BACKGROUND Congenital heart diseases are the most common congenital malformations and account for 6-10% of all infant deaths. Congenital heart defects affect 8 to 10 out of every 1000 live births. Pulse oximetry in newborn screening can detect mild hypoxemia that may not be recognised by clinical examination. Thus, pulse oximetry can help to identify babies that may be affected with critical congenital heart disease before they leave the newborn nursery. There are many studies carried out on pulse oximetry with different sensitivity and specificity for detection of congenital heart disease. The objectives of the present study were to screen all newborns admitted in NICU to rule out congenital heart disease before discharge and to find out the utility of pulse oximetry to detect congenital heart disease. METHODS This prospective study was conducted in Neonatal Intensive Care unit, Gauhati Medical College and Hospital in 1720 neonates over a period of 12 months (February 2015 to January 2016). Both pulse oximetry and clinical examination were done. Persistent pulse oximetry (SPO2) reading below 95% or more than 3% difference between right hand and one foot, it was considered as positive pulse oximetry. Newborns with positive pulse oximetry and abnormal clinical examination findings were subjected to echocardiography. RESULTS Positive pulse oximetry cases were 47(2.73%), out of which 39 cases had only positive pulse oximetry (with negative clinical examination). Positive clinical examination cases were 58(3.37%), out of which 50 cases had only positive clinical examination findings (with negative pulse oximetry). Eight (8) cases had both positive pulse oximetry and positive clinical examination. Total congenital heart disease cases detected in our study was 34(1.98%) out of 1720. VSD was the most common CHD followed by PDA, TOF, TGA in this study. The sensitivity, specificity, positive predictive value and negative predictive value of pulse oximetry were 41.18%, 98.04%, 29.79%, 98.80% respectively. CONCLUSION Pulse oximetry is a useful tool to detect congenital heart disease. Its accuracy in detecting congenital heart disease increases if combined with positive clinical examination.
Background: Diabetes mellitus is one of the most common metabolic disorder with its increasing incidence world wide. Thyroid dysfunction is another common endocrine disorder frequently encountered in clinical practice(1). The association between diabetes mellitus and thyroid disorder is widely known. Under this backdrop, the present study was undertaken with the following aims and objectives. 1) To know the prevalence of thyroid dysfunction in Type 2 diabetes mellitus. 2)To know the spectrum of thyroid dysfunction in Type 2 diabetes mellitus. Methods: This hospital based prospective study was conducted in the department of Medicine, FAA Medical College & hospital, Barpeta, Assam, India over a period of one year from May 2015 to April 2016. A total number of 120 patients with Type 2 diabetes mellitus were included in the study. Data collection was done by history taking, clinical examination and essential laboratory tests. Results: Out of 120 patients , 27 (22.5%) had thyroid dysfunction and remaining 93 patients had normal thyroid function. In this study, out of 27 thyroid dysfunction patients, 8 (6.6%) had clinical hypothyroidism , 17 (14.1%) had subclinical hypothyroidism and 2 (1.6%) diabetics had hyperthyroidism. Thyroid dysfunction was seen more in female 18 (15%) cases than in male 9 (7.5%) cases. Thyroid dysfunction was more common in diabetic patients above 60 years of age. Further, diabetics with microvascular complications had more thyroid dysfunctions. Conclusion: In conclusion, the present study showed a high prevalence of thyroid dysfunction (22.5%) among the diabetic patients studied. Subclinical hypothyroidism was more common than clinical hypothyroidism. It is known that undiagnosed thyroid dysfunction in diabetics increases the cardiovascular risk in these patients. Hence, screening for thyroid dysfunction among diabetic patients should be routinely performed to reduce the morbidity and mortality.
BACKGROUND Guillain-Barre syndrome (GBS) is a rare, immune mediated disorder which is associated with demyelination of peripheral nervous system and progressive muscle weakness, with an annual global incidence of approximately 1–2 per 100,000 person-years. GBS has an unpredictable clinical course with up to 30% of patients requiring assisted ventilation during the course of their illness. Recent advances in the eld of critical care has successfully improved the outcome of GBS. Successful management mandates anticipation, prompt recognition of modiable risk factors and optimal treatment of neuromuscular respiratory failure in GBS. There is limited Indian data with regards to the early determinants and outcome of severely affected GBS patients. Knowledge of early predictors can substantially improve patient care and provides essential data for triage at an early stage in the course of the illness. OBJECTIVE 1. To study the clinical, electrophysiological prole, progression and outcome of GBS in a tertiary care hospital. 2. To determine the factors associated with the poor functional outcome, including the need for mechanical ventilation. MATERIALS AND METHODS This was a single centre, prospective study with 50 patients with GB syndrome, conducted from from 1st June 2021 to 30th May 2022 for a period of 1 year at Gauhati Medical College and Hospital. Their clinical, electrophysiological, CSF parameters were analysed. Hughes grading, EGRIS, mEGOS, MRC sum score were used. Any clinical deterioration and need for mechanical ventilation were noted carefully. Patients were followed up at 3 months and 6 months at assess their outcome. The mean age of the patients was 30.5 RESULTS years with a male female ratio of 1.3:1. AIDP was the most prevalent subtype found in 23(46%) patients followed by AMAN in 14(28%), AMSAN in 9(18%) and 4(8%) cases were unclassied. 32(64%) had severe disease with Hughes score ≥ 4 and 28(56%) had MRC score <40 at presentation. Respiratory distress was found in 17(34%) of patients, and out of which 10(20%) required mechanical ventilation. During the study 2(4%) patients died of complications. At 3 months, 30(60%) patients had complete recovery, 12(24%) had partial recovery and 6(12%) had poor recovery. At 6 months, 35(70%) had good recovery, 9(18%) had partial recovery and 4(8%) had poor recovery. Delayed CONCLUSION presentation, early peak of illness, prolonged Hospital stay, bulbar weakness, neck exor weakness, bilateral facial weakness, quadriparesis, respiratory distress, need for mechanical ventilation, autonomic dysfunction; high Hughes grading, low average single breath count along with high EGRIS, mEGOS, MRC sum score, high CSF protein, albumin-cytological dissociation, presence of F-wave abnormalities and Non stimulable nerves or Inexcitable nerves on NCS, AMAN subtype and systemic complications are associated with poor outcome. The overall outcome of GBS is favourable.
BACKGROUND Anaemia is a very frequently occurring disorder associated with hypothyroidism especially in the elderly age group. Both conditions have similar presentations and are often confused with the nonspecific symptoms of old age. Although there is abundant data regarding relationships between hypothyroidism and anaemia in the general population, studies on the association between anaemia in hypothyroidism in the elderly population and the types of anaemia associated with elderly hypothyroidism are limited. In view of these considerations the current study, conducted at Gauhati Medical College, Guwahati, Assam, aims to seek the morphological types of anaemia associated with elderly hypothyroid patients. METHODS In the study, a total of 125 hypothyroid patients aged 60 years and above attending the outpatient and inpatient ward of the Department of Medicine, GMCH were examined clinically and through necessary investigations and the morphological types of anaemia associated with hypothyroidism were determined. RESULTS It was found that out of 125 elderly hypothyroid patients, the most common morphological type of anaemia was found to be normocytic normochromic type (59.4%) followed by macrocytic anaemia (21.6%) and microcytic hypochromic anaemia (19%). CONCLUSIONS Normocytic normochromic anaemia is the most common morphological type of anaemia associated in elderly hypothyroid patients, followed by macrocytic anaemia and microcytic anaemia.
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