ABSTRACT
Introduction: Cardiopulmonary bypass (CPB) is associated with well-described changes in thyroid hormone levels, consistentwith what is described as the euthyroid sick syndrome.Aim: This study aims to evaluate thyroid hormone changes and their association with post-operative care in low-risk patientsundergoing cardiac surgery with CPB.Materials and Methods: Fifty patients with euthyroid were included; no one received drugs with a known influence on thyroidstatus at the time of the operation. Eighteen of the patients had coronary artery bypass surgery, 29 had a single valve replaced,and 3 had both valve replacement. Blood samples were collected 6 h after surgery and on the 3rd postoperative days (POD).Results: Thyroid-stimulating hormone (TSH) levels were raised in 10 patients and free T3 level reduced in 14 patients in theearly post-operative period and TSH raised in 4 patients and free T3 reduced in 6 patients during the 3rd POD. Number of thecases with normal TSH is 36, free thyroxine [T4] remained within the normal range in all patients throughout the study.Conclusion: There is an advantage of prophylactic administration low dose of thyroxine to all cardiac patients, especially femalepatient who undergoes surgery to improve the general condition of the post-cardiac surgery patients.
ABSTRACT
Introduction: Cardiac disease is a major risk factor for stroke, ranking third after age and hypertension. Congestive Cardiac failure ranks second in cardiogenic stroke risk. The prevalence of cardiac failure increases substantially in prevalence as the population ages. Cardiac failure is also associated with high mortality, with a 15 year total mortality rate estimated at 39% for women and 72% for men. LVSD is common and treatable, accounting for 8%of people aged 25-75 years and 12% of 45-75 years. Of the 8%, 4% are asymptomatic6. The patients who appear to be at high risk of LVSD are those with ischaemic heart disease, hypertension or diabetes, and smokers. Aim of the study: Assessment of Left Ventricular Function in Ischaemic Stroke Patients. Materials and methods: LV function was assessed by Trans thoracic 2 - dimensional echo cardiography in patients admitted with ischaemic stroke under various medical units of our government hospital. Results: 142 Patients of the study group were divided into various sub groups. Ischaemic stroke was most commonly observed between 51-60 years of age followed by patients aged 61-70 years .The mean age of the patients was 58 years. All of these patients were men. Out of 94 men, 73 patients were chronic smokers (51%). The mean age of the smokers was 54 years. Associated history of chronic alcohol intake was seen in 33 male patients. Associated hypertension was seen in 11 patients who had statistical significance (P- value .00). Coexisting diabetes mellitus was observed in 8 patients. This correlation had a statistical significance (P- value .01) Prior history of coronary artery disease was obtained in 6 patients. This was not statistically significant. Hypercholesterolemia was noticed in 42 patients. Past history of stroke was present in 25 patients. History of shortness of breath of varying degree suggestive of left heart failure was observed in 20 patients. Conclusion: LVSD was observed in 30 patients of the present study (21.13%).Diastolic dysfunction was observed among 12 patients (3.4%).Association of LVSD with clinical severity and extent of the P. Sasikumar, P. S. Rani. Assessment of left ventricular function in ischemic stroke in GDMCH Dharmapuri. IAIM, 2017; 4(6): 64-70. Page 65 stroke had of positive correlation statistically .Association of LVSD with in hospital stay mortality was not significant. Hypercholesterolemia was observed as the most common risk factor among the ischaemic stroke patients. Coexisting coronary artery disease and diabetes mellitus had positive correlation with left ventricular systolic dysfunction.