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Background: Androgen deprivation therapy (ADT) is indispensable part of treatment for metastatic prostate cancer (MPC) patients. There is documented association between ADT and adverse cardiovascular (CV) events, with variability between the different modes. However, there is dearth of evidence on the background CV risk factors of these group of patients at diagnosis. Aims and Objectives: We envisaged this retrospective observational study in the department of oncology to document the background CV risk factors of MPC patients at diagnosis, to help us better select the available ADTs based on their CV risks. Materials and Methods: Over a period of 2 years, all patients registered for treatment with a diagnosis of MPC, indicated for ADT, and available detailed history and background cardiological evaluation at presentation, were included in the study. As indirect indicators of CV risks, history of smoking, presence and treatment of dyslipidemia, and type 2 diabetes mellitus (T2DM), were documented. As direct indicators of CV risks, presence and treatment of hypertension, ischemic heart disease (IHD), congestive cardiac failure (CCF), ECG, and echocardiography changes suggesting cardiac morbidity were documented and the data were analyzed using descriptive statistical methods. Results: Indirect indicators: dyslipidemia, habit of smoking, and T2DM were found in 74%, 29.3%, and 13.3% patients, respectively. Direct indicators: Presence of hypertension, IHD, CCF, abnormalities in ECG, and echocardiography were found in 38.7%, 10.6%, 4%, 28%, and 34.6% patients, respectively. ST-T changes on ECG, low EF, and IHD on echocardiography were seen in 28.5%, 23%, and 26.9%, respectively. Conclusions: MPC patients have a substantial pre-existing CV risk at diagnosis. Our findings warrant a meticulous screening of all MPC patients for CV risk factors, to help in judicious selection of their ADT.
RESUMO
The world is culturally endowed with various forms of healing practices having rich medical wisdom of immense importance. One of such pharmacognostically indispensable medicinal plant is Embelia tsjeriam-cottam A. DC. The active principle of E. tsjeriam-cottam is embelin, possessing a range of pharmacognostic activities including anti-cancer, antioxidant, antiinflammation, antibacterial and analgesic effects. Embelin in fruits of E tsjeriam-cottam was extracted using water bath method. For extraction of embelin from fruits of E. tsjeriamcottam, methanol and chloroform were used as solvents. Fruits were collected from five different agro-climatic zones of Odisha. Comparative estimation of embelin was done through spectrophotometer and High Performance Liquid Chromatographic (HPLC) methods. Samples extracted with chloroform and methanol showed embelin content in a range of 2.13- 0.29% dry wt., and 0.95-0.28% dry wt. respectively using spectrophotometer. In case of HPLC analysis, samples extracted in chloroform and methanol showed embelin content in a range of 1.86-0.27% dry wt., and 0.875-0.26% dry wt. respectively. However the water bath method, used as alternative method for extraction, proved to be less time consuming, costeffective in extracting a pretty good amount of embelin as compared to the conventional (soxhlet) methods of extraction.
RESUMO
To evaluate the thrombophilic risk factors and incidence in patients presenting at the hematology outpatient clinic for further investigation after the diagnosis of pulmonary embolism. A total of 15 cases [8 male, 7 female] with the diagnosis of pulmonary embolism and referred to hematology clinic for investigating thrombophilic risk factors were retrospectively evaluated. Thrombophilic screening tests for these patients are as follows: factor V leiden [FVL], prothrombin G20210 A [PTG] and methylentetrahydrofolate reductase [MTHFR C677 T] gene mutations, protein C [PC], protein S [PS] and antithrombin III [AT III] deficiency, active protein C resistance [APC-R], antinuclear antibodies [ANA], anti ds DNA, anticardiolipin antibodies IgM and IgG, lupus anticoagulant, homocysteine and factor VIII levels were investigated. The commonest thrombophilic defect was MTHFR C677T gene mutation [n=12] [80%].Single defect [n=4] was found at a rate of 26.6%, double defects [n=2] 13.3%, triple defects [n=5] 33.3% and four defects [n=3] 20%. One patient had no defects. In this retrospective study carried out in patients with pulmonary embolism, MTHFR gene mutation was found to be the commonest cause for hereditary thrombophilia as a single risk factor and/or together with other thrombophilic risk factors