Introduction: The prevalence of LV dysfunction is probably high in COPD patients because this condition shares common risk factors. The diagnosis of left heart failure is difficultin the early phases of COPD and also during exacerbation due to similarities in signs and symptoms. Bio-markers like hsCRP is found to be elevated in stable phase as well as in exacerbation of COPD. Objectives: To assess LV Dysfunction (Systolic and Diastolic) and to correlate Age, Symptoms, Duration and stage of illness, CRP with LV Dysfunction. Methods: Total 100 patients of which 50 were age and sex matched controls not having COPD complying with Inclusion and Exclusion Criteria. After taking history and clinical examination they were evaluated for COPD and Left ventricular Dysfunction using PFT and Echocardiogram. Results: Out of 50 patients, 37 patients (74%) had Diastolic dysfunction, of them 2 patients had Systolic dysfunction also. 13 patients were normal. In the control group only 4 had Diastolic Dysfuncion.CRP was high in 35% (70%) of patients. In the higher age group of 50-60 years Diastolic dysfunction was significant. In patients of GOLD stage IV 5 out of 5 patients (100%) whereas in GOLD stage I and II it was in 1 case (16.66%) and21 case (80.76%) respectively. While comparing with the control group incidence of LV dysfunction parameters and CRP is more in case group. Conclusion: There is increased incidence ofLV Diastolic dysfunction and also with advanced GOLD stage. CRP also correlates well LVDD. Therefore it is pertinent to explore LVDD in all patients with acute exacerbation of COPD and advanced disease stage.
Introduction: Scleroderma is a connective tissue disease characterized by brosis affecting the skin and internal organs.Joint involvement has been reported to occur in 46%- 97% of SSc patients. Bone and soft tissues may also be targeted; calcinosis and acro-osteolysis are thought to be the main characteristic ndings in SSc. Pulmonary disease in SSc falls into two major categories: interstitial lung disease (ILD) and pulmonary hypertension. Using PFTs, signicant pulmonary involvement is detectable in 25% of the patients with SSc within 3 years of initial diagnosis. The gold standard for determination of PAH in patients with SSc is right heart catheterization. The HRCT features of lung disease are ground-glass opacication predominant or admixed with reticular abnormalities in the majority of cases and little or no honeycombing. To study the demographic prole, Clini Aims and Objectives: cal Manifestations, Radiological abnormalities, Lung involvement and PAH. 35 newly diagnosed Sclederma patients Materials and Methods: attending Medicine and Rheumatology OPD of Medical College Kolkata were studied in this Cross-sectional observational study. Clinical Manifestations are noted and Radiological Investigations were recorded in structured Proforma. Data analysed using standard statistical methods. In Results and Analysis: our study, the study population had an F: M ratio of 10:1. majority of population (38%) having age group(30-40) yrs followed by less than 30 yrs & 41yrs or more (31% each). In our study clinically hand abnormality was evident in 69% patients & radiologically hand abnormality was evident in 74% patients. In our study population 29% patients have had acroosteolysis, 26% patients had erosion & 19% patients had exion contracture. In our study we found all the patient with documented ILD had abnormal PFT. In our study group restrictive pattern in PFT was evident in 63% patients & mixed pattern was evident in 23% patients. Twelve patients (35% of the total cohort) had pulmonary hypertension dened as PAs of 30 mm Hg or greater. In our study we found Out of 30 patients with documented ILD in HRCT 20 patients had PAH & 10 patients had no PAH. Females are more affected than males. Majority Conclusion: of the patients affected are in the age group of 30-40 years.69% patients had clinically evident hand abnormality and 74% patients had radiologically evident hand abnormality.CXR showed ILD in 63% patients whereas86% patients had documented ILD in HRCT.Restrictive pattern of PFT abnormality is more than mixed pattern.57% patients had documented PAH in echocardiography.HRCT is more sensitive than chest radiography for detection of ILD.
Introduction:Acute Myocardial infarction is one of the leading causes of morbidity and mortality worldwide. Cardiogenic Shock is the leading cause of death in patients hospitalised for acute MI. Although there is substantial evidence for a benefit of reperfusion therapy for ST elevation MI, the best treatment strategy for patients with non-ST segment elevated MI is less well defined. Outcome and prognosis differs with the presence or absence of ST segment elevation. Most of the studies have been done on urban population. Objective: To determine the frequency and profile of Non-ST elevated MI. Any differences in profile in a Rural population with different social and economic structure will also be documented. Methods: In this descriptive crosssectional study conducted in Medicine department, Malda Medical College &Hospital,WestBengal,India 100 patients of non STEMI are selected by using consecutive non probability sampling technique. After taking ethical clearance from Institution and consent from patients and their relatives, 100 patients of non STEMI are enrolled as per inclusion and exclusion criteria. They are evaluated for cardiogenic shock on the basis standard clinical examination and are managed as per protocol. All relevant data are recorded in predesigned proforma. Results: Out of 100 patients, 68 are male and 32 are female. Mean age of the patients is 60 + 1.26 years and majority of them are in the age group of 61-70 years(41%). 5% patients of non STEMI developed cardiogenic shock and majorities are male and more than 50% of patients with cardiogenic shock with non STEMI are above 70 years old. Conclusion: Frequency and Profile is comparable to other studies. This rising trendin a rural population of a developing country is due to probably more urbanisationrelated to change in food habits and life style changes.
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