ABSTRACT
Background: The electrocardiogram is the primary diagnostic tool to evaluate a patient with chest pain and suspected myocardial infarction. Anterior wall infarction due to occlusion of proximal LAD has worse prognosis compared to distal or branch vessel lesions. Diagnosis of anterior/inferior/posterior or lateral MI is based on patterns of ST deviation and risk assessment based on absolute magnitude of ST segment deviation or the width of QRS complexes. Although coronary angiography is the gold standard for determining the infarct related artery in acute myocardial infarction, ECG can be useful tool in identifying the culprit artery involved at the primary care.Methods: A prospective cross-sectional study was conducted in Aarupadai Veedu Medical College and Hospital. Standard 12 lead electrocardiograph were recorded for 50 patients at a speed of 25 mm/s and voltage of 10mm/mv. Patients who had acute inferior wall MI additional right pericardial leads were recorded (V3R and V4R). The recorded ECG was interpreted using the electrocardiographic algorithms of Zimet-baum PJ et al. An ST elevation or depression was considered significant only if it was >1mm.Results: The study result showed maximum specificity for LCx (100%) followed by RCA (92.67) and LAD (89.91). The sensitivity for identifying the culprit artery by ECG in acute myocardial infarction was 100% for both LAD and RCA coronary artery but 0% for LCx coronary artery. In case of LAD occlusion, the sensitivity is 100% for proximal LAD occlusion and 92.86%for distal LAD occlusion. The sensitivity and specificity for proximal and distal RCA is 100% and 80.43% respectively.Conclusions: ECG is an easily, widely available and non-invasive tool to localize the site of culprit artery in acute myocardial infarction.
ABSTRACT
Background: Diabetes Mellitus (DM) is a major emerging clinical health problem in this world. Anemia is a common problem in diabetes. Type 2 DM comprises about 90% of diabetic population of any country.Methods: A cross-sectional study carried out among 125 type 2 diabetic mellitus patients’ area at Department of Medicine Aarupadai Veedu Medical college (AVMC) and hospital, Puducherry during the period from May 2018 to October 2018.The objectives of the study were to evaluate the association of HbA1c with urinary ACR, eGFR and serum creatinine in Type 2 diabetes mellitus. Data was analyzed using the SPSS version 20.0 software.Results: The randomly selected study group comprised 100 type 2 DM patients and 25 control peoples of 35-70 years of age. Type 2 DM patients were evaluated of HbA1c, normotensives or hypertensives. FBS, serum creatinine, urinary albumin and creatinine were estimated. Urinary ACR and eGFR and were calculated. The data result was expressed as mean and standard deviation. A probability value is less than 0.05 and it was considered statistically significant.Conclusions: Type 2 diabetes mellitus patients, HbA1c and duration of diabetes were the strongest predictors of micro albuminuria and age was the strongest predictors of a low eGFR. The diabetes was poorly controlled, making the progression to end stage renal failure in concern patients. They measure the prevention of urinary albumin excretion, development of renal abrasion, smoking termination, strict glycaemic control and initiating lipid lowering therapy.