A Study of Correlation between High Normal Glycosylated Hemoglobin as Risk Factor for Coronary Heart Disease with Framingham 10 Year Risk Factor in Non-Diabetic Patients.

BACKGROUND AND PURPOSE: Framingham 10 year risk score traditionally used to diagnose future risk. There is need to find simple and powerful marker for future risks of coronary artery disease. Framingham 10 year risk score take many variables together. Recently, abnormal glucose metabolism is a major determinant of CHD. Although the relationship between cardiovascular disease (CHD) and glycaemia is believed to represent a continuum without a threshold effect, as it is a more stable, accurate parameter of glucose homeostasis. Therefore, the aim of the current study was to establish association between high normal HbA1c and Framingham 10 year risk score for coronary artery diseases in non-diabetics. METHODS: A total 100 patients of coronary artery disease, aged 18-80 years were enrolled. Complete physical and systemic examination including vitals was performed. Framingham's 10 year risk score, Height, Weight, Hip Circumference, Waist Circumference, and Waist-Hip Ratio and BMI are calculated. Investigated for HbA1c, HsCRP and other routine investigations needed to diagnose coronary artery disease. Chi square test was applied to detect association between HsCRP and High HbA1c and Correlation Coefficient(r) was calculated to study linear relationship. RESULTS: The Chi square Test significant meaning that higher value of HsCRP associated with high level of HbA1c (p=0.04). The Correlation Coefficient(r) is -0.02 so there were no linear relationship between HbA1c and Framingham risk score. In our study average Framingham risk score was 9.72 while average age of patient was 53.7 years. There were linear relationship between patient's age and Framingham 10 year risk score (r= 0.60). CONCLUSIONS: Coronary artery disease patients had high prevalence of High HsCRP. there was significant association between glycosylated haemoglobin and High HsCRP (P=0.04). We find association between high normal HbA1c and Framingham risk score in non-diabetic patient. But, There is no any linear correlation between high normal HbA1c and Framingham 10 risk score (r=0.02). We find out that Framingham 10 year risk score has linear relationship with patient's age and sex. It implies that coronary artery disease calculated by using Framingham 10 year risk score increases with increase in age. But Glycosylated Haemoglobin predicts coronary artery disease risk independence of patient's age. It predicts low risk in young female patients compare to young male patient in our study. Glycosylated haemoglobin is independent of age and sex of patient. So Glycosylated haemoglobin is good marker for coronary artery disease.

Can short-term video-EEG substitute long-term video-EEG monitoring in psychogenic nonepileptic seizures? A prospective observational study.

BACKGROUND: Psychogenic nonepileptic seizures (PNES), the commonest nonepileptic event, represent 20-30% of drug-resistant epilepsy. Correct identification of PNES avoids unnecessary hospitalization and exposure of antiepileptic drugs (AEDs), and helps implement appropriate psychological treatment. Long-term video-electroencephalography (LTVEEG) is the gold standard test to diagnose PNES. However, in a poor-resource country like India, hypothetically, short-term video-electroencephalography (STVEEG) may substitute it, as its usefulness is established in attack disorders. OBJECTIVE: The objective of this study was to evaluate effectiveness of STVEEG in PNES and to look into their clinical profile and outcome. DESIGN/METHODS: Consecutive cases of PNES diagnosed with STVEEG or LTVEEG during 2015-16 (two years) were enrolled. All cases were followed for 12 months or more. Detailed clinical evaluation was done including demography, semiology, coexisting anxiety/depressive disorders, and seizure frequency at time of first diagnosis and follow-up. The PNES were classified as Type I hypermotor, type II hypomotor, and type III unclassified/mixed. Favorable outcome was defined as seizure freedom or >50% reduction in seizure frequency while unfavorable outcome was defined as <50% reduction in seizure frequency on follow-up at 6 and 12 months. RESULTS: Among 57 patients with PNES [median age of onset 24 years (10-69 years), F:M ratio = 7:3)], STVEEG ± induction could record event(s) in 80.7% while the rest required LTVEEG to confirm diagnosis. Among 82 events analyzed, the mean ±â€¯2 standard deviation (SD) duration of events was 5'14″ ±â€¯13'4″. Sixty-two (75.6%) and 10 (12.1%) events were hypermotor and hypomotor respectively, while 10 (12.1%) were unclassified/mixed. Forty-five (79%) patients had pure PNES, while 12 (21%) had coexistent epilepsy. Forty-nine (86%) and 54 (94.7%) patients had statistically significant reduction of seizure frequency (favorable outcome), at 6 and 12 months of follow-up respectively, while the rest had an unfavorable outcome. CONCLUSIONS: The STVEEG has a remarkably good yield in diagnosing PNES, and it may be used when LTVEEG is not feasible. However, further studies are needed to show if it can substitute LTVEEG in PNES.