Prevalence of cardiovascular risk factors among municipality workers in Chitradurga, South India

Background: Cardiovascular disease (CVD) is the single largest cause for mortality and morbidity in the world. In India, non-communicable diseases (NCDs) were responsible for 53% of deaths and 44% of disability adjusted life years lost. Appropriate assessment and management of cardiovascular risk is vital to prevent fatal and non-fatal heart attacks and strokes and to improve health outcomes in individuals at high risk of cardiovascular events. Diabetes mellitus (DM) and HT are common diseases in adulthood, pre-disposing to many cardiovascular complications, posing a major public health challenge.This study aims to assess the prevalence of cardiovascular risk factors such as diabetes, HT, smoking, alcohol intake, dyslipidaemia and obesity among Municipality workers.Methods: A cross-sectional study was carried out between Jan 2019-June 2019 among 100 Municipality workers in Chitradurga, South India. Socio-demographic details and some of the risk factors such as alcohol intake and smoking history were obtained using a pre-tested, structured questionnaire. Blood pressure & waist circumference were measured by standard methods. Fasting blood sugar & lipid profile were measured.Results: Mean age of study participants was 38.03 years (SD ± 10.9). Out of the study subjects, 21% were known diabetic and 22% were known hypertensive. 34% of the participants had cholesterol level higher than the desirable level of 200 mg/dL. Around 72% had a history of alcohol consumption and 13% had a history of tobacco smoking during the last 1 month. The prevalence of overweight based on BMI (BMI >23) is higher among Municipality workers (56%) compared to the general population (35.4%).Conclusions: Burden of cardiovascular risk factors such as diabetes and HT were high among Municipality Workers of Chitradurga.

Evaluation of clinical, biochemical and hematological parameters in macrocytic anemia

Background: Macrocytosis can be seen in many hematological and non-hematological disorders and more than one cause may co-exist in an individual. Serum vitamin B12 and folic acid tests are routinely ordered but they are limited by their low sensitivity and specificity. This study is done to analyze the clinical, hematological and biochemical parameters in macrocytic anemia and to study the difference between megaloblastic and non-megaloblastic anemia in these parameters.Methods: There were 100 patients presenting with macrocytosis were taken in to study. A detailed clinical history and physical examination was done in all cases. CBC, biochemical investigations, peripheral blood examination, Vitamin B12, folate levels, bone marrow aspiration and reticulocyte count was done in all cases.Results: Primary bone marrow disorders were the most common cause of macrocytosis (45%). The other causes in decreasing order of frequency were megaloblastic anemia (36%), alcoholism and liver disease (15%), drug induced (2%) and idiopathic thrombocytopenic purpura (1%). There was a significant difference in the mean values of MCV and serum LDH between megaloblastic and non-megaloblastic macrocytosis. When serum LDH >1124.5IU/L or MCV>120.5fl (criterion values of ROC curve) with reticulocyte count <2% was taken as criteria, the sensitivity was 94.4% and specificity was 93% for diagnosing megaloblastic anemia.Conclusions: Systematic evaluation of macrocytosis will help us to distinguish megaloblastic and non-megaloblastic macrocytosis. The blood and biochemical parameters especially CBC, RC, and serum LDH along with supporting clinical features help us in diagnosing megaloblastic anemia in a setup where vitamin and metabolite levels are difficult to obtain.

The comparisons of the efficacy of two fixed dose combinations, i.e. Salmeterol and Fluticasone vs. Formoterol and Tiotropium bromide in moderate to severe COPD patients

Background: Bronchodilators are essential for symptomatic management of all stages of chronic obstructive pulmonary disease (COPD). For patients whose COPD is not sufficiently controlled by monotherapy, combining a ß2-agonist with either inhaled steroid or anticholinergic drug is a convenient way of delivering treatment. Currently, there is no documentation to say that one drug is superior to other or the contrary, but a combination of two drugs is more effective than giving single drug alone in patients suffering from COPD.Methods: The study was prospective, open labelled, randomized, comparative interventional clinical study conducted by the Departments of Pharmacology and Medicine, Basaveshwara Medical College and Hospital, Chitradurga in 60 moderates to severe COPD patients.Results: Both the treatments i.e. Salmeterol/Fluticasone and Tiotropium/Formoterol were equally effective as far as the improvement of the lung functions and Borg dyspnoea score are concerned. The difference in improvement with the combination of Salmeterol/Fluticasone was not statistically significant (p>0.05) compared to the combination of Tiotropium/Formoterol. However, Salmeterol/Fluticasone was found to be better than Tiotropium/Formoterol in improving the lung function of moderate to severe COPD patients.Conclusions: Salmeterol/Fluticasone is efficacious and better than Tiotropium /Formoterol combination for maintenance therapy in moderate to severe COPD patients.

Biological activities of Sarcanthus pauciflorus.

Sarcanthus pauciflorus is a pendulous epiphytic orchid belonging to the family Orchidaceae. The present study was conducted to determine antimicrobial, antioxidant, anthelmintic and insecticidal efficacy of methanol extract of S. pauciflorus. Antimicrobial activity of methanol extract was determined against four bacteria and two fungi by Agar well diffusion method. Antioxidant activity was performed by DPPH free radical scavenging and Ferric reducing assay. Anthelmintic activity was studied on the basis of time taken for paralysis and death of adult Indian earthworms by the extract. Insecticidal activity, in terms of larvicidal effect, was evaluated using II instar larvae of Aedes aegypti. Total phenolic content of extract was estimated by Folin-Ciocalteau reagent assay. Phytoconstituents viz., tannins, saponins and glycosides were detected in methanol extract. Content of total phenolics was found to be 258.65 mg GAE/g of extract. All test bacteria and fungi were susceptible to extract of orchid. Bacillus subtilis and Cryptococcus neoformans were susceptible to high extent among bacteria and fungi respectively. Gram positive bacteria have shown greater susceptibility than Gram negative bacteria to extract. The extract exhibited marked dose dependent scavenging of DPPH free radicals. An increase in absorbance at 700nm revealed reducing power of the extract. The extract caused paralysis and death of adult Indian earthworms in a dose dependent manner. The lethal effect of extract on II instar larvae of Aedes aegypti was found to be dose dependent. The results of the present study shows that the methanol extract of S. pauciflorus is found to possess antimicrobial, antioxidant, anthelmintic and insecticidal activities which might be attributed to the presence of secondary metabolites. Further experimentations concerned with isolation of the bioactive components present in the orchid and determination of their biological activities are under progress.

Mean corpuscular volume and biochemical markers of alcoholism - A comparative study.

Alcoholism is a serious health issue with major socioeconomic consequences. Significant morbidity is related to chronic alcohol use, and alcoholics seek advice only when complications of drinking set in. The diagnosis is often based on patients self-reporting of alcohol consumption, which is unreliable and requires high degree of clinical suspicion. However, if alcohol problems are recognized at an early stage, the physician may be able to prevent their further development and progression. The present study compares the mean corpuscular volume (MCV) with other traditional biochemical markers in alcohol abuse patients and healthy controls. It is a prospective study, and 40 cases and 30 controls were evaluated for biochemical parameters over a period of one year. The study revealed MCV to be possessing 87.5% sensitivity, 83.33% specificity, 87.5% of positive predictive value, 48.39% of negative predictive value and 54.29% of diagnostic accuracy, which makes it a reliable marker. The mean gamma glutamyl transferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) concentrations in alcohol dependent subjects were higher as compared to controls. Though clinical histories and questionnaires are the commonest initial means of detection of alcohol abuse, laboratory markers such as MCV should be used for confirming the diagnosis of alcohol abuse. They are also helpful in follow-up of patients undergoing treatment, and monitoring of abstinence