Timmy Woods
Timmy Woods
OMG! television program that the ghost is this??
so I was watching this show a few weeks ago this team of college students investigating alleged apparitions walking, a bit like science fiction Ghost Hunters, but no, so they are with this child who can see ghosts and demons or so, there was a ghost who had died in the area in the forest where the child of the family lived and chose the man, "Timmy", a line PPL in an old photo, so i didn't see the name of the show, but it was really good, WHAT IS THIS SHOW?? Please and thanks: P
Paranormal State on A & E. A very cool show. In fact, I would like to show more images. Here is the website for the show. 3A% http://www.aetv.com/paranormal-state/index.jsp?utm_source=google&utm_medium=cpc&utm_term=paranormal+state&utm_campaign=paranormal+state&keywords=paranormal+state&paidlink=1&ref_str=http / / Www.google.com / search% 3Fq%% State + 3Dcom.microsoft 3Dparanormal% 26rls% 3Aen-us%% 3AIE search-box 26ie% 3DUTF-8% 26oe% 3DUTF-8%%% 26sourceid 3Die7 3D1I7SUNA 26rlz%
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Treatment of hyperlipidemia with Vitamin
INTRODUCTION
Heart disease is a major cause morbidity and mortality worldwide. The incidence of coronary heart disease (CHD) in Pakistan is as high as in western Pakistan world.1 46% in cardiac deaths are due to myocardial infarction and 23% are due to other subsets of ischemic heart disease.70% of these patients die even before any medical help will available to them. The main risk factors associated with the development of heart disease are sex, age, cigrete smoking, diabetes mellitus, hypertension and a HDL-C level hyperlipidemia.13 regardless of the level of LDL-C, is also a risk factor for CHD.Moreover a substantial proportion of patients with CHD have low levels HDL-C concentrations.4, 19-20
There are several drugs that lower total cholesterol, triglycerides, LDL-C and increasing HDL-C in the primary hyperlipidemia patients, but niacin is the best HDL-C raising agent between the lipid-lowering drugs.11 niacin inhibits the activity of lipase hormone that causes decreased sensitivity of lipolysis and thus decreases the secretion of VLDL hepatocytes.14 of the factors responsible for lower VLDL production are the inhibition of lipolysis, a decrease of free fatty acids in plasma, decreased hepatic triglyceride esterification, and a possible direct effect on hepatic production of apolipoprotein B-. Niacin also increases HDL-C, reducing its catabolism. It also lowers plasma fibrinogen levels and increased tissue plasminogen activator. All these factors influence the process of atherogenesis and CHD.13 15-Some recent studies also suggest that niacin also lowers blood pressure. possible mechanism is that niacin causes vasodilation due to the production of prostaglandin-3.9-12, 16
Patients and methods
This study was conducted in the Department of Pharmacology and Therapeutics, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi, January to July 2002.Forty primary hyperlipidemia patients were initially enrolled in this study were selected from OPD ward and the National Institute of Cardiovascular Diseases, Karachi.Newly diagnosed and untreated primary hyperlipidemic patients of either sex, age range 17-70 years were selected at random. Patients with diabetes mellitus, peptic ulcer, kidney disease, liver disease, hypothyroidism, and alcoholism were excluded from the study for laboratory research available, history and clinical examination. After explaining the limitations, we obtained the written consent of all study participants. The study period consisted 90 days follow-up visits every two weeks. The required information as name, age, sex, occupation, address, previous medication, date of visit monitoring and laboratory investigations, etc. of each patient was recorded on a proforma, specially designed for this study. Initially a detailed medical history and physical examination of all patients were carried out aa. All baseline assessments were taken on the day of inclusion (Day-0) in the study and evaluation similar was taken on day-90 of research design. After fulfilling the inclusion criteria patients were divided randomly into two groups, ieDrug-1 (Tab: Niacin 2GM) and drug-2 (placebo capsules, containing equal amounts of wheat ground in part) the groups. Patients in group-1 drug card is advised: Niacin (250 mg), half a tablet three times daily, after meals for 2 days, then increasing the dose of one tablet three times a day, after food for two days, then two tablets three times daily after meals for 2 days, then the dose maintaibnace 3 tablets per day after food three times a day until the end of the study period, ieup to day 90. This dose regimen of the drug (called degree of niacin) was applied due to the cancellation of the adverse effects caused by higher initial doses of the drug patients Niacin.17-2 group received placebo capsules, the capsule ieone, Three times daily after meals for 90 days. The patients were called every two weeks during follow-up to check blood pressure, weight, frequency pulse and the general appearance of the individual. Drug compliance regime was monitored through interviews and counseling at each clinic visit. Serum HDL-cholesterol was determined by the direct method, on the day-0 and 90 days, using the diagnostic kit # 303 210 040 by Eli technology, expressed as France.Data mean + SD and "t test" was applied to determine statistical significance as the difference. A probability value <0.05 was the limit significance.
RESULTS
Of the 40 patients, 37 completed on throughout the study period. Three patients withdrew from the drug-1 (group niacin) due to drug side effects such as flushing, warmth, apparatus urinary and headache. Tables showing baseline and the values are the results after treatment is summarized explainatory.When car and compared the test parameters, was that, after 90 days of treatment with niacin, HDL-cholesterol increased from 36.41 1.96 mg / dl to 43.70 1.81 mg / dl, which is highly significant (P <0.001). total percentage change from day to day, "0-90 was 20.02, as shown in Table No 1. In the placebo group on day-0, the level of HDL-C was 35.50 1.13 mg / dl, which increased to 35.75 1.07 mg / dl, which is not significant (P> 0.05). The overall percentage increase in the parameter was 0.70.The difference between the mean values between the placebo group and the group Niacin is 19.32 as shown in this table: 3.I systolic blood pressure of patients on niacin, reduced from 3.48 125.88 119.70 mm Hg to 3.13 mm Hg at 3 months, which is highly significant (P <0.001). At this rate of reduction is 4.90%, as shown in Table No: 1 and placebo 3.In this reduction is 1.62% (P <0.01) and the difference in the average values of these two groups is 3.28. Niacin has been shown to reduce diastolic blood pressure in hyperlipidemic patients. Diastolic pressure is reduced in the day-0, from 89.11 1.92 mm Hg to 84.70 1.74 mm Hg, on day-90, which is highly significant (P <0.001). At this rate of reduction is 4.94%. Placebo Group has shown little effect on diastolic pressure ie only 2.67%, but this difference is significant (P <0.01). Difference in mean values of diastolic BP between 2groups is 2.27, as shown in Table No: 2 and 3.
DISCUSSION
Among the lipid-lowering drugs, niacin appears to be the best HDL raising agent. In our study, levels of HDL-cholesterol increased by 20% in men and women with low levels of HDL-C treated with a mean dose of niacin (2 gm / day). The drug has another advantage of being cheap. Levels HDL-C, not only increased by 20%, but kept going over 3-month study period with therapy. This finding is consistent with the study of Martin et al.4 Jadraque Treatment with placebo capsules for 90 days, HDL-cholesterol increased 0.7% versus 3.7% increase in a study of lipid Clinics.18 Research 7% increase in HDL-cholesterol was mentioned in another study by al.It et Rivellese was demonstrated by Miller et al5 that long distance runners have the concentration HDL-C higher than the more sedentary subjects. The increase in HDL-C concentration by physical training may be a consequence of increased catabolism triglyceride-rich lipoprotein (VLDL). Was studied by McKinney et al7, that high doses of crystalline niacin increased 30% in the concentration of HDL-observation C. This is in contrast to our observation, probably due to small sample size of low-dose niacin 6GM drug.They used in 80 patients during months.Drop four-out rate in our study was 15% and most patients discontinued treatment because of side effects as flushing, urticaria and feeling hot in the body. Other patients are convinced to continue therapy by dose regimen of concentration (degree) niacin or aspirin 250 mg OD, before taking first dose of medication in the morning. Wilkin et al, have described the mechanism by which aspirin blocks induced niacin flushing.8 Stern et al mentioned that tolerance is developed for flushing, hives and itching in the body, adjusting the dose of niacin. Niacin produces prostaglandin D-3, causing vasodilatat, and lowers blood pressure.
CONCLUSION
The results of this study and the data previously published literature concluded that niacin reduces the risk of heart disease by increasing HDL-C and lowering blood pressure, could therefore recommend that this drug may be used as monotherapy in patients of hyperlipidemia in which HDL-C levels are low and are likely to develop atherogenesis.
REFERENCES
1. Krira KA, SMS Shah, Salahuddin et al (2000). The incidence of lipid disorders in the offspring of patients with premature myocardial infarction. Medical Canal; 6:9-12
2. Samad A, Sahibzada WA, Sheikh SA (1996). Guidelines for the detection and management of lipid levels. PJC; 7:26-46.
3. Timmis AD (1991). Early diagnosis of MI.BMJ; 7:309-310.
4. Idraque Martin-R, Tato F, Mostaza JM, Vega GL, Grundy SM (1996). Effectiveness of low-dose crystalline nicotinic acid in men with low levels of HDL-cholesterol levels.Arch.Intern.Med; 156:1081-1088.
5.Miller NE, Rao S, Lewis B, et al (1979). HDL and physical activity. Lancet, 1:111
6. Kris-Etherton PM, Pearson TA, Wan Y et al (1999). High in monounsaturated fatty acid diets reduce plasma cholesterol and triglycerides concentration.Am.J.Clin.Nutr; 70:1009-1015.
7. McKenny JM, JD Proctor, S Harris, VM Chinchili (1994). A comparison of the efficacy and toxic effects of sustained vs immediate-release niacin in hypercholesterolemic patients. JAMA, 271:672-677.
8. Wilkin JK, Wilkin O, Kapp R, Donachie R, Chernosky ME, Buckner J (1982). Aspirin blocks nicotinic acid-induced flushing.Clin.Pharmacol.Ther; 31:478-482.
9. RH Stern, JD Spence, DJ Freeman, Parbtani A, (1991). Nicotinic acid tolerance flushing.Clin.PharmacolTherap; 50:66-70.
10. Tato F, Vega GL, Grundy SM, (1998). Effects of crystalline nicotinic acid-induced liver dysfunction transferase.Am.J.Cardiol serum LDL-cholesterol and lecithin cholesterol acyl; 81:805-807.
11. Garg A, Grundy SM (1990). Nicotinic acid as therapy for dyslipidemia noninsulin dependent DM.JAMA; 264:723-726.
12. Levy RI, Fredrickson DS, Shulman R, (1972). Dietary and treatment primary pharmacological hyperlipedemia.Ann.Int.Med; 77:267-294.
13. Qizilbash N, L Jones, C Warlow, J Mann, (1991). Fibrinogen and lipid concentrations as risk factors for transient ischemic attacks and minor ischemic strokes. BMJ, 303:605-609.
14. Rivelles AA, Auletta P, Marotta G, et al (1994). The long-term metabolic effects of two methods of treatment of hyperlipidemia diet. BMJ; 5:10-14.
15. Roche HM, Gibney MJ (2000). Effect of long chain n-3 polyunsaturated fatty acids in fasting and postprandial triglycerolmetabolism.AM.J.Clin.Nutr; 71:232 S-237S.
16. Chisholm, J Mann, W Sutherland, Duncan A Skeoff M, Frampton C (1996). Effect on lipoprotein profile of replacing butter with margarine in a low-fat diet. BMJ, 312:931-939.
17. Crouse JR (1996). New developments in the use of niacin for treating hyperlipedemia. Coron Artery Dis, 7:321-326.
18. Delong DM, Delong ER, Wood PD, K Lippel, Rifkind BM (1986). A comparison of methods for estimating lowand plasma very low density lipoprotein cholesterol. JAMA, 256:2372-2377.
19. Kanne WB, Castell WP, Gordon T (2002). Cholesterol in the prediction of atherosclerosis. New Framingham-based perspective study.Ann.Intern.Med; 90:85-91.
20. Grundy SM, Denke MA (1999). Dietary lipids influence plasma lipids and lipoproteins Res 1999 (3): 1, 1149-1172.
21. Valverde MA, V.tolo RM, Patin RV, (1999). Changes in lipid profile in obese children and adolescents.Arch Lantinoam Nutr, 49:338-343.
About the Author
M Ashraf Memon, Nighat Kafil, Shah Murad,Muhsin Turab,Ghulam Rasool Bhurgari, Raj Kumar Chohan,Sibghatullah Sangi
L-Way Central spreads the wealth What makes Lincoln-Way Central dangerous is your score so many options. These options were on full display on Monday against Lincoln-Way North. Credit gonna wext Connor, who distributed the ball to their big hitters – that is, Kentner Josh, Kyle Overby and Tony Szajkovics – All night. Wext finished with 32 assists to lead Central to a 25-20, 20-25, 25-22 victory over North in …