A Typical Presentation of Takayasu’s Arteritis – Takayasu’s Arteritis: An Approch to Dilated Cardiomyopathy | Chapter 19 | New Frontiers in Medicine and Medical Research Vol. 6

 Background: Takayasu vasculitis is a rare type of large artery vasculitis that predominantly affects the aorta and its main branches; depending on the group of blood vessels involved, signs and symptoms are usually related to systemic inflammation or ischemia of an organ. Increased platelet and coagulation activity are linked to Takayasu arteritis, resulting in hypercoagulability. Based on clinical findings, examinations, and symptom relief with steroids, a young female of 20 years old was diagnosed with Takayasu's arteritis.

In addition to a clinical examination and imaging studies, laboratory tests like C Reactive Protein and serum ferritin can help confirm a diagnosis of big artery vasculities. This is an unusual case of Takaysu's arteritis, demonstrating that Takaysu's arteritis can present in a variety of ways.

Aims and objectives: To improve symptoms by early diagnosis and therapy. To avoid the characteristic Takayasu's arteritis appearance.

Conclusion: When patients have a high serum ferritin level, innovative proteins should be used in the right clinical situation. The diagnosis of Takayasu Arteritis should be considered, and an echocardiogram should be performed. This could help with the early beginning of suitable treatment.

Author (S) Details

R. K. Vidyabati Devi
Department of Biochemistry, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India.

Rothang Pui
Department of Medicine, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India.

William Loitam
Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India.

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Fetal Growth Restriction and Doppler Waveform: Current Research | Chapter 1 | Research Trends and Challenges in Medical Science Vol. 3

Fetal growth restriction (FGR) is defined as the estimated fetal weight less than the 10th percentile for that gestational age on ultrasound study. There is no proven cure; management is reliant on a structured antenatal surveillance programme. Recent advances in ultrasound and Doppler have elucidated several mechanisms of growth restriction. Prediction of intrauterine hypoxia and acidemia can be done by Doppler study of fetal cardiovascular system. In this chapter it is discussed how to analyse the uteroplacental and fetoplacental blood flow using Doppler ultrasound in growth-restricted fetuses with reference to flow velocity and waveform indices. The Doppler ultrasound examination of the fetal cardiovascular system is mostly performed after 28 weeks of gestation in pregnancies with fetal growth restriction.  In the present chapter we highlight that preeclampsia and maternal anaemia have beed found to be the most important cause of fetal growth restriction. Abnormal Doppler indices in umbilical and middles cerebral artery statistically correlate with lower birth weights, higher rate of caesarean delivery, oligohydramnios, low Apgar scores, perinatal death and higher admission to neonatal intensive care unit. Reduced end diastolic flow or complete absence of it in the umbilical artery is associated with poor perinatal outcome. Cerebroplacental Ratio (pulsatility index of middle cerebral artery/pulsatility index of umbilical artery) less than 1 is a very sensitive and specific sign of fetal compromise. Conclusion: Abnormal Doppler waveforms within the umbilical and middle cerebral arteries are indicative of redistribution of cerebral blood flow in fetal hypoxia. If there is reduced or low blood flow during diastole in umbilical arteries, the fetal perfusion becomes intermittent and fetal hypoxia develops. The blood flow redistributes to vital organs like brain and kidneys and the pulsatility index of middle cerebral artery falls in the fetus. The plausible explanation of it is, sympathetic activation in a hypoxemic fetus leading to increased cerebral perfusion. The ductus venosus flow gets reduced and reversed along with continued hypoxia.

Author(s) Details

Nidhi Sharma 
Department of Obstetrics and Gynaecology, Saveetha Medical College Saveetha University, Chennai-602105, India.

Benjamin M. Sagayaraj
Department of Pediatrics, Saveetha Medical College, Saveetha University, Chennai-602105, India.

 Jayavelan Ramkumar 
Department of Cardiothoracic Vascular Surgery, Sri Ramachandra Medical College, Sri Ramachandra University, Chennai, India.

View Book :- http://bp.bookpi.org/index.php/bpi/catalog/book/211