Vijayashree Gokhale - Academia.edu (original) (raw)

Papers by Vijayashree Gokhale

The Journal of the Association of Physicians of India, 2014

1. To study types of neuropathy in Type 2 diabetes. 2) To correlate clinical features of peripher... more 1) To study types of neuropathy in Type 2 diabetes. 2) To correlate clinical features of peripheral neuropathy with nerve conduction study in Type 2 diabetes. A total of 50 diabetics, whose onset of diabetes after the age of 30 years were studied from Dr. D. Y. Patil hospital and research centre. Type 2 Diabetes mellitus with symptom suggestive of peripheral neuropathy were studied and included. Chronic alcoholic, peripheral neuropathy due to any other known cause were excluded. METHOD OF COLLECTION OF DATA: History of symptoms like paraesthesia like tingling sensation, burning feet, hyperaesthesia, foot ulcer, history of weakness and gait abnormality was noted. Complete central nervous system examination was performed to look for signs such as diminished ankle jerk, diminished power. Sensory examination for loss of light touch, superficial pain, temperature sense, vibration and joint position was done. Nerve conduction studies were performed using Clarity Octopus NCV/EMG machine. W...

International Journal of Research in Medical Sciences, 2021

Immune thrombocytopenic purpura (ITP) is defined as a hematologic disorder, characterized by isol... more Immune thrombocytopenic purpura (ITP) is defined as a hematologic disorder, characterized by isolated thrombocytopenia without any apparent cause. Some patients may be diagnosed during routine blood investigations or may present with bleeding diathesis. Treatment required for moderate to severe thrombocytopenia or those with bleeding manifestations. We present a case of 43 year old male, sputum positive pulmonary tuberculosis on isoniazid (H), rifampin (R), pyrazinamide (Z), and ethambutol (E) (HRZE) with persistent thrombocytopenia. He developed hepatitis hence isoniazid (INH) and rifampicin were stopped. He had fever, rash, purpura, hematuria and blood tinged sputum with platelet count of 10,000. 4 random donor platelets (RDPs) given. He suffered from mild COVID-19 infection and recovered in 2 weeks but platelets remained low. Bone marrow examination was suggestive of ITP. Inspite of steroid therapy no improvement was seen. Later was treated with injection romiplostim, and started...

International Journal of Research in Medical Sciences, 2017

Systemic lupus erythematosus (SLE) is a chronic, autoimmune inflammatory disease characterized by... more Systemic lupus erythematosus (SLE) is a chronic, autoimmune inflammatory disease characterized by the presence of autoantibodies, immune complex formation, and multiple organ system involvement. Gastrointestinal manifestations are common in SLE patients, but acute pancreatitis is rare. Here we present a case of a 23 yrs. old male who came to the medicine OPD with the chief complaints of pain in abdomen, swelling all over the body since, 8 days and multiple joint pain for 1 and half months. On examination he was febrile pallor present with anasarca, periorbital edema with heliotrope around both eyes. Dry and xerotic ski over the face, butterfly rash present. Blood investigations, USG and CECT suggestive of acute panceatitis. Patient was treated in ICU for pancreatitis. Patient was found to be hypothyroid and treated with thyroid supplements. ANA BLOT was suggestive of SLE. Renal biopsy showed diffuse proliferative lupus nephritis. Hence our patient had pancreatitis possibly due to SL...

International Journal of Advances in Medicine, 2021

Background: Electrocardiography (ECG) is an accessible, low cost diagnostic and prognostic tool. ... more Background: Electrocardiography (ECG) is an accessible, low cost diagnostic and prognostic tool. Recent studies have shown increased risk of deaths associated with cardiomyopathy and to study the patients with symptoms of cardiomyopathy on basis of ECG.Methods: A total of 50 patients were explained the procedure and the purpose of the study, informed consent was taken from the patient or the relative in a language they can understand. Required physical examination and necessary investigations were carried out. In our study, maximum subjects had normal voltage (80%) low voltage ECG findings were in 20%, normal QRS complex in 78%, wide QRS complex in 20% LBBB/RBBB in 24%. Evidence of ischemia like T wave changes in 34%, ST wave changes in 24% and tachycardia (26%). Thus ECG can give a clue for diagnosing cardiomyopathy and guide us for further managements but it is not a diagnostic marker for it since most of the patients had normal ECG findings.Results: In our study, electrocardiogra...

Journal of Pharmaceutical Research International, 2021

Background: India is becoming the “Diabetes Capital of the World”. Younger and younger individual... more Background: India is becoming the “Diabetes Capital of the World”. Younger and younger individuals are being diagnosed with Diabetes. This study was planned to diagnose prediabetes in younger individuals having positive family history with aim of encouraging to develop lifestyle modifications to delay progression to Diabetes. Aims: To study prediabetes in first degree relatives (FDR) of diabetic patients in the group of 30-45 years by glucose tolerance test (GTT), body mass index (BMI) and waist hip ratio (WHR). Study Design: Cross sectional observational study. Place and Duration of Study: Study was conducted at Department of general medicine, Dr D Y Patil Medical College, Pune 18 from July 2019-september 2021. Methodology: This study conducted in a semi-urban Teaching Hospital in Maharashtra, India. 100 asymptomatic first-degree relatives (31 women, 69 men) age group 30-45 years, of diabetic patients were selected for study after informed consent. The study participants were clin...

Journal of Pharmaceutical Research International

Background: Diabetes has a multitude of macrovascular complications, one of them being Carotid ar... more Background: Diabetes has a multitude of macrovascular complications, one of them being Carotid artery Atherosclerosis leading to stenosis and predisposing patient to Stroke. A hypothesis put forward is the presence of low-grade inflammation in Diabetic patients, which may enhance atherosclerosis. A study was planned to assess Carotid artery stenosis and HsCRP levels in Diabetic patients, so as to identify at risk group and take measures to prevent complications such as stroke and ischemic heart disease. Aim: To study the patients by clinical parameters, ultrasound carotid doppler study, and estimation of HsCRP with patients of type II DM. Study Design: Cross sectional observational study. Place and Duration of Study: Study was conducted at Department of General Medicine, Dr D Y Patil Medical College, Pune from July 2019 – September 2021. Methodology: The study included 50 subjects with type 2 DM (as per inclusion and exclusion criterion). All participants were explained the nature o...

International Journal of Research in Medical Sciences, 2020

A 40 year old male, first presented with erythema nodosum, fever, weight loss and joint pains and... more A 40 year old male, first presented with erythema nodosum, fever, weight loss and joint pains and did not respond to anti-tubercular treatment. One year later he came back with joint pains, erythema nodosum, fever and dry cough. He also had weakness in distal right lower limb more than left limb. He had raised ESR, hypocalcaemia, raised ACE levels and lymphnode involvement on HRCT, with skin biopsy suggestive of sarcoidosis. This time patient responded to treatment and is on regular follow up.

Gout is a disorder of uric acid metabolism, characterised by deposition of monosodium urate cryst... more Gout is a disorder of uric acid metabolism, characterised by deposition of monosodium urate crystals in joints and periarticular soft tissues as well as renal calculi and chronic nephropathy. The accumulation of crystals in the joints and periarticular soft tissue may cause recurrent episodes inflammatory arthritis. Over the years chronic form may occur with presence of tophi and chronic arthropathy frequently in peripheral and rarely in axial joints. Surgical intervention is usually reserved for cases of recurrent attacks with deformities, severe pain and joint destructions.

Introduction: ARDS or adult respiratory distress syndrome is serious illness of high mortality an... more Introduction: ARDS or adult respiratory distress syndrome is serious illness of high mortality and morbidity .A high index of suspicion and lookout for early signs ,helps in early diagnosis ,treatment and a fairly good outcome. Aims and objectives: This crosssectional observational study had the following aim-To study the clinical profile of Acute Respiratory Distress Syndrome,its radiology,and echocardiography , to identify etiology and co-morbid conditions. Methodology: 30 consecutive patients admitted to ICU of a Medical College Hospital in Semi-urban Maharashtra were selected after meeting inclusion criteria on the lines of Berlin Criteria of ARDS.Data collected ,tabulated and analysed. Conclusions: Our Study concluded that outcomes were not related to age, gender or the existence of co-morbidities .Rather Etiology , the time of coming to hospital, early detection and treatment of ARDS , affected outcomes.Both H1N1 ,with severe ARDS and Klebsiella +ve culture had worse prognosis.

Background: Atrial fibrillation (AF) is the most common arrhythmia. It is associated with signifi... more Background: Atrial fibrillation (AF) is the most common arrhythmia. It is associated with significant morbidity and mortality. The size and volume of left atrium is an important development of atrial fibrillation which land up subjects into various complications so present study was carried out to study echocardiography findings (size and volume) among AF Cases with various underlying aetiology. Material and methods: A cross-sectional observational study was conducted for duration of 2 years to measure left atrial size and volume by echocardiography in patients of atrial fibrillation in various diseases. A proforma was designed to collect the desired information from the patients. The preformed structured proforma consisted of recording of investigations was used as data collection tool. All efforts were made to diagnose the aetiology of atrial fibrillation. Results: A total of 50 cases of AF were studied with mean age of study participants 53.68±12.74 yrs (range 25-80yrs) and F: M-...

Aim To study variations in glucose levels over 48 hours in critically ill patients by capillary b... more Aim To study variations in glucose levels over 48 hours in critically ill patients by capillary blood glucose done on glucometer and compare the same in different categories of patients based on various diseases, as well as their correlation with sepsis and diabetes mellitus. To compare the same results in a subset of patients with the readings of continuous glucose monitoring. Material and Methods We studied 50 critically-ill patients (Age≥18 years), admitted in medical ICU (on mechanical ventilation/ionotropic supports/in sepsis) in a teaching hospital in semi-urban Maharashtra. Critical illness was defined as any physiological instability leading to disability or death within minutes or hours, based on neurological assessment, respiratory system involvement and cardiovascular involvement. Capillary blood sugar levels were done 4 hourly using 'NIPRO' glucometer. Site was rotated. 5 patients had simultaneous continuous glucose monitoring, using I-Pro bio-sensor. Results Tot...

Drug reaction with eosinophilia and systemic (DRESS) syndrome is a severe systemic drug reaction ... more Drug reaction with eosinophilia and systemic (DRESS) syndrome is a severe systemic drug reaction with a reported mortality of 10% 5 . The estimated incidence of this syndrome ranges from 1 in 1000 to 1 in 10,000 drug exposures. The syndrome consists of a severe skin eruption, fever, hematologic abnormalities (eosinophilia or atypical lymphocytes), and internal organ involvement. Here, we report a case of DRESS syndrome in a young male who presented with acute hepatitis.

International Journal of Medicine and Public Health, 2015

High incidence of retinopathy in neuropathy proven diabetic patients: A cohort study Background: ... more High incidence of retinopathy in neuropathy proven diabetic patients: A cohort study Background: Diabetes and diabetic complications are becoming major "health problems" in India. Diabetes affects all tissues, causing neuropathy, vasculopathy, myopathy, etc. Retina is both vascular and sensory neural tissue, and perhaps the damage is also twofold. Aims and Objectives: To study incidence of diabetic retinopathy (DR) in a cohort of diabetic patients with nerve conduction velocity (NCV) proven neuropathy. Materials and Methods: a total of 50 diabetic patients aged more than 30 years, with NCV-proven diabetic neuropathy were selected for the study from a Tertiary Care Hospital in semi-rural Maharashtra. Fundoscopy after midriasis and fluorescein angiography, where indicated were performed in all patients. Data were tabulated and analyzed by multivariate analysis and then subjected to regression analysis and anova. Results: Of cohort of 50, 38 patients had retinopathy (76%), mean age of patients with retinopathy was 55.3, a male preponderance was seen 72.7%. Conclusions: higher incidence of retinopathy was seen in diabetic patients with neuropathy more so in patients with sensory neuropathy. Thus making us reflect on the possibility: of DR also being a neuropathy, to begin with and whether neuroprotective agents will have a role in preventing and postponing DR.

International Journal of Medicine and Public Health, 2013

Background: Nonalcoholic fatty liver disease (NAFLD) fi brosis score and BARD score are two of th... more Background: Nonalcoholic fatty liver disease (NAFLD) fi brosis score and BARD score are two of the many noninvasive scoring systems used in the evaluation of the fi brosis in patients with NAFLD biochemically. Ultrasound (USG) is the most common imaging modality for detection of hepatic fi brosis, as it is inexpensive and easily available. Aims: This study attempts to correlate the biochemical and ultrasonographic evidence of fi brosis. It tries to correlate two noninvasive tools for assessing fi brosis in overweight population with NAFLD. Materials and Methods: Prospective study was conducted in which 106 patients participated with BMI; more than 25 underwent ultrasonography for evidence of fatty liver, which was then categorized in three grades, and also scored using biochemical parameters to obtain the NAFLD fi brosis score and BARD score. The scores were then compared with the grades of fatty liver on USG to see for correlation between the two. Results: No statistically signifi cant correlation was found between biochemical evidence of fi brosis and USG evidence of fi brosis in overweight patients of NAFLD. Conclusion: Thus, the biochemical evidence of fi brosis or NAFLD in the form of NAFLD fi brosis score did not correlate with USG evidence of fatty liver. The USG fi ndings of fatty liver may not directly correlate with actual fi brosis in these patients. Context: NAFLD is also an emerging disease in developing countries, which remains silent for years. Noninvasive methods are required for early diagnosis. This study attempts to correlate two noninvasive tools for assessing fi brosis in overweight population of NAFLD. Most of the patients of NAFLD are asymptomatic thus invasive methods are not routinely recommended in them. Thus, it becomes pertinent to study the noninvasive tools extensively for their possible additive use.

Thyroid Research and Practice, 2013

Thyrotoxicosis has varied manifestations, from its usual to rare presentations. Thyrotoxicosis pr... more Thyrotoxicosis has varied manifestations, from its usual to rare presentations. Thyrotoxicosis presenting as acute quadriplegia is a very rare phenomenon and is attributed to hypokalemia. Thyrotoxic hypokalemic periodic paralysis is known but rare manifestation and as a first presentation is relatively unknown. Here, we present a case of young male in whom thyrotoxicosis presented for the first time as hypokalemic paralysis.

Medical Journal of Dr. D.Y. Patil University, 2013

Parkinson's disease and its plus syndromes are an important cause of morbidity in the geriatr... more Parkinson's disease and its plus syndromes are an important cause of morbidity in the geriatric age group. Its plus syndromes show a myriad of clinical features characterized by progressive symptoms. Here we present a 65-year-old woman with progressive Parkinsonian-like features, i.e., mask-like face, slowness of all movements and tendency to fall, and difficulty in eye movements, leading to the diagnosis of Steele Richardson Olszewski Syndrome or progressive supranuclear palsy.

International Journal of Research in Medical Sciences

Background: Type 2 diabetes, with its complications is perpetually on the rise more so in India .... more Background: Type 2 diabetes, with its complications is perpetually on the rise more so in India .Diabetic Nephropathy progresses silently, and manifests at a stage where, patient can be offered only renal replacement. This study was undertaken to detect early markers of Diabetic Nephropathy. Aims and objective of the study was to study early nephropathy by UACR (urinary albumin/creatinine ratio), RFT (renal function test) and e-GFR in Type 2 diabetic patients of more than 2 years duration, with and without hypertension.Methods: A hospital based cross-sectional observational study, of 100 patients, 18-60 years of age, of type 2 Diabetes of 2 year duration and above, of which 50 were only diabetic and 50 had diabetes and hypertension. Patients who had an established renal disease were excluded from study.Results: Our study of 100 patients, 18-60 years of age, had 23 male and 77 female patients. Maximum patients were in age group 41-50 years, and 52% had diabetes of 2-4 years duration....

International Journal of Research in Medical Sciences

Background: Cardiomyopathy as a diagnosis almost signifies a kind of end stage disease of the myo... more Background: Cardiomyopathy as a diagnosis almost signifies a kind of end stage disease of the myocardium. With conditions like hypertension, diabetes and ischemic heart disease on the rise, we are seeing a large number of cases diagnosed as cardiomyopathy, most common presenting feature being Heart failure. Echocardiography (ECG), is non-invasive and easily available and can pick up early signs of failure in the form of diastolic and systolic dysfunction. To study patients with cardiac symptoms, by clinical, ECG, and Echocardiography parameters.Methods: A cross-sectional, observational study of 50 patients aged 18-80 years with cardiac symptoms (dyspnoea, palpitations, pedal odema) was carried out over a period of 3 years in a semi-urban Medical College Hospital in Western Maharashtra. Patients of Acute coronary disease, valvular and congenital heart disease and chronic obstructive pulmonary disease (COPD) were excluded from the study. Data collected, tabulated and subjected to stat...

The Journal of the Association of Physicians of India, 2014

1. To study types of neuropathy in Type 2 diabetes. 2) To correlate clinical features of peripher... more 1) To study types of neuropathy in Type 2 diabetes. 2) To correlate clinical features of peripheral neuropathy with nerve conduction study in Type 2 diabetes. A total of 50 diabetics, whose onset of diabetes after the age of 30 years were studied from Dr. D. Y. Patil hospital and research centre. Type 2 Diabetes mellitus with symptom suggestive of peripheral neuropathy were studied and included. Chronic alcoholic, peripheral neuropathy due to any other known cause were excluded. METHOD OF COLLECTION OF DATA: History of symptoms like paraesthesia like tingling sensation, burning feet, hyperaesthesia, foot ulcer, history of weakness and gait abnormality was noted. Complete central nervous system examination was performed to look for signs such as diminished ankle jerk, diminished power. Sensory examination for loss of light touch, superficial pain, temperature sense, vibration and joint position was done. Nerve conduction studies were performed using Clarity Octopus NCV/EMG machine. W...

International Journal of Research in Medical Sciences, 2021

Immune thrombocytopenic purpura (ITP) is defined as a hematologic disorder, characterized by isol... more Immune thrombocytopenic purpura (ITP) is defined as a hematologic disorder, characterized by isolated thrombocytopenia without any apparent cause. Some patients may be diagnosed during routine blood investigations or may present with bleeding diathesis. Treatment required for moderate to severe thrombocytopenia or those with bleeding manifestations. We present a case of 43 year old male, sputum positive pulmonary tuberculosis on isoniazid (H), rifampin (R), pyrazinamide (Z), and ethambutol (E) (HRZE) with persistent thrombocytopenia. He developed hepatitis hence isoniazid (INH) and rifampicin were stopped. He had fever, rash, purpura, hematuria and blood tinged sputum with platelet count of 10,000. 4 random donor platelets (RDPs) given. He suffered from mild COVID-19 infection and recovered in 2 weeks but platelets remained low. Bone marrow examination was suggestive of ITP. Inspite of steroid therapy no improvement was seen. Later was treated with injection romiplostim, and started...

International Journal of Research in Medical Sciences, 2017

Systemic lupus erythematosus (SLE) is a chronic, autoimmune inflammatory disease characterized by... more Systemic lupus erythematosus (SLE) is a chronic, autoimmune inflammatory disease characterized by the presence of autoantibodies, immune complex formation, and multiple organ system involvement. Gastrointestinal manifestations are common in SLE patients, but acute pancreatitis is rare. Here we present a case of a 23 yrs. old male who came to the medicine OPD with the chief complaints of pain in abdomen, swelling all over the body since, 8 days and multiple joint pain for 1 and half months. On examination he was febrile pallor present with anasarca, periorbital edema with heliotrope around both eyes. Dry and xerotic ski over the face, butterfly rash present. Blood investigations, USG and CECT suggestive of acute panceatitis. Patient was treated in ICU for pancreatitis. Patient was found to be hypothyroid and treated with thyroid supplements. ANA BLOT was suggestive of SLE. Renal biopsy showed diffuse proliferative lupus nephritis. Hence our patient had pancreatitis possibly due to SL...

International Journal of Advances in Medicine, 2021

Background: Electrocardiography (ECG) is an accessible, low cost diagnostic and prognostic tool. ... more Background: Electrocardiography (ECG) is an accessible, low cost diagnostic and prognostic tool. Recent studies have shown increased risk of deaths associated with cardiomyopathy and to study the patients with symptoms of cardiomyopathy on basis of ECG.Methods: A total of 50 patients were explained the procedure and the purpose of the study, informed consent was taken from the patient or the relative in a language they can understand. Required physical examination and necessary investigations were carried out. In our study, maximum subjects had normal voltage (80%) low voltage ECG findings were in 20%, normal QRS complex in 78%, wide QRS complex in 20% LBBB/RBBB in 24%. Evidence of ischemia like T wave changes in 34%, ST wave changes in 24% and tachycardia (26%). Thus ECG can give a clue for diagnosing cardiomyopathy and guide us for further managements but it is not a diagnostic marker for it since most of the patients had normal ECG findings.Results: In our study, electrocardiogra...

Journal of Pharmaceutical Research International, 2021

Background: India is becoming the “Diabetes Capital of the World”. Younger and younger individual... more Background: India is becoming the “Diabetes Capital of the World”. Younger and younger individuals are being diagnosed with Diabetes. This study was planned to diagnose prediabetes in younger individuals having positive family history with aim of encouraging to develop lifestyle modifications to delay progression to Diabetes. Aims: To study prediabetes in first degree relatives (FDR) of diabetic patients in the group of 30-45 years by glucose tolerance test (GTT), body mass index (BMI) and waist hip ratio (WHR). Study Design: Cross sectional observational study. Place and Duration of Study: Study was conducted at Department of general medicine, Dr D Y Patil Medical College, Pune 18 from July 2019-september 2021. Methodology: This study conducted in a semi-urban Teaching Hospital in Maharashtra, India. 100 asymptomatic first-degree relatives (31 women, 69 men) age group 30-45 years, of diabetic patients were selected for study after informed consent. The study participants were clin...

Journal of Pharmaceutical Research International

Background: Diabetes has a multitude of macrovascular complications, one of them being Carotid ar... more Background: Diabetes has a multitude of macrovascular complications, one of them being Carotid artery Atherosclerosis leading to stenosis and predisposing patient to Stroke. A hypothesis put forward is the presence of low-grade inflammation in Diabetic patients, which may enhance atherosclerosis. A study was planned to assess Carotid artery stenosis and HsCRP levels in Diabetic patients, so as to identify at risk group and take measures to prevent complications such as stroke and ischemic heart disease. Aim: To study the patients by clinical parameters, ultrasound carotid doppler study, and estimation of HsCRP with patients of type II DM. Study Design: Cross sectional observational study. Place and Duration of Study: Study was conducted at Department of General Medicine, Dr D Y Patil Medical College, Pune from July 2019 – September 2021. Methodology: The study included 50 subjects with type 2 DM (as per inclusion and exclusion criterion). All participants were explained the nature o...

International Journal of Research in Medical Sciences, 2020

A 40 year old male, first presented with erythema nodosum, fever, weight loss and joint pains and... more A 40 year old male, first presented with erythema nodosum, fever, weight loss and joint pains and did not respond to anti-tubercular treatment. One year later he came back with joint pains, erythema nodosum, fever and dry cough. He also had weakness in distal right lower limb more than left limb. He had raised ESR, hypocalcaemia, raised ACE levels and lymphnode involvement on HRCT, with skin biopsy suggestive of sarcoidosis. This time patient responded to treatment and is on regular follow up.

Gout is a disorder of uric acid metabolism, characterised by deposition of monosodium urate cryst... more Gout is a disorder of uric acid metabolism, characterised by deposition of monosodium urate crystals in joints and periarticular soft tissues as well as renal calculi and chronic nephropathy. The accumulation of crystals in the joints and periarticular soft tissue may cause recurrent episodes inflammatory arthritis. Over the years chronic form may occur with presence of tophi and chronic arthropathy frequently in peripheral and rarely in axial joints. Surgical intervention is usually reserved for cases of recurrent attacks with deformities, severe pain and joint destructions.

Introduction: ARDS or adult respiratory distress syndrome is serious illness of high mortality an... more Introduction: ARDS or adult respiratory distress syndrome is serious illness of high mortality and morbidity .A high index of suspicion and lookout for early signs ,helps in early diagnosis ,treatment and a fairly good outcome. Aims and objectives: This crosssectional observational study had the following aim-To study the clinical profile of Acute Respiratory Distress Syndrome,its radiology,and echocardiography , to identify etiology and co-morbid conditions. Methodology: 30 consecutive patients admitted to ICU of a Medical College Hospital in Semi-urban Maharashtra were selected after meeting inclusion criteria on the lines of Berlin Criteria of ARDS.Data collected ,tabulated and analysed. Conclusions: Our Study concluded that outcomes were not related to age, gender or the existence of co-morbidities .Rather Etiology , the time of coming to hospital, early detection and treatment of ARDS , affected outcomes.Both H1N1 ,with severe ARDS and Klebsiella +ve culture had worse prognosis.

Background: Atrial fibrillation (AF) is the most common arrhythmia. It is associated with signifi... more Background: Atrial fibrillation (AF) is the most common arrhythmia. It is associated with significant morbidity and mortality. The size and volume of left atrium is an important development of atrial fibrillation which land up subjects into various complications so present study was carried out to study echocardiography findings (size and volume) among AF Cases with various underlying aetiology. Material and methods: A cross-sectional observational study was conducted for duration of 2 years to measure left atrial size and volume by echocardiography in patients of atrial fibrillation in various diseases. A proforma was designed to collect the desired information from the patients. The preformed structured proforma consisted of recording of investigations was used as data collection tool. All efforts were made to diagnose the aetiology of atrial fibrillation. Results: A total of 50 cases of AF were studied with mean age of study participants 53.68±12.74 yrs (range 25-80yrs) and F: M-...

Aim To study variations in glucose levels over 48 hours in critically ill patients by capillary b... more Aim To study variations in glucose levels over 48 hours in critically ill patients by capillary blood glucose done on glucometer and compare the same in different categories of patients based on various diseases, as well as their correlation with sepsis and diabetes mellitus. To compare the same results in a subset of patients with the readings of continuous glucose monitoring. Material and Methods We studied 50 critically-ill patients (Age≥18 years), admitted in medical ICU (on mechanical ventilation/ionotropic supports/in sepsis) in a teaching hospital in semi-urban Maharashtra. Critical illness was defined as any physiological instability leading to disability or death within minutes or hours, based on neurological assessment, respiratory system involvement and cardiovascular involvement. Capillary blood sugar levels were done 4 hourly using 'NIPRO' glucometer. Site was rotated. 5 patients had simultaneous continuous glucose monitoring, using I-Pro bio-sensor. Results Tot...

Drug reaction with eosinophilia and systemic (DRESS) syndrome is a severe systemic drug reaction ... more Drug reaction with eosinophilia and systemic (DRESS) syndrome is a severe systemic drug reaction with a reported mortality of 10% 5 . The estimated incidence of this syndrome ranges from 1 in 1000 to 1 in 10,000 drug exposures. The syndrome consists of a severe skin eruption, fever, hematologic abnormalities (eosinophilia or atypical lymphocytes), and internal organ involvement. Here, we report a case of DRESS syndrome in a young male who presented with acute hepatitis.

International Journal of Medicine and Public Health, 2015

High incidence of retinopathy in neuropathy proven diabetic patients: A cohort study Background: ... more High incidence of retinopathy in neuropathy proven diabetic patients: A cohort study Background: Diabetes and diabetic complications are becoming major "health problems" in India. Diabetes affects all tissues, causing neuropathy, vasculopathy, myopathy, etc. Retina is both vascular and sensory neural tissue, and perhaps the damage is also twofold. Aims and Objectives: To study incidence of diabetic retinopathy (DR) in a cohort of diabetic patients with nerve conduction velocity (NCV) proven neuropathy. Materials and Methods: a total of 50 diabetic patients aged more than 30 years, with NCV-proven diabetic neuropathy were selected for the study from a Tertiary Care Hospital in semi-rural Maharashtra. Fundoscopy after midriasis and fluorescein angiography, where indicated were performed in all patients. Data were tabulated and analyzed by multivariate analysis and then subjected to regression analysis and anova. Results: Of cohort of 50, 38 patients had retinopathy (76%), mean age of patients with retinopathy was 55.3, a male preponderance was seen 72.7%. Conclusions: higher incidence of retinopathy was seen in diabetic patients with neuropathy more so in patients with sensory neuropathy. Thus making us reflect on the possibility: of DR also being a neuropathy, to begin with and whether neuroprotective agents will have a role in preventing and postponing DR.

International Journal of Medicine and Public Health, 2013

Background: Nonalcoholic fatty liver disease (NAFLD) fi brosis score and BARD score are two of th... more Background: Nonalcoholic fatty liver disease (NAFLD) fi brosis score and BARD score are two of the many noninvasive scoring systems used in the evaluation of the fi brosis in patients with NAFLD biochemically. Ultrasound (USG) is the most common imaging modality for detection of hepatic fi brosis, as it is inexpensive and easily available. Aims: This study attempts to correlate the biochemical and ultrasonographic evidence of fi brosis. It tries to correlate two noninvasive tools for assessing fi brosis in overweight population with NAFLD. Materials and Methods: Prospective study was conducted in which 106 patients participated with BMI; more than 25 underwent ultrasonography for evidence of fatty liver, which was then categorized in three grades, and also scored using biochemical parameters to obtain the NAFLD fi brosis score and BARD score. The scores were then compared with the grades of fatty liver on USG to see for correlation between the two. Results: No statistically signifi cant correlation was found between biochemical evidence of fi brosis and USG evidence of fi brosis in overweight patients of NAFLD. Conclusion: Thus, the biochemical evidence of fi brosis or NAFLD in the form of NAFLD fi brosis score did not correlate with USG evidence of fatty liver. The USG fi ndings of fatty liver may not directly correlate with actual fi brosis in these patients. Context: NAFLD is also an emerging disease in developing countries, which remains silent for years. Noninvasive methods are required for early diagnosis. This study attempts to correlate two noninvasive tools for assessing fi brosis in overweight population of NAFLD. Most of the patients of NAFLD are asymptomatic thus invasive methods are not routinely recommended in them. Thus, it becomes pertinent to study the noninvasive tools extensively for their possible additive use.

Thyroid Research and Practice, 2013

Thyrotoxicosis has varied manifestations, from its usual to rare presentations. Thyrotoxicosis pr... more Thyrotoxicosis has varied manifestations, from its usual to rare presentations. Thyrotoxicosis presenting as acute quadriplegia is a very rare phenomenon and is attributed to hypokalemia. Thyrotoxic hypokalemic periodic paralysis is known but rare manifestation and as a first presentation is relatively unknown. Here, we present a case of young male in whom thyrotoxicosis presented for the first time as hypokalemic paralysis.

Medical Journal of Dr. D.Y. Patil University, 2013

Parkinson's disease and its plus syndromes are an important cause of morbidity in the geriatr... more Parkinson's disease and its plus syndromes are an important cause of morbidity in the geriatric age group. Its plus syndromes show a myriad of clinical features characterized by progressive symptoms. Here we present a 65-year-old woman with progressive Parkinsonian-like features, i.e., mask-like face, slowness of all movements and tendency to fall, and difficulty in eye movements, leading to the diagnosis of Steele Richardson Olszewski Syndrome or progressive supranuclear palsy.

International Journal of Research in Medical Sciences

Background: Type 2 diabetes, with its complications is perpetually on the rise more so in India .... more Background: Type 2 diabetes, with its complications is perpetually on the rise more so in India .Diabetic Nephropathy progresses silently, and manifests at a stage where, patient can be offered only renal replacement. This study was undertaken to detect early markers of Diabetic Nephropathy. Aims and objective of the study was to study early nephropathy by UACR (urinary albumin/creatinine ratio), RFT (renal function test) and e-GFR in Type 2 diabetic patients of more than 2 years duration, with and without hypertension.Methods: A hospital based cross-sectional observational study, of 100 patients, 18-60 years of age, of type 2 Diabetes of 2 year duration and above, of which 50 were only diabetic and 50 had diabetes and hypertension. Patients who had an established renal disease were excluded from study.Results: Our study of 100 patients, 18-60 years of age, had 23 male and 77 female patients. Maximum patients were in age group 41-50 years, and 52% had diabetes of 2-4 years duration....

International Journal of Research in Medical Sciences

Background: Cardiomyopathy as a diagnosis almost signifies a kind of end stage disease of the myo... more Background: Cardiomyopathy as a diagnosis almost signifies a kind of end stage disease of the myocardium. With conditions like hypertension, diabetes and ischemic heart disease on the rise, we are seeing a large number of cases diagnosed as cardiomyopathy, most common presenting feature being Heart failure. Echocardiography (ECG), is non-invasive and easily available and can pick up early signs of failure in the form of diastolic and systolic dysfunction. To study patients with cardiac symptoms, by clinical, ECG, and Echocardiography parameters.Methods: A cross-sectional, observational study of 50 patients aged 18-80 years with cardiac symptoms (dyspnoea, palpitations, pedal odema) was carried out over a period of 3 years in a semi-urban Medical College Hospital in Western Maharashtra. Patients of Acute coronary disease, valvular and congenital heart disease and chronic obstructive pulmonary disease (COPD) were excluded from the study. Data collected, tabulated and subjected to stat...