Cardiovascular Disease Risk Profile and Risk Prediction Among Unskilled Workers of a Tertiary Care Teaching Hospital

Background: The prevalence of CVD risk factors in India is steadily increasing moreover CVD in Indians has been shown to occur prematurely. The study was designed to estimate the 10-year cardiovascular risk using region specific WHO/ISH risk prediction chart among unskilled workers of a tertiary care teaching hospital and to determine factors associated with risk. Material and methods: This was a hospital based cross sectional study conducted among 250 workers selected by simple random sampling. Using structured questionnaire, life style related risk factors name-ly, average daily consumption of fruits and vegetables, physical activity, perceived stress, tobacco and al-cohol use was collected. BMI and BP were measured using standard protocol and classified following standard guidelines. Bio-chemical parameters were also measured. Results: Among 250 workers, 37.2% and 10% consumed daily minimal recommended level of vegeta-bles and fruits respectively, 21.1% was current tobacco user, 17.2% was alcohol drinkers, 50.4% were obese, 18.8% had high blood pressure and 6% had elevated cholesterol. Among the workers 46.7 % had <10% risk, 5.3% had 10% to <20% risk and, 3.3% had 20% to <30% risk to develop CVD within future 10 years of lifetime. Drivers and current alcoholics were associated with being in the high-risk group. Conclusion: Employer initiated regular work place health screening and services need to be aimed at the unskilled workers, especially for CVD targeting drivers and alcoholics.

A Non-Randomized Prospective Study of Management of Intracapsular Fracture Neck of Femur with Bipolar Hemiarthroplasty.

Background: The fracture neck of femur is one of the commonest fractures in elderly. With life expectancy increasing with each decade, our society is becoming increasingly an active geriatric society, with significant number of hospitalized and nursing home patients with femoral neck fractures and their sequelae. Selection of the type of prosthesis is very important in hemiarthroplasty as different types are available. Since the last two decades, bipolar replacements of the femoral head have gained popularity for treating femoral neck fractures. Aim & Objective – To assess and analyse the results of management of fracture neck of femur with bipolar hemiarthroplasty. Methods: After obtaining ethical committee approval and informed consent from patient, detailed history of patient was taken with particular emphasize on mode of injury and associated medical illness. On the day of surgery , under anesthesia and patient in lateral position, following strict aseptic precautions, either lateral (Hardinge) or Posterior (Southern-Moore) approach incision made, tissues dissected, joint capsule incised and femoral head extracted with the help of cork screw. Then the appropriate size of prosthesis with cement was seated. The wound was closed meticulously in layers. Knee flexion, isotonic quadriceps exercises were started from 1st or 2nd post op day and patients were mobilized with walker as tolerated. Patients are educated on different position of legs that should be avoided in the postoperative period. Follow up was done after 6 weeks and for further at 3 months, 6 months & 1 year .Result: In our series, at the end of final follow-up, there was no evidence of loosening, radiolucent zones, distal migration or subsidence of prosthesis. The patient with Periprosthetic fracture healed and is weight bearing fully with no pain. One patient who had moderate heterotopic ossification had still has some mild pain occasionally. Conclusion: we conclude that bipolar hemiarthroplasty produces good functional outcomes with minimal complications for displaced intracapsular femoral neck fractures and has several advantages; these results are comparable to the other studies.

First case report of acute hemorrhagic leukoencephalitis following Plasmodium vivax infection.

Acute hemorrhagic leukoencephalitis (AHLE, Hurst's disease) is a rare hyperacute variant of acute disseminated encephalomyelitis (ADEM) characterized by severe, rapidly progressive clinical illness and hemorrhagic necrosis of white matter. Like ADEM, it is often preceded by viral illness or vaccination. Plasmodium vivax infection is usually uncomplicated and non-fatal with only a handful of reports of central nervous system complications. In this article, we report a previously unknown association between AHLE and P. vivax infection.

Simultaneous detection of strychnine and brucine in biological matrix by gas chromatography-mass spectroscopy.

A new gas chromatography-mass spectroscopy (GC-MS) method is being presented for the separation and detection of strychnine and brucine, alkaloids of Strychnos nux vomica in a single run. The analysis was carried out using 5% phenyl methyl silicone capillary column, electron impact ionization mode and quadrupole mass analyzer. The extracts of the exhibits were analyzed using the new method. The peaks of the two alkaloids were found to be well resolved, and there was clear separation between the two. The retention time and mass fragmentation pattern, base peaks, molecular peaks of strychnine and brucine standard/NIST library and crime case exhibits matched, establishing the presence of the two active principles of Strychnos nux vomica. The new method has the advantage of better separation of the two alkaloid peaks over the conventional GC-MS methods, and is useful for the identification and confirmation of Strychnos nux vomica constituents in biological matrices of poisoning cases that have ended in death.

Venous thromboembolism: the intricacies.

Venous thromboembolism (VTE) has been a subject of great interest of late. Since Rudolph Virchow described the famous Virchow's triad in 1856, there have been rapid strides in the understanding of the pathogenesis and factors responsible for it. Discovery of various thrombophilic factors, both primary and acquired, in the last 40 years has revolutionized prognostication and management of this potentially life-threatening condition due to its associated complication of pulmonary thromboembolism. Detailed genetic mapping and linkage analyses have been underlining the fact that VTE is a multifactorial disorder and a complex one. There are many gene-gene and gene-environment interactions that alter and magnify the clinical picture in this disorder. Point in case is pregnancy, where the risk of VTE is 100-150 times increased in the presence of Factor V Leiden, prothrombin mutation (Prothrombin 20210A) and antithrombin deficiency. Risk of VTE associated with long-haul air flight has now been well recognized. Thrombotic events associated with antiphospholipid syndrome (APS) are 70% venous and 30% arterial. Deep venous thrombosis and pulmonary embolism are the most common venous events, though unusual cases of catastrophes due to central vein thrombosis like renal vein thrombosis and Budd-Chiari syndrome (catastrophic APS) may occur.