Tuberculosis is the major public health concern globally. Cardiovascular involvement was observed in 1-2% of cases with pulmonary tuberculosis. The present study was designed to assess the ECG changes in pulmonary tuberculosis before and after anti-tuberculosis therapy. A total of 90 clinically diagnosed with sputum positive pulmonary tuberculosis cases above 21 years of age were included. Cases with abnormal findings on ECG were advised to echocardiography to detect the exact abnormality / cardiac complication due to pulmonary tuberculosis. Collected data were analysed to compare the ECG changes in pulmonary tuberculosis at the initial diagnosis and follow up for six months. In 60% of cases, the duration of symptoms was less than 6 months and in 40% cases, it was more than 6 months. ECG abnormalities was observed in 65.5% pulmonary tuberculosis cases before commencing antituberculosis therapy, whereas ECG abnormalities were noted in 34.4% of cases after completion of anti-tuberculosis therapy. Sinus tachycardia was observed in pulmonary tuberculosis cases before anti tuberculosis therapy was 42.2% and after 6 months follow up with ATT it was reduced to 11.1%. Sinus tachycardia, QRS axia+90 0 , p wave axis +90 0 , Right side axis deviation and p-pulmonale was the main abnormalities noticed in ECG before the commencement of anti-tuberculosis therapy. The values were reverted back to normal after anti tuberculosis therapy. PT cases with atypical features should be a monitor with echocardiography for early detection of cardiac complications.

Esophageal variceal bleeding is a severe lethal complication of cirrhosis due to its high rate of mortality. Non-invasive procedures like clinical, biochemical and USG have immense predictive value in the diagnosis of esophageal varices. The present study was designed to evaluate non-invasive predictors for esophageal varices. A total of 100 clinically diagnosed cases with cirrhosis of liver were recruited. Laboratory parameters like serum bilirubin, serum albumin, platelet count and prothrombin time, Clinical parameters like child Pugh class, ascites and splenomegaly and USG parameters like portal vein and spleen diameter along with echo texture of the liver, spleen size and direction of blood flow, portal vein diameter and platelet count/spleen diameter ratio was determined. Among the study cases, 57% cases had small (Grade I-II) varices and 43% cases had large varices (Grade III-IV). Alcohol was the most common etiology in 48.8% cases with large varices and 28% cases with small varices, followed by HBV. In large varices group, 55.8% were in CTP-C, 27.9% were in CTP-B and 16.2% were belonged to CTP-A. The Grade III-IV large esophageal varices were significantly correlated with the total bilirubin levels, low albumin levels, elevated prothrombin time, increased portal vein diameter, increasing spleen size, low platelet count, lower values of platelet count and spleen diameter ratio. The above parameters are the significant predictors of large esophageal varices.

Cardiovascular complications are common cause of mortality on cases with systemic lupus erythematosus (SLE). Both idiopathic and drug induced lupus have cardiac manifestations. The present study was designed to evaluate cardiovascular manifestations in cases with systemic lupus erythematosus. A total of 64 clinically and serologically diagnosed cases of systemic lupus erythematosus above 21 years of age were recruited. Clinical and serological examination was performed to assess the study participants. All the cases were subjected to ECG and chest X-ray and later were subjected to echocardiography to assess all the cardiac features. Majority cases were in between 21-30 years (32.1%) followed by 31-40 years (28.1%). 54.68% cases had disease >5 years and 45.31% cases had disease <5 years. 46.87% cases had oral and nasal ulcers, followed by chest pain (37.5%), dyspnoea (31.25%), photosensitivity (17.1%), Raynaud phenomenon (17.1%), arthralgia (15.6%), palpitations (15.6%), seizures (12.5%), syncope (10.9%) and myalgia (7.81%). Echo findings showed that 6 cases had systolic dysfunction, 4 cases had diastolic dysfunction, 7 cases had regional hypokinesia, 6 cases had global hypokinesia, 22 cases had pericardial effusion, 4 cases had pericardial thickening, 10 cases had mitral valve prolapse syndrome, 1 case had mitral stenosis, 16 cases had mitral regurgitation, 9 cases had aortic thickening, 6 cases had aortic regurgitation, 10 cases had tricuspid regurgitation, 11 cases had pulmonary hypertension and 1 case had pulmonary stenosis. Pericarditis and pericardial effusion was the most common cardiovascular manifestation and global hypokinesia was least common cardiac manifestation.