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Khedkar S.B.,Rajiv Gandhi Medical College | Haldankar V.A.,University of Mumbai
Journal of Krishna Institute of Medical Sciences University | Year: 2015

Background: Uremic anaemia has been the subject of several studies, since it causes serious problems. Decreased RBC production and survival seem to be due to erythropoietin deficiency combined with cell damage. Aims and Objectives: During haemodialysis, complement and leukocyte activation by contact with artificial surfaces promotes the formation of free radicals. However, the cell membrane is protected from this damaging effect by the presence of very efficient antioxidant enzyme defence mechanism. When this protective system is overwhelmed, it leads to cellular damage in the form of decreased RBC survival. It is postulated that antioxidant capacity in uremic patients is reduced, yet the exact mechanism remains unclear. In view of this data a study was undertaken to determine the activities of antioxidant enzymes to assess the oxidant damage to RBC in terms of TBARS (Thiobarbituric Acid Reactive Substances). Materials and Methods: Blood samples were collected from patients (n=40), before and after dialysis. They were compared with age and sex matched normals (n=45), who served as controls. The activities of enzymes glutathione peroxidase (GSH-Px) and Catalase (CAT) along with glutathione reduced (GSH) and malondialdehyde (MDA) expressed as TBARS in the RBC of patients on haemodialysis were determined. Results: The results indicated a marginal to moderate decrease in the antioxidant enzyme activities, such as CAT and GSH-Px, and increased TBARS levels before and after dialysis. Conclusion: Our results are suggestive of an increased susceptibility of the RBC to peroxidation on haemodialysis. © 2015 Journal of Krishna Institute of Medical Sciences University.

Pimparkar B.D.,Seth Gs Medical College And Kem Hospital | Bhave A.,Rajiv Gandhi Medical College
Journal of Association of Physicians of India | Year: 2010

Human health in the past and presently is influenced by the amounts and proportion of chemical elements to which humans have been exposed. Arsenic, as a therapeutic agent was known to ancient Greeks and Romans. Ehrlick introduced organic arsenicals as anti linetic agents but with advent of penicillin these have nearly become obsolete. Once considered toxic, harmful to humans, arsenic is now considered an essential ultra trace element at least in animals. Now the impact of arsenic on health is more from industrial and environmental than medicinal exposure. This article reviews human exposure to arsenic in non occupational population, mostly through drinking water which is a worldwide problem, more so in south East Asia. Sources of arsenic, normal and abnormal levels in blood and tissues levels, old and new methods of estimation of arsenic, mechanism of action of arsenic in experimental animal is briefly reviewed. Old described clinical manifestation of arsenic in humans is briefly reviewed and newly described clinical manifestations in human with special emphasis on atherosclerosis, liver and diabetes are discussed. Proposed biological mechanisms in experimental animals included up regulation of inflammatory signals like cytokines and TNF-α, oxidative stress, hypomethylation, decreased DNA repair and apoptosis, cell proliferation, angiogenesis, activation of several enzymes like methyl transferase which converts inorganic arsenic to MMA and DMA, and GSH in in-vivo and in-vitro in experimental rat liver slices. Experimentally NAC (N-Acetyl Cysteine) treatment attenuates oxidative stress in atherosclerosis apoptosis and liver injury. GSH probably plays an important role in deactivation of the intermediate products of arsenic metabolism and prevents peroxidation of membrane lipids. Chronic human exposure has been linked to several systems in the human body: dermal (exfoliative dermatitis, keratosis, vitiligo, skin cancer), peripheral neuropathy, encephalopathy, bronchitis, pulmonary fibrosis, hepatosplenomegaly resembling NCPF, portal hypertension, peripheral vascular disease and BFD, arteriosclerosis and cancers of lung, urinary bladder, other internal organs and diabetes. Experimental and epidemiological evidence support diabetes effect of high level arsenic exposure. Low and moderate exposure to arsenic in drinking water is widely prevalent and may play a role in diabetes prevalence and needs to be studied further. Role of arsenic in Indian arteriosclerosis, diabetes and liver diseases, (cirrhosis, NCPF), need to be studied further. Study of mechanisms and enzymes mentioned need to be studied in humans exposed to arsenic and other xenobiotics. Measuring arsenic exposure, metabolic and biologic effects by newly described and simpler urine proteomics may accelerate our understanding of arsenic on health consequences. © JAPI.

Naik A.U.,Rajiv Gandhi Medical College
Australasian Medical Journal | Year: 2010

Background: Vitiligo, an acquired discoloration of the skin and/or mucous membranes, is a dermatological disorder with profound cosmetic as well as psychosocial implications for the patient. This study aimed to determine the clinico-epidemiological characteristics concerned with vitiligo in patients attending the dermatology department of a tertiary care government hospital in Thane. Method: A single-observer, descriptive study conducted over a period of two-months recorded the clinico-epidemiological profile of 60 conveniently sampled vitiligo cases through history, clinical examination and study of previous medical records. The resulting data was presented in descriptive form. Results: Males constituted 41.67% (n=25) and females 58.33% (n=35) of the sample. Mean sample age was 34.35 years, with 73.33% (n=44) married and 26.67% (n=16) unmarried patients. Positive family history was noted in 15% (n=9) patients. Hypertension was the leading concomitant disease affecting 6.67% (n=4) individuals. The proportion of new cases and those on treatment accounted for 28.33% (n=17) and 71.67 %(n=43) respectively. 28.33 %(n=17) patients had lesions on exposed areas, 5 %(n=3) on unexposed areas and the rest 66.67 %(n=40) on both areas. Feet were the most commonly affected site. The proportion of patients with bilateral and unilateral involvement was 81.67% (n=49) and 13.33% (n=8) respectively. Vitiligo vulgaris was the predominant form with a proportion of 68.33% (n=41). Leukotrichia and Koebner's phenomenon were seen in 13.33% (n=8) and 3.33% (n=2) patients respectively. Conclusion: The data suggest that local epidemiological behaviour of vitiligo need not be the same across different regions. Variations did exist with regards to certain clinicoepidemiological parameters in Thane viz., prevalence of concomitant diseases, extent of involvement, etc. Such studies conducted on a regional basis may help to adopt a holistic approach towards management of vitiligo patients.

Tiwari R.P.,RFCL Ltd Formerly Ranbaxy Fine Chemicals Ltd | Jain A.,RFCL Ltd Formerly Ranbaxy Fine Chemicals Ltd | Khan Z.,Institute Pasteur Paris | Kohli V.,RFCL Ltd Formerly Ranbaxy Fine Chemicals Ltd | And 3 more authors.
Molecular Diagnosis and Therapy | Year: 2012

Acute myocardial infarction (AMI) is the leading cause of death worldwide, with early diagnosis still being difficult. Promising new cardiac biomarkers such as troponins and creatine kinase (CK) isoforms are being studied and integrated into clinical practice for early diagnosis of AMI. The cardiac-specific troponins I and T (cTnI and cTnT) have good sensitivity and specificity as indicators of myocardial necrosis and are superior to CK and its MB isoenzyme (CK-MB) in this regard. Besides being potential biologic markers, cardiac troponins also provide significant prognostic information. The introduction of novel high-sensitivity troponin assays has enabled more sensitive and timely diagnosis or exclusion of acute coronary syndromes. This review summarizes the available information on the potential of troponins and other cardiac markers in early diagnosis and prognosis of AMI, and provides perspectives on future diagnostic approaches to AMI. © 2012 Springer International Publishing Switzerland.

Kshirsagar P.,Rajiv Gandhi Medical College | Chauhan S.,Rajiv Gandhi Medical College | Samel D.,P.A. College
Journal of Association of Physicians of India | Year: 2016

Background: The authors wished to develop a scoring system for evaluating patients presenting with febrile thrombocytopenia for risk stratification, predicting patient outcome and optimization of care especially in resource poor countries. Method: Objective: 1. To decide a protocol in the management of patients with fever and thrombocytopenia. 2. To develop screening or therapeutic guidelines (early warning score-EWS) in febrile thrombocytopenic patients and decide about therapeutic interventions Design: Retrospective study and development of a bedside scoring system based on Platelet Count, Temperature, Respiratory Rate, Blood Pressure. Pulse, CNS, Respiratory, Hematological, Hepatic and Renal complications in a central civic hospital and teaching institute in India Participants: All patients >18 years presenting with fever and thrombocytopenia with platelet count of <150 × 109/L. Results: Number of patients requiring platelet transfusions decreases when total risk score is used for risk stratification and for transfusing platelets as against the platelet count at admission. Patients who died in our study had a platelet count at presentation between 20,000- 1,00,000 though their total risk score was 17 and 18 respectively; hence platelet count alone should not be relied upon for platelet transfusion. Irrespective of the number of platelets transfused the prognosis is poor as the total risk score increases. Conclusion: The platelet count is not the only indicator of transfusion. When we use total risk score instead of platelet count for classifying patients who need transfusions, number of patients who fall in severe risk category needing immediate transfusion reduces and haphazard use of platelets can be avoided. Patient outcome (death/survival), occurrence of complications and hematological manifestations (petechiae/purpura etc) are not dependent on platelet count at presentation. There is a significant association between risk category and patient outcome. © 2016, Journal of Association of Physicians of India. All rights reserved.

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