Background: Frequency of fatal and nonfatal cardiovascular events increase even in early stages of chronic kidney disease (CKD). This study was aimed to understand the cardiovascular profile of patients with CKD.Methods: This observational study was conducted on patients who were admitted with chronic kidney disease in Sri Venkateswara Rama Narayan RUIA Government General Hospital, Tirupati. Patients were classified according to their severity of CKD. All patients had an electrocardiogram and echocardiogram. Results of various biochemical investigations, electrocardiogram and echocardiogram were compared between patients with mild, moderate and severe CKD.Results: Combined diabetes mellitus and hypertension was found to be the most common case of CKD in Authors patient population (43%), followed by diabetes mellitus alone (37%). Serum creatinine and blood urea nitrogen were found to be significantly higher and creatinine clearance and haemoglobin were significantly lower among patients with severe CKD. Electrocardiography revealed 50% had left ventricular hypertrophy (LVH), 30% had tall ‘T’ waves and 15 % had ST-segment changes. Mean inter-ventricular septal end diastole thickness and mean left ventricular mass was found to be significantly in patients with severe CKD as compared to mild CKD.Conclusions: Extensive cardiovascular evaluation of patients with CKD is warranted even if the classical symptoms are not absent and early cardiovascular rehabilitation should be instituted in such patients.
Background: Homocysteine has primary atherogenic and prothrombotic properties. The present study aimed to assess serum homocysteine levels in patients with ischemic stroke and to find association of serum homocysteine levels with various patient related variables.Methods: This observational study included patients who were admitted with the diagnosis of stroke in Sri Ventateswara Ramnarain Ruia Government General Hospital. Patients were evaluated for risk factors like hypertension, diabetes mellitus and hyperlipidemia. Total homocysteine estimation was done and survival of the patients was assessed at the time of discharge from the hospital.Results: Most common risk factor for stroke in our study population was dyslipidemia (40%), followed by hypertension (36%). Total homocysteine levels were raised in 92% of the patients. Patients with homocysteine levels less than 15mM/L had lacunar infarcts. Homocysteine levels higher than 100mM/L were found in 18% of the patients and they all had large sized lesions. Significantly higher mean homocysteine levels were found among patients with large lesions (70.15±2.65 vs 21.68±8.02, p value <0.05). Among various risk factors, higher mean homocysteine levels were found to be associated with dyslipidemia (p value <0.05). No association between hypertension, diabetes mellitus or smoking history was found with higher homocysteine levels. Patients who survived had significantly lower homocysteine levels as compared to non survivors (39.3±19.84 vs 100±18.82, p value<0.001).Conclusions: Further studies are needed on homocysteine and stroke fur using homocysteine as screening test and for initiation of preventive therapy of stroke based on homocysteine levels.
BACKGROUND Vitamin D deficiency is highly prevalent worldwide, and is also noted to be high in India. Low levels of 25(OH) D, the principle circulating storage form of vitamin D, is present in as many as one third to one half of otherwise healthy middle aged to elderly population. Endothelial dysfunction plays an important role in pathogenesis of CAD and vitamin D deficiency is postulated to promote endothelial dysfunction. Because hypovitaminosis D is prevalent and easily correctable, establishing the relationship between vitamin D and risk of acute coronary Syndrome is important. Objectives-1. To estimate vitamin D levels in IHD patients, 2) To correlate vitamin D levels with complications of IHD. MATERIALS AND METHODS A Cross Sectional study of 80 patients admitted to BLDEU's Shri B. M. Patil Medical College Hospital and Research Centre, Vijayapura between December 2014 to March 2016 with diagnosis of IHD. Patients aged more than 18 years were included in studies. The Vitamin D levels were analysed in all the patients and correlated with different parameters for statistical significance. RESULTS During our study period 80 patients were assessed as mentioned above. The mean age of our study group was 58.5 ±9.6 years. Of the study population, there were 57 male patients and 23 were females accounting to 71.2 % and 28.8 % respectively. Out of 80 patients 66 had Vitamin D deficiency in 45 were males and 21 were females. In that 34 patients had heart failure with hypotension and 1 had ventricular tachycardia, I had Left Ventricular Apical clot. CONCLUSION There is a high prevalence of Vitamin D deficiency (82.5%) among acute coronary syndrome patients. The mean age group is 58.5±9.6 years. Vitamin D deficiency is associated with increased risk of complications (75.75%) in acute coronary syndromes. Vitamin D deficiency is one of the independent risk factor for acute coronary syndrome. Vitamin D deficiency is noticed more in STEMI. Vitamin D deficiency in females was more common than compared to males.
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