BACKGROUND Acute coronary syndrome is a set of signs and symptoms due to rupture of a plaque and is a consequence of platelet rich coronary thrombus formation. Platelet parameters, especially MPV could be an important and reliable marker in early detection of acute coronary syndrome when other markers are not available. Aim-To study the effect of platelet count and their indices, platelet volume and platelet distribution width and their prognostic significance in acute coronary syndrome. MATERIALS AND METHODS This was a case control study, and sample size was taken for convenience. Patients admitted to Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai during the period extending from April 2016 to September 2016, were included in the study for convenience sake. A total of 100 patients were included in the study, in which 50 patients were cases admitted with chest pain and diagnosed as ACS. The control group considered of 50 age matched subjects who were admitted for chest pain evaluation and subsequently found to be non-cardiac chest pain after performing relevant investigations. Blood samples were taken at the time of admission for platelet parameters. RESULTS A total of 50 patients with acute myocardial infarction and 50 age matched controls were studied. The mean platelet count of the cases was 4.98±0.23 lakhs/mm³ and that of controls was 1.29±0.42 lakhs/mm³. Mean Platelet Volume (MPV) was significantly elevated in acute myocardial infarction (10.2±1.1 femtolitres) when compared with controls (8.29±0.9 femtolitres). CONCLUSION Platelet parameters mainly MPV and PDW are readily available and relatively simple and inexpensive laboratory tests, which were detected to be significantly raised in patients who have suffered an acute coronary syndrome.
BACKGROUNDRabies is a preventable viral disease. In India, rabies is transmitted to humans mainly by dogs. Rabies has an incubation period lasting for several days to months or years. Here, we report a case of a young male who presented with aerophobia and hydrophobia, about twenty years after a suspected rabid dog bite, thus suggesting that rabies virus may have an unusually long incubation period.
BACKGROUND Glycated haemoglobin (HbA1c) is used as a gold standard for monitoring glycaemic control of patients and is used as a predictor of diabetes-related complications. The HbA1c fraction is abnormally elevated in chronic hyperglycaemic states, like diabetes mellitus and it correlates positively with the glycaemic as well as metabolic control. Conditions that affect erythrocyte turnover affect HbA1c levels. The aim of this study was to determine the effect of microcytic anaemia on the HbA1c levels in non-diabetic patients, so as to analyse whether microcytic anaemia influences the HbA1c levels. MATERIALS AND METHODS A descriptive comparative study with a convenient sample size of 100 non-diabetic, anaemic patients and 100 age-matched nondiabetic non-anaemic controls were chosen. The patients who had glucose tolerance abnormalities (Impaired glucose tolerance or diabetes mellitus), blood loss, haemoglobinopathies, haemolytic anaemia, infestation, chronic alcohol ingestion and chronic liver or renal failure were excluded from the study. Relation of HbA1c with MCV was calculated using Chi square test. And also, HbA1c levels were compared between both the groups and analysed using independent t-test and its correlation with microcytic anaemia was calculated. RESULTS The mean HbA1c level of the non-diabetic patients with microcytic anaemia (6.89 ± 0.55 %) was higher than that in the nonanaemic controls (5.35 ± 0.28 %) (p< 0.001). CONCLUSION Microcytic anaemia definitely has an impact on the HbA1c levels. In patients with microcytic anaemia, as the MCV decreases, the values of HbA1c tends to rise spuriously, probably because, the glycation of the globin chain, in the relative absence of iron would occur more readily.
BACKGROUNDHepatic encephalopathy (HE) is a potentially reversible, metabolically caused disturbance of central nervous system function that occurs in patients with acute or chronic liver disease. It encompasses a board spectrum of neurological symptoms of varying severity and is classified according to clinical symptoms. Minimal hepatic encephalopathy (MHE), previously known as subclinical or latent hepatic encephalopathy, is at the beginning of this spectrum. MHE has a high prevalence among patients with liver cirrhosis (22% to 74%). 1 It is defined as HE without symptoms on clinical/neurological examination, but with deficits in some cognitive areas that can only be measured by neuropsychometric testing and critical flicker frequency test. The areas with impairments are attention, visuospatial perception, speed of information processing, especially in the psychomotor area, fine motor skills, and short-term memory leading to impaired quality of life and ability to work associated with driving errors, accidents and further deterioration into overt encephalopathy and thereby with increased mortality. In our study, we study the effectiveness of Psychometric tests and Critical flicker frequency test in detecting minimal hepatic encephalopathy earlier in patients with cirrhosis.
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