Correlation between malondialdehyde (MDA) and uric acid levels in preeclampsia.

Background: Hypertensive disorders of human pregnancy, such as preeclampsia, complicates a sizeable percentage of all pregnancies, need its early indication and warning. The aim of present study was to determine the association between lipid peroxidation product, serum malondialdehyde (MDA) and serum uric acid levels in preeclampsia and find out any association between these two parameters in preeclampsia. Methods: Thirty preeclampsia and thirty gestational age matched normotensive pregnant women attending Narayana General Hospital, Nellore were included in the study. Serum MDA levels were measured by Thiobarbituric acid reactive substances(TBARS) method and serum uric acid levels were estimated by automated chemistry analyser using commercial kits. Results: Serum MDA (Mean±SEM 24.4±2.38 vs 7.9± 0.28 nmol/ml, p value < 0.000) and serum uric acid levels (7.2 ± 0.25 vs 3.9 ± 0.14 mg/dl, p value <0.000) were significantly elevated in preeclampsia cases when compared with that of normotensive pregnant women. A weak positive correlation between serum uric acid and serum MDA (r value 0.065, p value 0.734) was noticed in preeclampsia. Conclusion: Serum MDA and uric acid may be included as additional markers for screening and progression of preeclampsia, thereby helpful in effectively treating the condition at an early stage.

Correlation Between Lipid Peroxidation Product- Malondialdehyde (MDA) and Reduced Glutathione (GSH) in Preeclampsia.

Pregnancy is a stressful condition in which many physiological and metabolic functions are altered to considerable extent and hypertension is the most commonest problem encountered during pregnancy, complicating 5-10% of pregnancies. Recent reports suggest that free radical induced endothelial damage as an important factor in the pathogenesis of preeclampsia. Such cell injury might in turn is counteracted by the action of several in vivo antioxidants. But because of increased lipid peroxidation and increased demand of antioxidants , increased oxidative stress is suspected. The present study was undertaken to determine serum malondialdehyde (MDA) and RBC reduced glutathione (GSH) levels in clinically diagnosed preeclamptic women (n=30) and compared with that of normotensive pregnant women and to find out any association between the two parameters. Serum MDA levels were significantly elevated (p value<0.000) and RBC reduced GSH levels were significantly decreased ( p value <0.000) compared to that of normotensive pregnant women. A statistically significant negative correlation was observed between serum MDA and RBC reduced GSH (p value <0.003) in preeclamptic cases.

Alterations of Serum Uric Acid Concetrations in Preeclampsia.

Hypertensive disorders during pregnancy increase maternal and fetal risk. Preeclampsia is characterised by hypertension and proteinuria. Increased uric acid is a key clinical feature of preeclampsia; higher levels correlate with significant maternal and fetal morbidity and mortality. The present study was undertaken to estimate serum uric acid , the end product of purine catabolism, in clinically diagnosed preeclamptic women (n=30) and the values were compared with that of normotensive pregnant women (n=30) ,aged 18-30yrs. All of them were in their third trimester and primigravida. Serum uric acid levels were measured by spectrophotometry. We observed that serum uric acid levels were increased significantly when compared with that of normotensive pregnant women (p value < 0.000).

Lipid Peroxidation in Preeclampsia.

Hypertension in pregnancy is a leading cause of both maternal and fetal mortality and morbidity. Preeclampsia is characterised by hypertension and proteinuria. Lipid peroxidation is an important factor in the pathophysiology of Preeclampsia. The present study was undertaken to determine Serum Malondialdehyde (MDA) levels , a product of lipid peroxidation , in clinically diagnosed Preeclamptic women(n=30) and the values were compared with that of Normotensive pregnant women (n=30) aged between 18-30yrs. All of them were in their third trimester and were primigravida. Serum MDA was estimated by TBARS (thiobarbituric acid reactive substances) method. We observed that Serum MDA levels were significantly increased in Preeclamptic women (p <0.000) as compared to that of Normotensive pregnant women . Increased levels of lipid peroxiation product - MDA may contribute to the pathophysiology of Preeclampsia.

Vitamin D Receptor fok I Gene Polymorphism in Angiographically Proven Coronary Artery Disease Subjects: Case - Control Study.

Aims: Coronary artery disease (CAD) is multifactorial disease resulting from modifiable and non modifiable risk factors. Gene polymorphism is one of the non modifiable risk factors, which may contribute to disease susceptibility. Identifying genetic polymorphisms is essential for better understanding of pathophysiology and treatment strategies for a particular disease. The objective of our study was to evaluate the association of vitamin D receptor (VDR) fok I polymorphism with CAD. . Place and Duration of the Study: The study samples were collected at Narayana Medical College Hospital, Nellore and genetic analysis done at Sri Ramachandra University, Chennai, India, from Nov 2013 to June 2014. Materials and Methodology: The study included 40 angiographically proven CAD subjects as cases and 40 normal healthy controls .VDR fok I polymorphism was analysed by PCR-RFLP method. Chi Square and odds ratio was used to find the association. Results: F allele frequency is 66.25% in CAD vs 52.5% in controls. There is no significant association of FF (p= 0.099), Ff (p= 0.851), ff (p= 0.138) with CAD. Conclusion: There is no significant association of VDR fok I polymorphism with CAD in south Indian population. According to our study F allele frequency is more in CAD than in controls.

Study of insulin resistance and antioxidant vitamin status in prostate cancer patients.

The incidence of prostate cancer is 5 per 100000 in southern and eastern Asia. Both genetic and environmental factors have been implicated in its etiology. The mitogenic and growth stimulatory effects of Insulin growth factor may be involved in prostate carcinogenesis. To evaluate serum insulin and insulin resistance was passed by HOMA- IR. Prostatic specific antigen passed by immune-enzymatic assay. Vitamins were estimated by high performance liquid chromatography. In our study 30 prostate cancer patients aged 60-80years were taken as cases. 30 normal age matched disease free person were taken as controls in both groups, Insulin resistance and antioxidant vitamin status was studied. In the present study, the value of HOMA-IR was (P <0.05) is significantly higher compare to controls. Serum vitamin E and vitamin C values for cases was reduced (P <0.05) significantly lower than controls. The development of prostate cancer is a multistep process. Hyperinsulinemia associated with insulin resistance may play a role in pathogenesis of prostate cancer. Prostate cancer cells generate high levels a ROS.

Study of biochemical bone turnover markers in postmenopausal women leading to osteoporosis.

Osteoporosis is the term used for diseases that cause a reduction in the mass of bone perunit volume and is one of the dreaded afflictions of ageing. Osteoporosis increases bone fragility and susceptibility to fractures. This silently progressing metabolic bone disease is widely prevealent in India. This study was conducted to evaluate the role of biochemical bone turnover markers in postmenopausal women to assess the risk of osteoporosis. Study includes 70 women (40 postmenopausal, 30 premenopausal women) serum estradiol, serum alkaline phosphatase, urinary hydroxyproline were estimated in both cases and controls. There is decrease in serum estrodiaol levels in postmenopausal women when compared to premenopausal women estrogen deficiency induces bone loss similarly ALP is highly significant P<0.001 in prostmenopausal women suggesting that there is high alkaline phosphate activity in postmenopausal women as a result of the inhibitory effects of estrogen on bone turnover rate which is dependent on age and body mass index. Increased excretion of urinary hydroxyproline is due to increase in bone loss and this was a characteristic feature of immediate postmenopausal period.

Relationship between estrogen and lipid profile status in postmenopausal women.

Menopause is the permanent cessation of mensturation due to loss of ovarian follicular function, which results in decreased production of estradiol and other hormones. Decreased levels of estrogen leads to variations in lipid profile leading to atherosclerosis thus by increasing risk of coronary artery disease in post menopausal women. The present study was conducted to evaluate the relationship between serum estradiol and lipid profile status in postmenopausal women to assess risk for coronary artery disease. Study includes 70 subjects, 30 healthy premenopausal women (25-40yrs) and the healthy postmenopausal women in the age group of (55 – 65yrs).Serum estradiol and lipid profile status were estimated in both cases and controls. Reduced estradiol (P0.0001) in post menopausal women and p value is highly significant for total cholesterol, triglycerides, low density lipoproteins. Conclusion: Thus the study outlines that the low levels of estrogen exerts a significant effect on the plasma lipids and lipoprotein metabolism. The risk of coronary artery disease increases in women after menopause.

Association of TNF-α with insulin resistance in type 2 diabetes mellitus.

Background & objectives: TNF-α is an adipocytokine that has been implicated in the development of insulin resistance. Dysregulation of TNF-α production has been implicated in a variety of human diseases including type 2 diabetes mellitus. We aimed to find out the association of TNF-α levels with insulin resistance, body mass index and waist hip ratio; and to elicit its role with respect to duration of the disease, if any. Methods: 50 type-2 diabetic patients attending Narayana Medical Hospital, Nellore, were studied. Body mass index and Waist hip ratio were calculated. Homeostasis model assessment method was used to calculate insulin resistance (HOMA IR) and per cent β cell function (HOMA B) . Insulin was estimated by chemiluminescence method and TNF-α by ELISA method. The subjects were arbitrarily categorized into three groups based on duration of diabetes. Group 1 included subjects with diabetes of less than 5 yr duration, group 2 included diabetics of 6-10 yr duration and group 3 greater than 10 yr duration. Results: Our study revealed a significant correlation between TNF-α levels and BMI (P=0.006), the correlation being stronger in males when compared to females. A significant correlation was found between per cent β cell function and TNF-α (P=0.008). TNF-α correlated significantly with HOMA IR, HOMA B and insulin, in group 2 diabetes. Interpretation & conclusions: Our results suggest the possible role of TNF-α in the pathogenesis of type-2 diabetes mellitus and the importance of reducing obesity to prevent elevated levels of the cytokine and related complications.

Mineral status in thyroid disorders (hypo & hyper).

Thyroid hormones influences the metabolism of all the substrates including minerals. A patient with thyroid dysfunction may also manifests the symptoms that are consequents upon the altered minerals levels. The study shows that, low levels of Ca+ in hypothyroid cases, increased bone turnover in hyper thyroidism increases the Ca++ level decreased bone turnover. In hypothyroidism low tubular re absorption of Po4 - by affecting GFR, high clearance of Po4 -. In hyperthyroidism increased tubular re absorption of Po4 - affecting GFR, low clearance of Po4-. In hypothyroidism rapid blood flow will be leading to rapid clearance of Mg2+ & Zn+ from kidney. So over tubular excretion of Mg2+ & Zn+ will be low levels in plasma. In hyperthyroidism decreased blood flow will be leading to low clearance of Mg2+ & Zn+ from kidney. So low tubular excretion of Mg2+ & Zn+ will be high levels in plasma Materials & Methods The study was conducted over a period of six months. In this study 30 subjects hypo & 30 hyperthyroidism with euthyroidism were selected. Both males and females were included. Blood sample were collected for estimation of TSH, FT3,FT4, serum Ca, serum Po4 -, serum Mg2+ & serum Zn+. Results : In hypothyroid patients the serum levels of minerals Ca+, Zn+ , Mg2+ (p<0.001) were significantly decreased and PO4 (p<0.001) levels were significantly increased compared to controls. In hyperthyroid patients the serum levels of minerals Ca+, Zn+ , Mg2+ (p<0.001) were significantly increased and PO4 (p<0.001) levels were significantly decreased compared to controls. Conclusion : Mineral status is observed in all the patients Ca+ levels are low because high bone turnover prominent phosphorus levels positive influences on paratharmone and calcitonine, Zn+ & Mg2+ levels reflects the influences on GFR and decreased clearance of these minerals.

Association of dyslipidemia and inflammatory markers in type 2 diabetes mellitus.

Background: The interplay between inflammation and lipids has recently been the focus of research aimed at understanding the development of Type 2 diabetes mellitus and the process of atherogenesis. Inflammatory markers particularly Tumor necrosis factor-α and high sensitive C-reactive protein interfere with lipid homeostasis and activates proinflammatory mechanisms in type-2 Diabetes mellitus. Our aim of the study was to analyze and correlate the inflammatory markers with lipids in Type2 Diabetes mellitus. 50 diabetic subjects and 50 normal healthy controls were recruited from the outpatient department of Narayana Medical college and hospital, Nellore, A.P). Serum TNF-alpha concentration was measured using Sandwich ELISA kit method. commercial enzymatic methods were used in the determination of serum total.cholesterol, HDL cholesterol and Triacylglycerides. LDL cholesterol was estimated using friedewald equation. Turbidimetric immunoassay (QUANTIA CRP- US) is used for ultrasensitive determination of high sensitive C-reactive protein in serum. Results: serum levels of TNF-α and hs-CRP were significantly elevated in type 2 diabetes mellitus and correlated positively with triacylglycerides, total cholesterol and LDL cholesterol but negatively with HDL cholesterol. We conclude from our study that there is a strong association between proathergenic lipid profile and inflammatory markers in Type2Diabetes mellitus and suggests a significant role of the inflammatory markers in the pathogenesis of dyslipidemia in Type2diabetes mellitus.

Gestational diabetes mellitus: An overview.

The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance occurring for the first time during pregnancy. The prevalence of GDM varies in direct proportion to the prevalence of Type 2 diabetes for a given ethnic group or population. It is crucial to detect women with GDM as the condition is associated with diverse range of adverse maternal and neonatal outcomes. In addition, having a history of GDM puts the mother at risk for the development of Type 2 diabetes mellitus or recurrent GDM. Various screening guidelines have been introduced depending upon the suitability of test to the population characteristics, cost and screening accuracy. Still there are lots of controversies to which test to be used, when should the screening be done and who should be screened. However, recognizing GDM is becomimg a major health challenge for clinicians, and treating it results in lowering of both maternal and fetal complications. Also, clinicians must followup women with GDM postpartum so that the prevalence of Type 2 diabetes may start declining.

Tumor necrosis factor–alpha in the development of insulin resistance in type 2 diabetes mellitus.

Obesity and Insulin resistance are very frequent disorders and are described as the dominant risk factors for cardiovascular diseases. Recent research suggests that TNF-alpha, an adipocytokine plays a key role in the development of insulin resistance. Aim of the study was to estimate TNF-alpha levels and to investigate the association of TNF-alpha with the various factors associated with insulin resistance like Body mass index, Waist Hip Ratio, fasting insulin etc. A total of 100 subjects attending out patient department of General Medicine , Narayana Medical College , Nellore were selected for the study.50 patients were diagnosed as type-2 diabetics and 50 subjects were taken as normal healthy controls who attended for a general check-up. Anthropometric and biochemical measurements were analyzed. Serum Insulin and TNF-α were measured using chemiluminescence method and ELISA method respectively. Homeostasis model assessment score was used to gauge the level of insulin resistance. Our Results showed significant elevation in TNF-alpha levels in diabetic subjects and correlations between TNFalpha Body Mass Index and HOMAIR were significant. All correlations were stronger for females compared to males.

Imbalance of oxidants and antioxidant systems in subjects with cirrhosis.

Oxidative stress has been increasingly implicated in the pathogenesis of cirrhosis. Ethanol and various viral infections will increase the production of reactive oxygen species (ROS) in the liver, resulting in an imbalance between oxidants and antioxidants. Thus determination of oxidants along with antioxidants,stated the role of oxidative stress more accurately in the pathogenesis of liver cirrhosis. In the present study we measured the markers of prooxidants, erythrocyte malondialdehyde (MAD), antioxidants that included erythrocyte catalase, reduced glutathione (GSH), glutathione peroxidase (GPx). 30 subjects with age 25-60 years, who were diagnosed as having liver cirrhosis by the department of Gastroenterology, Narayana Medical Hospital were included, 30 normal healthy individuals of the same age were selected as control . The results clearly indicated that the levels of pro oxidants, MDA were high in cirrhotic subjects than in the controls with p value of 0.0001. The levels of antioxidant enzymes GSH, Catalase were low in cirrhosis with p value of 0.0001 (GSH) and 0.067(Catalase). But the mean value of glutathione peroxidase was high in cirrhosis than in controls. This may be due to conterregulation with oxidative stress. Hence this study indicates the role of oxidative stress in liver cirrhosis and it clearly defines the imbalance between oxidants & antioxidants.

Distribution of blood pressure and influence of subcutaneous fat on systolic and diastolic levels in a tribal population.

The distribution of arterial blood pressure levels and the influence of subcutaneous fat on blood pressure are investigated among Mall, an agricultural tribe of Andhra Pradesh. Majority of Mali people exhibit optimum levels of blood pressure. The incidence of stage 1 hypertension is moderate. The mean levels of blood pressure are relatively higher among women compared to men. The regression co-efficient values indicate a positive influence of triceps and subscapular skinfold thickness on both systolic and diastolic blood pressure among Manzai Mali. The results are discussed in the light of earlier studies.

Growing incidence of cutaneous and ungual infections by non-dermatophyte fungi at Jabalpur (M.P.).

A random survey of skin and nail infections was done at Jabalpur (M.P.). Out of the 80 suspected cases 60 were culture positive. Out of these 25 were of dermatophyte infection followed by 21 cases of phaeohyphomycosis, 7 of aspergillosis, 4 of hyalohyphomycosis, 2 of mixed infection in which a non-dermatophyte was associated with a dermatophyte and 1 had yeast infection. Trichophyton rubrum was the only dermatophyte isolated. Among the non-dermatophyte infections cases of Alternaria chlamydospora, Cladosporium sphaero-spermum, Curvularia senegalensis, Chaetomium globosum, Scopulariopsis brumptii, Paecilomyces variotii and Aspergillus chevalieri are for the first time documented as etiologic agent of cutaneous and ungual mycosis from India.

Detection of filarial infection using Wuchereria bancrofti microfilariae culture antigen and filter paper blood samples in enzyme linked immunosorbent assay.

Blood collected on filter paper by finger-prick gave results comparable to intravenous serum samples when analysed by enzyme-linked immunosorbent assay (ELISA). All the 100 microfilaraemia, 5 out of 100 endemic normals and none of the 10 nonendemic normal filter paper blood samples showed the presence of filarial antibody when tested by this method,using culture antigen and anti-immunoglubulins, class G, Μ and A — penicillinase conjugate. When the same samples were screened for the presence of IgM antibody, 91 out of 100 microfilaraemia, 13 out of 100 endemic normal and none of the 10 nonendemic normal samples showed a positive reaction. Enzyme linked immunosorbent assay, using culture antigen and filter paper blood samples, appears to work in large field studies for detection of filarial infection.