BACKGROUNDThe Polycystic Ovarian Syndrome (PCOS) is one of the most common reproductive disorder in young women affecting 5-10% of population. PCOS women are at increased risk of developing metabolic syndrome, type 2 diabetes mellitus and cardiovascular diseases. PCOS is now recognised as not only a reproductive disorder, but also a metabolic one with long-term effects on women's health. With this background, the present study was undertaken to assess the levels of High-Sensitivity C-Reactive Protein (hs-CRP) in young obese women with PCOS as compared with healthy obese women without PCOS.

INTRODUCTIONThiazide and thiazide like diuretics have been used in the management of hypertension for a longer period than any other anti-hypertensive agent.1 They are recommended as the first line agents by the JNC 7. They have also been included as a major class of anti-hypertensives in the JNC 8 recommendations. Thiazide diuretics are often considered a homogeneous therapeutic class, where all agents reduce cardiovascular event risk and all-cause mortality in elderly hypertensive patients equally, as a direct consequence of anti-hypertensive effects.2 However, not all thiazide-related medications have the same properties. Many studies have contrasted the most widely used thiazide diuretic, hydrochlorothiazide (HCTZ), and the thiazide-like diuretic, chlorthalidone (CTD), with ABSTRACT Background: Despite the differences in cardiovascular outcomes, pharmacokinetics, pharmacodynamics, the diuretics, chlorthalidone (CTD) and hydrochlorothiazide (HCTZ) are often considered as interchangeable. There is an on-going debate whether CTD should be preferred over HCTZ, because it appears to be more effective in the prevention of cardiovascular events. The relative difference in the incidence of hypokalemia and hyponatremia, is also a topic of debate. With this background, the study was carried out to compare the prevalence of hyponatremia between CTD and HCTZ used in the treatment of hypertension at the dose commonly prescribed in clinical practice. Methods: This was a cross sectional study carried out on a convenience sample of 74 adult patients with provisional diagnosis of hyponatremia or with a plasma sodium level of less than 135mmol/L and having a history of anti-hypertensive use of HTCZ or CTD in the dose range of 12.5-25mg/day and 6.25-12.5mg/day respectively. Chi square test and independent samples 't' test were used analyse the results in GraphPad Prism 6.0. Results: HCTZ was found to be the preferred diuretic in hypertension, whereas CTD was preferred in the age group of 65-74 years. The symptoms indicative of hyponatremia as well as a lower plasma sodium level were more common in the HTCZ treated group. Patients of hypertension using CTD were less predisposed to hyponatremia (OR 0.804,. Conclusions: Chlorthalidone, when used at a lower dose of 6.25-12.5mg/day for the treatment of hypertension cause a lesser risk of hyponatremia than hydrochlorothiazide.

Introduction: Ischaemic Heart Disease (IHD) is one of the most common co-morbidity among Indian population, so is Diabetes Mellitus (DM). IHD is associated not only with systolic, but also with Diastolic Dysfunction (DDFx) of Left Ventricle (LV). However, there is scarcity of data correlating the severity of Coronary Artery Disease (CAD) with LV DDFx. Aim: To assess the severity of CAD in diabetic stable IHD patients with normal LV systolic function (LV Ejection fraction ≥50%) and it’s association with degree of DDFx. Materials and Methods: A prospective cross-sectional study was conducted over a period of one year, in a tertiary care hospital of Odisha, India among diabetic stable IHD patients. Grades of DDFx were assessed among the study population, using Transthoracic Echocardiography (TTE). Subsequently, severity of CAD was assessed, using invasive Coronary Angiography (CAG) using The SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) score. Next, grades of DDFx were correlated with severity of IHD. Results: Among a total of 93 diabetic stable IHD patients with normal LV ejection fraction, 76.3% were males and the mean age was 60.7±8.9 years. Majority presented with chronic stable angina (59, 63.4%). Hypertension (50, 53.7%), followed by dyslipidaemia (36, 38.7%) and renal dysfunction (19, 20.4%) were the most common co-morbidities. Majority of patients had grade I (39.8%), followed by grade II (17.2%), and grade III (9.7%) DDFx. On invasive CAG, 39.8% had a SYNTAX score of ≤ 22, 36.6% had a score of 23-32, and 23.6% had a score of ≥33. Grades of DDFx were found to be significantly higher among the patients with greater SYNTAX score. Conclusion: Among diabetic stable IHD patients, greater the severity of CAD on CAG, higher were the grades of DDFx

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