Serum Zinc Status among Acute Myocardial Infarction Male Patients in Bangladesh.

This case-control study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2015 to December 2015. The aim of the study was to explore the serum zinc status among acute myocardial infarction (AMI) patients as a means to monitor the possibility of management of these patients. A total of 120 subjects were included in this study. Among them 60 were diagnosed AMI patients denoted as case group and 60 were normal healthy individuals denoted as control group. Serum zinc was determined by colorimetric method from each sample. Statistical analysis was performed by SPSS windows package, version 20. Among the study groups the Mean±SD values of serum zinc were 64.98±18.86µmol/L and 97.14±7.97µmol/L in case and control group respectively. Analysis showed that the mean serum zinc level was significantly (p<0.01) decreased in AMI patients in comparison to that of control group.

C-reactive Protein Level in Type-2 Diabetic Patients Attending Mymensingh Medical College Hospital, Mymensingh.

C-reactive protein (CRP) is a sensitive physiological biomarker of sub-clinical inflammation associated with hyperglycemia, insulin resistance and type 2 diabetic patients. A cross sectional study of 120 subjects attending outpatient department of Mymensingh Medical College, Mymensingh was done with an aim to evaluate serum C-reactive protein in type 2 diabetic patients and compare with age matched non-diabetic persons from July 2014 to June 2015. Of the total cases, 60 were Type 2 diabetic patients and 60 were apparently healthy non-diabetic persons recruited for the study. These diabetic and non-diabetic subjects were classified as male (50%) and female (50%). Fasting blood glucose and CRP were measured by following the standard laboratory methods. The mean CRP level was 16.48±12.69mg/L and <6.00±0.00mg/L in diabetic patients and non-diabetics respectively. The study revealed that fasting blood glucose and C-reactive protein were significantly higher in diabetic patients compared with age matched non-diabetic subjects. There was no significant difference in CRP between diabetic males and diabetic females. It was concluded from the results of this study that, CRP level was elevated in both male and female diabetic patients. These data can support a possible role of inflammatory biomarker in diabetogenesis.

Study on Glycaemic Status and Lipid Profile in Type 2 Diabetic Patients Attending Mymensingh Medical College Hospital, Mymensingh.

Recent increases in the incidence of diabetes in developing countries have been associated with complications resulting in mortality and morbidity. A case control study of 120 subjects attending out patient department of Mymensingh Medical College, Mymensingh was done with an aim to evaluate alteration of serum lipid profile and HbA1c in type 2 diabetic patients and compare with age matched healthy control. Of the total cases, 60 were Type 2 diabetic patients and 60 were apparently healthy persons recruited for the study. These patients and control subjects were classified as male (50%) and female (50%). Fasting lipid profile and HbA1c% were measured by following the standard laboratory methods. The study subjects had relatively poor glycemic control. The mean HbA1c was 9.21±1.19% in diabetes patient and 4.71±0.60% was in control. The mean fasting blood glucose level was 10.18±1.56mmol/L in diabetes patient and 4.51±0.48mmol/L in control. The mean total cholesterol, triacylglycerols, HDL-C & LDL-C were 211.93±11.83mg/dl, 156.90±7.96mg/dl, 35.20±3.17mg/dl & 133.20±3.99mg/dl in diabetes patient accordingly and the mean total cholesterol, triacylglycerols, HDL-C & LDL-C were 159.72±4.89mg/dl, 117.45±12.97mg/dl, 44.23±2.75mg/dl & 92.15±5.67mg/dl in control group accordingly. The study revealed that the most common abnormality seen was decreased serum HDL-Cholesterol levels (91.67%). Hypertriglyceridaemia present in 81.67% patients, 78.34% had high LDL-Cholesterol and 73.34% had hypercholesteromia. Diabetic males had significantly higher levels of total cholesterol and LDL-Cholesterol compared to diabetic females and diabetic females had significantly lower levels of HDL-Cholesterol compared to diabetic males. It was concluded from the results of this study that, diabetic patients are more prone to develop dyslipidaemia. Thus early diagnosis of dyslipidemia and good glycaemic control can be used as a preventive measure for the development of cardiovascular disease (CVD) in type 2 diabetics.

Serum Copper Status among Acute Myocardial Infarction Male Patients in Bangladesh.

This case control study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2015 to December 2015. The aim of the study was to explore the serum copper status among acute myocardial infarction (AMI) patients as a means to monitor the possibility of management of these patients. A total of 120 subjects were included in this study. Among them 60 were diagnosed AMI patients denoted as case group and 60 were normal healthy individuals denoted as control group. Serum copper determined by colorimetric method from each sample. Statistical analysis was performed by SPSS windows package, version 20. Among the study groups the mean serum copper levels were 150.30±26.16 and 103.65±9.38 in case and control group respectively. Analysis showed that the mean serum copper level was significantly (p<0.01) increased in AMI patients in comparison to that of control group.

Lipid profile in women receiving depot medroxyprogesteron acetate as contraceptive.

The study was conducted to estimate the serum lipid levels in women using depot medroxyprogesterone acetate (DMPA). A total of 90 Bangladeshi married women of age group 15-40 years attending the Model Family Planning Clinic, Mymensingh Medical College Hospital, Mymensingh, from July 2010 to June 2011. Patients were classified into three groups comprising those using the drug for 3 months (n=30), 1 year (n=30), and 2 years (n=30), respectively, compared to a control group (n=30) of married non-hormonally treated women of similar ages. Their age, weight, height, BP and BMI were recorded; all the subjects were clinically examined. Blood samples were collected for biochemical assay of serum lipid profiling parameters, such as total cholesterol, HDL-C, TAG and LDL-C. Data were collected and processed according to the design and objectives of the study. A significant (p<0.01) decrease in serum total cholesterol was observed up to 1 year of using DMPA, but a sharp increase was observed in 2 years group. Likewise total cholesterol, HDL-C was significantly (p<0.01) decreased in the 1 year group and rapidly increased in the 2 years group. A significant (p<0.01) reduction in TAG level was observed throughout the study tenure when compared with control group. No significant (p>0.05) difference in LDL-C level was observed among the treatment groups. The study concludes that DMPA induced significant alterations in lipid profiling parameters of the studied population and prolong use does not have risk of atherosclerosis; however, further study with a larger sample size is suggested for a general recommendation.

An evaluation of serum magnesium status in pre-eclampsia compared to the normal pregnancy.

Pre-eclampsia is a disease which causes significant maternal and fetal morbidity and mortality, especially in the developing countries. Despite numerous studies, the etiology of pre-eclampsia has not yet been fully elucidated. Although several evidences indicate that various elements such as serum Magnesium, Calcium etc. might play an important role in pre-eclampsia. The present study prospectively determines and evaluate whether maternal serum levels of magnesium has any association with pre-eclampsia or not. It was a cross sectional study carried out in the Department of Biochemistry, Mymensingh Medical College from July 2009 to June 2010. A total of 108 subjects were selected with the duration of pregnancy from 28th week of gestation to term of which 42 were normal pregnant women (as control) and 66 were pre-eclamptic (34 with mild and 32 with severe preeclampsia) admitted in the Obstetrics and Gynaecology department of Mymensingh medical college hospital. Serum Magnesium level was determined in the laboratory by colorimetric method using recommended commercial kit. Student's unpaired t-test was used to see the statistical significance of the difference between the mean values of the estimated parameters. The mean serum levels of Magnesium in normal pregnant group was 1.91±0.08mg/dl, mild pre-eclamptic group was 1.8±0.11mg/dl,and in severe pre-eclamptic group was 1.75±0.10mg/dl. The mean serum Magnesium of women with mild pre-eclampsia as well as severe pre-eclampsia was significantly (p<0.001) decreased in comparison to that of the control. A significant (p<0.05) decrease in serum magnesium was also found in subject with severe pre-eclamptic compared to that of the mild pre-eclamptic. So, these results indicate that reduction in serum levels of magnesium during pregnancy might be a possible contributor in the etiology of pre-eclampsia and supplementation of this element as diet or drugs may be of value to prevent pre-eclampsia.

Prevalence of colorectal diseases in immunological fecal occult blood test (I-FOBT) positive patients in a tertiary care hospital in Bangladesh.

Bleeding lesion anywhere in the GI tract can cause positive reaction to Immunological Fecal Occult Blood Test (FOBT). Although any colonic lesion can cause occult lower GI bleeding, relative frequency of this lesion not known. Guaic based tests require prior preparation and dietary restriction and less sensitive and specific than IFOBT for detection of occult bleeding .IFOBT is specific for human hemoglobin and is more sensitive and specific for detection of occult bleeding from any colonic lesion. Aim of this study was to diagnose occult gastrointestinal bleeding with positive IFOBT and the prevalence of colorectal disease in IFOBT positive patients in a tertiary care hospital in Bangladesh. This was a prospective cross sectional study conducted in Department of gastroenterology in collaboration with clinical pathology, BSMMU, Dhaka during the period of January 2009 to December 2009. In this study 200 patients meeting the inclusion criteria were included. Detailed clinical history and physical findings were recorded; FOBT was done on single stool specimen. Positive occult bleeding was confirmed in 90 patients of whom 80 patients underwent colonoscopy. The mean age of study population was 36.73±13.64 (range 16 to 72) years. At colonoscopy lesion were identified in 46(57.50%) patients, of which colonic polyp in12 (15%), colorectal cancer in 11(13.7%), inflammatory bowel disease in 3(3.75%), hemorrhoids and anal fissure in 7(8.75%), tuberculosis in 5(6.25%), and proctitis in 1(1.25%) cases. A positive IFOBT is more sensitive and specific test than other FOBT for detection of occult lower GI bleeding of colonic origin. In this study colorectal diseases were detected in 57.50% of the IFOBT positive patients, so IOBT can be used as an important diagnostic tool for detection of occult lower GI bleeding.

Serum zinc and magnesium level in newly diagnosed type-2 diabetic subjects.

This cross sectional study aimed to determine serum levels of zinc and magnesium in 80 newly diagnosed type 2 diabetic (Group I) and 80 healthy non-diabetic subjects (Group II). Diabetic patients without any complications were studied. It was carried out in the Department of Biochemistry, Mymensingh Medical College in cooperation with the out patient Department of Endocrinology of Mymensingh Medical College, Bangabandhu Sheikh Mujib Medical University and BIRDEM Hospital, Dhaka during the period from July 2008 to June 2009. A total of 160 subjects aged 55-65 years were enrolled for this study. Of them 80 were newly diagnosed type 2 diabetic (Group I) and 80 were apparently healthy non-diabetic (Group II) subjects. For both case and control, persons having no current medication, intercurrent illness, macro or microvascular complications and history of renal failure were selected. Atomic Absorption Spectrophotometer (AAS) was used to estimate the serum levels of zinc and magnesium. The Plasma zinc (72.07±6.84µg/dl) and magnesium (1.86±0.17mg/dl) significantly decreased in type 2 diabetic patients when compared with control (76.59±6.10µg/dl, 1.99±0.17mg/dl). It is concluded that type 2 diabetes mellitus can result in changes in zinc and magnesium levels. As the present study sample was small so it is difficult to draw any definite conclusion. However, the estimation and supplementation of both zinc and magnesium may be suggested in those cases.

Changes in lipid profile of postmenopausal women.

The study reveals that menopause leads to changes in hormonal status, metabolism and lipid profile. Since there is an increased risk of cardiovascular diseases for women after menopause, the present study is aimed at comparing the changes of serum lipid profile in premenopausal women with that of their postmenopausal counterparts. This is to enable us ascertain the relative risk of developing cardiovascular disease in postmenopausal women in Bangladesh. One hundred and eighteen (118) apparently healthy females (59 premenopausal = control and 59 postmenopausal = case) were selected for the study. The case-control cross-sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in cooperation with the Department of Gynaecology, Mymensingh Medical College Hospital and Community Based Medical College, Bangladesh during the period from January 2009 to December 2009. Data were collected through clinical evaluation from pre selected questionnaires and fasting blood samples were taken for laboratory investigations. Serum total cholesterol and their sub fractions- high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides (TG) were measured by autoanalyzer using enzymatic and established mathematical methods. Statistical significance of difference between two groups were evaluated by using unpaired 't' test with the help of SPSS software package. The results showed statistically significant increase in total cholesterol and LDL cholesterol (p<0.001) of menopausal women compared to reproductive age group. The postmenopausal women had higher but non-significant (p=0.675) concentrations of triglycerides than the premenopausal women with regular menstruation. However, a significant reduction of HDL was present in the postmenopausal group (p<0.001) than the premenopausal group. Therefore, it can be concluded that menopause leads to changes in lipid profile by increasing total and LDL cholesterol and by reducing HDL cholesterol. The elevated LDL and the reduction of cardio protective HDL is an indication that menopause is an independent risk factor for developing cardiovascular disease in Bangladesh.

Serum levels of copper and zinc in newly diagnosed type-2 diabetic subjects.

Diabetes mellitus is a chronic metabolic disorder which affects carbohydrate, lipid and protein metabolism. There is a strong relation between some specific oligoelements and diabetes mellitus. The study was undertaken to determine serum levels of copper and zinc in 60 type 2 diabetic (Group I) and 60 healthy non-diabetic subjects (Group II). Diabetic patients studied were without any complications. Serum copper and zinc were estimated by Atomic Absorption Spectrophotometer (AAS). The serum copper levels (144.00±12.87µg/dl) significantly increased in Group I compared to Group II (138.50±11.00µg/dl). On the other hand, the Plasma zinc (72.70±8.43µg/dl) levels significantly decreased in type 2 diabetic patients compared to control group (75.92±8.20µg/dl). It is concluded that type 2 diabetes mellitus can result in changes in copper and zinc levels. However, it is difficult to draw any definite conclusion from this small study sample but may be suggested that estimation of both copper and zinc is better to be considered in those cases.

Evaluation of hormone replacement therapy.

Hormone Replacement Therapy (HRT), once considered as the gold standard of treatment of menopausal symptoms and osteoporosis, introduced about seventy years ago still continuing with lot of controversies. Menopause, a transitional period of women's life, is not an illness when oestrogen level falls leading to its consequences. Results of earlier observational studies showed beneficial effects of HRT including cardiovascular protection. But all recent randomized controlled trials have failed to prove these positive effects, rather increases the cardiovascular risk and breast cancer. Women's Health Initiative(WHI), one of the recent randomized controlled trials was stopped prematurely in 2002 due to unfavorable risk-benefit ratio. HRT is not the only way of treating the menopausal symptoms and other consequences of estrogen deficiency. There are suitable alternatives without bearing the risk of HRT. Vasomotor symptoms with hot flushes and sweating experienced by about 75 percent of menopausal women can be treated with alternatives like phyto-estrogens, selective estrogen receptor modulators (SERMs), clonidine, selective serotonin reuptake inhibitors, acupuncture, exercise, behavioral therapy etc. HRT is no longer considered as the first line of treatment of postmenopausal osteoporosis. It can be treated with alternatives like regular weight bearing exercise, balanced calcium rich diet, maintaining weight, avoidance of bone robbers, (like excess alcohol, caffeine, smoking), use of SERMs etc. Use of HRT should be individualized and rationalized considering its risks and benefits.

Effects of prolonged use of injectable hormonal contraceptive on serum lipid profile.

The current study was carried out to determine serum levels of total cholesterol, triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) in human female volunteers taking injectable hormonal contraceptives. For this purpose, 200 (two hundred) subjects with age range of 20-35 years were selected. Out of them, 140 (one hundred and forty) were experimental subjects and 60 (sixty) were control. Women without hormonal contraceptive were selected as the subjects of control group. The experimental subjects were taking injectable hormonal contraceptive, DMPA (depo-medroxyprogesterone acetate) for 3-5 years uninterruptedly. The mean serum total cholesterol and mean serum triacylglycerol levels of the DMPA users were significantly (P0.05). The mean serum LDL-cholesterol level of the subjects of DMPA users was significantly (P<0.05) elevated in comparison to that of the control.

Effect of prolonged use of injectable hormonal contraceptives on blood pressure and body weight.

The study was undertaken to determine the effect of prolonged use of injectable hormonal contraceptive on blood pressure and body weight in young women. Two hundred volunteers were selected for the purpose. Of them, one hundred and forty were taking injectable hormonal contraceptive, DMPA for 3 to 5 years uninterruptedly. Rest forty subjects served as control using no contraceptive steroid. Blood pressure, systolic as well as diastolic, was measured by sphygmomanometer. Body weight was measured by weighing machine. It was observed that there were insignificant (P>0.05) elevations of systolic and diastolic blood pressure from DMPA use. But body weight of the experimental subjects was significantly (P <0.05) increased in comparison to that of the control.