Epidemiological determinants and clinical parameters of acute myocardial infarction in young adults

Background: Coronary artery disease (CAD) mostly occurs in persons older than 45 years of age and its major issue if it occurs in young individuals and is a burden to the society. Aim: To study the unique risk factors, clinical symptoms, epidemiological profile, angiographic features which helps in prognosis and prevention of acute myocardial infarction occurring in young adults. Materials and methods: 50 young patients of age < 40 years with acute myocardial infarction was admitted in the ICCU of Sheth L.G. Hospital, Maninagar, Ahmedabad from October 2018 to March 2019 were included in study. Necessary investigations were done within 24 hours of admission and CAG was done after hospital discharge within 6 weeks. All patients of age group 25-40 years and patients 1st time presented with CAD were included. Patients of age more than 40 years and patients with known structural or valvular heart disease or any form of cardiomyopathies were excluded. Results: Out of 50 patients, 44 were males and 6 were females. Mean age was 37 years. 26 adults (52%) had STEMI and 24 adults (48%) had NSTEMI. Inferior wall MI was present in 14 patients (28%), Anterior wall MI was present in 12 patients (24%), Lateral wall MI was present in 7 patients (14%), Anterolateral wall MI was present in 14 patients (28%) and Inferolateral wall MI was present 3 patients (6%). 40 were smokers (80%) and 10 were tobacco chewer (20%). 29 adults (58%) had hypertension and diabetes, 17 adults (34%) had hypertension, 4(8%) had diabetes. Family history of CAD was present in 27 patients (54%). Dyslipidemias was present in 21 patients (42%). Smoking was the most common and major risk factors followed by HTN, DM and Dyslipidemia.

Lessons in medical ethics from ancient Indian teachers.

Age of medicine is as old as the age of human on the earth. The doctor today is a scientist, technologist and healer at the same time. The ethics germane to the medical profession can’t be simple and uniform. Nor is the ethics simply a matter between the doctor and the patient; the society with its entire economic and political dimension is involved in much bigger way. Certain basic traditional thoughts given by ancient Indian teachers like Hippocrates, Charaka, Sushrutha and Vagbhata are still become relevant. Medical ethics in the medical curriculum, must be included not as a normative discipline but as a practical course with its own problems and considerations. As per Indian outlook, the role of ethics is certainly vast and varied, from treating a common cold, to the controversy on euthanasia, from the simple obligations of a family doctor, to the specialist services in the high cost, high technology five star nursing homes.

Demographic profile of Aluminium phosphide poisoning in Gandhinagar, Gujarat.

Background: Poisoning is an important cause of unnatural death, next to road traffic accidents in India even today. Incidence of aluminium phosphide poisoning is increasing day by day in western region of India including Gujarat. Demographic profile of aluminium phosphide poisoning cases is very helpful to be aware of current scenario and to implement preventive steps for betterment of health services. Objectives: The present study was undertaken to know the demographic profile of aluminium phosphide poisoning cases received as indoor or outdoor patient department of Gayatri Hospital, Gandhinagar, Gujarat, India. Material and methods: History taking, complete examination and necessary investigations of all cases of aluminium phosphide poisoning cases is very helpful to be aware of current scenario and to implement preventive steps for betterment of health services. Objectives: The present study was undertaken to know the demographic profile of aluminium phosphide poisoning cases received as indoor or outdoor patient department of Gayatri Hospital, Gandhinagar, Gujarat, India. Material and methods: History taking, complete examination and necessary investigations of all cases of aluminium phosphide poisoning was done, during the period of two years from 01-01-2012 prevalence of age and sex, socio-economic status, marital status, religion, literacy status, occupational status, time of consumption, manner of poisoning, reasons for suicidal consumption etc. Results: During the study period, 40 cases were diagnosed as of aluminium phosphide poisoning. Majority of the victims were in the age group of 41-50 years (25%), 70% were married, 80% were Hindu, 65% were of lower socio economical class and 57.5% belonged to rural area. Occurrence of aluminium phosphide poisoning was more common in evening time between 5 pm to 11 pm (45%) and among housewives (27.5%). Suicidal cases (82.5%) were more common compared to others. Conclusion: Based on these finding, preventive measures like restriction of sale and availability of aluminium phosphide, good availability of investigation and treatment, promoting poison information centre etc have been put forward.

Study of various cardiac arrhythmias in patients of acute myocardial infarction.

Background: Myocardial infarction is one of the major causes of sudden death in present era and cardiac arrhythmias are common complications of it. Material and methods: Present study was conducted at intensive coronary care unit (I.C.C.U) of tertiary care hospital, Ahmedabad on 100 cases of acute myocardial infarction to study the incidence of arrhythmia and their nature in relation with the site of infarction and to evaluate prognostic value of arrhythmias in Acute Myocardial Infraction (AMI). Results: Incidence of various arrhythmias was 76% in present study. S. tachycardia was more common (68%) than S. bradycardia (19%). S. tachycardia and tachyarrhythmia occurred more commonly with anterior wall myocardial infarction, while S. bradycardia and bradyarrhythmia with inferior wall myocardial infarction. Conclusion: Study of incidence of various cardiac arrhythmias, their nature and relation to site of infarction as well as prognostic value in patients of acute myocardial infarction proper treatment.

Nature helps to solve the crime â Diatoms study in case of drowning death.

Nature is everywhere surrounding us in different form. It includes single cell structure to extremely complex, living or non living, substance or creature. One of the important part of nature is diatom - submersion of body into water is known since ages. Diatoms study in case of drowing death is very useful for forensic investigators. It is one of the best example in which nature helps to solve the crime. In present article, we discussed about diatoms, diagnosis of drowning death and length of submersion of body in water with help of diatoms, collection, identification and preservation of diatoms for forensic analysis.

Study of pattern of acute myocardial infarction in tertiary care hospital of Ahmedabad, Gujarat.

Background: Myocardial infarction is one of the most common causes of death in adult and elderly people. Aim and objectives: To study age and sex wise incidence, various risk factors, involvement of anatomical site and mortality in cases of acute myocardial infarction. Material and Methods: The present study included 100 cases of acute myocardial infarction admitted in the intensive coronary care unit of tertiary care hospital, Ahmedabad. Patients with classical ECG changes of hyper-acute or acute MI with transient rise in cardiac enzyme levels and presence of pathological q waves accompanied by elevation of ST segment and symmetrical inversion of T waves with rise in cardiac enzyme levels were included. Results: Maximum MI cases occurred in sixth decade and more common in male. smoking was the most common risk factor and enterior wall MI was most common. Maximum mortality was found in MI involving anterior wall, inferior wall and right ventricle all together. Conclusion: Study of pattern of myocardial infarction, age and sex wise incidence, risk factor, anatomical site and mortality in cases of myocardial infarction is very useful for the treatment and prevention purposes.

Study of sodium and potassium ion disturbances in malaria at Ahmedabad, Gujarat, India.

Background: Malaria is an endemic disease in Gujrat, caused by the bite of the female anopheles mosquito. Electrolyte disturbances particularly hyponatremia is a common complication in malaria. Aim: To determine sodium and potassium ion disturbances in malaria cases at Ahmedabad, Gujarat Material and methods: Total 200 indoor and outdoor patients of malaria who came to tertiary care hospital, Ahmedabad during period of July – 2013 to June – 2014 were included in present study. Patients were diagnosed for malaria after the examination of both thick and thin film peripheral smears and malarial antigen detection rapid card test. All patients were subjected to relevant laboratory investigations like complete blood count and serum electrolyte (sodium and potassium ion). Observation: Hyponatremia and hypokalemia were more common in both P. Falciparum and P. Vivax malaria. Severity of hyponatremia and hypokalemia were more in P. Falciparum than P. Vivax Conclusion: Serum electrolytes must be estimated in each malaria case to prevent grave complications.