Prakash Kamath

COMPARISON OF LIPID PROFILE AND ANTIOXIDANT ENZYMES AMONG SOUTH INDIAN MEN CONSUMING COCONUT OIL AND SUNFLOWER OIL

In this study, we compared the lipid profile and antioxidant enzymes of normal and diabetic subjects consuming two different types of oil as cooking medium. 70 normal, healthy subjects were taken as controls and 70 subjects with Type 2 diabetes were recruited in patient group. Each group was further subdivided into two subgroups of 35 subjects each, consuming coconut oil and sunflower oil respectively as cooking medium. Samples of blood were collected and analyzed for serum total cholesterol, triacylglycerols, and cholesterol in lipoprotein fractions. Total glutathione and glutathione peroxidase were measured in erythrocytes and superoxide dismutase in serum. Triacylglycerols, LDL and VLDL cholesterol levels were high in the diabetic subjects compared to the controls. Total glutathione and glutathione peroxidase values showed significant decrease in diabetic subjects as compared to the controls, while superoxide dismutase values showed significant difference between coconut oil consuming groups. Though lipid profile parameters and oxidative stress were high in Type 2 diabetic subjects compared to controls, no pronounced changes for these parameters were observed between the subgroups (coconut oil vs. sunflower oil).

Composition of Plasma and Atheromatous Plaque among Coronary Artery Disease Subjects Consuming Coconut Oil or Sunflower Oil as the Cooking Medium

Objectives: Coconut oil, which is rich in medium-chain saturated fatty acids, is the principal cooking medium of the people of Kerala, India. Replacement of saturated fat with polyunsaturated fat is effective in reducing serum cholesterol levels. However, the effect of substituting coconut oil with sunflower oil on the fatty acid composition of plaque has not been thoroughly investigated. We therefore evaluated and compared the fatty acid composition of plasma and plaque among subjects consuming coconut oil or sunflower oil as the cooking medium. Methods: Endarterectomy samples and plasma samples were obtained from subjects who underwent coronary artery bypass grafts (n = 71). The subjects were grouped based on the type of oil they were using as their cooking medium (coconut oil or sunflower oil). The fatty acid composition in the plaques and the plasma was determined by HPLC and the data were analyzed statistically. Results: Sunflower oil consumers had elevated concentrations of linoleic acid (p = 0.001) in plasma, while coconut oil users had higher myristic acid levels (p = 0.011) in plasma. Medium-chain fatty acids did not differ significantly between the two groups in the plasma. Medium-chain fatty acids were detected in the plaques in both groups of subjects. In contrast to previous reports, long-chain saturated fatty acids dominated the lipid content of plaque in this population, and the fatty acid composition of plaque was not significantly different between the two groups. No correlation between fatty acids of plasma and plaque was observed in either group. Conclusion: A change in cooking medium, although it altered the plasma fatty acid composition, was not reflected in the plaque composition.

Permanent pacing in a patient with tricuspid prosthesis – Widening therapeutic use of coronary sinus

Unconventional sites are being used for pacing in patients with inaccessible right ventricle like single ventricle, atresia of tricuspid valve and in anomalous venous drainage. Here we report a case in which the right ventricle could not be accessed due to the metallic prosthesis. A 41-year-old lady required triple valve replacement for rheumatic involvement. Permanent pacemaker implantation was done with epicardial lead for bradycardia post operatively. Pulse generator change was needed within 3 years as the pacemaker reached end of life due to high lead threshold. Subsequent pacemaker implantation was done with a left ventricular lead in coronary sinus by percutaneous approach. One year after implantation, the threshold remains stable. Coronary sinus can be utilized for permanent pacing in patients with inaccessible right ventricle due to prosthetic tricuspid valve.

Estimation of Small, Dense LDL Particles Using Equations Derived FromRoutine Lipid Parameters as Surrogate Markers

Our objective was to assess small, dense LDL particles by using three equations: triglycerides/HDLcholesterol ratio, LDL-cholesterol/LDL-apo B ratio and small, dense particles in mg/dL = 0.580 (non HDL-cholesterol) + 0.407 (direct LDL-cholesterol) – 0.719 (calculated LDL-cholesterol) – 12.05 among normal (n=62) and type 2 diabetes subjects (n=64) and evaluate the correlation between these equations.

Assessment of small, dense LDL particles among subjects consuming coconut oil or sunflower oil as cooking medium by using LDL-cholesterol/LDL-apo B ratio as a surrogate marker

Background : Coconut oil is the major cooking oil used by the people of Kerala. On account of its hypercholesterolemic effects, people are shifting to sunflower oil as an alternate cooking medium. The effect of dietary fats on small, dense low-density lipoprotein (LDL) particles, a newly recognized cardiovascular risk factor, has not been thoroughly investigated in this population. Materials and Methods : We compared the effect of these two cooking oils on apolipoprotein B (apo B) and LDL-cholesterol/LDL-apo B ratio, which is a surrogate for small, dense LDL particles, among 62 control subjects and 64 subjects with type 2 diabetes. The subjects were divided into two subgroups based on the type of cooking medium used (coconut oil/sunflower oil). Total cholesterol, triglycerides, LDL-cholesterol, high density lipoprotein (HDL)-cholesterol and apo B were estimated, and the LDL-cholesterol/LDL-apo B ratio was calculated from these estimations. Results : Triglycerides, LDL-cholesterol, and apo B concentrations were significantly higher among diabetic subjects compared to the control groups. A predominance of small, dense LDL particles indicated by low LDL-cholesterol/LDL-apo B ratio was observed among subjects of both control and diabetic groups. These parameters were not significantly different between subjects with the same clinical condition, but using different cooking media. Conclusions : Small, dense LDL particles could be a major risk factor in this population, given its high prevalence in the study population. As the parameters studied did not differ significantly between the subgroups, it may be concluded that a change in the type of cooking medium has not considerably affected these parameters.