European Journal of Molecular & Clinical Medicine

Aim: To analyse the cardio vascular changes in newly detected hypothyroid patients.
Material and methods: This cross sectional study was conducted among patients attending the medicine OPD over a period of one year and total number of 50 patients was taken. In the present study for the measurement of TSH, T4, T3 radio-immuno assay was employed. ECG was recorded in all patients, in all the 12 leads, at a paper speed of 25mm per sec. at normal standardisation, PR interval of >0.2 seconds was taken as prolonged, QRS complexes of less than 5mm in limb leads and less than 10mm in chest leads was taken as low voltage complexes. In all the patients in the study, echocardiogram was done on 2-D MODE and Doppler. Each case was specifically screened for cardiovascular manifestations like pericardial effusion, ventricular dysfunction.
Results: Most common signs on general physical examination was skin changes (58%) followed by oedema (52%) and delayed ankle jerk (34%). No abnormality was detected among 54% of the subjects. ST & T wave change and sinus bradycardia was reported among 12% of the subjects. Low voltage complex was revealed in 10% of the subjects. Pericardial Effusion (PE) was present among 13 (26%) subjects.
Conclusion: Cardiovascular symptoms are less commonly associated with newly detected hypothyroidism. The occurrence of pericardial effusion in hypothyroidism is significantly related to the duration of disease, hence the need for early diagnosis of hypothyroidism.

Background: Currently for physicians, there are limited parameters to stratify patients at risk for short term cardiovascular collapse (i.e. vasopressor dependence). The shock index (SI, heart rate divided by systolic blood pressure) is a simple formula useful for detecting changes in cardiovascular performance before the onset of systemic hypotension. It is an easily accessible, non-invasive, and non-costly risk stratification tool that may enhance current methods for differentiating severe sepsis patients at risk for imminent cardiovascular collapse.
Materials: In this study, we have taken patients who are above 18 years diagnosed to have sepsis were followed up and shock index was calculated every 6th hour. In 50 such patients who required vasopressor use within 72 hours of admission, percentage of SI elevation for each patient was determined by taking the total number of SI values greater than 0.8 and dividing this number by the total number of vital signs taken. The patients were divided into Sustained SI elevation (i.e. >or=80%) group and non-sustained SI elevation group (i.e. < 80%) and comparison was done.
Results: 80 patients were followed up, out of which 50 patient’s required vasopressor use with in 72 hours of admission. Among them 41 patients had sustained shock index elevation and 9 patients had non sustained SI elevation. It is found that sustained shock index was statistically significant in predicting vasopressor use in sepsis patients. Sustained SI had sensitivity of 82%, specificity of 83.3%, PPV of 89.13%, NPV of 73.55% and Diagnostic accuracy of 82.5% in predicting vasopressor use.
Conclusion: Patients with sepsis and a sustained SI elevation appear to have higher rates of vasopressor use short term after admission contrasted to patients without a sustained SI Elevation. A sustained SI elevation may be a promising simple, cost-efficient, and non-invasive measurement to help risk stratify patients who present with sepsis, and may complement other predictors of disease progression. A sustained SI elevation may be a useful modality to identify patients with severe sepsis at risk for disease progression.

Background:Cardiovascular Diseases (CVDs) like ischaemic heart disease,
cerebrovascular diseases account for 17.7 million deaths and are the leading causes.
CVDs occurs in Indians a decade earlier than the western population.Lifestyle-related
behavioural risk factors are mainly implicated for the increased burden of CHD, and
research related to these risk factors among medical students is essential, considering
their role as future healers and role models in public health intervention programs.
Objective: Study the prevalence of coronary risk factors among students of a Medical
college in Mangalore.
Methodology: A cross sectional study was done among M.B.B.S students of a Medical
College from November 2017 to March 2018. The study comprised of 500 students. A
pre-tested semi structured questionnaire was used for collection of data. Data was
collected by interview cum, clinical examination and relevant laboratory investigations.
Statistical analysis was performed using SPSS software.
Results: Out of 500 subjects 293 were females and 207 were males. 380 (76%) subjects
were consuming transfattyacid food items. 150 (30%) subjects had overweight and 40
(8%) subjects had Obesity. 80 (16%) subjects had Truncal obesity, 135 (27%) subjects
were consuming alcohol and smoking was seen in 58 (11.6%) subjects.107(21.4%)
subjects had high cholesterol. 90 (18%) subjects had lack of physical activity, 71
(14.2%) subjects had family history of CHD. 8 (1.6%) subjects had Hypertension and
10 (2%) subjects had impaired fasting blood sugar.

Better understanding and early recognition of hypertrophy in hypertensive patient helps with effective treatment and prevention of cardiovascular events and morbidity.
It has been established that anti-hypertensive therapy may diminish LVH and hence lessen the risk of serious cardiovascular events in individuals with hypertension. Left ventricular hypertrophy (LVH) is an adaptation of the heart, specifically the left ventricle, to increasing ventricular stress.
Subjects with borderline isolated systolic hypertension in the Framingham Heart study also had modestly elevated left ventricular (LV) layer thickness.¹ It's widely recognized that left ventricular hypertrophy is linked to high blood pressure and the cardiovascular complications that come with it..

Background: Renalase is a blood-secreted protein produced only by the kidney; its
blood level approximately 3–5 μg/ml. The Left ventricular hypertrophy (LVH) is
defined by an augmented left ventricular mass that may be measured via
echocardiography or magnetic resonance imaging (MRI). The aim of the present
study was to study whether Renalase is a marker or has a potential role in
developing myocardial hypertrophy in CKD patients under hemodialysis (HD)
treatment.
Patients and methods: To achieve this target, 90 patients on maintenance HD were
incorporated in the present study.
Results: The mean renalase levels were 61.7±67.5 ng/mL in HD patients. The cutoff
value of Renalase was >57.9 ng/ml with a sensitivity of 92.3% and a Specificity of
84.0%. The mean LVMI of the studied dialysis patients was 138 g/m2. The majority
of cases were severely abnormal (60%). There was a statistically significant
difference between the age groups and the LVMI among dialysis patients. The level
of Renalase was significantly increased with the moderately and severely abnormal
LVMI among dialysis patients. The present study disclosed statistically significant
relations between the duration of dialysis and Renalase, HDL, CRP, and LVMI.
There were significant relations between the serum renalase and s. creat, bl. Urea,
Ph, LVMI and dialysis vintage. Also, there were significant positive relations
between LVMI and Hb, CRP, and dialysis vintage.
Conclusion: Renalase could be a novel predictive biomarker in the assessment of
LVH, which is closely associated with the increased risk of death in HD patients.

Background: Hyperthyroidism is defined as excess concentration of thyroid hormones
in the body due to either increased synthesis of the thyroid hormone, increased release
of preformed thyroid hormones, or from endogenous or exogenous extrathyroidal
sources. The present study was conducted to assess cardiovascular manifestations of
hyperthyroid disorder patients.
Materials & Methods: 104 patients of hyperthyroidism of both gendersunderwent
clinical evaluation, basic laboratory tests like CBC, RFT, LFT and ECG and 2D ECHO
were performed in these patients to evaluate the presence of any cardiac manifestations.
Results: There were 34 males and 70 females. Age group upto 40 years had 20, 41-60
years had 34 and >61 years had 50 patients. Common symptoms were pallor in 90,
edema in 86, moist skin in 74 and eye signs in 53. Cardiovascular symptoms recorded
were chest pain in 82, palpitations in 95 and breathlessness in 60. Among 104 patients,
ECG changes were seen in 42 patients. Out of this, sinus tachycardia was seen in 65%,
AF in 10%, ST T changes in 6%, RVH in 7%, LVH in 11% and RBBB in 5%. The
difference was significant (P< 0.05).
Conclusion: Cardiovascular manifestations are quite common in hyperthyroid patients.

Background: Raising cardiovascular diseases and its associated comorbidity, health risks and consequences carry a massive health care system and economic burden on the society. Aim: To compare the different Indian manufactured drug eluting stents (DES) in patients undergoing primary percutaneous coronary intervention (PCI) with primary objective of major adverse cardiac and cerebrovascular events (MACCE). Study design: Observational, retrospective, and prospective study. Methodology: Study conducted at Sunshine Heart Institute from Jan 2016 to April 2018 in all the patients who have undergone primary PCI with Indian manufactured DES. The baseline clinical, procedural, in-hospital data and follow-up data was taken at 01, 03, 06 and 12 months, till end of study period at regular intervals, after the index procedure. Results: 163 patients were considered for the data analysis in 3 groups i.e. Premier (51), Tetrilimus (47) & YCF (65). Conclusion: All the three study groups have shown similar primary and secondary outcomes. However, further studies are required on large scale for accurate assessment and evaluation.