Context: The incidence of pleural effusion is approximately one million per year. For diagnosing and treatment plan, pleural effusions have to be classified into transudate and exudate. If the diagnosis is not appropriate, it may result in severe complications. The established criterion for differentiating exudates from transudates is Light's criteria. But there were some false positive results in case of transudative effusions when Light's criteria were used. Aims: This study was done to determine the accuracy of serum effusion albumin gradient (SEAG) when compared to Light's criteria in differentiating transudates and exudates. Settings and Design: It is a prospective observational study. In the present study, the sample size is 66 patients, in whom the SEAG was used for the classification of pleural effusions with a cut-off value of 1.2 g/dl. Methods and Materials: All the blood samples were collected and biochemical parameters like total protein, albumin, and LDH were analyzed in both serum and pleural fluid using XL 640 fully automated random access analyzer. Statistical Analysis Used: Results were analyzed using SPSS software version 20. Results: 20 of 22 transudates and 41 of 44 exudates were classified correctly using SEAG. The diagnostic accuracy of SEAG (92.42%) is better than Light's criteria (87.87%) in differentiating both transudative and exudative effusions. Conclusions: The SEAG is superior to Light's criteria in identifying the transudative effusions. It is also observed that Light's criteria identified exudative effusions better than SEAG.
Introduction:Cardiomyopathy is the disease of the heart muscle, which causes deterioration of myocardial functioning. A study was conducted to find electrocardiographic findings in dilated cardiomyopathy. Materials and methods: This was a hospitalbased study, conducted in the department of General Medicine, GSL Medical College. Informed written consent was taken from each patient or his/her attendant prior to including in the study. Patients with dilated cardiomyopathy, both gender, all ages. Heart failure based on Framingham criteria, ECHO criteria -LV ejection fraction less than 45%, with left ventricular or biventricular dilatation, with global hypo-contractility were included in the study. ECG and 2 D Echo have been performed on the patients. Framingham criteria were used for the diagnosis of heart failure. Descriptive statistics were presented in the form of mean ± standard deviation and percentages. Results: Total 102 patients were included in the study, with a mean age of 56.3 ±12.5 years, the male-female ratio was 1.9. Tachycardia was 61%, left axis deviation was present 34.3% and right axis deviation in 8.8%. Left ventricular end-diastolic and systolic diameters were elevated in most of the patients. Conclusion: With these findings, it can be concluded severe LV systolic dysfunction is very common among dilated cardiomyopathy patients.
Background: Contrast media (CM) used during diagnostic and therapeutic percutaneous procedures is eliminated by the kidneys. A study has been planned to find the adverse effects of contrast agents on renal system. Methods: This was a hospital based cross sectional study, conducted in the department of general medicine, GSL Medical College. Individuals >25 age, both gender with heamoglobin concentration of > 10mg/dl were included. Exclusion criteria was also followed. Iodixanol or iohexol was used, administered at the rate of 80-100 ml per participants. Blood samples were collected standard techniques before the procedure and 48 hours after the procedure for serum creatinine levels. Renal function was assessed by estimating creatinine clearance using the Cockcroft-gault formulae. As per national kidney foundation participants were divided in to 4 categories normal, mildly impaired, moderately impaired and severely impaired renal function; p<0.05 was considered as statistically significant. Results: Out of 80 study subjects, CIN was increased with age, identified in 37.9% diabetics, 48.3% smokers, 41.4% alcoholics; statistically there was no significant difference. In the normal category 34.5%, 41.4% in mild category, 24.1% in moderate renal dysfunction category developed CIN, association was statistically significant. Conclusions: With these findings we conclude that overall increase in the incidence of CIN with age and no influence of gender as well as conditions like diabetes and hypertension.
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