Electrocardiographic Parameters in Indian Newborns

Objective: To generate data of electrocardiogram (ECG) parameters according to gestationalage in Indian newborns. Methods: An observational study was carried out over 7 months inneonatology unit of a tertiary care teaching hospital. Following auscultation, ECG parameterswere recorded simultaneously in 12 leads, on third day of life, in hemodynamically stableneonates. Data from 364 babies were analyzed, keeping at least 30 records for eachgestational age between 30 to 42 weeks. Results: There was no difference in mean heart raterecorded through auscultation and ECG traces. The mean (SD) values recorded were: Pwave duration 0.04 (0.01) s, P wave amplitude 1.3 (0.4) mm, T wave duration 0.07 (0.02) s, Twave amplitude 1.1 (0.6) mm, PR interval 0.09 (0.02) s, QRS duration 0.04 (0.01) s, QTinterval 0.26 (0.02) s, QTc 0.4 (0.03) s and QRS axis 127 (22) degree. Gestation age-wisepercentile charts of different ECG parameters were generated. Conclusion: Thesegestational age-wise percentile charts of different ECG parameters for Indian newborns canbe used as reference for neonatal ECG

Traumatic perforation of the tympanic membrane: Etiologies and risk factors for healing and intervention

OBJECTIVE: To study various etiologies of traumatic tympanic membrane perforation; evaluate the factors involved in healing of traumatic tympanic membrane perforation; and identify patients with perforations unlikely to benefit from conservative management.METHODS:Design: Prospective observational studySetting: Tertiary Government Medical College and HospitalParticipants: 64 consecutive cases of traumatic tympanic membrane perforation seen over one year were followed for 3 months. Perforations were assessed in terms of size, etiology, condition of edge and other associated factors or combinations of factors with regards to spontaneous healing using descriptive statistics and chi-square tests.RESULTS: Of the 64 cases, 51 perforations healed while 13 did not. There were significant associations between tympanic membrane condition after 3 months and explosive mode of injury (?2 = 23.30; p=.00001) as well as with size of perforation ((?2 = 25.75; p=.00001). The risk of persistence of a tympanic membrane perforation was 34.57 times more among patients with a perforation size >50% compared to those with perforation size ?50% [OR-34.57 (6.28, 190.14); p= .00001]. Combined, explosive etiology and perforation size >50% were significantly associated with non-healing ((?2 = 37.60; p = .00001). There were no significant associations with the condition of the edge of the perforation and upper respiratory tract infection.CONCLUSIONS: An explosive etiology and tympanic membrane perforation size >50% may be significant risk factors predicting non-healing of the perforation. Risk stratification of patients having one or both of these risk factors with early intervention for those with both, and close monitoring for those with any one of these may lessen unnecessary morbidity. Bigger multicenter future studies are necessary to confirm these initial findings.

Level of Auto Antibody Against Oxidized LDL in Myocardial Infracted Patients.

The aim of this study was to evaluate the level of auto antibody against oxidized LDL in myocardial infracted (MI) patients and normal healthy subjects of West Bengal (India) and to establish it to be also a cofactor for MI. Patients and Methodology : This study was carried out on 285 patients with MI as well as 75 healthy volunteers of comparable age and gender as control group. Blood was collected immediately after admission of the patients. Auto antibody against oxidized LDL, Nitric Oxide and malondialdehyde (MDA) were measured in all groups. Results : Mean serum level of auto antibody against oxidized LDL, MDA, total Cholesterol and LDL Cholesterol levels (118 ± 9.0, 7.4 ± 1.3, 233 ± 30, and 145 ± 38) were significantly (p<0.05) higher in MI patients when compared with control subject. The mean serum levels of nitric oxide (NO) and HDL, cholesterol were significantly (p<0.05) lower as compared to control group. Conclusion : Significantly high level of auto antibody against oxidized LDL associated with high level of MDA, total cholesterol and decreased level of NO and HDL cholesterol appear to be the factors responsible for the increase risk of coronary artery disease i.e., myocardial infarction in the population of West Bengal, India.

Bilateral antro-choanal polyps in an elderly female

@#<p style="text-align: justify;"><strong>OBJECTIVE</strong>: To report the first case of primary bilateral antro-choanal polyps in the elderly age group.</p> <p style="text-align: justify;"><strong>METHODS</strong>:<br /><strong>Design</strong>: Case report<br /><strong>Setting</strong>: Tertiary Government Hospital<br /><strong>Patient</strong>: One<br /><strong>Result</strong>: A 60-year-old, non-allergic female with progressive bilateral nasal obstruction was subsequently diagnosed with bilateral antro-choanal polyps. Endoscopic sinus surgery was performed and the patient remained asymptomatic on one year follow-up.</p> <p style="text-align: justify;"><strong>Conclusion</strong>: Antro-choanal polyps can occur bilaterally in the elderly age group. To the best of our knowledge, this is the first reported case of primary bilateral antro-choanal polyps in an elderly female.</p>