Dilated cardiomyopathy: a pharmacotherapeutic research

Background: AHA defines cardiomyopathies as a heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilatation and are due to a variety of causes that frequently are genetic.Methods: This is a prospective observational study conducted in the year 2017 at an OPD of Cardiology of a private hospital located in Telangana state, India. Data has been collected after diagnosis is made and treatment regimen is given by an Interventional Cardiologist.Results: Data has been collected from 78 cardiac patients, out of which 17.9% patients had Dilated Cardiomyopathy (DCM) among them 57.14% were male. In the present study DCM was reported more in the age group of 61-70 years (42.85%). Treatment pattern in most of the prescriptions include Diuretics, Beta blockers, Angiotensin Converting Enzyme Inhibitors (ACEI), Angiotensin Receptor Blockers (ARBs), Cardiac Glycosides, Antiplatelet and Antihyperlipidaemics.Conclusions: To conclude, lack of awareness among people about this disease is leading it to progress to advanced stages and prognosis of which is poor. Conducting community awareness programs can play a key component in improving the prognosis of this disease.

Patient compliance with drug therapy for postmenopausal osteoporosis

To determine compliance and factors affecting compliance to antiresorptive drugs in osteoporosis, and to compare compliant and non compliant groups in a tertiary care setting. Cross sectional study from May 2004 to April 2007. Hamdard University Hospital, Karachi. A total of 800 patients with postmenopausal osteoporosis were included in the study. The demographic and reproductive characteristics of all the patients were recorded Type of anti-resorptive drugs prescribed, degree of compliance, time and reasons for discontinuation were studied and analyzed. Results: The mean age of the patients was 64 [ +/- 9] years and their mean duration of follow-up 18 [ +/- 5] months. The prevalence of risk factors for osteoporosis were evenly distributed among treatment groups; 73% patients had a co-morbidity besides osteoporosis while 27% were osteoporotic alone. One or more previous vertebral fractures due to osteoporosis was reported by 14.5% of patients, whereas 35.5% had at least one non-vertebral fracture in their medical history. Out of the total patients 21.5% discontinued the prescribed drug before attending the bone mass re-evaluations, more than half of these within first six months of starting the drugs. The medication that was most frequently discontinued within one year was calcium and vitamin-D [33.7%, p < 0.01] while the least discontinued medication was Alendronate [5.9%, p < 0.01] which is taken once a week. In this study the most important determinant of compliance was the type of drug prescribed and its dose frequency, with a definite preference for Alendronate once a week. Treatment compliance was particularly poor for calcium and vitamin-D regimen, thereby emphasizing the need to find new ways of administering supplements, particularly for vitamin-D

Unusual soft tissue tumours of the abdominal wall

To highlight the importance of remembering unusual tumours in the differential diagnosis of Soft Tissue Tumours of the Abdominal wall. Retrospective, decriptive study conducted between June 2000 to June 2003. Hamdard University Hospital and other private hospitals in Karachi. All patients presenting with Unusual Soft Tissue tumours of the Abdominal wall. The biodata, symptoms and signs of these patients were recorded and analyzed. They were extensively investigated; besides routine investigations Ultrasound, CT Scan and MRI were done where indicated. All the tumors were surgically excised and the diagnosis was confirmed on histopathology and immunohistochemical studies. Ten patients, six females and four males, aged 16-59 years, were seen with Unusual Soft tissue Tumours of the Abdominal Wall. Most of them [90%] presented with a swelling, while some had pain [30%] and fever [10%].Surgical excision and histopathology revealed them as desmoid tumour [n-6], rhabdomyosarcoma [n-2], urachal remnant tumour [n-1] and port-site metastatic tumour [n-1]. There was no recurrence in all the patients, except the one with urachal remanant. He died inspite of further excision, radio and chemotherapy. Abdominal wall tumours are rare. They may be innocent like the lipoma, or may show variable behavior like the desmoid tumour, or may be very aggressive like the rhabdomyosarcoma. They need proper clinical workup before embarking upon surgery, which should be wide surgical excision as they show aggressive infiltration in the surrounding tissues. They also require proper follow-up as they are famous for recurrence

Depression in medical in-patients

This study was conducted to detect the prevalence of depression in medical inpatients staying for more than one week in the hospital and to assess the possible role of depression in prolonging the stay of the patients in the hospital. Two hundred and ninety eight patients with over a week stay in the hospital were screened for probable depression during three months with Hospital Anxiety and Depression Scale [Depression Subscale] and consequently they were assessed by two psychiatrists twice at 1 week interval with clinical interview and Hamilton Depression Rating Scale. Final diagnosis was made by using the ICD-30 diagnostic criteria. Depression in some form was detected in 39.26% of the total patients including major depression in 9.73% of the total patients. The hospital stay of the patients showed significant relation with depression. The substantial prevalence of depression with its significant association with longer hospital stay in medical inpatients requires greater cognizance and attention by simple screening instruments like HADS and subsequent liaison with the psychiatrist in selected cases for its appropriate management. This may help in improving the patient's physical and psychological health and reducing the hospital stay and costs. Future sound methodological studies are needed to explore the possible therapeutic and economic benefits of screening the patients in the medical wards for depression

Klippel-Feil syndrome, conductive deafness absent uterus and vagina

A case of Klippel-Feil Syndrome in a young Saudi female who also had a aplastic uterus and rudimentary vagina. This is the first reported case of Klippel-Feil syndrome with absent uterus and vagina. The deafness was caused by the thickened footplate and it improved following stapedectomy

Kaposi's sarcoma of the palate

A case of Kaposi's sarcoma of the palate in a patient who is imunosuppressed following renal transplant is reported

Chemodectoma of the larynx

A case of laryngeal chemodectoma is described, regional metastases occured in this case confirming that the chemodectoma of the larynx carries a high degree of malignancy