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- Role of Early 2D Echocardiography in Patient with Acute Myocardial Infarction in Correlation with Electrocardiography and Clinical Presentation
Abstract Views :481 |
PDF Views:100
Authors
Affiliations
1 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IN
2 Department of Ophthalmology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IN
3 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IN
1 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IN
2 Department of Ophthalmology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IN
3 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IN
Source
MVP Journal of Medical Sciences, Vol 1, No 2 (2014), Pagination: 51-55Abstract
Introduction: Echocardiography is noninvasive, most frequently used usually the initial imaging test to evaluate all cardiovascular disease related to structural, functional, or hemodynamic abnormality of the heart or great vessels. The major advantage of echocardiography is the ability to obtain instantaneous real time image even in emergency units. The present study was undertaken to evaluate left ventricular function, extent of myocardium involved and complications of acute myocardial infarction by 2D ECHO, to correlate these findings with ECG and clinical presentation, and to assess the role of 2D ECHO in management and prognosis of patients with acute myocardial infarction.
Materials and Methods: The present study was conducted on patients visiting our tertiary health centre, Nasik over a period of 2 years. 55 patients were included in the study. Patients with prior history of acute myocardial infarction, valvular heart disease, cardiomyopathy, cardiac surgery, congenital heart disease and non ST elevation MI were not included in the study. Patients were classified as per Killip classification and 2D ECHO was performed on the patients within 24 hours of admission. The findings of which were correlated with clinical and ECG findings.
Results: Of 55 patients studied it was found that MI had male preponderance with hypertension as major risk factor. Also, the severity of the infarction increased with the increase in the Killip class. Mean ejection fraction was also observed to be decreasing in patients with increase in severity of the infarction.
Conclusion: 2D ECHO performed within 24 hours of admission helps the clinician to predict and diagnose complications in patients with acute MI and take proper steps in the management of the patient.
Keywords
Echocardiography, Killip Classification, Myocardial InfarctionFull Text
- A Study of Cardiovascular Changes in Newly Detected Hypothyroid Patients
Abstract Views :317 |
PDF Views:86
Authors
Affiliations
1 Department of Medicine, Dr.Vasantrao Pawar Medical College Hospital & Research Centre, Nashik -422003, Maharashtra, IN
2 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik-422003, Maharashtra, IN
3 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik-422003, Maharashtra, IN
1 Department of Medicine, Dr.Vasantrao Pawar Medical College Hospital & Research Centre, Nashik -422003, Maharashtra, IN
2 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik-422003, Maharashtra, IN
3 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik-422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 4, No 2 (2017), Pagination: 102-106Abstract
Background and Objectives: Hypothyroidism has significant cardiovascular manifestations. Overt and sub clinical hypothyroidism both are associated with cardiovascular dysfunction and with an increased risk of cardiovascular disease. This study was done to recognize cardiovascular changes associated with newly detected hypothyroid patients. Methods: Based on the symptoms, clinical examination and hormonal assay, newly detected hypothyroid patients were subjected to detailed cardiovascular examination, blood tests, electrocardiography and echocardiography. Patients were investigated, before the thyroid hormone replacement therapy. Results: Hypothyroidism was newly diagnosed more in females and maximum in age group 18-48 years (77.8%) of age group. Out of 45 patients, 62.2% had symptoms less than 3 months duration. Cardiovascular symptoms were present in less number of patients. Bradycardia was observed in 6.6% of the patients. Stage 1 hypertension was noticed in 17.8% (diastolic blood pressure). Low voltage complexes in electrocardiogram were present in 40% study group. Pericardial effusion was present in 16.6% patients. Systolic and diastolic dysfunction was noticed respectively in 4.5% and 2.2% study group. Altered lipid profile was present in 60% (S. cholesterol) and 94.7% (S. Triglycerides). Interpretation and Conclusion: Hypothyroidism is common in females, maximum between 18-48 years age group. Majority of the patients did not have any cardiovascular changes. Observed cardiovascular changes were ECG abnormalities, pericardial effusion and diastolic blood pressure. Systematic study was done to know the early effects of hypothyroidism on cardiovascular system. The identification of patients with hypothyroidism is an important individual and public health issue. Hence, early detection and initiation of hormone replacement therapy can minimize associated cardiovascular changes.Keywords
Cardiovascular Changes, Diastolic Blood Pressure, Hypothyroidism, Pericardial Effusion.Full Text
References
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- Crowley F, Willam, et al. Noninvasive evaluation of cardiac function in hypothyroidism. The New England Journal of Medicine. 1977; 296:1–6. https://doi.org/10.1056/ NEJM197701062960101 PMid:830262.
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- Study to Evaluate Correlation of Blood Sugar Level and Glycosylated Haemoglobin at the Time of Admission with Severity of Acute Coronary Syndrome in Diabetic Patients
Abstract Views :257 |
PDF Views:76
Authors
Affiliations
1 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Department of Ophthalmology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
1 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Department of Ophthalmology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 5, No 1 (2018), Pagination: 39-48Abstract
Aim: To study the clinical profile of diabetic patients who present with Acute Coronary Syndrome (ACS) for the first time, to correlate the Blood Sugar Level (BSL) and Glycosylated hemoglobin (HbA1C) at the time of admission and the severity of acute coronary syndrome; and to assess the correlation between tight glycemic control of diabetics based on HbA1C estimation and presence of end organ damage in diabetics. Materials and Methods: The study was undertaken at our medical college in the medicine department. 64 adult patients who are known diabetics or detected for the first time presenting in outpatient department or emergency department as acute coronary syndrome were studied. Study period was 2 years from January 2011 to December 2012. Results: The study showed a definite male preponderance, with 56.23% males as compared to 43.73% females. Atypical presentations of acute coronary syndrome were more common as compared to typical chest pain (34.37%). Chest pain commonly is prevalent in younger age group. 95.30% of the patient had some or other associated risk factors like hypertension (59.37%), smoking (26.56%), obesity (15.62%) or dyslipidemia (65.62%). ST elevation MI was the commonest presentation (73.40%) and involvement of anterior wall was common (36.20%). On admission BSL (Blood Sugar Level) was not found to have a definite prognostic value in predicting outcome in diabetic patients with acute coronary syndrome. Impaired glycosylated haemoglobin was found to be an independent risk factor and had a definite prognostic value in predicting outcome. Diabetic patient with acute coronary syndrome had LV dysfunction, cardiac rhythm abnormalities, cardiogenic shock and are likely to be readmitted, thus having worst morbidity as well as mortality. Conclusion: The primary aim of this study was to study correlation of blood sugar level and glycosylated haemoglobin at the time of admission with severity of acute coronary syndrome and to study clinical profile of diabetic patients with due consideration to complications which are related to diabetes.Keywords
Acute Coronary Syndrome, Blood Sugar Level, Dyslipidemia, Glycosylated Hemoglobin.Full Text
References
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- Fuster V, Moreno PR, Fayad ZA, et al. Atherothrombosis and high-risk plaque: Part 1: evolving concept. J Am Cardiol. 2005; 46:937–54. https://doi.org/10.1016/j.jacc.2005.03.074 PMid:16168274
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- Clinical Study of Diagnosed Cases of Dengue Fever in Tertiary Care Hospital in North Maharashtra
Abstract Views :209 |
PDF Views:80
Authors
Affiliations
1 Department of General Medicine, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik - 422003, IN
1 Department of General Medicine, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik - 422003, IN
Source
MVP Journal of Medical Sciences, Vol 5, No 1 (2018), Pagination: 58-63Abstract
Aims and Objective: To study the clinical presentations, laboratory profile, hematological complications and outcome of dengue fever. Materials and Methods: Descriptive study was carried which includes adult males and females who were serologically confirmed cases of dengue. These patients were assessed for their demographic features (age/sex etc.); clinical profile various signs and symptoms; labotrary profile; complications and outcome as mentioned in the proforma. Results: Total 56 patients studied. Out of 56 cases, the maximum number of cases, 22 (39.2%), belonged to the age group between 20 to 40 years. Thus the mean age of hospitalized patients was 31.2 ± 4.5 yrs. There were 33 (58.9%) males and 23 (41.1%) female patients. Majority were Dengue Hemorrhagic fever 20 (35.7%) and 8 (14.2%) were cases of severe dengue according to WHO guidelines. Fever was present in all patients. Two patients developed DIC and died. Conclusion: Patients with dengue syndrome showed varied clinical presentation. Symptoms and clinical signs are non specific. Most adults were positive for symptoms like fever, myalgia, arthralgia, and skin rash and bleeding.Keywords
Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF), Disseminated Intravascular Coagulation (DIC), Dengue Shock Syndrome (DSS), Nonstructural Protein 1 (NS1).Full Text
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- Clinical Profile and Management of Patients Admitted with Acute Kidney Injury Secondary to Gastroenteritis in a Tertiary Care Teaching Hospital
Abstract Views :181 |
PDF Views:116
Authors
Affiliations
1 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik – 422003, Maharashtra, IN
2 Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik – 422003, Maharashtra, IN
1 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik – 422003, Maharashtra, IN
2 Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 5, No 2 (2018), Pagination: 134-139Abstract
Aim: To study clinical profile, laboratory features and importance of rehydration in patients admitted with acute kidney injury due to gastroenteritis. Materials and Methods: The study was carried out as a prospective observational study of 70 patients at medicine department of a medical college and tertiary health care center, over a period of two years that included cases of acute kidney injury due to gastroenteritis in the age group of 18-40 years. Results: Study showed male predominance (72.86%) in elderly age group. Prerenal type was more common (75.71%) as compared to acute tubular necrosis. Duration and frequency of diarrhea was associated with severity of the disease. Mortality was high (100%) in those who required more time (>12 hours) to achieve normal mean arterial pressure. Maximum deaths (93.33%) were observed in anuric patients. Most common complication observed was septicemia in 20% of patients. Overall mortality observed in our study was 21.43%, while 78.57% patients survived. Mortality was high in those having severe dehydration, high baseline creatinine, who received dialysis. Conclusion: Acute kidney injury due to gastroenteritis is preventable if presented early and adequate hydration can decrease mortality.Keywords
Acute Kidney Injuries, Acute Tubular Necrosis Gastroenteritis, Mean Arterial Pressure.Full Text
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- Fouda H, Ashuntantang G, Halle MP, Kaze F. The epidemiology of acute kidney injury in a tertiary hospital in Cameroon: A 13 months review. J Nephrol Ther. 2016; 6:250. doi:10.4172/2161-0959.1000250 https://doi.org/10.4172/2161-0959.1000250
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- Kumar SS, Paramananthan R, Muthusethupathi MA. Acute renal failure due to acute diarrhoeal Diseases. JAPI. 1990; 38(2):164–6. PMid:2380138
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- Silva Júnior GB, Daher Ede F, Mota RM. Risk factors for death among critically ill patients with acute renal failure. Sao Paulo Med J. 2006; 124:257–63. https://doi.org/10.1590/S1516-31802006000500004 PMid:17262155
- Clinical Profile of Cardiac Autonomic Neuropathy in Diagnosed Patients of Type 2 Diabetes Mellitus
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Authors
Affiliations
1 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon, Nashik – 422003, Maharashtra, IN
1 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 5, No 2 (2018), Pagination: 140-144Abstract
Background: Diabetes mellitus (DM) is a clinical syndrome characterized by hyperglycemia caused by relative or absolute deficiency of insulin1. Cardiac autonomic neuropathy is a complication of diabetes. Our study intends to study Cardiac Autonomic Neuropathy in diabetics attending our hospital. Aims and Objectives: To study the clinical profile of Cardiac Autonomic Neuropathy in type 2 DM. Materials and Method: The study was carried out in a tertiary care hospital. The data was collected from August 2013 to December 2015 in 54 patients. The history, examination and bedside tests were done and conclusions drawn. Tests performed included heart rate response to deep breathing, standing, valsalva maneuver; BP response to sustained handgrip and standing. Results: Of 54 patients studied, 25 (46.29%) had CAN. Of the 25 patients affected with CAN 3 were between age 41-50, 10 between 51-60, 10 in 61-70 and 2 in 71-80. Out of 25 patients having CAN in the study 14 (56%) are male and 11 (44%) are female. Mean age of patients having CAN was 10.36 as compared to 6.55 in those not having CAN. Our study gave the following. Conclusions: Cardiac Autonomic Neuropathy is one of the most common but under diagnosed complications of diabetes mellitus. Cardiac Autonomic Neuropathy is associated with both type 1 and type 2 Diabetes Mellitus. It correlates with the duration and age. Resting tachycardia is a signs of autonomic dysfunction. Heart rate response to deep breathing and B.P. response to sustained hand grip are the most sensitive and specific tests for diagnosis of autonomic dysfunction. Cardiac Autonomic Neuropathy is significantly associated with other microvascular complications of DM like Diabetic retinopathy and nephropathy.Keywords
Cardiac Autonomic Neuropathy, Diabetes Mellitus, Diabetic Neuropathy, Diabetic Nephropathy, Diabetic Retinopathy.Full Text
References
- Frier B, Fisher M. Diabetes mellitus, Davidson’s principles and practice of medicine. Boon, Colledge, Walker, Hunter, editors. 21st ed. Churchill Livingstone; 2010. p. 795–840.
- Vinik et al. Diabetic autonomic neuropathy. American Diabetes Association, Diabetes Care. 2003 May; 26(5): 1553–79. https://doi.org/10.2337/diacare. 26. 5. 1553 PMid :12716821
- Ewing DJ, Clarke BF. Diabetic autonomic neuropathy: present insights and future prospects. Diabetes Care. 1986 Nov-Dec; 9(6): 648–65. https:// doi. org/ 10. 2337/ diacare. 9. 6. 648 PMid:3100258
- Freeman R, The nervous system and diabetes, Joslin’s Diabetes mellitus. Kahn C, Weir G, King G, Moses A, Smith R, editor. 14th ed. Lippincott Williams and Wilkins; 2006. p. 952–78.
- Karavanaki K, Baum JD. Prevalence of microvascular and neurologic abnormalities in a population of diabetic children. J Pediatr Endocrinol. 1999; 12:411–22. https://doi.org/10.1515/JPEM.1999.12.3.411
- Basu AK, et al. A study on the prevalence of cardiac neuropathy in type-2 diabetes in Eastern India. JIACM. 2011; 13(1):22–6.
- Sinha PK, et al. Carotid intima-media thickness in type 2 diabetes mellitus patients with cardiac autonomic neuropathy. Journal of the Association of Physicians of India. 2012 Sep; 60:44–7.
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- Kempler, et al. Autonomic neuropathy is associated with increased cardiovascular risk factors: the EURODIAB IDDM Complications Study. Diabet Med. 2002 Nov; 19(11): 900–9. https:// doi.org/ 10.1046/ j.1464-5491. 2002.00821. x PMid:12421426
- Spallone V, et al. Autonomic neuropathy and cardiovascular risk factors in insulin-dependent and non insulin-dependent diabetes. Diabetes Res Clin Pract. 1997 Jan; 34(3):169–79. https://doi.org/10.1016/S0168-8227(96)01354-X
- Magri CJ, et al. The Diabetic Eye: A window to the heart and vascular system. J Diabetes Metab. 2012; S3. https://doi.org/10.4172/2155-6156.S3-008
- Valensi, et al. Cardiac autonomic neuropathy in diabetic patients: Influence of diabetes duration, obesity, and microangiopathic complications- The French multicenter study. Metabolism. 2003 Jul; 52(7):815–20. https://doi.org/10.1016/S0026-0495(03)00095-7
- Kubo K, et al. Studies of the relationship between diabetic retinopathy and progression of diabetic neuropathy. Medical Journal of Hiroshima perfectual hospital. 1999; 31(1):23–6.
- Clinical Profile of Primary Headaches and Awareness of Trigger Factors in Migraine Patients
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Authors
Affiliations
1 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik − 422203, Maharashtra, IN
1 Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik − 422203, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 5, No 2 (2018), Pagination: 145-150Abstract
Aim: To classify the patients as per the International Classification of Headache disorders 3rd edition Beta version. To study the demographic details and clinical profile. To study the trigger factors in migraine patients. To study the importance of family history is headache patients. Materials & Methods: The study was a cross sectional observational study of 300 patients at outpatient clinic tertiary health care center, over a period of two years. Patients diagnosed with primary headache were studied with help of an exhaustive questionnaire which covered the relevant details. Results: Our study had 158 migraines (MG), 137 Tension Type Headache (TTH) and 5 Trigeminal Autonomic Cephalgia (TAC) patients. Females are more affected, 1:2.9 in TTH and 1:1.5 in MG. Mean age for MG was 33.37 and for TTH were 36.11. Majority (46-48%) were employed, followed by housewives (43-38%) and students (9-13%) among both the groups. TTH patients had frequency of headache more patients than migraine patients. Family history was positive in 36% in MG and 14% in TTH patients. TTH had dull aching, holocranial pain with pericranial tenderness; whereas migraine had throbbing unilateral pain. Aura was seen only in 21% of MG patients; retinal (67%) being most common. Associated symptoms like nausea, phonophobia, photophobia were seen in 80% of MG patients. Trigger factors on history were present in 64%, which increased to 85% on showing detail list. Most common triggers were climatic, followed by travel, stress and sleep related. Females had hormonal, smell and emotional stress as more common TF. Conclusion: Migraine is most common primary headache presenting in clinics. With predominance in females TTH attacks are more frequent than migraine. TTH showed features like dull aching, pressure like and holocranial pain whereas migraine has throbbing and unilateral pain. Pericranial tenderness is more in TTH patients whereas migraine has associated vasomotor symptoms. It is important to have detail list of all Trigger factors for Migraine patients, so that they can avoid them and prevent their attacks, thus reducing analgesic use. Family history has more influence in migraine patients compared to TTH.Keywords
Migraine, Pericranial Tenderness, Tension Type Headache, Trigger Factors.Full Text
References
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- The Correlation of Hyponatremia with Neurological Features in Adult Patients Admitted in an ICU Setting in a Tertiary Care Centre
Abstract Views :195 |
PDF Views:92
Authors
Affiliations
1 Former PG Resident, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Associate Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
3 Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
1 Former PG Resident, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Associate Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
3 Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 7, No 1 (2020), Pagination: 113-122Abstract
Background: Hyponatremia is the most prevalent electrolyte abnormality worldwide, presenting at even higher rates in the ICU setting. It is one of the leading causes of metabolic encephalopathy and can present with a myriad of neurological features. It is defined by a serum sodium level <135 mEq/L. The present study is designed to evaluate the neurological symptoms in a patient with hyponatremia and to correlate them with the degree of hyponatremia. Aims and Objectives: 1) To study the neurological manifestations in ICU patients found to have hyponatremia 2) To study the correlation between neurological manifestations and serum sodium level. Materials and Methods: This is Prospective Observational study of 2 years duration in which 90 patients were studied with the following criteria: Age ≥18 years, either sex admitted in the ICU having sodium Level of < 135 mMol/L on admission. A thorough neurological examination including Mini Mental Status Examination (MMSE) and Glasgow Coma Scale (GCS) was done at presentation. The data was then analyzed. Results: There was a male predominance (64.44%) amongst the study population. Most patients belonged to the age group of 51-60 years (73.3%) followed by > 60 years (31.1%). Disorientation (41.11%) was the most common neurological features followed by drowsiness (31.11%).Maximum number (48.7%) of patients having mild hyponatremia were asymptomatic. At presentation, most had a normal Mini Mental Status Examination (MMSE) score (28.89%) followed by moderate cognitive impairment (27.78%), GCS scores ≥13 was seen in 56.67% population followed by GCS 9-12 (41.11 %). 2 (2.2%) patients succumbed in the study population. Conclusion: Hyponatremia is a common electrolyte abnormality causing significant morbidity and mortality, especially in the older age group. It is one of the leading causes of metabolic encephalopathy. As it can be asymptomatic in the initial stages, and is treatable, it should evaluated in all patients with subtle as well as overt neurological signs to prevent further neurological deterioration. MMSE scoring is a useful tool for neurological assessment in hyponatremia.
Keywords
Hyponatremia, Neurological Features, GCS, MMSEFull Text
References
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- Case Report of Rare Entity for Atypical Hemolytic Uremic Syndrome
Abstract Views :200 |
PDF Views:84
Authors
Affiliations
1 PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
2 Assistant Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
3 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
1 PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
2 Assistant Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
3 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 7, No 1 (2020), Pagination: 129-134Abstract
Background: Atypical Haemolytic Uremic Syndrome (aHUS) is a genetic or acquired disorder of regulatory component of the complement system. It is associated with mutations in genes coding for complement components. The abnormality in components of complement makes it susceptible and predispose to chronic uncontrolled hyperactivation of the alternative complement pathway, which results in endothelial damage and microvascular thrombosis. This case report describes a patient diagnosed with Thrombotic Microangiopathy (TMA) due to factor H autoantibody having haemolytic anemia, thrombocytopenia and acute kidney injury. Patient’s anemia and renal parameters improved after treatment with plasma exchange therapy. Conclusion: Atypical HUS must be strongly suspected in any patient who presents with nonspecific abdominal or respiratory symptoms along with anemia and thrombocytopenia. As extrarenal involvement is a rare entity of aHUS, the clinician should also keep a high index of suspicion to the possibility of thrombotic microangiopathy manifestation in almost any organ system. In a suspected or diagnosed case of aHUS, the development of new non renal symptoms and signs should prompt clinician for further evaluation to rule out ongoing thrombotic microangiopathy process.Keywords
Acute Kidney Injury, aHUS, Complement, Dialysis, Plasma Exchange, Thrombotic-Microangiopathy (TMA)Full Text
References
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- Study of Cardiovascular Manifestations in Patients with Thyroid dysfunction at Tertiary Care Center
Abstract Views :294 |
PDF Views:126
Authors
Affiliations
1 Postgraduate Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
2 Associate Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
3 Professor and Head of Department, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
1 Postgraduate Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
2 Associate Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
3 Professor and Head of Department, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 7, No 2 (2020), Pagination: 246-256Abstract
Introduction: Thyroid hormones have effects on virtually every organ system. The heart is the major target organ for thyroid action. It was thought that thyroid disorder is a circulatory disorder and manifestations of thyroid disorders are due to changes in cardiac work. Over the period it has become clear that the explanation for the altered circulatory hemo-dynamics of thyroid disease is because of involvement of cardiovascular system. Aims and Objectives: To find out the incidence of overt and subclinical cardiac manifestations in patients with thyroid dysfunction and to compare the prevalence of overt and subclinical cardiac manifestations in two subsets of patients belonging to hyperthyroid and hypothyroid groups respectively. Materials and Methods: It was an observational study carried out at the Department of Medicine for the period of August 2017 to December 2019. In total, 230 newly diagnosed patients with thyroid dysfunction were included in the study. Focused clinical and detailed cardiovascular system examination, necessary biochemical investigations were done. All patients underwent detailed 12 lead electrocardiogram and 2D Echo-cardiography procedure. Incidence of overt and subclinical cardiac manifestations in Hyperthyroid and Hypothyroid cases was calculated; and the Prevalence of overt and subclinical manifestations in the two subsets of patients belonging to Hyperthyroid and Hypothyroid groups respectively was compared and data was analyesd. Results: Total hypothyroid patients were 115 and that of hyperthyroid were 115. Incidence of thyroid is much more common in females as compared to males (81% in hyperthyroidism and 92% in hypothyroidism). In hyperthyroid group, 92% patients showed cardiac involvement either in the form of ECG, CXR, 2D ECHO abnormalities and in hypothyroid patients it was 93%. Statistically significant patients presented with symptoms of congestive cardiac failure in hyperthyroid group (73%) but not in hypothyroid group. In the both groups, fatigue was the most commonest presenting symptom related to cardiovascular system. In hypothyroid group, most common cardiac sign was Pulse, Pressure<40 mm of Hg (73%) whereas in hyperthyroidism it was sinus tachycardia (73%). 73% hyperthyroid patients showed sinus tachycardia as the most common ECG finding where again 73% hypothyroid patients showed ST-T changes as a most common ECG finding. Nearly 70% hyperthyroid patients had ejection fraction more than 60% on Echocardiogrphy the procedure and almost all patients of hypothyroidism had ejection fraction less than 60%. Conclusion: Thyroid dysfunction was found to be more common in the females with 41-50 years of age group in hypothyroidism group and 21-30 years in the hyperthyroidism group. Cardiovascular manifestations were the major presenting factors in both the groups pointing towards the adverse effects of thyroid dysfunction, Dyspnea and fatigue were the major cardiac symptoms in the hypothyroidism group. While chest pain and fatigue were the major cardiac symptoms in the hyperthyroidism group. The ECG and 2D ECHO findings in the current study also suggested that in both the groups of thyroid dysfunction, cardiac manifestations are likely to have higher incidence.Keywords
Echocardiography, Electrocardiography, Hyperthyroidism, HypothyroidismFull Text
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- Study of Clinical Course and Outcome in Patients Admitted with Sepsis using ‘SOFA and qSOFA’ Scoring Systems at a Tertiary Care Centre
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Authors
Affiliations
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharshtra, IN
2 Professor and Head, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharshtra, IN
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharshtra, IN
2 Professor and Head, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharshtra, IN
Source
MVP Journal of Medical Sciences, Vol 7, No 2 (2020), Pagination: 257-265Abstract
Introduction: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. The task force in the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) formulated the SOFA score based on six parameters of respiration, coagulation, liver, central nervous system, kidneys and cardiovascular systems representing the major organs of the body. A new score, the qSOFA score (q for quick) was formulated using respiratory rate, systolic blood pressure and altered sensorium. This score was intended to be used at the bedside and without laboratory investigations. Aims and Objectives: To study the clinical course & outcome in patients admitted with sepsis using ‘sofa & qsofa’ scoring systems at a tertiary care centre. Materials and Methods: This is a prospective observational study, done between a periods between August 2017 to December 2019 in patients admitted to the Medical Intensive Care Unit of a tertiary care hospital. The total number of patients studied was 180. The SOFA and qSOFA scores were calculated for each patient on admission and after 72 hours. The comorbidities like diabetes and hypertension were also recorded. The clinical features and outcome was correlated with the SOFA and the qSOFA scores. Results: There were 31 deaths (17.22%) out of a total of 180. The highest number of deaths occurred with SOFA scores between 11 to15 which was 16 deaths (51.6%). The highest number of deaths occurred with the qSOFA score 2 which were 24 deaths (77.4). Higher SOFA and qSOFA scores did not always correlate with increased mortality, probably because of other factors like associated comorbidities. Conclusion: This study confirmed the usefulness of SOFA and qSOFA scores to predict mortality and for screening of patients with sepsis. Nevertheless, mortality prediction needs assessment of many other factors such as concomitant comorbidities, infecting organism, site of sepsis, etc, along with SOFA and qSOFA scores. Hence, we should assess the SOFA and qSOFA scores of patients in sepsis and with it also assess the role of clinical history and examination and comorbidities along with other factors, for a complete understanding of the patient.Keywords
Sepsis, Sequential Organ Failure Assessment (SOFA), quick Sequential Organ Failure Assessment (qSOFA)Full Text
References
- Singer M, Deutschman C, Seymour C et al. The Third International consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016; 315(8):801-810. https://doi. org/10.1001/jama.2016.0287. PMid: 26903338, PMCid: PMC4968574.
- Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, Reinhart CK, Suter PM, Thijs LG. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. Jul 1996; 22(7):707-710. https://doi.org/10.1007/BF01709751. PMid: 8844239.
- Garbero RF, Simões AA, Martins GA, Ludmilla Vale da Cruz, Vinícius Gabriel Monteirovon Zuben. SOFA and qSOFA at admission to the emergency department: Diagnostic sensitivity and relation with prognosis in patients with suspected infection. Turkish Journal of Emergency Medicine. 2019; 19:106-110. https://doi. org/10.1016/j.tjem.2019.05.002. PMid: 31321343, PMCid: PMC6612625.
- Raith EP, Udy AA, Bailey M, McGloughlin S, MacIsaac C, Bellomo R, Pilcher DV. Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. JAMA. January 17 2017; 317(3).
- Eli J. Finkelsztein, Daniel S. Jones, Kevin C. Ma, Maria A. Pabón, Tatiana Delgado, Kiichi Nakahira, John E. Arbo, David A. Berlin, Edward J. Schenck, Augustine M. K. Choi, and Ilias I. Siempos. Comparison of qSOFA and SIRS for predicting adverse outcomes of patients with suspicion of sepsis outside the intensive care unit. Critical Care. 2017; 21:73. https://doi.org/10.1186/s13054-017-1658-5. PMid: 28342442, PMCid: PMC5366240.
- Vishal Gupta, Niteen D Karnik , Dhiraj Agrawal . SOFA score and critically Ill elderly patients. Journal of the Association of Physicians of India. July 2017; 65:47.
- Hae Jung Na , Eun Suk Jeong , Insu Kim , Won-Young Kim , Kwangha Lee . Clinical application of the quick sepsis-related organ failure assessment score at intensive care unit admission in patients with bacteremia: A single-center experience of Korea. Korean J. Crit. Care. Med. 2017; 32(3):247-255. https://doi.org/10.4266/kjccm.2017.00241. PMid: 31723643, PMCid: PMC6786730.
- Study of Clinical Profile of Patients with Upper Gastrointestinal Symptoms and their Association with Endoscopy at a Tertiary Care Centre
Abstract Views :301 |
PDF Views:86
Authors
Affiliations
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College and Hospital, Research Centre, Nashik – 422003, Maharashtra, IN
2 Associate Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College and Hospital, Research Centre, Nashik – 422003, Maharashtra, IN
3 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College and Hospital, Research Centre, Nashik – 422003, Maharashtra, IN
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College and Hospital, Research Centre, Nashik – 422003, Maharashtra, IN
2 Associate Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College and Hospital, Research Centre, Nashik – 422003, Maharashtra, IN
3 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College and Hospital, Research Centre, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 7, No 2 (2020), Pagination: 266-269Abstract
Introduction: Upper endoscopy, also referred to as Esophagogastroduodenoscopy (EGD), is performed by passing a flexible endoscope through the mouth into the esophagus, stomach, and duodenum. The gut is accessible with endoscopy, which can diagnose causes of pain, nausea and vomiting, bleeding, weight loss, altered bowel function, and fever1 . Aims and Objectives: To study indications and findings of patients undergoing upper gastrointestinal (GI) endoscopy, to make association of endoscopic findings in these patients presenting with different upper GI symptoms and to document the demographics of subjects undergoing upper GI endoscopy at a tertiary care centre. Materials and Methods: It was a prospective observational study carried out at the Department of Medicine at Dr Vasantrao Pawar Medical College and Hospital, with due permission from the ethics committee for the period of August 2017 to November 2019. All the patients who were found with upper GI symptoms and underwent endoscopy after giving informed consent were included in the study. Total of 136 patients presenting with upper GI symptoms fulfilling the criteria were included in the study and their endoscopic findings were associated. Results: Out of total 136 patients, maximum number of the patients belonged to 51-60 years age group (21.3%). There was male preponderance (61.8% were male 38.2% were female). The most common GI symptom was hemetemesis/malena (40.4%) followed by nausea/vomiting (27.9%). Esophagitis (37%) was the most common endoscopic finding followed by esophageal varices (33%). Out of 45 patients who had esophageal varices 32 (71%) were treated with Endoscopic Variceal Ligation (EVL) and they responded well. Conclusion: Through this study it was concluded that most of the patients presenting with upper GI symptoms were among the elderly age group (51-60 years). Upper GI bleed was the most common symptom and indication for endoscopy followed by nausea/vomiting. The common endoscopic finding among hematemesis/malena patient was esophageal varices and most of them responded well to Endoscopic Variceal Ligation.Keywords
Endoscopic Variceal Ligation, Gastrointestinal Endoscopy, Hematemesis, Malena, Upper Gastrointestinal SymptomsFull Text
References
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- Prediction of an Infarct Related Artery on Electrocardiogram and its Correlation with Coronary Angiography in an Acute Myocardial Infarction
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Authors
Affiliations
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik – 422203, IN
2 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik – 422203, IN
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik – 422203, IN
2 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik – 422203, IN
Source
MVP Journal of Medical Sciences, Vol 8, No 1 (2021), Pagination: 105-111Abstract
Aim: To Predict an infarct related artery on Electrocardiogram and its correlation with Coronary angiography in an Acute myocardial Infarction. Materials and Methods: The study was carried out as a prospective observational study of 70 patients at medical college & tertiary health care Centre, over a period of two years that included cases of patients diagnosed to have acute myocardial infarction on ECG for the first time & have also undergone coronary angiography. Results: Study showed most common age group amongst study population was 51 to 60 yrs (42.9%) followed by 61 to 70 yrs (37.1%). LAD (71%) was the most common coronary artery amongst study population followed by RCA (25%) and LCX (4%). Most of the study population had ECG findings like ST depression III + aVF ≥ 2.5 (36%) and ST segment in III and aVF isoelectric or elevated (36%) followed by ST depression in III + aVF ≤ 2.5 and ≥ 0.5 (28%) in LAD occlusion. In the present study, most of the study population had ECG findings like ST↑LIII > ST↑ LII > 1 (94.12%), ST↓LI, aVL (82.35%) and ST↑V4R > 1 mm (70.59%) in RCA occlusion. In the present study, most of the study population had ECG findings like ST ↑ LII > LIII (100%) and Isoelectric or ST ↑ I,aVL (66.7%) in LCX occlusion. Conclusion: ECG criteria have excellent sensitivity and specificity in predicting the culprit artery Anterior ST elevation identified all patients with LAD as the culprit artery with 100 % accuracy in our study population. In patients with inferior ST elevation, relative ratio of ST elevation in lead II and lead III, correctly identified the culprit artery as RCA or LCx with 100 % accuracy. (ST elevation in lead II > III predicts LCx occlusion and the reverse predicts RCA occlusion.Keywords
Acute Myocardial Infarction, Coronary Angiography, ElectrocardiographyFull Text
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- Study of Diabetic Ketoacidosis with Special References to the Biochemical Prognostic Marker
Abstract Views :123 |
PDF Views:85
Authors
Affiliations
1 Former PG Resident, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
2 Associate Professor, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Professor, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
1 Former PG Resident, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
2 Associate Professor, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Professor, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
Source
MVP Journal of Medical Sciences, Vol 8, No 1 (2021), Pagination: 124-131Abstract
Background: Diabetes Mellitus is a clinically and genetically heterogeneous group of metabolic disorders that manifest in an abnormally high level of glucose in the blood. Diabetic Ketoacidosis (DKA) represent extremes in the spectrum of decompensated diabetes. The mortality in patients with Diabetic Ketoacidosis is rarely caused by a metabolic complication of hyperglycemia or metabolic acidosis and it is usually related to the underlying medical illness that precipitates metabolic compensation. The second most important contributor to the development of DKA is inadequate insulin treatment, commonly seen as a result of noncompliance, especially in the young population. Methods: The present study was conducted for period of 2 years. It is a hospital based prospective observational study of 60 Diabetic Ketoacidosis patients. The biochemical prognostic markers were studied. Results: The study was done for 60 patients diagnosed with Diabetic Ketoacidosis presented to the medicine department. The mean age was 55.44 years. So from the current study it was proved that, serum phosphorus and APACHE II score can be used for predicting the prognosis in the the DKA patients. The mean serum phosphate among the deceased patients (n = 8) was more as compared to the discharged patients (n = 52). Out of 60 patients, highest patients (n = 38) had infection (AFI, LRTI, pneumonia. UTI, sepsis pancreatitis, enterocolitis, AKI, viral fever) as their precipitating factors. Conclusion: APACHE II score and serum phosphorus is an important biochemical marker in the prognosis of DKA. APACHE II score is directly proportional to mortality index in DKA.Keywords
APACHE II, Diabetic Ketoacidosis, Glasgow Coma Scale, Serum PhosphateFull Text
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- Study of the Risk Factors for Coronary Artery Disease and their Correlation with Thyroid Hormone Profile amongst Women with ST Segment Elevation in Acute Myocardial Infarction
Abstract Views :128 |
PDF Views:92
Authors
Affiliations
1 Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
2 Former PG Resident, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Associate Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
1 Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
2 Former PG Resident, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Associate Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
Source
MVP Journal of Medical Sciences, Vol 8, No 1 (2021), Pagination: 140–146Abstract
Background: Thyroid hormone has a major role in the cardiovascular function and cardiac hemodynamics as well as to maintain the cardiovascular homeostasis. The present study was planned to assess risk factors for coronary artery disease and their correlation with thyroid hormone profile amongst women with ST segment elevation in acute myocardial infraction. Material and Methods: A total number of 78 females having ST elevation myocardial infarction diagnosed through detailed clinical history and ECG evaluations were included after they satisfy the eligibility criteria. Patients were subsequently evaluated for presence of risk factors of ischemic heart disease such age, marital status, parity, and menopause, use of oral contraceptives, family history, obesity, diabetes mellitus, hypertension, hypercholesterolemia and hypertriglyceridemia. Their thyroid hormone profiles (T3, T4, TSH) were done and were correlated with risk factors for ischemic heart disease. Results: A total 78 patient included in the study most of the study population belongs to the age group of 40 to 50 years (43.6 %). Hypertension was the most common clinical features amongst study population (59%) followed by Diabetes (50%). Most of the study population had Normal Thyroid status (57.69%) followed by Hypothyroidism (25.64%) and Hyperthyroidism (16.67%) and SERUM TSH is the most sensitive test for evaluation. Diabetes Mellitus was statistically significant risk factor (p valueConclusion: Patients with coronary artery disease especially in the presence of other risk factors should be screened for thyroid dysfunction specially diabetes. We recommend tests for thyroid disorders in acute coronary syndrome can give predictor for risk of morbidity and mortality in those subjects.Keywords
MI-Myocardial Infarction, Hyperthyroidism, Hypothyroidism, STEMI-ST- Segment Elevation Myocardial Infarction, TSH- Thyroid Stimulating HormoneFull Text
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- Study of Incidence and Prevalence of Diabetic Peripheral Neuropathy in Type II Diabetes Mellitus by Bedside Screening Techniques at a Tertiary Care Centre
Abstract Views :157 |
PDF Views:87
Authors
Affiliations
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Associate Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Associate Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 8, No 2 (2021), Pagination: 253–257Abstract
Introduction: Diabetes mellitus commonly leads to peripheral neuropathy in patients with chronically high blood sugar levels. Diabetic peripheral neuropathy leads to numbness, loss of sensation or may have extremely painful symptoms. In some patients there might be marked neuropathic deficit which may be unnoticed. Objectives: Hence to evaluate patients with diabetes mellitus helps in early screening of peripheral neuropathy. Methodology: This involves using the bedside screening techniques like monofilament test, biothesiometer, tuning fork test and diabetic symptom and examination questioner. Results: Diabetic neuropathy was most commonly present in poor control of diabetes (67%) followed by fair control (24%) and good control (9%). It was observed that severity of peripheral neuropathy was related with blood sugar. With high frequency of patients leading to diabetic peripheral neuropathy the observation is that morbidity remains high in such patients. Conclusion: Diabetic peripheral neuropathy is a major complication of diabetes mellitus. Rapid diagnosis and management are important, since recent modalities include like tricyclic antidepressants or anticonvulsants and optimal glycemic control can improve outcome of these patients. Early diagnosis of diabetic peripheral neuropathy is considered at risk of foot ulcerations and must receive preventive education and care.Keywords
Bedside Screening, Biothesiometer, Monofilament, Peripheral Neuropathy, Tuning Fork Test, Type 2 Diabetes MellitusFull Text
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- A Study to Evaluate Correlation of C-Reactive Protein and Glycosylated Haemoglobin in Patients of Diabetes Suffering from Acute Coronary Syndrome
Abstract Views :153 |
PDF Views:79
Authors
Affiliations
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
2 Associate Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
3 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
2 Associate Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
3 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
Source
MVP Journal of Medical Sciences, Vol 9, No 1 (2022), Pagination: 1 - 8Abstract
Incidence of diabetes is increasing substantially worldwide. Cardiovascular disease is most prevalent cause of mortality and morbidity in diabetic populations. Cardiovascular risk factor including obesity, hypertension, dyslipidemia are common in patients with diabetes mellitus particularly with those of type 2 diabetes. Atherosclerosis has been described as an inflammatory disease. Aim: Study to evaluate correlation of C-Reactive Protein and Glycosylated Haemoglobin in Patients of Diabetes Suffering from Acute Coronary Syndrome. Material and Methods: A descriptive study after satisfying criteria was conducted in 115 patients in medicine department of a medical college and tertiary care hospital over a period of two years that included patients of diabetes suffering from acute coronary syndrome in the age group of 30 to 70 years. Evaluation and correlation was done by clinical profile. Results: Majority of patients were elderly age group of male of 51 to 60 yrs having mean BMI of 24 kg/m2 . CRP level of >3 mg/dl was found in 77.39% and majority of patients had HbA1C >7%. CRP and HbA1C were significantly correlated (p<0.05). Majority of patients with elevated CRP were found in with killip class I. But CRP and killip classification were not significantly correlated in our study. Conclusion: Elevated C Reactive Protein and Glycosylated Haemoglobin are better correlated as poor prognostic marker for cardiovascular event in patients of diabetes suffering from acute coronary syndrome.Keywords
CAD, Cholesterol, CRP, Diabetes, HbA1cFull Text
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- Comparative Outcome Study between Resolved and Unresolved St Segment in St Segment Elevation Acutemyocardial Infarction (STEMI) after Thrombolytic Therapy
Abstract Views :133 |
PDF Views:75
Authors
Affiliations
1 Former PG Resident, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, India ., IN
2 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422203, Maharashtra, India ., IN
3 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422203, Maharashtra, India ., IN
1 Former PG Resident, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, India ., IN
2 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422203, Maharashtra, India ., IN
3 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422203, Maharashtra, India ., IN
Source
MVP Journal of Medical Sciences, Vol 9, No 1 (2022), Pagination: 24 - 29Abstract
Background: To study the comparative outcome between resolved an unresolved ST segment in ST Segment Elevation Acute Myocardial Infarction (STEMI), after thrombolytic therapy. Method: A study was carried out on patients admitted with 1st episode of ST elevated myocardial infarction in MICU of a tertiary health care center of a teaching hospital. On admission detailed history was taken and a complete clinical examination was done. Thrombolysis was done using streptokinase, 2D ECHOs were performed before and after thrombolytic therapy. Result: Most of the study population in both the group (Unresolved STEMI and Successful thrombolysis), belonged to the age group of 41 to 50 years. Co-morbidities like hypertension were present in 83% of Unresolved STEMI and 53% of Resolved STEMI. Comorbidities like diabetes were present in 66.7% of Unresolved STEMI and 52.6% of Resolved STEMI. RWMA on 2D-Echo before thrombolysis was present in 58.3% of Unresolved STEMI and 47.4% of Resolved STEMI. RWMA on 2D-Echo after thrombolysis was present in 66.7% of Unresolved STEMI and 18.5% of Resolved STEMI. Conclusion: Symptom to needle time is an important predictor of whether thrombolysis will be successful or not in acute myocardial infarction patients. Hence it is important to educate the public about prompt recognition of symptoms and seeking medical help urgently. As the rate of unsuccessful thrombolysis is higher in patients with old age, diabetes, hypertension and dyslipidemia, such patients should be monitored and treated aggressively.Keywords
Diabetes, Hypertension, RWMA - Regional Wall Motion Abnormalities, STEMI - ST Segment Elevation Myocardial Infarction, ThrombolysisFull Text
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- Study of Clinical Profile, Radiological Findings and Risk Factors in Patients with Cerebral Venous Thrombosis in Tertiary Care Hospital
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Authors
Affiliations
1 Former PG Resident, Department of General Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
2 Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik; – 422003, Maharashtra, India ., IN
1 Former PG Resident, Department of General Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
2 Professor, Department of General Medicine, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik; – 422003, Maharashtra, India ., IN
Source
MVP Journal of Medical Sciences, Vol 9, No 1 (2022), Pagination: 62 - 67Abstract
Background: Cerebral venous thrombosis is a rare cause of stroke in adults especially in the young. It is a diagnostic and therapeutic challenge for the physician, given the wide spectrum of its clinical presentation. The purpose of the present study is to describe the clinical features, risk factors, radiological findings and outcome in a patient of Cerebral venous thrombosis. Objective: To study clinical profile, radiological findings and risk factors in patients with cerebral venous thrombosis amongst study participants. Material and Method: The prospective observational study was conducted on 60 patients admitted in department of General Medicine at tertiary health care institute at Nashik. Written informed consent was taken from all the study participants, and those who gave consent and satisfy eligibility criteria were enrolled in the present study between August 2017 to December 2019 with a radiologically confirmed diagnosis of cerebral venous thrombosis. Detailed history, clinical examination, laboratory investigations were carried out in all the cases and followed until discharge from the hospital or death. All the data will be analysed by applying appropriate statistical tests Microsoft Excel 2010. Results: Majority of incidence was seen in 18-30 age group comprising 50% of the cases, with equal sex distribution. Mean age of patient was found to be 37.3 years. Most patient had subacute onset with headache (76.67%) being the commonest presenting symptoms followed by convulsions and focal deficit in 46.67%. Hemiparesis 43.67% followed by papilloedema 33% were the most common neurological signs. Hyperhomocystinemia 33.67% and Protein S deficiency 20% were the most common risk factors identified in males whereas anemia 60% and puerperium 26.67% were most common in females. Transverse sinus (66.33%) was most common sinus involved radiologically followed by superior sagittal sinus in 43.67%. In 90% of the cases Low Molecular Weight Heparin [LMWH] was given and remaining 10% were given intravenous unfractionated heparin. 14% cases underwent decompressive surgery. Mortality was found to be 6.33% in the present study. Conclusion: High index of suspicion required for diagnosis of Cerebral venous thrombosis. The clinical presentation is nonspecific, can vary significantly and often makes the diagnosis of quite puzzling. MRI brain and MR Venogram are necessary for establishing a diagnosis. Patients are treated with anticoagulants, antiepileptics and antiedema measures and surgical decompression in case of continuing deterioration, in spite of maximum medical management. Cerebral venous thrombosis has a good prognosis unlike arterial ischemic stroke if the acute stage of illness has been survived.Keywords
Cerebral Venous Thrombosis, Low Molecular Weight Heparin [LMWH]Full Text
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