201 research outputs found
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Thyroid Dysfunction in Patients with Liver Disease
No full textBackground: Liver disease related to alcohol (Ethanol, ethylalcohol) is very common global problem and is one of the major medical complications of alcohol abuse. Daily consumption is usual for causation of liver disease. Aim: To estimate the prevalence of thyroid dysfunction in patients with liver disease. Subjects and Methods: Early morning fasting serum thyroid stimulating hormone (TSH), serum total free thyroxine (FT4) and free triiodothyronine (FT3) was measured by radioimmunoassays in 100 index patients with liver cirrhosis who did not have history of thyroid diseases. Study Period: November 2018 to October 2019 The age of study population was in the range of 25- 65 years. Out of 100 patients, 75 were males and 25 were females. Conclusion: Abnormalities in circulating thyroid hormone concentrations i.e hypothyroidism is noted especially in those with ethanol related liver cirrhosis and it is associated with more advanced liver disease. 
Study of Clinico Radiological Profile of Ischemic Cerebrovascular Stroke and Its Outcome at Tertiary Care Centre
No full textBackground: Ischemic CV stroke is disease of long term Disability and Death accounts for >80% of total stroke events. The main objective of the study was to study clinical and radiological profile, risk factors and outcome of stroke. Subjects and Methods: An observational study of 46 patients of acute ischemic cerebrovascular stroke was conducted during January 2014 to November 2014. All patients were subjected to Sociodemographic, Clinical, family h/o risk factors, dietary, other lifestyle habits and examination with written consent. Apart from routine blood investigations, special investigations like Uric acid, urinary albumin creatinine ratio, ECG,2D Echo, Carotid Doppler, CT Scan/MRI brain were done within24 hours of onset. NIHSS and MRS scores were used for severity assessment. Results: Majority of patients were in 55- 64 years (30.4%) age group with male predominance (52%) (mean age 55.52+12.61). Old aged patients are more likely to be selected for study. Microalbuminuria was found on 34 (73.9%) Patients with recent stroke. 52.1 % patients having serum uric acid >8. 36.9 % patients. ECG suggested LVH and normal findings in 36.9% while 15.2% and 10.8% had stroke related changes and myocardial ischemia. Majority 30
(65%) of patients showed concentric hypertrophy, followed by diastolic dysfunction 11(23%) on 2D Echo. Atherosclerotic changes seen in 60.8% on carotid Doppler study. majority 32.6 % patients were affected in MCA territory, followed by 23.9 % PCA territory followed by 19.5% infarct in thalamus. NIHSS and MRSmean score was 20.2+ 12 and 3.9+1.8 on admission and 15.7+13 and 3.23+ 1.91 on discharge respectively. Hospital outcome was good. No mortality during entire study period. Conclusion: Stroke a high socioeconomic burden in community. Apart from Age and hypertension, microalbuminuria and uric acid may be considered as independent risk factors for ischemic stroke. Identification and treatment of risk factors can prevent stroke related morbidity and mortality. 
Assessment of Vitamin D Status in Pregnant Women, a Prospective Observational Study from Northern District of Kashmir Valley
No full textBackground: An increased prevalence of vitamin D deficiency has been reported from across the globe including India. Various studies have shown an intrinsic relation between various parameters of maternal and fetal wellbeing with maternal vitamin D status during pregnancy. Aims: To prospectively assess the vitamin D nutritive status in pregnant women in North district of Kashmir Valley and to study the prevalence of suboptimal vitamin D status in apparently healthy pregnant North Kashmiri women.Study Design: Sixty three consenting pregnant women attending the antenatal clinic of the DH Baramulla and Endocrine OPD over the study period of 12 months were enrolled. Subjects and Methods: The subjects underwent a detailed history and physical examination as per a pre-formed Performa. History was focused on occupation, dietary history including diet taken in last 24 hours, exposure to sunlight, drug intake, menstrual history and history of any systemic illness. A particular record was made of the women’s dressing habits. Of the 63 subjects recruited, only 60 subjects (in whom Vitamin D levels could be estimated) were further analyzed for the study. Serum levels of [25 (OH) D] were estimated by 25-OH-D assay, an RIA based procedure. Results: In the present study, vitamin D insufficiency (defined as serum 25[OH] D levels <30 ng/ml) was observed in about 98.2 % of pregnant North Kashmiri women while as vitamin D deficiency (serum 25[OH] D <20 ng/ml)2 was observed in 71.6 %. In only about 3.2 % subjects vitamin D sufficiency (serum 25[OH] D >30 ng/ml) was observed. Conclusion: From our study we conclude that vitamin D deficiency is quite prevalent in normal pregnant women in North Kashmir valley. Taking a cut off value of 25 (OH) D of less than 20 ng/ml as vitamin D deficiency, overall 98 % of pregnant women were found to be vitamin D deficient. 
To Evaluate Serum Uric Acid as a Risk Factor For Micro- Vascular Complications of Diabetes Mellitus
No full textBackground: Diabetes Mellitus (DM) as a metabolic disorder of multiple etiology, characterized by chronic hyperglycaemia with disturbances of carbohydrate, protein and fat metabolism. The present study was conducted to evaluate serum uric acid as a risk factor for micro- vascular complications of diabetes mellitus. Subjects and Methods: The present study was conducted on 84 patients with type II diabetes mellitus of both genders. 10 ml of blood was obtained for assessment of blood glucose and uric acid level. Results: Age group 40-60 years had 46, 60-80 years had 25 and >80 years had 13 patients. Hyperuricemia was positive in 56 and negative in 28. The difference was significant (P< 0.05). Out of 56 patients with hypertension, 42 had high and 14 had low serum uric acid level. Out of 28 patients who had not hypertension, 18 had high serum uric acid and 10 had low. The difference was significant (P< 0.05). Among 48 patients who had stroke, 28 had high serum uric acid and 20 had low uric acid. The difference was significant (P< 0.05). Conclusion: Elevated serum uric acid levels in type 2 diabetes mellitus cause more micro vascular and macro vascular complications. 
Study of Serum Lipid Profile in Type-2 Diabetes Mellitus Patients
No full textBackground: Dyslipidemia may cause or exacerbate diabetic retinopathy and nephropathy and alterations in the coagulation-fibrnolytic system, changes in membrane permeability, damage to endothelial cells and increased atherosclerosis.Serum triglycerides and all types of lipoproteins are affected and this leads to increase morbidity and mortality in type 2 diabetic patients. Subjects and Methods: A total of 100 with type-2 diabetes mellitus irrespective of duration of diabetes in the age group of 35-80 years formed the study subjects. A pre-structural proforma will be used to collect baseline date detailed clinical history with clinical examination and relevant investigation will be done on participating individuals. Results: During our study we randomly selected 100 Diabetes mellitus-type-2 patients visiting OPD or admitted in the department of Medicine at our institution. Out of 100 DM patients, 61 were Males and 39 were Females. The Mean age of patients in our study was 57.29 +56.55 mg/dl and mean PPBS was 252 +73.76 mg/dl. Conclusion: This study shows significant increasing levels of TG, TC, LDl-C, and Vdl-C and significant decrease in level of HDL-C has the severity of diabetes. 
The Association between Serum Lipid Profile and Nephropathy in Type 2 Diabetes Mellitus Patients
No full textBackground: The prevalence of hypercholesterolemia (TC>200md/dl) alone, as reported tin numerous studies across India, has varied from about 20% to 35%. However, what is more important is the pattern of dyslipidemia. When compared with the western populations, Indians and migrant Asian Indians tend to have higher triglycriede levels and lower HDL-C levels. Subjects and Methods: This was a comparative study conducted among 100 cases. A pre-structural proforma will be used to collect baseline date detailed clinical history with clinical examination and relevant investigation will be done on participating individuals. Results: There was correlation between lipid levels and duration of diabetes for all lipid fractions which were significant. Conclusion: Correlation coefficient between nephropathy and lipid profile was found to be significant. 
Developing a Vaccine for Rheumatic Fever and Rheumatic Heart Disease: Current Research Strategies and Challenges
No full textRheumatic heart disease (RHD) is the most serious manifestations of rheumatic fever, which is caused by group A Streptococcus (GAS or Streptococcus pyogenes) infection. RHD is an auto immune sequelae of GAS pharyngitis, rather than the direct bacterial infection of the heart, which leads to chronic heart valve damage. Although antibiotics like penicillin are effective against GAS infection, improper medical care such as poor patient compliance, overcrowding, poverty, and repeated exposure to GAS, leads to acute rheumatic fever and RHD. Thus, effort to design a vaccine based on emm gene identification of GAS, M-protein going on for more than 40 years, is unlikely to succeed. M-protein is strain specific. Infection with one strain does not provide immunity from infection with another strain. Based on the emm gene identification, of 250 or more identified strains of GAS, the distribution is heterogenous and keeps changing. The M-protein gene sequence of the organism tends to mutate. A vaccine prepared from available strains may not be effective against a strain following mutation
Management of Idiopathic Pulmonary Fibrosis Cases at a Tertiary Care Hospital
No full textBackground: The clinical history of the disease is quite variable; there is usually a slow physiological deterioration, but in some patients there is a faster decline in lung function and death occurs within 6-12 months after diagnosis. Others experience an acute exacerbation during the course of the disease with a sudden worsening of respiratory symptoms, hypoxemia and the appearance of new radiological infiltrates without an identifiable cause. Despite different types of clinical course, IPF is inevitably associated with a poor prognosis, with a median survival of 2-
3 years. Subjects and Methods: Age, sex, occupation, address (including phone number) was noted down. A detailed occupational history was sought, enquiring about the age at start of the occupation, exact nature of work, any history of exposure to fumes, gases, dust, etc, any other person in the work place suffering from similar complaints etc were obtained. Results: Majority of the patients were treated with steroids alone 22(62.8%). 10(28.5%) patients were treated with steroids with azathioprine. 3(8.5%) patients were treated with pirfenidone. Conclusion: Majority of the patients, 17(48.5%) out of 35 patients, expired during the study period. 5(14.2%) patients were lost to follow up and the outcome was not available. 10(28.5%) patients remained stable, while 3(8.5%) patients worsened. None of the patients improved during the study period. 
Evaluation of CT Finding in heat stroke patients
No full textBackground: To describe the neurological manifestations and neuroimaging of heatstroke patients. Subjects and Methods: We extracted data retrospectively from patients’ files and described their neurological manifestations and radiological features. An experienced brain-imaging radiologist reviewed and analyzed patients’ radiographs to report on signs of abnormality. Results: This group included fifteen patients; eight males (53%) and seven females (47%), with an average age of (51.2 ± 10.1) years. Seven patients underwent brain imaging (CT scan), yet abnormal findings were detected in one patient images only. On the initial CT it showed bilateral thalamic and brainstem diffuse hypo densities. The follow-up CT scans showed acute hemorrhage in the pons and 4th ventricle. There was third intra-ventricular extension of blood, with mild hydrocephalus. Conclusion: The study presented non-specific neurological findings that were associated with heatstroke patients. These findings may affect management and potential complications prognosis. 
A Clinical Study on Hyponatremia in Elderly, Hospitalized Patients
No full textBackground: Electrolytes abnormalities are very common abnormalities in elderly individuals, among these hyponatramia is very dangerous and with high mortality hyponatramia is labelled as when serum sodium is less than 135 m.eq/l. It is associated with profound disturbance of cerebral function. Clinical features of hyponatremia include confusion, lethargy, vomiting convulsions and coma. To most cases of hypomatremiareflects water imbalance and abnormal water handling not sodium. Rapid rate of development of electrolyte abnormality causes more severe cerebral symptoms than the levels of Na Aggressive treatment and inappropriate therapy is more harmful than hyponatremia. Common causes of hyponatremia are dehydration, chronic renal failure, AIDS, Hypothyroidism and infections. Aim: To study the pattern, clinical features and outcome of patients with hyponatremia. Subjects and Methods: This study in conducted for 1year in 2 rural medical colleges in Telangana and Andhra Pradesh we have conducted this study on 80 elderly patients. Hospitalized patients. The age group is between 6.5 and 80 years males were 54 and females were 36. Results: We have examined 80 patients, males were 54 and females were 36. The age group is between 65 and 80 years. Hyponatremia was observed in 28 patients out of these 28 patients males were 18 and females were 10. The common age group is between 70 and 75 years. Conclusion: Hyponatremia is very common in elderly patients. And it is mostly seen in pts withCVA CAD, diabetes and sepsis. So when the elderly patients admitted with these coma bid conditions look for the early symptoms of hyponatremia and serum electrolyte should be tested. Early detection and early managements can prevent the mortality and morbidity is these patients.