1.
Relation between leucocyte count, myonecrosis, myocardial perfusion, and outcomes following primary angioplasty.
Prasad, A, Stone, GW, Stuckey, TD, Costantini, CO, Mehran, R, Garcia, E, Tcheng, JE, Cox, DA, Grines, CL, Lansky, AJ, et al
The American journal of cardiology. 2007;(8):1067-71
Abstract
We examined whether leukocytosis is a negative prognostic factor in patients who underwent primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI), and, if so, determined whether it is associated with impaired myocardial perfusion. Previous studies have identified leukocytosis as a predictor of mortality in AMI. Whether this association holds in patients how have undergone primary PCI using contemporary pharmacotherapy and correlates with impaired myocardial perfusion is unknown. Clinical outcomes and reperfusion success, using Thrombolysis In Myocardial Infarction (TIMI) flow and myocardial blush grades, were examined according to tertiles of baseline leukocyte count in 1,268 patients who underwent primary PCI for AMI in the CADILLAC trial. Patients with higher leukocyte count were younger and more likely to be current smokers. Preprocedure TIMI grade 0 flow was more frequent in patients with higher leukocyte counts, but postprocedural TIMI grade 3 flow rates were equally high (>94%) in all 3 groups. Myocardial blush grade 2/3 was achieved at similar rates after PCI in patients with low, intermediate, and high baseline leukocyte counts (52.0% vs 51.5% vs 50.1%, p = 0.8). Higher baseline leukocyte counts were associated with greater myonecrosis (p <0.0001) and increased mortality at 1 year (2.7% vs 4.6% vs 5.4%, respectively, p = 0.047). By multivariate analysis, baseline leukocyte count (in increments of 1,000, hazard ratio 1.07, 95% confidence interval 1.02 to 1.10, p = 0.005) and peak creatine phosphokinase (hazard ratio 1.22, 95% confidence interval 1.14 to 1.29, p <0.001) were independent predictors of 1-year mortality. In conclusion, baseline leukocytosis is an independent correlate of larger infarct and increased mortality after primary PCI in AMI, an effect not explained by decreased myocardial perfusion.
2.
Effect of Yoga asanas on nerve conduction in type 2 diabetes.
Malhotra, V, Singh, S, Tandon, OP, Madhu, SV, Prasad, A, Sharma, SB
Indian journal of physiology and pharmacology. 2002;(3):298-306
Abstract
Twenty Type 2 diabetic subjects between the age group of 30-60 years were studied to see the effect of 40 days of Yoga asanas on the nerve conduction velocity. The duration of diabetes ranged from 0-10 years. Subject suffering from cardiac, renal and proliferative retinal complications were excluded from the study Yoga asanas included Suryanamskar. Tadasan, Konasan, Padmasan Pranayam, Paschimottansan Ardhmatsyendrasan, Shavasan, Pavanmukthasan, Sarpasan and Shavasan. Subjects were called to the cardio-respiratory laboratory in the morning time and were given training by the Yoga expert. The Yoga exercises were performed for 30-40 minutes every day for 40 days in the above sequence. The subjects were prescribed certain medicines and diet. The basal blood glucose, nerve conduction velocity of the median nerve was measured and repeated after 40 days of Yogic regime. Another group of 20 Type 2 diabetes subjects of comparable age and severity, called the control group, were kept on prescribed medication and light physical exercises like walking. Their basal & post 40 days parameters were recorded for comparison. Right hand and left hand median nerve conduction velocity increased from 52.81 +/- 1.1 m/sec to 53.87 +/- 1.1 m/sec and 52.46 +/- 1.0 to 54.75 +/- 1/1 m/sec respectively. Control group nerve function parameters deteriorated over the period of study, indicating that diabetes is a slowly progressive disease involving the nerves. Yoga asanas have a beneficial effect on glycaemic control and improve nerve function in mild to moderate Type 2 diabetes with sub-clinical neuropathy.