scholarly journals EFFICACY OF THROMBOLYSIS (STREPTOKINASE) IN DIABETIC AND NON-DIABETIC PATIENTS PRESENTING WITH ACUTE ST ELEVATION MI & COMPARISON OF THEIR ANGIOGRAPHIC PROFILE.

2021 ◽  
pp. 1-5
Author(s):  
Ashish Chauhan ◽  
Rajeev Kumar Gupta ◽  
V.V. Agarwal

BACKGROUND: To determine the efficacy of streptokinase in diabetic versus non-diabetic patients presenting with acute ST Elevation Myocardial Infarction (STEMI). METHOD AND RESULTS: This is a hospital based observational study conducted in the department of Cardiology, S.M.S. MEDICAL COLLEGE and associated hospital, Jaipur, Rajasthan between March 2016 to August 2017. Two hundred one consecutive patients of acute STEMI admitted to the Cardiology department were enrolled in the study to maintain 95% CI and 80% power of study. Patients with acute STEMI within 12 hours of chest pain without contraindications to fibrinolytic therapy (streptokinase) were included. ECG was done before and at 90 minutes after the start of streptokinase. ST-segment resolution equal to or more than 70% at 90 minutes on ECG was taken as successful reperfusion. The data was analysed by using software SPSS version 10. The quantitative variables were presented as mean and standard deviation while qualitative variables as frequency and percentage. Chi square test was used to estimate significance and p-value of <0.05 was considered significant. Out of 201 patients, 127(63.2%) were non-diabetics and 74(36.8%) were diabetics. The age of presentation of these patients was 32-75yr (meanage=55.59yr). Of these patients, 80% (N=160) were male and 20% (N=40) were female. Among the 74 diabetic patients, streptokinase was not effective in any patients. So streptokinase is non-efficacious in diabetic patients. Among the 127 non diabetic patients, streptokinase was effective in 79 (62.2%). Among the risk factors, smoking and hypertension were found in 84.6% and 62.7% of the patients respectively. So, we found smoking as the most common risk factor followed by HTN and DM in our patients. HTN was found significantly more in diabetic patients (94.59%) vs (44.09% in non-diabetic patients). On angiography, 58.7% patients had SVD, 34.8% had DVD and 6.5% had TVD. Five (2.5%) of these were found to have LM disease. Coronary angiography showed SVD, DVD, TVD in 44(59.46%), 17(22.97%) and 13(17.57%) of diabetic vs 74(58.27%), 53(41.73%) and 0(0%) of non-diabetic patients. So, triple vessel disease is significantly higher in diabetic patients. CONCLUSION: This study shows that streptokinase is significantly more efficacious in non-diabetics as compare to diabetic patients presenting with acute STEMI. It is more efficacious in male than female (M=47.82%; F=5%). We found that the window period of presentation was significantly higher in diabetic patient because of atypical symptoms that may lead to a delay in seeking medical advice and streptokinase was significantly more efficacious in non-diabetics as compare to diabetic patients.

2021 ◽  
Vol 10 (02) ◽  
pp. 129-132
Author(s):  
Naimatullah Khan ◽  
Javed Iqbal Khan ◽  
Tariq Mehmood ◽  
Aqeel Peter

Objective: To assess the dyslipidemia in newly diagnosed diabetic patients and compare it with or without micro albuminuria. Study Design and Setting: Cross-sectional study at Department of Medicine, Military Hospital Rawalpindi from 01 March 2015 to 31 August 2015. Methodology: A total of 150 patients who fulfilled the inclusion criteria were included after taking informed consent and approval from hospital ethical committee. Blood sample was obtained from each patient and samples were sent to hospital laboratory and reports were assessed by pathologist. Presence or absence of microalbuminuria, trigiyceridemia (200-499 mg/dl), raised LDL-C (>160 mg/dl) and decreased HDL-C (<40 mg/dl) were noted by researcher himself on a pre-designed performa. The collected data was analyzed statistically by using SPSS version 12.Quantitative variables like age, TG, LDL HDL levels were presented in form of mean ± S.D. Qualitative variables like gender, diabetes mellitus, micro albuminuria and dyslipidemia were presented as frequencies and percentages. Chi-square test was applied to find association between dyslipidemia and micro albuminuria. P value = 0.05 was considered as statistically significant. Results: Mean ± SD of age was 47.97±7.08 years. Out of 150 patients 60% were male and 40% were female. Dyslipidemia was found in 42% patients. Highly significant association was found between dyslipidemia and micro albuminuria, i.e. (P=0.0001). Conclusion: The frequency of dyslipidemia among newly diagnosed diabetic patients with micro albuminuria was significantly higher than in subjects without micro albuminuria


Author(s):  
Etienne Belinga ◽  
Isidore Tompeen ◽  
Claude Cyrille Noa Ndoua ◽  
Junie Metogo Ntsama ◽  
Sandrine Mendibi ◽  
...  

Background: Uterine synechiae refers to a total or partial union of the inner walls of the uterus resulting from endometrial trauma. It is a cause of reproductive failure. Until now, synechia was not optimally treated and has remained understudied in Cameroon. Objective of present study was to Evaluate the diagnostic, therapeutic and prognostic aspects of uterine synechiae treated by hysteroscopy.Methods: We conducted a descriptive cross-sectional study with an analytical component from January 1st 2015 to July 31st 2017 at Yaounde. All patients diagnosed with uterine synechiae and treated with hysteroscopy were our sample. Sampling was consecutive. The chi-square test was used for the comparison of qualitative variables and Fisher's test for ANOVA variance analysis. The comparison of the averages was made by the Student's test. P-value less than 0.05 was considered as statistically significant.Results: Hysteroscopies were indicated for uterine synechiae in 14.50%. Nulliparous were 56.67%. A history of curettage/aspiration was present in 66.66%. All of the patients had a form of infertility and 83.33% had menstrual disorders. Hysterosalpingography showed a better sensitivity (88%). After hysteroscopic treatment, 63.30% had a complete anatomical restitution. There is a significant correlation between the stage of severity of synechia and anatomical restitution (p=0.008; Spearman correlation coefficient=-0.477).Conclusions: Uterine synechiae represent one-sixth of all indications for hysteroscopy and present clinically as menstrual disorder associated with infertility. A past history of uterine curettage is common. Hysterosalpingography has a better preoperative diagnostic sensitivity. Hysteroscopy allows optimal treatment.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ahmed Kh. Mohammed Almaawi

Objective: To assess CKD prevalence and risk factors including socio-demography among diabetics by estimating GFR rather than serum creatinine (sCr). Methods: A cross-sectional study was conducted in Dec. 15 2019 through Aug. 15 2020, among 800 diabetics attending tertiary diabetes centers, Baghdad. Data was collected by self-administered questionnaire. SPSS was used for data analysis by (mean, standard deviation and T-test) for quantitative variables and (frequency, percentage, Chi-square test and Kappa index) for qualitative variables. P-Value less than 0.05 was considered significant.  Results: 800 diabetics for last 5-40 years, 95.6% with type2. Aged 52.1±13.2 years, with male: female ratio 1.03:1, 63.6% were with no income, sCr level was 0.86±0.3 mg/dl, and eGFR by Cockcroft Gault (CG) and CKD-EPI equations was 100.4±36.5 & 92.2±25.5 ml/min/1.73m2 respectively. CKD prevalence based on sCr, and eGFR assessed by above equations was 13.3%, 20% and 15.9% respectively (p<0.001). Those with CKD were hypertensive, females, and living in peripheries. Conclusions: Diabetic patients, mainly those with risk factors are more likely to develop CKD. It is better to detect CKD intially by estimating the GFR, rather than serum creatinine level alone. Furthermore, using CKD-EPI equation might be better than the CG formula to estimate the GFR.


2019 ◽  
Vol 17 (01) ◽  
pp. 26-31
Author(s):  
Ritu Bashyal ◽  
Bhagawan Koirala ◽  
Bharat Jha ◽  
Bijaya Gautam ◽  
Mira Khadka

Background: Male sex has always been considered as an independent risk factor for cardiovascular disease. But recent studies have shown controversial results. This study aimed to investigate the relation of serum testosterone withrisk factors of coronary artery diseasesand with degree of severity of coronary artery stenosisin men with coronary artery diseases.Methods: After applying inclusion and exclusion criteria 102 men (aged 60.42 += 11.11), were included. Fasting blood sample were obtained and blood sugar, total testosterone and lipid profile were measured. Severity of coronary stenosis was estimated by Gensini score. The relationships were assessed using chi-square test, one way analysis of variance and Pearson’s Correlation. Results: Of the total 102 patients, majority of them 42 (41.2%) had triple vessel disease. Testosterone (nmol/L) was found to be 12.01 ± 6.1. Cardiovascular diseaserisk factors like age, body mass index etc. were found to be negatively correlated with testosterone but not statistically significant. Likewise, Gensini score also correlated negatively with testosteronebut not up to the threshold of statistical significance (r=-0.069, p-value = 0.496). Similar results were obtained when number of vessels involved and testosterone were compared. However, the number of diabetic patients gradually decreased with the increasing value of testosterone in the three tertile group (p-value = 0.040). Conclusions: This study could not find significant association between testosterone and coronary artery diseases, however low testosterone was associated with diabetes mellitus.Keywords: Coronary artery diseases; diabetes mellitus; gensini score; testosterone.


2021 ◽  
pp. 5-6
Author(s):  
Rohit Rohit ◽  
Lokesh Kumar Singh

Aim:-The aim of this study is to analyse the factors causing recurrence of infection in the corneal graft after therapeutic penetrating keratoplasty.Material and Methods:- This study was conducted at Upgraded Department of Ophthalmology, SVBPH,Meerut. This institution performs 120 keratoplasty procedures per year on an average. The study was conducted for a period of one year & 25 patients had reinfection and those who presented with reinfection constituted the sample size complete enumeration.The data thus obtained was compiled and analysed using Statistical Package for Social services (SPSS vs 20). The qualitative variables were analyzed by using frequencies and The qualitative variables were analyzed by using frequencies & percentages & chi square test was used as test of significance.The quantitative variables were presented as measures of central tendency and dispersion. A p value of less than 0.05 was considered as statistically significant Results Initial fungal etiology was the main risk factor for the recurrence of microbial keratitis after TPK in (24%) of the cases followed by persistent epithelial defects (16%),Initial bacterial etiology (12%), Lid abnormalities (8%) ,contact lens use (8%), Secondary ocular hypertension (8%), prior rejection episodes(8%), initial viral etiology (4%) ,peripheral ulcerative keratitis (8%) & suture related problems(4%). Conclusion:- .This study has shown that Fungal keratitis was the main reason for the initial TPK & initial Fungal aetiology was the main risk factor for the reinfection after TPK


2017 ◽  
Vol 24 (02) ◽  
pp. 308-314
Author(s):  
Farhat Bashir ◽  
Farzana Rehman ◽  
Samina Ghaznavi ◽  
Jamal Ara

Diabetes mellitus is a modifiable risk factor for generalized atherosclerosis.Measurement of carotid intima media thickness by Doppler ultrasonography can be used tomeasure the extent of atherosclerosis. Objectives: To determine the association of carotidatherosclerosis in patients with type 2 diabetes mellitus and its relationship with glycemiccontrol. Study Design: Cross-sectional comparative study. Period: 12 months June 2015 toMay 2016. Setting: Creek General Hospital in the Department of Medicine and Radiology,Karachi, Pakistan. Method: The subjects were selected from diabetic patients presenting tothe Out-Patient Department and controls from their attendants. All subjects had a detailedhistory, physical examination and laboratory investigations recorded. The variables includedage, gender, weight, BMI, blood pressures, fasting and post prandial blood sugars, HbA1cand lipid profile. All individuals underwent B-mode ultrasound for carotid Doppler studies. Asingle operator conducted all the Doppler studies. The carotid intima media thickness wasmeasured and the presence of carotid plaque was recorded for each subject. The data wasentered on SPSS ver 20.0. Numbers and percentages were calculated for categorical datawhile mean±standard deviation was calculated for continuous data. The carotid intima mediathickness and its association with diabetes were analyzed by Student’s t test. P-value of <0.05was considered significant. Among the diabetic patients the relationship of glycemic controland carotid intima media thickness was analyzed through student’s t-test. P-value of <0.05was considered significant. The association of presence of carotid plaque for diabetic and nondiabeticsubjects was assessed by Chi-square test. P-value of <0.05 was taken as significant.Association of carotid plaque among diabetic patients with satisfactory and unsatisfactoryglycemic control was also assessed through the Chi-square test and p-value of<0.05 wasconsidered significant. Result: Out of the total study population of 237 subjects, which consistedof 119 diabetic and 118 normal controls, there were 105 male and 132 female patients. Themean fasting blood sugar was 113.3±55.2 mg/dl, mean random blood sugar was 185.9±102.0mg/dl, mean HbA1c was 6.98±2.5 %. Mean ±SD of carotid intima media thickness was0.91±0.17 mm. Results revealed that diabetes has significant association with the thicknessof carotid intima media (p-value<0.000). A total of 28 individuals (11.8%) had a carotid intimamedia thickness that was classified as a localized carotid artery plaque. The presence of carotidplaque also showed a significant association with the presence of diabetes. The degree ofglycemic control showed no relationship with carotid intima media thickness. The presenceof carotid plaque also showed no association with degree of glycemic control. Conclusion:CIMT measured by Doppler ultrasonography was found to be significantly associated with thepresence of diabetes mellitus. There was no relationship of glycemic control with CIMT amongthe diabetic patients.


2021 ◽  
Vol 9 (11) ◽  
pp. 27-34
Author(s):  
Mansour M.A. Ghaleb ◽  

Background: Diabetes mellitus is one of the most common chronic diseases in nearly all countries. The most common type is type 2 diabetes.Dietarypractices of diabetes mellitus patients type 2 in relation with demographic variables at private and government hospitals in Sanaa city, Yemen the objective of present study. A hospital-based cross - sectional descriptive study conducted from October 2018 to May 2019, among adultsfrom both gender attended to the selected hospital in Sanaa to receive health service. A prepared questionnaire was used for data collection. Data analyzed by using SPSS softwareversion 20 was used. Descriptive statistics were performed to describe the socio-demographic and dietary practices variables. Data described by frequencies and percentages and presented in tables. Chi square test was used to test differences in dietary practicesin relation with demographic variables. Test considered to be significant p value < 0.05. The sample was formed of 200 adult diabetic patients, more than half (53.5%) were females. Ages of participant ranged between 25 years and 80 years, with a mean of 52 ± 11 years. Illiterate women represented 62% of total women, while illiterate men represented 13% of total men. Nearly half of participants had poor dietary practices (45.5%) towards diabetes.There was a better score of good & acceptable dietary practices tend to be more in private hospitals.There is a need to strengthen good dietary practices through health education.


2019 ◽  
Vol 23 (3) ◽  
pp. 188-192
Author(s):  
ABDUL MAJID ◽  
MUHAMMAD FAROOQ ◽  
MUHAMMAD SHAKIR ◽  
ZUBAIR MUSTAFA KHAN ◽  
SAJID IQBAL

Objective: The objective of this study was to compare the role of early and late tracheostomy in patients presenting with severe head injuries.Material and Methods: This randomized controlled trial study was conducted in the department of neurosurgery, Lahore General Hospital Lahore from March 2018 to August 2018, after taking approval from the ethical committee. A total of one hundred and thirty patients was divided randomly into early (within three days) and late(after three days) tracheostomy groups. After tracheostomy, data regarding acute physiology, age and chronic health evaluation II (APACHE II), the total number of days since ventilation, tracheostomy, weaning, discharge from ICU and hospital, complications and mortality were noted. All the data was entered and analyzed with SPSS23.0. Quantitative variables were presented as mean and standard deviation, qualitative variables were presented as numbers and percentage. The Chi-square test was applied. A p-value of ≤0.05 was considered significant.Results: The mean age of the patients was 33.13 ± 2.53 years. There were 84 males (64.61%) and 46 females (35.38%) in the study. The duration of mechanical ventilation, ICU stay and stay in hospital for early and late tracheostomy groups were 25.68 ± 2.94 vs. 33.37 ± 3.32 days, 29.42 ± 2.97 vs. 38.54 ± 3.80 days and 37.20 ± 2.98 vs. 47.15 ± 3.84 days respectively. Four patients (3.08%) and seven patients (5.38%) suffered from mortality.Conclusion: Early tracheostomy among the patients presenting with severe head injuries was associated with a better outcome than late tracheostomy.


Author(s):  
Tamojit Chatterjee ◽  
Shrutakirti Ghosh ◽  
Rinki Saha ◽  
Sandip Samaddar

Introduction: Conjunctiva is a transparent mucous membrane that lines inside of the eyelids and covers the sclera. It is composed of non keratinised, stratified columnar epithelium with goblet cells. Normal microbial flora constitutes organisms which are present in eyelids and conjunctiva without causing any disease. At birth eyes are sterile but they are later infected by various organisms. Gram positive organisms are mostly prevalent in ocular flora. Diabetes mellitus is a multifactorial disease that can affect all ocular structures. Aim: To compare the microbial flora between diabetic and non diabetic patients and to study there sensitivity to antibiotics. Materials and Methods: This was an analytical study conducted on a total of 100 patients attending Department of Opthalmology of Medical College and Hospital, Kolkata, India between June 2019 to July 2019. They were not using any topical ocular preparation. Conjunctival swab was taken from upper fornix of the patients and cultured and the results obtained were analysed using Chi-Square test. Results: Conjunctival flora of a total of 100 patients, 30 diabetic and 70 non diabetic, were screened. Among the 30 diabetic patients, there were 15 (50%) male and 15 (50%) female. The most common isolated bacteria in diabetic and non diabetic groups were staphylococcus aureus (diabetic 70%, non diabetic 85.7%). There was a statistically significant difference in microbial flora pattern between the diabetic and non diabetic group. There was higher proportion of staphylococcus epidermidis among diabetic patients compared to non diabetic patients (p-value<0.01) and there was a higher proportion of staphylococcus aureus among non diabetics (p-value<0.01). Conclusion: Present study found statistically significant difference in the microbial flora between diabetics and non diabetics. This will help the clinician to plan for the antibiotic prophylaxis before surgery for patients attending the Out Patient Department (OPD).


Author(s):  
Esmaeel Alsayed Mohamed ◽  
Nisha V Parmar ◽  
Amani Al Falasi

Introduction: Vitiligo is an acquired autoimmune disorder of depigmentation with a global prevalence of 1%. Phototherapy with Narrowband Ultraviolet B (NBUVB) light and excimer laser are both FDA approved treatments for vitiligo. Studies comparing the two modalities are few in patients with different skin colors. Aim: To compare the efficacy and safety of NBUVB versus excimer laser in vitiligo in terms of re-pigmentation achieved during treatment and side effects. Materials and Methods: This study was a retrospective chart review of vitiligo patients attending the phototherapy unit from January 2016 to August 2018. Patient profiles including age, gender, site and extent of vitiligo, type of phototherapy treatment (NBUVB vs excimer laser), sessions per week, sessions required for onset of repigmentation, sites of repigmentation, and side effects were noted. Qualitative variables were analysed using Chi-square test. Quantitative variables were analysed using mean and Standard Deviation (SD). A p-value of <0.05 was considered statistically significant. Results: A total of 146 patients aged 4-70 years were included. Ninety-six patients received excimer laser and 50 patients were on NBUVB. Initial repigmentation occurred after a mean±SD of 28.91±16.61 sessions in the NBUVB group and 24.26±17.57 sessions in the excimer laser group. The difference was not statistically significant (p=0.18). Repigmentation occurred faster on the face followed by the trunk in both groups. Side effects were higher with excimer laser compared to NBUVB (90.6% versus 76%) and the difference was statistically significant (p=0.017). Side effects were, however, mild and did not warrant treatment discontinuation. Conclusion: Number of sessions required for onset of repigmentation was similar in both groups. Side effects, although more frequent with excimer laser, were mild and required dose reduction rather than discontinuation of treatment.


Sign in / Sign up

Export Citation Format

Share Document