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Background: The objective of this study is to evaluate diagnosed cases of abdominal tuberculosis (TB) in terms of incidence,manifestation in different age groups, clinical presentations, treatment received (conservative or surgical), lesions foundintraoperatively, and its outcome on follow-ups.Methods: It is a retrospective study with 25 cases of abdominal TB treated at Guru Gobind Singh Hospital, Jamnagar, duringthe period of 2005–2007. Detailed history, physical examination, necessary investigations such as complete blood counts, ESR,urine examination, sputum examination, and radiological investigations were prescribed in all cases. Barium study, Mantouxtest, ascitic fluid examination, and computed tomography scan abdomen were carried out when indicated. Tissue or biopsymaterials were histologically examined. Results were analyzed with patient’s health status.Results: In 25 case series of abdominal TB, the average age of presentation was between 10 and 40 years with definitemale predominance (male:female = 3:2). Most of the patients belonged to low socioeconomic class which, in turn, reflectsovercrowding, undernourishment, bad sanitation, and poor hygiene in living conditions. In our study, ESR was raised in morethan 90% of patients. Abdominal pain was the most common presenting symptom followed by anorexia, fever, and vomiting.About 25% of patients were having TB foci in lung either active or healed lesion. Uncorrected anemia, malnutrition, andpulmonary TB were all contributory to poor prognosis and prolonged morbidity. Anti-TB drugs gave most satisfactory resultsin our patients.Conclusions: Koch’s abdomen is a clinical entity with varied clinical presentation. It is very common in tropics and maypresent with complications. Most of the patients are cured with conservative treatment and anti-TB drugs. Surgery is requiredin case of complications only. No drug-resistant cases have been found in this study. Investigations have played major role inconfirmation of disease.
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Introduction: Blunt abdominal trauma occurs when injuryto organs inside abdominal cavity is present due to externalforces exerted over abdomen as result of trauma. Widespectrum of clinical presentation is seen ranging from milderforms of injury to fatal solid organ injuries with irreversibleshock and ongoing bleeding. Management ranges fromwatchful observation to emergency laparotomy. Aim ofthis study was to evaluate different clinical presentation,organ specific injury and management of blunt abdominaltrauma.Material and Methods: A retrospective study with 25patients sustaining Blunt abdominal trauma who came toTrauma centre in Guru Gobindsingh Government Hospital,Jamnagar attached to medical college from 2016 to 2018 wereincluded. The patients were selected randomly.Results: Blunt abdominal injury was seen in all age from 1 to60 years. Highest incidence noted in age group 11 to 20 years.Male predominance was noted with Male: Female ratio21:4 of5.25:1.Most common mode of injury was road traffic accident(44%). Most common injured organ was Liver (32%).Liver and spleen injuries were associated with rib fractures.Abdominal pain and tenderness was most common clinicalpresentation (90%). Patients with hemodynamic instabilityhad more mortality.Conclusion: Blunt abdominal injury is one of the commonestinjuries encountered in polytrauma patients. Morbidity andmortality can be prevented by timely initial resuscitation andcorrect diagnosis as well as management (operative or nonoperative) which depend on patient’s hemodynamic stabilityand findings of imaging studies.
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Background: COPD is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. It leads to cor pulmonale causing right ventricular failure. Present study compares the serum level of CA-125 and 2 D Echo for detection of right ventricular failure in COPD patients.Methods: In this study 178 patients suffering from COPD has been taken after following inclusion and exclusion criteria and informed consent. Serum CA 125 levels are evaluated in all patients and compared with the right ventricular functions.Results: The mean CA125 was higher in subjects with RV failure (96.32) as compared to those subjects with RV normal (37.17). The result was statistically significant. (p<0.001). The mean duration of illness was higher in subjects with raised CA125 (8.71 years) as compared to those with normal CA 125 (6.67 years) and the difference was also statistically significant (P<0.001).Conclusions: CA-125 levels have a good sensitivity and specificity for predicting right ventricular failure in COPD patients. Diagnostic accuracy, high positive and negative predictive value makes CA-125 a good predictor of right ventricular failure in COPD patients.
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Heart rate variability is becoming a useful clinical tool in both the management of critically ill infants as well as in the identification of their future morbidity. To facilitate this process, we have recently reported the normative data on commonly used parameters of heart rate variability from a large cohort of normal newborns. From 24-hour Holter monitors, these parameters can be measured by time domain, geometric, and frequency domain methods. We have found that geometric methods like Triangular index is an easy and reliable measure to study total heart rate variability in newborns. Many of the commercially available monitoring systems routinely provide SDNN and r-MSSD parameters as a part of their software package. Because of ease of use, vagal dependent time domain parameters like r-MSSD and sNN50 can be used as surrogates for high frequency power in newborns. Based on our normative data, full-term infants during the first week of life with SDNN < 30, r-MSSD < 14, or Triangular index < 8 should be further investigated.
La variabilidad de la frecuencia cardíaca (VFC) está convirtiéndose en una herramienta útil tanto para el manejo del recién nacido críticamente enfermo como para conocer su morbilidad futura. Para facilitar este proceso, recientemente comunicamos datos normatizados sobre los parámetros más utilizados de VFC, a partir de una amplia cohorte de recién nacidos normales. Con monitoreos Holter de 24 horas, estos parámetros pueden ser medidos en los dominios temporal, geométrico y de frecuencia. Encontramos que los métodos geométricos, como el índice triangular, constituyen una medida sencilla y confiable para estudiar la VFC total en recién nacidos. La mayoría de los sistemas de monitoreo disponibles comercialmente proveen los parámetros DENN y RMSCD como parte de su paquete informático. Debido a su fácil utilización, los parámetros de dominio temporal vagal dependiente como RMSCD y SNN50 (suma de todos los pares de intervalos N-N adyacentes que difieren en más de 50 ms, estandarizada para el total de intervalos válidos y la longitud del registro pueden ser usados como sustitutos de los de potencia de alta frecuencia en recién nacidos. Sobre la base de nuestros datos normatizados, los recién nacidos de término con DENN < 30, RMSCD < 14 o índice triangular < 8 deberían ser investigados durante las cinco primeras semanas de vida.
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Infant, Newborn , Critical Illness , Time , Morbidity , LifeABSTRACT
Forty non-insulin dependent diabetes mellitus (NIDDM patients were subjected to bedside evaluation of cardiovascular autonomic reflexes. Autonomic neuropathy was detected in 23 patients (57.5%); orthostatic hypotension in 6 (15%), abnormal blood pressure response to sustained handgrip in 8 (20%), abnormal Valsalva ratio in 10 (25%), abnormal heart rate response to deep breathing in 12 (30%) and abnormal heart rate response to standing in 11 patients (27.5%). Incidence of parasympathetic neuropathy was 57.5% in comparison to 20% sympathetic neuropathy One abnormal cardiac reflex was seen in 6 (15%), 2 in 13 (32.5%) and 3 or more in 4 patients (10%). Raised glycated haemoglobin was seen in 17 patients,retinopathy in 3 and micro-albuminuria in 11 patients with autonomic dysfunction and in 13, 0 and 3 patients respectively in NIDDM patients without autonomic neuropathy. Positive correlation of cardiac autonomic neuropathy was seen with retinopathy and micro-albuminuria.