Manjula Shantaram

Is HbA1c a risk factor for type 2 diabetic subjects without macro and micro vascular complications

Objective: Our study attempted to evaluate the diagnostic value of HbA1c in predicting diabetic dyslipidemia and cardiovascular diseases (CVD). Methods: Study comprised 229 subjects (156 males and 73 females) with diabetic dyslipidemia without any micro and macro vascular disorders. Fasting blood samples were taken to analyse biochemical parameters like HbA1c, sugar and lipid profile. Results: The HbA1c levels did not differ much between males (6.96 ± 1.11) and females (7.01 ± 1.19). HbA1c demonstrated a positive significant correlation with cholesterol, LDL and a negative significant correlation with HDL. Patients with HbA1c >7.0% had significantly higher value of cholesterol, LDL when compared with <7.0%. Conclusions: The findings of this study clearly suggest that HbA1c endures the ability of predicting CVD risk in the diabetic patients without any micro and macro vascular disorder. Therefore study recommends using HbA1c as a marker for predicting the risk of developing CVD.

Antimicrobial properties of Cocos nucifera (coconut) husk: An extrapolation to oral health

Background and Objectives: Brushing the teeth with fibrous husk of Cocos nucifera (coconut) is a common oral hygiene practice among people of rural areas of South India. However, the probable antimicrobial properties of this plant material against common oral pathogens have not been proved scientifically. Therefore, the present study was designed. Materials and Methods: Alcoholic extract of the husk of Cocos nucifera was prepared and the antimicrobial properties against common oral pathogens like cariogenic bacteria, periodontal pathogens, and candidal organisms were performed by the Agar Well Diffusion Method. The results obtained were then subjected to statistical analysis using One-Way Analysis of Variance (ANOVA) and the Tukeys Honestly Significant Difference (HSD). Results: The alcoholic extract of Cocos nucifera showed a significant concentration-dependent antimicrobial activity, expressed as a zone of inhibition with respect to all tested organisms except Actinomyces species. The inhibitory effect was more significant, with a majority of cariogenic organisms and Candida, with a zone of inhibition ranging from 4.6 mm to 16.3 mm. However, the effect was lesser with Cocos nucifera compared to chlorhexidine. Minimum inhibitory concentration (MIC) ranged from 50 mg/ml to 75 mg/ml. Conclusion: Cocos nucifera has a significant inhibitory action against common oral pathogens, indicating the presence of highly effective antimicrobial compounds. Therefore, it is proved that its use can contribute to oral health to a great extent. Identification of these active compounds provides the scope for incorporating it into a modern oral care system, so as to control oral diseases.

Lipid-bound sialic acid in psoriasis and its correlation with disease severity

Background: Psoriasis is a common chronic persistent inflammatory skin disorder distinguished by hyperproliferation and reduced differentiation of keratinocytes. The inflammatory processes involved may be associated with the development of co-morbidities. Increased levels of total sialic acid have been shown to correlate with inflammation and atherosclerotic processes. Serum sialic acid has been reported as a marker of the acute phase response; increased sialic acid concentrations have been observed in inflammatory diseases and cancer. Objectives of the Study: To estimate serum lipid-bound sialic acid (LBSA) levels in patients with psoriasis and a group of healthy controls. To evaluate the correlation between LBSA levels and the severity of the disease. Materials and Methods: Serum LBSA was estimated in patients and controls by Katopodis and stock method. The degree of severity of psoriasis was clinically assessed by Psoriasis Area and Severity Index (PASI) score for each patient. The statistical significance was evaluated using unpaired ′t′ test and Pearson′s correlation. Results: The mean levels of LBSA in psoriasis cases was found to be higher compared with controls, and it was statistically significant (P < 0.001). There was a mild negative correlation between LBSA levels and PASI , but it did not differ significantly. Conclusion: This study suggests the potential utility of serum LBSA as a biomarker of hyper proliferation, inflammation, and oxidative stress in psoriasis.

Airway compromise due to irrigation fluid extravasation following shoulder arthroscopy

Sir, Shoulder arthroscopy is a commonly used technique for treating injuries or pathologies of the shoulder joint such as supraspinatus tear, subacromial lesion, and recurrent dislocations. Arthroscopy can be performed under general anesthesia with regional block like interscalene block or continuous interscalene block. We report a case of airway complications due to fluid extravasation, which is rare but can be life threatening.

Assessment of biomarkers in type 2 diabetic subjects without any complications.

BACKGROUND Type 2-diabetes (T2D), is a public health problem which has reached epidemic proportions due to the rapidly increasing rates of this disease worldwide. It is known that adipose tissue can synthesize and release pro-inflammatory cytokines, tumor necrosis factor-alpha, interleukin-1, adiponectin and leptin that are associated with body fat mass. Hence comparing the biomarkers with individuals without hyperglycemia would help us to understand the level of increase in their values though the vascular complications have not begun. MATERIALS AND METHODS This was a cross sectional study comprising 229 diabetic persons and 205 healthy individuals. High sensitivity reactive protein (hs-CRP) was estimated using nephelometry technique. Inflammatory markers and adiponectin were measured using ELISA instrument. RESULTS Tumor necrosis factor α (TNF-α) (40.56%) and Leptin (45.43%) were significantly increased in the diabetic group when compared with normal study population. Adiponectin was significantly decreased in diabetic study population (11.94%). This was supported by a significant correlation between the glycemic index HbA1c and TNF-α (r=0.376, p=0.01), adiponectin (r=-0.381, p=0.01) and leptin (r=0.269, p=0.01) in diabetic population, but the significance was lost among the normal healthy individuals. CONCLUSIONS The most promising biomarkers of diabetes such as TNF-α, adiponectin, leptin has shown a marked difference in this diabetic population. This study proves the assessment of these biomarkers as future predictors of type 2 diabetes.

Atherogenic lipid profile in psoriasis: Correlation with severity and duration of the disease

Background: Psoriasis has been considered of late as a dermatological disorder with systemic inflammation that could contribute to various systemic effects like atherogenic dyslipidemia. Materials and Methods: Eighty patients with psoriasis and 80 age and sex matched controls were included in the study for their serum lipid profiles. The lipid values were compared with special emphasis on the duration and severity of the disease. Results: Serum triglycerides were found to be significantly higher in the psoriasis group than in the control group ( P ≤ 0.05). No significant difference was found between serum total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) levels in the two groups. However, Low HDL-C levels were found in patients with disease of more than 2 years ( P ≤ 0.05) and elevated total cholesterol ( P P 12). Conclusion: Atherogenic dyslipidemia is observed in psoriasis, but the degree of change may vary based on the duration and severity of psoriasis. More studies with a higher sample size are required to obtain longitudinal data for conclusive evidence about the systemic effects on lipid profiles in psoriasis.

Antimicrobial properties of coconut husk aqueous extract on cariogenic bacteria

Background and Objectives: The husk fibers of coconut (Cocos nucifera) are reported to be used by people of rural areas of South India for daily cleaning their teeth. As the beneficial effects of this plant material, with respect to antimicrobial properties against common cariogenic bacteria, are not scientifically proven, the present study was conducted. Materials and Methods: The husk of coconut was collected and aqueous extract was prepared and antimicrobial properties against common oral pathogens like Streptococcus mutans, Streptococcus salivarius, Streptococcus mitis, and Lactobacillus acidophilus were performed by agar well diffusion method. The values obtained were then subjected to statistical analysis using one way ANOVA and Tukey HSD. Results: Aqueous extract of coconut husk showed a concentration-dependent antimicrobial activity against different tested organisms with zone of inhibition ranging from 4.44 to 15.33 mms. However, the efficacy was less in comparison to chlorhexidine. Conclusion: Inhibitory action against cariogenic bacteria exhibited by aqueous extract of coconut husk indicate presence of highly effective active compounds in these extracts, which can be identified and incorporated into modern oral care systems for controlling dental caries.