ABSTRACT
Background: Cerebral venous sinus thrombosis (CVST) is increasingly recognized entity in young patients due to the widespread availability of MRI and rising clinical awareness. CVST is a multifactorial condition with a wide clinical presentation, variable etiologies and prognosis and it requires high index of suspicion for diagnosis.Methods: It is an observational prospective study conducted in 57 patients. Patients above 12 years of age with a diagnosis of cerebral venous sinus thrombosis were included in the study to know aetiology, risk factors, clinical presentation and prognosis.Results: Mean age for males was 40 years and for females it was 36.5 and male to female ratio was 3:2. Headache was the most common symptom (89.47%) followed by convulsions, vomiting, focal neurological deficit, altered sensorium, fever and papilloedema. Superior Sagittal Sinus was the most common sinus involved followed by transverse sinus. Common risk factors were Hyperhomocysteinemia, alcohol, tobacco, APLA syndrome. 52.63% of patients had complete neurological recovery.Conclusions: CVST is uncommon condition and it is more common in neonates, children and females. The major risk factors for CVT in adults are prothrombotic (hypercoagulable) conditions, oral contraceptives, pregnancy and the puerperium, malignancy, infection, head injury. Headache is the most common symptom may be accompanied by focal neurologic deficits, seizures, and encephalopathy. It carries 5% mortality in the acute phase and 10% over a long-term follow up.
ABSTRACT
Background: Smoking is established as a causative risk factor for COPD as early as 1950. However, in the past decade it is shown that, other risk factors like indoor and outdoor air pollutants, workplace exposure to dust and fumes, poor nourishment and poor socioeconomic status are also associated with COPD. COPD is a disease associated poor quality of life due to recurrent exacerbations. Till to date focus has been on smoking as a risk factor for COPD, but other factors also need to be taken into consideration.Methods: Study was conducted in 60 eligible patients from urban area for a period of 18 months. Individual patient was asked detailed personal demographic data, respiratory symptoms, exposure to passive smoking, family history of COPD. Detailed physical examination including Anthropometric measurements and other relevant general and systemic examination was carried out. Biochemical investigations, ECG, Chest X-ray, CT chest, spirometry and 2D echocardiography were carried out in all patients.Results: The mean age of the patient was 65.7±7.95 with male preponderance. Common symptoms were dyspnea and cough and common signs were rhonchi and hyper resonance note on percussion. Common risk factors were indoor air pollution and low socioeconomic class. Most of the patients has hypoxia and hypercapnia. X-ray chest and CT chest showed hyperinflation, air trapping. Majority of patients had moderate FEV/FVC ratio on spirometry.Conclusions: Non-smoker COPD patients usually present in old age. Common presentation is dyspnea followed by cough and rhonchi on examination. Most common risk factor for non- smoker COPD is indoor air pollution, low socioeconomic class and cotton mill workers. Amongst indoor pollution, LPG, kerosene and wood are the risk factors for non-smokers COPD in urban population.