Serum uric acid level in newly diagnosed essential hypertension in a Nepalese population: A hospital based cross sectional study

Objective

To develop the missing link between hyperuricemia and hypertension.

Methods

The study was conducted in Department of Biochemistry in collaboration with Nephrology Unit of Internal Medicine Department. Hypertension was defined according to blood pressure readings by definitions of the Seventh Report of the Joint National Committee. Totally 205 newly diagnosed and untreated essential hypertensive cases and age-sex matched normotensive controls were enrolled in the study. The potential confounding factors of hyperuricemia and hypertension in both cases and controls were controlled. Uric acid levels in all participants were analyzed.

Results

Renal function between newly diagnosed hypertensive cases and normotensive healthy controls were adjusted. The mean serum uric acid observed in newly diagnosed hypertensive cases and in normotensive healthy controls were (290.05±87.05) µmol/L and (245.24±99.38) µmol/L respectively. A total of 59 (28.8%) participants of cases and 28 (13.7%) participants of controls had hyperuricemia (odds ratio 2.555 (95% CI: 1.549-4.213), P<0.001).

Conclusions

The mean serum uric acid levels and number of hyperuricemic subjects were found to be significantly higher in cases when compared to controls.     

Immune Response to Chlamydial 60-Kilodalton Heat Shock Protein in Tears from Nepali Trachoma Patients

Although the host immune response to the 60-kDa chlamydial heat shock protein (hsp60) has been implicated in trachoma pathogenesis, no studies have examined mucosal immune responses to hsp60 in populations for which chlamydia is endemic. Tears and sera from Nepali villagers were reacted against hsp60 fusion proteins, whole hsp60, and the major outer membrane protein (MOMP). Tears from villagers without disease were anti-hsp60 immunoglobulin G (IgG) reactive in 6 (38%) of 16 villagers compared with 36 (90%) of 40 with follicular trachoma (TF) (P < 0.001); 47 (89%) of 53 with inflammatory trachoma (TI) (P < 0.001); and 31 (84%) of 37 with conjunctival scarring (TS) (P = 0.002). By multivariate analysis, odds ratios for tear hsp60 IgG immunoreactivity in villagers with TF, TI, and TS were 49.2 (confidence interval [CI], 2.7 to 898), 22.6 (CI, 3 to 170), and 13.6 (CI, 1.4 to 133), respectively. There were no significant differences for tear IgA or secretory IgA (sIgA) reactivity to hsp60 or for tear sIgA and IgG reactivity to MOMP. Serum anti-hsp60 IgG immunoreactivity was associated with TI only. These data suggest that anti-hsp60 IgG immunoreactivity represents largely locally derived antibodies, which may promote disease pathology. In contrast, nonspecific high rates of anti-hsp60 sIgA antibodies suggest chronic or repeat stimulation from an endemic source of organisms.     

Epidemiology of Surgical Admissions to a Children’s Disability Hospital in Nepal

Background  

The goal of this retrospective review was to characterize the spectrum of surgical admissions to a tertiary hospital specializing in musculoskeletal conditions in children and adolescents in Nepal.     

Efficacy of carcinogenic embryonic antigen in differential diagnosis of diseases of pancreas and liver--a comparative study in a tertiary care hospital of Western Nepal

Objective: The objective of our present study was to assess the efficacy of carcinoembryonic antigen (CEA)for differentiating and diagnosis of pancreatic and liver diseases in Pokhara valley. Materials and methods:A hospital based retrospective study was carried out using data retrieved from the register maintained in theDepartment of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st January, 2011 and31st October, 2011. Estimation of CEA was performed by ELISA reader for all cases. Approval for the study wasobtained from the institutional research ethical committee. Results: Of the 771 subjects, 208 (27%), 60(7.8%),240(31.1%), 54(7.0%) , 75(9.7%), 59(7.7%), 75(9.7%) cases were of active chronic hepatitis , cryptogenic cirrhosis,alcoholic cirrhosis, primary biliary cirrhosis, hepatoma, acute or chronic pancreatitis, carcinoma of pancreasrespectively. The majority of cases (104) of active chronic hepatitis had CEA levels <5ng/ml(50%). CEA levelswere found to be increased in cases of alcoholic cirrhosis with maximum number of cases (106) in range of 10to 20 ng/ml (44%). There were no cases having more than 20ng/ml of CEA in primary biliary cirrhosis andacute or chronic pancreatitis. In cases of pancreatic cancer, maximum number of cases (35) were having CEA>20ng/ml(47%). Conclusion: High levels of CEA are associated with advanced stage of disease. CEA can thusprovide an important improvement in the diagnosis by differentiating pancreatic cancer especially from chronicpancreatitis when there is a high suspicion of malignancy. Increased CEA levels may also signify progressionfrom benign to malignant transformation in the liver.     

Long distance heart transplantation: a tale of two cities

In this ‘paired’ case report, we describe two heart transplants performed 3 days apart at our centre. Both cases involved very prolonged transportation time of the donor heart. In one case, the donor heart was transported in an ice chest, while in the other case the organ was transported using a normothermic ex vivo perfusion (NEVP) system. The additional retrieval costs incurred by the use NEVP were more than offset by the reduction in subsequent inpatient costs.     

Age-related changes in the activation of the intraparietal sulcus during nonsymbolic magnitude processing: an event-related functional magnetic resonance imaging study

Numerical magnitude processing is an essential everyday skill. Functional brain imaging studies with human adults have repeatedly revealed that bilateral regions of the intraparietal sulcus are correlated with various numerical and mathematical skills. Surprisingly little, however, is known about the development of these brain representations. In the present study, we used functional neuroimaging to compare the neural correlates of nonsymbolic magnitude judgments between children and adults. Although behavioral performance was similar across groups, in comparison to the group of children the adult participants exhibited greater effects of numerical distance on the left intraparietal sulcus. Our findings are the first to reveal that even the most basic aspects of numerical cognition are subject to age-related changes in functional neuroanatomy. We propose that developmental impairments of number may be associated with atypical specialization of cortical regions underlying magnitude processing.     

Improved quantification of amyloid burden and associated biomarker cut-off points: results from the first amyloid Singaporean cohort with overlapping cerebrovascular disease

European Journal of Nuclear Medicine and Molecular Imaging - The analysis of the [11C]PiB-PET amyloid images of a unique Asian cohort of 186 participants featuring overlapping vascular diseases...