ABSTRACT
Myocardial performance index (MPI)/Tei index measures the LV systolic and LV diastolic function. Several studies have proved its reliability in evaluating the LV systolic and diastolic performance, with clear benefit over other old indices. It is also helpful in determining the prognosis of heart diseases, especially coronary artery disease. Diabetes affects the heart in several ways. The prevalence of coronary artery disease in a patient with diabetes is well known. The cardiac status in prediabetes is not studied extensively. Hence this study was undertaken to assess the myocardial function in prediabetes using MPI. We wanted to assess myocardial performance index (MPI) in prediabetes and correlate myocardial performance index with cardiovascular risk factors like waist hip ratio (WHR), fasting lipid profile (FLP) and body mass index (BMI).METHODSIn this cross sectional study 200 prediabetics were enrolled as cases and 100 age and sex matched subjects were enrolled as controls. Thorough history, physical examination, biochemical investigations like FBS, PMBS, FLP and Echocardiography for myocardial performance index were done.RESULTSBody mass index (BMI), waist to hip ratio (WHR), total cholesterol, triglycerides, low density lipoprotein (LDL) and very low-density lipoprotein (VLDL) were significantly higher in prediabetes and high-density lipoprotein (HDL) were significantly lower in prediabetes in comparison to controls (p=0.0001). Out of 200 prediabetic subjects, 23 (11.5%) had abnormal MPI which was statistically significant in comparison with controls (p=0.037) There was no correlation of abnormal myocardial performance index with cardiovascular risk factors like BMI, WHR and fasting lipid profile (FLP).CONCLUSIONSPrediabetes had abnormal MPI in comparison to controls. However, no correlation was found between cardiovascular risk factors and MPI.
ABSTRACT
OBJECTIVES: To study clinical profile of the newly emerged novel strain non-O1, O139 of Vibrio cholerae, in the region of Ambajogai, District Beed of Maharashtra. METHODS: Out of 208 patients of acute gastroenteritis, 41 revealed to be positive for Vibrio cholerae by recommended method of stool examination. All the strains were sent to National Institute of Cholera and Infectious Diseases, Calcutta for confirmation. RESULTS: Out of 41 cases, 12 were of Vibrio cholerae O1, 29 Non-O1, of which nine found to be O139 strain. All patients were from 2-80 years of age with low-socioeconomic status and maximum incidence was in August (64.70%), presented with severe rice watery loose motions. Vomiting was observed in 26 (63.41%), more so in patients of O139 infection (88.88%) than four (33.33%) of O1 infection. Sweating was observed in three patients (33.33%) of O139 infection, cramps in gastrocnemis muscles in three patients (33.33%) of O139 infection and two (16.66%) of O1 infection. Signs of dehydration were mild to moderate in four patients (33.33%) of O1 infection; severe dehydration in six (66.66%), moderate in two (22.22%) and mild in one patient (11.11%) of O139 infection. While dehydration was severe in four (20%), moderate in one (5%) and mild in three patients (15%) of Non-O1 infection (excluding O139 cases). Clinical features were more severe in patients of serotype O139 than the patients of O1 and Non-O1 (excluding O139 cases). However all patients responded to intravenous fluids, oral rehydration and antibiotics (tetracycline) within 24-48 hours without any mortality. CONCLUSIONS: This study reflects the first emergence of Non-O1, strain O139 during the year 1997 with severe and critical clinical features in Ambajogai region causing high morbidity in the form of severe dehydration and peripheral circulatory collapse which requires early and correct diagnosis and prompt treatment.