Imbalances of Pro-inflammatory cytokines in myocardial infarction patients.

To assess levels of Interleukin-1 ß and CRP, in Diabetic and Non-diabetic Myocardial Infarction patients, prior to and post angioplasty. 200 patients were recruited in the study. MI patients between the age of 40 and 60 years. Patients came to NICVD with complaints of chest pain, positive Troponin T test and ECG was the confirmatory test for MI. They were divided into 2 groups 100 patients each. First group comprised of MI patients without DMT-II and second group comprised of MI patients with DMT-II. Serum triglycerides, cholesterol, LDL and HDL, FBS, by enzymatic kits, Insulin by RIA. HbA1C, Interleukin-1 ß and CRP by ELIZA. Interleukin1ß and CRP were significantly higher (P<0.001) in patients at the time of the infarction, prior to angioplasty as compared post angioplasty levels in both groups, which indicate their importance in development of ischemia and MI. FBS and Insulin were significantly higher (P<0.001), while HDL and HbA1C were significantly lower (P<0.001) in MI without DMT-II when compared to MI with DMT-II. BMI, SBP pressure were significantly higher (P<0.001) in MI patients with DMT-II when compared with MI patients without DMT-II. Interleukin1ß and CRP were found to be significantly higher prior to angioplasty as compared to post angioplasty levels in both groups which confirms their role in development of ischemia and MI.

Analysis of one-best MCQs: the difficulty index, discrimination index and distractor efficiency.

OBJECTIVE: To investigate the relationship of items having good difficulty and discrimination indices with their distractor efficiency to find how 'ideal questions' can be affected by non-functioning distractors (NF-Ds). METHODS: The cross-sectional study was conducted at Fatima Jinnah Dental College, Karachi, during Jan-Jun 2009, with 102 First Year dental students (17-20 years). Physiology paper of the first semester, given after 22 weeks of teaching general topics of physiology, was analysed. The paper consisted of 50 one-best MCQs, having 5 options each. The MCQs were analysed for difficulty index (p-value), discrimination index (DI), and distractor efficiency (DE). Items having p-value between 30-70 and DI > or = 0.25 were considered as having good difficulty and discrimination indices respectively. Effective distractors were considered as the ones selected by at least 5% of the students. RESULTS: The mean score was 27.31 +/- 5.75 (maximum 50 marks). Mean p-value and DI were 54.14 +/- 17.48 and 0.356 +/- 0.17, respectively. Seventy eight per cent items were of average (recommended) difficulty (mean p-value = 51.44 +/- 11.11) and having DE = 81.41%. Sixty two per cent items had excellent DI (0.465 +/- 0.083) with DE = 83.06%. Combining the two indices, 32 (64%) items could be called as 'ideal' (p-value = 30 to 70; DI > 0.24) and had DE = 85.15%. Overall 42% items had no Non-functioning Distractors (NF-D), while 12% had 3 NF-Ds. Excellent discrimination (DI = 0.427) was achieved with items having one NF-D, while items with 2 NF-D and no NF-D had nearly equal but lower DI (0.365 and 0.351 respectively). CONCLUSION: One-best MCQs having average difficulty and high discrimination with three functioning distractors should be incorporated into future tests to improve the test score and properly discriminate among the students. Items with two NF-Ds, though easier, are better discriminators than items with no NF-D.

Adipocytokines in subjects with and without ischemic cerebrovascular disease.

OBJECTIVE OF THE STUDY: To investigate adipocytokines in patients with ischemic cerebrovascular disease and to develop an association between them. METHODS: In this study plasma adiponectin, leptin and Interleukin 6 (IL 6) concentration were measured by ELISA. Blood glucose and lipid profile was done by standard kit methods. RESULTS: A total of 80 subjects with and without CVD were studied. The mean plasma level of IL6 of the forty patients with ischemic CVD was significantly higher than that of the forty subjects without CVD (41.64 + 2.50 versus 22.76 + 0.76 pg/mL; P < 0.001). The mean plasma level of adiponectin was significantly lower in patients with ischemic CVD than that of subjects without CVD (4.36 +/- 0.21 microg/mL versus 6.9 +/-0.241microg/mL; P < 0.001). Serum leptin concentrations were significantly higher (p < 0.001) in stroke patients (51.61 + 1.39) as compared with controls (37.76 + 1.207). Leptin levels were significantly negatively correlated with adiponectin (P < 0.01) and significantly positively correlated (P < 0.01) with interleukin 6 in stroke patients. CONCLUSION: Present report provides additional support to the evidence of involvement of cytokines in inflammatory immune response of patients with cerebrovascular disease.

Adiponectin and infarction size in subjects with and without cerebrovascular disease.

OBJECTIVE: To investigate whether hypo-adiponectinemia is present in ischemic stroke patients. METHODS: This comparative study was carried out in the Biochemistry Department, Ziauddin University, Karachi, Pakistan in 2008. In this study, plasma adiponectin concentration was measured by an enzyme-linked immunosorbent assay in subjects with and without ischemic cerebrovascular disease (CVD). RESULTS: A total of 80 subjects were studied (40 patients with CVD, and 40 without CVD as controls). The mean plasma level of adiponectin of the 40 patients with ischemic CVD was significantly lower than that of the 40 subjects without CVD (4.36+/-0.21 ug/mL versus 6.97+/-0.241 ug/mL; p=0.000). Decreasing concentrations of adiponectin were negatively correlated with infarction size in ischemic CVD patients. CONCLUSION: These data show that there are significantly lower levels of plasma adiponectin in patients with ischemic CVD. Moreover, adiponectin is negatively correlated with infarction size in these patients suggesting the possible role of adiponectin in cerebrovascular disease.

Comparison of adiponectin, leptin and blood lipid levels in normal and obese postmenopausal women.

OBJECTIVE: To determine adiponectin, leptin and blood lipid levels in normal and obese postmenopausal women and to compare them. METHODS: Eighty postmenopausal women were selected which included 40 normal controls and 40 obese women matched for age and height. Adiponectin and leptin levels were determined by ELISA. Triglycerides, cholesterol, LDL cholesterol and HDL cholesterol were determined by standard kit methods using Clinicon 4010. RESULTS: Serum adiponectin level decreased and leptin level increased significantly (P < 0.001) in obese women compared to controls. Similarly triglycerides, cholesterol and LDL cholesterol were increased significantly (P < 0.001) in obese subjects compared with controls. No significant change in HDL cholesterol was observed in both groups. Significant correlation of leptin with lipid profile was observed when both groups were combined. CONCLUSION: Serum adiponectin level decreased and leptin level increased significantly in obese women compared to controls. Significant correlation exists between leptin and lipid profile in combined group.

Leptin and blood lipid levels in postmenopausal diabetic women with and without complication of ischemic heart disease.

BACKGROUND: Recent studies have provided evidence that leptin has significant effects on vascular development and repair. The aim was to determine the levels of leptin and lipid profile in diabetic postmenopausal women with and without the complication of ischemic heart disease and to develop correlation between them. Moreover, the relationship between leptin levels and extent of ischemic changes were determined. MATERIAL/METHODS: One hundred twenty postmenopausal subjects between the ages of 45 and 60 years were included in the study. They were divided into three groups of forty subjects each. The first group comprised normal healthy controls, the second diabetic type 2 patients with no history of ischemic heart disease (I1ID), and the third diabetic patients with IHD. Serum leptin levels were determined by a Kit obtained from DRG and samples were analyzed on ELISA. Fasting and random blood glucose was determined by the glucose oxidase method, cholesterol, triglycerides, LDL cholesterol, and HDL cholesterol were also determined by kits obtained from Merck. RESULTS: The results show that leptin and serum lipid levels increased significantly in diabetic patients with IHD compared with diabetic patients without IHD as well as normal subjects. Moreover; the sertum leptin level increased significantly in the diabetic patients with IHD who had positive findings in myocardial perfusion scan compared with those having negative findings. CONCLUSIONS: Hyperleptinemia in diabetic patients shows that leptin contributes to the development of cardiovascular disease in diabetic patients.

Relationship between adiponectin, glycemic control and blood lipids in diabetic type 2 postmenopausal women with and without complication of ischemic heart disease.

BACKGROUND: Recently major adipocytokine, adiponectin, are thought to play important roles in the regulation of cardiovascular and metabolic homeostasis. We compared serum adiponectin concentrations and lipid profile in diabetic patients with and without complication of cardiovascular disease in postmenopausal women. METHODS: We included 120 female subjects between the age of 45 and 60 years. The subjects were divided into 3 groups and each group comprised of 40 subjects. First group comprised of normal healthy controls, second group diabetic type 2 patients with no history of ischemic heart disease (IHD) and the third group diabetic patients with IHD. Serum adiponectin concentrations, serum triglycerides, cholesterol, LDL cholesterol and HDL cholesterol concentrations were determined. RESULTS: Values of fasting and random blood glucose, serum triglycerides, cholesterol, LDL cholesterol were significantly increased (P<0.001) in diabetic patients with IHD as compared with normal control subjects except for serum adiponectin and HDL cholesterol concentrations, which were significantly decreased (P<0.001) in diabetic patients and diabetic patients with IHD group. When values of cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, fasting and random blood glucose and adiponectin were compared among diabetic and diabetic patients with IHD, it was observed that they were significantly increased (P<0.001) except for adiponectin, which was decreased significantly (P<0.001) and random blood glucose, LDL and HDL cholesterol in which no change was observed between the 2 groups. CONCLUSIONS: Serum adiponectin concentrations may be a predictor for development of cardiovascular disease in postmenopausal diabetic patients.