Assessment of Dyslipidemia in Ischemic and Hemorrhagic Stroke in Western Uttar Pradesh

Background: Stroke is one of the major global health problems and the leading cause of adult disability. This study was carried out to compare serum lipid profiles in patients with ischaemic and haemorrhagic stroke.Material & Methods:We conducted this study on 130 patients of 18-70-year age group with clinically and radiologically (CT Scan ) proven cerebrovascular accident. Detailed clinical evaluation was combined with biochemical and radiological evaluation.Results:76 patients were diagnosed to have ischaemic stroke while 54 had haemorrhagic stroke, showing that ischaemic stroke is more common, being 58.46% when compared to haemorrhagic stroke, which was 41.54%.The mean age for ischaemic stroke was 63.32 years while for haemorrhagic stroke was 58.87 years. Patients were evaluated according to gender and it was found that both ischaemic and haemorrhagic stroke is more common among males. It was found that 30.3% of patients with ischaemic stroke were diabetic while 18.5% of haemorrhagic stroke patients had diabetes. 48.7% of ischaemic stroke patients and 81.5% of haemorrhagic stroke patients had hypertension. It was found that smoking was associated with 51.3% in patients with ischaemic stroke and 40.7% in haemorrhagic stroke. Serum total cholesterol was significantly higher in ischaemic stroke than haemorrhagic stroke group. Mean value of s. HDL cholesterol was 40.24 mg/dl in ischaemic stroke group, 44.98 mg/dl in haemorrhagic stroke group showing s. HDL cholesterol was significantly lower in ischaemic stroke group. Thus, hypercholesterolemia is significantly more associated with ischaemic strokes. Our study showed that s. triglyceride was significantly higher in ischaemic stroke than haemorrhagic stroke group. Our study also shows that s. LDL cholesterol was significantly higher in ischaemic stroke group.Conclusions:Ischaemic stroke patients had higher serum total cholesterol, higher S. LDL cholesterol and lower HDL-cholesterol levels in comparison to haemorrhagic stroke. High risk patients of stroke may be screened using serum lipid profile and further studies are suggested to evaluate the effect of lipid lowering therapy in terms of morbidity and mortality in ischaemic stroke patients.

To Study the Association of Cerebrovascular Disease with Metabolic Syndrome in Western Uttar Pradesh

Objective: To Study the association of cerebrovascular disease with metabolic syndrome. Methods: A Total 104 patients were included in this study & investigated for cerebrovascular disease associated with metabolic syndrome or not. A study of presence or absence of metabolic syndrome in cerebrovascular disease was done. P value was calculated by using analysis of variance test (ANOVA) & P value <0.05 was considered as statistically significant. Results: Total 104 patients were included in this study in 72 patients (69.23%) were suffering from metabolic syndrome and 32 patient (30.77%) were not suffering from metabolic syndrome. Most of the patients suffering from cerebrovascular disease associated with metabolic syndrome were of older age groups (61.11%)>61 years. Second most common group was (22.22%) 51-60 years. Other patients of cerebrovascular disease not suffering from metabolic syndrome (56.25%) in 51-60 years followed by (31.25%) in 41-50 years. Amongst the patients suffering from cerebrovascular accident and metabolic syndrome males outnumbered females, although this data is not statistically significant p=0.4. Among the Cerebrovascular accident patient group prevalence was highest therefore raised fasting blood sugar (n=58) (80.55%) and low HDL values (75.2%), whereas it was highest for Hypertension (88.89%). In the cerebrovascular accident group out of total 104 patients 72%(n=72) were suffering from metabolic syndrome and 30.77%(n=32) were not suffering from metabolic syndrome there is positive correlation between metabolic syndrome and cerebrovascular accident .Using Test for equality for proportion (zscore) this data is found to be statistically significant. Conclusion: In cerebrovascular accident group (total patients =104) 67.5%(n=108) were having 3 risk factors, 50%(n=80) were having 4 risk factors and 11.25%(n=18) were having 5 risk factors of metabolic syndrome among the cases .Among the patients suffering from cerebrovascular accident (total patients =104) the prevalence of hypertension was 88.89%(n=64),of low HDL was 75.2%(n=54),of high TGs was 80.55%(n=58),of raised waist circumference was 58.32%(n=42) and of increased fasting blood sugar was 80.55%(n=58) in the case group.

Comparative Analysis of Indices of the Liver Function Tests in Patients with and without Non- Alcoholic Fatty Liver Disease at a Teaching Hospital in Hapur

Background: Non-Alcoholic fatty liver disease (NAFLD) has become a worldwide health concern with increase in the global incidence of obesity and it is now considered the hepatic component of the metabolic syndrome. Aims and Objective: The study’s aim was to compare the indices of the Liver Function tests in compensated chronic liver disease patients with and without NAFLD. Materials and Methods: A total of 100 consecutive patients with compensated chronic liver disease were recruited into the study. A structured questionnaire was administered to obtain relevant socio-demographic data. NAFLD was diagnosed based on clinical, biochemical, ultrasonographic and in a few histological features. The Adult Treatment Panel III criteria were used to identify patients with the metabolic syndrome. Results: In our study, 100 participants were recruited into study. 40 out of 60 patients (67%) showed grade-1 fatty liver findings and 20 out of 60 patients (33%) showed grade-2 fatty liver. Approximately 19% had fatty liver finding. The mean (SD) age of persons with NAFLD was 45.12 (±8.07) years compared  to 47.49(±11.79) years for persons without NAFLD. The difference was not statistically significant (p=0.2). Body mass index (BMI), central obesity (waist circumference), fasting  blood sugar, blood pressure, total cholesterol and triglycerides were significantly higher in  the NAFLD group (p= <0.05) respectively.  Conclusion: Indices of the deranged Liver functions were more prevalent in persons with NAFLD. It is recommended that patients with NAFLD be screened for metabolic syndrome and appropriate therapy instituted to decrease the risk of both hepatic and cardiovascular complications.

Rheumatoid Arthritis- Unique Combination of Rheumatic, Cardiac and Pulmonary Manifestation of a Multisystem Disorder

Rheumatic arthritis is a common inflammatory disease but combination of cardiac valvular dysfunction involving aortic valve calcification, tricuspid regurgitation and right atrioventricular enlargement with interstitial involvement of lung is very rare manifestation of this multisystem disorder.

Cyproheptadine adverse drug interaction with anti-epileptic drugs

Cyproheptadine is a H1 and 5- HT1/2 receptor antagonists, impairing the anticonvulsant activity of antiepileptic drugs and reduces threshold, increases severity of seizures, when administered chronically. Anuj a 13 years old male from Delhi, known case of SSPE stage-III with epilepsy, on oral anti-epileptic drug has seizure induction followed the use of oral cyproheptadine. Stopping cyproheptadine, patient didn’t sustain any further seizures.