فهرست مطالب mohit vijay rojekar

Stroke is one of the leading causes of mortality and morbidity worldwide accounting for 85% of global deaths from stroke. This study aimed to evaluate the role of homocysteine (HCY) in modulating various stroke parameters and its with carotid intima-media thickness (IMT).

78 patients of radiology-confirmed acute ischemic stroke were recruited for this study and National Institutes of Health Stroke Scale (NIHSS) score was evaluated upon admission. Blood samples were tested for serum HCY, fasting blood glucose (FBG) and lipid profile. Ultrasonography of neck ascertained IMT of Common (CCA) and Internal carotid artery (ICA).

Average age of male and female subjects was 57.88 ± 13.97 & 59.16 ± 13.62 years respectively. 71.93% of stroke patients were hyperhomocysteinemic (HHcyc) and 24.36% were hyperlipidemic. Patients with NIHSS ≥ 5 had higher low-density lipoprotein cholesterol (LDLC) than those with NIHSS < 5. HCY cutoff of ≥ 15 μmol/L had 91.7% sensitivity & 66.7% specificity for predicting. HHcyc state was associated with increased ICA IMT. HHcyc state was best predicted by ICA IMT with which it is positively correlated (P-Value = 0.012).

HHcyc state holds a good predictive value for severity of stroke. We also came to a conclusion that ICA IMT measurement may also reduce the need for a homocysteine test as it predicts higher HCY levels; this will reduce the burden on resources. We suggest that evaluating HCY and ICA IMT should be made part of the standard protocol for management of stroke.

Diabetes mellitus (DM) is known as the silent pandemic. It is hypothesized that other endocrine systems are affected by the metabolic changes occurring due to DM. We aimed to investigate the correlation of thyroid hormones with glycaemic and lipid parameters.

81 diabetic patients and 81 non-diabetic age and sex-matched healthy volunteers participated in the study. Their blood samples were analysed for fasting blood glucose (FBG), glycosylated haemoglobin (HbA1C), total tri-iodothyronine (T3), total thyroxine (T4), free T3 (FT3), free T4 (FT4), thyroid-stimulating hormone (TSH), total cholesterol (CHOL), High-Density-Lipoprotein cholesterol (HDLC) and Low-Density-Lipoprotein cholesterol (LDLC). Data was analysed using appropriate statistical tests.

Among the cases, 70.37% were euthyroid, while 24.7% had subclinical hypothyroidism, 2.47% had clinical hypothyroidism, 1.23% had subclinical and 1.23% had clinical hyperthyroidism. FBG, HbA1c and TSH (P< 0.05) were significantly higher in diabetics compared to controls. On the other hand, T3, FT3, FT4, and HDLC (P< 0.05) were significantly lower in diabetics compared to controls. A significant negative correlation (P< 0.05) was found when T3 and FT3 were compared against age, FBG and HbA1c. A significant positive correlation (P< 0.05) was found when T3 and FT3 were compared against HDLC, LDLC & CHOL.

Our statistics show that high-normal levels of T3 and FT3 are correlated with lower levels of FBG and HbA1c, hence improved glycaemic control. We recommend that thyroid profile of diabetic patients with poor control should be monitored regularly. Early detection of thyroid dysfunction and initiation of therapy for it, can improve the treatment outcome of hypoglycaemic drugs.

Polycystic ovary syndrome (PCOS) is an endocrine disorder associated with hyperandrogenism marked with hirsutism and ovarian dysfunction. These conditions may lead to the risk of insulin resistance (IR), type 2 diabetes, obesity, and cardiovascular disease. These conditions are related to PCOS complications hence our aim was to study and investigate the relationship between high-sensitivity C - reactive protein (hs-CPR) level and glycosylated hemoglobin (HbA1c) level in PCOS patients.

Female patients visiting the obstetrics and gynecology outpatient department (OPD), aged between 19 and 45 years with a body mass index (BMI) of 25 to 29 kg/m2. The individuals fulfilling the National Institute of Health (NIH) criteria for PCOS; including amenorrhea or oligomenorrhea and had been clinically diagnosed with hyperandrogenism were served as subjects.

Two hundred and ten individuals with HbA1c of 5.4% have a higher risk of cardiovascular disorders. The study showed the association between increased cardiac risk as measured by hs-CRP and patients with normal HbA1c values with a sensitivity of 77.2% and specificity of 75.99%. The HbA1c cutoff value can be used in the PCOS patients to assess the cardiac risk due to association of HbA1c cut off value with false positivity rate of 15.24%.

In PCOS patients with chronic low-grade inflammation, IR, and the degree of inflammation associated with HbA1c value was observed.

Significant alteration in lipid profile and antioxidant system occurs in response to diabetes mellitus (DM). Paraoxonase (PON) is a family of three enzymes PON1, PON2 and PON3 associated with high density lipoprotein (HDL). The HDL in human plasma consists of two main sub-fractions HDL2C and HDL3C. We studied the HDL subclasses and HDL associated enzyme paraoxonase with respect to diabetes.
The study was conducted in a tertiary care referral hospital in India. A total of 80 subjects were included in the study. Lipid profile, PON1 arylesterase (ARE), PON1 lactonase (LACT) and HDL fractions were estimated. Regression analysis was applied.
PON1 ARE, LACT and HDL fractions are found to be decreased among cases than in controls. PON1 ARE & LACT showed negative correlation with blood glucose levels and HDL 3C while positive correlation with HDL 2C.
PON1 ARE and PON1 LACT activities reduction are due to increased oxidative stress. PON1 as well as HDL fraction levels are oxidative stress subjects. Among the HDL fractions, HDL2C is the more variable fraction and reflects changes in HDL. The study suggested that the protective role of total HDL against oxidative damage and complications is mainly mediated through HDL2C fraction.

Metabolic syndrome (MetS) is a collection of various interrelated risk factors that appear to have an impact as development of atherosclerotic cardiovascular disease (CVDs). Epidemic of childhood and adolescent’s obesity has increased interest in the metabolic syndrome (MS) due to the potential projection into adulthood. The prevalence of MS in adolescents has been estimated to be 6.7% in young adults and 4.2% in adolescents. We aimed to study the MetS in children and adolescents with respect to metabolic changes.
The international Diabetes Federation criteria were used for the selection of cases. Serum paraoxonase 1 (PON1) activities were measured using spectrophotometer. Statistical analysis was done using MyStat statistical software.
Serum PON1 arylesterase (ARE) and lactonase (LACT) activities were found to be reduced significantly in patients with MetS than in controls. Regression analysis showed a significant correlation between PON1 activities and body mass index. Area under curve (AUC) found to increase from HDL to PON1 ARE to PON1 LACT.
From the present study, it is clear that in children and adolescents, reduction in PON1 activities in MetS is mainly due either to abnormalities with synthesis or secretion of HDL cholesterol or oxidative stress as a consequence of excess production of the free radicals. This study also iterates that it is the quality and not the quantity of HDL cholesterol which is important while studying the pathophysiology of MetS.

Any substance, which makes life better, if not used wisely and with proper care, would become dangerous to human life. These chemical substances can be termed poisons. A poison can be defined as a substance (solid, liquid, or gas), which if introduced into a living body or brought into contact with any part thereof would produce disease or even death by its constitutional or local effects or both. Pattern of poisoning in a particular region depends on various factors like availability and access to the poison, socioeconomic status of an individual, educational status, knowledge on pesticides, and their proper usage. In India, due to variations in geographical conditions and differences in religious and cultural practices, the incidence and pattern of poisoning vary from place to place, hence it is better to perform regional studies periodically to recognize the extent and evolution of the problem.
This is a cross-sectional and observational study, which was conducted in tertiary care teaching institutes in Western India. The study includes 318 deceased persons due to poison consumption brought for postmortem examination.
Incidence of death due to poisoning was more in the third (31.7%) and second decade (22.6%) of life as compared to both extremes of age. The majority of victims were males (64.2%) as compared to females (35.8%). It was also observed that most victims belonged to lower socioeconomic class (58.8%) with educational status from illiteracy to primary education. Majority were farmers commonly due to insecticidal poisoning.
Pattern of poisoning in the present study corresponds with the pattern found in most other studies. Majority of victims were male and agricultural poisons were the most common type. Our study suggests that establishment of poison information centers, availability of antidotes in rural area, and creating awareness among people help effectively to resolve the problem.