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Background: Arrhythmias commonly occur early in acute myocardial infarction and remain a common cause of sudden death in AMI. Magnesium has been implicated in the pathogenesis of acute myocardial infarction and its complication like arrhythmia. Magnesium improves myocardial metabolism, inhibits calcium accumulation and myocardial cell death. It improves vascular tone, peripheral vascular resistance, after load and cardiac output and reduces cardiac arrhythmias. The objective of this study to investigate the serum magnesium level and QTc interval prolongation in AMI and its correlation with arrhythmias.Methods: In this study, 200 patients of AMI were enrolled. ECG and cardiac parameters were examined. Serum magnesium level is measured and the QTc interval was calculated.Results: MI was more prevalent in the male patients (63.3%) and age group of 41-50 years. Hypertension (35.7%), smoking (34.2%), and diabetes (23.1%) were the major risk factor for MI. Mean serum magnesium level was 1.64±0.37 among those having arrhythmia that is significantly low as compared to those having no arrhythmia among which mean serum magnesium level was 2.28±0.31 (p<0.001). Mean QTc was higher (546.88 ms vs. 404.33ms) in patients documented with arrhythmia compared with those who had no arrhythmia (p<0.001).Conclusions: In acute myocardial infarction, patients with low magnesium levels and prolonged QTc interval are more prone to get arrhythmias. So magnesium treatment can be considered in patients of acute myocardial infarction with low magnesium levels.
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Background: Impaired fasting glucose (IFG) is a pre-stage to type 2 diabetes mellitus (T2DM) in adults and generally in obese population. In different studies this occurrence varied significantly, but the true prevalence is unknown due to lack of larger representative cohort studies. Authors objectives was to study the prevalence of IFG in different grades of obesity.Methods: One hundred obese subjects of obesity Grade1 (BMI >25 kg/m2 but <30) and Grade 2 (BMI >30 kg/m2) were studied at Gandhi Medical College, Bhopal from April 2019 to June 2019. Physical examination, blood investigations including fasting blood glucose and oral glucose tolerance test (OGTT) was carried out for all the patients.Results: Out of 100 subjects, 18(9%) males and 18(9%) females had IFG. Among male subjects highest IFG was recorded in the age group of 60+ years and in the weight rage of 71 to 80 kg. In female subjects, highest prevalence was in the age group 51 to 60 years and in weight range of 51-60 kg. Out of 24 males and 34 female of with Grade 1 obesity, 7% and 10.4% had IFG similarly, out of 25 males and 17 females with grade 2 obesity, 11% and 7.6% had IFG.Conclusions: IFG is highly prevalent in different grades of obesity. Obesity is the risk factor for the development of diabetes.
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Background: Arrhythmias are a common occurrence in acute myocardial infarction. Objectives of this study the hemodynamically significant arrhythmias and QTc interval in thrombolysed and non thrombolysed acute myocardial infarction patients.Methods: Two hundred patients of AMI were enrolled. ECG and cardiac parameters were examined. Arrhythmias and its various parameters like its incidence, type, frequency associated with site of infarction were recorded in thrombolysed and non thrombolysed patients of AMI.Results: AMI was more prevalent in the males (63.3%) and those with 41-50 years of age. Hypertension (35.7%), smoking (34.2%), and diabetes (23.1%) were the major risk factor. Incidence of AWMI (30.7%) is higher than IWMI (25.1%). Out of 200 subjects 130 were thrombolysed. Arrhythmias was observed in total 164 patients while 36 patients has no documentation of arrhythmias. Mean QTc was prolonged (546.88ms vs 404.33ms) in patients documented with arrhythmia compared with those who has no arrhythmia. Out of all arrhythmias, ventricular tachycardia was seen in 38% cases with 50% mortality and preponderance to antero lateral MI. Sinus Tachycardia was seen in 22% of cases with preponderance to Antero Lateral MI and persistence of Sinus Tachycardia was a prognostic sign, mortality being 12%. Complete Heart Block were seen with IWMI, incidence being 26%. Bundle Branch Block was common in AWMI (31%) than IWMI (10%).Conclusion: Tachyarrhythmias are common with AWMI and bradyarrhythmia’s in IWMI. Reperfusion arrhythmias are a benign phenomenon and good indicator of successful reperfusion.
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Background: Surgical Background: Impaired glucose tolerance is known precursor of type-2 diabetes mellitus and more prevalent in obese people, different studies have varied results and true prevalence is still debatable. Aims of this study to investigate the prevalence of IGT in different grades of obesity.Methods: Authors have studied100 patients with obesity Grade1 (BMI >25 kg/m2 but <30) and Grade2 (BMI >30 kg/m2) at Gandhi Medical College, Bhopal during April to June 2019. Complete physical examination and blood tests including fasting blood glucose and oral glucose tolerance test (OGTT) were done.Results: Results shows that 16% male and 14% female subjects had IGT. Male of age more than 60yrs and female aged between 51 to 60 were more pre-diabetic. Males having weight 71 to 80 kg and female of 51-60 kg were more pre-diabetic. Subjects with grade 1 obesity, 6.12% male and 5.88% female had IGT. Similarly, in grade 2-obese subjects 10.20% males and 7.84% females had IGT.Conclusion: IGT is more prevalent in grade-1 and grade-2 obese population and a strong indicator of diabetes.
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Background: Blockage of coronary artery lead to a reduction of blood flow towards heart resulting in Coronary Artery Disease (CAD). CAD leads to myocardial complications. CAD is one of the important causes of death all over the world including India. Diabetes mellitus is a risk factor for CAD. Reports have also shown to increase in cardiovascular morbidity among patients with glucose intolerance. In present study we tried to find the relationship of HbA1c levels with mortality, morbidity, and severity in Acute Coronary Syndrome (ACS).Methods: Two hundred patients with ACS were studied from 2018 to 2019 at Gandhi Medical College and Hamidia Hospital, Bhopal. Following a thorough medical history routine medical examination including laboratory investigations was performed in all the patients. Electrocardiography (ECG), creatine phosphokinase-muscle/brain (CPK-MB), echocardiography and coronary angiography (CAG) was also done as part of this study.Results: Mean age of the study cohort was 59.17±8.75 years. Out of 200 subjects, 110 (55%) were non-diabetic, 52 (26%) were diabetic, 38 (19%) had weakened glucose tolerance and 82 (41%) had hypertension. Left ventricular dysfunction (LVD) and heart failure (HF) were the common complications and were more prevalent among diabetic patients than the nondiabetics (p=0.009). HbA1c level (7.01±2.23) was high among subjects with complications than the subjects without complications (6.01±1.36).Conclusions: The patients with DM have higher morbidity and mortality than the non-diabetic patients of ACS and therefore such patients should be screened for diabetes and glucose intolerance for better management of CAD.
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Background: The severity of COPD is usually assessed on the basis of a single parameter – forced expiratory volume in one second (FEV1). However, the patients with COPD have systemic manifestations that are not reflected by the FEV1. The present study was undertaken to determine the predictive value of BODE index (Body-mass index (B), the degree of airflow obstruction (O) ,dyspnea (D), and exercise capacity (E) for development of pulmonary hypertension and as a predictor of severity in COPD patients. The original BODE index is a simple multidimensional grading system which is superior to FEV1 alone for prediction of mortality and hospitalization rates among COPD patients. Methods: This study was done from January 2013 to December 2014.Total one hundred male patients who attended the chest medicine department, with the symptoms suggestive of COPD were included in this study and the study was done to evaluate the BODE index and correlated with echo-cardigraphic findings suggestive of pulmonary hypertension as a predictor of severity in patients with COPD. Result: Among patients with COPD, there were (21%) patients who had mild COPD with a BODE score between 0 – 2, Moderate COPD (BODE score of 3 – 5) were (23%), Severe COPD (BODE score more than or equal to 6) groups had (56%) patients. The study results showed that as the BODE index scores severity increases the incidence of pulmonary hypertension increases as identified by echocardiography RVSP (Right ventricular systolic pressure) findings. The average RVSP was 59.6 in severe COPD patients (BODE index more than 6) 47.2 in moderate severe COPD (BODE index 3-5), while it was less than 36 in mild groups. These values were found to be significant on comparison to other groups. Conclusion: BODE index may offer superior and alternative reliable method to predict severity in patients with COPD in terms of pulmonary hypertension and for following up after medications. Since the assessment of BODE index requires only a spirometer, which is relatively inexpensive and can easily be made available, this index could be of great practical value in a primary health care setup to identify individuals who are at need for further evaluation in a higher referral center. Thus, BODE index can be used for judicious referral of patients with COPD thereby preventing the wastage of the limited resources available.
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We report a case of 11 years old male who developed trismus associated with left infranuclear facial palsy following injury over forehead. Cephalic tetanus was diagnosed. Rarity of the case as well as mild course it ran, though the incubation period was less than seven days, is the reason for this case report.