Diagnostic Efficacy of HbA1c in Diagnosis of Diabetes Mellitus in a Bangladesh Population

American Diabetic Association (ADA) affirms HbA1c with cut off value of 6.5% as a diagnostic criteria of diabetes mellitus. World Health Organization (WHO) also supports but recommended that a value <6.5% does not exclude diabetes which is diagnosed by glucose test. The aim of this study was to evaluate the diagnostic efficacy of HbA1c in terms of sensitivity, specificity, positive and negative predictive value and accuracy in a selected group of Bangladeshi subjects. This cross-sectional study included 761 adult Bangladeshi subjects of both sex attending the outdoor in a tertiary healthcare center during the period of September 2009 to September 2010. Fasting, postprandial (2 hours after glucose load) plasma glucose and HbA1c were measured. Diabetes is defined according to HbA1c and plasma glucose. Sensitivity, specificity, positive and negative predictive value of HbA1c were 90.00% (CI 86.48-92.86%), 76.21% (CI 71.68-80.35%), 78.17% (CI 73.94-82.00%) and 88.96% (CI 85.10-92.10%) respectively. Accuracy was 82.92% with odds ratio (OR) 28.84 (CI 19.10-43.54%); p < 0.001. Though HbA1c revealed remarkable diagnostic efficacy and ease of performance, still it can not over rule the role of plasma glucose in diagnosis of diabetes mellitus. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18785 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 53-54

The association between social stress and global cognitive function in a population-based study: the European Prospective Investigation into Cancer (EPIC)-Norfolk study

BACKGROUND

Stress is thought to exert both positive and negative effects on cognition, but the precise cognitive effects of social stress and individuals' response to stress remain unclear. We aimed to investigate the association between different measures of social stress and cognitive function in a middle- to older-aged population using data from the European Prospective Investigation into Cancer (EPIC)-Norfolk study.

METHOD

Participants completed a comprehensive assessment of lifetime social adversity between 1993 and 1997 and the short form of the Mini Mental State Examination (SF-MMSE), an assessment of global cognitive function, during the third health check between 2004 and 2011 (a median of 10.5 years later). A low MMSE score was defined as a score in the bottom quartile (20-26).

RESULTS

Completed MMSE scores and stress measures were available for 5129 participants aged 48-90 years. Participants who reported that their lives had been more stressful over the previous 10 years were significantly more likely to have low MMSE scores [odds ratio (OR) 1.14, 95% confidence interval (CI) 1.04-1.24 per unit increase in perceived stress], independently of sociodemographic factors, physical and emotional health. The effects were restricted to the highest level of stress and the association was stronger among participants with a lower educational level. Adaptation following life event experiences also seemed to be associated with MMSE scores after adjusting for sociodemographic factors, but the association was attenuated with further adjustment.

CONCLUSIONS

In this generally high-functioning population, individuals' interpretations and responses to stressful events, rather than the events themselves, were associated with cognitive function.

Nickel: an overview of uptake, essentiality and toxicity in plants

Nickel even though recognized as a trace element, its metabolism is very decisive for certain enzyme activities, maintaining proper cellular redox state and various other biochemical, physiological and growth responses. Study of the aspects related with uptake, transport and distributive localization of Ni is very important in various cellular metabolic processes particularly under increased nitrogen metabolism. This review article, in core, encompasses the dual behavior of Ni in plants emphasizing its systemic partitioning, essentiality and ill effects. However, the core mechanism of molecules involved and the successive physiological conditions required starting from the soil absorption, neutralization and toxicity generated is still elusive, and varies among the plants.

Quantitative structure activity relationship and risk analysis of some heavy metal residues in the milk of cattle and goat

Milk of cattle and goat was collected from various localities of Faisalabad, Pakistan. Heavy metal concentration in milk was determined by atomic absorption spectrophotometer. Milk from both of the species was found richly contaminated with cadmium (Cd), chromium (Cr), nickel (Ni), and lead (Pb). Lead concentration in the milk of goat was significantly higher as compared to cattle milk. Quantitative structure activity relationship (QSAR) models were suggested to predict the residues of unknown heavy metals in the milk of cattle and goat using their known physicochemical properties such as molecular weight (MW), melting point (MP), and boiling point (BP) as well as the milk characteristics such as pH, % fat, and specific gravity (SG) of both of these species. The analysis revealed good correlation coefficients ( R2 = 0.759) and ( R2 = 0.876) for cattle and goat QSAR models, respectively. This analysis indicates the need to construct species specific QSAR models for residue prediction. The coefficients for SG for the studied metals were higher in both cattle and goat milk. This suggests that SG is a better determinant for heavy metal residue prediction in the milk of these animals. Risk analysis was conducted based upon the determined heavy metal residues and their provisional tolerable daily intakes. The daily intake of Cd, Cr, and Pb was found to be 1.6, 27, and 116 times higher, respectively, in cattle milk and 1.8, 29, 262 times higher respectively, in goat milk. This intake of heavy metal contaminated milk might pose health hazards to humans in this locality.

Cadmium: toxicity and tolerance in plants

Of all the non-essential heavy metals, cadmium (Cd) is perhaps the metal which has attracted the most attention in soil science and plant nutrition due to its potential toxicity to humans, and also its relative mobility in the soil-plant system. This review summarizes the toxic symptoms of Cd in plants (i.e. growth retardation, alterations of photosynthesis, stomatal movement, enzymatic activities, water relations, interferences with mineral uptake, protein metabolism, membrane functioning, etc.) but also includes the mechanisms of cadmium uptake, translocation and deposition. Moreover, it also throws light on chelation, including identification of Cd ligands present in cytosol and vascular tissue. Cadmium-induced oxidative stress is also considered as one of the most widely studied topics in this review.

24-Epibrassinolide protects against the stress generated by salinity and nickel in Brassica juncea

The plants of Brassica juncea (L) were grown in the presence of NaCl and/or NiCl2 and were sprayed with 1muM of 24-epibrassinolide (EBL) at 15 days after sowing (DAS) and were sampled at 30 DAS. The plants exposed to NaCl and/or NiCl2 exhibited a significant decline in growth, the level of pigments and photosynthetic parameters. However, the follow up treatment with EBL detoxified the stress generated by NaCl and/or NiCl2 and significantly improved the above parameters. The NaCl and/or NiCl2 increased electrolyte leakage and lipid peroxidation, and decreased the membrane stability index (MSI) and relative water content. However, the EBL treatment in absence of the stress improved the MSI and relative water content but could not influence electrolyte leakage and lipid peroxidation. The antioxidative enzymes and the level of proline exhibited a significant increase in response to EBL as well as to NaCl and/or NiCl2 stress.

28-homobrassinolide protects chickpea (Cicer arietinum) from cadmium toxicity by stimulating antioxidants

In the present experiment the seeds of Cicer arietinum (L.) cv. Uday were inoculated with specific Rhizobium grown in sandy loam soil and were allowed to grow for 15 days. At this stage, the seedlings were supplied with 0, 50, 100 or 150 microM of cadmium in the form of cadmium chloride and sprayed with 0.01 microM of 28-homobrassinolide (HBL) at 30-day stage. The data indicated that plant fresh and dry mass, number of nodules, their fresh and dry mass, leghemoglobin content, nitrogen and carbohydrate content in the nodules, leaf chlorophyll content, nitrate reductase and carbonic anhydrase activities decreased proportionately with the increasing concentrations of cadmium but the content of proline and the activities of catalase, peroxidase and superoxide dismutase increased. The ill effect, generated by cadmium, was overcome if the stressed plants were sprayed with HBL.

Selective inhibition of MEK1/2 reveals a differential requirement for ERK1/2 signalling in the regulation of HIF-1 in response to hypoxia and IGF-1

The transcription factor hypoxia-inducible factor 1 (HIF-1) plays a pivotal role in tumour growth and progression, and HIF-1 is regulated through a number of signalling pathways. Here, we investigated the involvement of the mitogen-activated protein kinase (MAPK) signalling pathway in HIF-1 regulation. We found that overexpression of wild-type (WT) extracellular signal regulated protein kinase 1 (ERK1) greatly potentiated HIF-1 activation in hypoxia and HIF-1alpha induced in response to insulin growth-like factor 1 (IGF-1). Conversely, treatment of tumour cells with the MEK1/2 inhibitors PD98059 or U0216, or expression of a dominant-negative form of ERK1 blocked HIF-1 activation in hypoxia without affecting HIF-1alpha induction, localization or binding of HIF-1beta. Interestingly however, the highly selective MEK1/2 inhibitor PD184352 did not inhibit HIF-1 activity or vascular endothelial growth factor (VEGF) induced in response to hypoxia but blocked HIF-1alpha protein and HIF-1 activity induced by IGF-1 stimulation without affecting HIF-1alpha mRNA levels. Finally, we found that ERK5 phosphorylation status was not significantly affected by hypoxia in the presence or absence of PD184352. Taken together, our data suggest that although ERK1/2 signalling is important for HIF-1alpha induction and HIF-1 activity in response to IGF-1, it is dispensable for the induction of HIF-1alpha and activation of HIF-1 in response to hypoxia.

Acute myocardial infarction following sildenafil intake in a nitrate-free patient without previous history of coronary artery disease

OBJECTIVE

To report the occurrence of acute myocardial infarction (MI) associated with the intake of oral sildenafil (Viagra) in a nitrate-free patient without previous history of coronary artery disease.

CASE PRESENTATION AND INTERVENTION

A 50-year-old manual laborer was admitted to the hospital with acute inferoposterior wall MI occurring approximately 30 min after taking oral sildenafil 50 mg. This occurred before any attempted sexual activity. Subsequent angiography showed a 70% stenotic lesion in the midsegment of the dominant circumflex artery. The Naranjo scale indicated that sildenafil was a probable cause of MI.

CONCLUSION

This report shows a rare sildenafil-associated MI in a nitrate-free patient without a previous history of coronary artery disease.

Effect of salicylic acid on growth and enzyme activities of wheat seedlings

grains of wheat (Triticum aestivumL. cv. Raj-3077) were soaked in 0, 10-5, 10-4or 10-3 M aqueous solutions of salicylic acid (SA) for 3, 6 or 9 h. The seedlings raised from grains pre-treated with 10-5 M SA possessed significantly higher leaf number, fresh and dry mass per plant, and nitrate reductase and carbonic anhydrase activities 30 and 40 days after sowing. However, 10-3 M SA reduced all the above-mentioned parameters.