Background: Brachial artery flow mediated dilatation (BAFMD), assessed by high resolution ultrasonography, reflects endothelium dependent vasodilator function. BAFMD is diminished in patients with atherosclerosis and with coronary risk factors and improves with risk reduction therapy.Methods: Study was conducted on 50 patients of coronary artery disease from In-patients who were admitted in the Department of Medicine and 25 healthy control without cardiovascular disease risk factors. All patients having established CAD i.e. Acute coronary syndrome and past history of CABG/angioplasty were included in study. Those morbidly ill and patients with evidence of chronic inflammatory or malignant disease were excluded. Doppler ultrasound of brachial artery was performed in all of them to assess baseline lumen diameter and flow mediated dilatation (i.e. percent change in brachial artery diameter after occlusion cuff release). Patients were divided into two groups; first group was classified as those having BAFMD less than 7.5% and the second group consisted patients having BAFMD less than 10%.Results: Flow mediated dilatation in cases was 6.87±5.48% as compared to the control group in which it was 13.08±3.40% and was statistically significant (P value 0.000002). Brachial artery flow mediated dilatation was abnormal in 80% cases at a cut off value <10% significant abnormalities; i.e. BAFMD <7.5% was found in 66% patients.Conclusions: Endothelial function as assessed by FMD is significantly impaired in patient of coronary artery disease. Hence it may be used as an important screening tool in people having cardiovascular disease risk factors and may play as a crucial role in preventive cardiology.
Introduction: Cerebrovascular accident or stroke is a disease of the vascular system of the brain.According to ICD 11, stroke is classified as a neurological disease and not under the circulatorysystem. It is the second leading cause of death worldwide. It cannot be said that high Serum UricAcid [SUA] amongst patients with cerebrovascular accidents is directly correlated with theiroutcome. The present study planned to estimate uric acid levels and their association in acute strokepatients, both ischemic and hemorrhagic. Method: A total of 100 stroke patients admitted under theneurology department were included in the study. Brain imaging (CT/MRI) was performed. Theserum uric acid was estimated. Results: Out of a total of 100 patients, 74 were males, and 26 werefemales. Nine patients were less than 45 years old and 91 patients were 45 and above. Thirty-ninepatients had ischemic, and 61 patients had a hemorrhagic stroke, respectively. Out of 100 patients,23 patients had normal uric acid levels (<7mg/dl). Seventy-seven patients were with high uric acidlevels. The mean serum uric acid concentration in male patients was 8.48±2.7and 9.20±2.7 infemales. Among the total 100 cases, 69 survived, and the remaining 31 were among the non-survivor group at the time of discharge. Mean serum uric acid in stroke survivors was 8.5±2.6mg/dl, while in non-survivors, it was 8.6±2.2 mg/dl. There was no significant difference between thelevels of uric acid among survivors and non-survivors. Conclusions: The prevalence ofhyperuricemia (>9mg/dl) amongst stroke patients was 77% in the present study. The values ofserum uric acid were significantly elevated in the patients aged > 45 years. The serum uric acidvalues were high among the group of hyperglycemic and hypertensive patients at the time ofadmission. There was no significant difference between the levels of uric acid among survivors andnon-survivors.
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