Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



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Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
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Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2010 | Month : December | Volume : 4 | Issue : 6 | Page : 3425 - 3429

Cardiac Enzymes, Total Thiols And Lipid Peroxidation In Patients With Acute Myocardial Infarction

BABU SURESH1, JEEVAN KUMAR SHETTY2, MUNGLI PRAKASH3

1MD, Department of Biochemistry, JJM Medical College, Davangere, Karnataka, India; 2MD, Department of Biochemistry, Kasturba Medical College, Manipal University, Karnataka, India; 3MD, Department of Biochemistry and Genetics, St. Mathews University, School of Medicine, Grand Cayman, Cayman Island, BWI.

Correspondence Address :
Dr. Jeevan Kumar Shetty,
Associate Professor,
Department of Biochemistry,
Kasturba Medical College,
Manipal- 576104, INDIA
Telephone: 0091-0820-2922326 (office);
0091- 98443 03671 (mobile).
Email: drjkshetty1978@yahoo.com

Abstract

Background: Oxidative stress has been implicated in the pathogenesis of acute myocardial infarction. In the current work ,we have measured malondialdehyde (MDA), total thiols, total creatine kinase (CK), creatine kinase-MB isoenzyme (CK-MB) and aspartate aminotransferase ( AST) in electrocardiogram (ECG) proven acute myocardial infarction (AMI) patients at 12 hours after the onset of chest pain and also in healthy controls.

Methods: Blood samples from 25 AMI patients and 25 age and sex matched healthy controls were obtained for the measurement of cardiac enzymes like total CK, CK-MB and AST by using an automated analyzer. Serum MDA and total thiols were determined by using spectrophotometric methods.

Results: We have found a significant increase in MDA, total CK, CK-MB and AST (p< 0.001) and a significant decrease in total thiols (p<0.001) in AMI patients as compared to the healthy controls. MDA correlated negatively with total thiols (r = - 0.573, p<0.01) and positively with CK-MB (r = 0.845, p<0.01) and AST (r = 0.676, p<0.01) in the AMI patients.

Conclusions: Reactive oxygen species play a role in the pathogenesis of atherosclerosis, thus leading to acute coronary events and their levels are further elevated by the ischaemic event itself.

Keywords

MDA, total thiols, myocardial infarction, oxidative stress, cardiac enzymes

Introduction
Acute myocardial infarction (AMI) is one of the major causes of mortality and morbidity in the world.(1) The most common cause of AMI is atherosclerotic coronary artery disease (CAD) with the erosion or rupture of a plaque, thus causing transient, partial or complete arterial occlusion.(2) () Previous studies have shown that reactive oxygen species (ROS) cause the initiation and progression of atherosclerosis, thus leading to coronary artery disease. (3) During AMI, two distinct types of damage occur to the heart: ischaemic injury and reperfusion injury. The heart can tolerate a brief exposure to ischaemia, as the temporary protective mechanisms like anaerobic glycolysis, fatty acid utilization, increase in glucose uptake and decreasing contractility of heart muscles. Persistent ischaemia can develop a severe ATP deficit and myocardial cell death.(4)

During ischaemia, ROS can be produced both by the endothelial cells and the circulating phagocytes, and they are capable of damaging macromolecules; including nucleic acids, proteins, lipids, lipoproteins and carbohydrates.(5) On interaction with unsaturated lipids, ROS are capable of initiating the self-perpetuating chain reactions of lipid peroxidation in the membranes. Malondialdehyde (MDA), a lipid peroxidation end product, is considered as one of the markers of cell membrane damage.(6) The major antioxidant in the body fluids is the cysteine-SH which is bound to protein, a majority of it being found on albumin and glutathione (GSH). These –SH groups (total thiols) play a major role along with other antioxidants in the body to ameliorate the lipid peroxidative effects of ROS.(7)

In the current work, we have measured total thiols which are major antioxidants in body fluids, and MDA which is an important marker of lipid peroxidation, along with cardiac enzymes like total CK, CK-MB and AST in AMI patients at 12 hours after the onset of chest pain, to compare their levels with those of age matched healthy controls. We have also tried to establish a relationship between oxidative stress markers and cardiac enzymes.

Material and Methods

Subjects and Samples
The study was carried out in the Department of Biochemistry, JJM Medical College, Davangere, India. The study group consisted of 25 AMI patients and 25 age and sex matched healthy controls. The mean age and sex of the patients was 54±9 years, and 20 males/5 females, and that of the controls was 45±17 years, and 17 males/ 8 females, respectively. The patients who were recruited from the Bapuji and Chigateri Government hospitals were brought to the emergency room with a history of chest pain. Patients with chest pain were diagnosed to have AMI according to the clinical criteria- chest pain which lasted for more than 3 hours, ECG changes (ST elevation of 2mm or more in at least two leads) and elevation in total CK and CK-MB.

Informed consent was obtained from all the subjects who were involved and ethical clearance was obtained from the Institutional Ethics Committee (IEC). Blood samples were drawn into plain vacutainers from the antecubital veins of AMI patients immediately after admission. Similarly, samples were also obtained from age and sex matched healthy controls. Total CK, CK-MB, AST, MDA and total thiol levels were measured in all the obtained samples after proper processing.

Reagents
Special chemicals like 5’ 5’ dithio-bis (2-nitrobenzoic acid) (DTNB), reduced glutathione (GSH), and standard MDA were obtained from Sigma Chemicals, St Louis, MO, USA. All other reagents were of the analytical grade.

Biochemical Determinations
Measurement of cardiac enzymes:
Reagent kits for total CK, CK-MB and AST were obtained from Merck, India. Cardiac enzymes like total CK, CK-MB and AST were measured by an enzymatic assay by using a Ciba Corning 550 Express automated analyzer. (8), (9), (10)

The Total thiol assay:
The reaction mixture contained 900 µL of 2 mM Na2 EDTA in 0.2 M Na2HPO4, 20 µL of 10 mM DTNB in 0.2 M Na2HPO4 and 100 µL of serum. The reaction mixture was incubated at room temperature for 5 minutes and the absorbance was read at 412nm. Appropriate sample and reagent blanks were prepared simultaneously and the respective absorbance was noted. Corrected absorbance values were used to calculate serum total thiols by using the molar extinction coefficient of 1600 M-1 cm-1 and the values were expressed as µM. The calibration curve was produced by using GSH dissolved in phosphate buffered saline. (11)

MDA assay:
The reaction mixture contained 1 mL of 0.67% thiobarbituric acid (TBA), 500 µL of 20% Tri carboxylic acid (TCA) and 100 µL of serum. This was incubated at 100oC for 20 minutes and was centrifuged at 12,000rpm for 5 minutes. The absorbance of the supernatant was read at 532 nm. MDA was determined by using a molar extinction coefficient of 1.56 x 105 M-1 cm-1 and the values were expressed as nM. (12)

Statistical Analysis
The results were expressed as the mean ± standard error of the mean (SEM). p values <0.05 were considered to be statistically significant. Statistical analysis was performed by using the Statistical Package for Social Sciences (SPSS-16, Chicago, USA). The independent sample t test was used to compare the mean values between the cases and the controls. Pearson correlation was applied to correlate between the parameters.

Results

As shown in (Table/Fig 1), we have found a significant increase in MDA, total CK, CK-MB and AST (p< 0.001), and a significant decrease in total thiols (p<0.001) in AMI patients as compared to the healthy controls.
(Table/Fig 1): Total thiols, MDA, total CK, CK-MB and AST levels in healthy controls and myocardial infarction patients at 12 hours after the onset of chest pain (Values expressed in mean ± SD).
On applying Pearson’s correlation, MDA was found to correlate negatively with total thiols (r = - 0.573, p<0.01) (Table/Fig 2), and positively with CK-MB (r = 0.845, p<0.01) (Table/Fig 3) and AST (r = 0.676, p<0.01) in AMI patients.
(Table/Fig 2): Correlation graph between MDA and Total thiols in AMI patients
(Table/Fig 3): Correlation graph between CK-MB and MDA in AMI patients

Discussion

We have found a significant increase in the cardiac enzymes in AMI patients which rose in parallel to the extent of myocardial injury. The characteristic pattern of the rise in the serum cardiac enzymes was: they started to increase 4-6 hours after injury, reaching peak concentrations after 12-24 hours and returning to the baseline after 48-72 hrs. (13) The rise in the CK-MB levels was seen in all the AMI patients and they were elevated about an average of 8 times than the normal. This may indicate the extent of cardiac muscle damage during the ischaemic event, which can further damage the adjacent tissue by generating free radicals. Several previous studies have shown the presence of oxidative stress and the increased generation of reactive oxygen species during myocardial injury. (14)

One of the best markers of lipid peroxidation in serum is MDA, which indicates the amount of membranes which are being damaged by the reactive oxygen species. Being a lipid peroxidation product, the elevation of MDA in AMI patients is an indicator of increased oxidative stress. (14) We have found significant elevation in MDA levels after myocardial infarction as compared to the healthy controls. This finding further substantiates the role of free radicals in damaging the myocardial membrane. There is growing evidence that an increase in free radicals is relevant to atherosclerotic plaque formation and activation. (6) Furthermore, it has been shown that lipid peroxidation and MDA generation are enhanced by the ischaemic event itself. In ischaemia, the ATPs are drastically reduced and are degraded to hypoxanthine and then into uric acid by xanthine oxidase. During this process, enormous amounts of superoxide radicals are formed, which can stimulate the Haber-Weiss reaction by generating ROS, which enhance the lipid peroxidation process. (15) We have also observed that increased MDA levels after reperfusion, correlated positively with the cardiac marker enzyme, CK-MB, which may again explain the ROS mediated damage to the myocyte membranes, thereby increasing the release of the cardio specific marker, the CK-MB fraction. (16)

We have found a decrease in total thiols in AMI patients, thus indicating an increased consumption of thiols due to the increased generation of ROS due to ischaemia and reperfusion. The decrease in total thiols correlated negatively with MDA, thus indicating an increased consumption of thiols while neutralizing an enormous increase in MDA levels during ischaemia. Total thiols are important antioxidants and a part of them in plasma is derived from proteins, especially albumin. They constitute the foremost defense system that limits the biomembrane damage which is associated with free radicals. (17) It has been demonstrated that the plasma antioxidant capacity decreases and the oxidative/antioxidative balance shifts to the oxidative side in patients with AMI. (5) Total thiols being important antioxidants, a decrease in their levels may be the reason for increased lipid peroxidation in patients with AMI. (6)

In conclusion, ROS is responsible for the pathogenesis of AMI and their production is enhanced during ischaemia, due to decreased antioxidant defense mechanisms.

References

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Ojha SK, Nandave M, Arora S, Narang R, Dinda AK, Arya DS. Chronic administration of Tribulus terrestris Linn extract improves cardiac function and attenuates myocardial infarction in rats. Int. J. Pharmacol. 2008;4:1-10
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Kasap S, Gonenc A, Sener DE, Hisar I. Serum cardiac markers in patients with acute myocardial infarction: oxidative stress , C-reactive protein and N-terminal Probrain Natriuretic Peptide. J Clin Biochem Nutr. 2007; 41(1):50-57.
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Hori M, Nishida K. Oxidative stress and left ventricular remodelling after myocardial infarction. Cardiovasc Res. 2009; 81: 457–64.
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Misra MK, Sarwat M, Bhakuni P, Tuteja R, Tuteja N. Oxidative stress and ischemic myocardial syndromes. Med Sci Monit. 2009; 15(10): RA209-19.
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Patil N, Chavan V, Karnik ND. Antioxidant status in patients with acute myocardial infarction. Ind J Clin Biochem.2007; 22(1):45-51.
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Pasupathi P, Rao YY, Farook J, Saravanan G, BakthavathsalamG. Oxidative stress and cardiac biomarkers in patients with acute myocardial infarction. Eur Jour of Sci Res. 2009; 27 (2): 275-85.
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Prakash M, Shetty JK, Tripathy S, Vikram P, Verma M. Serum paraoxonase activity and protein thiols in patients with hyperlipidemia. J Hainian Medical College. 2009; 15(2):111-13.
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Horder M, Elser RC, Gerhardt M et al. Approved recommendation on IFCC methods for the measurement of catalytic concentration of enzymes. Part 7. IFCC Method for creatine kinase. Eur J Chem clin Biochem. 1991; 29:435-56.
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Neumeier D, Prellwitz W, Wurzburg et al. Determination of creatine kinase MB isoenzyme MB activity using immunological inhibition of creatine kinase M subunit activity-activity kinetics and diagnostic significance in myocardial infarction. Clin Chim Acta. 1976; 73:445-51.
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Bergmeyer HU, Horder M, Rej R. Approved recommendation (1985) on IFCC methods for the measurement of catalytic concentrations of enzymes. Part 2. IFCC method for aspartate aminotransferase. J Clin Chem Clin Biochem 1986; 24:497-508.
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Motchnik AP, Frei B, Ames NB. Measurement of antioxidants in human blood plasma: Protein thiols. In: Packer L, editor. Oxygen radicals in biological systems. Methods in Enzymology, Academic Press: California; 1994. p. 234(D): 273-4.
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Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction. Anal Biochem. 1979; 95(2):351-8.
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Kemp M, Donovan J, Higham H, Hooper J. Biochemical markers of myocardial injury. Br J Anesthesia.2004; 93(1):63-73
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Bhakuni P, Chandra M, Misra MK. Levels of free radical scavengers and antioxidants in post-perfused patients in myocardial infarction. Cur Sci. 2005; 89(1):168-70.
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Senthil S, Veerappan RM, Rao RM, Pugalendi KV. Oxidative stress and antioxidants in patients with cardiogenic shock complicating acute myocardial infarction. Clin Chim Acta. 2004; 348(1-2):131-37.
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Gupta S, Singh KN, Bapat V, Mishra V, Agarwal DK, Gupta P. Diagnosis of acute myocardial infarction: CK-MB versus cTn-T in Indian patients. Ind J Clin Biochem. 2008;23(1):89-91
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Gururajan P, Gurumurthy P, Nayar P, Chockalingam M, Bhuvaneshwari S, Babu S, Sarasabharati A, Victor D, Cherian KM. Lipid profile and non-enzymic antioxidant status in patients with acute coronary syndrome in South India. Heart Lung Circ. 2010; 19(2):75-80.

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  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com