ABSTRACT
To assess the value of QTc prolongation and heart rate variation as a marker of cirrhotic cardiomyopathy and severity of liver disease. This comparative study was conducted on selected patients with cirrhosis of liver, fulfilling inclusion criteria and were enrolled as group 1. An equal number of non cirrhotic patients were enrolled and included in group 2. QTc and heart rate were calculated and compared between the two groups. Analysis of QTc prolongation and increase in heart rate with regard to severity of liver disease was also made. Fifty confirmed cases of cirrhosis of liver were included in group 1 with equal number of age and sex matched non-cirrhotic patients included in group 2 as controls. The mean +/- SEM of QTc in group1 and group 2 were 0.4707 +/- 0.0065 and 0.3893 +/- 0.00542 seconds respectively. The mean +/- SEM of heart rate was 90.50 +/- 2.839 beats/min and 82.85 +/- 2.207 beats/min in group 1 and 2 respectively. The mean of QTc and heart rate in group 1 was significantly higher as compared to group 2 [p=.001 and p=.0179 respectively]. The mean of QTc and heart rate in subgroup 1A, 1B and 1C was not statistically significant. Patients with cirrhosis have a higher mean QTc and heart rate as compared to non cirrhotic adults. Both tests may be useful markers of Cirrhotic Cardiomyopathy
ABSTRACT
OBJECTIVE: To study the changes occurring in electrophysiological parameters such as nerve conduction velocity [NCV], conduction time [CT] and amplitude of median [sensory and motor] nerve action potential inpatients with carpal tunnel syndrome [CTS]
DESIGN: Experimental observational study
SETTING: This study was carried out in Department of Physical Medicine and Rehabilitation, Jinnah Postgraduate Medical Centre, Karachi
DURATION: August 2009 to September 2010
METHODOLOGY: Subjects were patients of carpal tunnel syndrome [n=30] and normal healthy persons [n=20] were examined during the course of present study. The electro-diagnostic recording of effected 33 wrists [17 unilateral and 8 bilateral] were obtained by electromyography, using "surface electrodes" for determination of median motor nerve conduction velocity [M-MNCV] and "ring-electrodes" for determination of median sensory nerve conduction velocity [M-SNCV]
The recordings of 5 patients were out of range of electromyography, therefore excluded from the study. Besides the NCV, other parameters such as, median motor conduction time [M-MCT], amplitude of motor action potential [MAP], amplitude of sensory action potential [SAP] and median sensory latency [M-SL] were also recorded in patients and healthy subjects for comparison of our results. Data was analyzed statistically on SPSS version 17.0
RESULTS: Among 30 patients with suspected CTS, 5 patients has unobtainable electro-diagnostic results
In 33 wrists of 25 patients M-MCT significantly increased [5.26 +/- 0.36 m sec] as compared with normal subjects [4.12 +/- 0.12 m sec P<0.01]. Highly significant slower M-MNCV found in patients of CTS [46.50 +/-1.26 m/sec] than normal subjects [58.30 +/- 0.73 m/sec P<0.01]
The amplitude of M-MAP was low [less than 4.29 mv in CTS], 2.25 +/-0.40 vs. 6.55 +/- 0.45, P<0.01
Finger III median sensory digital nerve of CTS showed significantly increased value of M.-SL [2.48 +/- 0.16] when compared with normal [1.89 +/- 0.03 msec P<0.01]
The significant decreased values of M-MSNCV recorded in CTS patients [42.14 +/- 2.22] as compared to the normal subjects [54.20 +/- 1.11 P<0.01]
The significant decrease amplitude of SAP also recorded in patients [7.25 +/- 2.42 mv] as compared to normal subjects [27.90 +/- 2.40, P<0.01]
CONCLUSION: This study confirmed that nerve conduction study is a sensitive and helpful test for early detection of abnormal functions of nerve which direct the physician towards the appropriate line of treatment