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Background: 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 it's with carotid intima-media thickness (IMT). Methods: 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). Results: 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). Conclusion: 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.
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BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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BACKGROUND: Glucometers are the excellent tools for self-monitoring of blood glucose (SMBG). They are important especially in the circumstances where continuous monitoring is mandatory and at decision making levels. Tight glycemic control protocols are important for preventing the ill effects of fluctuating glucose levels. This increases the use of glucometers in various healthcare settings. As technology advances, glucometers are getting better in terms of quality of results. But still some lacunae are there. METHODS: Present study was conducted in the tertiary care referral hospital. One hundred twenty five patients were recruited from pediatric wards. Bland-Altman plot, Parke error grid and Surveillance error grid analysis were used for comparing results of glucose meter with that of standard laboratory method. RESULTS: It is found that there is significant difference between the results by two methods. Though minimal but glucose meter results deviate from the results of standard lab method. This will affect the overall patient care especially in emergency conditions. CONCLUSIONS: This study is the first of its kind as no similar studies have been reported in the pediatric population. For effective use of glucose meter it should give as accurate as possible estimate of actual glucose levels. Results should not only be accurate but also precise without which critical errors may be possible. We recommend that for any glucose meter there should be regular maintenance as well as calibration is to be done. So that agreement with reference laboratory method is maintained and effective medical decisions are made.
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OBJECTIVES: To evaluate arylesterase and lactonase activity of paraoxonase (PON)1 in cord blood of neonates in relation to their birth weight. The authors hypothesized that cord blood PON1 arylesterase and lactonase activities will be compromised in neonates having low birth weight. METHODS: Eighty neonates born in authors' hospital, irrespective of mode of delivery were included. Forty children with low birth weight were included in case group and 40 with normal birth weight were included as controls. PON1 arylesterase and lactonase activities were measured. RESULTS: Serum arylesterase activity decreased significantly in low birth weight babies (p < 0.05). Linear regression analysis (R = 0.728) indicated significant correlation between arylesterase and birth weight. Serum lactonase activity was also reduced in low birth weight babies. Its linear regression analysis (R = 0.727) indicated significant correlation between lactonase and birth weight. CONCLUSIONS: PON 1 activity is significantly reduced among low birth weight babies in comparison to normal weight babies.