Perioperative evaluation of mycocardial function and electrocardiographic changes after subarachnoid hamorrhage

The aim of the present study was to evaluate perioperative myocardial function and electrocardiographic changes of patients after subarachnoid due to ruptured cerebral aneurysm and undergoing an aneurysm clipping procedure. Twenty adult patients scheduled for aneurysm clipping were assessed according to the Hunt and Hess scale.Echocardiography was done in all patients before operation and was repeated on the first postoperative day for patients with initial abnormal findings. Wall motion was assessed by segmental analysis. Wall motion index and left ventricular ejection fraction were determined. Standard twelve lead ECGs were performed daily. Creatinine kinase [CK] and its isozyme [CK-MB] were determined on admission, during the operation and on the first postoperative day. Group Ab were those with initial echocardiographic abnormalities [8 patients] and group N with a normal echocardiographic study [12 patients]. Out of 128 segments in group Ab patients, 16 segments showed moderate hypokinase [12.5%], 8 segments showed severe hypokinesia [6.5%] and 4 segments were akinetic [3%]. Wall motion index and left ventricular ejection fraction did not change before and after surgery in these patients. CK and CK-MB values were initially higher [19.6 +/- 4.6 IU/ L], [P < 0.001] in the Ab group but intra-and postopertively were statistically insignificant. Group Ab patients had a mean neurological grade of 4.1 while those Group N had a mean neurological grade of 1.4, a statistically significant difference. This was accompanied with a worse outcome in the form of permenant disability or death in 75% of cases and mortality in 50% of cases. Left ventricular wall abnormalities are common in patients with anetrysmal subarchonoid haemorrhage. They are associated with ECG abnormalities and myocardial enzyme elevations. They are more common in patients with high neurological grades and are associated with poor outcome and increased mortality

comparative study of some liver functions and haemodynamics in preeclamptic and normal pregnant females

Preeclampsia is a prevalent disease in pregnancy well known to affect liver function. 30 severely preeclamptic patients and 15 normal full term control patients were enrolled in the present study. Portal blood flow was compared between the 2 groups using combined Doppler flowmetry and ultrasonic sector scanning. Portal blood flow of preeclamptic patients was found to be significantly lower than controls [P <0.05]. Serum prealbumin and albumin were significantly lower, while bilirubin was higher in preeclamptic patients [P <0.001]. SGOT showed an insignificant difference between the 2 groups, while SGPT was higher in the preeclamptic subjects