Background: Excretion of albumin in urine, in the range of 30-300 mg/day is called microalbuminuria, which cannot be detected by routine urine tests. The presence of increased UAE (Urinary albumin excretion) signals an increase in the transcapillary escape rate of albumin and is therefore a marker of micro vascular disease. Thus, microalbuminuria is an early response to myocardial infarction.Methods: A prospective study of 50 patients of acute myocardial infarction was carried out to find out the sensitivity and the specificity of microalbuminuria in non-diabetic patients of acute STEMI; to verify the association between the level of microalbuminuria and the area of infarcts; and to establish the correlation of microalbuminuria with cardiac biomarkers.Results: Microalbuminuria test was positive in 92% patients in the study group and 20% subjects in the control group. The sensitivity of microalbuminuria in our study is 92% and the specificity is 80%. The level of Microalbuminuria does not statistically correlate with areas of myocardial infarction.Conclusions: Microalbuminuria is a non-specific yet highly sensitive marker of myocardial infarction and it can be used as an additional biochemical parameter in non-diabetic patients with acute myocardial infarction. Prognostic marker value of microalbuminuria appears unproved.
a b s t r a c tBackground: Malaria is the most important infectious disease of mankind. though, smear examination is gold standard in diagnosing malaria, it has many drawbacks particularly in developing countries. Methods: a prospective study was designed with duration of the study was six months. Based on previous work, we identified the most specific clinical features of malaria and assigned with score. Maximum score was 14. only adult patients with more than 13 years of age with complaint of fever were included for the study. clinical score was calculated for each patient by two different persons (clinician and intern). all the patients were subjected for peripheral smear by specialist or trained person to diagnose malaria. Clinical Score were compared with smear diagnosis of malaria. Sensitivity, specificity, positive predictive value (PPV) and negative predictive values (nPV) for each score were analyzed. receiver operative curve (roc) was prepared to assign a particular score which can diagnose malaria with good certainty. Results: a total of 142 consecutive fever cases were included in the study. 67 (47.18%) cases were of malaria and rests were control cases. Using score of more than eight, the sensitivity, specificity, positive predictive value and negative predictive value of clinical scoring system to detect malaria (either vivax or falciparum) were 95.52%, 85.33%, 85.33% and 95.52% respectively. Using score of more than nine, the same statistics were 91.04%, 93.33%, 92.42% and 92.10% respectively. Using roc curve score more than or equal to nine can give the clinical diagnosis of malaria with good certainty. Conclusion: Score more than nine can be used in clinics to assign as malaria with good confidence and can be treated empirically with antimalarials. this score can substitutes smear examination however, can not replace it. this scoring system is very helpful where smear examination is remote possibility or it can not be relied upon due to technical or staff problem specifically in rural part of India or peripheral health centre with least facilities.
Background: Epilepsy is a neurological condition characterized by the recurrence of paroxysmal episode of abnormal neuronal function. Epilepsy brings in undesirable social, psychological and economical consequences to its patients. In contrast to early onset of epilepsy in childhood, late onset of epilepsy is usually symptomatic; which usually responds well to antiepileptic drugs. Methods: A prospective study of 75 patients of late onset epilepsy was carried out to ascertain the etiology and to evaluate the usefulness of neuroimaging in late onset epilepsy. Results: We found that majority (72%) of patients of late onset epilepsy were male. About 65% of patients had abnormal CT scan-brain findings. Generalized seizure was the most common seizure type with about 59% cases. Conclusions: Generalized seizures are more common in idiopathic group of epilepsy whereas partial with or without secondary generalized seizures are more common in the symptomatic late onset epilepsy. The new neuroimaging techniques should be an integral part of investigation work up in all cases of epilepsy as they make it possible to find out the etiology in majority of cases. In late onset epilepsy, diagnostic usefulness of EEG is corroborative to CT and MRI.
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