Background; Magnesium has been implicated in the pathogenesis of acute myocardial infarction and its related complication like arrhythmia. Magnesium helps in myocardial metabolism, inhibits calcium accumulation and myocardial cell death. It has role in improving the vascular tone, peripheral vascular resistance, after load and cardiac output, reduces cardiac arrhythmias and improves lipid metabolism. Magnesium reduces vulnerability to oxygen derived free radicals, improves endothelial function and inhibits platelet function including platelet aggregation and adhesion. Objective: To know the relationship between the serum magnesium levels and arrhythmias in patients with acute myocardial infarction.70 cases of acute myocardial infarction, admitted in a tertiary care hospital over a period of 2 years i.e., between October 2015 to October 2017. Results: There is a signicant difference in the magnesium levels in patients with arrhythmias and without arrhythmias. Conclusion: In acute myocardial infarction, patients with low magnesium levels are more prone to get arrhythmias. That is the reason magnesium treatment can be considered in patients of acute myocardial infarction with low magnesium levels.
Arterial hypertension affects approximately a billion people worldwide and approximately 30 % of them remain undiagnosed.1% - 2% of known hypertensive patients will have hypertensive emergency at some time in their life Though hypertensive crisis contributes one fourth of all emergency visits and trend is increasing in last few years still there is lack of data over the actual incidence of hypertensive crisis The present study aims to know the incidence and clinical presentation of the hypertensive crisis ( hypertensive emergency and urgency ) in a tertiary hospital and will help us to know the incidence and pattern of clinical presentation with respect to different aspects. Methods; This is a prospective observational study of 100 cases of hypertensive crisis (hypertensive emergency and hypertensive urgency) presenting to the emergency department. Study conduct during 2016 to 2018. Results; The incidence of hypertensive crisis was found to be 20%.Most of the patients were belonged to the 5th and 6th decades of life and Male patients were more than female patients Majority of the patients were known hypertensives for 6 to 10 years and 22% of the known hypertensive patients has discontinued their anti hypertensive medications Cardiovascular symptoms in the form of dyspnoea & chest pain were the most common accompanying symptoms Acute coronary syndrome was the most common clinical manifestation followed by neurological decit. Conclusion; As the trend of hypertensive crisis is increasing efforts should be made to reduce the occurrence of hypertension Preventive measures should be taken in the form of community education for dietary modication and routine exercise Routine blood pressure check ups compliance to the anti hypertensive treatment and control of associated comorbidities is essential to reduce the risk of hypertensive crisis.
Tenecteplase is a modied tissue plasminogen activator and newer thrombolytic agent. It has a longer half life ,which is more brin specic, produces less systemic depletion of circulating brinogen, and is more resistant to plasminogen activator inhibitor. Because of its pharmacodynamic properties which results in rapid reperfusion and lower intracranial hemorrhages. Hence the objective is to study the efcacy of tenectaplase in acute ischemic stroke including, neurological and functional outcome at 3 months which is assessed by mRS scale and also to know the complications arising out of thrombolysis with tenectaplase. This is Methods- prospective observational study of 40 cases of acute ischemic stroke undergoing thrombolysis with tenecteplase within 4.5 hours of onset. Dose of 0.2 mg /kg of tenecteplase was used for thrombolysis and outcome was evaluated with improvement in NIHSS score at arrival , 24 hrs, 1 week and at discharge, 1 and 3 month and mRS scale at 1 and 3 months. In our study, 67.5% (27 out of 40) patients met the primary clinical efcacy outc Result- ome by achieving an improvement in NIHSS score of 4 or more points at 24 h and 67% (27out of 40 patients) met the secondary clinical efcacy outcome by having an mRS scale of 0 or 1 at 3 months. Adverse events were noted in 7 patients (17.5%) of which 4 developed ICH and 3 patients showed poor clinical outcome. ConclusionTenecteplase appears to be a safe and effective agent for acute ischemic stroke because of signicant improvement in NIHSS , low disability rates were observed in the present study
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