ePrints@TNMGRM (Tamil Nadu Dr. M.G.R. Medical University)
ePrints@TNMGRM (Tamil Nadu Dr. M.G.R. Medical University)Not a member yet
20811 research outputs found
Sort by
Prevalence of End Organ Damage to Hypertension in Patients Presenting with Acute Ischemic Stroke
No full textINTRODUCTION:
In the entire world, high blood pressure is the main risk factor for morbidity and mortality. One of the main factors affecting a patient's cardiovascular prognosis when they have arterial hypertension is the early diagnosis and degree of typical end-organ damage and secondary illnesses. An acute cerebral stroke, either ischemic or hemorrhagic, is the usual cerebrovascular consequence of arterial hypertension. Stroke presents a continuous challenge for therapy and rehabilitation because it is the second most prevalent cause of dementia, the most common
cause of disability, and the third most common cause of death worldwide.
AIMS AND OBJECTIVES:
1. To estimate the prevalence of End Organ Damage to Hypertension in Acute Ischemic Stroke patients.
2. To identify patients of acute ischemic stroke with a history of hypertension.
3. To measure microalbuminuria in those patients.
4. To examine the fundus for hypertensive retinopathy changes.
5. To investigate for Left Ventricular Hypertrophy.
MATERIALS AND METHODS:
Hypertensive patients admitted with acute ischemic stroke were assessed during the period of time. Patients fulfilling the inclusion criteria were enrolled in the study after obtaining informed consent. A Cross-sectional study is done. End organ damage to hypertension was measured using
1. Microalbuminuria using the Dipstick method.
2. Left Ventricular hypertrophy by echocardiography.
3. Hypertensive retinopathy by fundoscopic examination and its severity by Keith Wagner Barker Classification.
Continuous variables were summarised as Mean (SD) or median (IQR) and categorical variables were summarised as frequency (proportions).Associations between categorical variables were done using the Chi-square test and Data entry was made using MS Excel 2016.
Data analysis was done using SPSS Version 20.0. A p-value of less than 0.05 was considered significant.
RESULTS:
Among the 172 patients studied, majority 99 (57.6%) were male, and 73 (42.4%) were female.
Out of the 99 male patients, 73.7% (n=73) were non-alcoholic, while 26.3% (n=26) were alcoholic. Among the males, 81.8% (n=81) were non-smokers, while 18.2% (n=18) were smokers. Of 172 patients, 59.9% (n=103) had hypertension for 5 to 10 years, while 40.1% (n=69) had hypertension for less than 5 years. Of 172 patients, 36.6% (n=63) had Stage 1 hypertension, while 63.4% (n=109) had Stage 2 hypertension. When cholesterol levels were
compared among the admitted patients, it was found that 50.6% (n=87) patients had cholesterol levels less than 200, while 49.4% (n=85) patients had cholesterol levels above 200. Among 172 patients studied, 61% (n=105) patients were not having any micro-albuminuria while 39% (n=67) patients had micro-albuminuria. When the admitted patients were analysed for left ventricular hypertrophy by ECG, it was found that 50.6% (n=87) patients did not show LVH, while 49.4% (n=85) patients had shown LVH. When the admitted patients were analysed for left ventricular hypertrophy by 2D Echo, it was found that 51.7% (n=89) patients did not show LVH, while 48.3% (n=83) patients had shown LVH. When a total of 172 admitted patients was analysed for different grades of retinopathy, it was found that 17.4% (n=30) patients had grade 1 retinopathy, 7.6% (n=13) patients had grade 2 retinopathy, 4.1% (n=7) were having grade 3
retinopathy, and 2.9% (n=5) were having grade 3 retinopathy. While 68% (n=117) do not show any symptoms of retinopathy.
CONCLUSION:
After an ischemic stroke, end-organ dysfunctions are particularly prevalent, and their prevention and treatment typically call for specialised therapies. To enable rapid, early therapy of these individuals and improve their outcomes, knowledge of the nature and timing of systemic problems following ischemic stroke may be helpful in conjunction with the identification of high-risk patients. For example, left ventricular hypertrophy and retinopathy
are the most frequent sequelae following a stroke. Thus, a simpler and more approachable method is to check for micro-albuminuria and an echocardiogram for early diagnosis of
end-organ damage
Association Between Blood Urea Nitrogen (Bun) to Creatinine Ratio and Outcome in Patients with Upper Gastrointestinal Bleed at a Tertiary Care Hospital in Chennai
No full textINTRODUCTION: Upper Gastrointestinal bleeding (UGIB) is one of the most common gastrointestinal presentation in Emergency Department. Several risk factors for UGI bleed have been identified to assist physicians for managing and predicting treatment outcomes. Some parameters such as Age, Albumin, level of consciousness, Heart rate and Systolic Blood Pressure and INR can be used to predict risk of mortality prior to Endoscopy. Early identification of high risk patients and urgent interventions like use of medications, blood transfusions, urgent endoscopic therapy improves outcomes.
AIM OF THE STUDY:
To determine if Blood Urea Nitrogen to creatinine ratio is associated with short term outcomes in patients admitted with Upper GI bleed.
OBJECTIVE OF THE STUDY:
Is Blood Urea Nitrogen to Creatinine ratio associated with short term outcomes in patients admitted with upper GI bleed.
MATERIALS AND METHODS: using pretested proforma, patient details, history and clinical findings and investigations were documented. Descriptive study was conducted for a duration of 6 months from approval of study. RFT repeated at 24 hrs. BUN calculated from blood urea by dividing by a factor of 2.14. The BUN/Cr ratio was then calculated. The patient were followed up during the entire hospital stay. The intervention received by the patient, the endoscopic findings, and their clinical course in the hospital were noted.
RESULTS: In our study patients, 53 (55.2%) were observed with less than 30 BUN/CR ratios whereas 43 (44.8%) patients were reported with a BUN/CR ratio of more than 30. In our study of all 50 patients with a BUN/CR ratio of more than 30, the majority of patients 31 (62%) were reported with mortality. Whereas of 46 patients having a BUN/CR ratio less than 30, only 7 (15.2%) patients were found with mortality. In our study 57 (59.4%) required ICU care and 39 (40.6%) patients recorded no ICU care requirement. When ICU care was correlated with the BUN/CR ratio it was found that of all 57 patients requiring ICU care 38 (88.4%) patients were recorded with a BUN/CR ratio of more than 30. Whereas in patients with no requirement of ICU care majority 34 (64.2%) reported with BUN/CR ratio of less than 30.
CONCLUSION: In our study, a BUN/Cr ratio of >27.5 was identified as an independent risk factor for mortality and upper GI bleeding and may be useful for pre-endoscopic evaluation
A Comparative study of the Prognostic Significance of Curb 65 and Expanded Curb 65 in Community Acquired Pneumonia Patients
No full textINTRODUCTION:
Community acquired pneumonia is the eighth leading cause of mortality worldwide. Several scoring systems have been devised in the past to compute CAP severity. The aim of this study is to compare the prognostic significance of CURB 65 and Expanded CURB 65 in CAP patients. These are simple tests which can be done on day 1 of admission and have profound value in identifying the at risk individuals.
AIM OF THE STUDY:
The aim of the study is to compare the prognostic significance of CURB 65 and expanded CURB 65 in community acquired pneumonia patients.
PRIMARY OBJECTIVES:
1. To assess the length of stay in hospital in CAP patients and their CURB 65 and expanded CURB 65 score at admission.
2. To assess the need for intensive medical care admission in CAP patients and their CURB 65 and expanded CURB 65 score at admission.
3. To assess the in hospital mortality rate in CAP patients and their CURB 65 and expanded CURB 65 score at admission.
SECONDARY OBJECTIVE:
1. To correlate the serum LDH levels ,serum albumin levels and platelet levels with curb 65 and expanded curb 65 scoring.
MATERIALS AND METHODS:
The present study titled “A COMPARATIVE STUDY OF THE PROGNOSTIC SIGNIFICANCE OF CURB65 AND EXPANDED CURB65 IN COMMUNITY ACQUIRED PNEUMONIA PATIENTS” was carried out in the Department of General Medicine, Government Royapettah Hospital, Government Kilpauk Medical College Hospital, Chennai.
1. Study Design: Prospective cohort study.
2. Period of study: April 2022 to September 2022
3. Duration of study: 6 months.
4. Place of study: Government Royapettah Hospital, Chennai.
5. Study population:
Inclusion criteria:
1. Age more than 18 years of both sex.
2. Patients with at least two clinical signs and symptoms related to pneumonia (fever, cough, chest pain, dyspnoea and crackles on auscultation).
3. New infiltrates on chest x ray.
Exclusion criteria:
1. Age < 18 years,
2. Malabsorption and malnutrition status,
3. HIV infection,
4. Organ transplant recipient,
5. On immunosuppressant and steroids,
6. Pregnancy and lactation,
7. Symptoms after 48 hours of hospitalization.
Sample size:
100 patients of community acquired pneumonia in Government Royapettah Hospital.
RESULTS:
In this study it was found that both scores predicted the length of hospital stay, need for intensive care, need for mechanical ventilation with equal significance. However expanded curb score is sensitive in predicting the mortality better than curb 65 since it includes platelets, albumin and serum LDH values. Further serum albumin on day one admission is a better predictor of longer duration of hospital stay and intensive care.
CONCLUSION:
In a resource limited setting, CURB 65 is not inferior to expanded curb 65 in identifying the at risk patients and serum albumin better predicts mortality. Expanded curb 65 is sensitive but not specific in assessing the mortality
Study of Serum Uric Acid In Liver Cirrhosis and Its Correlation with Child Turcotte Pugh Score
No full textBACKGROUND: Cirrhosis cannot be accurately diagnosed by a serologic test. Even though aberrant biochemical patterns in combination with the clinical picture can point to certain liver illnesses, liver function tests may not always accurately reflect hepatic function. Hyperuricemia was found to be a risk factor for liver diseases. So, this study is an opportunity to determine serum uric acid level in liver cirrhosis and its correlation with Child Turcotte Pugh score.
AIM OF THE STUDY:
To study serum uric acid level in liver cirrhosis and its correlation with Child Turcotte Pugh score.
OBJECTIVES:
1. To determine serum uric acid level and Child Turcotte Pugh score among patients with liver cirrhosis.
2. To study the correlation between serum uric acid level and Child Turcotte Pugh score among patients with liver cirrhosis.
METHODS: A prospective study among patients with liver cirrhosis was conducted in a tertiary care centre with eight samples using simple random sampling. Their serum uric acid and CTP score was estimated and analysed using descriptive and inferential statistics by SPSS software.
RESULTS: 36.3% of patients had Class A score, 31.3% had Class B score and 32.5% of them had Class C scores. The mean uric acid value was 5.621+1.861 mg/dL ranging from 3.4 — 10.9.
There was a significant (0.0001) positive correlation (r value 0.642) between serum uric acid and Child Turcotte Pugh score among patients with liver cirrhosis.
CONCLUSION: Child Pugh score increases together with serum uric acid levels, suggesting that uric acid estimate may be a useful and affordable diagnostic marker for assessing the degree of liver cirrhosis
Comparative study on Early Versus Interval Cholecystectomy in Acute Cholecystitis with Late Presentation in GRH, Madurai
No full textA Comparative study of Mesh Fixation with Polydioxanone Versus Polypropylene Sutures in Assessing Inguinodynia in Lichtenstein Tension Free Hernioplasty
No full textA Study to Predict the Laparotomy in Blunt Injury Abdomen Based on Clinical Abdominal Scoring System
No full textA Comprehensive Analysis on Pre and Post Operative Serum TSH and Serum Calcium Levels in Benign Vs Malignant Thyroid Disease
No full text
