ABSTRACT
Abstracts: Background: Major depressive disorder is most common mood disorder and is one of the most burdensome and disabling disease in the world. Abnormalities in the hypothalamic-pituitary adrenal (HPA) axis in depressed patients play a substantial role in autonomic dysregulation, as patient with depression have elevated levels of cortisol. The present study was conducted with a motive to compare and evaluate the effects of depression on cardiovascular autonomic functioning compared with healthy controls. Methodology: In this study 72 subjects were selected out of that 36 were depressed and 36 were control. All depressed patient were taken from outpatient department of Psychiatry. All subjects were between the age group of 18- 60 years. Control group were students and employees of Surat Municipal Corporation (SMC) having no current or past psychiatric illness. HRV test was done in a well-lighted and ventilated room of Physiology Department. 5 minute ECG recording with 16 channel digital polywrite were taken at resting state. ECG was analysed on Kubios HRV analysis software version 1.1, for calculation of frequency domain parameter. Results: On analysis it was revealed that depressed patients showed altered values of HF component of HRV (23.33 +34.454) than control group (118.31 + 201.186), which is significantly lower (p< 0.05) indicating lower parasympathetic activity. Conclusion: The findings from this study are consistent with the hypothesis that cardiac autonomic dysfunction is experienced by individuals with depression, especially decreased parasympathetic nerve.
ABSTRACT
Background: Nearly 40% of patients presenting with Non ST-Segment Elevation Myocardial Infarction (NSTEMI) have Chronic Kidney Disease (CKD). CKD is a powerful predictor of adverse events among NSTEMI patients. The purpose of the present study was to evaluate the in-hospital outcome of patients with Chronic Kidney Disease presenting with Non ST-Segment Elevation Myocardial Infarction. Methods: In this prospective observational study a total of 128 patients with NSTEMI were enrolled. They were divided equally in group I (NSTEMI with CKD) and group II (NSTEMI with normal renal function) on the basis of estimated glomerular filtration rate. Patients were considered to have CKD if he/she had documented history of CKD or estimated glomerular filtration rate <60 mL/min/1.73 m². Presence of inhospital complications was identified. Results: Patients with CKD were significantly older, with a greater prevalence of hypertension, diabetes mellitus, lower left ventricular ejection fraction, and lower haemoglobin level compared with those without CKD. CKD patients had more atypical presentation during admission. In-hospital complications were significantly higher in CKD patients presenting with NSTEMI. Conclusion: CKD strongly predicts adverse in-hospital outcome among NSTEMI patients.
ABSTRACT
Retroperitoneal hematoma may occur as a result of trauma, rupture of arterial aneurysms (aortic or iliac), surgical complications, tumors and anticoagulation therapy. A life threatening retroperitoneal hemorrhage or hematoma is an infrequent complication of anticoagulation treatment. Enoxaparin is a low-molecular-weight heparin (LMWH) with several advantages over unfractionated heparin. Nevertheless, enoxaparin use is not without risk and severe retroperitoneal bleeding may occur following its use with a potentially fatal outcome. We report a case of sixty six years old female patient who develops a fatal retroperitoneal hematoma two days after enoxaparin treatment for acute coronary syndrome.