Effect of vitamin D on vascular health in hypertensive patients with vitamin D deficiency

Background: Many observational studies have shown association of cardiovascular disease and vitamin D deficiency. However, there is a need for prospective studies to show causal effect of vitamin D and cardiovascular diseases in India. Hence the present study was designed to study the effect of vitamin D on markers of vascular health in hypertensive patients with vitamin D deficiency. The objective of the study was to assess the effect of vitamin D supplementation on markers of vascular health in hypertensive patients with vitamin D deficiency.Methods: Hypertensive patients were screened for vitamin D deficiency defined as 25 OH vitamin D less than 20 ng/mL after written informed consent. Hypertensives deficient with 25 OH vitamin D were recruited for the study to receive cholecalciferol 60000 IU/ week for 8 weeks. The vascular parameters such as blood pressure, pulse wave velocity, arterial stiffness index, malondialdehyde and total antioxidant status were assessed at baseline and after 8 weeks of cholecalciferol. The results were analysed using paired‘t’ test.Results: A total of 119 hypertensive patients were screened for vitamin D status. Among them 57 patients were found to be vitamin D deficient (48.7%). Thirty two patients completed the study. The baseline serum 25 OH vitamin D3 was 12.55 ± 5.7 ng/mL and it increased to 40.06 ± 10.53 ng /mL after 8 weeks.Conclusions: The vascular parameters didn’t show any statistically significant difference between baseline and at 8 weeks. However trend for decline was observed for malondialdehyde, right brachial pulse wave velocity

Acute transverse myelitis: A rare neurological complication following wasp sting

Los catalizadores a base de carbón se presentan como una alternativa para la reacción de eterificación de glicerol, ya que pueden ser preparados a partir de precursores de bajo costo, resultan estables en condiciones de reacción no oxidantes, y ofrecen la posibilidad de ser funcionalizados y recuperados para su reutilización. En el presente trabajo se estudió la obtención de materiales carbonosos (Sintetizados con template, por carbonización directa o sintetizados y funcionalizados en un solo paso) funcionalizados con diferentes grupos sulfónicos (-SO3H y -PhSO3H) para emplearlos como catalizadores heterogéneos en la reacción de eterificación de glicerol (Gly) con alcohol bencílico (BA). Los resultados obtenidos fueron comparados con el desempeño catalítico (conversión y selectividad) de un carbón comercial (Cc), sulfonado en las mismas condiciones. A todos los sistemas ensayados (con y sin tratamiento de funcionalización) se les realizó el análisis superficial, microscopía SEM-EDAX, análisis termogravimétricos, FTIR y se les determinó la concentración de sitios ácidos. El avance de la reacción se siguió mediante el análisis de micromuestras en cromatografia gaseosa y los compuestos de reacción se identificaron utilizando un CG/MS. Para estudiar la estabilidad de los sistemas, se evaluó la reutilización de dichos materiales manteniendo las condiciones de reacción. El método de carbonización con "template" de sílicato resultó el más adecuado para conseguir un material carbonoso con características superficiales apropiadas para su posterior sulfonación (Cst-SO3H y Cst-PhSO3H). Con estos sistemas se consiguieron buenos resultados de conversión de BA (próximos al 100%) y de selectividad hacia dos de los productos de interés (mayor al 85% para la suma del mono y diéter). Además, estos catalizadores mostraron un desempeño aceptable luego de tres ciclos consecutivos de reacción. Sin embargo, la conversión obtenida fue menor ciclo tras ciclo, producto del bloqueo y lixiviado de los sitios ácidos.Universidad Nacional de La Plat

Comparison of Hemoglobin A1c with fasting and 2-h plasma glucose tests for diagnosis of diabetes and prediabetes among high-risk South Indians

Background: Glycosylated hemoglobin (HbA1c) has not been evaluated extensively for diabetes and prediabetes diagnosis and short-term variability of fasting plasma glucose (FPG), 2-h PG post-75 g glucose load (2 hPG) and HbA1c has not been studied among Indians. Objectives: The study aimed to compare the sensitivity of HbA1c, FPG and 2 hPG for diabetes and prediabetes diagnosis as per the American Diabetes Association criteria, assess short-term variability of three tests and determine optimal HbA1c cutoffs for diabetes and prediabetes diagnosis among high-risk south Indians. Methods: This diagnostic accuracy study, conducted at a tertiary care teaching hospital located in South India, enrolled 332 adults at high risk for diabetes and subjected them to testing (FPG, 2 hPG, and HbA1c) twice at 2–3 weeks interval. Sensitivity of three tests for diagnosing diabetes and prediabetes was determined based on the final diagnosis of normoglycemia/prediabetes/diabetes made with six test results for each participant. Optimal HbA1c cutoffs for diabetes and prediabetes were determined based on the final diagnosis of glycemic status made with four test results of FPG and 2 hPG. Results: FPG, 2 hPG, and HbA1c, at American Diabetes Association recommended values, had sensitivity of 84.4%, 97%, and 93.8% respectively for diabetes diagnosis. HbA1c had lowest short-term variability (CVw = 1.6%). Receiver operating characteristic curve plotted with mean (of two values) HbA1c for each participant showed optimal HbA1c cutoffs of 6.5% for diabetes (area under curve [AUC] =0.990, sensitivity = 95.8%, specificity = 96.2%, accuracy = 95.2%) and 5.9% for prediabetes (AUC = 0.893, sensitivity = 84.3%, specificity = 80%, accuracy = 75.6%) diagnosis respectively. HbA1c <5.6% had 100% negative predictive value to exclude prediabetes/diabetes. Conclusions: HbA1c ≥6.5% is a convenient and reliable alternative to plasma glucose tests to diagnose diabetes among high-risk South Indians. HbA1c ≥5.9% is optimal for prediabetes diagnosis and value <5.6% excludes prediabetes/diabetes

Disseminated kaposi's sarcoma in an HIV-positive patient: A rare entity in an Indian patient

AIDS-associated disseminated Kaposi sarcoma (KS) is a rare entity, especially in India due to the low prevalence of human herpes virus-8 infections in Indian population. Due to its rapid and progressive nature, early diagnosis and institution of highly active antiretroviral therapy is crucial in AIDS-associated KS, with a view to achieving favorable prognosis. We report a case of disseminated KS in an HIV-1 positive patient, who presented with two months history of multiple violaceous patches and plaques over the trunk, bilateral upper limbs, lower limbs, and hard palate. The patient died of recurrent massive pleural effusion before starting antiretroviral therapy. This case is being reported due to the paucity of KS in the Indian literature, especially the disseminated type and to highlight its rapidly progressive course which can be fatal

Assessment of vascular function in complete glycaemic spectrum

Purpose: The present study was conceived to delineate the point of vascular dysfunction along the glycemic spectrum (normoglycemic individuals with no family history of diabetes, normoglycemic individuals with family history of diabetes, prediabetic individuals, and diabetic individuals). Materials and Methods: In this cross-sectional comparative study, we enrolled 252 participants of both gender in the age group of 30–50 years. They were classified based on their family history of diabetes and glycemic status into four groups along the glycemic spectrum as mentioned above. We measured flow-mediated dilation (FMD) from brachial artery and vascular function biomarkers such as enthothelin-1 (ET-1), von Willbrand Factor (vWF), Vascular Endothelial Growth Factor (VEGF) to assess the vascular function. The comparison of data between groups were done using One Way ANOVA/Kruskal–Wallis followed by post-hoc analysis using LSD/Mann–Whitney U Test depending on the normality of the data. Spearman correlation was done between vascular function and plasma glucose levels to identify its relationship. Linear regression was carried out to identify the factors influencing the FMD across the glycemic spectrum. Results: We observed that vascular function negatively correlated with blood glucose levels. However, endothelin-1 and vWF derangement was there even in normoglycemic first degree relatives of diabetes (FDRD) and the derangement increased in prediabetes and diabetes. Physiological dysfunction in terms of decreased flow-mediated dilation starts from prediabetes only. VEGF derangement is found only in diabetic individuals. Conclusion: Vascular dysfunction is found even in normoglycemic FDRD and the derangement increased and compounded with the advancement of disease

Effect of vitamin D on vascular health in hypertensive patients with vitamin D deficiency

Background: Many observational studies have shown association of cardiovascular disease and vitamin D deficiency. However, there is a need for prospective studies to show causal effect of vitamin D and cardiovascular diseases in India. Hence the present study was designed to study the effect of vitamin D on markers of vascular health in hypertensive patients with vitamin D deficiency. The objective of the study was to assess the effect of vitamin D supplementation on markers of vascular health in hypertensive patients with vitamin D deficiency.Methods: Hypertensive patients were screened for vitamin D deficiency defined as 25 OH vitamin D less than 20 ng/mL after written informed consent. Hypertensives deficient with 25 OH vitamin D were recruited for the study to receive cholecalciferol 60000 IU/ week for 8 weeks. The vascular parameters such as blood pressure, pulse wave velocity, arterial stiffness index, malondialdehyde and total antioxidant status were assessed at baseline and after 8 weeks of cholecalciferol. The results were analysed using paired‘t’ test.Results: A total of 119 hypertensive patients were screened for vitamin D status. Among them 57 patients were found to be vitamin D deficient (48.7%). Thirty two patients completed the study. The baseline serum 25 OH vitamin D3 was 12.55 ± 5.7 ng/mL and it increased to 40.06 ± 10.53 ng /mL after 8 weeks.Conclusions: The vascular parameters didn’t show any statistically significant difference between baseline and at 8 weeks. However trend for decline was observed for malondialdehyde, right brachial pulse wave velocity