ABSTRACT
Background: Acute Myocardial Infarction (AMI) has become one of the major causes of mortality in the world at present, and it is for this reason various researches are being done for its diagnosis and prognostic assessment. Serum enzyme estimation is an important tool for it. Aim: To study changes in serum cardiac markers, after acute attack of MI Before & 2 hours after reperfusion and to establish usefulness of enzymes in early diagnosis of AMI. Methodology: A study of changes in serum cardiac markers CK-MB, LDH and AST, after acute attack of MI-before and 2 hours after reperfusion was conducted at govt. hospital. Total 100 patients were studied. All the patients were confirmed cases of AMI, admitted in the intensive care unit of hospital. Blood samples were collected in plain bulb, at the time of admission and at 90 minutes (i.e. after reperfusion) and enzyme estimation was done for all 3 enzymes. Result: It was found that the serum CK-MB is the first and earliest enzyme released in compare to AST and LDH, and after reperfusion it increases 6-7 folds. The mean levels of all enzymes were higher after reperfusion, suggestive of good prognosis in case of early reperfusion after an attack of AMI.
ABSTRACT
Management of hydatid cyst disease is basically of excision of cyst wall and removal of all daughter cysts which was previously done by open technique. With proper selection of patient our strategy was going for laparoscopic approach first with conversion to open approach in accordance with difficulties encountered. Aim : To study the role of Laparoscopy in Hydatid Cyst Disease. Method : In this study, we present 30 cases where all cases were planned for initial laparoscopic trial and conversion to open if difficulties were encountered. This is an observational study to evaluate the role of laparoscopy in hydatidosis. All the patients underwent thorough clinical examination with detailed history and investigation as per protocol. Written informed consent was obtained before enrolling for the study. All patients were followed for 3 months. Result : Conversion to open surgery was done in 40% of cases due to number of cysts more than 3 and GHARBI type IV cysts followed by biliary communication of cysts and then peritoneal cysts and unfavourble location of cysts. Rest 60% patients were managed laparoscopically with good postoperative outcome and shorter hospital stay. Conclusion : laparoscopic treatment of hydatid cyst disease is a safe and effective procedure; with an excellent learning curve; provided strict selection criteria are observed. Most common reason for conversion to open approach was cyst number more than 3 and GHARBI type IV cysts, which were not diagnosed preoperatively. Complication rate was less with laparoscopic approach as compared to patients undergoing open surgery. Postoperative recovery was excellent in patients operated laparoscopically with shorter hospital stay.