Small dense LDL and its Association with Hypertension: a Case-Control Study.

Hypertension is one of the most common diseases affecting humans throughout the world. The commonest variety of hypertension is benign essential hypertension. Cardiovascular risk is more in hypertensive patients as their lipid profile is more atherogenic than normotensive subjects. Traditionally, estimation of total serum cholesterol and LDL-C are used as an indicator of atherogenicity. But subjects may develop hypertension and CHD with normal levels of LDL cholesterol. So assessment of LDL cholesterol concentration may not entirely reflect its atherogenic potential. Because LDL-C is not a single entity rather it consists of seven distinct subclasses of different particle size. The size of the LDL particle is inversely correlated to their atherogenicity. Smaller LDL particles are more atherogenic despite their less cholesterol content than the larger more buoyant LDL particles containing more cholesterol. Therefore individuals having smaller LDL particles are more atherogenic and more at risk to develop hypertension inspite of even normal LDL cholesterol concentration. So measurement of small dense LDL particle is more important than any other lipid measure. With this aim 122 subjects were included in this study, among them 82 were diagnosed cases of essential hypertension with the mean age of 42.56±9.98 years and 40 were healthy controls. Serum apo-B was measured in all study subjects. The amount of apoB is almost similar in every LDL subtypes but the amount of cholesterol increases with the increasing particle size. So the ratio of cholesterol to apo-B decreases as the particle size decreases, thus LDL cholesterol / apo-B £ 1 indicates the presence of atherogenic small dense LDL. So the prevalence of small dense LDL was evaluated by calculating the ratio of LDL-C/apo B. The ratio was significantly lower in hypertensive cases (0.093±0.18) compared to controls, indicating presence of sd LDL in hypertensive patients. When the risk ratio was calculated, the patients having small dense LDL in their plasma were found to have 2.87 times more risk for developing CVD then the persons who doesn't have small dense LDL in their plasma.

Verrucous carcinoma of vulva.

Vulval carcinoma is an uncommon disease of old women and may manifest as verrucous carcinoma. Intraepithelial cancer of the vulna of women in their twenties and thirties is increasing. Invasive carcinoma of vulva usually appears long time after intraepithelial neoplasia or chronic irritation. We are presenting one young lady of 21 years who noticed whitening of vulva since her childhood and irregular vulval itching in that area. After nine to ten years she further noticed swelling in that area which used to discharge off an on along with itching. As she got married and had disturbed sexual life, on consulting with a specialist doctor, the lesion was diagnosed as an ulcerated malignant growth. Further investigation revealed the lesion to be as verrucous carcinoma of vulva. This is the first report of such case in our country. Any persistent complaints of vulva like itching, discharge, even ulcer should be taken care of for detection of intraepithelial vulvar cancer.

Iron-deficiency anaemia in pregnancy: (biochemical investigations of iron-deficiency and nutritional status).

Biochemical investigations on iron deficiency and nutritional status were carried out in a group of 130 women in the second or third trimesters of pregnancy and in 42 control non-pregnant women. The important findings were: 1. Anaemia was present in 46.1% of pregnant women in comparison with 19% in non-pregnant women. It was found to be more prevalent in the third trimester of pregnancy. 2. Iron deficiency with and without anaemia, as judged from serum transferrin saturation (%) was evident in 59.2% of pregnant women with an incidence of 70.3% in the third trimester of pregnancy. 3. Serum albumin, gamma globulin and A/G ratio were found to be decreased in pregnancy whereas serum levels of alpha-2 and beta globulins were elevated. The results have been discussed.