The Journal of the Association of Physicians of India
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J Assoc Physicians India · Jan 2012
Editorial Historical ArticleRheumatology, past, present and future.
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Thrombolysis revolutionized the treatment of acute ST - elevation myocardial infarction in the latter part of the last century and has been in use for more than two decades. Use of thrombolytic therapy is widespread owing to its safety, efficacy, ease of use, and affordability. ⋯ Primary percutaneous intervention is currently the preferred form of reperfusion therapy in the management of ST elevation myocardial infarction. However, thrombolytic therapy continues to have a role in many situations even in this era of intervention.
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Cardiovascular disease has become the leading cause of morbidity and mortality in renal transplant recipients, although its pathogenesis and treatment are poorly understood. Modifiable cardiovascular risk factors and graft dysfunction both play an important role in development of post transplant cardiovascular events. Prevalence of cardiovascular disease was studied in stable kidney transplant patients on cyclosporine based triple immunosuppression in relation to the various risk factors and post transplant cardiovascular events. ⋯ Age > or = 40 yrs, male sex, graft dysfunction, diabetes as primary renal disease, pre transplant cardiovascular event, chronic rejection showed significant correlation in univariate analysis and there was significant between age > or = 40 years (OR = 2.16 with 95% CI, 0.977-4.78) S creatinine > or = 1.4 mg % (OR = 2.40 with 95% CI, 1.20 - 4.82), diabetes as primary disease (OR with 95% CI 3.67, 3.2-14.82), PTDM (OR 3.67, 95% CI 1.45-9.40), pre-transplant cardiovascular disease (OR 4.14, 95% CI .38-13.15) with post transplant cardiovascular event on multivariate analysis. There was poor patient and graft survival among those who suffered post transplant cardiovascular event. The incidence of cardiovascular disease continues to be high after renal transplantation and modifiable risk factors should be identified to prevent occurrence of events in post transplant period.
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J Assoc Physicians India · Oct 2011
Case ReportsSuperior mesenteric artery syndrome secondary to tuberculosis induced cachexia.
Superior mesenteric artery (SMA) syndrome is a rare cause of obstruction of 3rd part of duodenum between abdominal aorta and the overlying superior mesenteric artery caused by decrease in the angle between the two vessels as a result of rapid loss of retroperitoneal fat. It is seen in conditions causing severe weight loss and catabolic states. We report a case of pulmonary tuberculosis leading to superior mesenteric artery syndrome.