ABSTRACT
The present study was done on 100 newly diagnosed patients of atrial fibrillation attending outpatient department of Internal Medicine, Govt. Medical College, Jammu over a period of 1 year with effect from June 2004 to May 2005. Patients who either attended OPD on a single day in a week or admitted patients were included in the study. Male: female ratio was 1:1.94, with mean age of the patient 50.16 years (range 13-96 years). 60% of patients were aged 50 years and above. Dyspnoea NYHA class II -IV was the commonest 74% complaint followed by palpitations 57%, fatigue 19%, syncope 17% and chest pain 11%. 14% patients were asymptomatic at presentation. Congestive cardiac failure was present in 67%. Rheumatic heart disease 54% was the commonest underlying etiological factor, followed by, coronary artery disease 9%, HTN (alone) and COPD (8% each), cardiomyopathy 7%, hyperthyroidism 3% and congenital heart disease 2%, 9% of the patients had the lone atrial fibrillation. Patient with left atrial dimension >4.0 cm had sustained atrial fibrillation. Thromboembolic phenomenon was more common in chronic AF and all the patients had mitral valve disease. Ventricular rate exceeded 100 per minute in 69 % of cases.
ABSTRACT
This is a first report of 20 adult cases describing clinical feature, epidemiological profile and treatment outcome of clinically diagnosed scrub typhus confirmed by test for antibodies (IgM) to O.tsutsugamushi using ELISA kit. Majority of the cases belonged to the district Rajouri (45%) froming hilly & rural belts.Outbreak was Autumn Winter type as all cases reported in month of September and October. The common clinical features were fever 100%, myalgia 50%, headache 30%, conjunctival congestion 30%, eschar 35%, rash 25%, lymphadenopathy 45%, splenomegaly 40%, hepatomegaly 40%, edema 25%, ARDS 35%, altered sensorium 10%, hypotension 20% & metrorrhagia in 5% of patients. Use of Immunological test helped to establish diagnosis of scrub typhus.Thus all the cases were managed successfully without any mortality with doxycycline and or azithromycine & one with addition of rifampicin.