Metabolic Syndrome in Hypothyroid Patients.

Thyroid functions affect metabolic syndrome (MetS) parameters including blood pressure, fasting plasma glucose, serum triglycerides and HDL-Cholesterol. But the relationship between MetS and thyroid functions is yet to be identified clearly. Metabolic syndrome is a state in which most features of hypothyroidism can be seen. The aim of the present study was to investigate the frequency of MetS in hypothyroid patients. Thirty one patients with overt hypothyroidism, 32 patients with subclinical hypothyroidism (SCH) and 58 euthyroid controls were enrolled in this study. NCEP-ATP III criteria was used to diagnose metabolic syndrome. Majority of the participants were in the age group of 30-40 years. Body mass index and waist circumference, blood pressure, fasting plasma glucose and serum triglycerides were found to be higher in hypothyroid patients compared to that of euthyroid controls (p<0.001). On the other hand serum HDL-C was found to be significantly lower in hypothyroid patients compared to that of euthyroid controls (p<0.001). Prevalence of MetS was 82.5% in the hypothyroid group and 27.6% in eythyroid controls (p<0.001). No significant difference was found between SCH (81.3%) and overt hypothyroid (86.7%) groups in respect to prevalence of MetS (p<0.05). The findings of the study suggest a need to investigate the presence of hypothyroidism during the management of MetS patients.

Chemical and biological studies of Kalanchoe pinnata (Lam.) growing in Bangladesh

Objective: To isolate compounds from K. pinnata and elucidate their structures and to explore preliminary antioxidant, antimicrobial, cytotoxic and thombolytic activities of extractives of the plant. Methods: The methanol extract of whole plant of K. pinnata has been subjected to different chromatographic separation and purification processes to isolate the secondary metabolites. The structures of the isolated compounds have been elucidated by extensive NMR studies. The free radical scavenging activity of the crude extract and its different Kupchan fractions were determined on stable radical DPPH. In vitro antimicrobial activity was determined by the disk diffusion method. Cytotoxicity screening has been performed against Artemia salina. Total phenolics content, membrane stabilizing activity and thombolytic activities were assessed by following established protocol. Results: The isolated compounds were identified as glut-5(6)-en-3-one, taraxerone, 3β-friedelanol, β-amyrin-3-acetate, 3,5,7,3',5'-pentahydroxyflavone and β-sitosterol. The chloroform soluble fraction showed potent antioxidant activity of (IC50=80.0 μg/mL) and significant cytotoxicity, while the crude extract demonstrated noticeable total polyphenol content (149.24 mg of GAE/gm of extractive), moderate membrane stabilizing activity and inhibition of clot lysis of blood. Conclusions: The obtained results rationalize the folkloric use of the plant and can be further investigated to isolate the active compounds responsible for the biological activities.

Serum and Erythrocyte Magnesium levels in Offsprings of Essential Hypertensive Parents.

Hypertension is an important public health challenge worldwide, 95% of which are primary or essential hypertension, where the exact causes are not known. It has been thought that magnesium level has an association with hypertension and plays role in the pathogenesis of essential hypertension. Several evidences suggested that decreased magnesium level may be a significant modifiable risk factor for developing essential hypertension. To explore the relationship between serum and erythrocyte magnesium level with blood pressure, this case control study was carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), during the year 2006. Thirty offsprings of essential hypertensive parents were taken as cases and 30 age and sex-matched offsprings of normotensive parents were taken as controls. Serum & erythrocyte magnesium were measured by colorimetric Calmagite method. Significantly lower serum magnesium level (mg/dl) was found in cases than that of controls (1.90±0.210 vs 2.13±0.366, p<0.01) and erythrocyte magnesium (mg/dl) was also found to be lower in cases when compared with that of controls (4.46±0.699 vs 5.43±0.775, p<0.001). Mean systolic and diastolic blood pressure were found to be significantly higher (p<0.01) in cases as compared to controls. Though it is difficult to draw any definite conclusion, it may be assumed that, a hereditary predisposition to hypertension may be related to magnesium metabolism and magnesium deficiency might have a role in the future development of hypertension in the offsprings of essential hypertensive parents.

Detection of urinary leishmanial antigen by latex agglutination test (KAtex) in kala-azar patients.

Background: A new unique latex agglutination test (KAtex) that detects a stable, nonprotein, disease specific parasite antigen in the freshly voided urine of patients suffering from active kala-azar has been introduced by Kalon Biological Ltd. UK. This is absolutely non-invasive method of diagnosis for visceral leishmaniasis and suitable for implementation as a rapid diagnostic tool at the point of care. Objective: Diagnostic potential of KAtex was evaluated among clinically suspected kala-azar patients in an endemic zone of Bangladesh. Methodology: KAtex was done using freshly voided urine according to the manufacturer’s instructions for sixty (60) clinically suspected patients of kala-azar admitted in Rajshahi Medical College Hospital (RMCH), Bangladesh and forty (40) healthy controls during December 2005 to June 2006. Leishmania nested Polymerase Chain Reaction (Ln-PCR) using peripheral blood buffy coat was performed for all study population (100) and Ln-PCR positive cases were considered as confirmed cases of kalaazar. Results: Out of 60 clinically suspected kala-azar patients, 56 were Ln-PCR positive and 53 of 56 Ln-PCR positive cases were KAtex positive (sensitivity, 94.64%; Mantel- Haenszel Chi sq. 79.66, p= 0.0000, confidence interval [CI], >95 to 100%). None of the healthy controls was found positive by Ln-PCR but 2 of 40 were KAtex positive (specificity, 95%; confidence interval [CI], >95 to 100%). The positive and negative predictive values of KAtex were noted as 98.10% and 92.85% respectively. Conclusion: This limited prospective study suggests that KAtex is an absolutely non-invasive urinebased antigen detection test with high sensitivity and specificity and may be useful for screening active kala-azar patients, particularly suitable for field use.

Detection of Entamoeba histolytica DNA from liver abscess aspirate using polymerase chain reaction (PCR): a diagnostic tool for amoebic liver abscess.

Amoebic liver abscess is common in Bangladesh. It is usually diagnosed by suggestive clinical features, ultrasound findings and positive serology. However, none of these are definitive and the picture overlaps with pyogenic liver abscess. It is critical to differentiate amoebic liver abscess from pyogenic liver abscess as the treatment are different. This study was designed to evaluate the feasibility of using polymerase chain reaction (PCR) for detection of Entamoeba histolytica (E.histolytica) DNA in liver abscess pus for confirmatory diagnosis of amoebic liver abscess. This study was carried out in the department of Hepatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Thirty patients of amoebic liver abscess were included in this study. PCR was done to detect E.histolytica DNA in liver abscess aspirate of all patients by real time PCR method, using oligonucleotide primer containing small-subunit rRNA gene of E.histolytica. Real time PCR detected E.histolytica in liver abscess aspirate in 29 cases out of 30 cases and the sensitivity was 97% (p<0.001). This study also showed that antigen detection by ELISA in liver abscess aspirate was positive in 12 cases only and sensitivity was 40%. The study indicates that detection of E.histolytica by PCR is more sensitive than amoebic antigen detection and PCR assay can be successfully used to confirm the diagnosis of amoebic liver abscess.

Socioeconomic status, clinical features, laboratory and parasitological findings of hepatic amebiasis patients--a hospital based prospective study in Bangladesh.

Socioeconomic status, clinical, laboratory and parasitological features of 31 hospitalized amebic liver abscess (ALA) and 8 amebic hepatitis (AH) patients were studied. Thirty-seven (94.9%) of the total 39 cases were from low socioeconomic class and 2 (5.1%) were from middle class (p<0.001). Sixteen (51.6%) ALA and 5 (62.5%) AH patients were admitted with duration of disease for 3 weeks or more. Twenty-one (67.7%) ALA and 3 (37.5%) AH cases gave no previous history of diarrhea or dysentery. Epigastric pain was the predominant symptoms in 71% patients compared to high fever (19.4%), nausea and vomiting (9.7%). Neutrophilic leukocytosis was found in 9 (29.0%) ALA and 2 (25%) AH cases. Raised alkaline phosphatase was the predominant abnormal liver function test found elevated in 22 (71.0%) ALA and 5 (62.5%) AH cases. Three (7.7%) of the 5 (12.8%) microscopy positive stool samples yielded growth of Entamoeba histolytica in culture. The right lobe was involved in 28 (90.3%) ALA cases; 29 (93.5%) patients had single abscess. Bacterial super infection was observed in 1 (12.5%) abscess, reactive changes in right lung was observed in 6 (19.4%) ALA and 1 (12.5%) AH cases. Ascaris lumbricoides was the predominant associated intestinal parasite.