Influence of CYP2C9 Polymorphisms on Plasma Concentration of Warfarin and 7-Hydroxy Warfarin in South Indian Patients

2021 ◽  
Vol 22 ◽  
Author(s):  
Dhakchinamoorthi Krishna Kumar ◽  
Chakradhara Rao Satyanarayana Uppugunduri ◽  
Deepak Gopal Shewade ◽  
Sai Chandran BV ◽  
Chandrasekaran Adithan
Keyword(s):  
Maintenance Dose ◽  
Plasma Concentrations ◽  
Probit Analysis ◽  
Individual Variability ◽  
South Indian Population ◽  
Uv Detector ◽  
Female Ratio ◽  
South Indian ◽  
Study Results ◽  
The Mean

Background: Warfarin is primarily metabolized by cytochrome P450 2C9 (CYP2C9), which is encoded by the CYP2C9 gene. CYP2C9*2 and CYP2C9*3 variants significantly influence warfarin metabolism and subsequently the required dose of warfarin. Objective: The current retrospective study was aimed to determine the influence of CYP2C9 variants on warfarin metabolic ratio (MR, warfarin/7-hydroxy warfarin) and warfarin maintenance therapy in 210 patients (mean age 44.6±11.6 (SD) years; male to female ratio 81:129). Method: High-performance liquid chromatography (HPLC) with UV detector was used to measure plasma concentrations of warfarin and 7-hydroxy warfarin. Plasma samples were collected 12 h after the previous dose of warfarin was administered. CYP2C9 variants (rs1799853 and rs1057910) were identified using real-time polymerase chain reaction allele-discrimination method. Results: The mean daily maintenance dose of warfarin was 4.6±1.8 (SD) mg. The mean plasma warfarin and 7-hydroxy warfarin concentrations were 3.7±1.6 (SD) µg/mL and 1.1±0.54 (SD) µg/mL, respectively. Patients carrying other CYP2C9 variants required 39% lower warfarin maintenance dose (3.3±1.2 mg) than CYP2C9*1*1 carrier (4.9±1.8 mg), (p<0.0001). MRs differed significantly between CYP2C9 variant carriers (8.1±5.1) and normal genotype carriers (4.8±3.9) (p<0.0001). Probit analysis identified an MR value of 7.6 as the anti-mode (sensitivity of 55% and specificity of 84%) to differentiate poor and intermediate metabolizers (carriers of any *2 or *3 variant allele) from normal metabolizers (CYP2C9*1*1 genotype). Conclusion : The present study results provide, insights on effect of CYP2C9 genetic polymorphisms on inter-individual variability in warfarin metabolism and emphasizes utility of phenotyping in a setting of genotype-guided dosing of warfarin in the South Indian population.

scholarly journals A comparative study of serum adiponectin levels in patients of acute coronary syndrome with and without central obesity

2019 ◽  
Vol 6 (1) ◽  
pp. 66
Author(s):  
Shashank R. Tiwari ◽  
Lokesh S. ◽  
Arunprasath P. ◽  
Arun Kumar R.
Keyword(s):  
Acute Coronary Syndrome ◽  
Central Obesity ◽  
Adiponectin Level ◽  
Serum Adiponectin ◽  
South Indian Population ◽  
Coronary Syndrome ◽  
South Indian ◽  
Tertiary Center ◽  
The Mean ◽  
First Time

Background: Coronary artery disease burden has been on a rise globally with it emerging as the principle cause of death even in the Indian subcontinent. Serum adiponectin has recently gained interest due to its close relation with atherosclerotic CAD and Metabolic syndrome. The levels of serum adiponectin are reduced in ACS. There is a paucity of studies in South Indian population comparing the effect of central obesity in patient with ACS. The aim of the present endeavour was to study the association of serum adiponectin in risk evaluation of patient with acute coronary syndrome with and without central obesityMethods: The study was conducted in a tertiary center in patient who presented with first time ACS they were grouped into two groups based on the presence and absence of central obesity. Central obesity was defined on the basis of waist to hip ratio. Serum adiponectin levels were estimated in both the groups using ELISA method. The results were statistically analyzed using t- test.Results: Authors concluded that the mean age of patients presenting first time with ACS was 55±12years in both the group. There was a significantly raised LDL and Total Cholesterol (TC) level in patient with central obesity. The estimated serum adiponectin level was reduced in both the group with more significant reduction in group with central obesity. The mean adiponectin level in CAD patients with central obesity was 2.326±1.437µg/ml as compared to 3.486±1.6999μg/ml in patients without central obesity, which was statistically significant (p value <0.0049).Conclusions: Authors concluded that serum adiponectin levels were reduced in both the group with ACS with a further reduction in patient with central obesity. It was also observed that there was a significant relation between adiponectin level and visceral fat as compared to superficial fat, as adiponectin was significantly reduced in patient higher waist-hip ratio.

scholarly journals Comorbidities and related factors in rheumatoid arthritis patients of south India- Karnataka Rheumatoid Arthritis Comorbidity (KRAC) study

Reumatismo ◽  
2017 ◽  
Vol 69 (2) ◽  
pp. 47 ◽  
Author(s):  
S. Chandrashekara ◽  
V. Shobha ◽  
B.G. Dharmanand ◽  
R. Jois ◽  
S. Kumar ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Thyroid Disease ◽  
South India ◽  
South Indian Population ◽  
Related Factors ◽  
Female Ratio ◽  
South Indian ◽  
Clinical Research Associates ◽  
Multi Center Study

The aim was to study the prevalence of comorbidities in rheumatoid arthritis (RA) patients in everyday clinical practice and their association with disease-specific and demographic factors. The multi-center study recruited 3,247 (at 14 centers, and 265) were excluded due to incomplete data. The number of subjects considered for the analysis was 2982. The mean (±standard deviation) age was 48.98±12.64 years and the male-to-female ratio was 1:5. The data was collected based on a pre-structured pro forma by trained clinical research associates through interview and verification of charts and reports available in the patient records. The following comorbidities were studied: cardiovascular disease, hypertension, diabetes mellitus, hypercholesterolemia, thyroid disease, psychiatric diseases like depression, and pulmonary disease. Hypertension (20.7%), diabetes mellitus (14.4%) and thyroid disease (18.3%) were the most prevalent comorbidities. Hypercholesterolemia (5.3%), pulmonary diseases (2.1%), cardiovascular diseases (0.2%) and depression (0.03%) were prevalent in ≤5% of the study population. The overall presence of comorbidity increased with age and reduced with the duration of illness prior (DOIP). The age, gender, and DOIP differed significantly between groups with and without hypercholesterolemia. Females had a statistically increased prevalence of thyroid disease. The prevalence of comorbidities in RA patients from south India is around 40% and the incidence of comorbidity increased with age. As per the literature evidence, the prevalence in the current study subjects was higher when compared to prevalence of similar diseases occurring in the general south Indian population.

scholarly journals Awareness of Chronic Kidney Disease among Tamil Nadu Population- ACross-sectional Study

2021 ◽  
Author(s):  
R Chandan Bala ◽  
M Jayabharathy ◽  
S Sheba Yesu Priya ◽  
S Ramya
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Early Detection ◽  
Public Awareness ◽  
South Indian Population ◽  
Sectional Study ◽  
South Indian ◽  
Study Population ◽  
The Mean

Introduction: Chronic kidney failure in India and around the world is a significant health problem. The most effective and affordable treatment may require screening for early detection,intervention and prevention. Public awareness is a key determinant to overcome the burden of Chronic Kidney Disease(CKD). However, there is a lack of information on CKD among South Indian people. Aim: To assess the awareness and knowledge of CKD among the South Indian population. Materials and Methods: A questionnaire-based cross-sectional study was conducted through an online form; the questions were generally based on the physiological role of kidney and awareness questions related to CKD. The sample size was 500 participants, of age >18 years and snowball sampling method was implemented. Among the study population, 68 participants had a family history of CKD and they were excluded. The data were analysed through Pearson Chi-Square test. Results: The mean knowledge score was 13 (SD±5.0), with values ranging from 0 to 22. The mean age of the population was 47.80±8.5 years. Multiple regression on demographic data and knowledge yielded statistically negligible results.The study population included 432 participants and the result showed the realms that most responded incorrectly were physiology of kidney, CKD symptoms, risk factors and the domain of testing and diagnosis. Conclusion: The participants had ample knowledge of the risk factors, signs and symptoms of CKD and insufficient knowledge of the physiological function of the kidney and the diagnosis of CKD. Therefore, efforts are necessary to create awareness and educate people about the early detection and prevention of CKD.

scholarly journals Lactulose versus lactitol in acute hepatic encephalopathy (HE).

2020 ◽  
Vol 27 (08) ◽  
pp. 1595-1601
Author(s):  
Shahid Rasool ◽  
Salman Azhar ◽  
Talha Munir ◽  
Mian Sajjad Ahmad ◽  
Rizwan Abbas ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Controlled Trial ◽  
P Value ◽  
Chi Square ◽  
Female Ratio ◽  
Study Results ◽  
Level Of Consciousness ◽  
Acute Hepatic Encephalopathy ◽  
The Mean ◽  
The Difference

Hepatic encephalopathy (HE), a syndrome observed in some patients with cirrhosis, with depressed level of consciousness. Lactulose as well as lactitol has been used in the treatment of HE. Lactitol is comparable to lactulose in the treatment of HE with fewer side effects and better tolerated. However, literature showed equal efficacy of both drugs. So we conducted this trial to find better drug to implement its use in future. Objective: To compare the effectiveness of lactulose and lactitol in patients with acute hepatic encephalopathy. Study Design: Randomized Controlled Trial. Setting: Department of Medicine OPD and Emergency (East, West, North, South), Mayo Hospital, Lahore. Period: 6 Months June 2017 to Dec 2017. Material & Methods: 570 patients were included through non-probability, consecutive sampling after informed consent. Initial grade of HE was assessed and patients were randomly divided in two groups by using lottery method i.e. lactulose or lactitol. Patients were admitted to ward for management and kept under observation for 5 days. After 5 days, HE grades was measured again, then improvement in grade of HE (effectiveness) was measured. All data was entered and analyzed by using SPSS version 21.0. Chi-square was applied to compare both groups for effectiveness taking p-value≤0.05 as significant. Results: In this study the mean age of the patients was 44.22 ±11.81 years, the male to female ratio of the patients was 2.4:1. The mean duration of the cirrhosis of the patients was 3.73±1.61 months. In our study the effectiveness was achieved in 538 (94.39%) patients, out of which 263 cases were from lactulose group and 275 were from lactitol group and the difference was significant (p<0.0.5). Conclusion: Our study results concluded that Lactitol is better choice for the treatment of patients with acute hepatic encephalopathy as compared to lactulose. More efficacy was achieved in lactitol group patients than in lactulose group patients.

scholarly journals MORPHOMETRY OF THE PEDICLE OF FIRST SACRAL VERTEBRAE AND ITS APPLICATION IN POSTERIOR TRANSPEDICULAR SCREW FIXATION. Morfometría del pedículo de la primera vértebra sacra y su aplicación en la fijación posterior con tornillo transpedicular

2016 ◽  
Vol 6 (3) ◽  
pp. 156-161
Author(s):  
Mangala M Pai ◽  
Bukkambudhi V Murlimanju ◽  
Latha V Prabhu ◽  
Rajanigandha Vadgaonkar ◽  
P P. Jagadish Rao ◽  
...  
Keyword(s):  
Indian Population ◽  
Screw Fixation ◽  
Spinous Process ◽  
South Indian Population ◽  
Male And Female ◽  
South Indian ◽  
Transpedicular Screw ◽  
Pedicle Length ◽  
The Mean ◽  
Transpedicular Screw Fixation

Los objetivos del presente estudio fueron determinar los parámetros anatómicos del pedículo S1 en la población India del sur para comparar los datos con respecto a los géneros masculinos y femeninos. El estudio incluyó 50 sacros secos (25 hombres y 25 mujeres) que se obtuvieron en el laboratorio de anatomía de nuestra institución. En el presente estudio se observa que la longitud media del pedículo S1 fue 49.9± 3,6 mm para los hombres y 46.3± 4,8 mm para las mujeres. La altura céfalo-caudal del pedículo S1 fue 27.2±4.0 mm y 23.9±3.7 mm para el varón y la hembra respectivamente. La anchura antero-posterior del pedículo S1 fue 7.5± 1,3 mm, 7.5± 1.7 mm en varones y mujeres, respectivamente. La distancia antero-posterior de S1, desde el promontorio sacro a la apófisis espinosa de S1 fue 52.9± 5.2 mm y 50.4± 6.8 mm en los géneros masculino y femenino respectivamente. El presente estudio demostró que la longitud y la altura de céfalo-caudal eran más altos (p0.05) en varones que en mujeres. Los datos de mujeres y varones con respecto a la anchura antero-posterior y la distancia antero-posterior de S1 no eran estadísticamente diferentes. El presente estudio ha proporcionado datos morfométricos importantes del pedículo de la primera vértebra sacra de la muestra anatómica de la población India del sur. El conocimiento de los diámetros del pedículo de S1 es crucial para la colocación segura de tornillos para la fijación transpedicular posterior. Objectives of the present study were to determine the anatomical parameters of the S1 pedicle in South Indian population and to compare the data, with respect to male and female genders. The stud­­y included 50 dry sacra (25 male and 25 female), which were obtained from the anatomy laboratory of our institution. It is observed in the present study that the mean S1 pedicle length was 49.9± 3.6 mm for male and 46.3± 4.8 mm for the female. The cephalocaudal heights of S1 pedicle were 27.2±4.0 mms and 23.9±3.7 mms for the male and female respectively. The anteroposterior width of S1 pedicle was 7.5± 1.3 mms, 7.5± 1.7 mms in males and females respectively. The anteroposterior distances of S1, from the sacral promontory to the spinous process of S1 were 52.9± 5.2 mms and 50.4± 6.8 mms respectively for the male and female genders. The present study observed that the mean S1 pedicle length and the cephalocaudal height were higher (p<0.05) for the males than that of females. The data (male vs female) were not found statistically different (p>0.05), with respect to the anteroposterior width of the S1 pedicle and the anteroposterior distances of S1 from the sacral promontory to the spinous process of S1. The present study has provided important morphometric data onto the pedicle of the first sacral vertebrae, from the anatomical samples of the South Indian population. The knowledge of pedicle diameters of S1 is crucial to the safe placement of screws in the posterior transpedicular screw fixation.

scholarly journals The Morphometric study of Internal acoustic meatus in dry skulls of South Indian adults

2017 ◽  
Vol 06 (01) ◽  
pp. 051-058
Author(s):  
Vinay KV ◽  
◽  
◽  
Keyword(s):  
Indian Population ◽  
Morphometric Study ◽  
South Indian Population ◽  
Internal Acoustic Meatus ◽  
South Indian ◽  
Bony Canal ◽  
The Mean ◽  
Skull Trauma ◽  
The Individual ◽  
Temporal Bones

Abstract Background: The internal acoustic meatus (IAM) is a bony canal present between labyrinth and posterior cranial fossa. The normal morphometry of IAM is useful during evaluation of cases of skull trauma, congenital anomalies of IAM affecting the individual nerves, and in pre evaluation of surgeries of ear. The present study was done to determine the normal dimensions of IAM and to have a morphological database of the IAM for South Indian population. Materials & methods: The present study was conducted on 37 temporal bones of adult skulls. The impression of IAM was taken by injecting polyvinyl siloxane (PVS) impression material into the IAM and the dimensions were measured by using digital vernier callipers on right and left side separately. The height and width of IAM at porous, middle and fundus were measured and tabulated. Results: As there was no significant statistical difference between the parameters of right and left sides the data were pooled together. The mean height & width of IAM at porous end was 4.5mm & 6.42mm respectively. The mean height & width of IAC at its middle portion was 4.04mm & 4.91mm respectively. The mean height & width of IAM at the fundus was 3.8mm and 4.60mm respectively. The superior length & inferior length was 8.60 & 8.70mm respectively. Conclusion:This study provides a ready reference for dimensions of IAM of adult dry skull in South Indian population. The present study confirms that there is difference in the dimensions of IAM among different races and regions and thus emphasizes the need to have normal data for our population.

scholarly journals Skull Base Angle Morphometry in South Indian Population with Review on Terminology

2021 ◽  
Author(s):  
Veeramani Raveendranath ◽  
Prafulla Kumar Dash ◽  
Krishnan Nagarajan ◽  
Thangaraj Kavitha ◽  
Srinidhi Swathi
Keyword(s):  
Skull Base ◽  
Adult Population ◽  
Mean Value ◽  
South Indian Population ◽  
Basal Angle ◽  
South Indian ◽  
Significant Difference ◽  
Coefficient Corrélation ◽  
Males And Females ◽  
The Mean

Abstract Introduction Basal angle, Boogaard’s angle, and clival angle are frequently used in diagnosing the craniometric angle malformations either on radiography or now more on MRI. But anatomic and clinical studies have used varied terms for these parameters. We aimed to look for these parameters among a normal south Indian adult population to standardize the measurements and their terminology. Materials and Methods One hundred MRI images (50 males and 50 female) were studied retrospectively. MRI images that were reported as normal by neuroradiologist were taken up for the study. Mean and the standard deviation of males and females were calculated for basal angle, Boogaard’s angle, and clival angle, separately. Unpaired t-test was used to analyze the significant difference (p < 0.05) between the genders. The intraclass coefficient correlation was used to analyze the interobserver variability. Results The mean value of basal angle in males and females are 113°and 114°, respectively. The mean value of Boogaard’s angle in males and females are 120°and 121°, respectively. The mean value of clival angle in males and females are 157°and 155°, respectively. There was no statistically significant difference (p > 0.05) between males and females in all three angles. Conclusion Knowledge about the normal angles will be an important tool in understanding the normal and abnormal skull base. Since the type of skull varies in accordance with race, the normal craniometric angle also varies in accordance with race. The present study tried to standardize the parameters of normal skull base angles for appropriate correction of the anomalies and uniform usage of terminology.

scholarly journals Measurement of Insall Salvati ratio and modified Insall Salvati ratio to assess the position of the patella in South Indian population

2016 ◽  
Vol 3 (1) ◽  
pp. 23 ◽  
Author(s):  
Arun Kumar C. ◽  
Ganesan G. Ram
Keyword(s):  
Observational Study ◽  
Knee Joint ◽  
Indian Population ◽  
South Indian Population ◽  
Age Group ◽  
Radiological Assessment ◽  
Patella Baja ◽  
South Indian ◽  
Female Predominance ◽  
The Mean

<p class="abstract"><strong>Background: </strong><span lang="EN-IN">This is an observational study that was carried out to find the mean Insall Salvati ratio and modified Insall Salvati ratio in people coming to outpatient department requiring radiograph of knee joint..</span></p><p class="abstract"><strong>Methods: </strong>Radiological assessment of 200 knees which included 100 men and 100 women above the age group of 18,in a period of 6 months for which Insall Salvati and modified Insall Salvati ratio were calculated.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The mean Insall Salvati ratio was calculated to be 0.805 and the mean modified Insall Salvati ratio was 0.605 in South Indian.</span></p><p class="abstract"><strong>Conclusions: </strong>Based on the above study i conclude that majority of South Indian population had patella baja with female predominance<span lang="EN-IN">.</span></p>

scholarly journals Morphometric Study of Distance of Axillary Nerve from Acromial Process of the Scapula in South Indian Population

2017 ◽  
Vol 06 (01) ◽  
pp. 016-023
Author(s):  
Lakshmi Kantha B.M ◽  
Shashanka M.J ◽  
Varsha Mokashi
Keyword(s):  
Average Distance ◽  
Axillary Nerve ◽  
Morphometric Study ◽  
South Indian Population ◽  
Lateral Aspect ◽  
Posterior Aspect ◽  
South Indian ◽  
Shoulder Region ◽  
The Mean ◽  
Deltoid Split

Abstract Background: The common cause of axillary nerve injury is due to lack of knowledge about the safe position of the nerve during orthopedic surgeries. Many workers have studied the safe area for axillary nerve by measuring its distance from various landmarks. The aim of the present study is to find the average distance of the location of the axillary nerve from the acromion process in the cadavers. Materials and Methods: 50 Shoulder region specimens from 25 cadavers (aged 45-55 years; both male and female sex) available in the department of Anatomy, BGS Global Institute of Medical Sciences, Bengaluru were utilized for the present study. After methodical dissection of shoulder region we measured the distance from 1) Lateral aspect of acromion processes to root of axillary nerve and 2) Posterior aspect of acromion processes to root of axillary nerve using measuring tape ( in centimeters) on both sides. The descriptive statistics including mean, standard deviation and quartile range were calculated for the measurements on both sides using SPSS software version16. Results: The mean distance of axillary nerve from the lateral edge of the acromion process was 6.39±0.8 cm on right side and 6.33±0.7cm on left side. The mean distance from posterior aspect of acromion process was 5.89±0.6 cm on right side and 5.82±0.6 cm on left side. Quartile distribution showed that, in 75% individuals the distance between lateral aspect of acromion process and axillary nerve was 7cm on both sides. The distance between posterior aspect of acromion process and axillary nerve was 6.4 cm on right side and 6.5 cm on left side. Conclusion: Knowledge of morphometric distance of axillary nerve from the acromion process is important in deltoid split surgeries and while giving intramuscular injection to deltoid region.

scholarly journals Morphology and morphometry of infra orbital foramen in South Indian adult dry skulls

2014 ◽  
Vol 03 (03) ◽  
pp. 122-127
Author(s):  
Vishal K. ◽  
Vinay K V. ◽  
Johncy I P.
Keyword(s):  
Regional Variation ◽  
Indian Population ◽  
Transverse Diameter ◽  
South Indian Population ◽  
Morphometric Data ◽  
Orbital Margin ◽  
South Indian ◽  
Horizontal Diameter ◽  
The Mean ◽  
Morphology And Morphometry

Abstract Background: The infra orbital foramen (IOF) situated below infra-orbital margin (IOM) transmits infra­orbital nerve and infra- orbital vessels. The knowledge of the dimension, shape and direction of the IOF has important implications in various surgical and anaesthetic procedures. This will avoid iatrogenic injury to neurovascular bundle emerging from the IOF. Material and methods: Sixty adult dry skulls of unknown sex from the Department of Anatomy and Department of Forensic Medicine were used. IOF on both sides of skulls were assessed for the shape and direction by inspection. The vertical and horizontal diameter of the IOF was measured using a digital Vernier caliper to the nearest millimeters and the results were statistically analyzed. Results: The shape of the IOF was vertically oval in majority of the skulls (37.5%) and was semi lunar shaped in 10.83% of the skull. The IOF was directed infero­medially in about 52.5% of the cases and was directed medially in 6.67% of the cases. The mean transverse diameter was 2.96mm and the mean vertical diameter was 3.7mm. All the above results were compared with studies of previous workers. Conclusion: The present study confirms that there is racial as well as regional variation in the shape and dimensions of IOF, thus emphasizing the need to have morphometric data for South Indian population.

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