ABSTRACT
Objective: To determine the current frequency and pattern of distribution of congenital heart defects [CHD] at National Institute of Cardiovascular Diseases [NICVD], with the age at which initial diagnosis of CHD was made and the age at which the participant first visited the study center
Methods: This is a descriptive and prospective hospital based study conducted in the pediatric cardiology unit outpatient department of NICVD. This study included all the patients, irrespective of age, having confirmed diagnosis of CHD on the basis of echocardiographic report. The collected data was entered and analyzed by using Statistical Package for Social Sciences v 20.0
Results: Out of 1100 cases of congenital heart defects 1003 could be analyzed. There are 565 males [56.3%] and 438 females [43.6%]. Total 609 cases [60.6%] were of simple acyanotic lesions and 387 [38.6%] were complex cyanotic lesions. In simple lesions septal defects constitute 64.9% and obstructive lesions were 11.0%. Tetralogy of fallot[TOF] was the commonest CHD and cyanotic lesion accounted for 24.4% of the total 1003 cases followed by Ventricular septal defect[VSD] 21.5%, Atrial septal defect [ASD] 9.3% and Patent ductus arteriosus [PDA] 8.6%. Pulmonary stenosis[PS] was the most common obstructive lesion making 3.1% of the CHD. In 147 [14.5%] cases combination of simple defects were encountered and the commonest combination was ASD with VSD in 34 cases
Conclusion: Congenital Heart Defects are very common in our setup and early detection of CHD is increasing. Overall burden of CHD is also increasing therefore a proper population based study on a large scale is needed to estimate the prevalence accurately
ABSTRACT
Background: Rheumatoid [RA] and osteoarthritis [OA] are common joint diseases. The former is a multisystem disease with underlying immune mechanisms. The latter is a debilitating, progressive disease of diarthrodial joints associated with the aging process. We hypothesize that the development of RA and OA is associated with alterations in T cell subsets [CD4/CD8] as well as cytokine production in the blood and synovial fluid
Objectives: We carried out this investigation to test this hypothesis. Also, we took an aim at analyzing of RA and OA patients for: 1] the clinicopathologic characteristics of the lesions, 2] immunologic alterations in the synovial fluid [SF], peripheral blood [BP] and 3] the correlation between the clinicopathologic characteristics and immunologic alterations
Methodology: Samples [PB, SF] were obtained from 24 RA, 15 OA patients and six age and sex matched healthy controls [HCs]. The CD4/CD8 lymphocytes, levels of TNF-alpha, ILI -1beta and IL-17 cytokines were examined in SF and serum using Enzyme Linked Immunosorbent Assay, and immunoperoxidase staining methods
Results: The mean ages of RA and OA patients were 34.3 +/- 1.7 and 51.1 +/- 2.0 year. In RA, the mean values of the morning stiffness, pain scale, grip strength and Richie articular index were 87.5 +/- 11.5. 6.5 +/- 0.5, 51.0 +/- 8.8 and 29.5 +/- 2.4, respectively. As compared to HCs, in RA and OA, respectively, there were statistically significantly [p<0.05] higher: 1] ESR1 [8.5 +/- 51vs. 33.9 +/- 2.8 vs. 62.3 +/- 6.8]; 2] ESR2 [13.3 +/- 2.1vs. 50.6 +/- 4.3 vs. 88.9 +/- 6.4]; and 3] cytokine levels in the serum [7.5 +/- 2.1 vs. 25.8 +/- 2.3 vs. 26.2 +/- 1.5 for TNF-alpha; 9.2 +/- 6.2 vs. 18.5 +/- 1.6 vs. 17.8 +/- 1.3 for lL-1beta; and 0.01 +/- 0.0 vs. 0.07 +/- 0.02 vs. 0.2 +/- 0.1 for IL-17]. As compared to· OA, RA had significantly higher [p <0.05] cytokine levels in SF [105.6 +/- 39.5 vs. 245.2 +/- 22.2 for TNF-alpha; 14.3 +/- 1.3vs. 26.8 +/- 4.1 for lL-1beta and 0.5 +/- 0.2 vs. 6.4 +/- 2.3 for IL-17]. In the blood, as compared to HCs, there were a statistically significant higher CD4, CDS and CD4/CD8 ratio in both RA and OA [p<0.05]. There were significant direct correlations between the disease activity vs. TNF-alpha; CD4 vs. IL-17; CD8 vs. IL-1beta; and CD4 vs. TNF-alpha in SF
Conclusions: CD4/CD8 lymphocytes, cytokine are altered in RA and OA. In RA, some of these alterations correlated with the underling disease process and therefore may have pathogenetic, modulatory and potential prognostic roles in these lesions