Vitamin D insufficiency prior to bariatric surgery: risk factors and a pilot treatment study

OBJECTIVE

To assess vitamin D status and the influences of race, sun exposure and dietary vitamin D intake on vitamin D levels, and to evaluate two vitamin D repletion regimens in extremely obese patients awaiting bariatric surgery.

METHODS

A cross-sectional analysis of dietary vitamin D, sun exposure, PTH [intact (iPTH) and PTH(1-84)] and 25-hydroxyvitamin D (25OHD; differentiated 25OHD2 and 25OHD3) in 56 obese [body mass index (BMI) > 35 kg/m(2)] men and women (age 20-64 years). In a pilot clinical trial, 27 subjects with 25OHD levels < 62 nmol/l were randomized to receive ergocalciferol or cholecalciferol for 8 weeks.

RESULTS

Serum 25OHD was low (mean 45 +/- 22 nmol/l) and was inversely associated with BMI (r = -0.36, P < 0.01). Each BMI increase of 1 kg/m(2) was associated with a 1.3 nmol/l decrease in 25OHD (P < 0.01). BMI, sun exposure, African American race and PTH predicted 40% of the variance in 25OHD (P < 0.0001). Serum 25OHD significantly increased at 4 and 8 weeks in both treatment groups (P < 0.001), whereas PTH(1-84) declined significantly in subjects treated with cholecalciferol (P < 0.007) and tended to decrease following ergocalciferol (P < 0.09).

CONCLUSIONS

In severely obese individuals, those who are African American, have higher BMI and limited sunlight exposure are at greatest risk for vitamin D insufficiency. These demographic factors can help to identify at-risk patients who require vitamin D repletion prior to bariatric surgery. Commonly prescribed doses of ergocalciferol and cholecalciferol are effective in raising 25OHD. Further investigation is needed to evaluate whether these regimens have differential effects on PTH, and to determine the optimal regimen for vitamin D repletion in the extremely obese patient.

Epidemiological correlates of nutritional anemia among children (6-35 months) in rural Wardha, Central India

BACKGROUND AND OBJECTIVES

Nutritional anemia is associated with impaired performance of a range of mental and physical functions in children, along with increased morbidity. Iron supplementation at a later age may not reverse the adverse effects. National Nutritional Anemia Control Program was launched in India in 1970, but it failed to make any impact. The present study was undertaken to find out prevalence of anemia and its correlates in rural Wardha in children 6-35 months of age.

MATERIALS AND METHODS

Seven hundred seventy-two children between 6 months and 35 months of age were studied for anemia by cluster-sampling method. The hemoglobin was estimated in the child by 'Filter paper cyanmethemoglobin method.' Pre-designed and pre-tested questionnaire was used to collect data on socio-demographic and other variables. Data was analyzed by SPSS 12.0.1.

RESULTS

Mean hemoglobin level was 98.5+/-12.9 gm/L. Prevalence of anemia was 80.3%. Only 1.3% children had severe anemia (hemoglobin<70 gm/L). The univariate analysis showed that anemia is significantly associated with age of the child, education of mother and father, occupation of father, socioeconomic status, birth order and nutritional status as measured by weight for age. The final model suggested that only educational status of the mother, occupation of the father, birth order and nutritional status of the child were significantly associated with anemia.

INTERPRETATION AND CONCLUSION

For short-term impact, appropriate nutritional interventions remain the only operational intervention as only the nutritional status (weight for age) is a modifiable factor. But for long-term sustained impact, policy makers need to focus on improving maternal education and reducing family size.

Idiopathic thrombocytopenic purpura with isolated tuberculous splenic abscess

We present a 14-year-old boy, a known case of idiopathic thrombocytopenic purpura (ITP) for five years, and was treated with intermittent oral steroids. He presented with left upper abdominal pain of three months' duration. The pain was dull, aching and non-radiating. There were no other associated features. Before this presentation, he was receiving oral steroids for a month. The patient had been hospitalised in the past for ITP-related bleeding. The patient was managed with anti-tuberculous therapy alone, and after nine months, his splenic abscess regressed significantly in size. Tuberculous splenic abscesses are rare, and in particular, isolated tuberculous splenic abscesses are extremely rare with only three cases reported to date. This may be the first case report of tuberculous splenic abscess in ITP. It is noteworthy that this abscess was minimally symptomatic, with no fever or constitutional symptoms.

The 2006 dengue outbreak in Delhi, India

Dengue is a worldwide condition spread throughout the tropical and subtropical zones between 30 degrees north and 40 degrees south. It is endemic in South East Asia, the pacific, East and West Africa, the Caribbean and the Americas. Dengue outbreaks are occurring almost every three yearly in Delhi for the last 12 years. The latest outbreak was in the year 2006, which started late in August, peaked in the month of October and lasted till late November. We describe here the clinical, hematological and biochemical data of 70 patients of dengue fever diagnosed as per WHO criteria in Lok Nayak Hospital, New Delhi during this outbreak. Hematological parameters were estimated by automated counter and dengue serology was done by capture ELISA technique. The results displayed widespread effect of dengue fever on hematological and biochemical profile. Some of our patients also had atypical dengue manifestations. These results suggest that dengue fever is a major public health problem which can lead to significant morbidity and can even be fatal at times. All efforts should be made to prevent it.

Biomedical waste management in nursing homes and smaller hospitals in Delhi

The management of biomedical waste is a crucial issue in health and environmental management. Rules in India were promulgated in 1998, originally with a deadline of December 2000 and extended to December 2002; however, the actual situation remains far from satisfactory. A study conducted in 2001 by CEE, New Delhi; indicated an implementation deficit. To gauge the present situation, a survey was undertaken during 2005-2006. A systematic analysis of current biomedical waste management practices in smaller nursing homes and hospitals in Delhi was carried out. A total of 53 nursing homes, with bed strengths ranging from 20 to over 200, were included. The survey results show that there is a marked improvement in the segregation practices of biomedical waste in small private hospitals and nursing homes. The majority of nursing homes and hospitals were found to be using a service provider for the collection, management, and disposal of healthcare wastes. Data was collected through a questionnaire and field visits. This paper discusses the relevant data indicative of current practices of healthcare waste management in the nursing homes and small healthcare facilities in Delhi.

The usefulness of CT perfusion in differentiation between neoplastic and tuberculous disease of the spine

INTRODUCTION

Routine diagnostic techniques are not sufficient to confidently differentiate diseases of the axial skeleton. Purpose of study was to determine whether CT perfusion (CTP) can differentiate inflammatory diseases like tuberculosis from neoplastic diseases of spine.

METHODS

Fifty-one patients with vertebrdraft%freshal body lesions associated with paraspinal mass underwent CT guided bone biopsy and histopathological evaluation. CTP was done before doing bone biopsy. Perfusion parameters like blood volume (BV), blood flow (BF), and time to peak (TTP) were calculated. Values are correlated with histopathological report of bone biopsy. Statistical analysis was done using Mann-Whitney test. P value < .05 was considered significant.

RESULTS

Of 51, 32 had infective osteomyelitis and 19 neoplastic disease (9 metastasis, 5 plasmacytoma, 4 lymphoma and 1 chordoma. Mean rBF was [inflammatory lesions, 1.79 and neoplastic lesions, 9.42 (P < .000)]. Mean rBV was [inflammatory disease, 1.63 and neoplastic lesions, 9.37 (P < .000)].

CONCLUSION

CTP technique has potential for differentiating inflammatory from neoplastic lesions affecting spine associated with paraspinal mass noninvasively.

The utility of phase alternated pulses for the measurement of dipolar couplings in 2D-SLF experiments

The measurement of hetero-nuclear dipolar coupling using two-dimensional separated local field (SLF-2D) NMR experiments is a powerful technique for the determination of the structure and dynamics of molecules in the solid state and in liquid crystals. However, the experiment is sensitive to a number of factors such as the Hartmann-Hahn match condition, proton frequency off-set and rf heating. It is shown here that by the use of phase alternated pulses during spin-exchange the effect of rf mismatch on the dipolar coupling measurement can be compensated over a wide range of off-sets. Phase alternation together with time and amplitude modulation has also been considered and incorporated into a pulse scheme that combines spin exchange with homonuclear spin decoupling based on magic sandwich sequence and named as SAMPI4. Such time and amplitude averaged nutation experiments use relatively low rf power and generate less sample heating. One of these schemes has been applied on liquid crystal samples and is observed to perform well and yield spectra with high resolution.

Evaluation of WHO haemoglobin colour scale & palmar pallor for screening of anaemia among children (6-35 months) in rural Wardha, India

BACKGROUND & OBJECTIVE

Anaemia is a public health problem in India, particularly in women and children. Clinical diagnosis by health workers may be inaccurate. It is therefore important to evaluate simple methods for diagnosis of anaemia in rural set up with no or minimal laboratory facilities. We carried out this study to evaluate the performance of haemoglobin colour scale and palmar pallor against filter paper cyanmethaemoglobin method as screening methods for anaemia in children 6-35 months of age.

METHODS

A total of 772 children between 6-35 months were studied from three primary health centres of Wardha district, central India, by house-to-house visit. The child was examined for presence of palmar pallor and haemoglobin estimated by haemoglobin colour scale (HCS) and filter paper cyanmethaemoglobin method independently by two persons.

RESULTS

Haemoglobin colour scale had sensitivity of 89 per cent and specificity of 97 per cent in detecting anaemia in children. Pallor had sensitivity of 73 per cent and specificity of 98 per cent. The predictive values were 99 per cent and 69 per cent for positive and negative HCS result. Similarly, the predictive values were 99 and 48 per cent for positive and negative pallor result. Correct diagnosis of anaemia was 34 and 0.1 times common if HCS test result was positive (Hb < 110.0 g/l) and negative (Hb > 110.0 g/l) for anaemia.

INTERPRETATION & CONCLUSION

HCS fulfills the requirement of field test for screening of anaemia in resource poor country. It also has acceptable precision and accuracy and hence can be used in national anaemia control programmes.

Electromechanical interactions in a carbon nanotube based thin film field emitting diode

Carbon nanotubes (CNTs) have emerged as promising candidates for biomedical x-ray devices and other applications of field emission. CNTs grown/deposited in a thin film are used as cathodes for field emission. In spite of the good performance of such cathodes, the procedure to estimate the device current is not straightforward and the required insight towards design optimization is not well developed. In this paper, we report an analysis aided by a computational model and experiments by which the process of evolution and self-assembly (reorientation) of CNTs is characterized and the device current is estimated. The modeling approach involves two steps: (i) a phenomenological description of the degradation and fragmentation of CNTs and (ii) a mechanics based modeling of electromechanical interaction among CNTs during field emission. A computational scheme is developed by which the states of CNTs are updated in a time incremental manner. Finally, the device current is obtained by using the Fowler-Nordheim equation for field emission and by integrating the current density over computational cells. A detailed analysis of the results reveals the deflected shapes of the CNTs in an ensemble and the extent to which the initial state of geometry and orientation angles affect the device current. Experimental results confirm these effects.

Isoniazid induces oxidative stress, mitochondrial dysfunction and apoptosis in Hep G2 cells

Isoniazid (INH) continues to be a sheet anchor in treatment of tuberculosis, however its chronic administration is known to cause hepatotoxicity through a poorly defined mechanism. Ellucidation of mechanism underlying INH induced hepatotoxicity may be beneficial in devising ways to counteract toxic manifestations. In view of this concentration dependent effects INH were evaluated in hepatoma cell line (Hep-G2). INH exposure produced cytotoxic effects in Hep-G2 cells in a characteristic dose dependent manner. There was considerable cell detachment, loss of viability and alterations in cellular morphology that were indicative of toxic insult. We observed cell shrinkage at highest concentrations (88 microM) suggesting an involvement of apoptosis. This finding was substantiated by the flow cytometry data and DNA fragmentation analysis which clearly indicated that INH induced cytotoxicity, was being mediated by induction of apoptosis. Furthermore there was mitochondrial dysfunction as indicated by significant inhibition of MTT Reduction as compared to control at all the concentrations and depletion of cellular glutathione (GSH) content along with increased production of Reactive oxygen species (ROS). Collectively these findings led us to conclude that INH induced apoptosis in Hep-G2 cells is mediated by generation of oxidative stress.

Chemokine receptor 5 (CCR5) deletion polymorphism in North Indian patients with coronary artery disease

BACKGROUND

Polymorphisms in genes coding for chemokine receptors, CCR2 and CCR5 have been studied as genetic markers of coronary artery disease (CAD). V64Ile polymorphism in CCR2 has been implicated in the manifestation of myocardial infarction in different populations, but data on association of the CCR5 deletion variant in etiology of CAD are conflicting. In the present study we tested genetic association between CCR5 Delta32 polymorphism and CAD among North Indians (Uttar Pradesh).

METHODS

Two hundred angiographically proven patients with coronary artery disease and two hundred age, sex and ethnically matched controls were genotyped for CCR5 Delta32 polymorphism by polymerase chain reaction. Genotype/allele frequencies were compared in patients and controls using the chi-square test.

RESULTS

The frequency of the heterozygote genotype in the population, including both patient and control group, was 3% and the frequency of the mutant allele Delta32 was 1.5%. CAD patients had a three times higher (4.6% vs. 1.5%) frequency of heterozygote genotype but the differences were statistically not significant. Association analysis did not achieve statistical significance, though odds ratio of 3.13 was observed for heterozygote genotype.

CONCLUSIONS

The allele frequency of the CCR5 Delta32 polymorphism in CAD patients is 2.25% and 0.75% among controls but the differences were not significant. Overall this fits well with the pattern of CCR5 Delta32 allele frequency in Indian subcontinent where it varies from 1 to 3%. The heterozygote (+/ Delta32) genotype does not seem to have any protective role against development of CAD in this population. In fact, North Indian CAD had a higher frequency of CCR5 Delta32 allele suggesting a possible susceptibility trend (odds ratio 3.08, CI 0.83-11.46, chi-square 2.167, NS).

Utility of carotid intimal medial thickness as a screening tool for evaluation of coronary artery disease in pre-transplant end stage renal disease

BACKGROUND

Coronary artery disease (CAD) is associated with a higher incidence of allograft failure and mortality in patients with end-stage renal disease (ESRD) following renal transplant.

AIM

To evaluate the efficacy of using carotid intimal medial thickness (CIMT) to predict the presence of CAD in patients with ESRD, using coronary angiography (CAG) as the gold standard.

MATERIALS AND METHODS

This prospective study enrolled consecutive patients with ESRD who underwent CAG as a part of pretransplant evaluation to rule out the presence of atherosclerotic CAD. An operator who was blinded with respect to the results of the CAG, measured carotid IMT in all patients prior to CAG and recorded it on videotape. Two independent observers blinded to the results of CAG measured carotid IMT offline to validate its predictive accuracy as a noninvasive test in predicting the presence or absence of CAD. Measurement of carotid IMT was done on USG B mode 7.5 MHZ probe [HP 5500 andover, Massachusetts]. Student's t-test was used for inter-group comparisons. Pearson correlation coefficient test was used to assess the relation between CAD and various risk factors and carotid IMT. Linear regression analysis was applied to identify independent factors determining presence of CAD. A P value < 0.05 was considered statistically significant.

RESULTS

Mean CIMT was significantly higher in those with CAD as compared to those without [0.80+/- 0.06 vs.0.70+/-0.06 mm, P< 0.0001). Patients with CIMT> 0.75 mm were older and had more incidence of diabetes(78% vs. 47%; P=0.001). Only 4/53 (7%) of patients with CIMT< 0.75 mm had CAD, vs. 38/52 (73%) in those with CIMT >0.75 mm. The sensitivity and specificity of using CIMT > 0.75 as a predictor of CAD was 90.47%and 73% and its positive and negative predictive values were 0.73 and 0.92. On multivariate analysis, only CIMT was a significant predictor of CAD.

CONCLUSION

Carotid IMT can be used to predict CAD in patients with ESRD. In the absence of other risk factors,patients with IMT< 0.75 mm may not need a pretransplant CAG.

Task Switching as a Two-Stage Decision Process

Saccades represent decisions, and the study of their latency has led to a neurally plausible model of the underlying mechanisms, LATER (Linear Approach to Threshold with Ergodic Rate), that can successfully predict reaction time behavior in simple decision tasks, with fixed instructions. However, if the instructions abruptly change, we have a more complex situation, known as task switching. Psychologists' explanations of the phenomena of task switching have so far tended to be qualitative rather than quantitative, and not intended to relate particularly clearly to existing models of decision making or to likely neural implementations. Here, we investigated task switching using a novel saccadic task: we presented the instructions by stimulus elements identical to those of the task itself, allowing us to compare decisions about instructions with decisions in the actual task. Our results support a relatively simple model consisting of two distinct LATER processes in series: the first detects the instruction, the second implements it.

Peptides and the development of double- and triple-resonance solid-state NMR of aligned samples

Peptides have been instrumental in the development of solid-state nuclear magnetic resonance (NMR) spectroscopy, and their roles in the development of solid-state NMR of aligned samples is reviewed. In particular, the roles of synthetic peptides in the development of triple-resonance methods are described. Recent developments of pulse sequences and NMR probes for triple-resonance NMR of aligned samples are presented.

TNFR2 gene polymorphism in coronary artery disease

BACKGROUND

Recently atherosclerosis and coronary artery disease (CAD) are considered to be inflammatory diseases. The genetic polymorphism in inflammatory markers has been well studied and found to be associated with development of CAD.

AIM

To study the association of biallelic polymorphism at position 196 in exon 6 of tumor necrosis factor 2 (TNFR2) gene and coronary artery disease.

SETTINGS AND DESIGN

The study design was a prospective case control study conducted at a tertiary referral center mainly catering to the north Indian population.

MATERIALS AND METHODS

One hundred and fifty angiographically proven patients with coronary artery disease and one hundred and fifty age matched controls were genotyped for TNFR2 gene by polymerase chain reaction followed by analysis of restriction fragment length polymorphism.

STATISTICAL ANALYSIS

Genotype frequencies were compared in patients and controls by Chi-square test. Binary logistic regression analysis was used to examine the relationship between genotypes and disease, incorporating other variables into the model.

RESULTS

The incidence of CAD in those with MM genotype was 65% and in those with RM genotype was 42%. Genotype frequency shows significant association of MM genotype with development of CAD (P < 0.001; odds ratio-2.585; 95% confidence interval 1.533-4.359). The association of TNFR2 genotype with CAD persisted on logistic regression analysis.

CONCLUSION

MM genotype of TNFR2 gene is associated with development of CAD and RM genotype appears to be protective.

Cellular and humoral immune responses to mycobacterial heat shock protein-65 and its human homologue in Takayasu's arteritis

Expression of heat shock protein (HSP)-65 as well as infiltration of T-cells in arterial lesions and raised levels of circulating antibodies against mycobacterial HSP65 (mHSP65) led us to the concept that mHSP65 or its human homologue (hHSP60) might be involved in the etiopathogenesis of Takayasu's arteritis (TA). Therefore, we investigated mHSP65 and hHSP60 reactive peripheral blood T-cell subsets by BrdU incorporation assay and flow cytometry as well as investigating the different isotypes of anti-mHSP65 and hHSP60 antibodies by ELISA. Eighty-four percent (22/26) of the TA patients were observed to show T-cell proliferation to mHSP65 and hHSP60 whereas only 16% (3/18) healthy controls showed such proliferation (P <0.001). Both HSPs induced proliferation of exclusively CD4+ T-cells and not CD8+ T-cells. We also observed a significantly higher prevalence of only the IgG isotype reactive to mHSP65 and hHSP60 in TA as compared to HC (mHSP65: 92% TA versus 11% HC, P <0.0001 and hHSP60: 84% versus 22%, P <0.001). Our data show a significant correlation between mHSP65 and hHSP60 reactive T-cells (CD3+: r=0.901; CD4+: r=0.968) as well as anti-mHSP65 and anti-hHSP60 IgG antibodies (r=0.814) suggesting an infection induced autoimmunity in TA, possibly induced by molecular mimicry between mHSP65 and hHSP60 or other tissue specific antigens.

Effects of aflatoxin B1 on embryo fetal development in rabbits

Aflatoxin B1 (AFB1), is a food borne mycotoxin produced by fungal species of the genera Aspergillus. To elucidate the teratogenic effects, AFB1 was dissolved in corn oil and given orally to New Zealand White rabbits during 6-18 days of gestation with the dose levels of 0.025, 0.05 and 0.1 mg/kg body weight. To assess pathomorphological features of the anomalies induced by AFB1, the fetal serial sections were histologically examined. There was no maternal mortality in any group. There was non-significant decrease in percent of live fetuses and increase in the percent resorptions and post-implantation losses at 0.1 mg/kg dose group as compared with those of controls. The mean crown to rump lengths of 0.05 and 0.1 mg/kg dose groups were significantly reduced than that of the control. The mean fetal weights were significantly reduced in 0.1 mg/kg dose group than that of other treated groups. The gross anomalies observed included wrist drop and enlarged eye socket whereas, skeletal anomalies were agenesis of caudal vertebrae, incomplete ossification of skull bones and bent metacarpals. The visceral anomalies of microphthalmia and cardiac defects were seen at 0.1 mg/kg dose group. The characteristic histological findings of fetal tissues were distortion of normal hepatic cord pattern and reduced megakaryocytes in liver, fusion of auriculo-ventricular valves, mild degenerative changes in myocardial fibers, microphthalmic eyes and lenticular degeneration. The results of this study indicated that AFB1 was found to be teratogenic in rabbits when given by oral route during gestation days 6-18 and the dose of 0.1 mg/kg could be considered as the minimum oral teratogenic dose. The histological examination of the fetal tissues indicated its importance in identifying the visceral anomalies which were otherwise not visible.

TNFR2 gene polymorphism in coronary artery disease

BACKGROUND

Recently atherosclerosis and coronary artery disease (CAD) are considered to be inflammatory diseases. The genetic polymorphism in inflammatory markers has been well studied and found to be associated with development of CAD.

AIM

To study the association of biallelic polymorphism at position 196 in exon 6 of tumor necrosis factor 2 (TNFR2) gene and coronary artery disease.

SETTINGS AND DESIGN

The study design was a prospective case control study conducted at a tertiary referral center mainly catering to the north Indian population.

MATERIALS AND METHODS

One hundred and fifty angiographically proven patients with coronary artery disease and one hundred and fifty age matched controls were genotyped for TNFR2 gene by polymerase chain reaction followed by analysis of restriction fragment length polymorphism.

STATISTICAL ANALYSIS

Genotype frequencies were compared in patients and controls by Chi-square test. Binary logistic regression analysis was used to examine the relationship between genotypes and disease, incorporating other variables into the model.

RESULTS

The incidence of CAD in those with MM genotype was 65% and in those with RM genotype was 42%. Genotype frequency shows significant association of MM genotype with development of CAD (P < 0.001; odds ratio-2.585; 95% confidence interval 1.533-4.359). The association of TNFR2 genotype with CAD persisted on logistic regression analysis.

CONCLUSION

MM genotype of TNFR2 gene is associated with development of CAD and RM genotype appears to be protective.

T1 and M1 polymorphism in glutathione S-transferase gene and coronary artery disease in North Indian population

BACKGROUND

DNA damage has been found to play an important role in atherosclerosis and coronary artery disease. Genetic polymorphisms of the genes coding for enzymes involved in the metabolism of genotoxins result in different phenotypes with respect to their ability to detoxify these agents. In the present study the contribution of the polymorphism in the glutathione S-transferase gene to the development of coronary artery disease has been investigated.

METHODS

One hundred and ninety seven angiographically proven patients with coronary artery disease and one hundred and ninety eight age-matched controls were genotyped for glutathione S- transferase polymorphism by polymerase chain reaction. Genotype frequencies were compared in patients and controls by Chi-square test. Binary logistic regression was used to examine the relationship between genotype and disease, incorporating other variables into the model.

RESULTS

GSTT1 null genotype was significantly decreased in patients with coronary artery disease. No significant association was found with GSTM1 genotypes. No such association was seen with smokers.

CONCLUSION

Null genotype of GSTT1 is protective against coronary artery disease in our population.

Interleukin-8 in Takayasu's arteritis: plasma levels and relationship with disease activity

OBJECTIVE

To investigate the plasma levels of interleukin-8 (IL-8) in Takayasu's arteritis (TA) and their relationship with disease activity.

METHODS

IL-8 levels were detected by quantitative enzyme-linked immunosorbent assay (ELISA) in the plasma of 53 TA patients, 25 age/sex-matched healthy controls and of 10 serially followed up active TA patients on immunosuppressive therapy.

RESULTS

Significantly increased levels of IL-8 were observed in TA patients (26.32 +/- 48.96 pg/ml) compared to controls (6.0 +/- 2.45 pg/ml) (p = 0.0006) and in patients with active TA (55.0 +/- 71.43 pg/ml) compared to those with an inactive disease (8.94 +/- 6.35 pg/ml) (p = 0.0001). The increased levels of the chemokine were present in 37% (20/53) of the patients compared to 8% (2/25) of the controls (p < 0.01) and in 80% (16/20) of patients with active TA compared to 12% (4/33) of those with an inactive disease (p < 0.0001). In the follow-up study, the plasma levels of IL-8 were normalized in 6/10 of the patients and the disease in 5 of these 6 patients was also observed to undergo remission.

CONCLUSION

These results suggest that IL-8 may play an important role in the pathogenesis of TA.

Anti-annexin V antibodies in Takayasu's arteritis: prevalence and relationship with disease activity

Annexin V has an important role in the regulation of apoptosis and antibodies directed against it have been shown to lead to apoptosis of vascular endothelial cells. To evaluate the role of anti-annexin V antibodies (AA5A) in Takayasu's arteritis (TA), we investigated these antibodies in the sera of 66 TA patients, 50 healthy controls and in the follow-up sera of 12 active TA patients by enzyme-linked immunosorbent assay. The AA5A-positive patients were analysed further for the presence of anti-endothelial cell antibodies (AECA) and anticardiolipin antibodies (ACLA) to determine the relationship of AA5A with these autoantibodies. AA5A were observed in 36% (24/66) of the patients versus 6% (3/50) of the controls (P<0.001) and in 53% (19/36) of patients with active TA versus 17% (5/30) of those with inactive disease (P<0.01). Levels of AA5A were also observed to be significantly higher in patients with TA compared to controls (0.557 +/- 0.362 versus 0.259 +/- 0.069; P<0.0001) and in patients with active disease compared to those with inactive disease (0.700 +/- 0.403 versus 0.385 +/- 0.205; P<0.0001). In the follow-up study, 6/12 patients who became inactive during follow-up also showed normalization of AA5A levels. AECA and ACLA were detected in 54% (13/24) and 12% (3/24) of the AA5A-positive patients, respectively. Our results show that a significant proportion of TA patients have AA5A, which exhibit an association with AECA and because they have a correlation with disease activity thus appear to be involved in the disease pathogenesis.

Absence of factor V Leiden (G1691A) mutation, FII G20210A allele in coronary artery disease in North India

BACKGROUND

Interaction between various genetic and environmental factors is associated with coronary artery diseases (CADs). Factor V Leiden mutation (FVL) and FII G20210A polymorphism are two recently described genetic factors with a propensity towards venous thrombosis, however, with a doubtful role in coronary artery disease and myocardial infarction.

AIM

Present study was conducted to assess the relationship of both these factors in coronary artery disease in population from North India.

SETTING AND DESIGN

Case control study.

MATERIAL AND METHODS

Two hundred angiographically proven coronary artery disease patients were studied to examine the association of Factor V Leiden mutation and FII G20210A mutation with coronary artery disease and myocardial infarction. Out of 200 patients, 51 had myocardial infarction. Two hundred controls were selected who were from north India and were also age and sex matched.

RESULTS AND CONCLUSIONS

Our results indicate that both these polymorphisms were totally absent in our population, therefore, these variants cannot be considered as independent risk factors or as a predictor for CAD. However, there is a need to confirm the above findings on patients from different populations from different parts of the country as there are reports which show that the incidence of Factor V Leiden varies from 1.3 % to 10%.