A comparative study on antioxidant activity and biochemical profile of exotic cocoa (Theobroma cacao L.) clones

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A Study on Serum Fibrinogen as an Independent Predictor of Major Adverse Cardiac Events (MACE) in known Diabetic Coronary Artery Disease Patients

INTRODUCTION: Diabetes Mellitus is one of the leading cause of morbidity and mortality worldwide. Its Prevalence is gearing up at a faster pace all over the world especially in developing countries like India. It is the most important risk factor in the pathogenesis of Acute Coronary syndrome. Coronary artery disease is one of the most common Macro vascular complications of Diabetes, especially Type 2 diabetes. It is the leading cause of mortality and morbidity in diabetes. In addition, diabetic patients are likely to have Poor treatment outcome compared with non-Diabetic controls. Its occurrence is increasing in younger age group,causing premature coronary artery disease and premature death inflicting economic burden to the family and to the society. Recently studies are focussing on serum Fibrinogen and its role in the pathogenesis of Coronary artery disease in Diabetes. Fibrinogen being an acute phase reactant is also a pro-coagulant. It plays a major role in coagulation of blood. It has a significant role in Athero-thrombosis. Hence its role in adverse cardiac events in Diabetics and its prognostic value is currently the study of interest. AIMS & OBJECTIVES: 1. To determine the concentration of Fibrinogen in diabet ic CAD and its causal relationship to adverse cardiac events. 2. To ascertain serum fibrinogen‟spredictive value of major adverse cardiac events in Diabetic CAD. 3. To ascertain the prognostic value of serum fibrinogen in Diabetic patients presenting with subs equent major adverse cardiac events. 4. To evaluate the relation between serum Fibrinogen and other factors that cause adverse cardiac events. MATERIALS AND METHODS: Study site: Department of General Medicine, Government Stanley Medical College and Hospital, Chennai. Collaborating Departments: Department of Cardiology and Department of Medical Biochemistry. Study Design: Cross sectional study. Study Period: June 2012 to November 2012. Selection of study population: Inclusion criteria: Diabetic inpatients with past history or evidence of Coronary artery disease. Sample size: • Using the above mentioned criteria 50 subjects were Recruited. Sampling method: • Convenience sampling method was adopted. Exclusion Criteria: • Disseminated intravascular coagulation. • Pregnancy. • Liver disease. • Sepsis. • Drug abuse like OCP,Antifibrinolytic, hormones. • Dysfibrinogenemia. CONCLUSION: The summary of results obtained is as follows: The study included 50 diabetic patients with coronary artery disease. • Age varied from 44 to 78 years. • 52% of the patients suffered from major adverse cardiac events(recurrent angina and congestive cardiac failure). • Older patients had more severe forms of major adverse cardiac events. • There is no significance between gender of patients and severity of major adverse cardiac events. • Longer the duration of diabetes more severe the major adverse cardiac events. • Higher blood sugar levels and poorer glycemic control leads to severe major adverse cardiac events. • No correlation between mean serum fibrinogen level and age or gender of the patient. • Mean serum fibrinogen levels was significantly higher in patients with longer duration of diabetes, higher blood sugars and poor glycemic control. • Increase in severity of major adverse cardiac events correlates with increase in serum fibrinogen titres

Anti asthmatic effect of Momordica Charantia and its comparison with montelukast an in vitro and in vivo model

Background: Momordica charantia (MC) (bitter gourd) have shown the inhibition of NF-κβ and Leukotrienes expression in many inflammatory pathological conditions. Based on ist anti-inflammatory action this study aimed to Identify MC fruit dry powder (MCp) and MC fresh juice (MCj) action on airway inflammation in Guinea Pig model and also to find out the presence of alkaloids and flavonoides.Methods: 18 adult Guinea pigs of both sexes (excluding mating animals) were randomly divided into three groups with six animals in each namely Montelukast, MCj and MCp groups respectively. They were given with OD oral administration of concerned drugs for 1 -7 days. 6 control animals were exposed to 2% histamine aerosol for 120 seconds using histamine chamber prior to treatment with Montelukast, MCj and MCp to observe the normal Pre-Convulsive Dyspnea (PCD) in seconds. After six hours of daily OD oral dose of test drugs administration, all the groups’ were exposed to 2% Histamine aerosol one by one for 120 sec on day1 & 7 to observe PCD. The MCj and MCp were also tested with chemical assay, TLC to confirm the presence of alkaloids, flavonoides.Results: ON DAY 1 and 7: MCj and MCp showed significant decrease in PCD occurrence and it is statistically significant compared to the control. PCD blocking action of MCj group was effective in DAY 1. TLC and Chemical Assay were not supportive for bronchodilator action.Conclusions: MCj and MCp have promising preventive role in asthma. This study had expressed the positive protective role of Momordica charantia in asthmatic condition based on its known anti-inflammatory action.

Demand-side financing for maternal and newborn health: what do we know about factors that affect implementation of cash transfers and voucher programmes?

BackgroundDemand-side financing (DSF) interventions, including cash transfers and vouchers, have been introduced to promote maternal and newborn health in a range of low- and middle-income countries. These interventions vary in design but have typically been used to increase health service utilisation by offsetting some financial costs for users, or increasing household income and incentivising 'healthy behaviours'. This article documents experiences and implementation factors associated with use of DSF in maternal and newborn health.MethodsA secondary analysis (using an adapted Supporting the Use of Research Evidence framework - SURE) was performed on studies that had previously been identified in a systematic review of evidence on DSF interventions in maternal and newborn health.ResultsThe article draws on findings from 49 quantitative and 49 qualitative studies. The studies give insights on difficulties with exclusion of migrants, young and multiparous women, with demands for informal fees at facilities, and with challenges maintaining quality of care under increasing demand. Schemes experienced difficulties if communities faced long distances to reach participating facilities and poor access to transport, and where there was inadequate health infrastructure and human resources, shortages of medicines and problems with corruption. Studies that documented improved care-seeking indicated the importance of adequate programme scope (in terms of programme eligibility, size and timing of payments and voucher entitlements) to address the issue of concern, concurrent investments in supply-side capacity to sustain and/or improve quality of care, and awareness generation using community-based workers, leaders and women's groups. ConclusionsEvaluations spanning more than 15 years of implementation of DSF programmes reveal a complex picture of experiences that reflect the importance of financial and other social, geographical and health systems factors as barriers to accessing care. Careful design of DSF programmes as part of broader maternal and newborn health initiatives would need to take into account these barriers, the behaviours of staff and the quality of care in health facilities. Research is still needed on the policy context for DSF schemes in order to understand how they become sustainable and where they fit, or do not fit, with plans to achieve equitable universal health coverage

A Comparative Study of Subfascial Endoscopic Perforator Surgery [SEPS] Versus Open Perforator Ligation [OSPL] in the Treatment of Great Saphenous Varicose Veins

INTROODUCTION: Varicose veins are defined as dilated and tortuous subcutaneous veins, larger than 4mm in the upright position. Severity of the disease may vary from telangiectatic veins to venous ulceration. Subfascial endoscopic perforator surgery (SEPS) is a new minimally invasive technique performed in patients with advanced chronic venous insufficiency, enables surgeons to address perforator vein incompetence less invasively, with small upper calf incisions remote from severely diseased skin in the distal leg, with less surgical complications compared to open subfascial perforator ligation. AIM OF THE STUDY: The aim of the study is to compare the outcomes and complications of open subfascial perforator ligation versus endoscopic perforator surgery (SEPS) for treatment of varicose veins in terms of intra operative time, number of perforators clipped/ligated. Post op pain, day of discharge, day of return to work ,scar size. Present study concludes that SEPS is feasible and cost effective technique. METHODOLOGY: After consulting with the statistician the sample size was set as 50 patients in the study as per the following calculation. SAMPLE SIZE: The required sample size is 12 patients per group by using formula. But after consideration the lost to follow up and to power the study, sample size will be 25 patients per group to test the mean difference between two groups for pain reduction (VAS score). The nMaster (2.0) software was used to calculate the sample size. INCLUSION CRITERIA: All consenting patients presenting with Great saphenous varicose veins and perforator incompetence. Age group between 18 and 65 years. EXCLUSION CRITERIA: Pregnancy, Morbid obesity, Uncontrolled medical conditions, History of previous varicose vein surgeries over the same leg, Patient unfit for anaesthesia. CONCLUSION: It is comparable with OSPL in terms of pre operative diagnosis, intra operative time ,number of perforators clipped/ligated, post operative pain, day of discharge, day of return to work, scar size and post op missed perforators. The operative time in SEPS technique is significantly low as compared to OSPL. The number of perforators clipped in SEPS is significantly higher as compared to number of perforators ligated in OSPL .Post operative pain at day 1, day 3, day 7 is significantly lower in SEPS as compared to OSPL Day of return to work and number of missed perforators assessed post operatively by Doppler study show that there is no significant difference .SEPS has cosmetic benefits over OSPL, both statistically and clinicall

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