ABSTRACT
The present study was aimed to compare traditional lipid measures with the lipid ratios to establish a bettermarker for the assessment of coronary artery disease (CAD) risk. The comparison of traditional lipid parametersand lipid ratios were made in terms of independent ‘t’ test, area under receiver operating characteristic(AUROC) curve and logistic regression analysis. LDL-C and HDL-C could not correlate well with CAD riskprediction. Strikingly, TG/HDL ratio was found to be more significantly associated in comparison to any ofthe individual lipid parameters as well as TC/HDL and LDL/HDL ratios when compared in terms of AUROCand logistic regression analysis, while LDL/HDL ratio could not correlate. Altogether, these findings infer thatTG/HDL ratio is a better parameter in CAD risk prediction. Additionally, the TG/HDL ratio being calculatedparameter incurs no additional cost to the patients and health care system. Henceforth, the authors suggest theincorporation of the TG/HDL ratio in the routine lipid panel for the better diagnosis and treatment of dyslipidemia.
ABSTRACT
Worldwide about 287,000 maternal deaths occur every year, and significant variation exists between low/high/middle-income populations.[1] Maternal death has direct and indirect causes. Indirect maternal deaths result from conditions existing before maternity or recently developed not related to maternity, e.g. cardiovascular diseases, HIV/AIDS, anaemia, infections. World Health Organization (WHO) outlined it as a condition within which “a woman nearly died, however survived throughout pregnancy, childbirth or within 42 days of termination of pregnancy, just by a chance or good hospital care.”[2] Heart conditions presently represent the most common reason behind indirect maternal obstetrics deaths. Pregnancy is related to substantial and progressive hemodynamic changes beginning early in maternity, reaching their peak at the end of 2nd trimester and remaining comparatively constant till child-birth. Major alterations in maternity include a 30 to 50 percent increase in blood volume and cardiac output and decreased blood pressure. In cardiac pregnant patients, these modifications might cause clinical decompensation, exposing these patients to probably life-threatening situations.[3] Here we represent a similar case of a maternal near miss due to severe cardiac dysfunction reported at 8 months amenorrhea.
ABSTRACT
Maternal near miss is defined as a pregnancy which survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.[1] India’s MMR has significantly declined from 167 in 2011-13 to 130 in 2014-16. According to guidelines on Maternal Near Miss given by Ministry of Health and Family Welfare, December 2014, for diagnosing a patient with severe cardiac dysfunction, grade-4 (WHO classification) which is a contra -indication to pregnancy, who met single heart criteria to be defined as MNM with abnormal acid-base values, need for ventilatory support, ICU admission, digitalisation, use of cardio- tonics, inotrope support, intra-cardiac intervention OR patient should meet minimum three criteria one each from clinical findings, investigations and interventions. There are certain single heart criteria like breathlessness, orthopnoea, tachycardia, organic murmurs, abnormal ECG and abnormal 2-D ECHO which puts the patient as MNM.[3]
ABSTRACT
Introduction: Smoking is an independent risk factor forischemic heart disease and acute myocardial infarction.Smoking raise both heart rate and blood pressure, thusincreasing myocardial oxygen demand, moreover it alsodecreases the dimension of coronary vessel and coronaryblood flow. Inferior wall Myocardial Infarction is consequenceof disease in usually Right coronary artery, whereas anteriorwall Myocardial Infarction is usually disease in left coronaryartery. The aim of the study is to evaluate whether smokinginfluence the incidence of inferior wall MI (Right coronaryartery). Study objective was to find out whether there was anassociation between smoking and inferior wall MyocardialInfarction and an early association of atherosclerosis andischemic heart disease with smoking.Material and methods: 126 patients of ST ElevationMyocardial Infarction admitted from the outdoor patientdepartment/ emergency department/ Cardiology OPD inMMIMSR, Mullana, Ambala, considered for study. Thosewho are willing to participate and fulfilling the inclusion andexclusion criteria.Result: In our study there was a high proportion of smokerin patient with inferior wall MI than other location of MI.Smokers were prone to get myocardial infarction at a youngerage as compared to others. Mortality was higher in anteriorwall MI as compared to Inferior wall MI. Anterior wall MIpresented with more complications i.e. cardiogenic shock andarrhythmias.Conclusion: Smoking enhance the risk of inferior wall MImore than other MI. Smoking thus appear to adversely affectthe Right coronary artery to greater extent than left coronaryarterial circulation by mechanism yet to be explored. Smokingleads to ischemic heart disease at early age.