Background:Coronary artery disease is mainly caused by atherosclerosis and its complications. Platelets and their activity have an important role in initiation of atherosclerotic lesions and coronary thrombus formation. Larger platelets are enzymatically and metabolically more active and have a higher potential thrombotic ability as compared with smaller platelets.Aims:To study the changes in platelet volume indices and platelet count in acute myocardial infarction, stable coronary artery disease and compare them with controls to assess their usefulness in predicting coronary events.Materials and Methods:This was a comparative study of 128 subjects; 39 patients with acute myocardial infarction (AMI), 24 patients with stable coronary artery disease (SCAD) and 65 controls. Venous sample were drawn from AMI subjects on admission (within 4 hours of chest pain) and collected in standardized EDTA sample tubes. Platelet count and volume indices were assayed within 30 minutes of blood collection, using Sysmex KX21-N autoanalyzer. Venous samples were also drawn from SCAD on who were admitted for angiography and subject attending routine checkups.Results:The mean platelet volume was significantly higher in patients with AMI (9.65 ± 0.96) as compared to SCAD (9.37 ± 0.88) and controls (9.21 ± 0.58). The best cut-off values for MPV when predicting AMI and SCAD in patients were 9.25 fl (sensitivity 56.4%; specificity 45.9%) and 9.15 fl (sensitivity 54.2%; specificity 42.23%), respectively.Conclusions:Measurements of MPV may be of some benefit in detecting those patients at higher risk for an AMI and CAD.

Background: Cardiovascular Autonomic Diabetic Neuropathy (CADN) is one of the most important diabetes-associated complications. Reduced heart rate variation (HRV) is the earliest indicator of CADN. The prospect of using time domain analysis of HRV using mental arithmetic as a stressor has for early diagnosis of CADN has not been studied so far. Aims & Objective: To compare time domain parameters of HRV at rest and during acute mental stress between Type 2 diabetics and non-diabetics. Materials and Methods: 30 male asymptomatic, Type 2 diabetics with duration of diabetes of 2-8 yrs with RBS ≥ 200 mg/dl or FBS ≥ 126 mg/dl in the age group of 30-65 yrs were chosen as subjects. 30 age and sex matched healthy nondiabetics were chosen as controls. HRV analysis was done using ECG recorded at rest in supine position for 5 min and during 5 min of acute mental stress testing. Results: At rest standard deviation of all R-R intervals (SDNN), root mean square of successive RR-interval differences (RMSSD), number of intervals differing by > 50ms from adjacent interval (NN50) and percentage of NN50 (pNN50) were significantly less in diabetics as compared to nondiabetics. Mental stress showed increases in HR, SBP and DBP in non-diabetics as well as diabetics but SDNN was significantly less in diabetics as compared to non-diabetics during stress. Conclusion: Data from the study demonstrated that diabetics with 8-10 yrs history had already developed parasympathetic autonomic neuropathy. Time domain analysis of HRV during mental stress can be used as a valuable tool for early diagnosis of autonomic neuropathy to prevent further complications.

A B S T R A C TBackground: Cardiovascular autonomic diabetic neuropathy (CADN) is an important diabetes-associated complication. Reduced heart rate variation is the earliest indicator of CADN. Aims: The aim was to study the prospect of using short term heart rate variability (HRV) analysis for early diagnosis of CADN. Settings and Design: The type of this study was hospital-based comparative cross-sectional study. Materials and Methods: A total of 30 asymptomatic, type 2 diabetic male patients with duration of diabetes of 1-5 years with random blood sugar ≥200 mg/dl (11.1 mmol/L) or fasting blood sugar ≥126 mg/dl (7 mmol/L) in the age group of 30-65 years were selected as subjects. Thirty age and sex matched healthy nondiabetics were selected as controls. HRV analysis was performed using electrocardiogram recorded in lead II, at rest, in the supine position for 5 min. Results: Total power, low frequency power, high frequency power, standard deviation of all R-R intervals, root mean square of successive RR-interval differences, number of intervals differing by >50 ms from adjacent interval (NN50), and percentage of NN50 (pNN50) were signifi cantly less in diabetics when compared to nondiabetics (P < 0.05). Conclusion: Data from the study demonstrated that asymptomatic diabetics with <5 years history had already developed autonomic neuropathy. Short term analysis of HRV can be used as a valuable tool for early diagnosis of autonomic neuropathy.

Background: Many studies have established a relationship between the administration of small amounts of sweet-tasting (sucrose) solution to the tongue and analgesia in rat pups and human infants. Hence, we intended to study the relationship between pain sensitivity and sweet taste in healthy male adults. Aims & Objective: To measure and compare duration of pain onset and duration of pain tolerance when nothing was placed in the mouth, when water was placed in the mouth, and when sugar was placed in the mouth. Materials and Methods: A total of 40 healthy male adults of the age group 20-30 years participated in this study. The cold pressor task (CPT) using cold water (7 ± 5 C) was administered on each subject with nothing in mouth, and duration of the pain onset (in seconds) and pain tolerance (in seconds) was recorded using a stopwatch. Similar CPT and recordings were obtained when the subjects had distilled water (25 ml) and 25% of sucrose solution (25 ml) in their mouths, after 10-min rest between each intervention. Results: A paired t-test was conducted to compare the pain onset and pain tolerance duration in the three conditions, which revealed that the mean scores of both pain onset (in seconds) and pain tolerance (in seconds) for the sugar-in-mouth condition were higher than those with nothing-in-mouth condition (P < 0.001). Conclusion: The study results suggest that sugar-in-mouth condition does have an effect on pain onset and pain tolerance, showing a reduced sensitivity to pain when the subjects placed sugar in the mouth. It shows a relationship between sweettasting solution and analgesia in adults also. Probably endogenous opioids may also play a role.

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