ABSTRACT
Introduction: Pulmonary Embolism is a major health problemwhich is associated with significant mortality and morbidity. Itis a common and lethal condition. This study was undertakento find the association between NT-Pro-BNP levels and thelocalisation of thrombus in acute Pulmonary Embolism and toprognosticate the patients.Material and methods: Prospective study conducted ata tertiary care hospital.Thirty patients with PulmonaryEmbolism of various etiologies, confirmed with clinicalfeatures, laboratory investigations and imaging and fulfillingthe inclusion and exclusion criteria were included. Aftergetting informed consent, Blood samples for assessmentof NT-Pro-BNP levels were collected within 24 hours ofadmission.Results: In 19 patients, the thrombus was located centrally(in main pulmonary artery) whereas in 11 patients, thethrombus was located in the peripherally (in segmental andsubsegmental pulmonary arteries). 22 participants of thestudy had normal clinical outcome. 5 patients were morbid(oxygen dependant/ heart failure) whereas 3 patients died.Patients with central pulmonary embolus had higher NT-ProBNP levels whereas patients with pulmonary embolus in thesegmental or subsegmental pulmonary arteries had relativelyless NTPro-BNP levels. Patients with high NT-Pro-BNPlevels had complicated in-hospital course/ mortality whereas,patients with relatively lower NT-Pro-BNP had uncomplicatedin-hospital course.Conclusion: This study shows that higher NT-Pro-BNPlevels indicate higher probability of a more central locationof thrombus in pulmonary embolism and also right ventricularoverload. Also patients with higher NT-Pro-BNP levels had acomplicated in hospital course.
ABSTRACT
Clinical human brucellosis is quite rare in India, that too in an non susceptible host. This report describes a case of clinical human brucellosis in India. This case involved a 36 years old male, a professor in an Engineering college. He presented with complaints of fever for 4 months with myalgia, generalized tiredness, loss of weight and loss of appetite. On evaluation, total counts and ESR was elevated and all other investigations were normal. Based on history, common causes like occult tuberculosis or autoimmune diseases were considered. But, blood cultures grew Brucella melitensis in all 2 samples and a diagnosis of brucellosis was made. He was treated with Rifampicin and Doxycycline. Suspicion of brucellosis in this patient is low because the patient has no history of contact with animals, consumption of unpasteurized milk or occupational exposure. So, the health care practitioners should be aware of this possibility of this zoonotic infection as a differential diagnosis in patients with nonspecific symptoms and unexplained prolonged fever.