ABSTRACT
Background: Assessment of health-related quality of life (HRQoL) is an important measure of a patient's recovery after an illness. However, HRQoL among acute coronary syndrome (ACS) survivors has not been extensively studied following cardiac management. Aim: The purpose of this study was to assess the quality of life (QoL) among ACS patients who have undergone percutaneous coronary intervention (PCI). Methods: This cohort study included 145 consecutive male ACS patients between March 2021 and May 2022. Of these patients, 138 (mean age 54.3 ± 10.7 years) completed the QoL assessment using the short form-12 (SF-12) health survey questionnaire. Seventy (51%) of them presented with ST-segment elevation myocardial infarction (STEMI), 18 (13%) had non-STEMI, 39 (28%) had evolved MI, and 11 (8%) had unstable angina. Recruited patients' QoL data were assessed at various time points post-PCI. Results: At the end of the 12 months of follow-up, major clinical events (MCE) defined as death, sudden death, or re-acute myocardial infarction occurred in 54.9% of patients. Out of 7 MCE, four deaths and three re-AMIs had occurred. SF-12 physical component score was found to be significantly improved when compared to the mental component score, which seems to improve without reaching statistical significance over time. Among event-free ACS patients, we found a significant positive correlation between left ventricular ejection fraction and HRQoL. Conclusion: Improvement in HRQoL (physical component) was seen among ACS patients post-PCI. Relevance for Patients: QoL assessment outcomes should be considered in clinical settings, practice guidelines, and treatment modality post-PCI to improve QoL in post-ACS survivors.
ABSTRACT
Objective Prevalence of type-2 diabetes mellitus (DM) and diabetic nephropathy is growing rapidly in Asian countries, affecting low- and middle-income groups. One of the epidemiological issues of Kolar district is fluorosis; advanced glycation end product, carboxymethyl lysine (CML), and a molecule of interest Sirtuin1 are employed in the present study. In the correlation of fluoride with sirtuin1and CML with sirtuin1 of cases lies the important rationale of the study to assess the extent of kidney damage. Materials and Methods This is a comparative cross-sectional study with three groups, each with 70 patients, as follows: G1, control; G2, diabetes with diabetic nephropathy; and G3, type-2 DM without any complications. Informed written consent was obtained from all study patients. All the routine investigations were performed by fully automated Vitro 5, 1 Fs, Vitros. Fasting insulin was analyzed by Vitro eCI and glycated hemoglobin was estimated by BioRad D10. Sirtuin1, CML, and fructosamine were estimated by double antibody sandwich technique. Statistical Analysis The statistical analysis was performed by SPSS 20 (IBM) software. Means of normally distributed data were compared using analysis of variance (ANOVA), and not normally distributed data were compared by Kruskal-Wallis test. A p -value of less than 0.05 was considered statistically significant. Results A decrease in sirtuin1, serum, and urine fluoride of group 2 (34.74 [25.08-53.2], 0.24 [0.2-0.5], and 0.24 [0.16-0.41]) was observed compared with other groups. Increased CML and fluoride act as prooxidant, restricting the effect of sirtuin1 on cellular damage, causing further complications such as increased insulin resistance and decreased insulin sensitivity. Conclusion The alterations in serum sirtuin1 levels indicate the severity of damage due to stress during hyperglycemia and fluoride toxicity; hence, sirtuin1 can be considered as biomarker of aging. Subsequently, the correlation of CML, estimated glomerular filtration rate (eGFR), and fluoride with sirtuin1 indicates that increasing sirtuin1 may defend the forthcoming damage and could be considered in therapeutics.
ABSTRACT
Type 2 Diabetes Mellitus is leading cause of Diabetic microvascular complications. India stands second across the globe in prevalence of diabetes mellitus. Due to deficit rain fall, the water table is exposed to more of salts and minerals from the rocks underground. One of the minerals is the Fluoride. Fluoride in negligible amount is good for dental health, chronic exposure to higher range of fluoride causes various metabolic disturbances. Aim: To study the effect of chronic fluoride exposure on diabetes mellitus. A total of 288 study subjects were recruited. The blood samples and urine samples were collected from all the study subjects. Study groups; Group1: Healthy Controls, Group2: Type 2 Diabetes Mellitus and Group3: Diabetic Nephropathy. The serum (0.313± 0.154) and urine (0.3±0.6) fluoride values of diabetic nephropathy group were significantly decreased in comparison between groups. The primary objective of the fluoride with insulin (-0.06) levels are inversely correlating and fluoride with microalbumin (0.083) levels are directly correlating. Results of the study gave a clear picture of effect of fluoride on insulin action and renal damage. In conclusion, though there is no significant effect of fluoride on FBS, PPBS and HbA1c, insulin is the determining factor for glucose homeostasis which is decreased. Microalbumin is yet another marker for renal clearance which is increased. Therefore, fluoride shall be considered as a parameter in prognosis of metabolic disorder especially Diabetes mellitus in fluoride endemic areas.
ABSTRACT
Two young women, were reffered to our hospital on two different occasions with history of breathlessness and mental confusion, following consumption of two different bio-organic plant nutrient compounds with a suicidal intent. On examination, they had cyanotic mucous membranes, and their blood samples showed the classic 'dark chocolate brown' appearance. Work up revealed cyanosis unresponsive to oxygen supplementation and absence of cardiopulmonary abnormality. Pulse oximetry revealed saturation of 75% in case 1 and 80% in case 2, on 8 liters oxygen supplementation via face masks, although their arterial blood gas analysis was normal, suggestive of "saturation gap". Methemoglobinemia was suspected based on these findings and was confirmed by Carbon monoxide-oximetry (CO-oximetry). Methylene blue was administered and the patients showed dramatic improvement. Both the patients developed evidence of hemolysis approximately 72 hours following admission which improved with blood transfusion and supportive treatment. The patients were eventually discharged without any neurological sequalae.
