Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario.

AIMS: To study platelet volume indices (PVI) in the spectrum of ischaemic heart diseases. METHODS: A total of 210 cases were studied; 94 patients had unstable angina (UA) or acute myocardial infarction (AMI) diagnosed on the basis of history, characteristic electrocardiographic changes, and increased cardiac enzyme activities. Seventy patients had stable coronary artery disease (stable CAD) or were admitted for a coronary angiography or coronary artery bypass graft procedure. The third group comprised 30 age and sex matched healthy controls with no history of heart disease and a normal electrocardiogram. RESULTS: All PVI-mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR)-were significantly raised in patients with AMI and UA (mean MPV, 10.43 (SD, 1.03) fL; mean PDW, 13.19 (SD, 2.34) fL; mean P-LCR, 29.4% (SD, 7.38%)) compared with those with stable CAD (mean MPV, 9.37 (SD, 0.99) fL; mean PDW, 11.35 (SD, 1.95) fL; mean P-LCR, 22.55% (SD, 6.65%)) and the control group (mean MPV, 9.2 (SD, 0.91) fL; mean PDW, 10.75 (SD, l.42) fL; mean P-LCR, 20.65% (SD, 6.14%)). CONCLUSIONS: Larger platelets are haemostatically more active and are a risk factor for developing coronary thrombosis, leading to myocardial infarction. Patients with larger platelets can easily be identified during routine haematological analysis and could possibly benefit from preventive treatment. Thus, PVI are an important, simple, effortless, and cost effective tool that should be used and explored extensively, especially in countries such as India, for predicting the possibility of impending acute events.

Role of F.E.S.S. in chronic sinusitis.

Functional endoscopic sinus surgery (FESS) is a new and exciting treatment for chronic sinus disease. A prospective study of 50 patients undergoing FESS was undertaken at the department of Otolaryngology, Dayanand Medical College & Hospital, Ludhiana. Parameters studied included patient symptoms, medical history, medical therapy, radiologic findings, complications and postoperative symptoms. 62% of our patients had sinonasal polypi (ethmoidal polypi 56%, antrochoanal polypi 6%) while 38% had chronic sinusitis. Osteomeatal complex involvement (88%) was the most common preoperative CT scan findings. All the cases were subsequently suhjected to functional endoscopic sinus surgery, studied for post-operative complications and 82% of the patients achieved improvement in preoperative symptoms. It was concluded that FESS is a highly successful treatment for chronic sinus disease.

Fungal infections and cavernous sinus thrombosis.

Rhino - Cerebral Mucormycosis, in uncontrolled diabetics, is a common entity Cavernous Sinus Thrombosis, secondary to fungal involvement is rarely encountered Two cases with fulminant spread are reported highlighting the symptoms, signs, and therapeutic modality.

Ameloblastic fibro-odontoma of the maxilla.

A rare case of Ameloblastic Fibro- Odontoma in a one year old child involving the maxilla is being reported. The tumor appeared to be of hamartotmatous origin rather than neoplastic osontogertic lesion.

Incidence and types of post extubation complications following endotracheal intubation and tracheostomy.

This study was undertaken to study early and late post extubation complications following endotracheal intubation and tracheostomy. A total 60 patients who were admitted in Dayanand Medical College and Hospital were studied prospectively. They were divided into 3 groups and were screened with various modalities like fiberoptic laryngoscopy. Bronchoscope, X-Ray Soft Tissue Neck and CT Scan, Complications like glottic edema, vocal tears, vocal granuhmas and tracheal stenosis were seen and were accordingly managed.

Foreign body bronchus - presenting with asthma.

Foreign bodies in the respiratory passages are always due to the accidental inhalation. Children are more affected while the adults rarely present with the foreign bodies in the respiratory tract. A case report of an accidentally inhaled foreign body ( a broken piece of a stainless steel spoon handle), where the patient was not aware of it and presented with bronchial asthma is being presented.