scholarly journals Modern critical approach to the diagnosis of acute viral myocarditis and inflammatory cardiomyopathies in clinical practice: Focus on the roles of echocardiography and antivirus antibodies

2021 ◽  
Vol 46 (2) ◽  
pp. 57-71
Author(s):  
Dušan Bastać ◽  
Biserka Tirmenštajn-Janković ◽  
Predrag Marušić ◽  
Zoran Joksimović ◽  
Vojkan Čvorović ◽  
...  

SIGNIFICANCE OF THE PROBLEM: The diagnosis of acute viral myocarditis is one of the diagnoses most difficult to make in cardiology and medicine in general. Echocardiography and cardiomagnetic resonance play a crucial role in the clinical diagnosis and the serum titer of antiviral antibodies to cardiotropic viruses is still unjustifiably used for the diagnosis of myocarditis in everyday practice. RESEARCH OBJECTIVES: To analyze the frequency and significance of echocardiographic parameters in the diagnosis of clinically suspected acute viral myocarditis, to determine the role of antiviral antibody titer (AVA) dynamics for the diagnosis of myocarditis and to compare viral serology and echocardiographic function versus echocardiographic function. METHODOLOGY: A retrograde transverse study was performed in the ten-year period from 2006. to 2015, where 126 consecutive patients from the database of the Office of Internal medicine ''Dr. Bastać'' were analyzed, with a working diagnosis of clinically suspected viral myocarditis. They were clinically, ECG, echocardiographically and serologically monitored for 4 to 8 weeks due to the dynamics of AVA titer. The examined group (A) was divided into subgroups: A1 with elevated AVA class IgM titer in 43 (32%) subjects and subgroup A2 without elevated IgM titer in 83 (68%) patients. The control group of healthy (B) of 103 subjects was comparable.Statistical processing was done in the EXCELL database via descriptive statistics, Student's-T test and Chi2 test. RESULTS: 126 patients had clinically suspected myocarditis (≥2 ESC criteria). Diastolic left ventricular dysfunction in 39/126 (31%) patients was the dominant echocardiographic criterion for clinically suspected myocarditis. Reduced ejection fraction (EF <50%) was measured at 19/126 (15%), followed by left ventricular dilatation. Regional systolic dysfunction was found in 21/126 (17%) and changes in myocardial texture in 17 (13%) subjects. The clinical probability of viral etiology was diagnostically supported by elevated titer of IgM antibodies in 43 (32%) subjects (subgroup A1) where IgM antibodies to Parvo B 19 virus predominate in 36/43 patients (84%). Most were without elevated titer of IgM antibodysubgroup A2 83 (68%). Clear dynamics of IgM antibody titer was observed in 23 persons, a decrease in IgM titer with an increase in IgG titer (seroconversion) in 13 patients. Determination of anti-heart autoantibodies (AHA) was done in 17 severe cases, of which 9 had positive AHA. A comparison of subgroups A1 and A2 did not reveal a statistically significant difference in echocardiographic parameters. The whole group A of clinically suspected myocarditis compared to control group B has statistically highly significantly lower parameters of global systolic (EF=8,7±4,6 vs. 63±7,9; p<0,001), longitudinal systolic (S'=6,9±1,3 vs. 9,9±2,1) and diastolic function (E/e'11,9±4,8 vs. 8,7±4,6; p<0,001), and a highly statistically significant increase in left ventricular telediastolic dimension, myocardial mass index, and left atrial size. CONCLUSION: The diagnosis of acute viral myocarditis in clinical practice is made on the basis of the clinical picture, ECG and echocardiography that indicate myocarditis with the exclusion of cardiac comorbidities, based on the ESC criteria for suspected clinical myocarditis. The whole group A had highly statistically significantly lower parameters of systolic and diastolic function compared to control group B. Normal ECG and echocardiography cannot serve to exclude the diagnosis of myocarditis. Comparison of subgroups A1 and A2 did not reveal a statistically significant difference in echocardiographic parameters.

Author(s):  
Patil Aniket ◽  
Dindore Pallavi ◽  
Arbar Aziz ◽  
Kadam Avinash ◽  
Saroch Vikas

The quest for excellence in mental and physical health is not new. We find various references and formulations in Ayurvedic classics meant for promoting mental and physical health of a child. Suvarna Prashan is one of the formulations explained in age old Ayurvedic classic Kashyap Samhita. This formulation is very widely used now days as a memory and immune booster for children. But there is very little systematic documented study which can be used to evaluate the efficacy of the formulation. Suvarna Bhasma was prepared in Ayurved Rasayani Pharmacy, Pune. Madhu and Ghrita were collected from KLE Ayurveda Pharmacy, Belgaum. Suvarna Bindu Prashan was prepared in KLE Ayurved pharmacy, Belgaum. It contains Suvarna Bhasma, Ghrita and Madhu. Twenty apparently healthy male and female children with age group of three to four years were ready to sign inform consent form were selected into two groups each. Subjects in Group A received Suvarna Bindu Prashan where as Group B (Control group) did not receive any treatment. Both the groups were observed for six months. Children in Suvarna Bindu Prashan group showed significant reduction in the scores of eating habits, behavior, mood, temperament and scores of event of illness. However there was no significant difference in the score of sleeping habit. There was significant increase in IQ percentage.


Author(s):  
Brij Bhushan Singh ◽  
Shubi Mirja ◽  
Samiya Husain

The purpose of this study was to investigate the effects of yogic practices on cardio-vascular efficiency. Material and methods: Total Forty (40) subject’s boys/girls were selected as the sample of the study through the random sampling and their age ranged between 20 to 25 years from the Department of Physical Education, Aligarh Muslim University, Aligarh. The subjects were divided into two groups comprising 20 subjects in each group, namely group “A” (the experimental group) performs yogic practices (Asanas, Pranayamas and Kriyas) and group “B” (the control group) served as control. Statistical technique: for the assessment of the cardiovascular efficiency through Harvard step test pre and post-test was conducted and t-test was applied for the analysis. Result: revealed that there exist a significant difference between group A and group B, at .05 level of significance. On the basis of the pre and post-test among experimental and control group, experimental group found better than the control group on cardiovascular efficiency and significant result were found in this study.


2021 ◽  
Vol 45 (5) ◽  
pp. 312-316
Author(s):  
Mishra Neha Sanjeev ◽  
Harsimran Kaur ◽  
Sandeep Singh Mayall ◽  
Rishika ◽  
Ramakrishna Yeluri

Objective: To evaluate the effectiveness of placing a resorbable collagen barrier in impeding the extrusion of obturation material in primary molars undergoing resorption. Study design: All the 94 canals in 47 mandibular molars were allocated to 2 groups- Group ‘A’- 47 canals with collagen barrier (Test group) and Group ‘B’- 47 canals without collagen barrier (Control group) based on randomization protocol. Pulpectomy was performed and obturation of both test and control canals were radiographically assessed. Pearson’s chi – square test was applied to analyze the results. The significance level was predetermined at p &lt; 0.05. Results: Among the test group, 93.6% of the canals showed no extrusion while, 6.4% showed visible extrusion of the material outside the apex. In the control group, 83% showed no extrusion whereas 17% of the canals showed visible extrusion outside the apex. But no significant difference was noted (p&gt;0.05). Conclusion: The placement of resorbable collagen barrier in the apical third of the canal prevented the extrusion of obturating material beyond the apex in resorbing primary molars.


2016 ◽  
Vol 124 (4) ◽  
pp. 1093-1099 ◽  
Author(s):  
Alexander Ivanov ◽  
Andreas Linninger ◽  
Chih-Yang Hsu ◽  
Sepideh Amin-Hanjani ◽  
Victor A. Aletich ◽  
...  

OBJECT The use of digital subtraction angiography (DSA) for semiquantitative cerebral blood flow(CBF) assessment is a new technique. The aim of this study was to determine whether patients with aneurysmal subarachnoid hemorrhage (aSAH) with higher Hunt and Hess grades also had higher angiographic contrast transit times (TTs) than patients with lower grades. METHODS A cohort of 30 patients with aSAH and 10 patients without aSAH was included. Relevant clinical information was collected. A method to measure DSA TTs by color-coding reconstructions from DSA contrast-intensity images was applied. Regions of interest (ROIs) were chosen over major cerebral vessels. The estimated TTs included time-to-peak from 0% to 100% (TTP0–100), TTP from 25% to 100% (TTP25–100), and TT from 100% to 10% (TT100–10) contrast intensities. Statistical analysis was used to compare TTs between Group A (Hunt and Hess Grade I-II), Group B (Hunt and Hess Grade III-IV), and the control group. The correlation coefficient was calculated between different ROIs in aSAH groups. RESULTS There was no difference in demographic factors between Group A (n = 10), Group B (n = 20), and the control group (n = 10). There was a strong correlation in all TTs between ROIs in the middle cerebral artery (M1, M2) and anterior cerebral artery (A1, A2). There was a statistically significant difference between Groups A and B in all TT parameters for ROIs. TT100–10 values in the control group were significantly lower than the values in Group B. CONCLUSIONS The DSA TTs showed significant correlation with Hunt and Hess grades. TT delays appear to be independent of increased intracranial pressure and may be an indicator of decreased CBF in patients with a higher Hunt and Hess grade. This method may serve as an indirect technique to assess relative CBF in the angiography suite.


2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Ning Ding ◽  
Jing Jiang ◽  
Xiaoxiao Liu ◽  
Yiyuan Xu ◽  
Jiatong Hu ◽  
...  

Acupoints microcirculatory dynamics vary depending on the body’s health status. However, the functional changes observed during acupoint sensitization, that is, the disease-induced change from a “silenced” to an “activated” status, remain elusive. In this study, the microcirculatory changes at acupoints during sensitization were characterized. Thirty SD rats were randomly divided into five groups: normal control group (N), sham osteoarthritis group (S), light osteoarthritis group (A), mild osteoarthritis group (B), and heavy osteoarthritis group (C). The obtained results showed that the blood perfusion levels at the acupoints Yanglingquan (GB34), Zusanli (ST36), and Heding (EX-LE2) in groups A, B, and C were higher than those in groups N and S on days 14, 21, and 28 (p < 0.01 or p < 0.05). A significant difference in the blood perfusion was also observed at the acupoint Weizhong (BL40) in groups B and C on days 21 and 28 (p < 0.01). In addition, remarkable differences in the level of blood perfusion at the GB34, ST36, and EX-LE2 acupoints were observed on day 28 (p < 0.01 or p < 0.05) among groups A, B, and C. No marked differences in blood perfusion levels were observed at the nonacupoint site among all groups. In conclusion, acupoint sensitization is associated with an increase in the level of local blood perfusion at specific acupoints, and this increase is positively correlated with the severity of the disease. The functional changes in microcirculation at acupoints during sensitization reflect the different physiological and pathological conditions imposed by the disease.


2013 ◽  
Vol 38 (3) ◽  
pp. 74-78
Author(s):  
MMH Talukder ◽  
KMT Islam ◽  
M Hossain ◽  
MU Jahan ◽  
F Mahmood ◽  
...  

This prospective study was conducted to compare the outcome between medical and surgical treatment of primary intracerebral haemorrhage at the department of Neurosurgery, Dhaka Medical College Hospital from January 2006 to October 2007. All patients with primary intracerebral haematoma with Glasgow Coma Scale (GCS) 5-15 (on admission) and heamatoma volume 30 cc or above admitted at Neurosurgery department managed conservatively or surgically were included in this study. Total 60 patients were selected, of them 30 patients managed conservatively and 30 patients managed surgically. Conservatively managed patients regarded as control group (Group-A) and surgically managed patients regarded as experimental group (Group-B). Patients or attendants refused to operate were included in the conservative group. All the selected patients were evaluated on the basis of detailed history, clinical examination (general and neurological examination) and CT scan findings. Outcome was evaluated in term of Glasgow Outcome Scale (GOS). Best medical treatment was given for conservative group and operations were done for surgical group and followed up after surgery till discharge by observing GCS and GOS at discharge. Number of death were 15 (50%) patients in group- A and 13 (43%) patients in group-B. There was no significant difference in mortality rate between two groups but outcome was relatively better in group-B. According to Glasgow Outcome Scale, dependency in group-A and group-B was 26.6% and 23.4% respectively. So dependency were more in group-A. But there was no significant difference statistically. Seven (23.4%) patients were independent in group-A but 10(43.3%) patients were independent in group-B. However in relative terms of outcome of group-B was better than that of group-A. In our study we found no statistically significant difference in outcome between medical and surgical management of primary intracerebral haemorrhage. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14328 Bangladesh Med Res Counc Bull 2012; 38(3): 74-78 (December)


1992 ◽  
Vol 263 (4) ◽  
pp. H1243-H1249
Author(s):  
Y. Qiu ◽  
M. Galinanes ◽  
R. Ferrari ◽  
A. Cargnoni ◽  
A. Ezrin ◽  
...  

The isolated blood-perfused rabbit heart, subjected to 60 min of cardioplegic arrest and 60 min of reperfusion, was used to assess the effects of polyethylene glycol-conjugated superoxide dismutase (PEG-SOD) on postischemic recovery of left ventricular developed pressure (LVDP), the tissue activity of SOD, and tissue redox state. The five groups studied were the following: PEG-SOD-free control (group A), PEG-SOD as a pretreatment and as an additive during cardioplegia and reperfusion (group B), PEG-SOD as a pretreatment and a cardioplegic additive (group C), PEG-SOD in cardioplegia alone (group D), and PEG-SOD in reperfusion alone (group E). The results show that pretreatment with PEG-SOD improves postischemic recovery of LVDP (72 +/- 2% and 66 +/- 7 vs. 47 +/- 4% in groups B, C, and A, respectively). This protection was associated with an improved tissue redox state. Thus the ischemia-induced rise in oxidized glutathione was reduced from 313 +/- 26% (group A) to 162 +/- 15 and 138 +/- 14% (groups B and C, respectively), and the fall in reduced glutathione was attenuated from 51 +/- 5% to 35 +/- 6 and 13 +/- 5%, respectively. Tissue Mn-SOD activity was also conserved from 36 +/- 4% (group A) to 71 +/- 6 and 94 +/- 4% (groups B and C, respectively). No significant effect was seen when PEG-SOD was applied in cardioplegia or during reperfusion alone.


2019 ◽  
Vol 17 ◽  
pp. 205873921984406
Author(s):  
Tao Zheng ◽  
Qingyun Zhou ◽  
Zhe Chen ◽  
Qinning Wang

The study aimed to study the correlation between expression levels of interleukin-37 (IL-37), granulocyte macrophage colony-stimulating factor (GM-CSF), and C-reactive protein (CRP) in peripheral blood and the status of atherosclerosis (AS) and plaque stability and to confirm the clinical significance of these inflammatory factors in the pathogenesis of AS. A total of 64 AS patients (case group) were selected and divided into unstable plaque group (group A, 28 cases) and stable plaque group (group B, 36 cases) according to the color ultrasonography results of arterial vessels. At the same time, 30 healthy subjects were classified into the control group. General information of the enrolled subjects was collected, including levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), CRP, and homocysteine (Hcy). The expression levels of IL-37 and GM-CSF in the serum of peripheral blood samples collected from these subjects were measured by enzyme-linked immunosorbent assay (ELISA). There was no significant difference between the case group and the control group in the levels of TC, TG, HDL, and LDL ( P > 0.05). However, the expression level of Hcy in the case group was significantly higher than that in the control group ( P < 0.05). Compared with the control group, the expression levels of IL-37, GM-CSF, and CRP in the case group were significantly increased ( P < 0.05). In addition, compared with group B, the expression level of GM-CSF in group A was significantly increased ( P < 0.05), while no significant difference was detected between group A and group B in the expression levels of IL-37 and CRP ( P > 0.05). In conclusion, inflammatory factors IL-37, GM-CSF, CRP, and Hcy were all involved in the pathogenesis of AS, and the increased levels of GM-CSF were closely related to the progress of unstable plaques. These results may aid the early diagnosis/treatment of AS.


2015 ◽  
Vol 77 (17) ◽  
Author(s):  
Rashidah Ghazali ◽  
Herlina Abdul Rahim ◽  
Mashitah Shikh Maidin ◽  
Shafishuhaza Sahlan

Previous research about the exposure of Mozart music and noise and the effects towards the feeding, growth rate and the stress level of the broilers were explored.Music has the ability to have a relaxing and antidepressant effect on humans, mammals and birds. Reports that music calms animals and improves productivity appear in commercial journals. The present study investigated the growth rate comparisons between the experimented broilers (Group A: water supply modification group; Group B: sound exposure group) and the control broilers (Group C: control group) in terms of weight and raw meat texture measured by shear force. The water supply modification group was given 12 litres of Yasin water twice per day while the sound exposure group were broadcasted with sound of Quran verses. Twenty-seven broilers were randomly selected from each group on Day 24 and weight measurement was carried out every week until the harvest day (Day 39). Group B showed a higher mean weight on Day 24 (1.441 ± 0.013 kg) than Group A and C. Significant difference in the weight on Day 39 existed for both Group A and B compared to Group C (p < 0.05). However, there was no significant (p > 0.05) difference of shear force in the same muscles (breast and drumstick raw meat) of the three groups but the shear force of the breast meat for Group A, B and C broilers was lower (p < 0.05) than that of their drumstick meat. Broadcasting the sound of the Quran verses in the coop and adding Yasin water to the broilers’ drink can be applied to improve the growth rate of broilers for producing better quality poultry.


2016 ◽  
Vol 14 (1) ◽  
pp. 37-42 ◽  
Author(s):  
M. G. Sorwar ◽  
M. Mostofa ◽  
M. N. Hasan ◽  
M. Billah ◽  
M. T. Rahman

This experiment was conducted to determine the effect of papaya leaf (Carica papaya) and kalo jeera (Nigella sativa) seeds powdered supplementation in drinking water as a growth promoter in broiler chickens. A total of 20 Cobb-500 broiler chicks (day-old) were purchased from local hatchery (Nourish Poultry and Hatchery Ltd.) and after seven days of acclimatization chicks were randomly divided into two groups, A (n=10) and B (n=10). The group A was kept as a control and not treated. The group B was supplemented with papaya leaf and kalo jeera powder with feed and water. Weekly observations were recorded for live body weight gain up to 5th weeks and hematological tests were performed at 35th day’s age of broiler to search for hematological changes between control (A) and treatment (B) groups. The initial body weight of groups A and B on 1st were 41.00±0.56 gm and 41.50±0.35 gm, respectively and after 35th day of experiment final body weight were 1470±57.35 gm and 1720±58.56 gm, respectively and economics of production were analyzed and found that net profit per broiler was Tk. 8.91 and Tk. 20.69, respectively. The treatment group B was recorded statistically significant (at 1% level) increased (17.00%) for live body weight than that of control group A. The hematological parameters total erythrocyte count (TEC), erythrocyte sedimentation rate (ESR) and hemoglobin (Hb) estimation value of treatment group shows significant difference, while hemoglobin estimation does not show significant difference from control group. The results suggest that better growth performance could be achieved in broilers supplemented with papaya leaf and kalo jeera seeds.


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