The Journal of the Association of Physicians of India
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The aVR is often neglected lead. It is an unipolar lead facing the right superior surface. As all the depolarisations are going away from lead aVR, all waves are negative in aVR (P, QRS, T) in normal sinus rhythm. ⋯ In acute pulmonary embolism, ST elevation in lead aVR is a bad prognostic sign. In Tricyclic antidepressant toxicity, R in aVR more than 3 mm is an adverse prognostic sign. So in variety of conditions, the aVR is proved to be a valuable lead not only in diagnosis but also in predicting the prognosis.
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Melioidosis caused by the gram-negative bacterium Burkholderia pseudomallei is endemic in Southeast Asia but may be under-diagnosed and under-reported in the Indian subcontinent. This study was undertaken to analyse the clinical presentation and epidemiological risk factors for melioidosis in India. ⋯ Melioidosis is an emerging infection in India especially in males from rural areas, with diabetes and alcoholism being the commonest risk factors. Both sepsis with bacteraemia and localised disease involving joints or focal abscess were common presentations. Diagnosis is readily made by culturing the organism from appropriate clinical specimens and identifying non-fermenting Gram negative bacteria to the species level. As there was an excellent response in 75% of patients, early suspicion, culture confirmation and therapy is warranted in India.
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J Assoc Physicians India · Sep 2013
Obstructive sleep apnoea and atopy among middle aged chronic obstructive pulmonary disease and bronchial asthma patients.
Obstructive sleep apnoea syndrome is associated with significant morbidity. A high prevalence of obstructive sleep apnoea (OSA) symptoms has been reported in patients with asthma and chronic obstructive pulmonary disease (COPD). There are limited studies regarding relationship between atopy and OSA. ⋯ There is an increased risk of obstructive sleep apnoea among middle aged chronic obstructive pulmonary disease and asthma patients. Atopy could be associated with OSA. The association needs to be proved in a larger study.
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J Assoc Physicians India · Sep 2013
Utility of SOFA and APACHE II score in sepsis in rural set up MICU.
To assess morbidity and mortality as well as to prognosticate the patients by using SOFA and APACHE II scores of patients with sepsis, severe sepsis and multi-organ dysfunction syndrome (MODS) in rural setup ICU. ⋯ Serial measurement of SOFA score during first week is very useful tool in predicting the outcome. The APACHE II score on day of admission was not reliable in predicting the mortality rate in this study and we believe that it may need modification in set up like ours.