Vitamin D in Patients of Chronic Liver Disease with Hepatic Encephalopathy.

Hepatic encephalopathy (HE) is a frequently encountered complication of chronic liver disease (CLD). The manifestation is thought to be due to alteration in absorption of nutrients with associated altered metabolism with deterioration in synthetic function of liver. Several factors are known to precipitate HE. Recent studies have demonstrated the role of 25 hydroxyvitamin D (25OHD) in development of HE. Although uncertain as a causative factor, studies have shown significant lower levels of 25OHD with worsening HE. This study was therefore undertaken with the aim to access the 25OHD levels in patients of CLD and the relationship with the degree of severity of HE. MATERIAL: A cross-sectional hospital based observational study for a period of one year (1st June 2020 to 31st May 2021) was carried out with a total of 88 subjects of either sex above 12 years of age after application of inclusion criteria and exclusion criteria. OBSERVATION: The results showed significant difference in serum albumin levels (p= 0.003) in patient groups of with and without overt HE. The mean levels of serum 25OHD was significantly lower in the overt HE group than the covert HE group (24.11 ± 6.46 ng/ml vs 11.72 ± 4.84 ng/ml, p< 0.001). The study showed the mean levels of serum 25OHD among patients with grade 1 HE is 24.11 ± 6.46 ng/ml, in patients with grade 2 HE is 13.61 ± 4.73 ng/ ml, followed by 8.41 ± 2.84 ng/ml and 8.00 ± 2.66 ng/ml in grade 3 and grade 4 HE respectively, p<0.001. There was a statistically significant negative correlation between serum 25OHD levels and HE (person's correlation coefficient r = -0.731, p <0.001). CONCLUSION: Serum 25OHD levels were significantly lower in patients with overt HE. Serum levels of 25OHD showed a negative correlation with the degree of severity of HE.

Insertion/Insertion Genotype of Angiotensin I-Converting-Enzyme Gene Predicts Risk of Myocardial Infarction in North East India.

Myocardial infarction (MI) is common in India and the disease occurs at a relatively younger age. We wanted to look for association of Angiotensin I-converting enzyme (ACE) gene with MI in North East India. We also wanted to examine possible environmental interaction of ACE gene with established cardiovascular risk factors in causation of MI. In the study carried out in Assam Medical College, 200 consecutive confirmed cases of MI were recruited. Equal numbers of age- and sex-matched control subjects from hospital workers and patients attending the hospital for diseases unrelated to cardiovascular disease were enrolled. Structured questionnaires were used to note demographic and clinical factors. Cardiovascular risk factors were determined from history, physical examination and biochemical investigations. ACE insertion/deletion (I/D) polymorphism was determined by PCR method. Interaction of ACE gene with other risk factors was noted. The study identified ACE II genotype (odds ratio = 3.02; 95% CI 1.40-6.51), smoking, hypertension, diabetes and serum triglyceride > 150 mg/dl as independent risk factors for MI. ACE II genotype showed greater risk in non-smokers, non-hypertensives, non-diabetics and in subjects with LDL-C < 130 mg/dl. Low HDL cholesterol enhanced the genetic risk. Subjects with ACE II genotype have an independent risk of developing MI, specially in low cardiovascular risk subjects.

ß-Thalassaemia and its Co-existence with Haemoglobin E and Haemoglobin S in Upper Assam Region of North Eastern India: A Hospital Based Study.

INTRODUCTION: ß-Thalassaemias are common genetic disorders in the Indian subcontinent and its status has not been well studied in the Upper Assam region of North Eastern India. AIM: The aim of the study was to show the prevalence of ß- thalassaemias and its co-existence with Haemoglobin E and Haemoglobin S in the Upper Assam region of North Eastern India. MATERIALS AND METHODS: A total of 1200 anaemic patients were investigated for ß- thalassaemias. Complete Blood Count (CBC) and High Performance Liquid Chromatography (HPLC) were done for screening. RESULTS: Out of 1200 patients screened, 5.83% ß-thalassaemia trait, 2.33% compound Hb E/ß-Thalassaemia, 1.33% ß-thalassaemia major and 0.42% compound Hb S/ß- thalassaemia were detected. A high incidence of thalassaemia is found among the people of Upper Assam region of North Eastern India. CONCLUSION: The only way to prevent the disease is carrier detection and awareness among the people about it.