Dyslipidemia among Patients with Type 2 Diabetes Mellitus Visiting a Tertiary Care Centre.

Introduction: A triad of lipid and lipoprotein metabolism is known as dyslipidemia. Dyslipidemia is one of the major risk factors for cardiovascular diseases in diabetes mellitus which is a leading cause of morbidity and mortality worldwide. The aim of the study was to find out the prevalence of dyslipidemia among patients with type 2 diabetes mellitus visiting a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in a tertiary care centre among patients with type 2 diabetes mellitus from 18 February 2020 to 18 August 2020 after obtaining ethical clearance from the Institutional Review Committee. Demographic and blood samples were analysed and recorded using validated and calibrated tools. A convenience sampling technique was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 390 patients with type 2 diabetes mellitus, 343 (87.95%) (84.72-91.18, 95% Confidence Interval) had dyslipidemia. The most prevalent dyslipidemia was high low-density lipoprotein cholesterol at 85 (24.78%) followed by mixed dyslipidemia at 305 (88.92%). Conclusions: The prevalence of dyslipidemia among patients with type 2 diabetes mellitus was found to be higher than studies conducted in similar settings. We recommend regular testing of blood glucose and blood lipid levels for early detection of dyslipidemia and putting them under medical supervision to reduce the unwanted complications of cardiovascular diseases. Keywords: cardiovascular disease; dyslipidemia; prevalence; type 2 diabetes mellitus.

Effects of 4-Oxo-2-nonenal on biochemical properties of bovine heart mitochondria.

The effects of lipid peroxidation products 4-Hydroxy-2-nonenal (4-HNE) and 4-oxo-2-nonenal (4-ONE) were evaluated using bovine heart mitochondria. Oxygen consumption rate (OCR), ultrastructure, antioxidant activity, and membrane permeability were examined to compare their effects on isolated mitochondria from beef cardiac muscle. For the mitochondrial morphology, the final concentration of mitochondria and 4-ONE or 4-HNE in the reaction tube were 10 mg/ml and 1 mM, respectively. For the OCR experiment, mitochondria (2.5 mg/ml) were incubated with 0.20 mM ONE or in a Clark electrode chamber at 25°C. Mitochondrial membrane permeability was determined by incubating 0.5 mg/ml of mitochondrial protein with either 0.05 mM ONE or HNE or ethanol control at pH 5.6 and 7.4 at 25°C. Transmission electron microscopy (TEM) revealed that the size of 4-ONE treated mitochondria at pH 7.4 increased (p < .05), as did permeability (p < .05), unlike ethanol controls. However, mitochondria incubated with 4-ONE at pH 5.6 showed a decrease in volume (p < .05). Incubating mitochondria with 4-ONE at pH 5.6 and pH increased oxygen consumption rate 7.4 caused less oxygen consumption than either 4-HNE treatment or ethanol control. The hydrogen peroxide assay (H2O2), ferric reducing antioxidant properties (FRAP), and 2,2'-azinobis (3-ethylbenzthiazoline-6-sulfonic acid) (ABTS.+) assays revealed that 4-ONE is a more potent inhibitor of the endogenous antioxidant system of mitochondria than 4-HNE (p < .05).

Perinatal Outcome of Vaginal Breech Delivery versus Caesarean Breech Delivery in a Tertiary Care Center.

INTRODUCTION: Breech delivery has always been matter of interest in obstetrics. Cesarean breech delivery has been preferred method of delivery. We aim to find out any differences in outcome between vaginal breech delivery and cesarean breech delivery in our setup. METHODS: Data were collected from record book of Department of Gynaecology and obstetrics, Pokhara Academy of Health Sciences, Kaski, Nepal. Pregnant with breech presentation who had delivery in the centre from 2074 Baishak to 2074 chaitra were enrolled in the study. Data of 174 patients were analysed among which 74 underwent vaginal delivery for breech and 110 underwent cesarean breech delivery. RESULTS: Only 1 (1.6%) of newborn delivered by vaginal route were admitted to NCU vs 17 (15.5% )in cesarean group which was significant (odds ratio= 0.071, 95% C.I 0.009-0.574; p= 0.004). There was only one death of newborn which was delivered by vaginal route. Mean APGAR score at 1 and 5 minute in vaginal breech delivery was 6 and 7 and in cesarean breech delivery was 6 and 8. CONCLUSIONS: Though perinatal morbidity was more with cesarean breech delivery but further study with more sample size is needed before reaching conclusion.

A comparative study of antioxidant potential of low density lipoprotein in type 2 diabetic men and women.

BACKGROUND: Hyperglycemia plays an important role in etiology of vascular complications like atherosclerosis in diabetes. Oxidative modification of low density lipoprotein (LDL) plays an important role in the progression of atherosclerosis. The aim of the present study is to compare the antioxidant potential (AOP) of LDL in type 2 diabetic men and women. MATERIALS AND METHODS: The study was carried out in 80 diabetic subjects and 80 control subjects. The men (40) and women (40) in the diabetic groups were studied separately and matched for age (50-60 years), body mass index (BMI), duration of diabetes, glycosylated hemoglobin, and lipid profile. LDL from the serum sample was precipitated by heparin citrate precipitation method. For the measurement of AOP in LDL, we used xanthine-xanthine oxidase method. RESULTS: Our results showed that AOP value was significantly low in diabetic women (P < 0.05) in comparison with diabetic men. CONCLUSION: It is therefore suggested that LDL from type 2 diabetic women is more prone for oxidation.

Reduced Antioxidant Potential of LDL Is Associated With Increased Susceptibility to LDL Peroxidation in Type II Diabetic Patients.

BACKGROUND: Type II diabetes mellitus is a complex heterogeneous group of metabolic conditions characterized by an increased level of blood glucose, due to impairment in insulin action and/or insulin secretion. Hyperglycemia is a major factor in the pathogenesis of atherosclerosis in diabetes. Oxidative modification of low density lipoprotein (LDL) is recognized as one of the major processes involved in the early stages of atherosclerosis in type II diabetes. LDL contains different antioxidants, which increase LDL resistance against oxidative modification, this is known as its antioxidant potential (AOP). OBJECTIVES: The present study has been carried out to investigate the sensitivity of LDL to oxidation, AOP of LDL and to assess whether hyperglycemia in diabetes mellitus is associated with increased LDL oxidizability, and whether these relationships are related to diabetic complications. PATIENTS AND METHODS: This study was carried out on 100 diabetic subjects, divided into two groups according to their glycosylated hemoglobin (HbA1c) values, either regulated ( < 0.50 M hexose/ M Hb) or unregulated ( > 0.50 M hexose/ M Hb.) A further 50 healthy subjects were included to determine the sensitivity of LDL oxidation and measurement of LDL AOP. LDL from the serum sample was precipitated by the heparin-citrate precipitation method. The LDL fractions were exposed to oxidation with copper sulphate and their sensitivity to oxidation was evaluated. AOP was measured by taking measurements from 30 subjects in each group. RESULTS: The sensitivity of LDL oxidation was significantly higher in both diabetic groups compared to the control group. AOP was significantly decreased in all diabetic groups compared to the control group. CONCLUSIONS: In type II diabetes, the increased susceptibility of LDL to oxidation is related to hyperglycemia and low AOP.