ABSTRACT
Background:Coronary artery disease(CAD)is major cause of death and mortality in the developed world. Coronary atherosclerotic disease involves the epicardial coronary arteries and may manifest as an acute or chronic coronary syndrome. Acute coronary syndrome(ACS) arises from atherosclerotic plaque rupture leading to coronary thrombosis and/or spasm. Methods:The present study was conducted in department of medicine, Guru Nanak Dev hospital attached to government medical college, Amritsar from May 2021 to December 2021. This was a prospective observational study in which a total of 50 patients of ACS were enrolled. Serum albumin levels of the patients were recorded and clinical outcomes based on the albumin levels were compared between the patients.Results:The patients with low serum albumin levels had worse outcomes. The mean serum albumin level of STEMI and NSTEMI patients in hypoalbuminemia group was 2.88±0.11 g/dl and 3.15±0.26 g/dl (p=0.047). The mean serum albumin levelof patients having mortality in hypoalbuminemia group was 2.87±0.06 g/dl and those who didn’t have mortality was 3.19±0.21 g/dl (p=0.013). The mean serum albumin level of patients developing new onset heart failure in hypoalbuminemia group was 2.85±0.06 g/dl and those not developing had 3.11±0.19 g/dl (p=0.021).Conclusions:We conclude that ACS patients presenting with hypoalbuminemia are more likely to develop worse outcomes in the form of heart failure, cardiogenic shock and mortality. ACS patients presenting with low serum albumin levels have more chances of developing STEMI.
ABSTRACT
Background:A stroke or cerebrovascular accident is defined as an abrupt onset of a neurologic deficit that is attributable to a focal vascular cause. Stress hyperglycemia has been defined as hyperglycemia in previously euglycemic patients that corrects once the acute process resolves.Methods: The present study was conducted in the medicine department, Guru Nanak Dev hospital attached to government medical college, Amritsar from April 2021-December 2021 after taking approval from institutional ethics committee. This was a prospective observational study. A total of 50 non-diabetic patients of acute stroke with age group >18 to <75 of either sex wereenrolled in this study. Comparison of mortality was done in hyperglycemic and non hypergylcemic non-diabetic patients on1stday of admission and up to 10thday during hospital stay.Results: Mortality percentage on day 1 was higher among those who had high blood glucose levels but there was no significant association between glucose levels and day 1 outcome (survival or death) observed in our study (p=0.078). Mortality percentage on day 10 was higher among those who had high blood glucose levels and there was significant association between glucose levels and day 10 outcome (survival or death) observed in ourstudy (p=0.001). A significant association was observed between glucose levels and overall outcome in our study (p<0.001).Conclusions:We conclude that even in non-diabetic patients, hyperglycemia on admission is independently associated with a higher risk of in-hospital mortality.
ABSTRACT
Background: Microalbuminuria is an early, less expensive and easily available parameter of detecting microvascular angiopathy of kidneys in diabetic patients and angiopathy may also involve retinal, coronary, cerebral and peripheral vessels in these patients. The present study was done to find the association of microalbuminuria with intimal medial thickness of the superficial femoral artery in type 2 diabetes mellitus. Methods: The study included two groups of 100 individuals each. Group 1 having type 2 diabetes mellitus and group 2 non-diabetic control persons. Statistical analysis was done by standard statistical methods. It revealed significant association of microalbuminuria with intimal medial thickness of superficial femoral artery in type 2 diabetes mellitus. Results: Mean age of group 1(diabetic) was 50.73+SD8.48 years. Mean age of group 2(non-diabetic) was 49.57+SD 7.677 years. Majority of patients were in age group 40-50 years in both group 1 and group 2. Mean microalbuminuria in group 1 (diabetic), was 214.74+71.174 and that in group 2 (non diabetic), was 41.500+23.837. Difference in mean microalbuminuria, in both groups was highly significant (p<0.001). Mean intimal media thickness (IMT) of superficial femoral artery( SFA) in group 1 (diabetic), patients was 0.0836+0.0167 cm and that of group 2 (non diabetic), was 0.059 + 0.00464 cm. Difference in mean IMT of SFA, in both groups was highly significant(p<0.001). Conclusion: There is highly significant correlation between microalbuminuria and intimal-medial thickness (IMT) of superficial femoral artery (SFA) in type 2 diabetes mellitus.