Assessment of early morning serum cortisol levels in adult male patients with alcohol-related disorders.

BACKGROUND: Alcohol-related disorders are a major health problem among Indian male professionals because of the unique nature of socioeconomic and demographic conditions. Various studies have highlighted the association between alcohol-related disorders and hypothalamic-pituitary-adrenal (HPA) axis dysfunction, but the evidence accrued so far is inconclusive. In our study, we have assessed early morning serum total cortisol concentration among Indian adult male population affected with alcohol-related disorder. METHODS: A case-based cross-sectional study in which all consecutive patients admitted in the psychiatry ward of a tertiary care hospital with diagnosis of 'alcohol-related disorders', who were meeting all the inclusion criteria, and who had none of the exclusion criteria were part of the study. Diseased controls and healthy controls were chosen by applying strict inclusion and exclusion criteria. Serum early morning (0400 h) total cortisol levels were estimated using automated quantitative enzyme-linked fluorescent assay technique. RESULTS: 98 psychiatric patients and 50 healthy controls were evaluated. Out of these 98 patients 66 patients were diagnosed cases of alcohol-related disorder. Morning serum total cortisol levels in patients with alcohol-related disorders was found to be significantly different from healthy controls. CONCLUSION: Our study suggests that alcohol-related disorders are associated with chronic changes in HPA axis and significant alteration of early morning serum total cortisol levels were demonstrated in this group of patients.

Analysis of relationship of hormonal, hematological and biochemical parameters in Indian alcoholics with severity of alcohol dependence.

Background: Alcohol dependence syndrome (ADS) is a major problem in India. ADS is known to be a systemic disorder involving almost all organ-systems. The evaluation of ADS patients' needs successive assessment of severity of clinical condition. In this study, we attempted to explore Severity of Alcohol Dependence Questionnaire (SADQ-C) as a severity measure by studying its association with laboratory parameters. Methods: During the two months study period 155 diagnosed ADS male patients who had been admitted to the Psychiatric Ward of two zonal level hospitals were enrolled for the study. The participants were examined by the Psychiatrist and the severity of alcoholism ascertained by the SADQ-C scoring. Based on SADQ-C scoring they were divided into three groups: severe alcohol dependence, moderate dependence and mild physical dependence. The patients' blood samples were collected and tested. Results: In our study, morning and evening level of serum cortisol showed positive correlation with increasing SADQ-C scoring. The differences in morning and evening cortisol level also augmented with increasing severity score (r=0.257; p=0.001). Hemoglobin, mean corpuscular volume (MCV) and serum level of LH, FSH and testosterone levels were not shown any statistically significant alterations amongst the studied groups. Serum LH, total bilirubin, direct bilirubin, AST, ALT and GGT level showed positive correlation with SADQ-C scoring but AST/ALT ratio showed negative correlation. Conclusion: This study elaborated relationship between SADQ-C scoring and laboratory parameters in Indian male ADS patients. It highlighted the requirement of incorporation of serum cortisol along with presently evaluated laboratory parameters for ADS severity evaluation.

Analysis of platelet-activating factors in severe sepsis by flow cytometry and its correlation with clinical sepsis scoring system: A pilot study.

BACKGROUND: Sepsis is a major global healthcare concern. Platelets and leucocytes play a key role in sepsis. Whole blood flow cytometry (FCM) is a powerful new technique for the assessment of leucocyte and platelet parameters and their functional state. In the present study, we have used FCM to examine platelet and leucocyte functions and parameters in sepsis patients. METHODS: Prospective, non-interventional cohorts of all adult patients with sepsis and history of intensive care unit stay for more than 24 h at mixed surgical- medical ICU were evaluated. The Simplified Acute Physiology Score-3 (SAPS 3) admission score was obtained, and whole blood FCM analysis of select platelets and leukocyte parameters were performed using a combination of monoclonal antibodies in a predefined panel. We also evaluated the correlation between these parameters and the severity of the illness, based on SAPS 3 admission score. RESULTS: Total leucocyte count (TLC) was statistically and significantly different between all the study samples, but platelet count was not. SAPS 3 acted as the best discriminant between the study groups. With a cut-off score of 55.5, SAPS 3 score predicted hospital mortality with a sensitivity of 82.8% and a specificity of 83.9%, with an area under receiver operating curves (AUROC) of 0.888 (95% CI = 0.807-0.969, p < 0.000). Parameters for CD62P, platelet-leucocyte aggregates (PLAs) and CD11b showed statistically significant differences between the patients and healthy volunteers. CD62P expression was positively correlated to PLA variables in severe sepsis patients. The median fluorescence intensity was found to be more informative than mean fluorescence intensity. New "62P adhesion index (62P AI)" and "PLA adhesion index" are proposed and is likely to be more informative. CONCLUSION: SAPS 3 score was the most robust of the parameters evaluated. Our study suggest the idea that the incorporation of platelet and leucocyte activation parameters, rather than mere static counts, will add the existing prognostic model though we could not conclusively prove the same in this study.

To study the awareness of osteoporosis in postmenopausal Indian women in a Northeast part of India: An evaluation of the Osteoporosis Health Belief Scale.

AIM AND OBJECTIVE: Our study's objective is to determine the level of awareness in postmenopausal women in Guwahati, Northeast part of India, using the Osteoporosis Health Belief Scale (OHBS). SETTINGS AND DESIGN: Osteoporosis is the most common silent health problem in postmenopausal Indian women. An awareness level among this subset of women needs to study. The present study is based on a self-explanatory questionnaire. METHODS: We conducted a self-explanatory questionnaire study on 2000 postmenopausal women in Guwahati, North East region of India. The bone mineral density (BMD) was measured using calcaneum Quantitative ultrasound (QUS) to assess BMD. Baseline characteristics were noted and analyzed. RESULTS: The awareness level was noted only in757 (37.85%). Women with education level 12th standard and above have some awareness regarding osteoporosis. CONCLUSIONS: Based on the present study, we can conclude that there is a lack of awareness in postmenopausal women regarding osteoporosis in India's North-East region. This subset of women is unaware of the condition that can leads to fragility fracture if not address in time. The study emphasizes that health care professionals should conduct frequent awareness programs in the community to prevent this silent disease, and morbidities so arise from osteoporosis can be minimized.

Prevalence of Osteoporosis in Peri- and Post-menopausal Women in Slum Area of Mumbai, India.

OBJECTIVE: We conducted our study involving 1400 peri- and post-menopausal women who live in a slum area of Mumbai to determine the prevalence of osteoporosis, awareness about osteoporosis, education (knowledge regarding osteoporosis), treatment and prevention of osteoporosis. MATERIAL AND METHODS: A detailed medical, surgical, obstetrical & gynecological, menstrual, and drug history was recorded in a predesigned questionnaire designated for the study. Height and weight and body mass index were measured, physical activity level especially load bearing exercise was recorded, and amount of sunlight exposure per day was also recorded. Food intake was estimated using the 24 h dietary recall method and calcium and Vitamin D consumption pattern was assessed. We used calcaneum quantitative ultrasound to assess bone mineral density (BMD) for such large population. RESULTS: The prevalence of low BMD was found in more than half of this population (81%). The mean age in Group I was found to be 36.50 ± 2.74 years as compared to 37.5 ± 3.44 years in Group II with low BMD, which was statistically significant (P = 0.02). The average age at menopause was 51.62 ± 5.72 years in Group I and 49.43 ± 4.52 years in Group II. The number of children and type of menopause has been found to be associated with low BMD in our study. Lack of physical exercise and low-calcium diet were significantly associated with low BMD. CONCLUSION: Our study showed that there is a high prevalence of Vitamin D deficiency and Osteoporosis even in adult women who live in a slum area. The findings from the study also suggest the need for large community-based studies so that high-risk population can be picked up early and early interventions and other lifestyle changes can be instituted so that no delay in implementing state and national or international health policy to tackle this increasing global health problem. The public awareness is important, and strategies to identify and manage low BMD in the primary care setting needs to be established and implemented.