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QUARTESIAN NEWS LETTER

Aims to provide interesting articles and news on current areas of research


Issue 04 to scientific fellow members of the industry

Vol 01
th EDITORIAL
10 Dec, 2010
Cardiovascular Disease – The leading killer…
Greetings from Quartesian! Hope you had nice festival season!!

QNL readers now can join “QNL - Community for Science” a community in Orkut. It is
an effort to bring all the readers to one forum.

It is nice to know that many like our effort and are interested to contribute. I am
happy to make a mention on Dr. Karthik of IDM and Ms. Kirti of Abbott Vascular, who
have contributed articles for QNL.

We are very glad to present fourth issue of QNL. In this issue the main focus is on
Cardio Vascular Diseases and seven important study findings in this area have been
briefed.

Chief Editor We have tried to explore the relationship of CVD with albumin levels, serum
magnesium levels, job strain in women and sleep duration. In addition, we have
Dr. Shiva Murthy N provided brief study reports on association between preoperative angiotensin
blockade and the occurrence of postoperative atrial fibrillation and beta blockers in
Scientific Contributors
CVD with COPD.
Ms. Manjula Devanur
Occupational health hazard of alcohol hand rubs and effects of passive alcoholism is
Dr. Shiva Murthy N
Ms. Renuka Gahlawat yet to be explored. We hope that some young scientists like postgraduate students
Dr. Karthik Anantharaman may take up this as their research topic and provide more insights on this.
Ms. Kirti Narang
In the next issue we will be coming up with many more features like case study with a
Review Board prize question, review article on disease management, brain teasers.

Mr. Soumitra Chowdhury We are sure that writer in you want to contribute and realize his/her satisfaction. We
Mr. Benjamin Jackson are also sure that you don’t want to suppress him/her. Please do your creative work
Dr. Vladimir Mats and send us your article at shiva.murthy@quartesian.com or shivuindia@yahoo.com.
Mr. John Packianathan
Mr. Prakash Velappan We look forward to bring many more issues… thanks again for your continued
Mr. Prasanna Sondur support….
Ms. Ramya Krishna
Dr. Rhuta Khaparde
QNL EDITORIAL BOARD

Send your queries to


shiva.murthy@quartesian.com
LOW SERUM ALBUMIN LEVELS INCREASES HEART FAILURE RISK1
Researchers (Gopal DM and associates) evaluated the association of serum albumin levels
with heart failure (HF) risk in 2907 participants without heart failure (HF) aged 73.6 ± 2.9
years with 48.0% male and 58.7% white in the community-based Health ABC study.
Using the standard and competing risks proportional hazards models controlling for HF
predictors, inflammatory markers, and incident coronary events, researchers assessed the
association between baseline albumin and incident HF.
The participants were followed up for a median period of 9.4 years during which 11.8%
developed HF.
It was noted that, with significance retained for up to 6 years, albumin was a time-
dependent predictor of HF.
This association persisted in models controlling for HF predictors, inflammatory markers, and
incident coronary events and when mortality was accounted in adjusted competing risks
models.
Similar association of albumin with HF risk was observed in men and women and in whites
and blacks in adjusted models.
Based on these data, researchers concluded that low serum albumin levels are associated
with increased risk for HF in the elderly in a time-dependent manner independent of
inflammation and incident coronary events.

SUPPORT AND FEEDBACK ON THIRD


ISSUE OF QNL
We are glad to share that we received lot of support and positive feedback from the prominent personnel
in the industry and the list below is a sample one. We thank each and everyone and request for continued
support….

K. Venkateshwarlu (Natural Remedies) B.Elangovan (Company Not Known) Chetan J. Somaiya (company not known)
VG Nair (Sami Labs) Herman Rhee (ISS Lab) Balaji P (Company Not Known)
Chirag Shah (Company Not Known) Hrushikesh Joshi (Company Not Known) Jyo Devi (Company Not Known)
Devesh Mishra (Quintiles) Mihai Manolache (CEBIS International) Shashikumar Nair (Company Not Known)
Tristan W Elliott (Era consulting) Arnab Mandal (Kamud Drugs) Rajeshwar Singh (Scripta Medica)
Guruprasad B (Company Not Known) Deepak Kainth (Company Not Known) Sudha Suresh (St. John's Research Institute)
Kushal Sarda (Company Not Known) Chandra Sekar (Pfizer) Salil U. Varma (DBMS Consulting)
Parvathi Chandrasekar (Company Not Known) Deboleena Goswami (Student of CDM and SAS) Kuldeep Patil (Omnicare Clinical Research)
Sowmya Naidu (Student, B Pharma) Krishnakumar (Azidus) Subodh Bhardwaj (Sanofi Pasteur)
Ranga Prakash (Company Not Known) Gayatri Jaiswal (Sanofi Synthelabo (India)) Sharon Bingert (Freelancer-Creative Technical
Shantaram Shenai (Company Not Known) Renuka gahlawat (Fortis Clinical Research) Writer)
Hariom Upadhyay (Novartis Healthcare) Rashi Gandhi (Triesta) Sandip Chakraborty (Company Not Known)
Vamsi Krishna G (Glorigin Lifesciences) Pralhad Patki (The Himalaya Drug Company) Vivek Badoni (Ranbaxy)
Ram Balani (FDASmart Inc) Edward (company not known)

Please send your feedback and support to our initiative by emailing to


shiva.murthy@quartesian.com 2
LOW SERUM MAGNESIUM AND ITS ASSOCIATION WITH SUDDEN CARDIAC DEATH2

Researchers reported in American Heart Journal recently that low levels of serum Magnesium (Mg) may
be an important predictor of sudden cardiac death (SCD) based on the results from the Atherosclerosis
Risk in Communities Study.
The risk factors and levels of serum were assessed by researchers in a cohort of 14,232 subjects aged 45-
45- to
64-
64-years during 1987-
1987-1989.
The duration of the follow up was for over 12 years during which researchers observed 264 cases of SCD,
as determined by physician review of all suspected cases.
Proportional hazards regression method was used to evaluate the association of serum Mg with risk of
SCD.
The subjects who were in the highest quartile of serum Mg were at significantly lower risk of SCD in all
models.
After adjusting for potential confounding variables also, this association persisted with an almost
40% reduced risk of SCD (hazard
(hazard ratio 0.62, 95% CI 0.42-
0.42-0.93) in quartile 4 versus 1 of serum
Mg observed in the fully adjusted model.
The study data suggests that low levels of serum Mg may be an important predictor of SCD.
Researchers opine that further research on the effectiveness
effectiveness of Mg supplementation for those
considered being at high risk for SCD is warranted.

No ASSOCIATION between POSTOPERATIVE ATRIAL FIBRILLATION AND ANGIOTENSIN-


ANGIOTENSIN-
BLOCKING DRUG THERAPY3

Rader F et al., conducted a large observational study to assess the link between preoperative use of
angiotensin-blocking drug therapy (ABDT) with angiotensin-converting enzyme inhibitors or
angiotensin II receptor blockers to occurrence of postoperative atrial fibrillation (POAF), a common
marker of poor outcomes after cardiac surgery.
This study involved 10,552 patients who underwent coronary artery bypass grafting with or without
valve surgery during the period 1997 to 2003.
Propensity score analyses were conducted to adjust for differences of clinical characteristics between
patients who received ABDT within 24 hours before surgery compared with those who did not.
45% (4,795) of patients were prescribed with Angiotensin-blocking drug therapy before surgery, of
which 36% (1,725) developed POAF before discharge versus 33% (1,908) of 5,757 patients who did not
receive ABDT (unadjusted odds ratio 1.13, 95% CI 1.05-1.25, P < 0.01).
ABDT was not associated with POAF (odds ratio 1.05, CI 0.95-1.16, P = 0.38) in 6,744 propensity score-
matched patients with well-balanced comorbidity profiles.
These findings were confirmed by stratified analysis within propensity score and propensity-adjusted
logistic multivariable regression.
As researchers found no evidence of an association between preoperative angiotensin blockade and the
occurrence of POAF in this large observational study, they opined that adequately powered randomized
studies are required to clarify the best strategy of perioperative ABDT in patients with and without
guideline-based indications.

Partnership for
Conferences, Workshops, Road shows, Seminars
QNL would be happy to partner with any of the above mentioned events in healthcare and clinical research
sector as “supporting partner”. Please send your queries to shiva.murthy@quartesian.com (Note: QNL reaches
3
more than 25,000 professionals worldwide)
A small study shows - Benefits outweigh risks for beta-blockade for patients with
CV disease with COPD4

Beta blockers have substantially reduced the mortality rate in patients with coronary Heart disease,
Coronary Heart failure and Hypertension.
Clinicians are fearful of using it in patients with COPD (Coronary Obstructive pathway disease) due to the
possibility of worsening of disease from the potential side effect of broncho constriction.
Patients with COPD took a nonselective beta- and alpha-adrenergic blocker (Carvedilol), for a period of 3
months. Eighty-five percent of the 89 patients with COPD tolerated carvedilol.
One of the site which has participated in cohort study published smaller retrospective analysis of 31
patients with heart failure and COPD without reversible airflow obstruction who were started on
carvedilol therapy.
Patients followed for more than 2.4 years and found that only one patient had stopped taking carvedilol
due to wheezing.
Researchers opined that benefits outweigh risks while using Beta-blockers in patient with heart disease
coexisting with COPD.
Prudent management of these patients shows that it should be initiated with low dose and continuous
monitoring of patient is required. Bigger studies may give better overview on this topic.

A
ACADEMIC PARTICIPATION
5TH DIA ANNUAL CONFERENCE ON DRUG
DISCOVERY
AND CLINICAL DEVELOPMENT

TUTORIAL WORKSHOP ON BIOSIMILARS

Dr. Srinivas and Dr. Shiva Murthy jointly hosted 4


hours session on “Biosimilars: prospects and
challenges in the development, licensing, and
B commercialization”.

The course included 4 case studies,


introduction to biosimilars, definition, market
outlook, companies, molecules, advantages,
production, sources & technology, analytical
tools, new developments, challenges,
regulatory scenario in US, EU, India and other
countries.

We thank DIA for providing this opportunity and


Connexios for sharing the responsibility and
contribution.

4
HIGH JOB STRAIN IN WOMEN INCREASES CVD RISK5
Job strain, a form of psychological stress, is defined as having a demanding job, but little to no decision-
making authority or opportunities to use one’s creative or individual skills.
Researchers have reported a 40% increased risk of CVD among women who reported to have high job
strain in the study population in Women’s health study in US.
Researchers examined the relationship between job strain, job insecurity, and incident CVD among
17,415 apparently healthy female health professionals of mean age 57±5 years for about 10 years.
134 myocardial infarctions (MI), 125 ischemic strokes, 342 coronary revascularizations, and 40 CVD
deaths were reported during the study period.
Results showed that high job strain predicted increased risk of physical inactivity and
hypercholesterolaemia (all p-values <0.05), and women reporting job insecurity had increased risk of
smoking, physical inactivity, hypertension, diabetes mellitus, hypercholesterolaemia, and higher BMI (all
p-values <0.05).
In models adjusted for age, race, education, and income, women with high job strain were 40% more
likely to experience a CVD event than their counterparts who reported low job strain (Risk Ratio
(RR)=1.40, CI=1.06, 1.86).
Outcome-specific analyses revealed that high job strain predicted MI (RR=1.88, CI=1.07, 3.30), and
coronary revascularization (RR=1.43, CI=1.01, 2.01), but not stroke (RR=1.31, CI=0.74, 2.32) or CVD
death (RR=0.99, CI=0.37, 2.67). No evidence of an association between job insecurity and risk for CVD
was observed.
Researchers concluded that job strain was related to increase CVD among working women.
With increased dual responsibilities of both career and childrearing among working women,
researchers emphasize the importance of assessing job stress in CVD prevention efforts.

Clinical Data Management and SAS programming Industry Training Courses 5


An innovative Industry-Academia collaboration has been established between Quartesian and CliniMinds to
offer 6 months diploma courses. For course details please contact/write to shiva.murthy@quartesian.com
We believe in “Build the Nation for Better Tomorrow” concept.
Spread the news on below mentioned national programs by forwarding this news letter

Collaborative Innovation Proposals on Call for Expression of Interest (EOI)


Affordable Health Care Technologies
Technical Support Unit To Manage
Called by Targeted Interventions and Other Civil
Govt of India Society Initiatives in State AIDS Control
Dept. of Biotechnology Societies (SACS)
The Biotechnology Industry Research Assistance Program (BIRAP)

Interested companies may submit their


application (formats available in NACO website
www.nacoonline.com).
Detailed advertisement available in Times of India,
Bangalore edition, Nov 21, 2010 on Page 20. The detailed advertisement is available in The
Times of India, Bangalore edition, Wednesday,
You need to submit application online only. So please November 10, 2010 page 22.
visit www.birapdbt.nic.in.
Selection will be based on guidelines set out by
the World Bank.
Contact person is
Dr. Renu Swarup EOI should be sent to
Advisor Incharge-BIPP, Department of Biotechnology Director (Finance) NACO, 6th Floor, Chandralok
Email: swarup@dbt.nic.in / bipp.dbt@nic.in Building, 36 Janpath, New Delhi -110001.

Alcohol-Based Hand Rubs - Passive Alcoholization and Risks6


Alcohol-
(A potential new area of research for PG students)

Alcohols-based hand rubs (ABHRs) are the most effective measure to prevent nosocomial
infections in healthcare.
ABHRs contain on an average 70% by weight of one or more alcohols.
Through dermal contact and inhalation, users are exposed to these alcohols, due to the
physical and chemical properties of alcohols volatilizing from alcoholic solutions or gels into
the air.
Ethanol ingestion increases risks of several diseases affecting the pancreas, liver,
cardiovascular system etc..
Healthcare worker may be exposed to a maximum 5,500 mg/m3 per work shift after an
average 30 hand rubbings (five times above the recommended occupational time weighted
average limit) per healthcare professional per day.
More studies required in order to answer the question posed in the title.
Studies on spatial and temporal variability of alcohol emission from ABHRs in real world
situations and studies on certain high risk individuals are needed.

6
Sleep Duration and Cardio Vascular Disease7
Shorter and longer sleep durations than 7 hours per day is associated with an increased CVD risk reported
a study by Sabanayagam et al.
A cross-sectional study was conducted among 30,397 volunteers aged ≥18 years (57.1% women) who
participated in the 2005 National Health Interview Survey, which collected information on demographic
factors, socioeconomic characteristics, lifestyle and health.
Results showed that both short and long sleep durations to be independently associated with CVD,
independent of age, sex, race-ethnicity, smoking, alcohol intake, body mass index, physical activity,
diabetes mellitus, hypertension, and depression.
Compared with a sleep duration of 7 h (referent), the multivariate odds ratio (95% CI) of CVD was 2.20
(1.78, 2.71), 1.33 (1.13, 1.57), 1.23 (1.06, 1.41), and 1.57 (1.31, 1.89) for sleep duration ≤5 h, 6 h, 8 h,
and ≥9 h.
Researchers observed that this association persisted in subgroup analyses by gender, race-ethnicity, and
body mass index categories.
Furthermore, similar associations were observed in case of myocardial infarction and stroke when
examined separately.
Researchers concluded that Compared with sleep duration of 7 h, there was a positive association
between both shorter and longer sleep durations and CVD in a representative sample of US adults.
These results suggest that sleep duration may be an important marker of CVD.

References
1. Gopal DM, Kalogeropoulos AP, Georgiopoulou VV, et al. Serum albumin concentration and heart failure risk The Health,
Aging, and Body Composition Study. Am Heart J. 2010 Aug; 160(2):279-85.
2. Peacock JM, Ohira T, Post W, et al. Serum magnesium and risk of sudden cardiac death in the Atherosclerosis Risk in
Communities (ARIC) Study. Am Heart J. 2010 Sep; 160(3):464-70.
3. Rader F, Van Wagoner DR, Gillinov AM, et al. Preoperative angiotensin-blocking drug therapy is not associated with atrial
fibrillation after cardiac surgery. Am Heart J. 2010 Aug; 160(2):329-336.
4. Lynda M. Baselli, Mark A. Oswald, Joan M. Nashelsky. Do beta-blockers worsen respiratory status for patients with
COPD?. The journal of family practice; VOL 54, NO 5 / MAY 2005;472-3.
5. Natalie Slopen, Robert J Glynn, Julie Buring, Michelle A Albert. Job Strain, Job Insecurity, and Incident Cardiovascular
Disease in the Women's Health Study. Circulation. 2010; 122:A18520.
6. Vincent Bessonneau, Michel Clément and Olivier Thomas. Can Intensive Use of Alcohol-Based Hand Rubs Lead to Passive
Alcoholization?. Int. J. Environ. Res. Public Health 2010, 7, 3038-3050; doi:10.3390/ijerph7083038
7. Sabanayagam C, Shankar A. Sleep duration and cardiovascular disease: results from the National Health Interview Survey.
Sleep. 2010 Aug 1;33(8):1037-42.

Disclaimer: The contents of the news letter are for internal circulation only and not for sale. To the
best of our knowledge the information was collected from the open sources and the article is re-
synthesized at Quartesian. We do not claim any copyrights and original authors of the research
retains all the claims and copyrights. We have done best to convey messages and conclusions to
reflect original article. We will not be responsible for any misunderstanding and disputes arising
out of this article. If you believe that any work included violates any copyrights you hold or
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distributed with the intention to spread the knowledge and enhance the research in the area
7
described. All queries are welcome to shiva.murthy@quartesian.com