RESUMEN
Background: Chronic obstructive pulmonary disease is a leading cause of morbidity and mortality in adults all over the world. Pulmonary hypertension (PH) is a severe disorder defined by a mean pulmonary artery pressure of ?25 mmHg at rest. Pulmonary hypertension can occur as an isolated disease or as a consequence of a number of underlying diseases and conditions, such as heart failure and chronic obstructive pulmonary disease (COPD). The aim of our study was to study the prevalence of pulmonary hypertension in COPD patients and to highlight the importance of early diagnosis of pulmonary hypertension to prevent further complications.Methods: This was a retrospective observational hospital based study conducted at Integral Institute of Medical Sciences and Research Lucknow U P, during 1st January to 31st December 2017. A total of 210 patients were evaluated for presence of pulmonary hypertension using chest X-ray, electrocardiogram, 2D echocardiography.Results: The present study finding reveals 38.02 % patients of various severity of COPD have findings of pulmonary hypertension, that is similar in prevalence of previous studies.Conclusions: The prevalence of PH in patients with COPD was 38.02%. As PH has an important role in the prognosis of COPD patients, it should be evaluated in as many COPD patients as possible.
RESUMEN
Background: The burden of diabetes mellitus is increasing worldwide. The prevalence of TB has been rising in recent years globally. Aging, changes in life style, socioeconomic factors, and population growth have lead to an increased prevalence of DM, particularly, type 2 DM. Diabetes Mellitus (DM) almost triples the risk of developing tuberculosis (TB). India, the nation with the highest number of TB cases in the world, is also undergoing epidemic growth in DM rates. With the demographic transition underway globally, increase in life expectancy, improvements in provision of health services and a subsequent increase in the elderly population, the absolute numbers of cases of diabetes will increase exponentially. As a result, DM and TB are increasingly present together, and this calls for renewed interest in this topic. Various studies done in different parts of India and in other parts of globe where TB is endemic have shown a higher prevalence of DM among PT infected with tuberculosis. We in our study undertaken in Department of medicine in IIMS&R Lucknow UP found a high prevalence of DM amongst TB patients. Routine screening of TB patients for DM will help detect cases of diabetes and pre-diabetes early, so that primary prevention methods may be initiated early and effectively.Methods: This hospital-based cross-sectional study was undertaken in Department of medicine in IIMS and R Lucknow UP. All TB cases more than 18 years of age, including new and re-treatment cases, sputum positive, sputum negative and extra-pulmonary cases currently on treatment in the were included in the study.Results: Using the diagnostic criteria, as mentioned in the methodology, the prevalence of diabetes among TB patients in this study was found to be 24.5% of which 18.5% were known DM cases and 5.9% were newly diagnosed.Conclusions: The burden of diabetes mellitus is increasing worldwide. The association between diabetes and tuberculosis is the next challenge for global tuberculosis control. Improved understanding of the bidirectional relationship of the two diseases is necessary for proper planning and collaboration to reduce the dual burden of diabetes and TB. In people with TB, it may be appropriate to actively screen for DM. Prevention, screening, and treatment of both diseases together is more effective.
RESUMEN
Background: Febrile patient with thrombocytopenia is commonly encountered by physicians especially during monsoon and perimonsoon period. Infections with protozoa, bacteria and viruses can cause thrombocytopenia with or without disseminated intravascular coagulation. Commonly dengue, malaria, scrub typhus and other rickettsial infections, meningococci, leptospira and certain viral infections present as fever with thrombocytopenia. Occasionally these patients can go on to develop a stormy course with multiorgan dysfunction requiring intensive care unit admission associated with high morbidity and mortality. Though thrombocytopenia is encountered in various diseases, it is for sure that potentially fatal bleeding due to thrombocytopenia is rare. The study was intended to know the underlying etiology of febrile thrombocytopenia in our community, the various presentations and relationship between platelet level and severity of disease and prognosis.Methods: This study was carried out in 218 adult patients (age above 18 years) presenting with fever having thrombocytopenia (platelet count <1,50,000/mm3) in Dept. of medicine in IIMS and R Lucknow UP.Results: Dengue was the commonest cause of fever with thrombocytopenia (58.71%) followed by P. falciparum malaria 8.71% and P. vivax malaria 6.88%. Bleeding manifestations were seen in 24.31% of patients. 58.49% of patients had patechie/purpura as the commonest bleeding manifestation followed by hematuria in 16.98 %.Conclusions: Fever with thrombocytopenia consists of occult presentations of common diseases rather than rare disease. Infection is the commonest cause of fever with thrombocytopenia. Among infections, dengue was the commonest cause. Treatment of underlying condition will lead to rapid improvement in platelet count with complete clinical recovery.