Clinical and biochemical profile of scrub typhus patients with emphasis on liver dysfunction in a tertiary care centre in South Rajasthan

Background: Scrub typhus is a zoonotic infectious disease presenting commonly with acute febrile illness of variable severity and symptoms. It mimics other more prevalent tropical febrile illnesses such as dengue, malaria, and leptospirosis. Prevalence is high in and around Udaipur due to hilly terrains and agricultural farmlands. Multisystem involvement is common but liver dysfunction is a fatal comorbidity. Methods: In a retrospective observational study, we analyzed the clinical, biochemical, and demographic parameters of 85 patients of scrub typhus. The study population was distributed into four groups for abnormal liver chemistries based on American College of Gastroenterology (ACG) clinical guidelines: normal, borderline high, mild elevation, and moderate elevation. Results: Almost 80% of patients had abnormal liver chemistries including either serum bilirubin or transaminases. More than 30% of patients were categorized in group 2 and group 3 of the abnormal liver chemistries. Group 4 with moderate to severe liver dysfunction had 15.3% (n=13) patients. Thrombocytopenia and elevated blood urea and Creatinine were significantly seen in patients with both scrub typhus and liver dysfunction. Conclusions: Thus, in our study prevalence of hepatitis and jaundice with multiorgan failure in scrub typhus patients was significantly high. Timely identification of systemic complications and screening of liver chemistries on presentation is of utmost importance for better outcomes, among seriously ill patients.

Oxidative stress in relation to obesity in Gujrati and non Gujarati young girls before and after maize diet.

Background: Obesity is the first of the “diseases of civilization” to appear. Its prevalence is escalating at an alarming rate. Environmental and behavioral changes brought about by economic development, modernization and urbanization has been linked to the rise in global obesity. Obesity may induce systemic oxidative stress. Objective: The present scenario suggests that higher oxidative stress is the key factor of obesity and hence a management strategy aiming at control of lipid peroxidation in obesity by use of maize diet is envisaged. Material and methods: This study has been conducted on 1001 Gujarati and non Gujarati girls aged between 18-30 years. They were further distributed according to age, inhabitance, socio economic status, dietary habits, family history and blood pressure. Every subject in each group was asked to replace the wheat chapatti by maize chapatti for 30 days; the girls were examined for oxidative stress parameter MDA before and after maize diet along with the statistical evaluation. Results: There was a positive effect of maize diet on biochemical parameter of all the girls in all the subgroups Malondialdehyde level in total girls before the maize diet was 2.35 ± 0.76nmol/ml which reduced to 1.8 ± 0.46nmol/ml after the diet (P<0.001). Conclusions: The oxidative stress showed improvement in normal, overweight and obese girls, most significantly on overweight and obese girls after taking the diet (P<0.001). Current dietetic practice is to recommend a healthy eating plan of reduced fat, and increased fiber intake.

Apolipoproteins A-1 and B as predictors of angiographically assessed coronary artery disease.

Serum lipids, lipoproteins, apolipoproteins (A-1 and B) were determined in 225 patients with angiographic evidence of coronary artery disease (having abnormal coronary angiogram and positive exercise stress test), and 112 patients without any clinical and/or angiographic evidence of coronary artery disease. The variable with the strongest association with coronary artery disease was the ratio of apo B/A-1. Thus, the determination of apolipoproteins yielded complementary information in this case control study and warrants further study in a prospective setting.