Investigating risk factors for developing autism, cerebral palsy and down syndrome in a Trinidadian population

Background: Autism, Cerebral Palsy and Down Syndrome are three lifelong, non-curable common developmental disorders that affect approximately 1 in 59, 1 in 323, and 1 in 700 children respectively. This research is to study the effects of prenatal, perinatal, and postnatal factors on the development of Autism, Cerebral Palsy (CP) and Down Syndrome (DS) in a Trinidadian population.Methods: This was a descriptive case-control study comprised 75 subjects, with 25 cases from each of the three disorders investigated, i.e. autism, CP and DS.Results: The highest risk of autism was associated with mothers having high stress levels (p=0.002), high blood pressure (0.042), and low iron levels (p=0.012) during the pregnancy, as well as having a family history of autism (p=0.002) and residing in an air polluted area (p=0.034). The highest risk of cerebral palsy was associated with a child being born preterm (case 24%, control 0; p=0.009), experiencing postnatal complications (case 80%, control 4%, p=0.000), having a birth weight less than 2500 g (p=0.002), having an abnormal appearance at birth (p=0.045), specifically the prevalence of blue baby (case 20%, control 0) and abnormal appearance (case 12%, control 4%), a case father having a low educational level (p=0.002), a case of mother having gestational diabetes during the pregnancy (p=0.037) and having older mothers (p=0.033) and fathers (p=0.033) than the controls. The highest risk of down syndrome was associated with mothers having high stress (p=0.017) and blood pressure (p=0.021) during pregnancy.Conclusions: The findings of our research confirm that autism, CP and DS are multi-factorial developmental disorders. A combination of environmental conditions, genetics, prenatal and postnatal factors are associated with an increased risk of developing autism, cerebral and down syndrome.

The association between indices of obesity and common clinical measures in adults with and without type 2 diabetes.

Background: The aim of this study was to determine the differences amongst the anthropometric measurements, lipid profile, blood pressure and body shape in diabetics as well as non-diabetics. Methods: This was a cross-sectional study comprised of 309 subjects with 91 males and 218 females. Of this, there were 217 diabetics and 92 non-diabetics. The sample was taken from three hospitals in Trinidad. Lipid profile and blood pressure were taken from each facility’s physician’s notes while anthropometric measurements were taken from the patients themselves. Results: The diabetic group had elevated body mass index and waist to hip ratios were significant (P <0.05) when compared to non-diabetics. There was no significant association of lipid profile, blood pressure, waist circumference and waist to height ratios between diabetics and non-diabetics. As age increased, the prevalence of type 2 diabetes mellitus was more common. Out of 217 diabetics, 173 were of East Indian descent. With regards to gender, more males were found to be diabetics resulting from having an android body shape as compared to females (gynoid body shape). Conclusion: It was found that of all the anthropometric measurements used, waist to hip ratio was found to be the most effective indicator of type 2 diabetes mellitus in Trinidadians, while body mass index was found to be the least effective indicator.

Association between altered lipid profile, body mass index, low plasma adiponectin and varied blood pressure in trinidadian type 2 diabetic and non-diabetic subjects.

Background: The obesity and hypertension have become the causes for the development type 2 diabetes. There is a limited study done on the contribution of body mass index (BMI) to blood pressure (BP) in the Caribbean population. Aim of our study was to determine the associations between lipid profile, BMI, adiponectin, and BP in Trinidadian type 2 diabetic patients with regards to age and ethnicity. Materials and Methods: This was a cohort study comprised of 266 subjects (85 males and 181 females) attending primary and tertiary healthcare settings in central Trinidad. Of which, 126 diabetic subjects were matched with 140 non-diabetic subjects. Along with clinical history and anthropometry, adiponectin and lipid profile were measured in fasting blood samples. Results: The diabetic group had higher triglycerides, very low density lipoprotein (VLDL), and BP values which were statistically significant (P < 0.05) when compared to non-diabetic subjects. The high-density lipoprotein cholesterol (HDL-c) and adiponectin were lower in diabetic subjects. HDL-c showed significant changes for ethnicity (P = 0.013) and gender (P = 0.043). The mean adiponectin concentrations were found to be significantly different among the ethnic groups (P = 0.001). Systolic pressure varied significantly with age (P = 0.018). As age increased, BP also increased. Ethnic groups had a significant difference in diastolic pressure (P = 0.027). East Indians had the highest mean diastolic pressure (80.74 ± 10.29) when compared to all other ethnic groups. Conclusion: HDL-cholesterol, low levels of adiponectin, and varied BP are associated in Trinidadian type 2 diabetic subjects with regards to age, gender, and ethnicity.

Wound healing activity of Carica papaya L. in experimentally induced diabetic rats.

The aqueous extract of C. papaya fruit (100 mg kg(-1) day(-1) for 10 days) was evaluated for its wound healing activity in streptozotocin-induced diabetic rats using excision and dead space wound models. Extract-treated animals exhibited 77% reduction in the wound area when compared to controls which was 59%. The extract treated wounds were found to epithelize faster as compared to controls. The wet and dry granulation tissue weight and hydroxyproline content increased significantly when compared to controls. The extract exhibited antimicrobial activity against the five organisms tested. Carica papaya promotes significant wound healing in diabetic rats and further evaluation of this activity in humans is suggested.

Serum copper, ceruloplasmin, protein thiols and thiobarbituric acid reactive substance status in liver cancer associated with elevated levels of alpha-fetoprotein.

Serum copper, ceruloplasmin, protein thiols and thiobarbituric acid reactive substances (TEARS) were estimated in 25 patients of liver cancer. The copper to ceruloplasmin ratio was moderately increased (P<0.05) but the copper (P<0.001) and ceruloplasmin (P<0.001) levels were significantly increased in liver cancer patients when compared to controls. Protein thiols levels were found to be highly significant (P<0.001). Where as the TEARS levels were not found to be significant. Trace elements and free radicals have been implicated in the etiology of cancer. Hence the estimation of ceruloplasmin and protein thiols along with the copper may be of high value in the early diagnosis of cancer.

Serum copper, ceruloplasmin and thiobarbituric acid reactive substance status in patients with ovarian cancer.

Serum copper, ceruloplasmin and thiobarbituric acid reactive substances (TBARS) were estimated in 30 patients of ovarian cancer. The copper to ceruloplasmin ratio was moderately increased (P<0.05) but the copper (P<0.01( and ceruloplasmin (P<0.001) levels were significantly increased in ovarian cancer patients as compared to controls. TBARS levels were also found to be highly significant (P<0.001). Trace elements and free radicals have been implicated in the etiology of cancer. Hence the estimation of antioxidants like ceruloplasmin and TBARS along with the trace element like copper may be of value in the early diagnosis of cancer.

Copper and ceruloplasmin status in serum of prostate and colon cancer patients.

Serum copper and ceruloplasmin levels were estimated in 20 patients each of prostate and colon cancer. Although copper to ceruloplasmin ratio was not significantly altered, copper and ceruloplasmin levels were increased significantly in the cancer patients as compared to controls. Trace elements and free radicals have been implicated in the etiology of cancer. Hence determination of specific antioxidants (like ceruloplasmin) and trace elements (like copper) may be of value in the early diagnosis of prostate and colon cancer.