Serum organochlorine pesticide levels in patients with metabolic syndrome.

INTRODUCTION: Organochlorine pesticides (OCPs) are endocrinal disruptors that tend to accumulate in adipose tissue and have been found to be associated with Metabolic Syndrome (MS). AIM AND OBJECTIVES: 1. To measure serum OCP levels in patients of MS and control subjects, 2. To identify differences, if any, in serum OCP levels, in patients with MS and control subjects. MATERIALS AND METHODS: Cross-sectional study was conducted in the Departments of Medicine and Biochemistry at University College of Medical Sciences (UCMS) and Guru Teg Bahadur Hospital (GTBH), Delhi. Nine OCPs [α-HCH (Hexachlorocyclohexane), ß-HCH, g-HCH, α-endosulfan, ß-endosulfan, aldrin, dieldrin, p, p'-DDT (Dichloro-diphenyl-trichloro-ethane), and p, p'-DDE (Dichloro-diphenyl-dichloro-ethylene)] were studied. Fifty subjects ≥18 years with MS (study group) and 50 age and sex-matched controls were included in the study. EXCLUSION CRITERIA: (1) Persons having chronic occupational exposure to OCPs such as workers of pesticide factories, (2) Recent exposure to OCPs within 4 weeks. RESULTS: Levels of all nine OCPs were higher in cases as compared to controls. However, only the mean value of ß-HCH in cases (8.40 ± 8.64 ng/ml) was significantly (P < 0.001) higher as compared to controls (2.58 ± 2.34 ng/ml). After adjustment of confounding factors like age, sex, smoking, alcohol, and body mass index (BMI), only ß-HCH and aldrin levels were positively and significantly associated with the risk of having MS. Adjusted Odds Ratio (OR) was 1.34 [CI = 1.14-1.57 (P < 0.001)] and 1.23 [CI = 1.01-1.50 (P = 0.045)], respectively. CONCLUSION: There was a significant association of ß- HCH and aldrin levels with MS.

Monoclonal gammopathy associated with visceral leishmaniasis.

Monoclonal gammopathy can accompany diverse conditions and is usually benign. It should be distinguished from monoclonal gammopathy of undetermined significance (MGUS) which can rarely turn malignant. Visceral leishmaniasis has only rarely been associated with monoclonal gammopathy. We describe the case of a 55-year-old male who had monoclonal gammopathy associated with visceral leishmanisais, which reversed with stibogluconate therapy.

Monoclonal gammopathy associated with visceral leishmaniasis

Monoclonal gammopathy can accompany diverse conditions and is usually benign. It should be distinguished from monoclonal gammopathy of undetermined significance (MGUS) which can rarely turn malignant. Visceral leishmaniasis has only rarely been associated with monoclonal gammopathy. We describe the case of a 55-year-old male who had monoclonal gammopathy associated with visceral leishmanisais, which reversed with stibogluconate therapy.

Monitoring oxidative stress across worsening Child Pugh class of cirrhosis.

CONTEXT: Oxidative stress has been increasingly implicated in the pathogenesis and progression of cirrhosis. AIMS: We studied oxidative stress in patients with cirrhosis by measuring markers reflecting pro-oxidant (serum malondialdehyde-MDA) and antioxidant factors (RBC catalase-CAT, superoxide dismutase-SOD and blood reduced glutathione-GSH) factors. The level of oxidative stress was also assessed with respect to functional compromise of liver, as determined by Child Turcotte Pugh (CTP) scoring. DESIGN: Case-controlled retrospective study. MATERIALS AND METHODS: Twenty-three patients of cirrhosis along with 23 age and sex matched healthy controls were studied. Exclusion criteria were concurrent use of anti-oxidant drugs; co-existing diseases like DM, CKD; alcohol use, gastrointestinal bleed or blood transfusion within previous 2 weeks. Besides routine investigations, MDA, CAT, SOD and GSH levels were measured and compared with controls. STATISTICAL ANALYSIS: Continuous variables were recorded as mean +/- SD; ANOVA-f test, followed by Tukey's test, was used to evaluate the significance of difference (P < 0.05) among groups. RESULTS: Mean age of patients was 41.04 +/- 12.3 yrs. Patients showed a significant increase in MDA {control 3.31 +/- 0.25 (95% CI 3.21-3.41), Child B 6.30 +/- 0.4 (95% CI 6.03-6.53), Child C 8.05 +/- 0.66 (95% CI 7.29-8.81) nmol/l} and a significant decrease in levels of SOD {control 845.13 +/- 36.44 (95% CI 829.92-860.34), Child B 582.91 +/- 42.12 (95% CI 557.45-608.32), Child C 489.5 +/- 17.66 (95% CI 479.3-499.7) U/gm Hb}, CAT {controls 2.54 +/- 0.22 (95% CI 2.45-2.63), Child B 1.93 +/- 0.23 (95% CI 1.72-2.14), Child C 1.46 +/- 0.10 (95% CI 1.40-1.52) U/ gm Hb} and GSH {controls 6.52 +/- 0.25 (95% CI 6.42-6.52), Child B 3.85 +/- 0.18 (95%CI 3.74-3.96), Child C 2.99 +/- 0.30 (95% CI 2.82-3.16) mmol/ gm Hb}. CONCLUSIONS: Oxidative stress is associated with the development and progression of cirrhosis.