Genetic Association Between Insulin Resistance And Total Cholesterol In Type 2 Diabetes Mellitus - A Preliminary Observation

We investigated the degree of genetic association between insulin resistance (IR) with type 2 diabetes mellitus (DM) and abnormalities in lipid metabolism in 42 patients. IR was assessed by fasting insulin test (FI), McAuley (McA), HOMA and QUICKI methods. IR was detected in 34 (81%) patients by FI, McA and in 39 (93%) patients by HOMA and QUICKI. 26 (62%) patients had family history of DM and 23 (89%) of them displayed IR by FI & McA. 24 of them (92%) displayed IR by HOMA and QUICKI. Our results suggest that association between the family history of DM and IR were statistically significant by chi-square test (P<0.05). Further, 29 (69%) patients had elevated total cholesterol levels. Association between elevated total cholesterol and IR as assessed by FI test was also statistically significant (x2=4.6; p<0.05). Results of our study indicate the statistically significant genetic association of IR with abnormal cholesterol metabolism and family history of D

Effects of Deliberate Ingestion of Organophosphate or Paraquat on Brain Stem Auditory-Evoked Potentials

Organophosphate (OP) and paraquat (PQ) ingestion is a serious health problem. A common pathology behind OP or PQ poisoning is the generation of reactive oxygen species (ROS) which is known to cause ototoxicity. The aim of the study was to identify the effects of deliberate ingestion of OP or PQ on brain stem auditory-evoked potentials (BAEPs). Consecutive patients with deliberate self-poisoning with OP or PQ who were admitted to a secondary and a tertiary care hospital in the Southern province of Sri Lanka and matched controls were recruited. BAEPs were performed at 1 week (first assessment) and 6 weeks (second assessment) after the exposure. Interpeak latencies of I–III, III–V, and I–V were measured. There were 70 and 28 patients in the OP and PQ arms with the mean age of 32 ± 12 and 29 ± 12 years, respectively. There were 70 controls and their mean age was 33 ± 12 years. In OP and PQ poisoning, 53/70 and 18/28 came for the second assessment, respectively. The interpeak latency was not statistically different in the controls vs the first assessment, controls vs the second assessment, and the first vs the second assessment. There were no significant lesions in the auditory pathway in OP or PQ poisoned patients. The generation of ROS within the perilymphatic space following the ingestion of OP or PQ may not be sufficient to cause lesions in the auditory pathway. Further studies with the assessment of auditory threshold are needed

Autonomic Function following Acute Organophosphorus Poisoning: A Cohort Study

Autonomic dysfunction after chronic low level exposure to organophosphorus (OP) pesticides has been consistently reported in the literature, but not following a single acute overdose. In order to study autonomic function after an acute OP overdose, sixty-six overdose patients were compared to 70 matched controls. Assessment of autonomic function was done by heart rate response to standing, deep breathing (HR-DB) and Valsalva manoeuvre; blood pressure (BP) response to standing and sustained hand grip; amplitude and latency of sympathetic skin response (SSR); pupil size and post-void urine volume. The patients were assessed one and six weeks after the exposure. The number of patients who showed abnormal autonomic function compared to standard cut-off values did not show statistically significantly difference from that of controls by Chi-Square test. When compared to the controls at one week the only significant differences consistent with autonomic dysfunction were change of diastolic BP 3 min after standing, HR-DB, SSR-Amplitude, SSR-Latency, post-void urine volume and size of the pupil. At 6 weeks significant recovery of autonomic function was observed and only HR-DB was decreased to a minor degree, −5 beats/min [95%CI 2–8]. This study provides good evidence for the lack of long term autonomic dysfunction following acute exposure to OP pesticides

Slow Repetitive Nerve Stimulation in Patients with Acute Organophosphorus Poisoning after Clinical Recovery

Background: Prolonged inhibition of acetylcholine esterase may lead to the intermediate syndrome. Neuromuscular junction (NMJ) dysfunction has been shown with repetitive nerve stimulation (RNS). Subclinical NMJ dysfunction may also occur. We aimed to examine the NMJ function following acute organophosphorus (OP) poisoning by using exercise modified slow RNS. Methods: A cohort study was conducted with matched controls. Patients with acute OP poisoning were enrolled. NMJ function, muscle power and tendon reflexes were assessed at discharge and six weeks after exposure. NMJ function was assessed with exercise modified supramaximal slow RNS of the median nerve. Results: There were 68 patients and 71 controls. Mean (SD) age of patients and controls were 32 (12) and 33 (12) years. In some particular amplitude, the decrement response was statistically significant. They were decrement response at rest, at fourth amplitude (95% CI: -0.2 to -2.7) and two minutes post-exercise at fourth and fifth amplitudes (95% CI: -0.8 to -5, -1 to -5 respectively) in the second assessment compared to controls, decrement response at rest at fourth and fifth amplitudes (95% CI: -4 to -0.5, -3.9 to -0.01 respectively) and two minutes post-exercise at fourth amplitude (95% CI: -5 to -0.8) in the second assessment compared to the first assessment. Patients in the first assessment and controls showed more than 8% decrement response either to the second, fourth or fifth stimuli in seven and five occasions respectively. Conclusion:  There was no significant neuromuscular junction dysfunction assessed by exercise modified slow repetitive stimulation following acute exposure to OP. Since, NMJ dysfunctions are likely to occur following OP poisoning, other electrodiagnostic modalities such as SF-EMG are probably more efficient to assess these abnormalities

Correlation matrix to identify multicollinearity.

<p>Analyzed with Spearman's correlation. Values are Spearmans's rho (P value),</p>‡<p>significant at 0.05 level.</p

Descriptive data of the participants.

©<p>values are mean (SD).</p

Autonomic function assessment in patients and controls.

<p>Values are in mean (SD) except</p>†<p>median (interquartile range),</p>‡<p>significant at 0.05 level (2-tailed).</p

Cut-off values of autonomic function tests [11].

<p>Cut-off values of autonomic function tests <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0037987#pone.0037987-Ewing3" target="_blank">[11]</a>.</p

Number of poisoned cases by type of OP.

<p>Number of poisoned cases by type of OP.</p