ABSTRACT
Background : India shares a considerable share of the Global Disease Burden of Diabetes Mellitus which is a major public health concern. Among the many Vascular Complications of Diabetes, Peripheral Arterial Disease (PAD) is one and a major cause of Foot Related Disorders in Diabetics. The Ankle-Brachial Pressure Index (ABPI) is an efficient tool for objectively documenting the presence of lower extremity Peripheral Arterial Disease (PAD).The present study was conducted to find the prevalence of PAD in Diabetic Patients in a teaching hospital using ABPI.Materials and Methods : A total number of 100 cases of Type 2 Diabetic patients who were more than 40 years of age were included in the study after fulfilment of the inclusion and exclusion criteria. Ankle Brachial Pressure Index was measured in all and used to assess PAD. ABPI value of <0.9 was taken as indicative of PAD. Results : The prevalence of PAD using a ABPI Value of <0.9 was 31%. A significant association of PAD was found with duration of disease, hypertension, smoking and glycemic control.Conclusion : Peripheral Arterial Disease (PAD) is more commonly associated with Diabetes Mellitus than is generally thought. ABPI (Ankle Brachial Pressure Index) is a simple, noninvasive and cost-effective method for early detection of PAD.
ABSTRACT
Introduction: Hypertension is a global pandemic andrising every year. Detection of hypertension among doctorsis of utmost importance as hypertension is one of the majorcauses for diseases like chronic kidney disease, stroke, heartfailure and there is paucity in the studies done on doctors forprevalence of hypertension in India. Objective: The studywas undertaken to estimate the occurrence of hypertension inresident doctors of the clinical departments of a tertiary carehospital of northeastern India.Material and methods: It is a hospital based cross-sectionalstudy, conducted in the Department of General Medicine,Paediatrics and General surgery of tertiary care hospital ofnortheastern India including 100 doctors participants. Datalike age, height, weight, family history, smoking history weretaken. Blood pressure was measured on two occasions, oneon an emergency day and another on a non- emergency day.Statistical analysis: Data entry was done and evaluated usingMicrosoft Excel 2010 and IBM SPSS statistics 20.Results: The prevalence of hypertension and prehypertensionamong the doctors was found in 36% and 13% respectively,on an emergency day. This huge number of hypertension wasreduced to 19% when BP was taken on a non- emergency day.There was also significant positive relation between smokingand mean systolic BP (p-value <0.05).Conclusion: The prevalence of hypertension among doctorsis no less than the general population. Stress like emergencyduties may be an important factor of higher prevalence ofhypertension in doctors. There is a need of changes in lifestylefor better future for doctors and hence for the population.
ABSTRACT
Background: Lymphadenopathy is one of the commonest manifestations of a variety of diseases of diverse etiology. Tuberculosis, metastasis, acute suppurations and lymphomas are some of the entities. Fine needle aspiration cytology is a precise diagnostic technique for evaluation of different causations of lymphadenopathy and is comparable to the gold standard test excision biopsy and histopathological examination. Aims and Objectives: The study was designed to evaluate the clinicopathological profile of patients presenting with peripheral lymphadenopathy, establishing the role of fine needle aspiration cytology in the etiological diagnosis and to assess its sensitivity and specificity to correlate the findings with histopathological examination. Materials and Methods: One year single centered hospital based prospective analytical study was conducted in a tertiary care teaching hospital in north eastern India among 100 adult patients aged above 15 years presenting with accessible peripheral lymphadenopathy. Results and Observation: A male preponderance with maximum occurrence in the age group 15-40 years with features of neck swelling, fever, night sweats, unilateral cervical lymphnode involvement, anemia and raised ESR were common. Fine needle aspiration cytology was successfully done in 98% cases whereas excision biopsy in 90% cases. Diagnosis arrived on the basis of aspiration cytology and histopathology were tubercular in 52.04% vs 52.22%, metastasis in 25.51% vs 28.88%, nonspecific reactive lymphadenitis in 17.34% vs 13.33%. Hodgkin’s and Non-Hodgkin’s lymphoma in 2.04% vs 2.22% and 3.06% vs 3.33% cases respectively. The respective sensitivity and specificity of aspiration cytology vis-a-vis histopathology obtained in various groups are statistically significant (p< 0.0001) in each of tuberculosis 95.65% vs 100%, metastasis 96% vs 100%, nonspecific reactive lymphadenitis 100% vs 96%, Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma 100% vs 100%. Conclusion: Peripheral lymphadenopathy is a manifestation of a variety of diseases and fine needle aspiration cytology is a convenient and accurate diagnostic tool in evaluation of lymphadenopathies.
ABSTRACT
Coronary artery disease in Indians occurs at an earlier age than most other populations. Risk profile and angiographic severity of young acute coronary syndrome (ACS) patients differ from those in the elderly. Methods: This cross-sectional study included 46 young (≤45 years) and 45 elderly (>45 years) ACS patients. Clinical features, risk factor profiles and coronary angiograms of these patients were studied and compared. Results: Compared with the elderly, more young patients had chest pain and ST-elevated myocardial infarction. Smoking, atherogenic dyslipidemia and abdominal obesity were most frequent in young, while hypertension, high low-density lipoprotein (LDL) cholesterol and abdominal obesity were most prevalent in elderly. High serum homocysteine was the most prevalent novel risk factor in either group. Serum Lp(a) was significantly higher in the young group compared to elderly (p = 0.03). Angiographically, multivessel coronary disease and high Gensini score were more common in elderly. Young group had a low positive correlation between serum triglyceride level and Gensini score (rs = 0.33, p = 0.03). In the elderly, fasting blood glucose and serum triglyceride levels had low positive correlation with Gensini score (rs = 0.36, p = 0.01 and rs = 0.32, p = 0.04 respectively). Conclusions: Cardiovascular risk factors differ in young and elderly ACS patients. Lifestyle changes and behavioral modifications should be emphasized to prevent the development of ACS in the young Indians.