A REVIEW ON HYPERHOMOCYSTEINEMIA AND ITS RISK FACTORS

ABSTRACTHyperhomocysteinemia (Hhcy) is a pathological condition characterized by abnormally large levels of homocysteine in blood. Homocysteine (Hcy) is a highly reactive sulphur-containing amino acid derived from methionine, an essential amino acid. Excess homocysteine produced in the body is excreted out of the tightly regulated cell environment into the blood. It is the role of the liver and kidney to remove excess Hcy from the blood. Hyperhomocysteinemia increases the generation of ROS by activating NADPH oxidase, downregulates the endothelial nitric oxide synthase (eNOS) and thus reduces the bioavailability of nitric oxide (NO). Moreover, it increases the production of proinflammatory cytokines like tumor necrosis factor-α (TNF-α) by activating nuclear factor-kappa B (NF-κB). Hyperhomocysteinemia is caused by the excess deficiencies of the vitamins like pyridoxine (B6), folic acid (B9), or B12 and is considered as an independent risk factor for various cardiovascular diseases like endothelial dysfunction, vascular inflammation, atherosclerosis, hypertension, cardiac hypertrophy and heart failure.Â

PREVALENCE AND RISK FACTOR OF POLYCYSTIC OVARIAN SYNDROME

ABSTRACTPolycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women. Its clinical manifestation varies from mild to severedisturbance of reproductive and metabolic functions. PCOS is clinical and public health importance because it is affecting up to one in five womenof reproductive age. It is an X-linked dominant condition and has diverse clinical implications such as psychological features (anxiety, depression),reproductive features (hirsutism and hyperandrogenism), and impaired glucose tolerance. It is widely dependent on environmental, genetic, ethnicityfactors including lifestyle and body weight. Weight loss improves the endocrine profile and increases chances of ovulation and pregnancy. It canbe treated with medications such as clomiphene citrate, tamoxifen, aromatase inhibitors, and gonadotrophins. The last option for fertilization isin vitro fertilization when other treatment fails. Its prevalence is estimated at 4-8% from studies performed in Spain and USA. Lifestyle including diet,exercise, and behavior therapy improves fertility. PCOS has unique interactions with the ever increasing obesity prevalence worldwide as obesityinducedinsulin resistancesignificantlyaggravatesall thefeaturesof PCOS.EducationabouthowPCOSaffectslong-termhealth shouldbe providedtowomenwith this disordertofeelphysicaland psychologicalbenefits so that theycould engagethemselvesmorewith their health careproviders.Keywords: Polycystic ovarian syndrome, Hyperinsulinemia, Hormone disbalance, Hirsutism, Ovarian cyst, Obesity, Sleep disorders

Role of cardiac renin angiotensin system in ischemia reperfusion injury and preconditioning of heart

Cardio-vascular diseases are the leading cause of morbidity and mortality. Ischemia is a state of oxygen deprivation in tissues, whereas reperfusion is restoration of blood flow in ischemic tissues. Myocardial damage of tissue during reperfusion after ischemic insult is known as myocardial ischemia–reperfusion (I/R) injury. It induces damage to cardiac muscle via increasing expression of oxygen, sodium and calcium ions which are responsible in the activation of proteases and cell death. Heart renin angiotensin system (RAS) plays an important role in the myocardial ischemia and reperfusion injury. Angiotensin (1–7) is responsible for vasodilation and angiotensin II for vasoconstriction. Here-in we reviewed how myocardial I/R injury sets in by up-regulation of angiotensin II that leads to increased infarct size, which can be reduced by the use of ACE inhibitors, ACE2 activators and angiotensin II antagonist