Résumé
Background: Following Myocardial Infarction some proteins and enzymes, CPK-MB/ Troponin-I, T, are released into the blood from the necrotic heart muscle. Serum Uric Acid (SUA) may be a risk factor and negative prognostic marker for cardiovascular diseases. Aim of the study was to study serum uric acid levels in patients of acute Myocardial infarction with congestive heart failure, its relation with stages of congestive heart failure as per Killip classification and the role of serum uric acid levels as a marker of mortality.Methods: The case control study was conducted on 120 patients divided into two groups. Group A included 60 patients of acute Myocardial infarction. Group A was further divided into two categories. One includes 30 patients of with congestive heart failure and another includes 30 patients without congestive heart failure. Group B consists of 60 control patients. Serum uric acid levels were measured in Group A on 1st, 3rd and 7th day of hospital admission and in Group B on 1st day.Results: The study showed females have higher degree of hyperuricemia than males. SUA was significantly higher in patients of acute myocardial infarction than control group patients. SUA were also higher in patients with history of IHD, in patients with BNP >100 and it correlates with Killip class and mortality rates. Patients of acute myocardial infarction with diabetes mellitus had higher degree of hyperuricemia than nondiabetic and control group. No significant difference in SUA levels were observed with regard to age, alcohol intake, lipid profile, ejection fraction and hypertension.Conclusions: In acute myocardial infarction, patients with hyperuricemia had higher mortality and may be considered as poor prognostic biomarker.
Résumé
Low back pain is a problem that is common and costly to society and its effective management remains a challenge. Major cause of morbidity due to low back pain is prolapsed intervertebral disc which mostly affects young adults in their fourth decade of life. Epidural steroid injection (ESI) is a low-risk alternative to surgical intervention in the treatment of lumbar disc herniation. This follow up study was planned to know the results of epidural injections with corticosteroids in symptomatic patients of lumbar disc prolapse. Out of 159 patients who were evaluated before and after the ESI for pain relief, 78% had positive response. No major post-injection complications were reported in this study. Carefully administered epidural steroid injection is a safe and effective modality in the treatment of pain in lumbar disc herniation.