Correlation of ECG Changes with Coronary Angiographic Findings in Patients of Coronary Artery Disease.

Coronary Artery Disease (CAD) is the most common type of heart disease. Assessment of coronary artery disease (CAD) is the starting point of determination of prognosis of patients presenting with clinical symptoms. ECG reflects the physiology of the myocardium during ischemia, while Coronary Angiography identifies vessel anatomy. In the present study, we aimed to correlate ECG changes with coronary angiographic findings along with prediction of number of vessels involved in patients of coronary artery disease. This study also intended to determine sensitivity and specificity of ECG for diagnosis of coronary artery disease using CAG as gold standard. MethodsThis cross-sectional study was carried out for a period of 2 years at Acharya Vinobha Bhave Rural Hospital, a tertiary rural health institute. 200 patients above 18 years of age who presented with or without symptoms and were willing for ECG and Angiography were included in study. Patients with valvular and congenital heart disease were excluded. Patients were divided into groups according to ECG changes and correlated with coronary angiography findings. ResultsIn the present study, the sensitivity and specificity of ECG to diagnose myocardial infarction or ischemia (AWMI / AWI, IWMI / IWI, and LWMI / LWI) ranged from 87.50% to 96.63% and 91.30% to 95.45%, respectively. Diagnostic accuracy of ECG to detect myocardial infarction or ischemia (AWMI / AWI, IWMI / IWI, and LWMI / LWI) ranged from 89.36% to 96.40%. ConclusionsECG is used as reliable tool for the diagnosis of coronary artery disease due to its high sensitivity and specificity, though CAG is the Gold Standard method for the diagnosis of CAD.

Tetralogy of Fallot- Not an Innocuous Abnormality in Adult.

Among cyanotic congenital heart disease, Fallot’s tetralogy most commonly presents in childhood and rarely goes beyond second decade as death is inevitable without surgical correction of the abnormality. Here we report about unusual course of an uncorrected tetralogy, in which patient reach adulthood and presented only with seizure later found to have brain abscess.Fallot’s tetralogy (TOF) accounts for 10% of cyanotic congenital heart disease, which has combinations of a) ventricular septal defect, b) overriding aorta, c) right ventricular hypertrophy, and d) right ventricular outflow tract obstruction.[1] Although known complication, cerebral abscess has been reported in patients with CHD mostly at the age of 4–7 years, only rarely in adults as their survival is minimal without surgical interventions.[2] In this case, a 49 year old female who presented with a cerebral abscess later diagnosed as TOF on 2 D echocardiography.

Neurocysticercosis Presenting as Complex Partial Seizures

Neurocysticercosis (NCC) occurs in 60-90 percent of cases when parasite disease cysticercosis affects the central nervous system. This disease occurs when an organism becomes the intermediate host to the larvae form of Taenia solium, the pork tapeworm. The clinical features, diagnostic modalities, and management of the condition all differ depending on the position and quantity of cysts, whether the parasite is functional and living or dormant and died, as well as the immune response of each person to the disease. The most common clinical feature when central nervous system is affected is seizures, and the most common seizure types being generalized tonic-clonic seizures seen in 30-60% patients followed by simple partial seizures seen in 8-50% patients. Complex partial seizures (CPS) are the rare type of seizure presentation seen in 2-20% patients. We present a case of 30 year old male who presented with complex partial seizures and severe bilateral headaches. Magnetic resonance imaging was done which showed multiple ring enhancing lesion throughout the brain parenchyma suggestive of neurocysticercosis. Ultrasound of subcutaneous nodules also showed presence of scolex which confirmed our diagnosis. He was started on albendazole, steroids in tapering doses, clobazam and levetiracetam. He was symptom free at 2 months after follow-up.

Primary Sjogren s Syndrome Presenting as Hypokalaemic Periodic Paralysis- A Rare Case Report

Sjogren’s syndrome is “an autoimmune disorder which is characterized by lymphocytic infiltration of salivary and lacrimal glands”. The commonest presenting symptoms are dryness of eyes, mouth and parotid gland enlargement. SS also has extra glandular manifestation in the form of RTA (renal tubular acidosis) seen in one-third cases. RTA presenting as hypokalaemic periodic paralysis is described in few cases in the literature as a rare presentation