Anterior Wall Myocardial Infarction With Conduction Defect And It's Outcome During Hospital Stay

Background: Qrbb myocardial infarction has high mortality and morbidity. So we want to study in hospital outcome of qrbbb myocardial infarction Methods: It is a prospective study. We studied qrbbb mi patients admitted in our hospital from December 2016 to June 2017 Results: About 90% of patients had heart failure. And 80% of patients required ventilatory support in the form of non–invasive positive pressure ventilation (NIPPV) or invasive ventilation. About 37% of patients had ventricular arrhythmias. Thrombolysis with streptokinase was done in 64% of patients and with tenecteplase for 20% of the patients. Percutaneous transluminal coronary angioplasty (PTCA) was done in 47% patients. Two patients had pharmacoinvasive PTCA. 16% of patients were conservatively treated due to late presentation. 24% patients died during hospital stay while 76% got discharged. 14% of patients had reversal of rbbb wave. 14% had stent thrombosis. 100% of patients had left anterior descending artery (LAD) disease. While 10% had left main coronary artery disease and 14% had triple vessel disease (TVD), 10% were sent for coronary artery bypass grafting (CABG). Conclusions: qRBBB AWMI carries high mortality of 24% with 90% of patients going in to heart failure. Ejection fraction is a good predictor of death and diabetes is a covariate of predictor of death.

Which is better among FEV1/FVC and FEV1/SVC in obstructive airway disease?

Background: Forced expiratory volume in 1 second (FEV1) to forced vital capacity ratio (FVC) is being used to diagnose the obstructive lung diseases. Forced manoeuvre (FVC) or relaxed/slow manoeuvre (SVC) can be used to determine vital capacity (VC). In healthy individuals the difference between SVC and FVC (SVC-FVC) is minimal whereas in the presence of airway obstruction this difference will become significant. The present study was done with the objective to detect and compare the airway obstruction by determining the FEV1/FVC and FEV1/ SVC ratios.Methods: This was a prospective cross-sectional study done at OPD, Government Thiruvoteeswarar hospital of thoracic medicine/Kilpauk medical college during the period from September 2016 to February 2017among the patients presenting with symptoms of obstructive airway disease. The sample comprised of 353 patients who underwent spirometry according to standard of ATS/ERS guidelines. As per the criteria, the patients are classified into four groups, by spirometry.Results: The analysis of FEV1/FVC revealed the presence of airway obstruction in 131 (37%) individuals compared to 165 (46%) individuals by the analysis of Fev1/SVC ratio. In the obstruction and mixed groups, the difference in vital capacity SVC – FVC is statistically superior (p<0.05) when compared to normal and restriction groups.Conclusions: The FEV1/SVC ratio detected the presence of airway obstruction in more individuals than did FEV1/FVC ratio and hence FEV1/SVC considered as more reliable factor in the detection of obstructive airway diseases.

A study of cardiovascular manifestation in patient with hypothyroidism

Background: Reduced production of thyroid hormone is the central feature of the clinical state termed Hypothyroidism. Hypothyroidism is associated with bradycardia, a decreased cardiac output, increased vascular resistance and perhaps a decreased sensitivity of the sympathoadrenal system. Aim and objective: To assess the cardiovascular functions in diagnosed hypothyroidism patients. Materials and methods: A total number of 70 hypothyroid patients were enrolled in this study. The clinical features, cardiovascular manifestations were studied by ECG, ECHO, chest X-ray lipid profiles. Results: Most of the cases fell in the age group of 31-40 years at a percentage of 52.9%. On analysis of 70 cases, 41% of cases were in moderate hypothyroidism group. On analyzing the pulse rate of 34% of the cases had bradycardia (PR <60/min). Mean BP- 131/84 mm Hg (Range: 118-166/66 – 102 mm Hg). Most of the patients fell into the pre-HT group which was around 66%. 24% of hypothyroid patients were hypertensive (BP >140/90 mm Hg). Lipid analysis in hypothyroid patients showed an increase in total cholesterol. 54.3% of patients had hypercholesterolemia (> 300 mg/dL). On analyzing the ECG changes in hypothyroid patients the most common finding was sinus bradycardia. It was found in 39% of cases. Next was low voltage complex which is around 34%. Normal ECG was found in 14% of patients. Least common findings were ST-T changes, RBBB and LBBB. Out of 70 cases, 12 (17.14%) patient showed enlarged cardiac silhouette (cardiomegaly). 34% of the patients had pericardial effusion. 30 % of the patients had diastolic dysfunction. Systolic dysfunction occurred in 4.3% of them, while IVST and LVPWT were seen in 14.3% and 12.9% respectively. Conclusion: Any unexplained diastolic dysfunction or pericardial effusion should be screened for hypothyroidism. Early detection of hypothyroidism and proper replacement therapy found to reverse the cardiovascular complications and thereby can decrease the morbidity and mortality.

A study on clinical profile of patients with atrial fibrillation

Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice. This study is about the etiological and clinical profile of paroxysmal, persistent and permanent AF. Aim: The aim of this article was to review the clinical epidemiological features of atrial fibrillation. Materials and methods: A hospital-based descriptive study was conducted among 50 patients, diagnosed as atrial fibrillation in Cardiology Department, from 2016 to 2017. Results: Out of 50 patients with atrial fibrillation, 32% were aged between 60 – 69 years and 42(84%) were females and 8 (16%) were males. Permanent AF was seen in 56% patients. Conclusions: Palpitation followed by dyspnoea was the major symptoms encountered with atrial fibrillation, and in females within the age group of 50 years and above are prone to develop AF.

Mechanical Behavior of Concrete Modified by Replacement of Cement by Rice Husk Ash

ABSTRACT Construction industry is in need of lump sum quantities of materials which has increased both their demand and price. The use of large quantities of cement leads to increasing CO2 emission and as a consequence, the greenhouse effect. Consumption of wastes and byproducts from various sources in the manufacture of concrete has gained a great deal of importance in present days. Various researches are currently being conducted concerning the use of such products in concrete. RHA is a carbon neutral green product. Lots of ways are being thought of for disposing them by making commercial use of this. Rice husk ash is a good super-pozzolan which can be used to make special concrete mixes. The rice husk ash has been taken for this present study due to its easy availability and effective pozzolonic properties that are expected to improve the mechanical strength properties of concrete. Concrete specimens were made for evaluation of Compressive, Split Tensile, Flexural strength and Stress-Strain Behavior of concrete. The tests were conducted at the age of 7 and 28 days. Generally all mixes containing RHA achieved better properties than the conventional mix without RHA. By the experimental investigation the recommendation is given for using optimum percentage of RHA in concrete.

Intra‑arterial chemotherapy for retinoblastoma: First Indian report.

Aim: To describe treatment outcomes and complications of selective intra‑arterial chemotherapy (IAC) for retinoblastoma (RB) in Indian eyes. Materials and Methods: Single center, retrospective interventional case series of 6 eyes with RB who underwent IAC using Melphalan (3 mg/5 mg/7.5 mg) and topetecan (1 mg) (n = 4) or melphalan (3 mg/5 mg/7.5 mg) alone (n = 2) between December 2013 and June 2014. In all, 17 IAC procedures were performed using selective ophthalmic artery cannulation. Treatment outcomes were evaluated in terms of tumor control, vitreous and subretinal seeds control and globe salvage rates. Results: IAC was employed as primary (n = 1) or secondary (n = 5) modality of treatment. Each eye received mean 3 IAC sessions (median: 3; range: 1–4 sessions). Eyes were classified according to international classification of RB as Group B (n = 1), C (n = 1), D (n = 2) and E (n = 2). Following IAC, complete regression of the main tumor was seen in 3 cases (50%), partial regression in 2 (33%), while 1 case (15%) showed no response. Of 4 eyes with subretinal seeds, 1 (25%) eye had complete regression while 3 (75%) eyes had partial regression. Of 5 eyes with vitreous seeds, 2 (40%) eyes had complete regression while 3 (60%) eyes had a partial response. Globe salvage was achieved in 5 of 6 eyes (83%). Diffuse choroidal atrophy and vitreous hemorrhage were observed in 1 (17%) eye, each. No hematologic toxicity or cerebro‑vascular events were observed. Mean follow‑up period was 5.5 months (median: 6 months, range: 1–6 months). Conclusion: IAC is an effective therapy for globe preservation in eyes with RB. Larger studies with longer follow‑up are required to validate these results.

Controlled delivery of ranitidine in the stomach using magnetic field / Administración controlada de ranitidina en el estómago usando campos magnéticos

An attempt has been made to localize ranitidine loaded microspheres in the stomach by magnetic means. Since ranitidine undergoes metabolism by microbial enzymes in the intestine, it is ideal to localize the controlled drug delivery system within the stomach to get uniform release and absorption of the drug for the desired period. Gelatin magnetic microspheres loaded with 9.1, 17.9, 26.3 and 33.3% w/w of ranitidine hydrochloride were prepared by emulsification-cross linking technique. The formulated microspheres were characterized by magnetite content, particle size and in vitro drug release. The efficiency of microspheres to be localized in the stomach is tested in vivo in rats. The prepared microspheres were spherical and had a size distribution from 10 to 105 µm. The in vitro study revealed the capability of microspheres to release the drug over a period of 8 to 12 hours, depending on drug loading. The release was found to be diffusion controlled and followed fickian diffusion principle. The in vivo study showed the efficiency of microspheres to be retained in the stomach over a period of 8 hours.

Se ha hecho el intento por localizar las microesferas cargadas de ranitidina en el estómago mediante medios magnéticos. Como que la ranitidina experimenta metabolismo mediante enzimas microbianas en el intestino, resulta ideal localizar el sistema de administración del medicamento controlado dentro del estómago para alcanzar la liberación y absorción uniformes del medicamento por el período deseado. Microesferas de gelatina magnética cargadas con 9.1, 17.9, 26.3 y 33.3% p/p de hidrocloruro de ranitidina, fueron preparadas mediante una técnica de emulsificación-entrecruzamiento. Las microesferas formuladas se caracterizaron por su contenido de magnetita, el tamaño de las partículas y la liberación del medicamento in vitro. La eficiencia de las microesferas a ser localizadas en el estómago se prueba in vivo en ratas. Las microesferas preparadas eran esféricas y tenían una distribución de tamaño de 10 a 105 µm. El estudio in vitro reveló la capacidad de las microesferas para liberar la droga en un período de 8 a 12 horas, en dependencia de la carga de la droga. Se halló que la liberación estaba sujeta difusión controlada y seguía la ley de Fick para la difusión. El estudio in vivo mostró la eficiencia de las microesferas para ser retenidas en el estómago por un período de 8 horas.