicosis, a hypermetabolic clinical syndrome which occurs when there are elevated serum levels of T3 and/or T4. There are very less studies on the nutritional deficiencies related to hyperthyroidism. Methods: Quantitative determination of Thyrotropin (TSH), triiodothyroinine (T3) and tetraiodothyronine (T4) was analyzed along with nutritional analysis of dietary nutrients like carbohydrate, proteins, fat, vitaminA, B1, B2, C, niacin, etc. Biostatistical analysis and correlations were analyzed by using Graph Pad prism software. Results: The mean intake of nutrients in Hyperthyroid and control groups are: Carbohydrate (147.9 ± 41.89 g, 218.3 ± 100.0 g), Thiamin (0.567 ± 2.850 mg, 1.051 ± 0.470 mg), Riboflavin (0.590 ± 0.341 mg, 1.121 ± 0.415 mg), Niacin (7.560 ± 2.346 mg , 11.59 ± 3.571 mg), pyridoxine (0.066 ± 0.262 mg , 0.317 ± 0.627 mg), Vitamin B1 (0.087 ± 0.205 μg, 0.199 ± 0.306 μg), Folacin (130.0 ± 36.57 μg , 143.4 ± 57.29 μg) and the mean values of all these nutrients were not optimum as recommended by ICMR. Conclusion: We should all be aware of the nutritional deficiencies encountered in hyperthyroidism and hence we can provide considerable support by eliminating adverse influences and normalizing the nutritional status by including multivitamins , antioxidants, etc. along with daily antithyroid drugs.

Estimation of RBC membrane and serum lipid composition in central Indian sickle cell disease population with and without pulmonary hypertension.

Aim: This study is designed to estimate and examine the relation between the levels of RBC membrane and serum lipids in central Indian sickle cell disease population with and without Pulmonary Hypertension .Methods: This study was carried out on central Indian sickle population at the Dept.of Biochemistry at MGM medical college & M.Y. hospital, Indore. From june 2011 to October 2012. Plasma Lipid concentrations were determined in 135 Sickle cell disease (SCD) patients, out of this 65 patients had sickle cell disease with Pulmonary Hypertension (SCD-PH) and 80 normal healthy matched individuals (controls). Study group comprises of both male and females in the age group of 18-56 years. Weight , height, waist hip ratio and blood pressure were recorded. All the blood samples were analyzed to determine the serum lipid concentration and RBC membrane lipid composition. Results: The body mass index and the systolic blood pressure of SCD with Pulmonary Hypertension (27.87 ± 4.68, 128.60 ± 22.49 mmHg) and without pulmonary hypertension (25.87 ± 4.68, 125.23 ± 15.89 mmHg ) were higher when compared with controls (24.67 ± 5.18, 119.15 ± 13.03 mmHg). The SCD with PH population (1.21 ± 0.07) and SCD without PH (1.09 ± 0.04) subjects showed significantly higher levels of RBC membrane cholesterol compared with controls (0.84 ±0.01). The trends of decreased serum cholesterol and normal high-density lipoprotein(HDL) levels in SCD patients were noted as compared with controls and these levels are statistically significant. The low-density lipoprotein cholesterol (LDL) was also significantly lower in SCD-PH and SCD when compared with control subjects. Interestingly serum Triglyceride levels are highly elevated in SCD-PH (208.43±.56.97) when compared with SCD (132.34±8.97) and controls (141.43±26.98). Elevated TGL concentrations are positively correlated with haemolytic markers (Lactate dehydrogenase and Total Bilirubin, (r=0.326 and r=0.468,P<0.001)). On a prospective screening of SCD population we found that around one third total population are with elevated tricuspid regurgetant jet velocity (TRJV) of 2.5m/s or higher. Conclusion: Our study data suggests that there is a relationship between RBC membrane and serum lipids in SCD population. Significant increase in RBC membrane cholesterol and decreased phospholipids in sickle cell disease play an important role in the fluidity and structural stability of the membrane and possibly in the Hemolysis and sickle shape of RBC. In pulmonary hypertension except the elevated levels of TGL remaining serum lipids are equal to the normal SCD population. This indicates the relation between TGL and vascular dysfunction in SCD.

Assessment of nutritional status in hyperthyroidism patients.

Background: Hyperthyroidism often referred to as overactive thyroid, is a type of thyrotoxicosis, a hypermetabolic clinical syndrome which occurs when there are elevated serum levels of T3 and/or T4. There are very less studies on the nutritional deficiencies related to hyperthyroidism. Methods: Quantitative determination of Thyrotropin (TSH), triiodothyroinine (T3) and tetraiodothyronine (T4) was analyzed along with nutritional analysis of dietary nutrients like carbohydrate, proteins, fat, vitaminA, B1, B2, C, niacin, etc. Biostatistical analysis and correlations were analyzed by using Graph Pad prism software. Results: The mean intake of nutrients in Hyperthyroid and control groups are: Carbohydrate (147.9 ± 41.89 g, 218.3 ± 100.0 g), Thiamin (0.567 ± 2.850 mg, 1.051 ± 0.470 mg), Riboflavin (0.590 ± 0.341 mg, 1.121 ± 0.415 mg), Niacin (7.560 ± 2.346 mg , 11.59 ± 3.571 mg), pyridoxine (0.066 ± 0.262 mg , 0.317 ± 0.627 mg), Vitamin B1 (0.087 ± 0.205 μg, 0.199 ± 0.306 μg), Folacin (130.0 ± 36.57 μg , 143.4 ± 57.29 μg) and the mean values of all these nutrients were not optimum as recommended by ICMR. Conclusion: We should all be aware of the nutritional deficiencies encountered in hyperthyroidism and hence we can provide considerable support by eliminating adverse influences and normalizing the nutritional status by including multivitamins , antioxidants, etc. along with daily antithyroid drugs.

Study of clinical parameters in chronic periodontitis.

Back ground: Periodontitis is a chronic inflammatory disease, causes changes in peripheral blood markers with slight abnormal lipid profile including the production of different enzymes that are released by stromal, epithelial or inflammatory cells. These changes reflect metabolic changes in the gingival and periodontium in inflammation. Design of study: This important cohort study includes 54 subjects as chronic periodontitis patients along with 26 healthy age matched controls of both sexes, In this study, different peripheral blood markers (Neutrophils,WBC,RBC,Thrombocytes and Hb%), major inflammation markers (plasma Homocysteine, CRP),Total lipid profile (Cholesterol, TGL,HDL, LDL) and salivary enzymes (CK, LDH,AST, ALT, ALP, ACP and GGT) are studied to evaluate diagnosis, prognosis and therapeutic effects in this disease. Results: Due to stasis of blood stream in periodontitis causes margination of central blood stream cells and finally there will be significant correlation in Neutrophils (r=0.342), WBC(r=0.431),thrombocytes(r=0.216),RBC(r=-0.183)Hblevel(r=-0.162).Inflammation markers and total lipid profile also show significant positive correlation: plasma homocystein (r=0.763),C-reactive protein(r=0.842),Total cholesterol,TGL,LDL (r=0.134,0.529,0.293) except HDL(r= -0.734). Salivary enzymes (CK-0.923, LDH-0.314, AST-0.841, ALT-0.832,ALP-0.782, ACP-0.826 and GGT-0.794) with gingival index and pocket depth. Conclusion: By studying this simple, economical clinical parameters we can assess the damage of periodontal tissue and useful in prediction of future risk of atherosclerosis in chronic periodontal patients.

Hematological profile of sickle cell disease: A hospital based study at CIMS, Bilaspur, Chhattisgarh.

Hematological profile of total 1260 individuals were tested for Sickle Cell Disease who attended CIMS OPD, Bilaspur during a period of May 2008 to October 2009 is presented here. At least 4.44% of the total subjects tested were identified as homozygous for sickle cell gene (SS) and 35% were with sickle cell trait (AS). The patients were confirmed by examining the blood samples for solubility test and hemoglobin electrophoresis using cellulose acetate membrane. Among the SS patients about 58% were males and 42% were females and their ages vary from 7 months to 65 years. The SS patients showed comparatively low level of hemoglobin as well as the RBC count in both the sexes than the AS or normal subjects (AA). PCV was higher in males (31.44±3.1%) than in females (28.62±3.6%). Average MCH and MCHC did not show any significant difference between the sexes. MCV and MCHC were found to be quite higher in SS subjects than AS or AA. Thus in absence of any definite data this investigation may put some insight on the incidence of sickle cell disease in Chhattisgarh.

Significance of gammaglutamyl transferase estimation in hepatobiliary diseases.

The present study was conducted to evaluate the significance of gamma glutamyl transferase (GGT) in hepatobiliary diseases and made to prove the GGT as a significant differential factor in diagnosis of high serum alkaline phosphatase conditions. In 166 patients of hepatobiliary diseases.The results were compared with 32 healthy age matched volunteers, patients were subjcted to detailed clinical examination and laboratory investigations. Blood samples were collected for estmation of serum Bilirubin, AST, ALT, ALP and GGT. Ratio of serum AST/ALT and serum ALP levels were significantly (P<0.001) increased in alcoholic liver disease and hepatic carcinoma. The results give enough evidence of increased GGT in microsomal induction by alcohol and other factors.

Study of road traffic accidental deaths (RTA) in and around Bastar Region of Chhattisgarh.

To analyze the magnitude of head injury in fatal RTA cases, present study was conducted in the department of Forensic Medicine Toxicology, Govt. Medical College, Jagdalpur (Chhattisgarh) in 2009 calendar year. The present study was undertaken on 105 victims of RTA who died due to head injuries, which autopsied at GMC, Jagdalpur (C.G). Most of the accidents occurred in the afternoon hours (12: 01 - 18:00). There was a clear male dominance (88.57%). The most affected age was middle age (21-40 yrs) & most commonly affected age group is 21-30 yrs. Vehicular occupants were commonly affected (63.80%) & amongst them two wheeler occupants most commonly involved. Fissure fracture of the skull was commonest (45.71%) & parietal region of head was mostly involved region of the head (27.61%). Among the intracranial hemorrhages, subdural hemorrhage (SDH) was commonest (31.42%). In relation duration of survival time 59.04% of victims died within 24 hrs of fatal accident.