Keywords : Cardiovascular disease
CLINICAL STUDY OF CARDIAC INVOLVEMENT IN GERIATRIC TYPE 2 DIABETES MELLITUS WITH REFERENCE TO ELECTROCARDIOGRAPHY AND 2D ECHOCARDIOGRAPHY
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 1, Pages 1579-1593
Cardiovascular problems brought on by ageing and the premature atherosclerosis unique to DM are the most common consequences.Thus Geriatric Diabetic patients have a high prevalence of cardiovascular disease (CVD). Coronary Artery diseases,Heart failure,Diabetic Autonomic cardiomyopathy causing arrhythmias are more common type of cardiovascular diseases in these group of patients.
Materials and Methods: The present prospective cross sectional hospital based observational study was conducted among 150 Geriatric patients with Type 2 diabetes Mellitus. A detailed clinical history was taken from all the patients regarding symptoms of Diabetes Mellitus Type 2. The data was collected and entered into a spread sheet application (Microsoft9 Excel ).
Results: Majority of the study participants were among 60-70 years (89.33%) and least being >80 years(0.67%) .Majority of the study participants were females with 50.67% and 49.33% were males.
considering BMI,47.61% cases were Overweight (25-30) and 15.65% cases were Obese (>30).Major duration of DM among study population was 10-20 years(50.67%) followed by <10 years (27.33%).Major symptoms suggestive of cardiovascular involvement was palpitation 44% followed by 37.33% fatigue.Major signs suggestive of cardiovascular involvement was crepitations 13.33%, followed by 10% pedal edema. Major chest x-ray finding was cardiomegaly 12%, followed by 6.67% Pleural effusion.Major ECG changes considering infarction was NSTEMI 15.33% followed by 12% STEMI.Major ECG changes considering arrhythmias was sinus tachycardia 18% followed by 6.67% sinus bradycardia, 0.67% atrial fibrillation, 1.33% VPC, 19.33% LVH and 0.67% BBB.Major 2D Echo findings was 36.67% LVDD followed by 32.67% had Hypokinesia, 31% akinesia, 27.33% LVSD.It was observed that Around 62% had no cardiovascular involvement, 31.33% had Myocardial infarction, 20.67% arrythmia, 12.67% heart failure and 12% Diabetic cardiomyopathy (HCM+DCM).
Conclusion: Geriatric Diabetics are at significantly increased risk for cardiovascular disease. Myocardial Infarction is commonest cardiovascular abnormality detected.ECG and Echocardiography are basic yet most sensitive diagnostic procedure to detect CVD at an early stage .
ASSESSMENT OF CARDIOVASCULAR MORBIDITIES IN PREDIABETIC INDIVIDUALS - A COMPARATIVE CROSS SECTIONAL STUDY
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 1, Pages 1252-1258
Background: Prediabetes is a disorder of glucose homeostasis characterized by impaired glucose tolerance or impaired fasting glucose. Prediabetes is associated with structural RA and RV changes, and impaired RV systolic and diastolic function, independent of cardiovascular risk factors. Prediabetics are at increased risk of developing type 2 DM. Present study was aimed to assess cardiovascular morbidities in prediabetic individuals.
Material & Method: This hospital based analytical comparative study was conducted among the individuals attending the medicine OPD of Aarupadai Veedu Medical College & Hospital aged more than 18 yrs with impaired fasting glucose and healthy controls. Comparison between Venous Blood Glucose Levels(Fasting, Impaired Glucose Tolerance) and changes in Electrocardiography, Echocardiography were done.Patients with pre-diagnosed cardiac disease, pancreatic disease, chronic kidney disease, thyroid disorders, dyslipidaemia, obese persons and pregnant women were excluded from the study. All the collected data were analysed using SPSS v21 operating on windows 10, with p<0.05 considered statistically significant.
Results: Total 252 participants included among them assessment of the cardiovascular morbidities were done, There were significant higher incidence of ECG and 2D ECHO changes among prediabetic compared to the controls. The ECG and 2D ECHO abnormal findings were seen in 71.5% among the prediabetic cases and zero % in controls.(p<0.05). Mean weight of cases was significantly higher than controls, BMI was significantly higher in cases compared to controls. (p<0.05)
Conclusion: Present study concludes that there is higher incidence of cardiovascular morbidities among the Prediabetes individuals compared with normoglycemic healthy individuals.
Evaluation of Drug Utilization in Cardiovascular Disease: A Prospective Analysis
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 3586-3591
Background: Cardiovascular disease (CVD) is the major reason of mortality among noncommunicable diseases (NCDs), constituting 26% in India. The present study was conducted to evaluate drug utilization in cardiovascular disease.
Material and methods: The prospective observational study was conducted for a period of 6 months to evaluate drug utilization in cardiovascular disease. The study included a total of 600 patients admitted to intensive coronary care unit. All the medical prescriptions were collected and the data was used to analyze the prescription pattern by prescribing indicators and individual drug use by DDD measure. The data was collected and analyzed for counts and percentages. The mean and standard deviation was computed for continuous variables.
Results: Of the total 600 records, males were 60% and females were 40%. Ischemic Heart Disease (31.66%) and Hypertension (30.25%) were the most common cardiovascular diseases in the study population. Clopidogrel and Isosorbide dinitrate were most commonly prescribed Cardiovascular Drugs. It was found that Clopidogrel (51.80%), atorvastatin (48.95%), Isosorbide dinitrate (50.76%), were highly used. DDD was highest of Enalapril maleate i.e. 4.43. The average drugs per prescription during hospitalization was 4.15. Percentage number of drugs Prescribed by generic names was 71.5%. Percentage of Drugs Prescribed From National Essential Drug List was 88%.
Conclusion: The present study concluded that the most commonly prescribed medications are Clopidogrel, Isosorbide Dinitrate. Percentage of drugs prescribed by Generic name should be improved. The percentage of drugs prescribed form national Essential Drugs List was satisfactory but still have to be improved.
“Impact Of “Non- Surgical Periodontal Therapyon Plasma Homocysteine Levels In Patients With Chronic Periodontitis”
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 4299-4336
Understanding the etiology and pathogenesis of periodontal diseases and their chronic, inflammatory and infectious nature necessitates recognizing the possibility that these infections may have effects somewhere in the body. The concept that oral diseases and systemic diseases influence each other goes back to the theory of “focal infection”. In 1891, Miller published his theory regarding focal infection in which he indicated that microorganisms and their products are able to access parts of the body that are adjacent to or distant from the mouth. The proponents of this concept assume that microorganisms present in dental plaque and their metabolic products may enter the bloodstream, thereby causing many systemic diseases and sometimes resulting in degenerative conditions. Associations have been reported between periodontal disease and cardiovascular disease (CVD), stroke, diabetes, preterm low birth-weight babies, respiratory infections and rheumatoid arthritis (RA).
BIOCHEMICAL ASSESSMENT OF SERUM PARAOXONASEAND SERUM LIPID PROFILE AS PREDICTOR OF CARDIOVASCULAR DISEASES IN PATIENTS OF PSORIASIS
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 1222-1232
Background:Psoriasis is the most prevalent chronic inflammatory disease, with an approximate worldwide prevalence of 2-3% [1]. The etiological factor is yet to be known but the genetic factor, trauma, skin infections, drugs, emotional stress like anxiety, alcohol, smoking etc greatly impact the clinical evolution of Psoriasis [2]. Oxidative stress which is induced by the excessive production of reactive oxygen species and inflammatory cytokines that play a significant role in the evolution of severe psoriatic plaques. Serum Paraoxonase is synthesized by the liver and is related with HDL particles.
Materials and Methods: Sample Collection– After 12 hours of fasting, a morning sample of 5 ml of venous blood has been collected from the antecubital vein from each subject under aseptic conditions. Parameters Serum Paraoxonase using paranitrophenol substrate by spectrophotometric method. Serum Lipidprofile Serum totalcholesterol by CHOD-PAP Enzymatic photometric method. Serumtriglycerides by GPO-POD method. Serum Hdl- cholesterol by Direct Enzymatic Cholesterol- DL estimation in the presence of detergent. Serum LDL-Cholesterol estimated by Friedewald formula. Serum VLDL- Cholesterol is estimated automatically by dividing triglyceride by5.
Results: The [mean ± SD] age of the cases was 43.67±11.069 and in the controls 42.8±11.679 years. Statistical analysis showed that there was no statistical difference in age between the two groups (as the P-value is > 0.005). The [mean±SD] basal PON activity in cases was 69.08±13.03 and in controls was 74.46±9.79. There is statistical significance in the basal PON activity between the two groups. The mean serum total cholesterol is increased incases (p value is 0.630) when compared with controls, but it is not statistically significant. there is a high significance in the serum high densitylipo protein (HDL-C) between the two groups: 1. The mean increase in the levels of serum low densitylipo protein (LDL-C) cases are statistically significant when compared with controls. There was a high statistical significance in the serum triglycerides levels between the two groups.
Conclusion: This study was undertaken to study the levels of serum Paraoxonaseandserum lipid profile in 40 patients who are diagnosed with psoriasis to assess the irrole in causing cardiovascular diseases. 2. Inpsoriasis, the elevated levels of triglycerides, low densitylipo protein and very low-density lipoprotein are due to lowered levels of hepatic lipase at acute phase reaction, results in elevation of triglycerides in serum. Decreased levels of HDL-C levels are observed because the systemic Inflammation caused by cytokines. As PON is associated with HDL. The PON levels are affected by the decrease in HDL levels and results in lipidperoxidation along with formation of Oxidised LDL. This OX-LDL accumulates in the smooth muscle of artery and causes atherosclerosis.
Knowledge And Perception About Diabetic Retinopathy In Ischemic Heart Disease In Practicing Physicians -An Original Research
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 10913-10919
Aim: The purpose of the present research was to assess the knowledge as well as
perception amongst various practicing physicians about diabetic retinopathy in
ischemic heart disease patients.
Methodology: A cross-sectional study was designed to assess the knowledge, perception
amongst 209 practicing physicians. A self-administered questionnaire about
demographic and professional data, knowledge regarding Diabetic retinopathy (DR),
and about attitudes and practices toward DR screening and management in
Cardiovascular disease (CVD) patients were distributed amongst participants.
Descriptive statistical analysis was conducted for the data obtained from the present
survey.
Results: A total of 141 physicians completed the questionnaire for a response rate of
67%. Nevertheless, only 36.9% taught their patients abouthow to detect complications
early in CVD patients. The overall mean knowledge score was 1.23±0.67 for males and
1.98±1.11for females p = 0.260.
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 9, Issue 3, Winter 2022
10914
Conclusion: It is important for DR to be detected in a timely manner in CVD patients
by the physicians that will allow early treatment and prevention of visual loss.
Serum Uric Acid Level in Predicting Outcome in Acute Myocardial Infarction: A Prospective Study from North India
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 4, Pages 2575-2581
Background: In India, cardiovascular disease (CVD) is the main cause of morbidity and
mortality. According to recent trends, this group of disorders has expanded to younger
age groups as well. Cardiovascular illnesses are on the rise in India, affecting both men
and women in both urban and rural areas. The objective of this study was to analyse
serum uric acid levels correlate these values with Killip class in patients of acute MI.
Materials and Methods: Study was prospective type conducted at Dr. Baba
SahebAmbedkar Medical College and Hospital, Rohini, New Delhi from September
2016 to August 2017. A total of 100 patients of acute MI admitted to the ICCU, falling
into inclusion criteria were enrolled. Information was collected through a pre tested
and structured proforma for each patient. Also, physical examination and laboratory
investigation with special reference to Killip classification of heart failure was carried
out. During data analysis, a p value of <0.05 was considered statistically significant.
Results: Mean age of population 54.77 years. This study population had male
predominance (69.0%). In our study out of 100 patients 85 (85%) patients were STEMI
and 15 (15%) patients were NSTEMI. Mean uric acid on day 7 in patients with Killip
class I was 4.72 mg/dl and subjects with Killip class II was 6.62 mg/dl. In multivariate
logistics regression no factors were significantly affecting mortality after adjusting for
confounding factors.
Conclusion: From our study, we conclude that serum uric acid levels are correlated
with Killip class and patients with higher Killip class have higher serum uric acid levels
in acute myocardial infraction.
Assessment of the profile of CAD patients: An observational study
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 7125-7129
Background:Cardiovascular diseases (CVD) and its complications account for approximately 12 million deaths annually in the Indian subcontinent. Hence; the present study was undertaken for assessing the profile of CAD patients. Materials & methods:A total 50 cases of CAD in young patients [age < or = 40 years] were studied. The cases were taken from medical, surgical, cardiology OPD, wards & ICU. The study population was a mix of urban and rural population. Both males and females were included in our study. The history of each patient was noted in detail and a thorough clinical examination was performed. Relevant investigations were performed in individual
case. Each patient was followed up until discharge and the final Outcome was noted – complications / recovery / death. Data analysis was done with the help of experts.
A REVIEW STUDY ON THE RELATIONSHIP AMONG COVID-19 AND CARDIOVASCULAR DISEASE
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 7, Pages 5678-5686
In the scenery for Coronavirus Disease 2019 (COVID-19), the early data has indicated a decline in presentation and an improvement in pre-hospital latency for acute patients with stroke or AMI,3,4 the condition in Michigan, but it is not clear how acute stroke and AMI (COVID-18) should be administered and how these are treated. In reported cases and deaths, COVID-19 has had a disproportionate effect on Black Americans. Blacks make up about 14 percent of the population in Michigan but 19 percent of cases of COVID–19 and 36% of the deaths by October 22, 2020.5 The rise in the incidence of pre-hospital delay among Black Americans which further worsen established racial disorders6 compared with their white counterparts. We wanted to use a quick appraisal methodology in order to advise existing and prospective public health camps, both locally and globally, because of the pressing repercussions for clinical and public health.