scholarly journals Morphological spectrum of atherosclerotic lesions in a tertiary care Institute in Punjab

2018 ◽  
Vol 10 (1) ◽  
pp. 19-24
Author(s):  
Rajiv Kumar Gupta ◽  
Ruchita Tyagi ◽  
Vikrampal Singh ◽  
Samir Kapoor ◽  
Gurmeet Singh ◽  
...  
Keyword(s):  
Coronary Artery ◽  
South Asians ◽  
Tertiary Care ◽  
Disease Process ◽  
Heart Association ◽  
Lifestyle Changes ◽  
Female Ratio ◽  
Fibrous Cap ◽  
Atherosclerotic Lesions ◽  
Morphological Studies

Background: The incidence of coronary artery disease (CAD) has risen considerably in developing world due to industrialization, urbanisation and lifestyle changes, especially among Indians and South Asians. The onset of CAD has been seen to occur at an early age and the severity of the disease and mortality associated with CAD has also increased. The pathology of atherosclerosis needs to be re-evaluated to develop targeted therapy which can contain the disease process at the earliest stage. Aims and Objectives: Most of the morphological studies on atherosclerosis have been done on autopsy cases. In this study, we have analysed the morphological spectrum of atherosclerotic lesions in live patients. Materials and Methods:  We retrospectively analysed the histopathology slides of 85 cases whose endarterectomy plaques were received in the Department of Pathology over a period of three and half years (January 2014 to June 2017) and classified the lesions according to Modified American Heart Association classification of atherosclerosis. Results: The average age of patients was 60 years and male to female ratio of 4.3:1. Left anterior descending artery was the commonest vessel involved (52.4%). Majority of the cases had fibrocalcific plaques,followed by fibrous cap atheroma and calcified nodules. Conclusion: Coronary artery plaques were found even in patients less than 40 years old.  Aggressive lipid defense therapy needs to be the cornerstone of management of CAD.

Computed Tomography Findings in Sinonasal Wegener's Granulomatosis

2009 ◽  
Vol 23 (5) ◽  
pp. 497-501 ◽  
Author(s):  
David Grindler ◽  
Steven Cannady ◽  
Pete S. Batra
Keyword(s):  
Computed Tomography ◽  
Wegener’S Granulomatosis ◽  
Tertiary Care ◽  
Disease Process ◽  
Wegener's Granulomatosis ◽  
Sinus Surgery ◽  
Female Ratio ◽  
Bony Destruction ◽  
The Impact ◽  
Bony Erosion

Background Wegener's granulomatosis (WG), an autoimmune disease, is intimately associated with the sinonasal tract, with involvement reported in 85% of patients during the course of the disease process. The objective of this study was (1) to describe Lund-Mackay (L-M) scores, (2) to delineate patterns of neo-osteogenesis and bony erosion, and (3) to analyze the impact of surgery on the computed tomography (CT) findings of WG patients. Methods A retrospective review was performed on 74 patients with WG presenting to a tertiary care referral center. CT analysis was performed and graded by two independent reviewers. Results The mean age was 53 years with a male/female ratio of 0.6:1. The average L-M score was 10.0. Neo-osteogenesis was evident in 78% of the patients with overall average neo-osteogenesis score of 4.2 (range, 0–16). Bony erosion was noted on imaging in 62% of patients with overall average score for bony erosion of 2.0 (range, 0–8). Patients having undergone previous sinus surgery compared with no previous surgery had statistically significant elevation of overall L-M, bony erosion, and neo-osteogenesis scores (p = 0.024, 0.0009, and 0.0015, respectively). Conclusion CT imaging in WG patients shows elevated L-M scores and evidence of bony erosion and neo-osteogenesis. Furthermore, surgical manipulation in WG patients is associated with increased bony abnormalities and greater elevations of L-M scores, possibly because of worsening vasculitis and/or inflammation. The presence of concurrent neo-osteogenesis and bony destruction of the paranasal sinuses should raise clinical suspicion of WG in patients presenting with symptoms of chronic rhinosinusitis.

Evaluation of Endothelial Dysfunction in Patients with Isolated Coronary Artery Ectasia by Ultrasonographic Brachial Artery Flow Mediated Dilation

2021 ◽  
Vol 8 (05) ◽  
pp. 246-250
Author(s):  
Syed Imamuddin ◽  
Chamarti Venkata Arunavalli ◽  
Parvathareddy Krishna Malakonda Reddy ◽  
Ponnapati Venkata Anil Kumar Reddy
Keyword(s):  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Brachial Artery ◽  
Molecular Mechanisms ◽  
Tertiary Care ◽  
Surrogate Marker ◽  
Disease Process ◽  
Seldinger Technique ◽  
Flow Mediated Dilation ◽  
Coronary Artery Ectasia

BACKGROUND Evaluation of endothelial function in isolated coronary artery ectasia (ICAE) with flow-mediated dilation (FMD) is limited and use of flow mediated vasodilation as a surrogate marker for the extent of coronary atherosclerosis remains unknown. Thus, the following study was done to evaluate for endothelial dysfunction (ED) in subjects with ICAE by assessing the FMD in the brachial artery. METHODS This was an observational study, conducted at a referral hospital providing tertiary care in India between June 2017 and November 2018. Fifty patients with ICAE and fifty control patients with normal coronary arteries (NCA) on coronary angiogram, done by using a standard Seldinger technique via femoral route, were the subjects of the study. Brachial artery FMD was determined by using a highresolution ultrasound system (Samsung RS80A) using a linear transducer of a frequency of 7.5 Mega Hertz. RESULTS The groups had same baseline characteristics in terms of age, sex etc. (all P values > 0.05). However, values of serum uric acid and low-density lipoproteins were statistically significantly higher in ICAE subjects (P < 0.0001). Whereas, dilatation of brachial artery in response to shear stress was significantly lower in patients with ICAE subjects than in patients with normal coronaries. (8.85 ± 0.49 vs. 12.83 ± 0.45, P < 0.0001). Marki’s classification, type 1, type 2, type 3 and type 4 coronary artery ectasia (CAE) was present in 8 (16 %), 4 (8 %), 13 (26 %), and 25 (50 %), respectively. CONCLUSIONS Atherosclerosis may play a pivotal role in the genesis of ICAE. Hyperlipidaemia may have a specific role in the disease process. Further research is required to evaluate the exact molecular mechanisms involved in CAE. KEYWORDS Coronary Artery Disease, Ectasia, Endothelial Dysfunction, Hyperlipidaemia

HISTOPATHOLOGICAL SPECTRUM OF GALLBLADDER DISEASES IN A TERTIARY CARE CENTER – A RETROSPECTIVE STUDY

2021 ◽  
pp. 34-36
Author(s):  
Kanimozhi. S ◽  
Veera Raghavan. G ◽  
Sofiya. C ◽  
Pushpa. B
Keyword(s):  
Retrospective Study ◽  
Care Center ◽  
Gallbladder Disease ◽  
Tertiary Care ◽  
Lifestyle Changes ◽  
Parasitic Infections ◽  
Female Ratio ◽  
Gallbladder Diseases ◽  
Medical College ◽  
Male Female Ratio

BACKGROUND: Gallbladder disease is known to affect a substantial number of people throughout the world. In India, the disease prevalence is on the rise, largely attributable to dietary & lifestyle changes, thus causing a signicant disease burden. The purpose of this study is to evaluate the varied histological manifestations of gallbladder pathology and their association with cholelithiasis. MATERIALS & METHODS: This retrospective study was conducted in the department of pathology, Kilpauk medical college from January 2018 to December 2018. The clinical data and the histopathological changes were evaluated. RESULTS: Of the 156 cases which were studied, 120 cases (77%) had gallstones. The mean age was 47 years. Females had a slight preponderance for gallbladder diseases with the Male: Female ratio being 1:2. 138 cases (89.8%) were diagnosed as chronic cholecystitis. 3 cases were diagnosed to have invasive malignancies. CONCLUSION: A diverse spectrum of diseases affect the gallbladder encompassing inammatory conditions, parasitic infections, pseudoneoplastic lesions and neoplasms. Routine cholecystectomy specimens should be evaluated meticulously as incidental ndings and diagnosis can be transformative.

scholarly journals Erythroderma: a clinico etiological study of 77 patients in a tertiary care centre in Kerala

2020 ◽  
Vol 7 (1) ◽  
pp. 73
Author(s):  
Abin Abraham Itty ◽  
Rajiv Sridharan ◽  
Anoop Thyvalappil ◽  
Bindurani Sudhamani
Keyword(s):  
Tertiary Care ◽  
Disease Process ◽  
Underlying Disease ◽  
Clinical Findings ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Histopathological Correlation ◽  
Elderly Males ◽  
Etiological Study

<p class="abstract"><strong>Background:</strong> Erythroderma is defined as generalized erythema and scaling of the skin affecting more than 90% of body surface area. Identification of the underlying disease process represents one of the most complex challenges in proper patient care.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was done in Department of Dermatology in a Tertiary Care Centre. History, clinical findings and investigations of erythroderma patients were recorded and clinic-histopathological correlation was analyzed by kappa coefficient (К).<strong></strong></p><p class="abstract"><strong>Results:</strong> Erythroderma was more prevalent in elderly males with a mean age of 64.56 years and a male to female ratio of 3:1. A clinical evidence of pre-existing dermatoses was found in 65 patients, commonest being eczema (41.3%) followed by psoriasis (40.3%). Evidence of a trigger was seen in 54.54% patients, commonest being the use of ayurvedic medications (42.8%). Clinico-histopathological correlation was seen in 53.9% cases.</p><p class="abstract"><strong>Conclusions:</strong> Although the clinical presentation of erythroderma is similar, etiological factors are varied and it depends largely on the population studied. Most commonly, erythroderma is due to generalization of pre-existing dermatoses as seen in our study. Hence careful evaluation of clinical clues and histopathological correlation plays a pivotal role in diagnosis of the primary cause and the effective management of erythroderma.</p>

“A STUDY OF ATHEROSCLEROSIS OF RIGHT CORONARY ARTERY AND THORACIC AORTA IN POST MORTEM CASES”

2021 ◽  
pp. 71-73
Author(s):  
Thushara K ◽  
Rupashree S ◽  
Chidananda P S ◽  
Ramesh Babu K
Keyword(s):  
Coronary Artery ◽  
Thoracic Aorta ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Dietary Habits ◽  
Cerebral Arteries ◽  
Atherosclerotic Lesion ◽  
Heart Association ◽  
Atherosclerotic Lesions ◽  
Luminal Narrowing

Background: Atherosclerosis is a chronic disease which primarily affects the intima of large and medium sized muscular arteries, commonly involving aorta, coronary arteries and cerebral arteries. The contribution of atherosclerosis in morbidity and mortality of young adults is on the rise. Objective: To demonstrate histopathological spectrum of atherosclerotic lesions in Right Coronary Artery and Thoracic aorta and to compare the age, gender and BMI variation in prevalence of atherosclerotic lesions. 150 specime Materials And Methods: ns of heart with intact coronary arteries and thoracic aorta received by Department of pathology, Shimoga Institute of Medical Sciences, Shivamogga. Heart was grossly examined and sections were taken from Right Coronary Artery and Thoracic Aorta which were processed and stained with Haematoxylin and Eosin. Microscopically typing of the atherosclerotic lesion was made using American Heart Association classication of atherosclerosis. Of the Results: 150 cases, males 91% and females 9% were affected. Majority of the cases were in the age group of 30-40 years (33.33%) and BMI range of 18.6- 24.9 (72.67%). Commonest type of atherosclerosis in Right coronary artery was type 5 (Fibroatheroma) (25.33%) and in Thoracic aorta was type 3 (Preatheroma) (30%). Grade 1 Luminal narrowing (1-25% obstruction) was most commonly seen in Right coronary Artery (50% cases). Conclusion: Due to increase in cardiac death rates screening of cardiovascular risk factors, preventive measures, life style modication and having healthy dietary habits should be implemented early in 3rd decades of young Indians to retard the progression of atherosclerosis.

scholarly journals Clinico-Haematological Study of Pancytopenia – An Experience from a Tertiary Care Centre in Western Odisha

2021 ◽  
Vol 8 (24) ◽  
pp. 2052-2057
Author(s):  
Anupa Toppo ◽  
Harish Chandra Singh ◽  
Rojalin Nanda
Keyword(s):  
Bone Marrow ◽  
Aplastic Anaemia ◽  
Tertiary Care ◽  
Disease Process ◽  
Bone Marrow Aspiration ◽  
Megaloblastic Anaemia ◽  
Care Hospital ◽  
Haematological Malignancies ◽  
Female Ratio ◽  
Haematological Disorders

BACKGROUND Pancytopenia is a relatively common haematological entity with simultaneous presence of anaemia, leucopenia and thrombocytopenia. It is a feature of many medical and haematological disorders like megaloblastic anaemia, drug-induced bone marrow hypoplasia, even fatal leukaemia and bone marrow aplasia. The clinical and haematological studies determine the proper diagnosis and management of patients. Bone marrow examination is an important diagnostic procedure for determining the cause of pancytopenia. This study was conducted to evaluate clinico-haematological findings, identify the causes of pancytopenia, and compare our findings with other similar studies. METHODS The four-year retrospective study was carried out in the Department of Pathology at a tertiary care hospital in western Odisha, India. Data regarding clinical details, peripheral blood and bone marrow aspirations were collected and analyzed using simple statistical methods. RESULTS A total of 131 cases of pancytopenia were studied. The age range of patients was 3 years to 72 years, with a mean of 36.5 years. Male to female ratio was 0.84 : 1. The majority of cases were in the age group of 31 – 40 years (20.61 %). Generalized weakness with pallor (54.96 percent) was the commonest clinical finding, followed by splenomegaly (16.79 %), and hepatomegaly (11.45 %). Aplastic anaemia (43.51 %) was the most common cause found on the bone marrow aspiration followed by megaloblastic anaemia (22.14 %) and haematological malignancies. Among the haematological malignancies, acute myeloid leukaemia was the commonest cause of pancytopenia (10.69 %). CONCLUSIONS Bone marrow aspiration in cytopenic patients helps in understanding the disease process and to diagnose or rule out the causes of cytopenia. Different geographical areas have a different presentation of haematological disorders. KEYWORDS Bone Marrow Aspiration, Pancytopenia, Aplastic Anaemia

scholarly journals Assessment of Lipid Profile and Serum Creatinine Kinase in Subjects with Hyperlipidemia on Moderate Intensity Statin Therapy Attending a Postgraduate Teaching Hospital in South India

2021 ◽  
pp. 1-10
Author(s):  
T. K. Mohammed Muneersha ◽  
R. T. Saravanakumar ◽  
K. G. Revikumar
Keyword(s):  
Drug Therapy ◽  
Coronary Artery ◽  
Lipid Profile ◽  
Teaching Hospital ◽  
South India ◽  
Tertiary Care ◽  
Lifestyle Changes ◽  
Moderate Intensity ◽  
Lifestyle Modifications ◽  
Muscle Toxicity

Atherosclerosis of large and medium sized arteries are believed to be the major reason behind the development of Coronary Artery Diseases and Hyperlipidemia has been found to be one of the most important contributing factors. Appropriate lifestyle changes along with proper drug therapy lead to a considerable reduction in mortality rate due to coronary artery disease. Reduction of LDL Cholesterol is the primary goal of cholesterol-lowering therapy, but most of the patients are usually unable to achieve the treatment goals with lifestyle modifications alone; and in such situations, drug therapy is essential to prevent the disease progression and further future complications. The aim of the study was to demonstrate impact of three moderate intensity statins on lipid profile and biomarker representing muscle toxicity. It was a prospective observational study conducted in a tertiary care teaching hospital in south India. Patients of both gender falling the age group between 30 and 70 years with newly diagnosed Hyperlipidemia attending the Department of Medicine OPD, were enrolled in the study. Total 229 participants were enrolled in study and all the drug treatment were found to be effective in achieving the treatment goal; at the same time Rosuvastatin 10 mg treatment group exhibited better efficacy along with minimal muscle toxicity.

LIVING WITH HEPATITIS: THE EFFECT OF INFECTED SUBJECTS ON EVERYDAY LIFE

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Khaled Hassan
Keyword(s):  
Hepatitis B ◽  
Everyday Life ◽  
Disease Process ◽  
Analysis Data ◽  
Structured Interview ◽  
Lifestyle Changes ◽  
Life Change Events ◽  
Life Change ◽  
The Everyday ◽  
Content Review

To identify changes in the everyday life of hepatitis subjects, we conducted a descriptive, exploratory, and qualitative analysis. Data from 12 hepatitis B and/or C patients were collected in October 2011 through a semi-structured interview and subjected to thematic content review. Most subjects have been diagnosed with hepatitis B. The diagnosis period ranged from less than 6 months to 12 years, and the diagnosis was made predominantly through the donation of blood. Interferon was used in only two patients. The findings were divided into two groups that define the interviewees' feelings and responses, as well as some lifestyle changes. It was concluded that the magnitude of phenomena about the disease process and life with hepatitis must be understood to health professionals. Keywords: Hepatitis; Nursing; Communicable diseases; Diagnosis; Life change events; Nursing care.

Quantification of Coronary Artery Stenosis with 16-Slice MSCT in Patients before CABG Surgery: Comparison to Standard Invasive Coronary Angiography

2005 ◽  
Vol 8 (1) ◽  
pp. 42 ◽  
Author(s):  
C. Probst ◽  
A. Kovacs ◽  
C. Schmitz ◽  
W. Schiller ◽  
H. Schild ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Artery Bypass ◽  
Invasive Coronary Angiography ◽  
Bypass Graft ◽  
Heart Association ◽  
Artery Stenosis ◽  
Vessel Disease ◽  
Selective Coronary Angiography

Objective: Invasive, selective coronary angiography is the gold standard for evaluation of coronary artery disease (CAD) and degree of stenosis. The purpose of this study was to compare 3-dimensional (3D) reconstructed 16-slice multislice computed tomographic (MSCT) angiography and selective coronary angiography in patients before elective coronary artery bypass graft (CABG) procedure. Methods: Sixteen-slice MSCT scans (Philips Mx8000 IDT) were performed in 50 patients (42 male/8 female; mean age, 64.44 8.66 years) scheduled for elective CABG procedure. Scans were retrospectively electrocardiogram-gated 3D reconstructed. The images of the coronary arteries were evaluated for stenosis by 2 independent radiologists. The results were compared with the coronary angiography findings using the American Heart Association segmental classification for coronary arteries. Results: Four patients (8%) were excluded for technical reasons. Thirty-eight patients (82.6%) had 3-vessel disease, 4 (8.7 %) had 2-vessel disease, and 4 (8.7%) had an isolated left anterior descending artery stenosis. In the proximal segments all stenoses >50% (56/56) were detected by MSCT; medial segment sensitivity was 97% (73/75), specificity 90.3%; distal segment sensitivity was 90.7% (59/65), specificity 77%. Conclusion: Accurate quantification of coronary stenosis greater than 50% in the proximal and medial segments is possible with high sensitivity and specificity using the new generation of 16-slice MSCTs. There is still a tendency to overestimate stenosis in the distal segments. MSCT seems to be an excellent diagnostic tool for screening patients with possible CAD.

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