ABSTRACT
Introduction: The Guillian Barre syndrome (GBS) is characterised by acute areflexic paralysis with albumincytological dissociation. Study was undertaken to analyze the electrophysiological studies, clinical profile and outcome of GBS at our institute. Material and Methods: This study was a hospital based descriptive and prospective study was conducted on patients admitted in the Medical intensive care unit. Patients with age more than 18 years, irrespective of their sex, diagnosed as GBS, fulfilling the criteria as modified by Asbury were included in the current study. Association between qualitative variables was assessed by Chi-Square test. Quantitative data was represented using mean ± SD, median. Results: Out of 50 enrolled, 21 patients belonged to age 21 to 40. 33 pts were male and 17 pts were female, 7 patients expired. Two peak of occurrence of GBS was found in age one in age group 21 to 41years and another in age more than 51 years.13 patients had history of antecedent infection. 35 patients had albumin-cytological dissociation. As per the results of nerve conduction study, patients were categorized in the following 3 groups AMAN-24, AIDP-14 and ASMAN-12. Conclusions: The independent predictors for the need of mechanical ventilation were history of breathlessness on admission, SBC of equal to or less than 10, upper or lower limb power of less than or equal to 2 (P valve <0.01). The predictors of poor outcome were presence of sepsis, need for mechanical ventilation, VAP, SBC of < 10 and lower limb power < 2.
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Background: C-peptide and insulin are secreted by pancreatic beta cells in equimolar concentrations. C- Peptide is associated with increased risk of cardiovascular disease. Methods: Routine outpatient department patients were investigated for serum C-peptide, Diabetes, Ischemic heart disease, hypertension and skin lesion acanthosis negrican. Results: Total ninety five patients enrolled in study of these peptide level 2, 2 to5 and >5 found in 22,46,27 patients respectively, with diabetes mellitus in 21 (95%), 39(55%) and 24 (89%), ischemic heart diseases 1(5%), 15(33%), 13(48%) , hypertension 9(41%), 20(44%), 12(45%), acanthosis negrican 9 (41%), 27 (59%), 21 (78%), family history 1 (5%), 18 (39%), 11 (41%) respectively. Conclusion: Significant incidence of hypertension and ischemic heart disease is related to raised level of circulating C-peptide
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In the era of the Consumer Protection Act, doctors running small private hospitals in rural settings face unique ethical challenges, especially in acute medical emergencies. I would like to share a few such cases