ABSTRACT
Paraquat is a herbicide which is widely used by agricultural communities worldwide. It is extremely toxic for humans and ingestion of as less as 30 mL of 20%–24% concentration is usually lethal. The lack of an effective antidote is a concern due to the fatal outcomes associated with ingestion of paraquat. Herein, we are presenting a case of fatal paraquat poisoning in a young male from a center in India. The clinical course was complicated by liver, renal, and lung injury. We also describe its mechanism of toxicity, clinical features, and newer strategies being tried for treatment.
ABSTRACT
The present study was aimed to compare traditional lipid measures with the lipid ratios to establish a bettermarker for the assessment of coronary artery disease (CAD) risk. The comparison of traditional lipid parametersand lipid ratios were made in terms of independent ‘t’ test, area under receiver operating characteristic(AUROC) curve and logistic regression analysis. LDL-C and HDL-C could not correlate well with CAD riskprediction. Strikingly, TG/HDL ratio was found to be more significantly associated in comparison to any ofthe individual lipid parameters as well as TC/HDL and LDL/HDL ratios when compared in terms of AUROCand logistic regression analysis, while LDL/HDL ratio could not correlate. Altogether, these findings infer thatTG/HDL ratio is a better parameter in CAD risk prediction. Additionally, the TG/HDL ratio being calculatedparameter incurs no additional cost to the patients and health care system. Henceforth, the authors suggest theincorporation of the TG/HDL ratio in the routine lipid panel for the better diagnosis and treatment of dyslipidemia.
ABSTRACT
Objectives: To assess the comparative as well as collective role of various grey scale (GS) ultrasonography (USG) and color doppler (CD) parameters in distinguishing benign from malignant thyroid nodules. To suggest a scoring system for predicting malignancy in thyroid nodules using this array of parameters. Methods: 140 patients with non palpable thyroid nodules were examined by five GS USG and three CD parameters. The results were compared with histopathological examination and evaluated statistically. Each GS and CD parameter was evaluated individually as well as collectively, comparatively. Total score was calculated by assigning each of these eight parameters a score of 0 to 2. Results: Scoring used in this study showed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy of 87.5%, 90.6%, 70%, 96.7% and 80% respectively. These parameters were 85.4%, 86.2%, 60%, 96%, 80% for CD and 69.2%, 71.9%, 50%, 85.2% and 64% for GS. Two GS USG features showing p value < 0.05 were poorly defined margins and thick incomplete halo while on CD Resistivity index (RI) was found to be very highly significant (p < 0.0001) and Pulsatility index (PI) was highly significant (p < 0.001). Conclusion: Scoring system proposed in this study proved better than GS or CD individually for predicting malignancy in thyroid nodules. Amongst various GS and CD parameters RI showed highest statistical significance. Overall CD showed better accuracy, sensitivity, specificity than GS USG.