ABSTRACT
Introduction: Pleural effusion is one of the most frequentlyencountered pathology in our hospital. Thoracocentesis,thoracostomy, pleurodesis is the most commonly usedtreatment options for recurrent and persistent pleural effusion.Sterile talc powder is most commonly used as an sclerosingagent. In our study we have used sodium tetradecyl sulfateas a newer sclerosing agent and we have compared thecomplication rate, clinical response and success rate inboth sodium tetradecyl sulfate and talc sclerosing agent forpleurodesis. Study aimed to compare the safety and efficacyof the sodium tetradecyl sulfate and talc as a pleurodesis agentin pleural effusion cases.Material and methods: Pleural effusion cases (both malignantand non-malignant cases) were randomly allocated into groupA or group B. Group A patients were treated with 60mg of3% sodium tetradecyl sulfate, Group B patients were treatedwith 2 grams of sterile talc powder. Clinical data regardinggeneral complications, the rate of success, reduction in ICDdrainage and lung expansion were noted for every patient whounderwent pleurodesis.Results: 25 patients were allocated in each group. Patientscharacteristics were balanced between the two groups withthe majority of pleural effusion malignant in etiology. There isa statistically significant difference between the use of sodiumtetradecyl sulfate and talc in clinical response, ICD drainageand lung re-expansion. Sodium tetradecyl sulfate patient hasbetter lung reexpansion and clinical response in comparison totalc powder. The general complication was observed to be lowwith sodium tetradecyl sulfate than talc pleurodesis.Conclusion: Sodium tetradecyl sulfate pleurodesis appearsto have better pleurodesis effect than talc pleurodesis in ourstudy
ABSTRACT
Background: The most frequent cause of atrial fibrillation is atrial dilatation resulting from volume or pressure overload of the heart, which may occur in ischemic heart disease, valvular disease, dilated cardiomyopathy, chronic heart failure or, less frequently, due to degenerative, inflammatory or fibrous disease. Aim of the study: Echocardiography changes in pre and post-operative patients who under gone mitral value replacement in concerned with left atrial size. Materials and methods: Totally 76 patients were included in the study. The study was conducted in the department of cardiothoracic surgery, Government Mohan Kumaramangalam Medical College Hospital, from 2015-2018. 76 patients underwent isolated mitral two groups were identified based on left atrial size: Group 1 <60 mm (n=44) and Group 2 >60 mm (n=32). Clinical assessment, preoperative and last postoperative echocardiograms were considered for analysis. Results: The left atrium decreased by 5.84 mm 10.5 in group 1 compared to 20.9 mm 10.64 in group 2 (p=0.0001). This correlated with preoperative mitral valve area (p=0.009), preoperative mitral regurgitation (p=0.000), and preoperative atrial fibrillation (p=0.022). Linear regression analysis revealed atrial fibrillation (p=0.001, b1=6.006), a high grade of mitral regurgitation (p=0.001, b1=3.812), and larger size of the left atrium (p=0.000, b1=0.701) predicted a greater reduction of left atrial size during follow-up. Left atrial size decreased by 28mm in patients with a preoperative left atrium >60 mm (75% sensitivity and 100% specificity). Pon. A. Rajarajan, R. Vijay Anand. Echocardiography changes in pre and post-operative patients who under gone mitral valve replacement in concerned with left atrial size. IAIM, 2019; 6(3): 105-110. Page 106 Conclusion: The asymptomatic left atrium reduces in size considerably after mitral valve replacement, and the decrease is greater in patients with a left atrium >60 mm in size. Surgical treatment of mitral valve disease results in a significant reduction of left atrial size and, in some patients, also in the restoration of sinus rhythm.