Evaluation of Inflammatory Markers and Demographic Profile of Type 2 Diabetes Mellitus Patients among the Ethnic Communities Attending Central Referral Hospital, East Sikkim.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is the most common metabolic disorder and inflammation plays a key role in the pathogenesis of the disease. Ethnic variations have been linked with an increased prevalence of diabetes. This pilot study was designed to evaluate the inflammatory markers and demographic characteristics in T2DM patients among the ethnic group of Sikkim. MATERIALS AND METHODS: A total of 100 type 2 diabetic patients and 50 healthy controls were enrolled in the study. Demographic characteristics were recorded among the patients and inflammatory markers [high sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6)], body mass index (BMI), glycemic status, fasting blood sugar (FBS), and postprandial blood sugar (PPBS) level were compared between the cases and controls. Inflammatory markers were correlated with BMI, glycemic status, and duration of diabetes. RESULTS: Type 2 diabetes mellitus was found to be highest in between the age-group of 45 and 55 years with males being mostly affected. Among the ethnic group, Nepalis (57%) comprised the highest with diabetes. No significant correlation was found between inflammatory markers with BMI, glycemic status, and duration of diabetes. CONCLUSION: Our study showed that T2DM increases as age progresses with males being mostly affected. The Nepalese community showed a high proportion of the disease mostly living in the urban residences. Though we included patients on statin therapy, its specific roles and relationship were not in the scope of the current study, but further studies should be conducted at the community level to understand the role and relationship of statins among type 2 diabetic patients and the possibilities of ethnic differences in the levels of biomarkers due to variation in the body fat distribution.

Advances in HPV Screening Tests for Cervical Cancer-A Review.

HPV is responsible for almost all cases of cervical cancer which in turn is one of the common causes of death among female genital malignancies. Cervical cancer being a preventable disease, screening plays a vital role in its reduction. In this era of advanced health care system and technologies this cancer is still in the increasing trend, especially in the Low and Middle Income Countries, which reflects the poor coverage of women for screening. Advances in screening tests and techniques for better and larger coverage of women is the need of the hour globally. Clinicians also need to be aware of the various promising technologies available for screening of cervical cancer precursors, application of which in general practice can be of immense help in cervical cancer reduction.

Prevalence of Metabolic Syndrome and Its Components in Adults with Central Obesity at Janakpur Zone, Nepal.

BACKGROUND: Urbanization, surplus energy uptake, decreased physical activities are general risk factors of metabolic syndrome However, it's status, and associated components remain unexplored in the Terai region of Nepal. This study evaluated the prevalence of metabolic syndrome and its components among adults with central obesity of Terai region of Nepal using International Diabetes Federation criteria. METHODS: Community based cross-sectional study was conducted in three Terai districts of Janakpur Zone, Nepal. A total of 378 adults having central obesity were selected using cluster sampling by camp approach. Interview, physical and clinical examination, measurement of fasting blood sugar, and lipid profile were conducted for all participants. The prevalence of metabolic syndrome and its components with 95% CI were estimated. RESULTS: The metabolic syndrome prevalence was 74.9% (95% CI:70.2-79.2%), with no significant differences between male (77.7%, 95% CI:71.0-83.5%) and female (72.2%, 95% CI: 65.2-78.3%). The most common factors observed were low high density lipoproteins with highly significant differences between male (77.7%, 95% CI:71.0-83.5%)) and female (90.2%, 95% CI: 85.094.0%-; p=0.001) and hypertriglyceridemia with significant differences between male (57.6%, 95% CI: 50.1-64.5%) and female (46.9%, 95% CI: 39.7-54.2%; p=0.037). CONCLUSIONS: Higher prevalence of metabolic syndrome and its risk factors in Janakpur of Nepal likely suggest lack of awareness and health promotion activities for metabolic syndrome and indicate an urgency for a public health program to maintain quality of life.

Oxidative stress in metabolic syndrome & its association with DNA-strand break.

BACKGROUND & OBJECTIVES: Oxidative stress (OS) is associated with numerous components of metabolic syndrome (MetS). This study was aimed to investigate if hydrogen peroxide (H2O2) as the reactive oxygen species was capable of depicting OS in MetS, and If MetS patients showed DNA damage in the form of DNA strand breaks (DSB). METHODS: A total of 160 participants (90 males, 70 females) ≥20 yr of age were categorized into four groups based on the number of MetS risk parameters (n=40 in each group). Sugar and lipid profile, H2O2concentration in blood and DNA-strand breaks were measured. RESULTS: DSB was significantly more in those with MetS (n=40) than those without (n=120) whereas H2O2levels were the same in both the study groups. The number of DSB differed significantly between the control and 3 risk factor groups. DSB was also higher in groups with 2 and 1 risk factors compared to 0 risk but the difference was not significant. H2O2 level was higher in groups with 3, 2 and 1 risk factors compared to 0 risk group but the difference was not significant. The H2O2level correlated positively with triglyceride values but not with other MetS risk parameters. There was no significant correlation between DSB and MetS risk parameters. INTERPRETATION & CONCLUSIONS: Our findings showed a cumulative and synergistic effect of the risk factors of MetS on DSB. Individuals with three risk parameters had a greater effect on DNA damage than in those with two or one risk parameter. Although plasma H2O2level increased with an increase in the fat depots, use of H2O2to depict OS in MetS should be coupled with an adjunct and estimation of DSB in peripheral blood lymphocytes may be used as indicator of OS in MetS patients.

Correlation of cartilage metabolic markers & antioxidants with the severity of knee osteoarthritis.

Osteoarthritis is characterized by the degeneration of articular cartilage. Cartilage metabolic markers have been explored as possible markers for osteoarthritis, and osteogenic protein -1 (OP-1) has emerged out to play a major role in cartilage repair. Oxidative stress has been implicated as a mediator of cartilage damage in patients with osteoarthritis. The aim of this study was to correlate the cartilage metabolic markers and antioxidants with the severity of knee osteoarthritis.

Production of a polyclonal antibody against osteogenic protein-1, and its role in the diagnosis of osteoarthritis.

INTRODUCTION: Osteoarthritis (OA) is a progressive degenerative disorder of the articular cartilage. Available diagnostic radiography has been poorly associated with the progress and severity of this clinical disease. As osteogenic protein-1 (OP-1) has been identified as a bone morphogenetic protein with a major role in cartilage repair, we aimed to evaluate its potential role in the diagnosis of OA. METHODS: This was an experimental study conducted at the Department of Biochemistry, Sikkim Manipal Institute of Medical Sciences, India. Polyclonal antibodies (i.e. anti-OP-1[f]) were raised against OP-1 in mice, and subsequently used in a sandwich enzyme-linked immunosorbent assay (ELISA) to detect the presence of OP-1 in the synovial fluids of 75 osteoarthritic patients. For the purpose of correlation, the radiographic assessments of the knees of the 75 patients were graded using the Kellgren-Lawrence scoring system. RESULT: The polyclonal antibody (i.e. anti-OP-1[f]) raised against OP-1 was able to detect the presence of OP-1 in the synovial fluids of all the osteoarthritic patients via sandwich ELISA. The level of the OP-1 was found to be much higher than the reference range and correlated positively with the severity of OA (r = 0.24; p = 0.04). CONCLUSION: Our study shows that the polyclonal antibody, anti OP-1(f), could be used for the immunodiagnosis of osteoarthritis via sandwich ELISA.

Correlation of the Osteogenic Protein-1 (OP-1) with Age, Cartilage metabolic Markers and Antioxidants in the Osteoarthritic Patients of Sikkim.

BACKGROUND: Age and oxidative stress have been implicated as the main causes of the cartilage damage in osteoarthritis (OA). The osteogenic protein-1(OP-1), a member of the bone morphogenetic family (BMP), plays a major role in cartilage repair. AIM: To correlate the OP-1 in the synovial fluid with the age and antioxidants like superoxide dismutase (SOD), glutathione peroxidase (GPx) and uric acid (UA) in the blood and with the cartilage metabolic markers like hyaluronic acid (HA) and keratan sulphate (KS) in the synovial fluid of osteoarthritic patients. METHOD: Seventy five osteoarthritic patients were taken up for the study. Heparinized blood samples were collected for the estimation of SOD, GPx and UA. Synovial fluid was aspirated for the estimation of HA, KS and OP-1. OP-1 was estimated by using a polyclonal antibody (anti-OP-1) which was produced against OP-1 in the mouse ascitic fluid by sandwich ELISA. RESULT: Age and UA showed a significant correlation with OP-1. On the other hand, the correlations between OP-1 and the antioxidants (SOD and GPx) and the cartilage metabolic markers (HA and KS) were insignificant in osteoarthritic patients. CONCLUSION: The study suggests about the important role of OP-1 in cartilage aging and degeneration, which may help us in understanding the potential for the therapeutic interventions in the treatment of cartilage degenerative processes.