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Biomedical subjects

S Dwivedi

Publications and source records attributed to S Dwivedi.

At least 37 records · Page 2Linked to original sources

Profile of hypertension in elderly subjects.

OBJECTIVE: To study clinical profile of hypertension in elderly subjects. METHODS: Two hundred and five consecutive subjects aged 60 years and above reporting to preventive cardiology clinic with cardiovascular disorders were studied. One hundred fifty six subjects (76.09%) were found to have essential hypertension (HTN). Newly detected hypertensives were classified as per JNC-VI classification. Detailed clinical examination and laboratory investigations were carried out to find evidence of associated ailments with HTN. RESULTS: Most of the patients belonged to 60-70 years age group. Mean age was 67.36 +/- 6.23 years (range 60 to 90 years) and male to female ratio was 1.44:1. Out of hypertensives 99 (63.46%) had HTN for long period, while 28 (17.94%), 17 (10.89%) and 12 (7.67%) belonged to mild, moderate and severe HTN categories, respectively. Out of newly detected hypertensives 14 (24.56%) were having isolated systolic HTN. Associated clinical conditions in hypertensives were coronary artery disease (CAD), non-insulin dependent diabetes mellitus (NIDDM), cerebrovascular disease (CVD), left ventricular hypertrophy (LVH) and chronic obstructive pulmonary disease (COPD) in 69 (57.05%), 49 (31.41%), 37 (23.71%), 20 (12.80%) and 10 (6.4%) subjects, respectively. HTN alone was found in 31 (19.87%) subjects only. Since most of these patients had other concomitant illnesses such as CAD. NIDDM etc. therapy was initiated accordingly. Four (20%) patients with LVH died within short period of 1 to 12 weeks. CONCLUSION: HTN is the commonest cardiovascular disorder in elderly subjects. CAD, NIDDM and CVD are commonly associated clinical conditions. Patients with associated LVH have very high short term mortality.

Age Distribution↗

Lipoprotein(a) and coronary heart disease in Indian population.

OBJECTIVE: Present study was undertaken to evaluate the role of lipoprotein(a) in coronary heart disease (CHD) patients and its relationship with other established risk factors. METHODS: Blood samples of 67 control patients (non-cardiovascular problems) and 222 CHD patients (> or = 4 weeks post myocardial infarction) were analyzed. Lipoprotein(a) was measured in serum samples by enzyme-linked immunosorbent assay utilizing rabbit polyclonal antibodies against purified human Lp(a). Step-wise linear discriminant analysis was used to find the important parameters to discriminate CHD and non-CHD subjects. RESULTS: The LDL to HDL cholesterol ratio (p < 0.01) and serum level of lipoprotein(a) (p < 0.01) were significantly higher in CHD patients. Levels of lipoprotein(a) were found to be higher in females compared to males (p < 0.01). Positive family history of CHD did not show significant difference in Lp(a) levels. Lp(a) level in CHD patients with positive family history of NIDDM and hypertension was higher than in with negative family history. CONCLUSION: Clinical significance of serum level of Lp(a) and albumin in determining the risk of CHD has been observed. Lp(a) alone could correctly discriminate a CHD individual from a control subjects by 95%. Estimating of Lp(a) together with albumin provided 99% correct discrimination between control and CHD patients. These results also suggest that Lp(a) together with malnutrition could be responsible for the increased incidence of CHD in Indians. It is also indicated that in females atherothrombogenic potential of lipoprotein(a) remains suppressed before menopause but after this stage women lose this advantage.

Adult↗

Significance of elevated IgG anticardiolipin antibody levels in patients with Budd-Chiari syndrome.

OBJECTIVES: Budd-Chiari syndrome (BCS) is characterized by hepatic venous outflow obstruction. Though hypercoagulable states are implicated in the causation of BCS, the etiology remains unknown in most cases. Presence of anticardiolipin antibodies (aCL) is a known cause of hypercoagulable state. We therefore studied the frequency of IgG aCL in BCS. METHODS: Sera were obtained from 19 patients with BCS, 50 healthy controls, 18 age- and gender-matched patients with cirrhosis, and 15 patients with acute viral hepatitis. IgG aCL levels were measured using a solid-phase enzyme immunoassay. Values exceeding mean + 2 SD of healthy controls were taken as abnormal. RESULTS: Mean +/- SD IgG aCL levels (GPL units) in the four groups were: healthy controls, 6.3 +/- 4.4; BCS, 13.8 +/- 13.3 (p < 0.05, compared with healthy controls); cirrhosis, 15.1 +/- 14.9 (p < 0.05, compared with healthy controls and p = ns, compared with BCS patients); and acute viral hepatitis, 5.0 +/- 2.5 (p = ns, compared with healthy controls). The levels in BCS and cirrhosis patients were similar (p = ns). The number of patients with elevated aCL was: healthy controls, 3/50; BCS, 6/19; cirrhosis, 7/18; and acute viral hepatitis, 0/15. The number of patients with elevated IgG aCL was significantly higher among patients with BCS and cirrhosis, compared with controls (p = 0.03 and p = 0.002, respectively). CONCLUSIONS: Patients with BCS had higher IgG aCL levels than healthy controls. However, as aCL levels were also elevated in patients with cirrhosis, the pathogenetic role of IgG aCL in the causation of BCS is doubtful.

Acute Disease↗