Comparative study of echocardiography and electrocardiography criteria for detecting left ventricular hypertrophy in hypertensive patients

Background: The study aimed to compare seven different electrocardiogram (LVH) criteria for diagnosing left ventricular hypertrophy (LVH) with echocardiogram as diagnostic standard in hypertensive patients.Methods: This was a hospital-based, cross-sectional study conducted in out-patient department and at medical wards of a tertiary care hospital at Bangalore. The study was carried out for a total duration of 12 months. All hypertensive patients underwent examination for prevalence of LVH using echocardiogram and ECG. Seven different ECG criteria were applied to diagnose the presence of LVH. Then the specificity, sensitivity, kappa measurement value, positive predictive value and negative predictive value for all criteria was calculated subsequently.Results: Out of the 100 patients studied, 34 had LVH as diagnosed by echocardiography. Sokolow-Lyon criteria had a sensitivity of 35% and specificity of 94%. Cornell voltage had a sensitivity of 26% and specificity of 95%. Modified Cornell voltage had a sensitivity of32% and specificity of 94%. Framingham adjusted Cornell voltage, Minnesota code and Cornell product had a sensitivity of 23.5% and specificity of 98.4%. Framingham score had a sensitivity of 38% and specificity of 95.4%.Conclusions: It can be concluded that among all the different criteria used in the study, Framingham score showed better sensitivity compared to others. In the evaluation of hypertensive patients for LVH, the role of ECG with all the commonly used criteria is of limited value and echocardiography is the method of choice

The RNA Helicase Rm62 Cooperates with SU(VAR)3-9 to Re-Silence Active Transcription in Drosophila melanogaster

Gene expression is highly dynamic and many genes show a wide range in expression over several orders of magnitude. This regulation is often mediated by sequence specific transcription factors. In addition, the tight packaging of DNA into chromatin can provide an additional layer of control resulting in a dynamic range of gene expression covering several orders of magnitude. During transcriptional activation, chromatin barriers have to be eliminated to allow an efficient progression of the RNA polymerase. This repressive chromatin structure has to be re-established quickly after it has been activated in order to tightly regulate gene activity. We show that the DExD/H box containing RNA helicase Rm62 is targeted to a site of rapid induction of transcription where it is responsible for an increased degree of methylation at H3K9 at the heat shock locus after removal of the heat shock stimulus. The RNA helicase interacts with the well-characterized histone methyltransferase SU(VAR)3-9 via its N-terminus, which provides a potential mechanism for the targeting of H3K9 methylation to highly regulated genes. The recruitment of SU(VAR)3-9 through interaction with a RNA helicase to a site of active transcription might be a general mechanism that allows an efficient silencing of highly regulated genes thereby enabling a cell to fine tune its gene activity over a wide range

Hyponatremia secondary to acute urinary retention

Acute urinary retention is a rare cause of hyponatremia. Symptomatic acute hyponatremia is of grave medical concern and needs to be managed aggressively. In our two cases with acute urinary retention, a simple bladder catheterization and drainage of urine followed by conservative management resulted in complete resolution of symptoms and normalization of sodium levels. Association of bladder distension and hyponatremia is considered to be due to release of vasopressin triggered by bladder distension itself or by pain due to bladder distension. These cases are presented to bring to light an unusual and easily treatable cause of hyponatremia