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
Background: Gastro esophageal reflux disease is the commonest pathologies encountered by gastroenterologist in day to day practice. Longstanding and untreated gastro esophageal reflux disease can lead to many complications including adenocarcinoma. This study was conducted to evaluate the various symptoms and to analyze the lifestyle and dietary factors influencing gastro esophageal reflux disease which can be modified.Methods: Hundred patients with gastro-esophageal reflux disease of age more than 18 years were enrolled in the study. Various patient details including demographic details, lifestyle information and symptomatology data were analyzed and compared with complications.Results: Mean age of gastro esophageal reflux disease patients was 56.09±15.93 years. Gastro esophageal reflux disease is more prevalent in males than females. Gastro esophageal reflux disease is more frequent in BMI <25, greater number of co morbidities and in non-vegetarians. Mean age of gastro esophageal reflux disease with complications was 67±11.53 years and without complications was 52.64±15.57 years. No strong association of smoking, alcohol, spicy foods, fried foods, citrus fruits, heavy meals, tea/coffee, aerated drinks, sleep disturbance and effect on work was identified in gastro esophageal reflux disease.Conclusions: Classical symptoms of gastro esophageal reflux disease were not present in all the patients. Higher age of the patient infers higher risk of complications. Daily episodes of heartburn, regurgitation and retrosternal chest pain implies higher risk of complications. Presence of Helicobacter pylori in gastro esophageal reflux disease patients signify higher risk of complications.