Epidemiological study of dilated cardiomyopathy from eastern India with special reference to left atrial size

Dilated cardiomyopathy (DCM) is a common cause of emergency visit in our country. The disease is often misdiagnosed and mistreated. There are very few studies on DCM from India. We undertook a small study on DCM patients from Eastern India to find the demographic and echocardiographic characteristics. Patients and methods: We under took this study in a tertiary care Medical College of Eastern India. All patients coming to the emergency with dyspnea were evaluated for cardiac dysfunction. Emergency echocardiography was done to diagnose dilated cardiomyopathy. Patients with DCM were then evaluated as per protocol. After stabilization, echocardiography was repeated to note the study parameters like left atrial diameter. Standard statistical tests were used. Results: we had a total of 70 patients in our study with a male: female ratio of 43:27. Most patients were aged over 40 years. Patients with COPD, history of radiation, malignancy or drug abuse were excluded. Most patients (47%) were on NYHA stage 3 at the time of presentation. In our patient cohort, 24% were alcoholic and 46% were smokers. Atrial fibrillation was present in 15.7% of the patients and right and left bundle branch block had been present in 8 and 15 patients respectively. In echocardiography, increased left atrial (LA) size (>40 mm) was found in 45 patients. Many patients had valvular regurgitation, mitral, aortic or tricuspid. LA size was positively correlated with left ventricular systolic diameter (r=0.403) and negatively correlated with ejection fraction (r= -0.23). Analysis and conclusion: different ECG abnormalities like bundle branch block and arrhythmias like atrial fibrillation are quite common in DCM. In echocardiography, left atrial size is an important prognostic marker and correlates with left ventricular function

Design analysis of a hot strip mill runout table bed under ANSYS workbench

A structural analysis has been performed on the setup of a spray cooling system for a model of a hot strip mill. The objective was to design a run out table (ROT) whose length is reduced for a spray cooling system. The setup consists of a bed (ROT) whose height can be adjusted as desired, and a carriage which would be carrying the hot plate, moving along the bed, for experimentation. The CAD modelling was done in CATIA and the analysis was performed in ANSYS Workbench. A prototype of the whole setup was built from the virtual model and was controlled using products from National Instrument Corporation (NI). The analysis is being conducted for the design optimization of the entire setup and its safety

Design analysis of a hot strip mill runout table bed under ANSYS workbench

A structural analysis has been performed on the setup of a spray cooling system for a model of a hot strip mill. The objective was to design a run out table (ROT) whose length is reduced for a spray cooling system. The setup consists of a bed (ROT) whose height can be adjusted as desired, and a carriage which would be carrying the hot plate, moving along the bed, for experimentation. The CAD modelling was done in CATIA and the analysis was performed in ANSYS Workbench. A prototype of the whole setup was built from the virtual model and was controlled using products from National Instrument Corporation (NI). The analysis is being conducted for the design optimization of the entire setup and its safety

Study of C reactive protein as a prognostic marker in malaria from Eastern India

Background: C-reactive protein (CRP) is useful as marker of severity in malaria. African studies have shown that serum CRP levels correlate with parasite burden and complications in malaria, especially falciparum. However, there are very few data on CRP levels in Indian malaria patients. Materials and Methods: We assessed CRP levels in malaria patients at presentation and studied for any relation of CRP levels with subsequent prognosis. Statistical tests included student′s t-test, Mann Whitney U test, and chi square test, all with 2-tailed analyzes. Results: Of 71 patients in our study, 42 (59.1%) were infected with P. falciparum. 23 (32.4%) patients needed admission and 10 (14.1%) died. Average CRP levels were quite high in malaria patients (31.29 ± 20.4 mg/L). There was no significant difference in CRP between vivax and falciparum cases. Admitted patients had significantly higher CRP levels compared to those treated on outdoor basis (47.11 ± 19.13 vs. 23.71 ± 16.35 mg/L; P < 0.0001). 8 patients were admitted with multiple complications. They had significantly high CRP level compared to those with 1 complication (P = 0.015). Also, patients who died had higher CRP levels compared to survivors (P = 0.000346). CRP levels at presentation showed positive correlation with duration of hospital stay (r = 0.59; P < 0.05). CRP levels >35 mg/L was highly sensitive in predicting mortality. Conclusion: Our study in Indian population corroborates the findings in African studies regarding prognostic role of CRP in malaria. CRP is an effective biomarker in assessing malaria severity and also for follow-up

Suprasellar Tuberculoma Presenting as Sudden Onset Blindness in a Patient of Lupus

Tuberculosis can be an opportunistic infection complicating the course of patients receiving prolonged immunosuppression. In these patients, the tuberculosis can involve the central nervous system and can cause diagnostic difficulty due to atypical features. Often, the diagnosis of central nervous system tuberculosis in resource limited settings is indirect, like imaging. But anti-tubercular drugs, given even on empirical basis can be life saving. A case of a young female systemic lupus erythematosus patient (on prolonged steroids) with intracranial tuberculoma is presented here. She presented with blindness and headache and her computed tomography scan showed a calcified mass in the suprasellar location. However, she responded well to anti-tubercular drugs. The differential diagnoses of such lesions are also discussed