Introduction:In the past few decades, rates of cardio vascular Disease (CVD) have increased from 4 to 11% in the Indian population. Gene polymorphisms play an important role in causing disease. A number of candidate genes have been associated with CVD. Studies suggest an association of CVD and polymorphisms with Angiotensinconverting enzyme (ACE). Angiotensin I is converted to a vasoconstrictor angiotensin II by ACE. Increase in angiotensin II can lead to the increase in blood pressure, inducing various cardiovascular problems. Increased ACE levels have been shown to be associated with D-allele.Methods: We analyzed 73 cases referred to the department of cardiothoracic surgery for cardiac surgery. The cases were categorized as coronary artery disease (CAD) (n=39), congenital heart disease-(CHD) (n=20), rheumatic heart disease (RHD) (n=14). 2 ml heparinised blood was collected prior to surgery. DNA was isolated and PCR for ACE genotype carried out using specific primers. The products were then run on 2 % agarose gel to identify the insertion (490 bp), insertion / deletion (490/190 bp) and deletion (190 bp) polymorphisms.Results: 74.3% CAD cases, 60% CHD cases and 57.1% of RHD cases showed the D-allele. These were compared with control group and our results showed that there was significant increase in the Dallele in CAD group with 'p' value < 0.05. Conclusions:Our results indicate that ACE gene D allele is playing a role in the development of CAD and knowing the genotype of the patient will help manage the patient appropriately.
Aims and Objectives:In this study the efficacy of two betalactumbetalactamose inhibitor combination (used along with Ofloxacin and Amikacin) in prevention of gram negative ESBL producing bacterial growth (primary endpoint) and sepsis induced by them (secondary endpoint) has been evaluated.Methods: In a single blind RCT, 123 high risk patients (acute myocardial infarction, severe unstable angina and uncontrolled hyperglycaemia) undergoing CABG (without pump support) were evaluated for evidence of significant bacterial growth in ET-tube or throat swap, central line tip three days post hospitalization. For secondary endpoint, patients were examined for increased total leucocyte count, presence of toxic granules and sepsis (if present) was confirmed by procalcitonin assay. Patients were randomized by drawing of cards and were distributed into two groups. Group A comprising 45 patients received Amoxycillin clavulinic acid combination and Group B comprising 78 patients received cefoperazone-sulbactum combination. Primary and secondary end point results are evaluated for statistical significance using chi-square test and z-testing respectively.Results and Analysis: Of 45 patients in Group A-9 patients showed bacterial growth and 6 patients showed evidence of sepsis and in Group B-6 patients showed significant bacterial growth of whom 2 developed sepsis. Evaluating the numerical values for primary end point by chi-square test showed p<0.05 and secondary endpoint showed computed 'z' value to be greater than predicted value.
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