ABSTRACT
Background: Obesity has become a common problem worldwide due to changes in lifestyle and food habits. Obesity has been associated with many chronic diseases like diabetes mellitus, hypertension, gallstones etc. Excessive adipose tissue through release of adipokines maybe a risk factor for derangements in iron parameters. Authors aim is to study Serum Iron, TIBC, and Serum Ferritin levels in Obese women (BMI >25 kg/m2) in age group of 16 to 45 years and its comparison with normal BMI women.Methods: The case control study was conducted on 100 patients divided into two groups. Group A included 50 patients of obese women (BMI >25 kg/m2) in age group of 16 to 45 years. Group B consists of 50 control patients in similar age group with BMI of 18-23 kg/m2. Serum Iron, TIBC, and Serum Ferritin levels were measured in both groups and compared.Results: The study showed significant derangements of iron parameters in obese women.Serum Ferritin was significantly raised (p<0.001) in obese women whereas Serum Iron and TIBC were significantly decreased in obese women as compared to control group. No significant difference was seen in Serum Hemoglobin and MCV.Conclusions: Obesity is associated with derangements in iron parameters in women of reproductive age group similar to derangements seen in chronic inflammatory state.
ABSTRACT
Background: Diabetes mellitus (DM) is on the increase globally. Cardiovascular complications, such as left ventricular dysfunction is a major cause of death in patients with type II DM. Prior to the development of symptomatic heart failure, subclinical left ventricular dysfunction (systolic and diastolic) may exist for some time. Aim of this study is to find out abnormalities in left ventricular function in patients of type 2 diabetes mellitus with help of 2D Colour Doppler Echocardiography. To find its correlation with glycemic control on the basis of glycosylated haemoglobin (Hba1c).Methods: Total 100 Patients of type 2 Diabetes Mellitus of duration more than 10 years of both sexes were included in the cross-sectional study conducted from Jan 2018 to Aug 2019.All the patients were assessed through clinical examination and 2-D echocardiography and control of diabetes determined on the basis of HbA1c.Results: Study consisted of 100 patients with type 2 DM, 55(55%) were females and 45(45%) males. Majority of patients were in the age group of 4th to 6th decade of life. Diastolic dysfunction was present in 81(81%) patients. systolic dysfunction was present in 14(14%) patients. There was a linear increase in prevalence of diastolic dysfunction with increasing age, increased FPG, increased BMI. There was also significant correlation between LV diastolic dysfunction (LVDD) and LA size. While no statistical correlation found between gender, duration of diabetes, HbA1c with diastolic and systolic dysfunction.Conclusions: LV diastolic dysfunction is an early manifestation of diabetic cardiomyopathy. LVDD contributes significantly to morbidity of congestive heart failure in diabetic patients. Echocardiography is a very useful non-invasive tool in detecting LVDD and systolic dysfunction in type 2 DM patients.
ABSTRACT
Background: Cardiac arrhythmias are quite common in the setting of acute myocardial infarction. Ninety percent of patients with acute myocardial infarction (AMI) have some cardiac rhythm abnormality, and 25% have cardiac conduction disturbance within 24 hours of infarct onset. These are tachyarrhythmias, ventricular arrhythmias, and atrioventricular block. A good correlation exists between the site of infarct and type of arrhythmias. Sinus bradycardia, sinoatrial escape rhythms, Wenkebach type and complete heart block are usually associated with inferior wall myocardial infarction (IWMI). Atrial premature contraction (APC) and ventricular premature contraction (VPC) are usually seen in anterior wall myocardial infarction (AWMI). Methods: The present cross-sectional study was conducted on 100 consecutive cases of acute myocardial infarction with arrhythmias attending as indoor emergency patients of Guru Nanak Dev Hospital attached to Government Medical College, Amritsar were included. History, clinical examination and required investigations including lipid profile, blood sugars, electrolytes, CPK-MB, ECG, and 2D-Echo were done. Results: Out of the hundred patients in the study, males (57%) outnumbered females (43%). Most of the patients were found in the age group of 51-60 years (34%). Smoking was the most significant risk factor (38%), followed by diabetes mellitus (35%), hypertension (30%) and prior ischemic heart disease (28%). The majority (56%) of the patients had anterior wall myocardial infarction (AWMI), followed by IWMI (24%), IWMI + RVMI (13%) and AWMI + IWMI (7%). Most of the arrhythmias (62%) developed during initial 24 hours of admission, while 27% in next 24 hours and 11% after 48 hours of admission to hospital. The most common arrhythmia observed was VPC (50%), followed by sinus tachycardia (48%), sinus bradycardia (16%), accelerated idioventricular rhythm (9%), 3rd degree heart block (7%), ventricular tachycardia (6%), 1st degree Heart Block (5%), 2nd degree Heart block (5%), ventricular fibrillation (4%), APC (4%) and AF (1%). Maximum incidence of VPC, sinus tachycardia, ventricular tachycardia (VT) and ventricular fibrillation (VF) were recorded in AWMI, while the maximum incidence of sinus bradycardia and AV block were observed in IWMI. Mortality was more common in patients developing arrhythmias specifically VT, VF and heart blocks especially 2nd-degree heart block and 3rd-degree heart block. Conclusion: Most of the patients with acute myocardial infarction develop some kind of arrhythmias which is an important cause of morbidity in these patients, develop during the initial 24 hours of admission to the hospital. Most common arrhythmias observed were VPC, followed by sinus tachycardia, AV block, bundle branch block, sinus bradycardia, VT, and VF. VPC, sinus tachycardia, VT, and VF were more common in AWMI, while sinus bradycardia and AV block were more common in IWMI. Diligent monitoring for arrhythmias and appropriate treatment can be life saving.
ABSTRACT
Background: In cirrhotic patients, in addition to hepatocyte and Kuppfer cells dysfunction, portopulmonary shunt, intrapulmonary arteriovenous shunt and VA/Q inequality can induce a decrease in PaO2 and SaO2 as well as acid base disturbances. The present study was done to analyse arterial blood gas changes, prevalence of hypoxemia and acid base disturbances as well as to correlate grading of hypoxemia with different aetiologies and Child-Pugh score in patients with liver cirrhosis and ascites. Methods: The present correlative cross sectional study was conducted on 100 patients with cirrhosis and ascites for a period of 24 months. Arterial blood gas samples obtained by percutaneous radial puncture were analysed for various acid base abnormalities and arterial blood gas oxygenation. Results: Acid base disturbances observed were: respiratory alkalosis in 39 cases (39%), metabolic alkalosis in 20 cases (20%), metabolic acidosis in 11 cases (11%), metabolic acidosis with respiratory alkalosis in 10 cases (10%) and no acid base disturbance in 20 cases (20%). Mean values of PaO2 was 75.85±7.8 mmHg, PaCO2 was 35.27±5.13 mmHg, pH was 7.44±.115 and HCO3- was 23.65±3.85 mmol/l. Alcoholic cirrhotics had hypoxemia in 42% cases in contrast to hypoxemia in other aetiologies ( Hepatitis C 18%, Hepatitis B 5%).Conclusion: Metabolic abnormalities, hypoxemia and hypocapnia are commonly found in cirrhotics. Hypoxemia is more common in alcoholic cirrhotics but has no correlation with Child-Pugh score.