Xanthelasma Palpebrarum is the most common of the xanthomas with asymptomatic, symmetrical, bilateral, soft, yellow, velvety, polygonal papules around the eyelids. Xanthelasmas may be associated with hyperlipidemia. This prospective study included 66 clinically diagnosed patients with Xanthelasma Palpebrarum and 50 controls with non-inflammatory skin disorders. Serum triglyceride, cholesterol, HDL, LDL and VLDL estimated in all cases indicated that patients with Xanthelasma Palpebrarum have underlying lipid abnormalities.
The serum markers of myocardial injury are used to help in establishing the diagnosis of myocardial infarction. The older markers like aspartate amino-transferase, creatine kinase, lactate dehydrogenase etc. lost their utility due to lack of specificity and limited sensitivities. Among the currently available markers cardiac troponins are the most widely used due to their improved sensitivity specificity, efficiency and low turn around time. Studies have shown that cardiac troponins should replace CKMB as the diagnostic 'gold standard' for the diagnosis of myocardial injury. The combination of myoglobin with cardiac troponins has further improved the accuracy in the diagnosis of acute coronary syndromes and thereby reducing the hospital stay and patients' money. Among the other new markers of early detection of myocardial damage, heart fatty acid binding protein, glycogen phosphorylase BB and myoglobin/carbonic anhydrase III ratio seem to be the most promising. But the search for the most ideal marker of myocardial injury is still on.
Treatment with Centchroman (3,4-trans-2,2-dimethyl-3-phenyl-4-p-(beta-pyrrolidinoethoxy) phenyl-7-methoxy chroman) has been evaluated in 4 male and 75 female patients with advanced breast cancer. The overall response rate, including both male and female cases, was 40.5%. Among the female patients, the overall response rate was 38.7%. The median duration of response was 6 months. One of the 4 male patients showed a complete response and 2 showed partial responses. The responses were more marked for bone, pulmonary, soft tissue, skin and lymph-node metastases than for liver metastases.
Serum lipid profile has now become almost a routine test. It is usually done in fasting state due to certain limitations in non-fasting serum sample. In the recent past efforts have been made to simplify blood sampling by replacing fasting lipid profile with non-fasting lipid profile. However, fasting specimen is preferred if cardiovascular risk assessment is based on total cholesterol, LDL cholesterol or non-HDL cholesterol. A lot has yet to be done in this area. Till then we have to believe in fasting lipid profile for assessment and management of cardiovascular disease.
Sialic acid, the acylated derivatives of 9-carbon sugar neuraminic acid, present as terminal component of oligosaccharide chains of many glycoproteins and glycolipids, has been recognized to be involved in the regulation of a great variety of biological phenomena. Studies have shown that serum sialic acid predicts both coronary heart disease and stroke mortality and reflects the existence or activity of an atherosclerotic process. Most of the studies have shown an elevation in serum sialic acid concentration in coronary heart disease and a positive correlation between the raised serum sialic acid and the severity of the coronary lesions is observed. However, a few contradictory reports are also available. Racial differences in serum sialic acid have also been reported and correlated with international differences in the prevalence of atherosclerosis. Reduced sialic acid content of platelets, erythrocytes and lipoproteins may play important role in the pathogenesis of atherosclerosis. Elucidation of the mechanism of alternation in sialic acid concentration may throw more light on its potential clinical utility. Hence more studies are needed to designate sialic acid as a cardiovascular risk factor / marker.
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