The Journal of the Association of Physicians of India
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J Assoc Physicians India · May 2016
ReviewEarly Warning Scoring System for Early Recognition of and Timely Intervention in Deteriorating Patients in the Hospital.
Delay in recognizing clinical deterioration in acutely unwell patients often leads to cardiac arrests and unexpected admissions to the Intensive Care Unit. Early Warning Scoring Systems based on vital physiological parameters help in early detection of clinical deterioration. ⋯ A standardised National Early Warning Score has been implemented in the United Kingdom. There is a need to implement an early warning scoring system in hospitals in India in order to ensure effective and judicious utilization of our overburdened acute services and to minimize adverse outcomes.
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J Assoc Physicians India · Apr 2016
DemographIc Assessment and EValuation of DEgree of Lipid Control in High Risk Indian DySlipidemia PatiEnts (DIVERSE Study).
Cardiovascular diseases (CVD's) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy. In Indian patients, comprehensive data on dyslipidemia management and its treatment outcomes are inadequate. There is lack of information on existing treatment patterns, the patient's profile being treated, and factors that determine treatment success or failure in achieving desired goals. ⋯ As per the European Society of Cardiology guidelines the ideal LDL-C levels in high risk dyslipidemic patients should be less than 70 mg/dL. In the present study, 7.7% of the patients achieved LDL-C levels < 70 mg/dL on lipid lowering therapy which is very less. Most of high risk dyslipidemic patients in India are on suboptimal dosage of statin. So more aggressive and high dosage statin therapy may be required to achieve target LDLC levels in high risk Indian dyslipidemic patients.
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J Assoc Physicians India · Apr 2016
Case ReportsOsmotic Demyelination Syndrome Presenting with Chorea.
Osmotic demyelination syndrome is an acute shift in serum osmolality causing demyelination, which may be due to rapid correction of hyponatremia, hyperglycaemia, hypokalemia and ketoacidosis. We present a case of 55yr old female and a known diabetic presented with the choreic movements involving left upper and lower limb for 2 days without any weakness. ⋯ Patient's sugar levels improved with Insulin and chorea controlled with carbamazepine and sodium valproate. Osmotic demyelination can occur not only due to rapid correction of hyponatremia but also due to wide fluctuations in the blood sugar levels causing swinging of serum osmolarity.
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Cysticercosis, a parasitic disease caused by larval form of Taenia solium, is a major health concern in the developing world. The encysted larval stage can affect any part of the body, but are most frequently detected in brain, eye, skeletal muscle and subcutaneous tissue. Most muscular cysticercosis are almost always associated with central nervous system involvement or with multiple intramuscular cysts or both. Here we report an unusual case of cysticercosis in right rectus muscle which was an isolated muscle involvement without any other systemic manifestation.