To Study Association of Neck Circumference with Metabolic Syndrome and Cardiovascular Risk Factors - A Hospital Based Case Control Study in Ethnic Population of Sikkim.

Metabolic syndrome is known to increase the risk of cardiovascular diseases, diabetes, stroke. Upper body obesity is found to be associated with metabolic syndrome and increased risk of cardiovascular diseases. This present study is being conducted with the objective to evaluate association of neck circumference with metabolic syndrome in ethnic population of Sikkim. MATERIAL: The present study is a hospital based pilot study conducted at Dept. of Medicine at a tertiary care centre in Northeast India after ethical clearance from institute's ethical committee and after taking written informed consent, A total of 30 subjects had been evaluated for components of metabolic syndrome and cardiovascular risk factors. OBSERVATION: 30 subjects of metabolic syndrome were screened, raised triglyceride level was most commonly found, Neck circumference was found to be statistically significant associated with metabolic syndrome, 56.6 % subject with metabolic syndrome had abnormal neck circumference. CONCLUSION: Upper body obesity had been recognized as to increase risk of cardiovascular disease and neck circumference can be used as simple and novel indicator. Patients with larger neck circumference should be screened for cardiovascular risk factors.

Sp1 Binding Site Polymorphism at COL1A1 Gene and Its Relation to Bone Mineral Density for Osteoporosis Risk Factor Among the Sikkimese Men and Women of Northeast India.

Single nucleotide polymorphism in the first intron of Collagen type I alpha 1 (COL1A1) gene which is the binding site of specificity protein 1 (Sp1) transcription factor associated with low bone mineral density and osteoporosis. To evaluate such genetic factors among the Sikkimese population, a total of 150 cases (75 men and 75 women) with primary osteopenia and osteoporosis and 150 healthy controls (75 men and 75 women) of age range between 35 and 65 years were enrolled in this study. The COL1A1 genotypes [SS, Ss and ss] were assessed by restriction enzyme [MscI] digestion of DNA after amplification by polymerase chain reaction. There, only 2.7% women and 1.3% men cases had restriction site with heterozygous genotype (Ss) and no homozygous genotype (ss) were detected. There was no statistically significant association between low bone mass and genotypes on analysis (χ2 = 1.014, P = 0.314; RR = 1.510) that, the Sp1 binding site polymorphism at the COLIA1 gene is very rare and has no contribution in the development low bone mineral density.

Assessment of Acoustic Features and Machine Learning for Parkinson's Detection.

This article presents a machine learning approach for Parkinson's disease detection. Potential multiple acoustic signal features of Parkinson's and control subjects are ascertained. A collaborated feature bank is created through correlated feature selection, Fisher score feature selection, and mutual information-based feature selection schemes. A detection model on top of the feature bank has been developed using the traditional Naïve Bayes, which proved state of the art. The Naïve Bayes detector on collaborative acoustic features can detect the presence of Parkinson's magnificently with a detection accuracy of 78.97% and precision of 0.926, under the hold-out cross validation. The collaborative feature bank on Naïve Bayes revealed distinguishable results as compared to many other recently proposed approaches. The simplicity of Naïve Bayes makes the system robust and effective throughout the detection process.

Clinico-etiological profile of hyponatremia among elderly age group patients in a tertiary care hospital in Sikkim.

BACKGROUND: Hyponatremia is a common condition observed in hospitalized patients. The incidence is much more in the elderly patients owing to impaired ability to maintain water and electrolyte homeostasis. It is important to evaluate and understand the causes and patient characteristics in order to deliver precise management. MATERIALS AND METHODS: Study was conducted at a teaching referral hospital in Sikkim and total of 100 elderly patients, diagnosed with hyponatremia, were enrolled in the study. Detailed medical history, clinical and laboratory examination were performed and data including treatment details were collected. Descriptive analysis was performed and results were correlated with patient characteristics. RESULTS: Mean age of the patients was 73.87 ± 6.54 years with a male to female ratio of 1:0.96. About 81% of patients were symptomatic among which lethargy (50%), drowsiness (40%), and abnormal behavior (39%) were common symptoms. Most patients (51%) had profound hyponatremia and Syndrome of inappropriate antidiuretic hormone secretion (SIADH) (36%) and drugs (26%) were the most common cause of hyponatremia in this study. The common treatment given in this study was 0.9% NaCl (71%). Mortality of patients in this study was 20%. CONCLUSION: Clinicians need to be aware of the common occurrence of hyponatremia in the elderly, especially acutely sick elderly. A systematic approach to its diagnosis with the application of simple standardized diagnostic algorithms can significantly improve the assessment and management of hyponatremia as the outcome in profound hyponatremia is governed by etiology, and not by the serum sodium level.

Assessment of metabolic syndrome in HIV-infected individuals.

BACKGROUND: Metabolic syndrome (MS) is a cluster of risk factors for cardiovascular disease and Type 2 diabetes mellitus. OBJECTIVES: The aim is to assess the prevalence of MS in HIV patients receiving highly active antiretroviral therapy (HAART) and to compare it with treatment naïve HIV patients. METHODS: Cross-sectional study carried out in a teaching hospital in North India. A total of 116 HIV positive patients who were on HAART and those who were treatment naïve were included in the study. Adult Treatment Panel III (ATP III) and International Diabetes Foundation (IDF) definitions were used to define MS. Clinical and laboratory investigations were performed as per requirement and then analyzed using SPSS software. RESULTS: A high prevalence of MS was observed in HIV positive patients (ATP III - 19.8% and IDF - 25.9%). The prevalence of MS was higher in the anti-retroviral therapy (ART) group (ATP III - 33.3% and IDF - 36.4%) than ART-naïve group (ATP III - 2% and IDF - 12%). CONCLUSIONS: A sincere effort should always be made to detect MS in patients on HAART, especially in Indian subcontinent where there is a genetic predisposition to cardiovascular risk.

Moyamoya Disease Associated with Recurrent Right Thalamic Haemorrhage and Hydrocephalus: A Case Report.

Moyamoya disease, a rare chronic, progressive cerebrovascular disease leads to occlusion of intracranial internal carotid arteries and its proximal branches. We report a case of a 51-year-old female who presented with recurrent thalamic bleed and intraventricular haemorrhage nine years apart in the same territory. The first bleed was managed conservatively and second bleed led to development of hydrocephalus. The acute phase of the hydrocephalus was managed by external ventricular drainage and the final CSF diversion was managed by ventriculoperitoneal shunt. The definitive treatment could not be done to denial of consent from the patient. We present the case to highlight the role CSF diversion as a means of palliative treatment for the Moyamoya disease.