Cross-Sectional Study to Find Out the Prevalence of Cardiovascular Diseases Through Detection of ECG Abnormalities in Undiagnosed Population Using a Handheld ECG Device, SanketLife Pro Plus

: In India, cardiovascular diseases (CVDs) are now the main cause of sudden death. Statistics on prevalence or nationally representative surveillance statistics, however, are lacking. Aim: The objective of this cross-sectional study was to assess the ECG findings in general OPD patients not yet diagnosed with any CVD using SanketLife Pro Plus handheld ECG device. Materials and methods: The study data was extracted from a free ECG test camp, which was organized in the common OPD waiting area at Indraprastha Apollo Hospitals in New Delhi. Of the 100 persons screened, 78% had sinus rhythm and 13% had tachycardia. Apart from these, no other major findings were detected in the study population. One percent ST depression and 4% T-wave inversions were the significant findings of concern, suggestive of myocardial ischemia or infarction, especially in the undiagnosed population. Conclusion: Considering the sample size, even at a 1% incidence of major ECG abnormalities, the outcome is indicative of a possible underlying danger, which is avoidable with early detection and thorough awareness. A mass ECG screening along with collection of relevant data and appropriate research design may help to identify the population at risk. Besides the ECG screening, a stroke risk assessment should be done and prophylaxis must be given to the individuals who have been diagnosed with CVDs

One-Step versus Two-Step Diagnostic Test for Gestational Diabetes Mellitus

Comparison between one-step Diabetes in Pregnancy Study Group India (DIPSI) andAmerican Diabetes Association (ADA) recommended two-step oral glucose tolerance test(OGTT). Material and methods: This study has a sample size of 200; 100 participants eachwere subjected to either of the two tests. Gestational diabetes mellitus (GDM) and non-GDMdiagnosed by one-step test versus two-step test, respectively, were compared to one anotherand results were compared on the basis of various antenatal complications and fetomaternaloutcomes. Results: No statistical difference was found between both the groups on the basis ofvarious antenatal and fetomaternal outcomes. Conclusion: In Indian subcontinent with poorresources and lack of follow-up, single-step DIPSI can be preferred to ADA recommendedtwo-step OGTT; however, large database studies are still required

Lighter Side of Medicine

LIGHTER READIN

An Interesting Case of Pulmonary Tuberculosis with Hypoxemic Respiratory Failure Mimicking Interstitial Lung Disease

Hypoxemic respiratory failure is a rare presentation of active pulmonary tuberculosis (TB). Though tuberculous acuterespiratory distress syndrome (ARDS) is well documented in medical literature, non-ARDS respiratory failure is seldomreported in active pulmonary TB. We herein report a case, which posed a diagnostic dilemma as it clinically mimickedinterstitial lung disease. Imaging showed unilateral localized smooth interlobular septal thickening along with consolidationwithout significant mediastinal lymphadenopathy. To the best of our knowledge, this rare radiological finding has not beenreported in medical literature as being associated with hypoxemic respiratory failure in pulmonary TB patients

Hydroxychloroquine - An Antimalarial and Anti-inflammatory Drug

Hydroxychloroquine – a quinoline antimalarial, has hypoglycemic effects that manifest due toits action on the intracellular insulin metabolism in peripheral tissues. Recent studies confirmthat the use of Hydroxychloroquine can aid in preventing new onset diabetes and complicationsof diabetes, systemic lupus erythematosus and rheumatoid arthritis, as well as in improvingthe mortality rate of these patient

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Hepatic Granulomas: A Clinician’s Perspective

Hepatic granulomas are focal aggregates of transformed epithelioid histiocytes with or without multinucleated giant cells that are cuffed by lymphocytes and plasma cells. They represent delayed-type specialized cell-mediated immunity to a wide-spectrum of antigenic stimuli. Hepatic granulomas are found in up to 10% of liver biopsies and the causes are usually multifactorial. Different antigens like infectious agent, medication, foreign body and malignancy can initiate granuloma formation. Hepatic granulomas per se seldom cause architectural changes and often provide a clue to a systemic disease. Most often, to a practicing clinician, it is a combination of clinical presentation, laboratory parameters with information on the typical localization and characterization of the granuloma within the liver by the pathologist that often provides a clue to a definitive diagnosis

A Patient-centered Approach to Management of Migraine in Primary Care

Primary care physicians are in a prime position to enhance the diagnosis and treatment of migraine for a large number of patients since they see a large number of migraine patients for the first time in these settings. Case report: This is a case report of a young woman with a known history of migraine headaches with aura who presented to the Emergency Unit of a primary care facility with complaints of severe headaches, which were not improving after long-term use of herbal preparations. The onset of her symptoms was associated with generalized weakness, loss of appetite, nausea and seizure of the right side of the upper body lasting for 10 seconds, which was self-limiting. There was no associated vomiting or dizziness. The initial workup included a computed tomographic (CT) scan of the head and an electroencephalogram (EEG), which were unremarkable. The patient’s perspectives were explored and patient-centered approaches were employed to manage the patient with analgesics and oral amitriptyline and propranolol combination as a migraine prophylaxis. Conclusion: A patient-centered approach to care can be a crucial strategy for efficient migraine treatment once a patient has been diagnosed with the conditio

Retinal Vascular Changes in Pregnant Women with Gestational Diabetes Mellitus A2: A Cross-sectional Study

Diabetes complicates a significant proportion of pregnancies, with gestational diabetes mellitus (GDM) posing a considerablehealth concern. While the incidence of GDM is rising, its implications extend beyond pregnancy, affecting both maternaland fetal health. Notably, diabetic retinopathy (DR) presents a substantial risk, particularly in women with pre-existingdiabetes. However, there remains a dearth of data on retinal vascular changes in pregnant women with GDM managed withmedication, particularly in the South Indian population. This study aims to address this gap by evaluating retinal vascularchanges in pregnant women with GDM managed with medication, focusing specifically on GDM type A2. We conducted acomprehensive assessment of retinopathy prevalence and associated factors in this population, employing various imagingmodalities including fundus photography, optical coherence tomography angiography and Doppler sonograph

Innovative Urinals with Proteinuria Detection: A Potential Screening Tool for Diabetic Kidney Disease

Chronic kidney disease (CKD) poses a considerable health challenge, particularly in populations with high-risk factorssuch as diabetes and hypertension. This article proposes a novel and cost-effective approach to address this concern byintegrating proteinuria detection technology into urinals. We suggest the installation of these innovative ‘smart’ urinals inhomes of individuals with diabetes, offering a convenient and proactive means of monitoring kidney health. Furthermore,the deployment of such ‘smart’ urinals in public places could serve as accessible screening facilities, enabling early detectionof CKD in a broader population. The potential cost-benefit ratio of this approach is highlighted, emphasizing the long-termeconomic benefits associated with early intervention. We argue that the proposed technology has the potential to revolutionizeCKD screening, providing a valuable tool for individuals at risk and contributing to the global effort to mitigate the impactof CKD on public health. Further research and pilot programs are warranted to explore the feasibility and effectiveness ofthis innovative screening strateg