Background: Stroke is an important health problem causing of morbidity and mortality globally. Serum ferritin has gained clinical significance as a prognostic factor that can aggravate the cytotoxicity of brain ischemia. The present study investigated the prognostic significance of serum ferritin levels with the severity of stroke using NIHSS scale.Methods: It was a prospective observational study conducted on 60 patients with acute ischemic stroke admitted in the general medicine department of a tertiary care teaching hospital. Serum ferritin levels were assessed on all participants using the instrument “immulite”. National institute of health stroke scale scoring was applied at the time of admission and on the seventh day to assess the impairment caused by a stroke. IBM SPSS version 22 was used for statistical analysis.Results: The mean serum ferritin levels at admission in patients with severe stroke, moderate stroke and mild and less stroke were 337.41±58.76, 285.56±49.37, and 197.91±111.01 ng/mL, respectively. The mean serum ferritin levels at admission were 178.76±114.70 ng/mL and 341.91±62.292 ng/mL in subjects who did not deteriorate and those who deteriorated, respectively. Whereas the mean serum ferritin levels on the sixth day were 198.34±106.88 and 348.10±57.34 ng/mL in subjects who did not deteriorate and those who deteriorated, respectively.Conclusions: Serum ferritin has a significant positive correlation with the severity of acute ischemic stroke severity on admission (p<0.001) and negative correlation with the severity of acute ischemic stroke severity on seventh day of admission (p<0.001). Thus, serum ferritin can be used as a prognostic marker in acute ischemic stroke.
The coronavirus disease (COVID-19) pandemic has incurred high costs for the entire planet. The complex interactions between the host, virus, and environment have resulted in various clinical outcomes. It is crucial to comprehend sickness severity and outcome predictors to provide early preventative measures for a better outcome. The current study aimed to determine the association of clinical and inflammatory profiles with the outcome of COVID-19 infection in patients admitted to the intensive care unit. MethodsThis retrospective study was done in patients admitted to intensive care units for COVID-19 with a positive reverse transcriptase polymerase chain reaction (RTPCR) assay. A total of 125 patients above 18 years were included in the study. The patient's age, gender, and co-morbidities like type 2 diabetes mellitus, hypertension, respiratory illness, and coronary artery disease were noted. The patient's symptomatology, vital signs, oxygen saturation (Spo2), need for inotropes, and non-invasive positive pressure ventilator support (NIPPV) were observed. Computed tomography severity score (CTSS) and hematological and inflammatory parameters at the time of admission were noticed. Patient's management and treatment outcomes as survivors and non-survivors were noted. ResultsThe mean age was significantly greater in non-survivors. The common symptoms were fever, respiratory distress, cough, muscle pain, and sore throat. The leucocyte count, C-reactive protein (CRP), urea, creatinine, interleukin-6 (IL-6), and lactate dehydrogenase (LDH) were greater, and platelet counts were lower significantly in the non-survivors group. On multivariable logistic regression, CT severity score, NIPPV, and IL-6 had an odds ratio of 1.17, 0.052, and 1.03, respectively. IL-6 had a sensitivity of 81.5% and a specificity of 81.8% with a cut-off value of 37.5. ConclusionVigilant monitoring of leucocyte count, CRP, urea, creatinine, IL-6, LDH, platelet count, and CT severity score is essential for managing COVID-19 infection. IL-6 was found to be a significant marker as a predictor of outcome in our study.
Introduction: Breast feeding of infants and young child is the natural and effective method which plays a major role in reducing the mortality of infants and under five children. There is significant reduction in the morbidities in the above age due to breast feeding. Inadequate knowledge and poor practices of breast feeding hinders the successful establishment of breast feeding. Objective: To determine the breast feeding and complementary feeding practices of mothers with children of age below 3 years from rural area who visited the outpatient department of paediatrics of karpagavinayaga institute of medical sciences, Kancheepuram, Tamilnadu. Materials and Methods: This was across sectional study done in hospital from 2017 September to 2018 January for a total duration of five months with structured questionnaire. Results: Exclusive breast feeding was given to 68.7% (n=76) of children. About 69.5% of the mothers had initiated the breast feeding within one hour of delivery. About 89.6% had given colostrum. Prelacteal feeds were given in 10.4%. Only 32.2% of mothers fed their babies on demand. Complementary feeding was started after six months by 80.9% mothers. Complementary feeding was started with homemade food by 49.6% of mothers. Conclusion: This study emphasis on education of mothers during their antenatal care, postnatal care and follow up care by obstetricians, paediatricians, residents and staff nurses regarding the importance of breast feeding and their advantages for better outcome in terms of reducing the morbidities and mortality in children below five years.
Objectives Metabolic syndrome (MS) is a collection of metabolic disorders including hyperglycemia, hypertension and dyslipidemia. The outcome of metabolic syndrome depends on structural changes in heart like increased left atrial size or increased left ventricular mass. This study was done to determine the echocardiography abnormalities in metabolic syndrome. Methods After obtaining informed consent, 75 subjects with metabolic syndrome and 75 controls were included in the study. 2D echo/M mode examination was performed for all. Aortic root, left atrial size, left atrial volume, septal wall thickness during systole (SWs) and diastole (SWd), posterior wall thickness during systole (PWs) and diastole (PWd), left ventricle dimension during systole (LVDs) and diastole (LVDd), and ejection fraction were measured. The values were compared between the groups. Results After adjustment for age, sex, smoking, alcohol and BMI; left ventricular diameter in systole and diastole was significantly more than controls (p<0.001); HR of 1.29 (95% CI 1.13–1.46), 1.29 (95% CI 1.15–1.45) respectively. Left ventricular mass and left atrial volume were increased significantly in subjects with metabolic syndrome (p<0.001); HR were 1.06 (95% CI 1.03–1.08), 1.13 (95% CI 1.06–1.19) respectively. Ejection fraction was low normal in subjects with metabolic syndrome compared to controls (p<0.05); HR 0.90 (95% CI 0.83–0.98). Conclusions Cardiac abnormalities were common in subjects with metabolic syndrome, predominantly affecting the left ventricular mass, diameter and left atrial volume. Early life style modifications are essential to prevent these complications.
Background: Urinary albumin excretion between 20 to 200 mg per litre is defined as microalbuminuria (MAU). MAU acts as a marker for endothelial cell destruction and is associated with atherosclerosis in both diabetics and non-diabetics. This study aimed to assess the MAU prevalence in nondiabetic patients with myocardial infarction.Methods: A cross-sectional study was conducted at tertiary care hospital. Among non-diabetic patients with myocardial infarction. The study was conducted from October 2019 to March 2020. All patients were subjected to complete physical examination, electrocardiography (ECG) and echocardiography. Quantitative determination of MAU was done in a urine sample. Diagnostic coronary angiogram was performed for all patients. Appropriated statistical tests were applied.Results: Among 80 study participants, 73.75% were men, and 26.25% were women. Smoking habit was present among 60%, and 56.25% were hypertensive. The prevalence of microalbuminuria was 27.5%. A statistically significant difference was seen between TIMI scoring and presence of MAU (p<0.001). The difference in vessels type between the microalbuminuria status was found to be significant (p=0.005).Conclusions: Evidence from this study shows that the presence of MAU had a strong association between myocardial infarction and its application as a risk factor of cardiovascular diseases in general non-diabetic population proves practical.
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