Sensitivty and specificity of Romhilt-Estes point score system for detecting left ventricular hypertnophy

The present study was conducted to determine the sensitivity and specificity of Romhilt and Estes point score system of ECG for the assessment of left ventricular hypertrophy by comparing it with the gold standard of echocardiography. Fifty clinically diagnosed patients of LVH were included in this collaborative study of Dept. of Physiology, Army Medical College, Rawalpindi and Department of Cardiology, Armed Forces Institute of Cardiology, Rawalpindi. ECG of the patients were recorded and Romhilt-Estes point score calculated. This was followed by echocardiography and left ventricular mass and left ventricular mass index was calculated. It was found that Romhilt-Estes point score system had a sensitivity of 35% and specificity of 90%. The sensitivity of ECG is low in detecting LVH, however, sensitivity can be increased by combining Sokolow Lyons voltage criteria and Cornell voltage criteria with Romhilt-Estes point score. ECG is however still recommended as a routine investigation because of its cost effectiveness and easy availability

High risk levels of lipoprotein [A] in Pakistani patients with type 2 diabetes mellitus

To find the prevalence of high risk levels of lipoprotein[a] [Lp[a]] and the ratio between low-density lipoprotein [LDL] and high-density lipoprotein [HDL] in patients with type 2 diabetes mellitus [DM] as evidence has been provided that Lp[a] and LDL can act additively in the development of atherogenesis. This cross sectional study was carried out at the Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from February 2001 to May 2001. The patients participating in the study were diagnosed cases of type 2 DM. Fasting blood samples were analyzed for Lp[a], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], glucose and glycosylated hemoglobin. The data was analyzed by computer software SPSS 10. The data was analyzed by considering Lp[a] levels <30 mg/dl as desirable level and >/= 30mg/dl as the high risk level. It was found that in the control group 73.3% of individuals had desirable levels of Lp[a] while 26.7% had high risk levels. In diabetic patients with good glycemic control 56.6% of patients had desirable levels of Lp[a] while 43.4% had high risk levels. The same data was also analyzed by taking Lp[a] levels of <20 mg/dl as desirable levels and the same pattern was observed. Diabetic patients have elevated levels of serum Lp[a] as compared to healthy subjects and the frequency of high risk levels of Lp[a] is also higher in diabetics compared to non-diabetic subjects. The increased prevalence of high risk levels in patients with type 2 DM may be due to increased prevalence of low molecular weight isoforms of apoprotein[a] [apo[a]]