DIAGNOSIS OF MYOCARDIAL ISCHEMIA USING PLASMA FREE FATTY ACID AS A BIOMARKER

Objective: Diagnosis of myocardial ischemia (MI) in patients attending emergency intensive care unit (ICU) with symptoms of an acute coronarydisease is often difficult. Biochemical markers such as cardiac troponin (cTn) and creatinine kinase MB (CK-MB) may not rise during reversible MI.Previous studies suggest unbound free fatty acid (FFA) increased significantly in ischemic related events. Thus, plasma FFA has shown to be an earlybiochemical marker. To diagnose MI using plasma FFA as a biomarker.Methods: Blood samples were collected from 30 ischemic heart disease (IHD) patients admitted to ICU and 30 healthy volunteers for plasma FFA.Patients were diagnosed as IHD based on the clinical presentation, electrocardiogram (ECG), and coronary angiography findings, cTn, CK-MB. PlasmaFFA was measured enzymatically with (acyl-CoA synthetase- acyl-CoA oxidase) non-esterified fatty acid kit (Randox Laboratories Ltd., Co.Antrium,United Kingdom) on Bayer RA 50 analyzer in both normals and IHD patients.Results: Around 93.3% of the patients presented with the chest pain as a major symptom and 6.7% of the patient presented with dyspnea. Allthe patients showed a positive ECG change and angiographic findings suggestive of IHD. Plasma FFA (1.134±0.21) in IHD was significantly higher(p<0.0001) than the control (0.5233±0.13). With respect to lipid profile triglycerides, low-density lipoprotein (LDL), very LDL was significantly higherin MI when compared to normal with p<0.001, whereas HDL was significantly higher in normals than the study group with p<0.05. There was nostatistical difference in total cholesterol and hemoglobin value between the study group and the normals. Further standard biomarker like cTn waselevated in 60% (18) and CK-MB in 63% (19) of the patients when compared to FFA, which was elevated in 86% (26) of the patients.Conclusion: Thus, plasma FFA can be used as a simple, quick, and early marker of MI. However, should FFAs be measured routinely as a standarddiagnostic marker of ischemia still warrants further studies?Keywords: Myocardial ischemia, plasma FFA, cardiac troponin, creatinine kinase M

INFLUENCE OF SHIFT WORK ON PSYCHOLOGICAL HEALTH AND MEMORY PERFORMANCE

  Objective: In this modern society, 24 hrs continuous operation has become mandatory in many fields. Long and variable working hours for the shift workers lead to inadequate sleep. Hence, the objective of this study was to analyze the impact of rotating shift work on their psychological health and memory performance.Methods: 40 healthy male security guards (25-35 years) who did rotating night shifts at least for 1 year and 40 day workers (25-35 years) who did not do night shift in last 2 years were involved in the study. Psychological health status was assessed using Depression Anxiety Stress Scales (DASS) questionnaire. Their memory performances were assessed by digit symbol substitution test, letter cancellation test, word recall, and object recall. Data were analyzed using SPSS-20.Result: For assessing DASS questionnaire, Chi-square test was done. Among night shift workers, 60% significantly suffered from mild depression and 40% from moderate depression, 37.5% from mild stress, 52.5% from moderate stress, 45% from mild anxiety. 10% of the day workers suffered only from mild stress. Student's unpaired t-test showed a significant difference (p<0.05) for all the memory tests performed between night shift and day workers. Spearman correlation analysis was done and found to have a weak correlation between the memory performance and the psychological health status of the night shift workers.Conclusion: Rotating night shift workers who are prone to the circadian rhythm alteration suffer more from depression and stress than anxiety. There is deterioration in the memory performance and psychological health of the night shift workers when compared to day workers. Hence, psychological health status should be monitored regularly, and those who can cope up with night shift duties can continue, and others may be transferred to day shift.Keywords: Shift workers, Stress, Depression, Anxiety, Memory, Circadian rhythm