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Shah V.K.,Sir Hn Hospital And Research Center | Shalia K.K.,Sir HN Medical Research Society
Stem Cells International | Year: 2011

Stem cell therapy for conditions characterized by myocyte loss in myocardial infarction and heart failure is intuitively appealing. Stem cells from various sources, including heart itself in preclinical and animal studies, have shown the potential to improve the function of ventricular muscle after ischaemic injury. The clinical experience from worldwide studies have indicated the safety profile but with modest benefits. The predominant mechanisms of transplanted cells for improving cardiac function have pointed towards paracrine effects rather than transdifferentiation into cardiomyocytes. Thus, further investigations should be encouraged towards bench side and bedside to resolve various issues for ensuring the correct type and dosing of cells, time, and method of delivery and identify correct mechanism of functional improvement. An interdisciplinary effort at the scientific, clinical, and the government front will bring successful realization of this therapy for healing the heart and may convert what seems now a Pandora's Box into a Pot of Gold. Copyright © 2011 V. K. Shah and K. K. Shalia. Source


Shalia K.K.,Sir HN Medical Research Society | Shah V.K.,Sir Hn Hospital And Research Center | Pawar P.,Sir HN Medical Research Society | Divekar S.S.,Sir HN Medical Research Society | Payannavar S.,Rajawadi Municipal Hospital
Indian Heart Journal | Year: 2013

Aims/objective: Influence of genetic variations on the response of clopidogrel, an antiplatelet drug is implicated. In the present study, the prevalence of single nucleotide polymorphisms of MDR1 (C3435T), CYP2C19 [CYP2C19*2 CYP2C19*3, CYP2C19*17] and P2Y12 (i-T744C) in Indian population and their effects on clopidogrel response was analyzed. Methods and results: To analyze the prevalence of polymorphisms, 102 healthy individuals were recruited. Clopidogrel response was assessed by ADP induced platelet aggregation in clopidogrel naïve acute myocardial infarction (AMI) patients (n = 26) screened from 100 AMI cases, before loading dose of 300 mg, at 24 h before next dose and 6 days after on 75 mg per day and platelet aggregation inhibition (PAI) was calculated between these time intervals. Genotyping was carried out by PCR-based restriction enzyme digestion method for C3435T of MDR1 and i-T744C of P2Y12, by multiplex PCR for CYP2C19*2 (G681A) and CYP2C19*3 (G636A) and by nested PCR for CYP2C19*17 (C806T). The effect of the above mentioned genetic variations on PAI was analyzed. Variant allele of CYP2C19*3 was not observed while the prevalence of 3435T of MDR1 (0.524), CYP2C19*2 (681A, 0.352); i-744C of P2Y12 (0.088), as well as wild type allele CYP2C19*17 (C806, 0.897) associated with decrease clopidogrel response were observed. Trend toward poor response to clopidogrel was observed at 24 h with the variant genotypes of CYP2C19*2 and i-T744C of P2Y12 as compared to wild type. Conclusion: The present study did show a trend toward impaired response of clopidogrel to inhibit platelet aggregation with variant genotypes of CYP2C19*2 and iT744C of P2Y12 compared to respective wild type genotype at 24 h. Copyright © 2013, Cardiological Society of India. All rights reserved. Source


Deo S.S.,Sir HN Medical Research Society | Deo S.S.,Sir Hospital and Research Center | Chogle A.R.,Sir Hospital and Research Center | Mistry K.J.,Sir HN Medical Research Society | And 5 more authors.
Experimental and Clinical Cardiology | Year: 2012

BACKGROUND: Studies have shown that rheumatoid arthritis (RA) patients are two to five times more likely to develop premature cardiovascular disease, thus shortening their life expectancy by five to 10 years. This risk has risen to approximately 12.6% in the urban population and 7.4% in the rural population of India. The Framingham risk score (FRS) identifies patients at increased cardiovascular risk and helps determine the need for preventive interventions. An investigation of the patients' coronary arteries and coronary artery calcification (CAC) - a measure of atherosclerotic plaque - has been found to be a strong predictor of cardiovascular disease. OBJECTIVE: To identify important biological markers for easy and noninvasive identification of cardiovascular disease in RA patients, and to investigate whether there is a relationship between the FRS and coronary artery atherosclerosis in RA patients. METHODS: The present study included 43 established RA patients and 50 healthy individuals (controls). Traditional and nontraditional risk factors were studied and compared with the control group. Insulin resistance was assessed using the homeostasis model of assessment of insulin resistance (HOMA-IR) and the homeostasis model of assessment of beta cell function. The FRS and the 10-year cardiovascular risk were compared between RA patients and controls. The presence of CAC was determined using electronbeam computed tomography, and the association between the FRS and CAC was examined. RESULTS: Significant differences in body mass index, waist circumference, rheumatoid factors (immunoglobulin [Ig]G, IgM and IgA) and inflammatory markers - C-reactive protein and erythrocyte sedimentation rate - were noted. There was significant correlation between HOMA-IR and body mass index, hypertension and C-reactive protein, but no correlation was seen with the homeostasis model of assessment of beta cell function. Significant differences were observed in the nontraditional biomarkers in RA patients, thus supporting their importance. Calcium deposition was observed in only seven RA patients. CONCLUSIONS: RA patients with increased C-reactive protein levels and erythrocyte sedimentation rates showed an increase in serum insulin levels and significant differences in HOMA-IR, thus indicating insulin resistance, which could lead to underlying progression of artherosclerosis. Significant differences were observed in the nontraditional risk factors, which could be chosen as biomarkers for endothelial dysfunction. There was a significant correlation between calcium score and the FRS in seven patients, suggestive of an underlying risk of atherosclerosis. ©2012 Pulsus Group Inc. All rights reserved. Source


Kulkarni N.B.,Sir HN Medical Research Society | Ganu M.U.,Sir HN Medical Research Society | Godbole S.G.,Sir HN Medical Research Society | Deo S.S.,Sir HN Medical Research Society
Journal of Clinical and Diagnostic Research | Year: 2014

Background: Increased arterial stiffness may be an important path- way linking diabetes mellitus to increased cardiovascular risk. Aim: The study was conducted to assess the surrogate markers of arterial stiffness in patients with Type 2 diabetes mellitus (T2DM), and compare with age-matched hypertensive and healthy controls. Also the effect of age and blood pressure on these markers was evaluated. Settings and Design: This cross-sectional study was carried out at a tertiary care hospital in West India. Methods: After a detailed medical history and anthropometric evaluation, all the participants were subjected to measurements of Arterial Stiffness Index (ASI), Pulse Wave Velocity (PWV), and Augmentation Index (AIx) using a non-invasive oscillometric method. The four study groups consisted of patients with T2DM (>5 years) along with hypertension, newly diagnosed patients with T2DM (<2years) without hypertension, hypertensive controls, and healthy controls. Results: PWV, ASI, AIx were elevated in patients with T2DM compared to healthy controls (p<0.05). Patients with T2DM above 60 years had higher carotid-femoral PWV, ASI and AIx than those below 60 years (p<0.05). ASI and AIx were significantly increased in patients with T2DM with hypertension having systolic BP > 140 mmHg compared to those with systolic BP < 140 mmHg. A very strong correlation between PWV and AIx in patients with T2DM and hypertensive controls was observed. Conclusion: This study reveals that markers of arterial stiffness (PWV, ASI, AIx) were increased significantly in patients with T2DM compared to healthy controls. Age and systolic blood pressure had significant influence on these markers. Thus, oscillometric markers have potential utility in identifying subclinical atherosclerosis in patients with T2DM. Source


Kulkarni N.B.,Sir HN Medical Research Society | Vedak T.K.,Sir HN Medical Research Society | Ganu M.U.,Sir HN Medical Research Society | Godbole S.G.,Sir HN Medical Research Society | Deo S.S.,Sir HN Medical Research Society
International Journal of Diabetes in Developing Countries | Year: 2015

The present study was conducted to assess biochemical markers and Framingham risk score (FRS) (30-year risk of cardiovascular diseases) in patients with type 2 diabetes mellitus (T2DM) and compare with hypertensive and healthy controls. We also evaluated the influence of systolic blood pressure and duration of DM on biochemical markers and their correlation with the FRS in patients with T2DM. The study groups consisted of patients with T2DM (>5 years) with hypertension (n = 55), newly diagnosed T2DM <2 years without hypertension (n = 28), hypertensive controls (n = 31), and healthy controls (n = 30). After detailed medical history, all the participants were subjected to anthropometric measurements and biochemical estimations like blood sugar (fasting and post-prandial), glycosylated hemoglobin (HbA1c), creatinine, blood urea nitrogen, lipid profile, and microalbumin levels, and FRS was calculated. The blood sugar, HbA1c, cholesterol (total and low-dense lipoprotein), microalbumin, as well as FRS were elevated in patients with T2DM compared to healthy controls (p < 0.05). A significant correlation was observed between the FRS and blood sugar, HbA1c, and microalbumin in patients with long-term T2DM. Also, duration of DM significantly influenced levels of serum triglycerides, HbA1c, and microalbumin. This study reveals that elevated blood sugar, HbA1c, and microalbumin levels are associated with increased risk of cardiovascular diseases in patients with long-term diabetes mellitus. © 2015, Research Society for Study of Diabetes in India. Source

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