Background and Objectives: Diabetes, a lifelong progressive disease, with metabolic dysregulation, is associated with increased risk of cardiovascular complications. Paraoxonase (PON), an enzyme associated with high-density lipoprotein (HDL) is known to modulate the antioxidant and anti-inflammatory role of HDL and may have a protective role in the prevention of these complications. The present study was undertaken to evaluate serum PON, thiobarbituric acid reacting substances (TBARS) and serum lipid profile in Type 2 diabetes mellitus (DM). Materials and Methods:The study group consisted of 60 cases of clinically diagnosed Type 2 DM and 60 age and sex-matched controls. Lipid profile was estimated by enzymatic methods using EM-200 auto-analyzer, TBARS by thiobarbituric acid assay and serum PON by spectrophotometric method. Results: Type 2 DM patients showed significant increase in total cholesterol (P < 0.05), triacylglycerol (P <0.0001), very low density lipoproteins (P < 0.0001), TBARS (P < 0.0001) levels, and significant decrease in HDL (P < 0.05) compared to controls. A significant decrease was observed in both basal (P < 0.0001) and salt stimulated PON activity in cases (P < 0.0001). Salt stimulated PON activity showed a positive correlation with HDL levels (P < 0.05) in cases, whereas basal PON activity showed negative correlation with TBARS in controls (P < 0.005). Conclusion: Type 2 DM patients have significantly lower levels of PON activity along with dyslipidemia with a direct correlation of PON with HDL levels. This may reduce the protective role of HDL and increases the susceptibility of cardiovascular complications.

Diabetic retinopathy (DR) remains the leading cause of mortality and disability in adults with diabetes. Recently apolipoprotein A-I (Apo A-I) and apolipoprotein B (Apo B) have been found to be associated with biophysiological changes of DR than traditional lipids. The objective of the present study was to evaluate the lipid profile including Apo A-I, Apo B, and Apo B/Apo A-I levels in diabetes patients with or without retinopathy. The present study was conducted at Adichunchanagiri Institute of Medical Sciences and Hospital, India. The total numbers of subjects were 90, divided into three groups. Group I included 30 healthy controls, group II included 30 cases of diabetes mellitus (DM) without retinopathy, and group III had 30 cases of DR. Blood samples were drawn under aseptic precautions from study subjects. The investigations carried out were fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), and lipid profile including Apo A-I and Apo B in all subjects. The FPG, PPPG, lipid profile, and apolipoproteins (Apo A-I and Apo B) were estimated using autoanalyzer EM 200.There was significant increase in FPG, PPPG, total cholesterol, triglycerides (TGs), low-density lipoproteins (LDLs) and no significant decrease in high-density lipoprotein (HDL) levels in group II and III subjects. There was significant decrease in Apo A-I and increase in Apo B levels and Apo B/Apo A-I ratio in group II and III subjects. There is a suggestive association of TGs, LDL, and Apo B/Apo A-I ratio in diabetic subjects with and without retinopathy. The Apo A-I, Apo B, and ratio of Apo B/Apo A-I are strong indicators of dyslipidemia in diabetic and DR patients. The ratio of Apo B/Apo A-I is better associated with DR and may contribute to development and progression of DR. How to cite this article Namitha D, Nusrath A, Rajeswari A, Rani NA, Shilpashree YD. Apolipoprotein A-I and Apolipoprotein B: Better Indicators of Dyslipidemia in Diabetic Retinopathy Patients? Indian J Med Biochem 2017;21(2):142-146.

From the standpoint of pathology, the term pyloric stenosis is usually inaccurate at least in adult patients, since the site of obstruction is rarely situated at the pylorus itself but is more often placed immediately proximal to the sphincter where the diagnosis of carcinoma is most probable or more distally in the duodenal bulb where the cause is almost invariably a duodenal ulcer. This study has been taken up to review the changes in presentation of gastric outlet obstruction in view of changing trends in the aetiology analysing the occurrence of benign and malignant causes, signs and symptoms, investigatory modalities, management and their results. The present study is an observational study a total of 50 cases were studied with Cicatrised duodenal ulcer and carcinoma pyloric antrum being the major causes. Clinical profile, investigations and treatment outcomes were analysed. The majority of patients had malignant gastric outlet obstruction with 32[64%] patients presenting with Gastric cancer and 18[36%] patients presenting with cicatrised duodenal ulcer. In this study most patients were in the fifth and seventh decades of life. Men outnumbered women by 3: 1. The clinical presentation is not different from those in other studies with non-bilious vomiting being common to all the patients with dehydration. Visible gastric peristalsis and succussion splash were more prominent in Cicatrised Duodenal Ulcer. All cases were subjected to serum electrolyte estimation. Out of them 20 cases [40%] showed electrolyte imbalance barium meal, ultrasound abdomen pelvis and CT scan abdomen being the other investigating tools. Blood group 'O' was common in cicatrized duodenal ulcer patients [77.7%] followed by blood group 'A' [11.1%]. Upper GI endoscopy was done in all cases [100%]. 32[64%] cases had pyloric antral Carcinoma in which 23 cases had fungating growth and the rest 9 had ulcerative growth and 18[36%] had cicatrized duodenal ulcer. 100% of cicatrized duodenal ulcer patients underwent truncal vagotomy with posterior gastrojejunostomy. In carcinoma of pyloric antrum, 56.25% underwent Billroth II Polya gastrectomy after subtotal resection and 25% underwent anterior gastrojejunostomy and 18.75% underwent feeding jejunostomy alone depending on the stage of the disease. The average hospital stay was 10 days. The overall mortality rate was 6% (9.3% for malignant cases). Mortality rate was zero in case of cicatrised duodenal ulcer. Surgical site infection was the most common post-operative complication accounting for 38.2% of cases. One patient with carcinoma pyloric region developed duodenal blow out on the 5th day and died due to biliary sepsis.

Introduction: Metabolic Syndrome (MS) identifies a group of metabolic disorders that includes glucose intolerance, central obesity, hypertension and dyslipidaemia that place the affected individual at exaggerated risk for developing disorder, in addition as exaggerated mortality from all causes. Aim: To evaluate serum Thyroid Stimulating Hormone (TSH) levels and to determine the correlation between serum concentrations of TSH with components of MS among postmenopausal women with MS. Materials and Methods: A cross-sectional observational study was conducted for the period of four months on 100 postmenopausal women between 45-65 years who attended Outpatient Department (OPD) of Obstetrics and Gynaecology, Adichunchanagiri Institute of Medical Sciences (AIMS), Mandya, Karnataka, India. A fasting blood sample was collected from all the subjects, serum was used for estimating Fasting Plasma Glucose (FPG), Lipid profile, and Serum TSH. Results were presented on Mean±SD (Standard Deviation) (Min-Max) and in Number (%). For the comparison of means, Analysis of Variance (ANOVA) test was used. Correlation was examined by determining Pearson correlation coefficient (r-value). A p-value <0.05 was taken as statistically significant. Results: Among the study population, the dysfunction in thyroid gland was found in 35 (35%). The major thyroid dysfunction was found to be hypothyroidism (32%) and only three had hyperthyroidism (3%). Waist Circumference (WC), Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) were 98.2±12 cm, 128.84±13.65 mmHg and 79.2±9.2 mmHg, respectively. Fasting Blood Glucose (FBS), Triglyceride (TAG), High Density Lipoprotein (HDL) cholesterol (HDL-C) and TSH were 166.7±71 mg/dL, 125.94±90.67 mg/dL, 45.46±13.13 mg/dL and 3.35±2.01 mIU/L, respectively. Statistically significant positive correlation was observed between FPG (p=0.049) and both SBP (p=0.0008) and DBP (p=0.001) and negative correlation was observed between TAG, HDL and TSH but not statistically significant in women with hypothyroidism when compared to euthyroid. A statistically negative correlation was found with WC (p=0.001) and positive correlation was found with TAG (p=0.008) and TSH among women with euthyroid condition. Conclusion: Hypothyroidism alters lipid levels and increases blood pressure leading to increased risk for cardiovascular disease (CVD). Together hypothyroidism and metabolic syndrome could increase the risk for CVD in postmenopausal women. Thus, assessing thyroid function in postmenopausal women with metabolic syndrome may aid in early detection of CVD risk and better clinical management among these patients and reduces the already existing high incidence of CVDs.

Background: Medical students' learning environment is crucial for effective learning and plays an important role in their academic success. Understanding the perception of medical students' learning environment, especially in first year may help in planning for interventions that will facilitate learning. Aims and objectives: Aim of the study was to assess the perceptions of first year medical students about their learning environment in a south Indian Medical college using Dundee Ready Education Environment Measure (DREEM) scale Materials and methods: The Dundee Ready Educational Environment Measure (DREEM) questionnaire was distributed to all 145 first-year medical students of a South Indian medical college during their induction programme. The questionnaire contained 50 items scored on a 0-4 Likert scale. There were five domains in the questionnaire, including students' perceptions about learning, teachers, atmosphere, academic self-perceptions, and social self-perceptions. Results: 143 first year medical students participated in the study. The overall mean scores for student perception about learning, perception of teachers, academic self-perception, perception of atmosphere and social self-perceptions was 39.20/48, 28.24/44, 26.75/32, 32.74/48 and 18.47/28 respectively. Conclusion:The overall student perception about their learning environment was positive. The analysis of the results also helped in identifying the areas that needed to improvement.