ABSTRACT
Background@#The purpose of this study is to evaluate cardiac functions using transthoracic echocardiography, change in lead parameters and electrocardiogram (ECG) morphology in patients undergoing permanent pacemaker implantation over a follow-up period of 6 months. @*Methods@#This is a prospective study in patients undergoing permanent pacemaker implantation in a tertiary care hospital. Patients undergoing permanent pacemaker implantation were enrolled for up to one year and Echocardiographic parameters (by 2 blind operators) and ECG parameters were recorded at admission (within 24 h), before discharge (within 7 days of pacemaker implantation), after 1 month (± 7 days) and after 6 months (± 7 days) of follow-up. @*Results@#A total of 96 patients (60.4% males and 39.6% female, mean age 66.65 years) were implanted with permanent pacemaker. The mean QRS duration was 133.18 ms and increased significantly to 146.03 ms by 6 months despite septal lead placement in majority (92%) of patients. The mean baseline ejection fraction of 51.47 decreased significantly to 47.83 by 6 months. Diastolic parameters like left atrial volume index, early to late diastolic transmitral flow velocity (E/A) and early diastolic mitral annular tissue velocity (E/e′) showed a significant increase (> 5%) from baseline by the end of first week. By the end of first month, systolic dysfunction of RV sets in with significant (> 5%) change from baseline in parameters like Right ventricle myocardial performance index, transannular plane systolic excursion and right ventricle systolic excursion velocity (RVS′). @*Conclusion@#We have observed that pacemaker recipients with baseline reduced left ventricle (LV) systolic functions perform significantly worse compared to those with baseline normal cardiac functions and had a higher rate of deterioration of LV function. RV dysfunction is the first abnormality that occurs, by 1 week followed by LV dysfunction which starts by 1 month and the diastolic dysfunctions precede the systolic dysfunction. QRS duration also showed a gradual increase despite septal lead placement in majority (92%) and lead parameters showed no significant change over 6 months.
ABSTRACT
Background@#The purpose of this study is to evaluate cardiac functions using transthoracic echocardiography, change in lead parameters and electrocardiogram (ECG) morphology in patients undergoing permanent pacemaker implantation over a follow-up period of 6 months. @*Methods@#This is a prospective study in patients undergoing permanent pacemaker implantation in a tertiary care hospital. Patients undergoing permanent pacemaker implantation were enrolled for up to one year and Echocardiographic parameters (by 2 blind operators) and ECG parameters were recorded at admission (within 24 h), before discharge (within 7 days of pacemaker implantation), after 1 month (± 7 days) and after 6 months (± 7 days) of follow-up. @*Results@#A total of 96 patients (60.4% males and 39.6% female, mean age 66.65 years) were implanted with permanent pacemaker. The mean QRS duration was 133.18 ms and increased significantly to 146.03 ms by 6 months despite septal lead placement in majority (92%) of patients. The mean baseline ejection fraction of 51.47 decreased significantly to 47.83 by 6 months. Diastolic parameters like left atrial volume index, early to late diastolic transmitral flow velocity (E/A) and early diastolic mitral annular tissue velocity (E/e′) showed a significant increase (> 5%) from baseline by the end of first week. By the end of first month, systolic dysfunction of RV sets in with significant (> 5%) change from baseline in parameters like Right ventricle myocardial performance index, transannular plane systolic excursion and right ventricle systolic excursion velocity (RVS′). @*Conclusion@#We have observed that pacemaker recipients with baseline reduced left ventricle (LV) systolic functions perform significantly worse compared to those with baseline normal cardiac functions and had a higher rate of deterioration of LV function. RV dysfunction is the first abnormality that occurs, by 1 week followed by LV dysfunction which starts by 1 month and the diastolic dysfunctions precede the systolic dysfunction. QRS duration also showed a gradual increase despite septal lead placement in majority (92%) and lead parameters showed no significant change over 6 months.
ABSTRACT
The reported rates of Barrett's esophagus [BE] ranged from 2.6% to 23% in Indian patients with gastro-esophageal reflux disease [GERD] symptoms. The role of methylene blue chromoendoscopy during endoscopy, either for the diagnosis of Barrett's esophagus or for the detection of dysplasia and early cancer, remains controversial. Our study was designed to find out the endoscopic as well as histological prevalence of BE in India in a specified patient population affected by GERD, and whether methylene blue chromoendoscopy improves detection of specialized intestinal metaplasia in endoscopically suspected Barrett's esophagus in GERD patients. Three hundred and seventy eight patients with characteristic symptoms of GERD from Northern India were subjected to upper endoscopy. On endoscopic suspicion of columnar lined epithelium [CLE] either 4-quadrant conventional biopsies at 2 cm interval or Methylene Blue [MB] directed biopsies were obtained randomly. The two groups were compared for the detection of Specialized Intestinal Metaplasia [SIM], which was diagnosed if the intestinal goblet cells were present. Out of 378 patients with GERD, 56 [14.81%] were suspected of CLE on endoscopy. After taking biopsy samples from the 56 patients, only 9 [2.38%] had specialized intestinal metaplasia on histopathological examination. Five [15.15%] patients in the conventional group and four [17.39%] patients in the chromoendoscopy group [P=0.55] were diagnosed as having BE. On univariate analysis the predictors of SIM were symptoms of reflux and length of CLE. The prevalence of biopsy proven BE and CLE in Northern India was 2.38% and 14.81%, respectively in patients with symptoms of GERD. The results of MB directed biopsies were similar to conventional biopsies in detecting SIM
Subject(s)
Humans , Male , Female , Prevalence , Risk Factors , Gastroesophageal Reflux , Methylene Blue , BiopsySubject(s)
Humans , Female , Radiography, Thoracic , Bronchiectasis , Dextrocardia , Electrocardiography , Tomography, X-Ray ComputedABSTRACT
Primary splenic cyst is a rare entity and majority of the cases are classified as epithelial cysts. They are uncommon, comprising only about 10% of benign non-parasitic cysts. Most of the cysts are asymptomatic, and they are incidental findings during abdominal ultrasonography. We report a case of 20 years old male who presented with 1 year history of mild abdominal pain and left upper quadrant fullness. Ultrasound and computed tomography [CT] both were suggestive of splenic cyst. Serological tests were negative for parasitic infection. Splenectomy was done. Histopathological findings are consistent with splenic epithelial cyst