ABSTRACT
Background: Chronic Kidney Disease (CKD) and Cardiovascular Disease (CVD) have been inextricably linked since the earliest days of hemodialysis. Several statistics accrued since that time attests to the impact of cardiovascular disease in renal patients. Approximately one-half of all deaths in end-stage renal disease patients are attributable to cardiovascular disease, a proportion that is remarkably similar throughout the world. The aim of the study: To Evaluate latent systolic dysfunction and its relation with diastolic dysfunction in hemodialysis patients with normal ejection fraction, using Doppler-derived systolic time intervals. Materials and methods: This retrospective study was conducted in the Department of General Medicine, Government Mohan Kumaramangalam Medical College, Salem in 2017. Patients with systolicand diastolic blood pressures above 140 and 90 mmHg were grouped as hypertensive. According to this classification, 44% of patients were hypertensive. The control group comprised of healthy normotensive persons with no cardiovascular complaints, normal electrocardiogram (ECG) and normal blood chemistries. Results: In our study, 90% of patients with systolic dysfunction had normal IVRT and 84.4% of patients with diastolic dysfunction had normal STI index. However, as in the previous study, the impaired STI index, and prolonged IVRT are independent of the presence of hypertension or left ventricular hypertrophy and IVRT was more sensitive than E/A ratio to diagnose diastolic dysfunction. R. Karthikeyan, V. Ramkumar. Echocardiographic assessment of systolic time intervals in hemodialysis patients with normal ejection fraction. IAIM, 2019; 6(4): 42-48. Page 43 Conclusion: The most common features of uremic cardiomyopathy namely left ventricular hypertrophy, diastolic dysfunction and systolic dysfunction were present in 40%, 24%, and 40% of our hemodialysis patients respectively. The diastolic dysfunction and latent systolic dysfunction (STI>0.4) were randomly distributed. Impaired STI index and prolonged Isovolumetric relaxation time are independent of the presence of hypertension or left ventricular hypertrophy
ABSTRACT
Purpose: To report the prevalence of amblyopia risk factors in children with congenital nasolacrimal duct obstruction. Methods: A retrospective review of records of children with the diagnosis of congenital nasolacrimal duct obstruction (NLDO), who underwent probing from January 2009 to October 2011, was done. All of them underwent a complete ophthalmic evaluation including cycloplegic refraction and strabismus evaluation before probing. Results: A total of 142 children were included in this study. The mean age at presentation was 22.38 months (sample standard deviation (SSD) ‑ 15.88). Amblyopia risk factors were defined according to two sets of guidelines: The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) referral criteria guidelines and the new AAPOS Vision Screening Committee guidelines. Twenty‑eight (20%) children were found to have some form of amblyopia risk factor based on the referral criteria prescribed by AAPOS . However, on applying modified guidelines described by Donahue et al., to analyze the same cohort, 21 children were found to have amblyogenic risk factors. Of these 28 children, 13 had significant astigmatism (>1.50 D), 8 children had hypermetropia (>3.50 D), and six children had anisometropia (>1.50 D). One child had significant cataract (media opacity >1 mm). None of the children in this series had either myopia or strabismus. Conclusion: Prevalence of amblyopia risk factor was found to be 20% in our study based on the older guidelines; however, it reduces to 14.78% by applying the modified guidelines. Despite this reduction, importance of a comprehensive ophthalmic examination including cycloplegic refraction in all children presenting with NLDO cannot be overstated. A close follow‑up of these children is also essential to prevent the development of amblyopia.
ABSTRACT
Abdominopelvic tuberculosis (genital tuberculosis) may mimic ovarian malignancy in clinical presentation, ultrasound findings and laboratory tests. We present two cases of genital tuberculosis where a provisional diagnosis of ovarian carcinoma was made. One patient underwent surgery and the other was treated conservatively. These cases underline the mandatory need of a high index of suspicion in our country, towards pelvic tuberculosis preoperatively in a patient with adnexal mass.