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A Study of Clinical and Laboratory profile of Scrub Typhus in a Tertiary care Teaching Hospital
No full textBackground: Scrub typhus, also known as bush typhus, is a disease caused by bacteria called Orientatsutsugamushi. This ricketssial infection is transmitted to humans through the bite of infected heptombidium mite larvae. Subjects and Methods: All patients were subjected to investigations to establish cause of febrile illness. After complete physical examination, routine laboratory investigations like CBC, serology for enteric fever, malaria, Scrub typhus and USG abdomen, chest x-ray ,urine analysis and renal function tests were done in all patients. In all cases diagnosis was based on detection of antibodies using a single step rapid immunochromatography method. Results: 120 patients, who were admitted with undifferentiated acute febrile illness during the study period diagnosed to be suffering from Scrub typhus with positive antibodies, the following results were noted. Fever was the most common symptom seen in all the 120 patients (100%). The duration of fever ranging from one to seven days was present in 94 patients (78.3%), fever for 7-12days present in 5 patients(4.2%) and fever for more than 2 weeks was present in 5 patients(4.12%). Headache and vomitings were the commonly associated symptoms. Generalized muscle pain (myalgia) was present in 63patients(52.5%). Headache was present in 64 patients (53.3%), diarrohea was complained by 2 patients(1.7%), vomiting in 47patients(39.2%), shortness of breath was present in 16 patients(13.3%), abdominal pain was present in 17patients(14.2%) and skin rash was seen in 1 patient(0.8%). Conclusion: Majority of the cases of Scrub typhus are seen in the cooler months of the year and in the rainy season. It has to be considered in the differential diagnosis of undifferentiated acute febrile illness. 
A Prospective Study of Lipid Profile and BMI as Risk Factors in MI in Young [
No full textBackground: In recent years’ cardiovascular disease is the leading cause of mortality and morbidity worldwide in both male and female is accepted. The urbanisation has made its impact on the rising incidence of MI in India. One should not overlook however that MI in rural areas has doubled as well. This study is aimed at studying the Dyslipidaemia and Body mass index as risk factors in MI in young in rural background. Subjects and Methods: This prospective observational study was done in General Medicine Department at SVS hospital during July 2007 to July 2009.Out of 100 patients admitted with MI 20 selected and studied based on inclusion and exclusion criteria. Results: The study showed patients with high LDL>100mg/dl and low HDL<35mg/dl were prone for MI than other individuals. Furthur it was shown that patients with BMI>30 had increased risk for MI than otherwise. It was also observed that female preponderance was more compared to males. Conclusion: The study shows that dyslipidaemia and abnormal BMI do contribute to MI in young in rural background. 
Estimation of Plasma BNP Levels in Rheumatic Heart Disease Patients at a Tertiary Care Teaching Hospital in Eastern India
No full textBackground: Brain natriuretic peptide (BNP) is a cardiac hormone secreted from the ventricular myocardium as a response to ventricular volume expansion and pressure overload. Rheumatic heart disease is a major health problem, mostly in developing country like India and particularly in this part of the country. In young age group rheumatic heart disease is the most common cause of cardiac morbidity and mortality. In this study our aim is to measure BNP levels in patients with RHD and to find out whether BNP concentrations correlate with clinical and echocardiographic findings. A total of 88 patients with rheumatic valve disease having different type of single or multivalvular lesions were included in this study. BNP was measured using the chemiluminescence methods (Bayer Centure, Germany) by BNP kit. 2D Echocardiography with colour Doppler was performed in all patients to assess the severity of the valve disease and for the measurement of pulmonary artery pressure. The plasma concentrations of BNP were found significantly higher in patients with aortic stenosis than in control (355.92±204.31pg/ml vs.183.39±93.51pg/ml, p < 0.001). The plasma BNP level was significantly higher in NYHA class IV than in class I (921.50±301.93 in class I and 125.85±52.88 pg/ml, p < 0.001 in class III). The independent determinants of higher BNP levels were NYHA functional class and systolic pulmonary artery pressure in multivariate analysis. Along with these results we got all other relative output which suggested that increased plasma BNP levels in patients with rheumatic heart disease compared with healthy subjects. 
Clinical Profile of Snake Bite Envenomation in Patients Admitted at Tertiary Care Hospital
No full textSnakebite envenoming is a potentially life-threatening disease that typically results from the injection of venom following the bite of a venomous snake. Sometimes envenoming can also be caused by venom being sprayed into a person’s eyes by certain species of snakes that have the ability to spit venom as a defense measure. Not all snakebites are venomous. Some snakes are non-venomous and venomous snakes do not always inject venom during a bite. Subjects and Methods: Patients were examined for complications of snake bite. Haemotoxicity was assessed based on features like bleeding from the bite site, gums, epistaxis, haemoptysis, haematemesis, rectal bleeding or malaena, haematuria, vaginal bleeding, bleeding into the mucosae, skin (petechiae, purpura, discoid haemorrhages, ecchymoses. Neurotoxicity by drowsiness, paraesthesiae, abnormalities of taste and smell, ptosis, external ophthalmoplegia, paralysis of facial muscles and other muscles innervated by the cranial nerves, respiratory and generalized flaccid paralysis. Results: Majority of the patients were farmers with 44% followed by housewives (26%). Lower limbs were the most common site of bite in our study group comprising of74% of the patients. Conclusion: Most common manifestation of envenomation is local envenomation comprising of 66%. 
To Analyze the Modifier Effect of NOS3 Gene in Hypertensive Patients of ADPKD
No full textBackground: Nitric oxide is important for the functional integrity of the vascular endothelium and is produced in endothelial cells by the enzyme endothelial nitric oxide synthase (eNOS). Hypertension has a strong genetic component, and the NOS3 gene, which encodes eNOS, represents an interesting candidate for contribution to the phenotype. The most clinically relevant polymorphisms in the NOS3 gene are a variable number tandem repeat (VNTR) in intron 4, and rs2070744 (T-786C) in the promoter region. Subjects and Methods: This study aims to investigate the association between these three polymorphisms in the NOS3 gene and modifier effect on age, progression of disease and hypertension in patients of ADPKD. Results: The present study carryout in the ADPKD patients admitted in NRI Medical College & Hospital. Univariate and multivariate logistic regression analyses were performed to assess the effect of genotypes and hypertension on the progress of chronic kidney disease (CKD). A stratified analysis was also performed to assess the evidence of the modification of hypertension-CKD relationship among VNTR genotypes. Conclusion: The results of this study indicated that the polymorphism in NOS3 may be a genetic susceptibility factor for hypertension in the Indian population. 
To Study the Pattern and Prevalence of Lipid Profile Abnormality in Newly Diagnosed Type 2 Diabetes Mellitus
No full textBackground: Diabetes is one of the commonest chronic non communicable disease affecting the society at large both in developing and developed countries. Present study aimed to study the Pattern and Prevalence of lipid profile abnormality in newly diagnosed type 2 diabetes mellitus. Subjects and Methods: In this study, 100 newly diagnosed cases of type 2 diabetes mellitus patients were evaluated. A cross section of both male and female diabetes patients diagnosed within the last 3 months (new onset) was taken into study. A detailed history, clinical examination and relevant investigations were performed. Collected data were analysed by using appropriate software. Results: In our study 60% were male and 40% were female. Majority of cases were in the age group of 46-55 years, followed by in age group 56-65 years. Dyslipidemia was present in 36.66% of male and 35 % of female. Highest prevalence of dyslipidemia was present in 56 -65 age group. Hypertriglyceridemia was present in 33.33% of cases, Hypertriglyceridemia with low HDL-C was present in 33.33 % of cases, Hypertriglyceridemia with low HDL-C and low LDL –C was present in 13.88% of cases while 19.44 % were having other mixed pattern of dyslipidemia. Conclusion: Endeavour should be made to control hyperglycemia and hyperlipidia tightly by appropriate therapeutic measures so that the occurrence and worsening of complications could be mitigated. 
To Assess Correlation of Fasting Blood Glucose, Hb1Ac and Serum Lipid Level in Type II Diabetes Mellitus Patients
No full textBackground: Diabetes Mellitus (DM) refers to a group of common metabolic disorder that share the phenotype of hyperglycaemia caused due to either deficiency of insulin secretion or insulin resistance. The present study was conducted to assess correlation of fasting blood glucose, Hb1Ac and type II DM in given adults. Subjects and Methods: The present study was conducted on 134 patients with type II diabetes mellitus (DM) of both genders. Patients were subjected to estimation of fasting and random blood glucose level. Modified method of Fluckiger and Winterhalter was used for estimation of glycosylated haemoglobin (HbA1C). Results: Out of 134 patients, males were 84 and females were 50. Age group 20-30 years had 11, 30-40 years had 14, 40-50 years had 38, 50-60 years had 46 and >60 years had 25 patients. The mean fasting blood glucose level in patients with good degree of control was 106.2, in fair was 164.4 and in poor was 208.2. Glycosylated hemoglobin level was good (6.74), fair (8.12) and poor (12.54). A positive correlation of fasting blood glucose and glycosylated hemoglobin level and serum cholesterol & glycosylated hemoglobin level (P< 0.05) was found. Conclusion: Authors found a positive correlation of fasting blood glucose and glycosylated hemoglobin level and serum cholesterol & glycosylated hemoglobin level in type II diabetes mellitus patients. 
Relationship between Glycemic Control in Type II Diabetes Mellitus and Anaemia
No full textBackground: Chronic hyperglycemia in uncontrolled diabetes is related to higher incidence of anaemia which goes unrecognized prior to the development of chronic renal failure.This study was conducted to know the prevalence of Anaemia in persons with with Type II Diabetes Mellitus,in relation to glycemic control using HbA1c as a tool to it. Subjects and Methods: 60 Diabetic subjects were divided into two groups of 30 each based on their glycemic control(group A,with poor glycemic control and group B with good glycemic control taking 7% Hba1c as cut off value),incidence of anaemia was measured and compared among them and also with 30 age and sex matched healthy non Diabetic controls. Results: Incidence of anaemia was found to be significantly higher in diabetics group as compared to non diabetics and among diabetics it was significantly higher in uncontrolled group as compared to group with controlled diabetes. Conclusion: Good glycemic control in diabetes is associated with a better haemoglobin levels,hence it is desirable to evaluate the haemoglobin level often to monitor the micro and macrovascular complications of diabetes even when the renal parameters are normal.  
A Clinico-Hematological Study of Influenza Virus Infection
No full textBackground: Influenza is a seasonal infectious viral disease which accounts for approximately 3-5 million cases of severe illness and 250,000 to 500,000 deaths in a yearly outbreak. The objectives of our study were to study the various clinical presentation of influenza infection and to correlate the demographic data and clinical symptoms with hematological parameters. Subjects and Methods: 95 cases which were positive by One-step RT-PCR were included in the study. Elevation of serum transaminase levels, thrombocytopenia and raised creatinine levels are important parameters which mandates vigilant follow up in patients with influenza infection. Results: The most common symptoms were fever in 88.42% and cough in 88.42% of cases. 51.57% of patients presented with anemia on admission. 11.5% of patients had thrombocytopenia of which 36.36% had elevated liver enzymes. 35.78% of cases had leukocytosis of which 32.35% had elevated liver enzymes. 15.78% of patients had raised creatinine levels. Conclusion: Authors suggested that elevation of serum transaminase levels, thrombocytopenia and raised creatinine levels are important parameters which mandates vigilant follow up in patients with influenza infection. 
Gastrointestinal Manifestations in Patients with Chronic Kidney Disease
No full textBackground: Chronic kidney disease is a silent epidemic of the 21 century. Surveys have suggestedthat as many as 16% of the adult population have CKD1. The most common, non –renal, chronic disorders in patients with ESRD are gastro intestinal disorders2. Among upper gastrointestinal lesions caused by chronic kidney disease gastritis, an esophagus is,gastric ulcers are the most prevalent lesions. Here an attempt is being made to study the upper gastro intestinal changes in chronic kidney disease and evaluate theirrelationship with the stage of CKD or GFR. Objectives: 1. To determine the prevalence of various upper gastro intestinal lesions withthe use of fibro optic endoscopy.2. To evaluate the relation between the gastro intestinal lesion with the stage ofCKD or GFR. Subjects and Methods: We conducted a cross sectional study on 50 patients ,who are diagnosed to haveChronic kidney disease and being presented to OPD and admission in NavodayaMedical College and Research Center, Raichur over a period of one year. All patientswith chronic kidney disease underwent upper gastrointestinal endoscopy wereincluded in the study. Results: Majority of the subjects belongs to age group of 31 to 40 years (26%) and least belongs to 70 to 80 years age group (6%).Out of the 50 subjects, males were 28 and females were 22.Majority of the cases in our study belonged to stage IV. 84% of the cases had upper gastrointestinal involvement on endoscopic examination in our study. Erosive gastritis (26%), either antral or fundal, was the predominant lesion found on endoscopy. Majority of the subjects having erosive gastritis, had stage IV CKD (53.8%).Out of 50 cases in our study 55% of subjects had lesions of the stomach, 26% of subjects had lesions in the duodenum, 19% of subjects had lesions in esophagus. Out of 50 subjects in our study 52% were undergoing haemodialysis and 48% of subjects were under conservative management. Majority of subjects undergoing haemodialysiswere belongs to stage V. Conclusion: Majority of the patients with chronic kidney disease have upper gastrointestinal involvement on endoscopic evaluation. Erosive gastritis is the most common upper gastrointestinal manifestation in our study. Upper gastrointestinal manifestations are predominant in stage V. Upper gastrointestinal findings are frequently observed in chronic kidney disease patients on dialysis. Early diagnosis and management can reduce mortality and morbidity and prevent fatal complication like massive upper gastrointestinal bleed.