Serum lipoprotein ratios as markers of insulin resistance: A study among non-diabetic acute coronary syndrome patients with impaired fasting glucose.

Background & objectives: Recent data suggest that insulin resistance can predict cardiovascular disease independently of the other risk factors, such as hypertension, visceral obesity or dyslipidaemia. However, the majority of available methods to evaluate insulin resistance are complicated to operate, expensive, and time consuming. This study was undertaken to assess whether serum lipoprotein ratios could predict insulin resistance in non-diabetic acute coronary syndrome (ACS) patients. Methods: Ninety non-diabetic patients with impaired fasting glucose admitted with a diagnosis of ACS were included in the study. At the time of admission fasting glucose and insulin concentrations were measured. The homeostatic model assessment-insulin resistance (HOMA-IR) was used for insulin resistance. The fasting serum total cholesterol (TC), triglycerides (TG) and high density lipoprotein cholesterol (HDL-C) levels were checked, and then TC/HDL-C and TG/HDL-C ratios were calculated. The areas under the curves (AUC) of the receiver operating characteristic (ROC) curves were used to compare the power of these serum lipoprotein ratios as markers. Results: Lipoprotein ratios were significantly higher in patients with HOMA-IR index > 2.5 as compared to patients with index <2.5 (P < 0.05). Both TG/HDL-C and TC/HDL-C ratios were significantly correlated with HOMA-IR (P<0.05). The area under the ROC curve of the TG/HDL-C and TC/HDL-C ratio for predicting insulin resistance was 0.80 (95% CI, 0.67 to 0.93), 0.78 (95% CI, 0.65 to 0.91), respectively. Interpretation & conclusions: The findings of this study demonstrate that serum lipoprotein ratios can provide a simple means of identifying insulin resistance and can be used as markers of insulin resistance and cardiovascular diseases risk in adult non-diabetic patients.

Contribution of efflux pumps in fluroquinolone resistance in multi-drug resistant nosocomial isolates of Pseudomanas aeruginosa from a tertiary referral hospital in north east India.

Background: Pseudomonas aeruginosa is one of the leading opportunistic pathogen and its ability to acquire resistance against series of antimicrobial agents confi ne treatment option for nosocomial infections. Increasing resistance to fl uroquinolone (FQ) agents has further worsened the scenario. The major mechanism of resistance to FQs includes mutation in FQs target genes in bacteria (DNA gyrase and/or topoisomerases) and overexpression of antibiotic effl ux pumps. Objective: We have investigated the role of effl ux pump mediated FQ resistance in nosocomial isolates of P. aeruginosa from a tertiary referral hospital in north eastern part of India. Materials and Methods: A total of 234 non-duplicate, consecutive clinical isolates of P. aeruginosa were obtained from a tertiary referral hospital of north-east India. An effl ux pump inhibitor (EPI), carbonyl cyanide m-chlorophenylhydrazone (CCCP) based method was used for determination of effl ux pump activity and multiplex polymerase chain reaction (PCR) was performed for molecular characterisation of effl ux pump. Minimum inhibitory concentration (MIC) reduction assay was also performed for all the isolates. Results and Conclusion: A total number of 56 (23%) have shown effl ux mediated FQ resistance. MexAB-OprM effl ux system was predominant type. This is the fi rst report of effl ux pump mediated FQ resistance from this part of the world and the continued emergence of these mutants with such high MIC range from this part of the world demands serious awareness, diagnostic intervention, and proper therapeutic option.

Evaluation of phytoconstituents and assessment of adaptogenic activity in vivo in various extracts of Rhododendron arboreum (leaves).

Natural products particularly of plant origin with antistress property and nutraceutical value have become the focus of scores of scientific investigation in recent times. Against this background the present study was carried out to analyse the phytochemical components and adaptogenic activity of Rhododendron arboreum which grow in high altitudes. Adaptogenic activity of the plant extract was evaluated in vivo in rat and mice animal models. Methanol, hydroethanol and aqueous extract of the leaves were prepared and preliminary screening of the phytochemical constiteunts was carried out. The important phytoconstituents viz. flavonoids and phenolics were estimated and amount of gallic acid and quercetin were evaluated by HPTLC. Adaptogenic activity of the extract was studied in vivo using rat and mice as test animals. The criteria taken were forced swimming test in rat and mice and tail suspension test in mice. Methanol extract showed the presence of diterpenes, triterpenes, flavonoids, steroids, tannin, phenolics. Hydroethanol extract showed the presence of diterpenes, triterpenes, saponin, glycosides, alkaloids, tannin and aqueous extract showed the presence of tannin, glycosides, triterpenes, flavonoids, diterpenes. Quantitative analysis exhibited that the methanol extract have the highest amount of flavonoid and phenolics. The HPTLC profile of methanol extract showed the presence of highest amount of quercetin. Gallic acid was detected only in methanol extract. In vivo study in test animals revealed that the methanol extract of R. arboreum exhibited potent anti stress activity. Hence, presence of these compounds which are known to have strong anti-oxidant activity in high quantity might be responsible for adaptogenic activity.

Impact of paper mill effluent on growth and development of certain agricultural crops.

The physico-chemical characteristics of paper mill industry effluent were measured and some were found to be above the permissible limits prescribed by Indian irrigation water standard. A study was conducted in pots to investigate the effects of different concentrations (10, 20, 30, 40, 50, 60, 70, 80 and 100%) of paper mill effluent on growth and production of rice, mustard and pea for three years. The study reveals that the paper mill effluent has deleterious effect on the growth of crop at higher concentrations. However, at lower concentration (viz. 10 to 40% in rice, 10 to 50% in mustard and 10 to 60% in pea) of effluent, beneficial impact on general welfare of the crops was noticed. Growth and development was increased with increasing the concentration of the effluent up to 30% in rice, 40% in mustard and 50% in pea. Investigation showed that the growth and production of rice, mustard and pea was found maximum at a concentration of 30, 40 and 50% effluent respectively.

Heart failure and acquired immune deficiency syndrome: report of 2 cases.

Acquired immune deficiency syndrome (AIDS) patients usually present with prolonged fever, chronic diarrhoea, weight loss and other opportunistic infections. Congestive heart failure is not a usual presentation of AIDS. Here two cases, one a female of 38 years and another a male of 22 years presented with fever and breathlessness. On examination they were found to have features of congestive heart failure. Echocardiography revealed dilated cardiomyopathy. Laboratory investigations suggested human immunodeficiency virus was reactive in both cases with immune deficiencies of different degrees. The first patient expired during hospital stay, but the second one is progressing well with antiretroviral therapy.

Pyrexia of unknown origin with neutropenia, cervical lymphadenopathy, pneumonia and marrow hypoplasia.

A 56 years adult male presented with fever for 3 weeks with neutropenia and cervical lymphadenopathy with left sided pneumonitis. Histopathology of lymphnode was consistent with Kikuchi's Necrotizing Lymphadenitis. Kikuchi's disease is usually a self- limiting illness characterized by pyrexia, neutropenia and cervical lymphadenopathy in young women of Asian decent. This often leads to the misdiagnosis of lymphoma or tuberculosis. The notable feature here is an older male presented with severe neutropenia and pneumonia with hypoplastic marrow.

Philadelphia chromosome positive essential thrombocythemia with dilated cardiomyopathy.

We report here an unusual case of a 30-year old male patient with essential thrombocythemia (ET) and dilated cardiomyopathy, who on further investigation was found to have Philadelphia chromosome positive (Ph+) cells in the bone marrow. The reverse transcriptase-polymerase chain reaction (RT-PCR) test on his peripheral blood leucocytes revealed b2a2 transcript of the bcr-abl fusion gene. Literature shows that the boundary line between Ph+ essential thrombocythemia and chronic myeloid leukemia (CML) is getting blurred day by day. Each one may be a part of the spectrum of a single clonal proliferative disease. Association of dilated cardiomyopathy with ET has not been reported.