Résumé
Background: Acute myocardial infarction (MI) is a significantly raising problem particularly in India. The various aspects of myocardial infarction such as risk factor profiles, clinical presentations and prognosis differ significantly in south Indian people when compared to others. This study was undertaken to study the association of socio-demographic and life-style factors with acute myocardial infarction in South India.Material: This was a prospective study included 100 patients admitted in ICCU for acute MI in Government Rajaji Hospital Madurai over a period of 1 year. History, ECG, CPK-MB, and 2-D Echo was done to diagnose MI.Results: In this study, 68% patients were males. In this study, 34% patients had diabetes, 42% had hypertension, 58% were smokers. In our study 70% patients had BMI between 25-30kg/m2. In this study, 86% patients had TGL more than 200mg/dl, 28% patients had LDL more than 100 mg/dl and 78% patients had NON-HDL more than 130 mg/dl. In this study, 9 patients had depression. In our study 61% male patients had waist hip ratio more than >1 and in females 69% patients had waist hip ratio more than >0.85. In our study, 22% patients had hemoglobin >16g/dl.Conclusion: Prevention of coronary artery syndrome by modifying the risk factors were crucial. Serum cholesterol, LDL cholesterol, BMI were not significant to predict ACS in our study Waist Hip ratio, Triglyceride, Non-HDL cholesterol, smoking and Depression were significant to predict acute coronary syndrome in this study
Résumé
Background: Cigarette smoking is a major public health problem and is the most important cause of chronic obstructive pulmonary disease (COPD). This study shows the importance of smoking cessation for improvement in respiratory function and quality of life and brings out the potential usage of pharmacological and behavioural therapy for the same.Methods: This prospective study was conducted on 50 male smokers at Kilpauk Medical College, Chennai. During the treatment only 43 patients were continued till the end of follow up. During the period, varenicline treatment was given for three months as per schedule, regular periodic counselling was given to these patients and followed up for a period of 1 year. Forced expiratory volume at one second (FEV1), COPD assessment test (CAT) scoring, 6 min walk test (6MWD), BODE index, was taken before starting therapy and on 3rd month and at the end of one year of follow-up. All the values obtained were analysed statistically.Results: The mean age of the 43 patients was 44.7±7.34, mean BMI was 22.27±4.24. The mean difference between pre and post treatment scores of CAT, 6MWD and BODE index were found to be statistically significant (p<0.0001).Conclusions: Combined behavioural counseling and pharmacotherapy with varenicline significantly improved the odds of achieving tobacco abstinence in the participants by the end of one year of treatment.
Résumé
Background: Febrile thrombocytopenia due to various etiologies is very common in India. Its clinical manifestations range from asymptomatic infections to severe disease. Cardiac involvement in such systemic illness should be evaluated. Aim of present study is to evaluate cardiac involvement in patients with Febrile thrombocytopenia with platelets count less than 50,000/µL with the help of handheld echocardiography.Methods: Two hundred patients who had fever with thrombocytopenia were enrolled in the study. ECG and echocardiogram were done to all the patients. One-way ANOVA, Chi square test and correlation coefficient from Pearson correlation and P value of < 0.05 was taken as significant.Results: Out of 200 patients there were 146 males and 56 females. The mean age was 24.12yrs in males 28.32yrs in females .Rhythm abnormalities were present in 60 patients and the most common abnormality was sinus tachycardia; 17 patients had ascites and right pleural effusion; 24 patients presented with pericardial effusion and incidental diagnosis of CHD, RHD, and CAD were made; two patients had myocarditis as evidenced by global hypokinesia of left ventricle. All of those cardiac manifestations were common in Dengue Shock Syndrome.Conclusions: Cardiovascular manifestation in Febrile thrombocytopenia is relatively common ranging from pericarditis to myocarditis. Clinician should routinely screen patients with pyrexia with thrombocytopenia for cardiac manifestations. Early diagnosis at bed side may improve the outcome. Management of patients with pre-existing cardiac diseases should be individualized.
Résumé
Background: Non-resolving pneumonia is a problem not only for the patient but also to the treating physician because establishing the cause for the non-resolution of pneumonia takes time and requires invasive investigations. The present study was done with the aim to evaluate the etiology and clinical outcome of non-resolving pneumonia by using fibre-optic bronchoscopy (FOB).Methods: This prospective study was done on 45 patients with symptoms and signs of non-resolving pneumonia attending the Govt. Thiruvotteeswarar Hospital of Thoracic Medicine, Otteri, Chennai, a tertiary care teaching centre, during the period January 2016 to December 2016. All the patients were investigated systematically to find out the etiological factors for non-resolution pneumoniaResults: Males preponderance was seen in the study (80%). Patients of age group 51-60 years are more affected (26.6%). Bacterial pneumonia not responding to empirical antibiotics (42.2%) was the most common cause followed by pulmonary tuberculosis (28.8%) and malignancy (24.4%). On FOB, inflammation with secretions was noticed in most of the patients (66.6%).Conclusion: The findings of the study concluded that apart from bacterial pneumonia not responding to empirical antibiotics, tuberculosis and malignancy were found to be the major causes of non-resolving pneumonia. Hence, it is necessary to observe every patients for the adequate response to treatment and to utilize other modalities of investigations like FOB,CT guided FNAC/biopsy whenever required to offer exact management to the patients.
Résumé
Background: The study was conducted with the aim to evaluate the pre-treatment drug susceptibility profile and to assess the influence of drug resistance on treatment outcome among patients treated with category- II (cat- II) regimen under programme conditions.Methods: This study was conducted on 58 smear positive patients with history of previous anti-tuberculosis treatment for more than one month, comprising cases of ‘Failure’, ‘Treatment after Default’ (TAD) and ‘Relapse’. They received cat- II regimen in Chennai Corporation, RNTCP (revised National tuberculosis control programme) centers from July 2006 to September 2006 and they were monitored upto July 2007 as per RNTCP guidelines to assess the outcome of cat-II treatment by sputum smear status.Results: Male dominance (n=40) was seen in the study participants. Most common age group affected was 35-44 years (n=20). Out of 57 cases, 50.9% cases come under ‘Relapse’, 26.3% arises from ‘TAD’ and 22.8% cases were from ‘Failure’. After completion of treatment with cat-II regimen, out of 57 patients 33 patients were cured and 11 cases were into the category of failure, 10 patients were defaulted during treatment and 3 were died.Conclusions: Besides, the low treatment efficiency in MDR-TB cases, cat- II regimen was effective in sensitive and INH resistant cases.
Résumé
Antitumor activity of ethanol extract of Pandanus fascicularis Lam. [EPF] was studied in mice. The antiturnor activity of EPF was evaluated against Dalton's ascitic lymphoma [DAL] tumor model on dose dependent manner. The activity was assessed using survival time, average increase in body weight, haemalological parameters and solid tumor volume. Oral administration of EPF increased the survival time and decreased the average body weight of the tumor bearing mice. After 14 days of inoculation. EPF is able to reverse the changes in the haematological parameters, protein and PCV consequent to tumor inoculation. Oral administration of EPF was effective in reducing solid tumor mass development induced by DAL cells. The results show that EPF possess significant antitumor activity in dose dependent manner