Failure of Thrombolysis with Streptokinase In Acute Myocardial Infarction Using ECG Criteria: An Observational Study.

Abstract To Study failure of thrombolysis with streptokinase in acute myocardial infarction using E.C.G criteria a prospective study of patients presenting with acute myocardial infarction in G.M.C Jammu for a period of one year. A total of 220 patients who presented with acute myocardial infarction were included in the study . Out of 220 patients 193(87.7%) males and 27 (12.3%) females participated in the study. All the patients underwent thrombolysis with streptokinase. Out of 220 patients who were being thrombolysed with streptokinase, most of them (97; 41.1%) were in the age group of 56-65 years. Out of all the patients who underwent thrombolysis (n=220), thrombolytic failure was observed in 121 (55%) patients. Failure rate was significantly higher in the age group of 56-65 years (88; 72.7%). Significantly higher prevalence of thrombolytic failure with streptokinase was observed among diabetic patients (65.2% ) as compared to non diabetics (52.3%).

Cardiotoxicity Profile of Snake Bite.

The present study was conducted in 80 cases of snake bite to understand their possible, biochemical and electrical cardio toxic effects. All patients were subjected to routine and specific investigation (ECG, X Ray, SGOT, CPK, CPK - MB, Troponin levels). Subjects were included in three groups, haemotoxic, neurotoxic and non - envenomed group. They were subjected to investigations at the time of admission, 24 hours and 72 hours after the admission. No significant statistical change occurred in cardiac enzymes in all groups at the time of admission. Significant statistical change occurred in LDH, CPK-MB at 24 hours and 72 hours after admission in haemotoxic group. Significant statistical change occurred in Troponin levels and CPK and SGOT at 24 hours after admission but no statistical change occurred at 72 hours after admission. But there was no statistical significant change in biochemical parameters in a neurotoxic group. At admission, there was tachycardia in 29 cases (53.7%) in haemotoxic group and in 16 cases (29.7%) at 24 hours which was statistically significant. At admission there was bradycardia in 10 cases (18.5%). In neurotoxic group there was tachycardia in 6 (60%) cases at admission and in 2 cases (20%) at 24 hours. There was bradycardia in 1 case in neurotoxic group. No significant change occurred in all groups at 72 hours. The present study showed significant statistical ECG changes at admission in the non - envenomated, neurotoxic and hemotoxic groups in the form of tachycardia or bradycardia. Also significant statistical ECG changes in the form of tachycardia was observed 24 hours after admission in hemotoxic group. It could be concluded that snake bites especially haemotoxic group carry the risk of inducing cardio toxic effects but these effects are not fatal.