Association of Small Dense LDL with Coronary Artery Disease and Diabetes in Urban Asian Indians - The Chennai Urban Rural Epidemiology Study (CURES-8)

Objective: Earlier studies in Europeans have identified small dense LDL to be associated with coronary artery disease and diabetes. In this study we assessed the association of small dense LDL with diabetes and CAD in Asian Indians. Methods: Study subjects were selected from the Chennai Urban Rural Epidemiology Study (CURES), a population based study on representative sample of Chennai city in southern India. Group 1:non-diabetic subjects (n=30); Group 2: diabetic subjects without CAD (n=30); Group 3:diabetic subjects with CAD (n=30). LDL subfractions were estimated using LipoPrint LDL system. LDL subfractions 3 and above, defined as small dense LDL was summed up to determine the overall small LDL. 75th percentile of the overall small dense LDL in non-diabetic subjects was used as a cut-off for defining elevated levels of small dense LDL. Results: The mean age of the study subjects was not significantly different among groups. Overall small dense LDL was significantly higher in diabetic subjects with CAD (16.7 ± 11.1 mg/dl, p<0.05) and without CAD (11.1 ± 8.0 mg/dl, p<0.05) compared to non-diabetic subjects without CAD (7.2 ± 6.8 mg/dl). Small dense LDL showed a positive correlation with fasting plasma glucose (r=0.252, p=0.023), HbA1c (r=0.281, p=0.012), total cholesterol (r=0.443, p<0.001), triglycerides(r=0.685, p<0.001), LDL(r=0.342, p=0.002), total cholesterol/HDL ratio (r=0.660, p=<0.001) and triglycerides/HDL ratio(r=0.728, p<0.001) and a negative correlation with HDL cholesterol (r= -0.341, p=0.002) and QUICKI values (r= -0.260, p=0.019). ROC curves constructed to predict elevated small dense LDL ((9.0 mg/dl) revealed that triglycerides/HDL ratio and total cholesterol/HDL ratio had higher AUC values compared to other parameters. A triglycerides/HDL ratio of 3.0 had the optimum sensitivity (80.0%) and specificity (78.0%) for detecting elevated small dense LDL. Conclusion: This data suggests that in Asian Indians, small dense LDL is associated with both diabetes and CAD and that a triglycerides/HDL ratio (3.0 could serve a surrogate marker of small dense LDL

Study on permanent tubal sterilisation in a semi-urban based medical college hospital

Background: Tubal sterilisation is a permanent method of contraception in use for many years. Main objective of our study is to find the acceptance of permanent method of tubal sterilisation in women delivering in a semi-urban based medical college hospital.Methods: Retrospective analysis was carried to find the number of women undergoing tubal sterilisation in our hospital for period of one year from April 2015 to March 2016.Results: Total women delivered over a period of one year were 10959 out of them 2619 women underwent tubal sterilisation. Analysis showed acceptance was high when combined with lower segment cesarian section (LSCS) and more among women in the age of 20-29 years.Conclusions: The present study showed the acceptance of tubal sterilisation following vaginal delivery to undergo mini lap is still low compared to concurrent sterilisation with LSCS. High order births are still prevalent in semi-urban based hospitals. Not only motivation, also regular review of registers that update the eligible couples, identification of complications and timely referral to higher centers will help in achieving the goal of bringing down the number of high order birth which in turn will reducing the maternal and perinatal mortality and morbidity

Acceptance of postplacental intrauterine contraceptive device: recent increase in trend

Background: IUCD is a temporary method of contraception in use for many years. Our main objective is to find the acceptance of (postplacental intrauterine contraceptive device) PPIUCD in recent years.Methods: Retrospective Analysis was carried out to collect information regarding IUCD insertion in all women delivered at semi urban based medical college in Tamil Nadu from April 2014 to March 2016.Results: Total women delivered in our hospital were 20949 over a period of two years. Two year comparative study revealed significant increase in acceptance of PPIUCD insertion among primipara from 39.1% TO 68.9%. Acceptance of PPIUCD in primipara was 51.6% in first year (April 2014 to March 2015) to 87.8% in second year (April 2015 to March 2016).Most of the women were in the age group of 20 to 29 years (81.5%).Conclusions: The present study being retrospective analysis showed sudden increase in coverage rate of PPIUCD from 2014-2015 to 2015-2016. Though the patients were motivated in the same way throughout the period, training and motivation given to the staff nurses and duty doctors in the labour ward for PPIUCD insertion and daily review instead of weekly had brought the significant increase in the coverage. This clearly shows the role of service provider in the success of a national program though acceptor is always ready in most of the times

Association of Leukocyte Count and hsCRP with Metabolic Abnormalities in Subjects with Normal Glucose Tolerance (CURES – 64)

Objective : The aim of the present study was to assess the association of leukocyte count and high sensitivity C-Reactive protein (hsCRP) with metabolic abnormalities in subjects with normal glucose tolerance. Methods : Subjects with Normal Glucose Tolerance (NGT) (n = 865) were recruited from the Chennai Urban Rural Epidemiology Study [CURES]. Standard methods were used for assessing hsCRP [Nephelometry, in a subset] and leukocytes [Flowcytometry, Sysmex SF-3000]. Insulin resistance was calculated using the Homeostasis Assessment model (HOMA-IR). Results : Body mass index, waist circumference, systolic and diastolic blood pressure, fasting plasma glucose, HbA1c, serum cholesterol, LDL cholesterol, HOMA IR and hsCRP increased significantly with increasing tertiles of leukocyte count [p for trend < 0.001]. Both leukocyte count and hsCRP showed a positive correlation with cardiovascular risk factors. Leukocyte count showed a positive correlation with hsCRP [p=0.008]. Both mean leukocyte count [p<0.001] and hsCRP [p=0.04] were higher in subjects with Metabolic Syndrome (MS), which increased with increase in number of metabolic abnormalities [p for trend <0.001]. Regression models showed leukocyte count [p<0.001] and hsCRP [p=0.03] to be associated with MS, even after adjusting for age and gender. Conclusion : A significant association exists between systemic inflammation [leukocyte count and hsCRP] and MS/ cardiovascular risk factors in Asian Indians even among non-diabetic subjects

DETECTION AND REMOVAL OF DUST PARTICLES IN PIPELINES USING 3-D MEMS

Currently, the detection of dust particles is realized through manual sampling. Thus it is desirable to develop an automated online technique. Generally, industries run with the help of pipelines through which liquid can flow. The main aim of the work is to detect the dust particles which are present inside the pipeline when liquid is flowing through it. Distributed Acoustic Sensing (DAS) is a recent addition to the pipeline security world. Opta sense system is designed to prevent the damage in pipeline by providing the advance warning to the concern department and make them alert. The dust particles are detected by using MEMS, which can sense in three axis (Heat, Vibration, Movement). It is identified by the IR sensor. The approach can also be simulated by using MATLAB

A1C Cut Points to Define Various Glucose Intolerance Groups in Asian Indians

Objective: To determine A1C cut points for glucose intolerance in Asian Indians. Research Design and Methods: A total of 2,188 participants without known diabetes were randomly selected from the Chennai Urban Rural Epidemiology Study. All had fasting plasma glucose (FPG) and 2-h postload plasma glucose measurements after a 75-g load and were classified as having impaired fasting glucose (IFG) (American Diabetes Association [ADA] criteria, FPG ≥5.5 and &lt;7 mmol/l, and World Health Organization [WHO] criteria, FPG ≥6.1 and &lt;7 mmol/l), impaired glucose tolerance (IGT) (2-h postload plasma glucose ≥7.8 and &lt;11.1 mmol/l), or diabetes (FPG ≥7 mmol/l and/or 2-h postload plasma glucose ≥11.1 mmol/l). A1C was measured using the Bio-Rad Variant machine. Based on receiver operating characteristic curves, optimum sensitivity and specificity were derived for defining A1C cut points for diabetes, IGT, and IFG. Results: Mean ± SD values of A<SUB>1</SUB>C among subjects with normal glucose tolerance, IGT, and diabetes were 5.5 ± 0.4, 5.9 ± 0.6, and 8.3 ± 2.0%, respectively (P<SUB>trend</SUB> &gt; 0.001) with considerable overlap. To identify diabetes based on 2-h postload plasma glucose, the A1C cut point of 6.1% had an area under the curve (AUC) of 0.941 with 88.0% sensitivity and 87.9% specificity. When diabetes was defined as FPG ≥7.0 mmol/l, the A1C cut point was 6.4% (AUC = 0.966, sensitivity 93.3%, and specificity 92.3%). For IGT, AUC = 0.708; for IFG, AUC = 0.632 (WHO criteria) and 0.708 (ADA criteria), and the A1C cut point was 5.6%. Conclusions: In Asian Indians, A1C cut points of 6.1 and 6.4% defined diabetes by 2-h postload plasma glucose or FPG criteria, respectively. A value of 5.6% optimally identified IGT or IFG but was &lt;70% accurate

Glucolipotoxicity initiates pancreatic beta-cell death through TNFR5/CD40-mediated STAT1 and NF-kappa B activation

Funded by Diabetes UK, NovoNordisk UK Research Foundation, and St. Bartholomew’s & The Royal London Charitable Foundation grant awards