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Comparative study of Large Incisional Hernia Repair by Posterior Component Separation Technique -Transversus Abdominis Release with Onlay Mesh Repair
No full textDesign and Development of Gallic Acid Decorated Lipid Nanoparticles for Targeting Tumor Cells
No full textA Study of the Hernia Neck Sac Ratio (HNR) Predictive Factor for Complications in Umbilical Hernia
No full textIodine Status in Pregnancy and Its Impact on Maternal and Neonatal Thyroid Gland Functions and Clinical Outcomes
No full textSerum Cortisol Levels in Assessing the Severity of Acute Stroke: A Cross Sectional study in Chengalpattu Medical College and Hospital
No full textINTRODUCTION: The stress response that occurs after the event of acute stroke causes the activation of the hypothalamo–pituitary–adrenal (HPA) axis. Certain studies have found that increased serum cortisol level in patients with acute stroke is related to greater stroke severity. Whether the stress response is just an epiphenomenon to stroke severity or independently contributes to prognosis remains uncertain. But there is a immense need to detect a biomarker for predicting the outcome of acute stroke.
OBJECTIVE OF THE STUDY:
The aim of the study was to investigate if a single serum cortisol determination was related to severity of acute stroke.
METHODS:
A cross sectional study was conducted in 120 patients with acute stroke presenting within 24 hours of stroke onset after getting informed consent. The patients were studied from medical wards and IMCU in Chengalpattu government hospital. Scandinavian Stroke Scale (SSS) was used to study severity of acute stroke. Diagnosis of Acute Ischemic or Hemorrhagic stroke was based on CT imaging in all patients. Blood samples are taken for assessing serum cortisol levels. Data was entered in MS excel analyzed using SPSS software for appropriate descriptive and inferential statistics.
RESULTS:
The mean age group is 50 to 59 years with 50% males and 50 % females. The mean cortisol level was 637nmol/L. Of the 120 cases 98 had acute ischemic stroke and 22 had acute hemorrhagic stroke. The mean SSS score was 20.85 and mean time duration was 9.5 hours. The correlation coefficient for SSS and serum cortisol was -0.984 which had significant correlation indicating high serum cortisol levels had low SSS score and also the P value being < 0.001 which was statistically significant.
CONCLUSION:
Acute stroke severity related to increasing serum cortisol levels. Serum cortisol was associated with stroke severity and markers reflecting stroke severity
Study of Clinical Profile of Organophosphorous Compound Poisoning with Special Reference to Electrocardiographic Changes
No full textINTRODUCTION:
Most common electrocardiographic abnormalities associated with the organophosphate poisoning with sinus tachycardia, sinus bradycardia, QTc prolongation, ST-T shifts, and a variety of arrhythmias, some of which can be deadly and serious. Myocardiotoxic injury from organophosphate poisoning has been hypothesised to occur in both animal and human research (myocardial necrosis). Organophosphate chemical poisoning has been linked to structural cardiac damage and electrocardiographic abnormalities. If detected early and properly managed, many consequences may be avoidable.
OBJECTIVES:
To study the clinical profile, Electrocardiographic changes and its prognostic significance among patients with organophosphorus compound poisoning.
METHODOLOGY:
This is a Prospective observational study among 89 patients admitted with organophosphate poisoning, under the Department of General Medicine, Thanjavur Medical College. A thorough, in-depth history was obtained from the subjects, including the clinical profile, findings, ECG changes and outcomes were analyzed.
RESULTS:
In this study All the subjects had sinus rhythm in ECG. 43 (43%) had Normal rate, 35 (35%) had Sinus tachycardia and 22 (22%) had Sinus bradycardia. 93 (93%) had Nil Conduction Defects and 7 (7%) had PR prolonged in ECG. 60 (60%) had Nil ST changes, 18 (18%) had QT prolongation and 12 (12%) had ST depression. Mortality rate were significantly higher, when the with the presence of QT prolongation and ST depression. Each unit increase in Duration between Ingestion & Admission (hours) had increase of risk of death by 2.24 times. Compared to normal level of consciousness, Drowsy or stupurous level of consciousness had 45.3 odds of getting death.
CONCLUSION:
ECG can play a significant role in identification of the high-risk population among the patients with OPC poisoning and the mortality rates can be reduced
A Study of Serum Sodium Level and Its Prognostic Significance in Patients with Acute Stemi in Tertiary Care Center
No full textINTRODUCTION:
Following a Myocardial Infarction, hyponatremia is frequent, and a rise in plasma sodium contents coincides with clinical recovery. Hyponatremia was present in about one third of the congestive heart failure patients. It has been demonstrated that in patients with heart failure and STEMI, it is a predictor of cardiovascular death. Acute STEMI patients who presented with hyponatremia at the time of admission and within 72 hrs of admission had high mortality and so serum sodium level (hyponatremia) is a prognostic indicator. Patient at risk can be identified by a simple marker of plasma sodium level.
OBJECTIVES:
To study the prognostic importance of serum sodium level (hyponatremia) among 80 patients with acute STEMI.
METHODOLOGY:
This is a Cross sectional analytical study, among 80 patients admitted with acute STEMI under the Department of General Medicine, Thanjavur Medical College and hospital, Thanjavur. Relevant history, clinical findings, biochemical measurements especially the serum sodium levels were compared with the outcomes. Prognostic value of the serum sodium levels were analyzed.
RESULTS:
Among the subjects, 71 (88.75%) were Recovered and 9 (11.25%) had Death. The mean Serum Sodium at admission, at 24 hours, at 48 hours and 72 hours (mEq/L) among Death was lower and statistically significant compared to the Recovered. Serum Sodium on admission, at 24 hours, at 48 hours and 72 hours in predicting Death was significant, with the good diagnostic accuracy value.
CONCLUSION:
Serum sodium can be used as a prognostic parameter for predicting death among the acute STEMI patients. The role of correction of the hyponatremia in prevention of the mortality rate among the acute STEMI patients’ needs to be explored
A Study on Left Ventricular Diastolic Dysfunction and Its Correlation with HbA1c Level in Type 2 Diabetes Mellitus Patients in Thanjavur Medical College Hospital
No full textBACKGROUND: Diabetes, a long term illness occurs by either insufficient insulin production by the pancreas or inefficient insulin utilisation by the body. A common and potentially fatal consequence of diabetes mellitus is heart failure. It is believed that LVDD is a first-stage preclinical sign of heart failure. Recent studies have shown that diabetics have a 30– 75% DD incidence rate. However, the proportion or the burden of LVDD among DM cases changes from study to study.
OBJECTIVES: To evaluate the prevalence of LVDD in T2DM patients in relation to duration of diabetes and to study the association between HbA1c level with LVDD and grading in T2DM patients.
METHODS: This study was conducted as observational cross sectional study in the department of General medicine in Thanjavur Medical College among cases with T2DM during November 2021 to August 2022. A total of hundred cases with DM were included in the study. Ethical committee approval was obtained for this study from the Institutional Human Ethics Committee All cases were assessed for the demographic and clinical presentation by the principal investigator using a pre structured proforma. For assessing LVDD all the cases underwent echo and also FBS, PPBS, HbA1c were also assessed using 5 ml of venous blood sample. All the reports from both cases and controls were entered in the same proforma where clinical presentation was entered by the principal investigator. Data was entered in excel sheet and analyzed using SPSS.
RESULTS: LV dysfunction was noted among 83% of the cases with DM while it was absent among 17% of the cases. Based on the LVD grading 17%, 45%, 26% and 12% of the cases were found to be in grade 0, 1, 2 and 3 respectively. Grades of LVDD was remarkably associated with age, mean HbA1c, duration of DM, LVM and LA size however, the factors
like gender, BMI, smoking habit and alcohol consumption were associated with the grades of LVDD.
CONCLUSION: We infer that as LVDD is predominantly noted among DM cases however its severity increases with duration of DM and HbA1c levels. Hence we suggest controlling glycemic status strictly and also most notably periodic assessment for LVDD should be done
