Aplastic crisis and leg ulceration.
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Biomedical subjects
Publications and source records attributed to K C Garg.
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We present a case with hairy cell leukaemia which was diagnosed on a splenic aspirate. The patient refused splenectomy.
During a 15 months period, 97 patients with AMI were monitored continuously at hospital discharge for one hour. The VPCs or no VPC noted during this period of continuous monitoring were correlated with subsequent cardiac events during one year follow up. Patients with complicated VPCs had a significantly higher incidence of cardiac deaths and non-fatal re-infarctions during one year follow up (54.5%) as compared to patients with no VPCs (6.5%) (p less than .001). Patients with higher grades of VPCs had more complicated course (30.3% to 66.7% for Lown Grade II to IV) as compared to 6.5% and 20.8% for grade Lown O and I. Though, the results of this 1 hour continuous monitoring at hospital discharge are not as sensitive as with ambulatory Holter monitoring as is evident from this study where complicated VPCs were detected in 11.4% patients vs. 33% with Holter monitoring, it could be a useful tool in institutions where the facility of Holter monitoring does not exist.
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Fifty patients (mean age 48.6 +/- 9.4 years) with uncomplicated acute myocardial infarction were randomly assigned to propranolol therapy (n = 25) or placebo (n = 25) in a double-blind manner within 24 hours of their presentation with acute symptoms. M-mode and cross-sectional echocardiography were performed at one week and three months to evaluate the left ventricular function. A comparison of the two groups revealed that the group receiving propranolol had higher left ventricular ejection fraction (69% vs 52%, P less than 0.001), fractional shortening (32% vs 24%, P less than 0.01), lower mitral E-point septal separation (6 mm vs 14 mm, P less than 0.001) and wall motion abnormality score (2.5 vs 6.0, P less than 0.001) than the group receiving placebo therapy. At three months there was further significant improvement in wall motion abnormality score (1.1 vs 2.5, P less than 0.001) in the propranolol-treated group as compared to the placebo group, whereas the other parameters remained unchanged. We conclude that the left ventricular function detected by M-mode and cross-sectional echocardiography showed significant improvement in patients with acute myocardial infarction after early intervention with propranolol. This is possibly due to a reduction in the size of infarction.
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Variations in the counts of circulating basophile leucocytes in 225 subjects were studied. The results obtained are as follows: 1) The counts (per mm3) show a gradual rise with growth, from infancy to adolescence, and maintain a fair constancy in adults. 2) No significant sex difference was found in the peripheral basophile counts. 3) A definite diurnal variation in the counts exists, which is lowest in the morning and highest in the evening. 4) the counts are altered in different phases of the menstrual cycle. 5) Pregnant women show lower counts than nonpregnant women. 6) Surgical trauma and a single electroconvulsive shock lowers the counts significantly but variations are not significant after meals and physical exercise. 7) Smokers have slightly higher counts than non-smokers. 8) course of irradiation therapy lowers the counts significantly in patients with inoperable noplastic diseases. 9) Counts show insignificant variation with alteration of blood glucose level. The results mentioned above are discussed.
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