Detailed epidemiological analysis of cerebrovascular disease, the first study from Eastern India

Background: Prevalence of cerebrovascular diseases (CVD) is rising in India along with its morbid impact. Till now there is no study from Eastern India to reflect the current scenario of cerebrovascular diseases in this part of world. This study destined to know and analyse several epidemiologic factors behind cerebrovascular diseases in Eastern India.Methods: 108 patients who were admitted with symptoms of stroke were analysed based on several parameters. They were investigated, treated and their outcomes were followed.Results: Correlation between clinical findings and radiological confirmation was much more in case of infarction (65%) compared to haemorrhagic cases (22%). Superior division of the middle cerebral artery was the commonest site get involved in infarction cases and internal capsule area is the most commonly involved area in lacunar infarction almost one third of haemorrhagic patients had intraventricular extension. Most common association with this was thalamic bleeding although most common site of haemorrhage was lentiform nucleus. Among the patients with hemorrhage with intraventricular extension 50% were thalamic bleed and 50% were non thalamic bleed (mainly lentiform nucleus). In hospital mortality rate was found to be highest in non-thalamic group (63%). Overall mortality in non-thalamic bleed was higher though not statistically significant.Conclusions: Haemorrhagic CVD is much more prevalent in this part of world compared to western population. Clinico radiologic correlation is much more in ischaemic infarction hypertension and smoking are two strong associations in cerebrovascular diseases.

A case of severe hypothyroidism presenting only with bleeding diathesis

Hypothyroidism can present with the variety of clinical features; however, bleeding manifestations as a sole presentation ofhypothyroidism is extremely rare. Hemostatic disorder may be a manifestation of several underlying etiology. Here, we reporta case of a 14 year old girl who initially presented with bleeding diathesis without any other symptoms suggestive of thyroiddysfunction but later on investigations was found to be suffering from severe hypothyroidism

Prevalence of Novel Risk Factors in Patients of Acute Coronary Syndrome in Eastern India: A Detailed Analysis

Background: To identify prevalence of the novel risk factors among young patients with Acute Coronary Syndrome (ACS) and having no or minimal conventional risk factors. Methods Total 70 patients (male 48, female 22) who were admitted in our hospital with ACS, without any traditional risk factors were analyzed for hsCRP [highly sensitive C reactive protein], Lp(a) [Lipoprotein(a)], Homocysteine and uric acid level. Results 44.29% of the study population have high values of hs-CRP, more in older age group but not significant (40 yrs) (P=0.79). High homocysteine present in 42.86% of cases, more in older age (>40 yrs) (54.55%) than <40 years age (23.08%) which is statistically significant (P-0.01). High uric acid level found in 32.86% of cases without any significant age and sex difference. High Lp(a) level is found in 41.43% of cases more among ≥40 years (50%) than <40 years (26.92%), the difference was not found to be statistically significant. [Chi-square = 3.587; P=0.058; OR=2.71 95% CI= 0.95 – 7.7]. Conclusions hsCRP is most useful cost effective screening method for ACS in younger individual among all other parameters in this part of world

Prevalence of Subclinical Hypothyroidism in Acute Coronary Syndrome in Nondiabetics: Detailed Analysis from Consecutive 1100 Patients from Eastern India

Background. The association between subclinical thyroid dysfunction (defined by no symptoms or clinical features of hypothyroidism but biochemically TSH level in the range of above 5 miu/ml but below 10 miu/ml with normal FT4 level) and Acute Coronary Syndrome (ACS) is not known so far. This study was done to calculate the prevalence of subclinical thyroid dysfunction in patients with ACS. Methods. A retrospective chart review of 1100 consecutive patients was done who presented to Emergency Department with symptoms suggestive of ACS and admitted. They were later classified in 3 categories that includes Acute ST Elevated Myocardial Infarction (STEMI), Unstable Angina (UA), and Acute Non-ST Elevated Myocardial Infarction (NSTEMI). Thyroid function test (FT4, TSH) and antithyroid peroxidase (TPO) were done and evaluated properly. Results. Of 1100 consecutive patients 168 (15.27%) patients had the biochemical features of subclinical thyroid dysfunction. These 168 patients include 60 STEMI, 66 NSTEMI, and 42 Unstable Angina patients. There were no statistically significant differences in terms of left ventricular ejection fraction (LVEF) and catheterisation results considering thyroid dysfunction. Conclusions. Subclinical thyroid dysfunction is quite prevalent in ACS patients. There are no significant associations between STEMI, Unstable Angina, or NSTEMI patients in terms of thyroid dysfunction neither in single vessel versus multivessel disease involvement. The causative role and outcomes of treatment are still uncertain and need further follow-up

Detailed epidemiological analysis of cerebrovascular disease, the first study from Eastern India

Background: Prevalence of cerebrovascular diseases (CVD) is rising in India along with its morbid impact. Till now there is no study from Eastern India to reflect the current scenario of cerebrovascular diseases in this part of world. This study destined to know and analyse several epidemiologic factors behind cerebrovascular diseases in Eastern India.Methods: 108 patients who were admitted with symptoms of stroke were analysed based on several parameters. They were investigated, treated and their outcomes were followed.Results: Correlation between clinical findings and radiological confirmation was much more in case of infarction (65%) compared to haemorrhagic cases (22%). Superior division of the middle cerebral artery was the commonest site get involved in infarction cases and internal capsule area is the most commonly involved area in lacunar infarction almost one third of haemorrhagic patients had intraventricular extension. Most common association with this was thalamic bleeding although most common site of haemorrhage was lentiform nucleus. Among the patients with hemorrhage with intraventricular extension 50% were thalamic bleed and 50% were non thalamic bleed (mainly lentiform nucleus). In hospital mortality rate was found to be highest in non-thalamic group (63%). Overall mortality in non-thalamic bleed was higher though not statistically significant.Conclusions: Haemorrhagic CVD is much more prevalent in this part of world compared to western population. Clinico radiologic correlation is much more in ischaemic infarction hypertension and smoking are two strong associations in cerebrovascular diseases.

Retinal Nerve Fibre Layer Thinning in Patients with Thalassaemia, Iron Deficiency Anaemia, and Anaemia of Chronic Diseases

Purpose. Retinal nerve fibre layer (RNFL) is a sensitive structure, which is affected by anaemia due to hypoxia. A timely detection of RNFL thinning may aid preventing devastating complications. Optical coherence tomography (OCT) measures RNFL thinning with accuracy and helps in detecting thinning of the retinal layer in anaemic patients. This study was destined to evaluate thinning of RNFL in anaemic patients and their correlation with the haemoglobin level. Methods. It was a prospective comparative study. Total of 151 patients were included in this study. Patients with retinal diseases were excluded from this study. After initial evaluation, haematological and ophthalmological parameters were measured. RNFL was measured with OCT and corroborated with the Hb level and analysed accordingly. EPI and SPSS softwares were used for detail analysis and the correlation between RNFL thinning and the Hb level. Initially, each eye was separately assigned a value (0, 1, and 2) (normal, borderline, and abnormal, respectively) as per the severity of thinning, and then, the sum of the scores of both eyes were considered as a separate variable, and a multiple linear regression analysis was performed with the independent variables. Results. RNFL thinning was found to be significant in each group of patients. There was a strong correlation of RNFL thinning with degree of anaemia. Conclusions. Thalassaemia, iron deficiency anaemia, and anaemia of chronic diseases are associated with the significant damage to RNFL. Degree of anaemia is the most important parameter for such thinning of the RNFL layer

Oxidative stress as a potential biomarker for determining disease activity in patients with Rheumatoid Arthritis

Rheumatoid arthritis is an inflammatory, autoimmune disease where oxidative stress has been proposed to contribute to the joint tissue damage. To establish whether measurement of the redox status in blood mirrors the oxidant status at sites of inflammation in patients with rheumatoid arthritis, we concomitantly examined their oxidant status by spectrophotometry and/or flow cytometry. The basal levels of total reactive oxygen species (ROS), superoxide and hydroxyl radicals were significantly raised in neutrophils sourced from peripheral blood and synovial infiltrate, as also showed a strong positive correlation; however, there was no major increase in the reactive nitrogen species RNS generated in monocytes from both sources. Furthermore, raised levels of superoxide in neutrophils of synovial infiltrate showed a positive correlation with NADPH oxidase activity in synovial fluid. Additionally, as ROS generated in both peripheral blood and synovial infiltrate correlated positively with both DAS 28 and CRP/anti-CCP levels, its measurement can serve as an indirect measure of the degree of inflammation in patients with RA

Oxidative stress in blood mirrors the oxidant status in synovial infiltrate of patients with rheumatoid arthritis

This article does not have an abstract

A Review on the Fabrication of Polymer-Based Thermoelectric Materials and Fabrication Methods

Thermoelectricity, by converting heat energy directly into useable electricity, offers a promising technology to convert heat from solar energy and to recover waste heat from industrial sectors and automobile exhausts. In recent years, most of the efforts have been done on improving the thermoelectric efficiency using different approaches, that is, nanostructuring, doping, molecular rattling, and nanocomposite formation. The applications of thermoelectric polymers at low temperatures, especially conducting polymers, have shown various advantages such as easy and low cost of fabrication, light weight, and flexibility. In this review, we will focus on exploring new types of polymers and the effects of different structures, concentrations, and molecular weight on thermoelectric properties. Various strategies to improve the performance of thermoelectric materials will be discussed. In addition, a discussion on the fabrication of thermoelectric devices, especially suited to polymers, will also be given. Finally, we provide the challenge and the future of thermoelectric polymers, especially thermoelectric hybrid model

A Review on the Fabrication of Polymer-Based Thermoelectric Materials and Fabrication Methods

Thermoelectricity, by converting heat energy directly into useable electricity, offers a promising technology to convert heat from solar energy and to recover waste heat from industrial sectors and automobile exhausts. In recent years, most of the efforts have been done on improving the thermoelectric efficiency using different approaches, that is, nanostructuring, doping, molecular rattling, and nanocomposite formation. The applications of thermoelectric polymers at low temperatures, especially conducting polymers, have shown various advantages such as easy and low cost of fabrication, light weight, and flexibility. In this review, we will focus on exploring new types of polymers and the effects of different structures, concentrations, and molecular weight on thermoelectric properties. Various strategies to improve the performance of thermoelectric materials will be discussed. In addition, a discussion on the fabrication of thermoelectric devices, especially suited to polymers, will also be given. Finally, we provide the challenge and the future of thermoelectric polymers, especially thermoelectric hybrid model