ABSTRACT
Background: In Aneurysmal Sub Arachnoid haemorrhage, precise Cerebral Perfusion Pressure (CPP) and Intracranial Pressure (ICP) measurement can only be achieved by an invasive monitoring device. The study aimed at non-invasively estimating the preoperative values of CPP and ICP by use of validated formulae. These estimated flow velocities (estimated CPP or eCPP and estimated ICP or eICP) of the Middle Cerebral Artery were obtained by Trans Cranial Doppler ultrasound and comparing it with the preoperative CT Head Fisher Scale. In the Institute Rimed Digi-Lite Trans Cranial Doppler machine was used for research and Siemens (Somatom) 64 CT Scanner from GE (Signa) was used to perform CT scan of patients.Methods: It is a prospective, observational study which was studied between July 2017 and December 2018 in Post Graduate Institute of Medical Education and Research, Chandigarh, India. This study is a secondary analysis of a prospective observational study which was primarily designed to evaluate the neurological outcome related to the effect of estimated Intracranial Pressure and estimated Cerebral Perfusion Pressure as measured by Trans Cranial Doppler in patients with a SAH. A total of 100 patients were recruited in this study.Results: There was significant correlation between estimated CPP and Fisher Grading. There was no strong correlation between the modified Fisher Grade and estimated ICP.Conclusions: This study was able to give a statistically significant correlation between eCPP and Fisher Grading (p value- 0.047), as the Modified Fisher grading increased, so did the eCPP, this observation was unique, and it went against the hypothesis. However, no statistically significant co-relation was seen during comparison of eICP and Fisher Grading (p value- 0.069).
ABSTRACT
Introduction: Assessment of thyroid function duringpregnancy is important for assessing maternal and foetalwell being. However, the complex physiological alterationsoccurring during normal pregnancy cause thyroid hormonelevels to change. Hence, the interpretation of the thyroidprofile becomes difficult in pregnancy if normal referenceranges are not defined. Study objective was to determinetrimester specific reference ranges for thyroid hormone innormal pregnancy.Material and methods: Serum sample was collected from194 females in various trimester of normal intrauterine singlepregnancy and total T3, total T4 and TSH was determined.The results obtained were then analysed to determine gestationspecific thyroid hormone levels.Result: The normal ranges of thyroid hormone in first, secondand third trimesters during normal pregnancy in our studywere: total T3 (83.9-196.6, 86.1-217.4, 79.9-186 ng/dl), totalT4 (4.4-11.5, 4.9-12.2, 5.1-13.2 μg/dl) and TSH (0.1-2.7, 0.4-3.3, 0.5-3.8 IU/ml) respectively.Conclusion: The levels of thyroid hormones in pregnancynot only show characteristic changes from non pregnant statebut also vary with each trimester. Hence, trimester specificreference ranges for thyroid hormone need to be defined toensure correct interpretation of these tests.