Uhl's Anomaly: A Rare Case of Portal Hypertension.

Uhl's anomaly is a rare congenital heart disease characterized by partial or complete absence of the right ventricular myocardium and high early mortality rates. We describe a case of Uhl's anomaly in a 27-year-old young male patient presenting with portal hypertension and esophageal varices. In this article, we review the literature associated with this condition and highlight a rare presentation of a rare disease. This report adds to our current knowledge of this exceedingly rare disorder.

Micro-albuminuria: a predictor of 7-day mortality in acute myocardial infarction.

A study was undertaken amog 80 non-diabetic patients of acute myocardial infarction (AMI) admitted within 24 hours of the onset of pain, to investigate the prevalence and significance of microalbuminuria (MA) as a predictor of in-hospital mortality, and also to correlate it with other well-established prognostic markers. Spot urinary albumin-to-creatinine ratio (ACR) was measured in first morning sample on day 1 (D1), day 4 (D4) and/or day 7 (D7). Haemodynamic status was assessed clinically by Killip's class and the ejection fraction was measured by echocardiography on D1, D4, and/or D7. Total 7 days mortality was recorded. MA (>30 microg/mg) was found in 95% of patients on 1,. In the group with higher value of MA (>100 microg/mg) on D1, there was significantly more deaths (p <0.01). Also there was significantly more deaths with static or increasing MA value from D1 to D4/D7 (p <0.01). Increasing or static MA had a positive correlation with deteriorating Killip's class in non-survivors, and also there was a correlation between decrease in left ventricular ejection fraction from D1 to D4/D7 and an increasing trend in MA over that period. Thus, MA was found to be a reliable predictor of short-term in-hospital mortality in AMI.

Prevalence of malnutrition and its correlation with various diseases in elderly patients in a tertiary care centre in eastern India.

Geriatric population is growing very fast but they do not receive due attention from the family members as well as in the society. So incidence of malnutrition is likely to be very high in them. This fact prompted us to evaluate nutritional status in this group of population. In this study persons more than 60 years were included. A total of 76 patients, both inpatients and outpatients, in a tertiary care centre were studied. Their ages ranged from 60-84 years. Their nutritional status were assessed clinically by body mass index (BMI), triceps skin fold thickness, waist-hip ratio (WHR), mid-arm muscle circumference (MAMC) and from investigational parameters like blood for total and differential counts, ESR, serum for albumin, sugar, urea, creatinine, cholesterol and routine urine examination. According to BMI, undernutrition was found approximately in a quarter of all the elderly under study while overnutrition which includes both overweight (BMI 25-29.9 kg/m2 of body surface area) and obesity (BMI > or = 30 kg/ m2 of body surface area) was found in only 14.5% of patients. Central obesity as per WHR was strikingly high in females (85%) compared to males.

Micro-albuminuria: a predictor of short-term mortality in acute ischaemic stroke.

We studied 89 non-diabetic patients of acute ischaemic stroke, confirmed by imaging, admitted within 24 hours of onset, to investigate the prevalence and significance of micro-albuminuria (MA) as a predictor of in-hospital mortality. Two control groups consisted of 70 patients with non-stroke chronic neurological diseases and 60 age- and sex- matched healthy individuals. Spot urinary albumin-to-creatinine ratio was measured in first morning sample on days 1, 4 and/or 7. Functional status was assessed daily for 7 days by National Institute of Health Stroke Scale (NIHSS). Outcome data were recorded for 14 days. MA was found in 61.79% of acute ischaemic stroke patients on day 1 compared to 13% in non-stroke neurological patients and 7% of healthy controls. Patients with MA were older and had a higher systolic blood pressure. The 14-day disease-specific mortality was higher in patients with MA (25.45%) compared to patients without it (5.88%). High day 1 MA (>100 microg/mg) and rising or static value from day 1 to day 4 or day 7 correlated with statistically more chance of death. Increasing MA had a positive correlation with higher NIHSS score. Thus, MA was found to be a reliable predictor of shortterm in-hospital mortality in acute ischaemic stroke.

An unusual presentation of tuberculous lymphadenitis.

A 43 years male presented with recurrent epistaxis and had generalised lymphadenopathy on examination. No haematological disorder could be established even after bone marrow aspiration and biopsy but the patient was found to have tuberculosis of the lymph node on histopathology, with severe thrombocytopenia in the peripheral blood and increased platelet precursor in the marrow suggesting peripheral platelet destruction. Anti-tuberculous therapy was started but the patient died due to subarachnoid haemorrhage.