High prevalence of coronary artery calcification and increased risk for coronary artery disease in patients with Sheehan syndrome-A case-control study.

OBJECTIVE: Patients with Sheehan syndrome (SS) are predisposed to coronary artery disease (CAD) due to risk factors like abdominal obesity, dyslipidemia and chronic inflammation. In addition to estimate CAD risk enhancers like high sensitive C reactive protein (hsCRP), apolipoprotein B (ApoB) and lipoprotein A [Lp(a)], this study applies Framingham risk score (FRS) and coronary artery calcium (CAC) score to compute a 10-year probability of cardiovascular (CV) events in SS patients. DESIGN: Case-control study Sixty-three SS patients, on a stable hormonal replacement treatment except for growth hormone and 65 age, body mass index and parity-matched controls. MEASUREMENTS: Measurement of serum hsCRP, ApoB and Lp(a) and estimation of CAC with 16-row multislice computed tomography scanner. RESULTS: The concentrations of hsCRP, ApoB and Lp(a) were significantly higher in SS patients than in controls (p < .01). After calculating FRS, 95.2% of SS patients were classified as low risk, 4.8% as intermediate risk and all controls were classified as low risk for probable CV events. CAC was detected in 50.7% SS patients and 7.6% controls (p = .006). According to the CAC score, 26.9% SS patients were classified as at risk (CAC > 10) for incident CV events as against 1.6% controls. The mean Multi-Ethnic Study of Atherosclerosis (MESA) score was significantly higher in patients with SS than controls. CAC corelated significantly with fasting blood glucose (r = .316), ApoB (r = .549), LP(a) (r = .310) and FRS (r = .294). CONCLUSION: Significant number of asymptomatic SS patients have high coronary artery calcium score and are classified at risk for CAD.

Hydrogen storage potential of coals as a function of pressure, temperature, and rank.

We conducted measurements of hydrogen adsorption on three coal samples of varying ranks at high pressure (0 to 102 bar) and elevated temperatures (303 K to 333 K) to assess their hydrogen storage potential. The excess adsorption capacity increased with increasing pressure but decreased with increasing temperature irrespective of coal rank. The highest hydrogen adsorption recorded was 0.721 mol/kg for the anthracite coal at 303 K and 102 bar. Furthermore, the hydrogen adsorption capacity correlated positively with coal vitrinite and fixed carbon contents (i.e. the high-rank coal exhibited greater adsorption), while all samples depicted predominantly type-I adsorption behavior for the entire pressure range. Micropore analysis and Fourier-transform infrared spectroscopy measurements were conducted to explore the microstructural and surface chemistry associated with these adsorption trends. The micropore content of the three samples followed the order: anthracite > sub-bituminous > bituminous, while H2 adsorption followed the trend: anthracite > bituminous > sub-bituminous - i.e., no direct correlation between coal micropore content and its H2 adsorption capacity - attributable to high clay content of bituminous coal which lowered its micropore content. Moreover, bituminous, and sub-bituminous samples exhibited an abundance of oxygen-containing functional groups, while anthracite coal depicted notable aromatic content - suggesting that the H2 adsorption capacity is a complex function of coal surface chemistry and micropore content. Overall, high-rank coal seams at high pressure and temperature showed the largest hydrogen adsorption i.e., analogous to CO2 adsorption potential albeitat lower absolute values. These results, therefore, provide preliminary data on the hydrogen storage potential of coal seams and the associated scientific understanding of the mechanisms causing hydrogen adsorption.

Nonalcoholic fatty liver disease as an independent risk factor for carotid atherosclerosis.

PURPOSE: Nonalcoholic fatty liver disease (NAFLD) is a frequently encountered clinical condition in clinical practice, particularly in obese and diabetic patients. Carotid atherosclerosis is regarded as surrogate marker of coronary atherosclerosis. We aimed to know whether evaluation for carotid atherosclerosis should be done in all patients of NAFLD. MATERIALS AND METHODS: A total of 200 NAFLD patients and 100 age- and sex-matched controls were enrolled into the study. Ultrasound was done to document fatty liver and carotid intimal thickness, and relation between these two was observed. RESULTS: Grade 1 fatty liver was seen in 36% patients while Grade 2 fatty liver was found in 39% and Grade 3 fatty liver in 25%. Patients with Grade 1 fatty liver had left intima-media thickness (IMT) in the range of 0.4-0.6 mm (mean IMT - 0.69 mm) and had right IMT in the range of 0.5-0.8 mm (mean IMT - 0.71 mm). In patients with Grade 2 fatty liver, left IMT was in the range of 0.6-1.0 mm (mean IMT - 0.80 mm) and right IMT in the range of 0.7-1.0 mm (mean IMT - 0.84 mm), while in patients with Grade 3 fatty liver, left IMT was in the range of 0.8-1.2 mm (mean IMT - 0.93 mm) and right IMT in the range of 0.9-1.4 mm (mean IMT - 0.99 mm). Among controls, the mean left IMT was 0.579 mm and mean right IMT was 0.575 mm. CONCLUSION: The level of carotid intimomedial thickness was more in cases than in controls and progressively increased with the grade of fatty liver which was statistically significant.