Analysis of plasma myeloperoxidase levels and functional gene –463G>A and –129G>A polymorphisms with early onset of coronary artery disease in South Indian population

Introduction. The present investigation is pursued to study the possible association of –463G>A and –129G>A polymorphism in MPO gene and assessment of plasma MPO levels with the risk of developing coronary artery disease.Material and methods. A total of 200 angiographically documented CAD patients and 200 age, gender ethnicity matched healthy controls were recruited for the study. Plasma MPO levels were assessed using enzyme-linked immunosorbent assay (ELISA) kit and genotypes were determined by PCR-RFLP technique.Results. The MPO levels were found to be significantly increased in CAD patients when compared with controls (p < 0.04) but there were no significant effect of –463G>A gene polymorphism on MPO levels. A significant association of –463G>A polymorphism was observed with coronary artery disease. The frequency of recessive genotype “AA” at –463 promoter site was considerably lesser in patients (4%) relative to controls (11%) (odds ratio [OR] = 0.3371, 95% confidence interval [CI] 0.1463–0.7766, p = 0.012). However we did not find significant association of –129G>A polymorphism with CAD. Additionally, haplotype analysis revealed that single nucleotide polymorphisms (SNP) 1 of AA genotype and SNP 2 of GG genotype showed significant protective effect with disease (OR = 0.64; 95% CI [0.42–0.96], p = 0.032).Conclusion. The results revealed that –463G>A polymorphism in the MPO gene lowers the CAD related condition in patients by down regulating serum MPO concentration, which is known to aggravate the atherosclerotic events observed in CAD

Complications and pitfalls of lumbar interlaminar and transforaminal epidural injections

Lumbar interlaminar and transforaminal epidural injections are used in the treatment of lumbar radicular pain and other lumbar spinal pain syndromes. Complications from these procedures arise from needle placement and the administration of medication. Potential risks include infection, hematoma, intravascular injection of medication, direct nerve trauma, subdural injection of medication, air embolism, disc entry, urinary retention, radiation exposure, and hypersensitivity reactions. The objective of this article is to review the complications of lumbar interlaminar and transforaminal epidural injections and discuss the potential pitfalls related to these procedures. We performed a comprehensive literature review through a Medline search for relevant case reports, clinical trials, and review articles. Complications from lumbar epidural injections are extremely rare. Most if not all complications can be avoided by careful technique with accurate needle placement, sterile precautions, and a thorough understanding of the relevant anatomy and contrast patterns on fluoroscopic imaging