ABSTRACT
Background and Objectives: This study was performed in a tertiary care hospital in western India. Our aim was to understand and analyze the clinical profile and causes of acute non-traumatic paraparesis and correlate them with relevant biochemical and radiological investigations. Methods: 100 cases of acute nontraumatic paraparesis admitted over a period of three years were studied. Data on age, sex, presenting symptoms, clinical signs and medical investigations was analyzed critically. This study used the mean and the median as measures of central tendency and standard deviation as a measure of dispersion. Results: Incidence of acute non-traumatic paraparesis was found to be the highest in the third and fourth decade of life (36% of cases). Incidence among males (54%) and females (46%) was fairly equal. An inability to walk (72%) or a difficulty in walking (28%) were the chief presenting symptoms. 76% of cases presented in a stage of spinal shock. Tuberculosis was the commonest cause (40%), followed by acute transverse myelitis (26%). 50% of cases had compressive myelopathy while 30% had non-compressive myelopathy. Investigations such as cerebrospinal fluid (CSF) analysis, nerve conduction studies and Magnetic Resonance Imaging (MRI) were useful in diagnosing the causes. Conclusion: The commonest cause of acute non-traumatic paraparesis was tuberculosis. Early use of the MRI scan helps to confirm etiology and site of lesion.
ABSTRACT
Background and Objective: Microalbuminuria is a well accepted marker for micro and macrovascular damage in patients with diabetes mellitus. There is growing evidence that microalbuminuria is an important risk indicator for development of ischemic heart disease. This study was conducted to establish a relationship between microalbuminuria and ischemic heart disease in non-diabetic subjects. Methodology: Fifty randomly selected non-diabetic patients with ischemic heart disease who fulfilled the criteria for the study were evaluated for traditional risk factors and microalbuminuria. Results: Microalbuminuria was detected in 36 (72%) patients with Ischemic Heart Disease (p<0.05). 77% patients with infarct pattern on ECG and 22% patients with ischemia pattern on ECG had microalbuminuria. Majority of patients had microalbuminuria levels between 30-100 mg/day (41% males and 64% females). 72.72% of female patients had microalbuminuria (MA) compared to 71.79% of the male patients. 71.79% of hypertensive patients had microalbuminuria compared to 72.72% of normotensive patients. 79.17% of smokers with microalbuminuria presented with myocardial infarction compared to 62.5% of non-smokers with microalbuminuria. MA level is also associated with ECG (LVH, QTc prolongation) and 2D ECHO findings. Conclusion: Our patients with ischemic heart disease had a significantly positive association with microalbuminuria. Hence, microalbuminuria can be regarded as an additional risk factor for ischemic heart disease.
ABSTRACT
Background & objectives: Varicose veins and their associated symptoms and complications constitute the most common chronic vascular disorders leading to surgical treatment. The objectives of the study are analysis of the clinical features of varicose vein and to know the various treatment modalities adapted for the management of varicose veins. Methods: A prospective follow up was undertaken for 25 patients who were admitted for various symptoms of varicose veins. They were subjected to detailed history taking and examination with relevant investigations including Doppler venous study and were subjected to surgery. They were followed up for at least 6-month period to assess long-term morbidity, late complications. Results and Interpretation: In our study, maximum number of patients 8 (32%) were presented in the 31-40 years age group. In our study, in 13 (52%) cases, right lower limb was involved and in 10 (40%) cases left lower limb was involved and in 8 (8%) both limbs were involved. In the present study, the commonest symptom in 24 (96%) cases was that of dilated and tortuous veins. 13 (52%) cases had complaints of pain in the affected limb and 5(20%) cases had limb edema, venous ulcer was present in 18 (72%) of cases. Most patients were subjected to operative management.Conclusion: The outcome of cases of primary varicose veins depends on a thorough and complete clinical examination and duplex scan by experienced radiologists. Operative line of treatment is a primary procedure in the management of varicose veins of lower limbs.