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Lipid Profile Level among Healthy Subjects and Their Relation with Obesity- A Clinical Study
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Background: Obesity is a common metabolic disease world-wide and dyslipidemias among the most common metabolic disorders associated with obesity. The present study was undertaken to assess lipid profile level among healthy subjects and their relation with obesity. Subjects and Methods: This cross sectional study was conducted on 100 subjects. General information related to data such as name, age, gender etc. was recorded in case history proforma. BMI was evaluated based on formula of BMI = Weight (kg)/Height (m)2. Based on BMI, subjects were divided into two groups according to their BMI values as- group I- Obese and Group II- Non obese. Group I had 65 and group II had 35 subjects. Lipid profile was done. Results: There was significant difference in group I and group II regarding waist circumference (WC), BMI (kg/m2), body adiposity index (BAI), visceral adiposity index (VAI), total cholesterol (TC) (P< 0.05). Waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), HDL- C, LDL- C, TG, TC/HDL- C, LDL-C/HDL-C and TG/HDL-C was non- significant (P< 0.05). There was negative correlations between BMI and TC, LDL-C, HDL-C; WC, WHR, VAI and HDL-C and positive significant correlations were found between WC, WHR, and TG/HDL-C, as well as between VAI and TC, TG, TC/HDL-C, LDL/HDL-C, and TG/ HDL-C. Conclusion: Authors found that there was alteration of lipid profile in obese subjects. VAI is strongly related with lipid profile and may be considered as reliable obesity index in obese patients with dyslipidemias. 
A Study on Uric Acid Levels in Type 2 Diabetes Mellitus with Chronic Kidney Disease
No full textBackground: The classification of stages of CKD is based on the level of kidney function measured by GFR, stage 1 represents kidney damage with normal or elevated GFR and stage 5 represents a GFR of less than 15 ml/min or who require treatment with dialysis. In recent times a new equation the Chronic Kidney Disease-Epidemiological Collaboration (CKD-EPI) has been introduced. The CKD-EPI equation has lower bias, especially at an estimated GFR greater than 60 mL/min per 1.73 m2; however, precision remains limited. Subjects and Methods: The study was undertaken in the Department Of General Medicine,and a total 64 CKD patients are included in study who fulfilled the inclusion and exclusion criteria. These cases taken are not overlapped with other postgraduate students. The patients were randomly divided into two groups according group chosen by time of enrollment. Results: The Study reveals that, there was no statistical significant difference of mean serum uric acid among smokers and non-smokers in Type 2 diabetes mellitus with CKD(P>0.05). Conclusion: Study reveals that, there was no statistical significant difference of mean serum uric acid among alcoholic and non-alcoholic cases in Type 2 diabetes mellitus with CKD(P>0.05). 
A Study on Correlation between Serum Cortisol and Stroke Severity with Serum Cortisol
No full textBackground: The stress response that occurs after the event of acute stroke causes the activation of the hypothalamo–pituitary–adrenal (HPA) axis. Certain studies have found that increased serum cortisol level in patients with acute stroke is related to larger infarct volume, greater stroke severity and poor outcome, including death. Subjects and Methods: About 50 new cases of acute ischemic stroke patients, within 72 hours of the acute neurological event , who were admitted in the Sridevi Medical College & Hospital were included in the study. The study was conducted for a period of 6 months.(June 2018-December 2018). CT Brain was taken during admission to confirm acute ischemic stroke. NIHSS (National Institute of Health Stroke Scale)score for all the patients were assessed for severity at the time of admission. Results: Of the 50 cases, serum cortisol level of 23 cases were within normal limits(</=690nmol/L) of which 65.2% had NIHSS score of less than or equal to 6 and 34.8% of the cases had NIHSS score more than 6. Conclusion: Among the patients with acute ischemic stroke ,high serum cortisol levels at the time of admission correlates with,1. Clinical severity which is assessed by National Institute of Health Stroke Scale and 2, Poor prognosis and functional outcome after 15 days which is assessed by Modified Rankin Scale. 
Assessment of Serum Uric Acid Levels in Patients with Acute Myocardial Infarction
No full textBackground : Aim of the study was to discover if there is the efficacy of serum uric acid in the prognostication of myocardial infarction subjects. Subjects and Methods: A total of 200 subjects were incorporated into the research. Of them, 74 patients had ST- elevated myocardial infarction, as in 26 subjects they were diagnosed with non-ST elevation myocardial infarction. Of the total of 100 subjects in the study group, there were 70 males and 30 females. A total of 100 healthy individuals as a control group were also incorporated in the study. Serum uric acid was measured on day 0, 3, 7 as well on day 30 of MI. Results: Serum uric acid was calculated on day 0, day 3, and day 7 and on day 30 of the myocardial infarction in the case study group. The mean uric acid levels on day 0 were found to be 6.32 ± 1.45 mg/dl, mean uric acid level on day 3 was found to be 5.98 ± 0.98 mg/dl, mean uric acid level on day 7 was found to be 5.14 ± 2.18 mg/dl and mean uric acid level on day 30 was found to be 4.98 ± 0.44 mg/dl. Conclusion: Serum uric acid stages are elevated in subjects of acute MI in contrast to standard well individuals. Subjects with higher Serum uric acid levels have an elevated probability of transience and it can be measured as a marker of appalling prediction
Multidetector Computed Tomography Evaluation of Anomalies of Aortic Arch Branching
No full textBackground: Anatomic variations in the branching pattern of the aortic arch is known for a long time. Advances in modern medicine have led to an increasing number of endovascular and vascular reconstructive procedures where the pre-procedural information about these variations is extremely important. Besides, these variations may serve as a marker of thoracic aortic disease. Hence, we tried to evaluate the incidence of these anatomic variations in the branching of the aortic arch utilizing routine contrast-enhanced computed tomography of the thorax (CECT-Th) rather than aortograms. The aims and objectives is to the main aim of the study was to evaluate the role of multidetector routine CECT-Th in the detection of anomalies of branching of the aortic arch along with an estimation of their incidences. Subjects & Methods: Three-hundred and fifty CECT-Th examinations were included in our study over some time with the exclusion of 27 examinations. The type of aortic arch branching pattern was noted, and their incidence was calculated. Results: Majority of the patients in our study were in 41-60yrs age group with male predominance. Majority of the patients had three branches arising from the arch of aorta. The commonest variant was bovine type (14.2%) where the left common carotid arises from the right brachiocephalic artery followed by the isolated vertebral artery and aberrant right subclavian artery in the decreasing order of frequency. Conclusion: Anomalies of branching of aortic arch can be optimally detected on routine CECT-Th examinations performed on a multidetector CT scanner. Anomalies are seen in nearly one-fifth to one-quarter of subjects with the bovine type being the commonest and aberrant right subclavian artery being the rarest. 
A Prospective Comparative Study on Metabolic Syndrome Among Urban and Rural Women Population- A Cross Sectional Study
No full textBackground: Metabolic syndrome is a combination of individual risk factors that are associated with several serious health conditions such as diabetes, cardiovascular disease or stroke. The present study was conducted to assess metabolic syndrome among urban and rural women population. Subjects and Methods: 128 females diagnosed with metabolic syndrome were included. Smoking, drug history, past history, family history etc. was taken. Weight, height, BMI, waist circumference, hip circumference, waist to hip ratio, systolic and diastolic blood pressure was also recorded. Results: Age group 20-35 years comprised of 24, 35-50 years had 36 and >50 years had 68 patients. The socio- economic status was middle in 70 and upper in 58, education was primary in 45 and high in 73, occupation was unemployed in 80 and employed in 48. Smoking was seen in 52 (40.6%), hypertension in 78 (60.9%), Hypertriglyceride in 84 (65.6%), alcoholics in 40 (31.2%), increased FBS in 102 (79.6%) and low HDL in 80 (62.5%). Conclusion: Maximum women with MS was seen in age group >50 years. Smoking, hypertension, hypertriglyceride, alcoholism, increased FBS and low HDL was seen in all patients. 
Mid Regional Natriuretic Peptide for Predicting Prognosis of Hypertrophic Cardiomyopathy
No full textBackground: Hypertrophic cardiomyopathy (HCM) is a genetic disorder of cardiac myocytes that is characterized by cardiac hypertrophy, cel lular disarray and interstitial fibrosis. Mutation of MYH7 and MYBPC3 encoding proteins β-myosin heavy chain and myosin binding protein C, respectively, are the two most common genes involved, together accounting for about 50% of cases. The present study was conducted to evaluate the prognostic value of MR-proANP in patients with HCM. Subjects and Methods: The present study was conducted at Narayana Medical College & Hospital, Chintareddy Palem, Nellore, Andhra Pradesh from July 2016 to July 2017 on 46 patients of hypertrophic cardiomyopathy of both genders. Serum NT-proBNP was measured by a two-site electrochemiluminescence immunoassay on a Roche Diagnostics E170 analyser. Results: The mean systolic blood pressure was 124.8 mm Hg, diastolic blood pressure was 78 mm Hg, heart rate was 68 beats/minutes, NYHA 1(n=4), NYHA 2 (n=27), NYHA 3–4 (n=15) and atrial fibrillation was 12%. The mean MR-proANP was 106 pmol/L and NT-proBNP was 540 pg/mL at the start of the study. At the end of 12 months of follow up, 15 patients had a primary end point defined as heart failure hospitalisation (n=10), heart transplant (n=3) death(n=2). Both mean MR-proANP and NT-proBNP were strongly associated with the primary end points at the end of study period with values of 1010 pmol/L and 2545 pg/ml respectively. This showed a strong association with P <0.05. Conclusion: Authors found that MR-proANP is a valuable biomarker for the prediction of heart failure related events in patients with HCM. 
Assessment of Glutathione Level in Non-Alcoholic Fatty Liver Disease Patients
No full textBackground: Non-alcoholic fatty liver disease (NAFLD) is a range of hepatic disorders associated with fatty deposits in liver, which occur in the absence of alcohol consumption or alcohol abuse. NAFLD. The present study assessed glutathione level in non-alcoholic fatty liver disease patients. Subjects and Methods: The present study was conducted in Department of Internal Medicine, Narayana Medical College & Hospital, Chintareddy Palem, Nellore, Andhra Pradesh. Duration of the study was from February 2018 to January 2019. 40 patients of NAFLD and 20 cases of fatty liver disease were recruited. Serum levels of 8-OHdG were measured using the highly sensitive 8-OHdG Check enzyme-linked immunosorbent assay (ELISA). Serum levels of GGT were measured using the Qualigent® GGT kit. Serum levels of glutathione (GSH) were measured using the GSH kit. Results: The mean total bilirubin in group I was 1.2 mg/dL and in group II was 0.7 mg/dL, aspartate transaminase was 58.2 U/l in group I and 62.6 U/l in group II, alanine transaminase in group I was 142.4 U/l in group I and 128.2 U/l in group II, alkaline phosphatase was 284.2 U/l in group I and 302.4 U/l in group II and γ-glutamyltranspeptidase in group I was 98.2 U/l and 118.4 U/l in group II. The difference was non- significant (P> 0.05). The mean glutathione level in group I was 0.6 and in group II was 0.4 and which increased to 1.4 in group I and 1.2 in group II after 3 months. The difference within the group found to be significant (P< 0.05). Conclusion: Authors found that there was reduction in alanine transaminase, glutathione and gamma-glutamyltranspeptidase level. Antioxidant therapy with glutathione may reduce the pathological oxidative stress in the liver in NASH, preventing the progression from NAFLD to NASH cases
A Study on Angiographic profile of Acute Coronary Syndrome in Smokers
No full textBackground: Coronary artery disease is a devastating disease precisely because an otherwise healthy person in the prime of life may die or become disabled without warning. The objectives of the study were to study the clinical profile, risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in acute coronary syndrome (ACS) patients admitted in Cardiology Department of Cardiology Katuri Medical College & Hospital, Guntur. Subjects and Methods: A total of 208 patients of ACS were analyzed for various risk factors, angiographic patterns and severity of coronary artery disease in smokers vs non-smokers at Katuri Medical College, Andhra Pradesh. Results: Study group consisted of 208 subjects, of which 108(51.9%) subjects were smokers including all forms of tobacco use and 100 (48.1 Out of 108 study subjects in the smokers group, family history of CAD was present in 21 (19.4%) subjects. Killip class is not applicable to 13 (12%) study groups as they presented with Unstable Angina with ECG changes. Killip class 1 was most common presentation (67.6%) in smokers. 28 patients (25.9%) had LV dysfunction with EF < 50% by echocardiography. 80 patients (74.1%) had normal LV function. The mean EF was 55.56+/-10.16%. The median EF was 56.5%. LAD was type 3 in 100 (92.6%) patients and type 4 in 8 (7.4%) patients out of 108 study subjects. LAD type 3 was statistically significant with P value < 0.05 when compared with LAD type 4. No statistically significant difference was seen with respect to the Normal coronary arteries as CAG diagnosis between smokers and non-smokers (6.7% versus 8%, p>0.1, Not significant). Conclusion: Smokers were predominantly male and around 3 years younger than non-smokers. Diabetes mellitus and hypertension were less common among smokers and single-vessel disease was the more common angiographic finding for smokers as compared to 3-vessel disease for non-smokers. ST-segment elevation myocardial infarction in smokers despite younger age and the low atherosclerotic risk profile, in our region, emphasize the need for nicotine addiction management and smoking cessation campaigns at large and for pre-discharge counseling. 
Left Atrial Appendage (LAA) Function by Transesophageal Echocardiography before and after Percutaneous Balloon Mitral Valvuloplasty (PBMV)- A Comparative Study
No full textBackground: In the past, the left atrial appendage (LAA) has been considered to be a relatively insignificant portion of cardiac anatomy. It is now recognized that it is a structure with important pathological associations. First, thrombus has a predilection to form within the LAA in patients with non-valvar atrial fibrillation and to a lesser extent in those with mitral valve disease (both in atrial fibrillation and in sinus rhythm). Second, the use of transoesophageal echocardiography has made clear imaging of the LAA possible, so that its size, shape, flow pattern, and content can be assessed in health and disease. Subjects and Methods: This study population consisted of 40 patients with symptomatic mitral stenosis who underwent percutaneous mitral balloon valvotomy in the cardiology department of GSL medical college, Rajahmundry over a time period of 1 April 2017 to 30 March2018. Patients in all age groups, with evidence of severe MS (MVA<1.0cm2) admitted in our institution, in whom PBMV was feasible were included. Those who were fulfilling the PBMV intervention criteria and those who had good results only were included. Results: Left atrial appendage late emptying velocity, LAALF: Left atrial appendage late filling velocity Spontaneous echocontrast (SEC) was present in 10 of the 40 patients before a procedure but completely disappeared (6 patients) or decreased (4 patients) after the procedure. LAALE & LAALF velocities measured by Doppler were increased significantly after PBMV and at 6 months follow up compared with baseline (P <0.001). Conclusion: Successful Percutaneous balloon mitral valvotomy decreases the intensity of spontaneous LA contrast, reduces the size of the LA, and improves LA and LAA function. Relief of MS may confer not only hemodynamic benefits for improvement of symptoms but also have a favorable influence on future thromboembolism.