European Journal of Molecular & Clinical Medicine

Leptospirosis is a zoonosis of ubiquitous distribution, caused by infection 
with pathogenic Leptospira species. The spectrum of human disease caused by leptospires is extremely wide, ranging from subclinical infection to a severe syndrome of multiorgan infection with high mortality.⁽¹⁾Cardiovascular implication in leptospirosis is infrequent we Report a 39 year old farmer who had  jaundice ,abdominal pain, vomiting along with dry cough ,breathlessness, oliguria and massive pericardial effusion following a short febrile illness which required mechanical ventilation and renal replacement therapy. His diagnostic workup revealed leptospirosis  and workup for TB was negative. The patient presented a good response to the treatment, being discharged from hospital completely asymptomatic, with no pericardial effusion.He was evaluated again one month later, with no trace of effusions or symptoms.

Aim: To analyse the cardio vascular changes in newly detected hypothyroid patients.
Material and methods: This cross sectional study was conducted among patients attending the medicine OPD over a period of one year and total number of 50 patients was taken. In the present study for the measurement of TSH, T4, T3 radio-immuno assay was employed. ECG was recorded in all patients, in all the 12 leads, at a paper speed of 25mm per sec. at normal standardisation, PR interval of >0.2 seconds was taken as prolonged, QRS complexes of less than 5mm in limb leads and less than 10mm in chest leads was taken as low voltage complexes. In all the patients in the study, echocardiogram was done on 2-D MODE and Doppler. Each case was specifically screened for cardiovascular manifestations like pericardial effusion, ventricular dysfunction.
Results: Most common signs on general physical examination was skin changes (58%) followed by oedema (52%) and delayed ankle jerk (34%). No abnormality was detected among 54% of the subjects. ST & T wave change and sinus bradycardia was reported among 12% of the subjects. Low voltage complex was revealed in 10% of the subjects. Pericardial Effusion (PE) was present among 13 (26%) subjects.
Conclusion: Cardiovascular symptoms are less commonly associated with newly detected hypothyroidism. The occurrence of pericardial effusion in hypothyroidism is significantly related to the duration of disease, hence the need for early diagnosis of hypothyroidism.