Comparative Study between 12 and 15 Lead Electrocardiograms for Evaluation of Acute Posterior Myocardial Infarction.

Background: The ECG diagnosis of acute posterior infarction has traditionally been based on the presence of ST segment depression on the pericardial chest leads. However, such ST segment depression is neither specific nor sensitive for the diagnosis of a posterior infarction. Detection of ST segment elevation in V7- V9 in 15 lead ECG can help in early diagnosis of acute Posterior myocardial infarction. Method: Total of 100 patients Inferior myocardial infarction was evaluated by Electrocardiography in standard 12 lead and 15 lead. The patients were categorized into group I having posterior/ and or associated changes and group II having without posterior changes in ECG. Echocardiography and LVgraphy was done to evaluate the posterior wall movement. Result: For diagnosis of posterior myocardial infarction, 43.3% sensitivity and 95.1% specificity was found in 12 lead ECG, whereas in 15 lead ECG it was 80.0% sensitivity and 95.1% specificity. Conclusion: 15 Lead ECGs (including V7-V9) more sensitive than 12 lead ECGs in diagnosis of acute posterior myocardial infarction. Patient with inferior myocardial infarction or anterior ischemia developed more complications if associated with acute posterior myocardial infarction. 15 lead ECGs can routinely be used in patients with ischaemic type of chest pain.

Effects of long term iodized table salt consumption on serum T3, T4 and TSH in an iodine deficient area of Bangladesh.

The effect of iodized and non-iodized table salt in goiter hyper-endemic area on the thyroid gland and its hormones T3, T4 and Thyroid Stimulating Hormone (TSH) were studied in two hundred subjects from the Center for Nuclear Medicine and Ultrasound, Mymensingh. Iodized and non-iodized salt users were called study and control groups respectively. The mean concentration of T3 were 2.38 nmol/L and 2.22 nmol/L & T4 concentration were 128.67 and 123.72 nmol/L in the study and control group respectively. The mean TSH concentration was 1.52 mIU/L and 1.62 mIU/L in study and control group. The data indicated that continuous and long term use of iodized salt increased both T3, T4 and decreased TSH in such a limit which was not statistically deferent at P< 0.05 level as compared to the control group. There was no significant change in occurrence of (hypo and hyper thyroidism or iodinated salt induced thyrotoxicosis) adverse effect, following iodine supplementation. The study shows that, mandatory mass iodination of table salt consumption in a hyper-endemic iodine deficient area is safe and does not cause any side effect. We suggest close regular monitoring of T3, T4, and TSH and further evaluation by specifically designed studies for any probable link between iodine induced hypo or hyperthyroidism and mass iodination of table salt consumption.

Efficacy of a modified Ultra Fast Papanicolaou (UFP) stain for breast aspirates.

The chief limitation of Ultra Fast Papanicolaou (UFP) stain, suggested by Yang and Alvarez (1995), is that, Richard Allan Haematoxylin (RA-H) and Richard Allan Cytostain (RA-C), used in the staining procedure are not universally available. It has not been established so far, whether, changes in the reagents and their proportions depending on the local availability, influence the performance of the stain. The objective of this study was to assess the feasibility and applicability of a modified UFP stain to suit our local laboratory supplies of chemical dyes, as applied to the permanent smears prepared from Fine Needle Aspiration (FNA) of breast lumps. In the present study, smears from FNA from 100 breast lumps were stained by the modified UFP stain. The modification consisted of following two changes: use of Gill's Haematoxylin instead of RAH and omission of Orange G from cytostain. Eighty Six breast aspirates were adequate for interpretation. Smears showed transparent cells with crisp nuclear features, equal to and even better than the conventional Papanicolaou stain, in a blood free background. There was an increase in total staining time by 40 seconds. We recommend the use of this modified UFP stain, only if similar reagents are being used in other laboratories. Otherwise situation specific modifications may be needed. If the UFP stain is to be used for tissues where the chances of cytoplasmic keratinization are negligible, then the use of Orange G component of the stain may become redundant.

Effect of zearalenone on the activity of some steroid transforming enzymes in rats

Zearalenone, a mycotoxin with estrogenic activity, is used in vivo to study its effect on some steroid transforming enzymes. The enzyme activities of 5 beta-reductase [EC. 1.1.1.125] and 17 beta-hydroxysteroid dehydrogenase [EC. 1.1.1.25] are involved in the metabolism of progesterone and estradiol-17 beta-. These hormones are responsible for the formation of mature ovum and prevention of abortion in females. Zearalenone was injected subcutaneously at a dose of 3.3 mg/kg body weight to female mature rats at estrus phase. Control rats were injected with 0.5 ml corn oil. After 48 hours treatment time, liver, uterine tissues and serum samples were used for enzymes assay using spectrophotometric methods. The activity of 5 beta reductase from hepatic and uterine preparations and serum samples was significantly higher in Zearalenone treated rats than that of control group [p < 0.0001]. The results also showed a significant increase in the activity of 17 beta-hydroxysteroid dehydrogenase [17beta-HSD] in the samples obtained from Zearalenone treated rats as compared with that of the control group [P < 0.0001]. Furthermore, the estrogenic effect of Zearalenone on the uterine weights of female rats was noted

Aspiration cytology of salivary gland lesions advantages and pitfalls.

FNAC of the major salivary glands was performed on 72 patients during a period of two and a half years. In 64 patients samples were satisfactory. The cytologic diagnosis was correlated with histology available in 36 cases. 21 out of 22 benign lesions and 12 out 4 malignant lesions were correctly identified rendering a diagnostic accuracy of 91 percent. The pitfalls of FNAC of salivary gland lesions are reflected by the overall false positive rate of 5.5 percent of false negative rate of 2.7 percent. Diagnostic pitfalls are due to variability of tumor morphology which makes sampling & interpretation difficult. Multiple sampling and increasing experience help to minimize errors.

Collagen-vascular disease associated with multiple endocrinol deficiencies

There are two main types of autoimmune diseases which are usually considered to be separate from each other: The collagen-vascular disorders, which are due to non-organ specific autoantibodies [antigens present in all cells of the body, e.g. antinuclear antibodies], and the other major group, in which antibodies specific to a certain organ or group of organs occur, e.g. the autoimmune endocrinal disorders [antithyroid, antiadrenal,. etc]. It is considered very unusual to have manifestations of both types of disorders in the same patient. The case presented in this study is an example of a patient presenting with multiple endocrinal defects [growth hormone deficiency, hypothyroidism, as well as diabetes mellitus with insulin resistance]. She also has evidence of a collagen-vascular disorder [systemic lupus]. She may be an example of the syndrome of insulin resistance due to antibodies against insulin receptors, in which collagen disorders may be associated