Author Archives: pisrt

Abstract:Background: Hypothyroidism manifests itself in a wide range of clinical manifestations. ECG and ECHO changes have been reported among patients with both subclinical and manifest hypothyroidism.
Objectives: To enumerate the cardiological manifestations of hypothyroidism in ECG and ECHO.
Methods: The study was carried out as a cross-sectional study comprising 50 patients aged 18 years and above, of both sexes who were detected to have hypothyroidism. A convenient non-random sampling technique was used to select study participants from all eligible patients in the study population. The diagnosis of hypothyroidism was confirmed by measuring serum TSH, total T3 and T4, and subsequently, patients underwent ECG and echocardiography. A p-value <0.05 was considered statistically significant.
Results: It was observed that the majority of the study patients belonged to the middle age group and were females. Overt hypothyroidism was noted in 78%, and low levels of T3 and T4 were observed in 64% and 78%, respectively. Most of the study patients had elevated triglyceride levels (96%), while ECG and ECHO abnormalities were detected in 30%. Low voltage complex was the most commonly noted ECG abnormality (8%), and left ventricular diastolic dysfunction (LVDD) was the most common ECHO abnormality (18%).
Conclusions: ECG and ECHO changes are observed in a considerable proportion of patients with hypothyroidism, with low voltage complexes and LVDD being the most common, respectively.

Abstract:The pathogenesis of autoimmune diseases (AD) is based on the “recognition of the body’s own structures by immunocompetent cells and subsequent activation, proliferation, and induction of inflammation. Most lymphocytes directed towards their own antigens are removed in the thymus through apoptosis.” Currently, research is being conducted to investigate the genes involved in the development of autoimmune diseases, specifically in the context of vitiligo, such as HLA genes (HLADR3 associated with a common process, HLADR4 with limited), TNFAIP3 genes, and A20 deficiency haplotype (a product of this gene). The importance of immune inflammation, mononuclear infiltration of marginal zones, and the cytotoxic effect of CD8+ on melanocyte changes in CD4, CD8, and their ratios have been identified as early indicators of vitiligo progression. A local deficiency of SOD, glutathione, and scavengers from ROS regulated through Nrf2 and ARES in the skin and blood of vitiligo patients has also been revealed. This study included 287 patients with non-segmental vitiligo (148 men and 139 women) aged 19-68 years who sought treatment at the Republican Specialized Scientific and Practical Medical Center of Dermatovenerology and Cosmetology between 2018 and 2022. The average age was 28.1\(\pm\)1.3 years, and the duration of the disease was 42.6\(\pm\)3.6 months. Of these patients, 114 (40%) had the debut of vitiligo less than a year before treatment. The study found that the average level of TNF-alpha was higher than the reference interval and the data of the control group, supporting the contribution of inflammation and apoptosis to depigmentation in vitiligo. The study also highlighted the levels of TNF-alpha and IL-21 in patients who had an unfavorable allele for the SNPs among the other patients in the main group.

Abstract:This article discusses the feasibility of using lightweight polypropylene nets for onlay plastic surgery of postoperative ventral hernias (POVH). The study involved 137 patients with POVH, who were divided into two groups: the control group (64 patients) who underwent traditional Esfil-heavy mesh endoprosthesis and the primary group (73 patients) who received Esfil-light endoprostheses. The study investigated the clinical and immunological aspects of using propylene nets in these two groups of patients. Before surgery, the examined patients showed a suppression of the cellular link of immunity, an imbalance of the humoral link, and non-specific factors of protection. The use of polypropylene meshes (Esfil-light and Esfil-heavy) triggered an inflammatory reaction associated with the structural properties of the prostheses. However, the use of Esfil-light PP prosthesis in onlay allogernioplasty caused less inflammation in the alloplasty area compared to Esfil-heavy. Overall, the findings suggest that Esfil-light PP prosthesis can be a suitable alternative to traditional Esfil-heavy mesh endoprosthesis for onlay plastic surgery of postoperative ventral hernias. The reduced inflammatory reaction in the alloplasty area may lead to improved outcomes for patients undergoing this procedure.

Abstract:Background: Hypertension affects individuals of all classes and across all groups. The relationship between blood pressure and the risk of cardiovascular disease events is continuous and independent of other risk factors.
Aim and Objectives: The present study aimed to identify various modes of presentation and the clinical profile of hypertensive emergencies in our hospital.
Materials and Methods: Data were collected from 100 patients admitted to this hospital over a period of two years. Patients who presented with an elevated blood pressure of systolic blood pressure >180mmHg or diastolic blood pressure >110mmHg, with a history of acute target organ damage, or with laboratory evidence of acute target organ damage were included in the study.
Results: Of the 100 patients studied, 88 were known hypertensives, among whom 54 had discontinued their antihypertensives before the incident, while the remaining 46 patients continued their medication. Among the 100 patients, 28 had diabetes mellitus and 28 had dyslipidemias. Out of 100 patients with hypertensive emergencies, 12 died before discharge, resulting in a hospital mortality rate of 12%. All expired patients had intracerebral hemorrhage.
Conclusion: Known hypertensives are at a higher risk of presenting with acute target organ damage associated with hypertensive emergency. The presence of diabetes mellitus and dyslipidemia increases the chance of developing hypertensive emergencies.