scholarly journals Pattern of mortality in sudden death: an autopsy study

Author(s):  
Pinkal A. Shah ◽  
Bhavna Gamit ◽  
Chintan Dalal ◽  
Pinal Shah

Background: Sudden death has plagued mankind from time Immemorial. Clinical presentations include wide spectrum from symptom complex to completely asymptomatic. Sudden cardiac death in many cases, ‘first and only symptom. The high incidence, sudden, unexpected nature, combining with the low successful rate of resuscitation, make sudden cardiac deaths a major unsolved problem. Therefore, this study was conducted to illustrate etiolopathology, risk factors and triggers of sudden death with the expectation to provide new insight in epidemiological aspects of sudden death, which will help in care of patients, and prevention of premature cardiac deaths.Methods: A study of 50 cases of sudden death was conducted at tertiary care hospital. After evaluating detailed history from the family members, autopsy has been performed to find out cause of sudden death.Results: Principal culprit of sudden death is cardiovascular disease. Highest numbers of sudden death are in middle age group and having male preponderance might be due to presence of multiple risk factors, which have added or multiplicative effect. There are few autopsy negative cases, which are unexplained sudden death.Conclusions: Sudden and unexpected deaths in young population frequently become the subject of pathologic investigation to determine the cause of death. 

2020 ◽  
pp. 1-3
Author(s):  
Shubhratha S. Hegde ◽  
Asha Rani J ◽  
Sandhya Dharwadkar ◽  
D. N. Prakash

BACKGROUND:Retinal Vein Occlusion(RVO) is a multifactorial, with many systemic and ocular risk factors.The incidence of RVO has increased with increased life expectancy and increased incidence of risk factors. AIM:This study was done to determine the demographic characteristics and risk factors in a tertiary care hospital in South India. METHODS:100 consecutive newly diagnosed cases of RVO were included in the study. A detailed history, complete ophthalmic examination and systemic evaluation was done. RESULTS: The majority of the patients were aged more than 60 years(55%) with male preponderance(54%).The study also found that RVO was strongly associated with increasing age.Hypertension,dyslipidemia,diabetes mellitus,smoking and hyperhomocysteinemia were important systemic risk factors.Glaucoma was an important ocular risk factor.BRVO is the most common type of RVO. CONCLUSION:RVO is associated with many systemic and ocular diseases.Identifying and managing these risk factors help in preventing a second attack in either eye and thereby the visual morbidity.


2017 ◽  
Vol 4 (5) ◽  
pp. 1369
Author(s):  
Puneet Patil ◽  
Aamera Sait ◽  
Dilip Ratan Patil

Background: Complications like arrhythmias, cardiac failure, cerebrovascular and mechanical complications. Among these complications, arrhythmias are the most common complication of acute myocardial infarction. The objective of this study was to study the risk factors of various arrhythmias in patients with coronary heart disease.Methods: Present study was a hospital based cross sectional study conducted at department of General Medicine of a tertiary care hospital for a period of two years among 102 patients. Detailed history, clinical examination, investigation was done. All patients were followed for one year to assess the outcome among them. All data was entered in the Microsoft Excel worksheet and analyzed using proportions.Results: Arrhythmias were more common with low ejection fraction (72.73%). The overall mortality was 7.84%. Ventricular fibrillation was seen in 50% of the patients who did not receive thrombolytic therapy. First-degree AV block and second-degree AV block were present in 6.25% and 7.50% respectively and did not affect the mortality while complete heart block was present in 8.75% and mortality rate of 28.57% with right ventricular involvement. Risk factors like smoking, alcohol, hypertension, diabetes mellitus and obesity had higher incidence of arrhythmias but was not found to have any statistical significance (p >0.05). However, patients having multiple risk factors strongly associated with the high mortality in statistically significant manner (p value 0.0006).Conclusions: Patients with risk factors like smoking, alcohol, hypertension, diabetes mellitus and obesity had higher incidence of arrhythmias. Multiple risk factors increase the incidence of both arrhythmias and mortality (67% mortality with 4 risk factors and 75% mortality with 5 risk factors).


Author(s):  
Sushil Y. Sonawane ◽  
Pushkar P. Matkari ◽  
Gopal A. Pandit

Background: Natural deaths represent a large proportion of sudden (unexpected and unattended) deaths. The term “sudden cardiac death” (SCD) refers to death from the abrupt cessation of cardiac function due to cardiac arrest. The objective of this study was to identify various causes, risk factors, age and sex distribution associated with sudden cardiac death in an Indian setting.Methods: Detail review of medical records and an autopsy study of all cases of sudden cardiac death that occurred instantaneously or within 24 hours of onset of symptoms in a tertiary care institution, between December 2010 and December 2015 was carried out.Results: In total, 124 cases of sudden death were studied during this period. Out of 124 cases, 109 cases (87.90%) showed pathology in heart and aorta. Atherosclerotic coronary heart disease was the most common cause of death (72.58%) followed by Hypertensive heart disease (4.83%), Hypertrophic cardiomyopathy (3.22%), Myocarditis (3.22%), Infective endocarditis (1.61%), Rheumatic heart disease (0.8%), Aortic dissection (0.8%), and syphilitic aortitis (0.8%).Conclusions: Sudden death is a source of concern and a detailed postmortem examination is mandatory to ascertain its cause. Presence of co-existing conditions like diabetes and hypertension contribute immensely to the risk of sudden death. Occurrence of sudden death at a younger age presents a formidable challenge. Prevention of development of risk factors of atherosclerosis at an early age can be an effective strategy to counter this ailment at all levels.


2016 ◽  
Vol 1 (2) ◽  
pp. 29
Author(s):  
Rekha Bachhiwal ◽  
Rajni Sharma ◽  
Pooja Gupta ◽  
Jyotsna Shukla

Introduction: To ascertain the seroprevalence of enterically transmitted Hepatitis A (HAV) and Hepatitis E (HEV) in cases with acute/subacute hepatitis attending a tertiary care hospital in North West India. Methods: A total of 2936 cases were examined for the presence of current infection with HAV and HEV, determined by demonstration of HAV-IgM and HEV-IgM antibodies using ELISA. Results: Overall seroprevalence for enterically transmitted hepatitis was found to be 24.89%. HAV IgM was present in 7.35% and HEV IgM was present in 17.54% of total cases. HAV infection was predominantly found in pediatric age group while HEV infection was mostly seen among adults. Male preponderance was noted. Enteric hepatitis cases occurred throughout the year. No definitive seasonal pattern was observed. Conclusion: Our data demonstrated high seropositivity of enterically transmitted hepatitis indicating the need for improvement in personal and public hygiene, and development of HEV vaccine.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S600-S601
Author(s):  
Dong Hoon Shin ◽  
Seung-Jin Yoo ◽  
Jongtak Jung ◽  
Kang Il Jun ◽  
Hyungjin Kim ◽  
...  

Abstract Background Invasive pulmonary aspergillosis (IPA) is a life-threatening opportunistic infection which usually occurs in immunocompromised patients. Recommended duration of voriconazole therapy is a minimum of 6-12 weeks for IPA, despite the lack of any firm evidence. In addition, risk factors for relapse of IPA are still unclear. Here, we explored risk factors for IPA relapse after initial treatment. Methods All patients with proven or probable IPA who had finished voriconazole treatment between 2005 and 2019 in a tertiary-care hospital were reviewed. IPA relapse was defined as re-diagnosis of proven or probable IPA at the same site within 1 year after treatment termination. Short course of voriconazole treatment was defined as a treatment less than 9 weeks, which is a median of the recommended minimum duration of therapy from the Infectious Disease Society of America. The radiological response was defined as a reduction in IPA burden by more than 50% on chest computed tomography (CT). Results Of 87 patients who had completed voriconazole treatment, 14 (16.1%) experienced IPA relapse. Multivariable Cox regression identified that short voriconazole treatment duration (adjusted hazard ratio [aHR], 3.7; 95% confidence interval [CI], 1.1–12.3; P=0.033) and radiological non-response (aHR, 4.6; 95% CI, 1.2–17.5; P=0.026) were independently associated with relapse of IPA after adjusting for several clinical risk factors. Conclusion Less improvement in CT, and short duration of voriconazole therapy were the independent risk factors for relapse after treatment of IPA. Longer duration of therapy should be considered for those at higher risk of relapse. Disclosures All Authors: No reported disclosures


Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.


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