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Maheshwari, M.
- Rare Case of Ebstein Anomaly Presented as Supraventricular Tachycardia with Aberrancy in a 40 Year Old Adult Patient
Abstract Views :202 |
PDF Views:0
Authors
S. Samadhiya
1,
T. Nag
1,
M. Palsania
1,
R. Meena
1,
V. Hawa
1,
V. Sharma
1,
S. Chaudhary
1,
M. Maheshwari
1,
S. Maheshwari
2
Affiliations
1 Deptt of Medicine, Jawaharlal Nehru Medical College and Hospital, Kala Bagh, Ajmer, Rajasthan 305001, IN
2 Jawaharlal Nehru Medical College and Hospital, Kala Bagh, Ajmer, Rajasthan 305001, IN
1 Deptt of Medicine, Jawaharlal Nehru Medical College and Hospital, Kala Bagh, Ajmer, Rajasthan 305001, IN
2 Jawaharlal Nehru Medical College and Hospital, Kala Bagh, Ajmer, Rajasthan 305001, IN
Source
The Indian Practitioner, Vol 69, No 2 (2016), Pagination: 42-43Abstract
Ebstein's anomaly is a congenital heart defect. The septal and posterior leaflets of the tricuspid valve are displaced toward the apex of the right ventricle called as atrialization of right ventricle. Most of them have interatrial communication. Ebstein's anomaly accounts for >1% of all cases of congenital heart disease. It has a high mortality rate in first few months of life and rarely patients with Ebstein's anomaly live up to adulthood. We here are presenting a case report of a 40-year-old male who presented with palpitation and lightheadedness and was found to be a case of Ebstein's anomaly with the late presentation in fourth decade of life.
- Organophosphorus Poisoning Complicated by Acute Myocardial Infarction-A Case Report
Abstract Views :204 |
PDF Views:1
Authors
M. Maheshwari
1,
V. Sharma
1
Affiliations
1 J.L.N. Medical College, Ajmer, IN
1 J.L.N. Medical College, Ajmer, IN
Source
The Indian Practitioner, Vol 69, No 8 (2016), Pagination: 32-34Abstract
Acute organophosphate (OP) poisoning represents a major health problem in developing countries where OP compounds are widely and easily available as pesticide. Toxicity due to these agents can affect many organs including lungs, brain and heart. The possible mechanisms for myocardial injury include sympathetic/parasympathetic overactivity, hypoxemia, acidosis, dyselectrolemia, and direct cardio toxicity. Cardiac manifestations consist of electrocardiographic ST-T segment changes, AV conduction disturbances and QT prolongation, leading to torsades de pointes and sudden cardiac death. Acute coronary syndrome as a complication of OP poisoning has been reported rarely. We report herein a fatal case of OP poisoning complicated by acute myocardial infarction.Keywords
Organophosphorus Compound, Cardiac Toxicity, Myocardial Infarction.References
- International Programme on Chemical Safety, World Health Organization (WHO). Epidemiology of pesticide poisoning: harmonized collection of data on human pesticide exposure in selected countries. Geneva, Switzerland: WHO Press; 2004.
- Linden CH, Burns MJ, Mycyk MB. Poisoning, drug overdose and envenomation. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison’s Principles of Internal Medicine. 17th ed. New York: McGraw-Hill; 2008. p.2741-8.
- Yamashita, M., M. Yamashita, J. Tanaka and Y. Ando, 1997. Human mortality in organophosphate poisonings. Vet. Hum. Toxicol., 39: 84-85
- Karki P, Ansari JA, Bhandary S, Koirala S. Cardiac and electrocardiographical manifestations of acute organophosphate poisoning. Singapore Med J 2004;45:385-9
- Kidiyoor Y, Nayak VC, Devi V, Bakkannavar SM, Kumar GP, Menezes RG. A rare case of myocardial infarction due to parathion poisoning. J Forensic Leg Med 2009;16:472-4.
- Madhu Pankaj, Kavita Krishna. Acute Organophosphorus Poisoning Complicated by Acute Coronary Syndrome JAPI 2014;62;62-63
- Ludomirsky A, Klein HO, Sarelli P, Becker B, Hoffman S, Taitelman U, Q-T prolongation and polymorphous (torsade de pointes) ventricular arrhythmias associated with Organophosphorus insecticide poisoning. Am J Cardiol 1982;49:1654-8.
- Yasue H, Touyama M, Shimamoto M, Kato H, Tanaka S. Role-of autonomic nervous system in the pathogenesis of Prinzmetal’s variant form of angina. Circulation1974;50:534-9.
- Karasu-Minareci E, Gunay N, Minareci K, Sadan G, Ozbey G. What may be happen after an organophosphate exposure: Acute myocardial infarction? J Forensic Leg Med 2012;19:94-6.
- Electrolyte Profile of Dengue Infected Patients:An Observational Study from a Tertiary Care Centre in Rajasthan
Abstract Views :169 |
PDF Views:1
Authors
Affiliations
1 J.L.N. Medical College, Ajmer (Rajasthan), IN
1 J.L.N. Medical College, Ajmer (Rajasthan), IN
Source
The Indian Practitioner, Vol 70, No 1 (2017), Pagination: 16-18Abstract
Dengue infection is one of the most common and potentially fatal mosquito-borne infections in tropical and subtropical countries. No specific treatment is available and the mainstay of treatment is careful fluid management, specific organ support and correction of metabolic and electrolyte derangement. The aim of our study was to evaluate electrolyte disturbances in patients with dengue infection in our hospital. In this study we included total 60 clinically diagnosed and serologically confirmed age and sex matched dengue infected cases. Serum electrolytes [sodium, potassium&calcium] were measured using semi- auto analyser. The mean age of the study group was 32 years. 65% of the patients were males and 35% were females. On analysis it was found that the amount of calcium decreased significantly (p < 0.03) in the study group as compared to control group while value of sodium (p < 0.6) and potassium (p < 0.5) reduced non-significantly. Hence timely diagnosis and supportive therapy of these electrolyte disturbances can reduce associated morbidity and mortality in dengue patients.Keywords
Dengue, Electrolyte Disturbance, Hypocalcaemia.References
- L. Castilla-Guerra, M. C. Fernandez-Moreno, J. M. Lopez-Chozas and R. Fernandez-Bolanos. Electrolytes Disturbances and Seizures. Epilepsia, 2006; 47:1990–1998.
- Wichmann D, Kularatne S, Ehrhardt S, Wijesinghe S, Brattig NW, Abel W, et al. Cardiac involvement in dengue virus infections during the 2004/2005 dengue fever season in Sri Lanka. Southeast Asian J Trop Med Public Health. 2009;40:727–30.
- Bunnag T, Kalayanarooj S. J Med Assoc Thai. Vol. 94. Bangkok, Thailand: 2011. Dengue shock syndrome at the emergency room of Queen Sirikit National Institute of Child Health; pp. S57–63.
- Uddin KN, Musa AKM, Haque WMM, Sarker RSC, Ahmed AKMS. A follow up on biochemical parameters in dengue patients attending BIRDEM hospital. Ibrahim Med Coll J. 2008;2:25–7.
- Kapoor S, Singh A. Hypocalcemic tetany: An infrequently recognized association with acute dengue infection. Indian J Pediatr. 2012;79:1673.
- Constantine GR, Rajapakse S, Ranasinghe P, Parththipan B, Wijewickrama A, Jayawardana P Hypocalcemia is associated with disease severity in patients with dengue J Infect Dev Ctries. 2014 ;12:1205-9
- Bielefeldt-Ohmann H, Meyer M, Fitzpatrick DR, Mackenzie JS. Dengue virus binding to human leukocyte cell lines: Receptor usage differs between cell types and virus strains. Virus Res. 2001;73:81–9.
- Dhawan R, Chaturvedi UC, Khanna M, Mathur A,Tekwani BL, Pandey VC. Obligatory role of Ca2+in the cytotoxic activity of dengue virus-induced cytotoxin. Int J Exp Pathol. 1991;72:31–9
- Khanna M, Chaturvedi UC, Dhawan R, Tekwani BL, Pandey VC. Presence of Ca 2+ is obligatory for the cytotoxic activity of dengue virus-induced cytotoxic factor. Immunology. 1991;72:73–8
- Chaturvedi P, Saxena V, Dhawan R, Chaturvedi UC. Role of calcium in induction of dengue virus-specific helper T cells. Indian J Exp Biol. 1995;33:809–15
- Baton, S.M , Oncog A . A pilot study on the level of serum calcium in pediatric patients with dengue fever and dengue shock syndrome. Pediatric critical care medicine: 2014 ;15: suppl - p 153
- Cabrera-Cortina JI, Sanchez-Valdez E, Cedas-DeLezama D, Ramírez-González MD. Oral calcium administration attenuates thrombocytopenia in patients with dengue fever. Report of a pilot study. Proc West Pharmacol Soc. 2008;51:38–41.
- Splenic Infarction by Coeliac Artery Thromboembolism
Abstract Views :220 |
PDF Views:3
Authors
Affiliations
1 J. L. N Medical College, Ajmer, IN
1 J. L. N Medical College, Ajmer, IN
Source
The Indian Practitioner, Vol 70, No 8 (2017), Pagination: 31-32Abstract
Splenic infarction is an uncommon clinical entity with only few case reports published in literature. We report here a 43-year-old female patient, presenting with abdominal pain, who had splenic infarction caused by celiac artery thromboembolism.Keywords
Splenic Infarction, Celiac Artery Thrombo-Embolism, Abdominal Pain.References
- (1) O’Keefe JH, Jr, Holmes DR, Jr, Schaff HV, Sheedy PF, 2nd, Edwards WD. Thromboembolic splenic infarction. Mayo Clin Proc. 1986;61:967–972.
- (2) Beeson MS. Splenic infarct presenting as acute abdominal pain in an older patient. J Emerg Med. 1996;14:319–322.
- (3) Chang RW, Chang JB, Longo WE. Update in management of mesenteric ischemia. World J Gastroenterol. 2006;12:3243–3247.
- (4) Stefano F, Shah KT, Goodreau JJ, McLoughin TM, Sinclair MC. Splenic infarction caused by large thoracic aorta thrombus. J Vasc Surg. 1997; 26:1069-72.
- (5) Jaroch MT, Broughan TA, Hermann RE. The natural history of splenic infarction. Surgery. 1986;100:743–750
- Echocardiographic Evaluation of Hepatic Venous Doppler flow in Patients with Isolated Left Ventricle Anterior Myocardial Infarction
Abstract Views :173 |
PDF Views:0
Authors
Affiliations
1 J.L.N. Medical College, Ajmer, Rajasthan, IN
1 J.L.N. Medical College, Ajmer, Rajasthan, IN
Source
The Indian Practitioner, Vol 70, No 11 (2017), Pagination: 21-24Abstract
Introduction: The importance of RV functions as a predictor of outcome among patients with heart failure, myocardial infarction and pulmonary embolism has been established. Hepatic venous (HV) doppler flow predicts right atrial pressure and right ventricular (RV) dysfunction. Doppler technique offers unique advantage for evaluation of RV functions in that they are independent of complex geometry and shape of RV.
Aims And Objectives: To evaluate non-invasively right atrial pressure and predict right ventricular functions in patients with isolated left ventricle anterior myocardial infarction (LV-AMI) by analyzing hepatic venous doppler flow and to correlate it with left ventricle ejection fraction (LVEF)
Material And Methods: The study group comprised of 50 patients with isolated LV-AMI with normal right coronary angiogram, further subdivided into 2 subgroups:
Sub-group-1 consisted of 25 patients with stenosis of proximal left anterior descending artery (LAD)
and Sub-group-2 composed of 25 patients with stenosis of both LAD and left circumflex artery (LCx.). The control group comprised of twenty five age, sex, BMI, pulse and blood pressure matched healthy subjects.
Observations: A wave peak velocity and VTI were increased in both subgroups of AMI, X wave peak velocity and VTI was reduced in both subgroups of AMI, Y wave peak velocity and VTI was reduced in both sub-groups of AMI. VI ratio remained unchanged. On multivariate analysis LVEF and LVFS were independent negative predictors of X wave VTI.
Conclusion: This study demonstrates that even in patients with isolated LV AMI there is RV dysfunction due to 'ventricular interdependence' and hepatic venous doppler is non - geometric sensitive echocardiographic parameter, to detect RV dysfunction non-invasively.
References
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- (7) Startt R H, Wagner G S, Idekar R E. Myocardial infarction. In Comprehensive Electrocardiography. Theory and Practice in Health & Disease eds Peter W Mac farlane, T D Veitch Lawrie Newyork Vol 1:1989;565-629
- (8) Nagueh SF, Kopelen HA, Zoghbi WA. Relation of mean right atrial pressure to echocardiographic and Doppler parameters of right atrial and right ventricular function.Circulation 1996;93:1160-69
- (9) Himura Y, Kannagi T, Tamo H,Nakamura Y, Kumada Ta, Kawai C.Venous flow velocity patterns and cardiac functions studied by Doppler echocardiography.J Cardiol 1988;18:775-86.