Background and Aim: The clinical applicability of substitution of central venous oxygen saturation for mixed venous oxygen saturations in monitoring global tissue hypoxia is still a matter of controversy. Hence aim of the study is comparison of paired samples of mixed venous and central venous oxygen saturation and comparison in relation to cardiac index in varying hemodynamic conditions. Materials and Methods: Prospective clinical observation: Postoperative cardiac surgical ITU: 60 adult patients, >18 years of age of either sex: A PAC was inserted through ® IJV, triple lumen catheter was inserted through ® IJV. Blood samples were taken from distal tip of PAC and central venous catheters. An arterial blood sample was drawn from either radial or femoral arterial line. Measurements: Continuous cardiac output monitoring. Analysis of blood samples for hemoglobin concentration and oxygen saturation. Mixed venous oxygen saturations and central venous oxygen saturations were compared. The study was carried over a period of 30h in the postoperative period and samples were taken at 6h intervals. Patients were classified into three groups as follows depending on the CI: Low (< 2.5 L/m 2), medium (2.5-4 L/m 2), high (> 4 L/ m 2) and correlated with Svo 2 and Scvo 2. Results: 298 Comparative sets of samples were obtained. Svo consistently lower than Scvo 2 throughout the study period. The difference was statistically significant. By using Bland-Altman plot, the mean difference between Svo 2 and Scvo 2 (Svo 2-Scvo 2) was-2.9% ± 5.14 and confidence limits are + 7.17% and-12.97%. The coefficient r is > 0.7 throughout the study period for all paired samples. The correlation Svo 2 and Scvo 2 with cardiac index in all the three groups were >0.7. Conclusion: Scvo 2 and Svo 2 are closely related and are interchangeable. Even though individual values differ trends in Scvo 2 may be substituted for trend in Svo 2

Background: Diabetes is one of the many chronic medical conditions, which is adversely affected by comorbid depression. Research so far suggests an association between clinically significant levels of depression and a range of poorer self-care behaviors such as nonadherence to diet, exercise, and prescribed medications. Objective: (1) To study the prevalence of depression among type 2 diabetic patients; (2) to study the impact of depression on self-care among type 2 diabetic patients. Materials and Methods: A hospital-based cross-sectional study carried out in Urban Health Center, Raichur, Karnataka, India. Totally, 166 patients with established type 2 diabetes mellitus attending the Urban Health Center were interviewed using a predesigned questionnaire based on Summary of Diabetes Self-Care Activities and Patient Health Questionnaire to assess depression. Data were entered in Microsoft Excel and analyzed using Epi Info 7. Results: The mean age of the study subjects was 54.8 years, and the mean duration of diabetes was 7.5 years. Only 18.7% of diabetic patients had done HbA1c test; 77.7% of diabetics were on oral hypoglycemic agents. Depression was found in 28.3% of participants. Nonadherence to treatment, smoking, and decreased physical activity was significantly associated to having depression (P < 0.05). Conclusion: This study showed high prevalence of depression in patients with type 2 diabetes mellitus. Physicians caring diabetic patients must recognize and manage comorbid depression.

Background and Aim:It is well known that dialysis dependent renal failure increases the likelihood of poor outcome following cardiac surgery. But the results of CABG in patients with mild renal dysfunction are not clearly established. The aim of the study is to analyze the risk of preoperative mild renal dysfunction on outcome after isolated coronary surgery.Materials and Methods:We reviewed prospectively collected data between June 2006-Nov 2006 in 488 patients who underwent isolated CABG. We separated the data into two groups. Control group having normal renal function and study group having mild renal dysfunction (serum creatinine 1.4 mg-2.2 mg%). Among 488 patients, 412 patients were in control group and 76 patients were in the study group.Results:Analysis of data showed significant postoperative complications in the mild renal dysfunction group, like increased operative mortality (7.5% vs 1.6%), increased requirement of postoperative renal replacement therapy (10% vs 1.2%), increased incidence of new onset atrial fibrillation (20% vs 4.2%) and prolonged duration of ICU stay. Multivariate analysis adjusting for known risk factors confirmed preoperative mild renal dysfunction (S.creat.1.4-2.2 mg/dl) is an independent risk factor for postoperative morbidity and mortality. (Adj. OR: 4.47; 95% CI: 1.41-14.16; P=0.010).Conclusion:Mild renal dysfunction is an important independent predictor of outcome in terms of in-hospital mortality and morbidity in patients undergoing CABG.

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