Low plasma HDL-C levels are positively associated with premature coronary heart disease in patients ≤55 years. As only small sample size case-control studies were found to focus on this age group in the last 10 years, additional population-based cohort studies with large samples are necessary.
Background: Electrical injury and its consequences after exposure to electric shock has been associated with an increased risk of developing immediate and delayed cardiac arrhythmias. The aim of this study was to evaluate the prevalence of cardiac arrhythmias and different symptoms in patient with high voltage and low voltage electrical injury. Methods: All 50 consecutive patients who were admitted in Chitwan Medical College from April 2018 to March 2020 were prospectively studied. Patients were categorized into high and low voltage injury group and their variables were compared. Results: The mean age of the patients was 32.3±10.4 years among them 41 (82%) were male. Patients who sustain high voltage electrical injury (>1000V) were 18 (36%) and low voltage injury (<1000V) were 32 (64%). Cardiac arrhythmias like sinus tachycardia (11.1% vs 6.2%, p=0.054), sinus bradycardia (11.1% vs 3.1% p=0.254), ventricular premature beats (5.6% vs3.1%, p=0.674), atrial fibrillation (11.1% vs 0%, p=0.054) were observed in high voltage and low voltage group. The commonest presenting symptoms in both groups were pain (77.8% vs 84.4% p=0.560) and fatigue (55.6% vs 40.6%, p=0.328). Conclusion: In this study few non fatal cardiac arrhythmias were observed in both high and low voltage electrical injury group. There is no significant difference in the presenting symptoms and types of arrhythmias observed between low voltage and high voltage injury group.
Nirmasi is a commonly used herb in Nepal especially in hilly and Himalayan regions. It is known as Delphinium species herb. Nirmasi has been used in Nepalese and Indian rural communities since ages for treatment of chronic illnesses like headache, epilepsy, mania, paralysis, rheumatism, toothache, and various types of pain. However, many species of Nirmasi (Delphinium) are poisonous and look quite similar in morphology to the beneficial ones. As a result, unintentional poisoning is common. Poisoning due to these plant products results in various symptoms attributed to gastric irritation, competitive neuromuscular blockade, and cardiotoxicity caused by various alkaloids present in them. We report here a case of poisoning due to Nirmasi herb ingestion presenting as epigastric pain, vomiting, profuse sweating, syncopal attack, hypotension and malignant ventricular arrhythmias managed successfully with antiarrhythmics and supportive treatment.
Introduction: Information on the cardiac manifestations of coronavirus disease 2019 (COVID-19) is scarce. In this study we assessed the echocardiogram of consecutive patients with COVID-19 infection to assess the frequency of cardiac abnormalities. Materials and Methods: This retrospective descriptive study examined the echocardiographic study of 43 patients with severe and critical COVID-19 infection admitted at the ICU of Chitwan Medical College from May 16, 2021 to June 05, 2021. The study focused on left ventricle (LV) and right ventricle (RV) function. The results were then compared between severe and critical infections to examine if any differences exist between them. Results: The mean age of the study population was 54 years and predominately males. One-third were classified as critical COVID-19 while the remaining were severe COVID-19. Majority(83.7%) had a normal echocardiogram. Among the patients with abnormal reports, the distribution of echocardiographic pattern were biventricular dilation with biventricular dysfunction in two patients (4.6%), LV dialtion with LV dysfunction in two patients (4.6%) and isolated LV dysfunction (diastolic and systolic) in three patients (6.9%). None of the echocardiographic parameters were significantly different between the severe and the critical infection. Conclusion: COVID-19 in primarily a respiratory disease and the cardiac complications is largely attributed to the critical nature of the illness than the specific infection. Considering the risk of infection spread, routine echocardiography for all patients with COVID-19 infection is not advisable.
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