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Background: Hypothyroidism is known to be the commonest form of endocrine disorders and has been linked with disturbances in various minerals metabolism. Calcium, phosphorus and magnesium and trace element zinc are required for many enzymes in various metabolic pathways which are directly or indirectly regulated by thyroid hormones. Aim and objectives of the study was to estimate serum zinc, calcium, magnesium and phosphorus in hypothyroid patients, with the objectives to evaluate any relationship with TSH and to compare them with euthyroid controls.Methods: The analytical cross-sectional study included 50 hypothyroid subjects with TSH levels >4.5 mcg IU/mL and 50 euthyroid subjects of 20-50 years in RMCH, Bareilly. TSH was estimated by ECLIA, serum calcium and phosphorus were estimated by autoanalyzer and serum zinc & magnesium by the kit method using semi autoanalyzer. All the biochemical parameters were expressed as median with Interquartile Range (IQR). Mann-Whitney test was applied to compare the parameters of cases and control. Spearman’s rank correlation coefficient 2-tailed was used to correlate the parameters among the cases.Results: A significantly decreased level of serum calcium and increased level of serum magnesium and phosphorus were observed in hypothyroid cases. A significant negative correlation between TSH and serum calcium while a significant positive correlation of serum magnesium and phosphorus with TSH was observed.Conclusions: The indexed study indicates the significant effect of overt or subclinical hypothyroidism over the mineral status of the body which may have inconsistent effect over the various metabolism and enzymes and thereby clinical manifestations.
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Background: Acute toxic leukoencephalopathy following intrathecal methotrexate administration is well documented but intracranial haemorrhage is extremely rare. Case Characteristics: A 2½-year-old girl with acute lymphoblastic leukemia developed sudden onset neurological deterioration following intrathecal methotrexate. Observations: Computed tomography scan of brain demonstrated intraventricular and subarachnoid hemorrhage. Outcome: Child improved gradually on conservative management. Follow-up neuroimaging showed resolution of hemorrhage. Message: Intracranial haemorrhage is a rare but serious complication of intrathecal methotrexate.
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Aim: The study was carried out with an aim to evaluate an association of serum lipid profile with breast carcinoma and benign breast disease. Methods: For this purpose, a case-control study was planned in which a total of 105 subjects were enrolled according to a purposive sampling design - A total of 35 (33.3%) patients in each group having breast carcinoma, benign breast disease, and healthy controls were included for assessment. Lipid levels were assessed. Data were analyzed. Results: Age of subjects enrolled in the study ranged from 16 to 58 years. The mean age of subjects in malignant, benign and control group was 45.71 ± 10.04, 24.91 ± 6.83 and 35.60 ± 12.42 years, respectively. The majority of malignant cases were in advanced stage (T3 and T4), together accounted for 94.29% of total malignant cases. The remaining 2 (5.7%) cases were in T2-stage. A total of 21 (60%) cases had metastasis too. Mean triglyceride (TG) levels of malignant cases were significantly higher as compared to that of benign and healthy controls. Mean serum high density lipoproteins levels were significantly higher in benign group as compared to healthy controls. Mean serum low density lipoproteins levels were maximum in healthy controls and minimum in benign breast disease group. Statistically, the difference between healthy controls and benign breast disease was also found to be significant. Conclusion: For different lipid components, the relationship with different types of breast lesions was found to be varying. In malignant cases, TG levels showed an increased trend. The possibility of these relationships being random cannot be ignored. A larger study on larger sample size is recommended.
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While type 1 diabetes mellitus (DM) is characterised by insulin deficiency due to pancreatic beta-cell destruction; type 2 DM is characterised by a state of longstanding insulin resistance (IR); compensatory hyperinsulinaemia and varying degrees of elevated plasma glucose levels (PG); associated with clustering of cardiovascular (CV) risk and the development of macrovascular disease prior to the diagnosis of DM. Coronary artery disease (CAD) accounts for 70of mortality and morbidity in patients with diabetes. Studies in diabetes care have helped prevent or reduce microvascular complications in type 1 and 2 diabetes. However the same cannot be said about macrovascular disease. Despite all data concerning the association between diabetes and cardiovascular disease (CVD); the exact mechanism by which diabetes is linked to atherosclerosis is incompletely understood; and this is especially true in the case of hyperglycaemia. The positive effect of intensive glucose management in comparison to non-intensive glucose control is far from proven. The DCCT and UKPDS studies have shown that while glycaemic control is important for preventing long-term macrovascular complications; early glucose control is far more rewarding (metabolic memory). Later trials such as ACCORD; ADVANCE and VADT do not advocate tight glycaemic control. In fact; the ACCORD trial has shown increased mortality with tight glucose control. Tight glucose control may be beneficial in selected patients with short disease duration; long life expectancy and no CVD. In critically ill patients; a blood glucose target of 140-180 mg is fairly reasonable and achievable. The ESC/EASD guidelines of October 2013; like those of the ADA; AHA and ACC; continue to endorse a treatment target for glucose control in diabetes of HbAlc level 7; based predominantly on microvascular disease with acknowledged uncertainty regarding the effect of the intensive glucose control on CVD risk. Management of hyperglycaemia in diabetics should not be considered in isolation; diabetics require multifactorial intervention for hypertension; dyslipidaemia and microalbuminuria besides hyperglycaemia. In fact; the combined use of antihypertensives; aspirin and lipid-lowering agents makes it difficult to discern the beneficial effects of antihyperglycaemic therapy
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Cardiovascular Diseases , Coronary Artery Disease , Diabetes Mellitus , Hyperglycemia , Insulin Resistance , ReviewABSTRACT
Introduction: Background & objective: Pre-eclampsia and eclampsia are the most common obstetrical complications during pregnancy. The objective of this work was to quantitate and find significance of serum calcium and lipid profile levels in pre-eclamptic and eclamptic pregnancy in comparison with normal pregnancy. Methods: Study includes 105 subjects divided into three groups. Estimation of Calcium, Triglycerides, Total-Cholesterol and HDL-C were analyzed by O-Cresolphthalein-Complexone, GPO-PAP, CHOD-PAP and Phosphotungstic acid precipitation method, using Erba Chem-5 plus semi-autoanalyser. Results: Mean serum calcium and HDL-C levels were significantly decreased in group-II and group-III in comparison to group-I,p<0.05. The mean triglyceride, VLDL-C and LDL-C levels were significantly increased in group-II as compared to group-I,p<0.05. There was no difference in the mean values of total-cholesterol between cases (group-II and group-III) and control (group-I),p>0.05; but the mean level of VLDL-C was higher in group-III in comparison to group-I,p<0.05. Non significant (p>0.05) difference was found in mean values of triglyceride and LDL-C in group-III cases in comparison to group-I. Interpretation & conclusion: Women having pre-eclampsia and eclampsia had low levels of serum calcium and disturbed lipid profile. These levels may have cause and effect relationship with these disorders.
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Reverse cholesterol transport by high density lipoprotein cholesterol (HDL-C) has been traditionally considered to be the most important mechanism by which HDL-C protects against atherosclerosis. Recently HDL-C has been shown to have cardioprotective effects at many levels which include prevention of low density lipoprotein cholesterol (LDL-C) oxidation, vascular wall inflammation and thrombosis. Apolipoprotein A-1 (ApoA-1) is major constituent of HDL and is synthesised in the liver and intestine. ApoA-1 is lipidated by ATP binding cassette transporter (ABC A-1) which is rate limiting step in HDL biogenesis. Once in the plasma, the nascent HDL undergoes intensive remodelling. The HDL-C has important biological effects on endothelial cells, monocytes, Tlymphocytes, and platelets. Currently, the HDL is being tested as a therapeutic agent with beneficial role being shown in coronary artery disease, diabetes mellitus. The reconstituted HDL (rHDL) is being tried also in neural damage.