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Background: Now-a-days, myocardial infarction (MI) is one of the most prevalent disorders. Lack of blood supply causes MI/heart attacks. Ischemia or a lack of oxygen causes heart tissue damage and is ultimately fatal. Several studies demonstrated the association of magnesium deficiency with MI. Aim and Objectives: The aim of the study was to evaluate the levels of serum magnesium in MI patients and to compare them with normal healthy individuals. Materials and Methods: The present study assessed magnesium levels in 50 MI and another 50 without MI, healthy participants serve as a control. All the study participants were recruited from Government Medical College, Amritsar. Results: In normal individuals (n = 50), the Mean ± standard deviation (SD) of serum magnesium was 1.994 ± 0.28 mg/dl and SE. of 0.04, while in MI patients Mean ± SD was 1.13 ± 0.49 mg/dl and SE of 0.07. The mean of magnesium was significant (t = 10.8, P < 0.001) high in MI patients as compared to the control. Conclusion: Thus, it concludes that magnesium can be used as a diagnostic investigation tool for assessing patients suffering from MI.
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Conventional revascularization strategies for ischemic heart disease (IHD) are designed to prompt reperfusion of the coronary artery to the salvaged cardiomyocytes. However, these strategies may cause myocardial reperfusion injuries. Therefore, a safe and effective strategy needs to be developed to improve the conventional strategies. Here, we investigated the pro-angiogenic effect of Ginsenoside Rb1 (Rb1) to provide the experimental basis for angiogenesis-mediated drug therapy of IHD. Thus, Human umbilical vein endothelial cells (HUVECs) were treated with either a vehicle or Rb1 at 4, 8, 12 or 16 ?M for 24 h. A model of hindlimb ischemia was established using C57BL/6J mice. In sham-operated mice, only the femoral artery was isolated without ligation whereas the other operations and supplementation control group were consistent. The mice in the supplementation group were injected with Rb1 (50 mg/kg body wt./day) for 7 days. The results indicated that Rb1 promotes cell proliferation, adhesion, migration and tube formation in the HUVECs in a dose-dependent manner. The ED50 of Rb1 to improve cell adhesion is 8 ?M. In mice, Rb1 promoted angiogenesis after the ligation of the femoral artery and ameliorated the ischemic conditions. Intriguingly, more blood flow recovery was observed in the Rb1 supplemented mice than in the vehicle-treated mice (0.85 ± 0.05 vs. 0.71±0.10 on day 3; 0.94±0.10 vs. 0.75±0.08 on day 7). In HUVECs, Rb1 increased the phosphorylation of STAT3 and JAK, which may be the mechanism through which Rb1 mitigates IHD. Moreover, our results confirmed that Rb1mitigates IHD potentially by activating the JAK-STAT3 pathway. Further clinical trials are warranted to verify the clinical implications of Rb1.
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Hridroga (heart diseases) is one of the major causes of death in India. Hridroga means Cardiac Disorders in Ayurveda. Heart is described as Marma (vital organ) in Ayurveda. Number of people suffering from the heart diseases are quite increased in last few years. According to the global burden of disease, the 24.8 % of all deaths are occurred due to CADs [1] and it affects elders as well as young population, so it is needed to review the concept of Hridroga and its management according to Ayurvedic perspectives with its present updates so, one can prevent these conditions or manage them with more precise approach. Previously number of works has been done on Hridroga in relation to its pathology, treatment aspect, dietary regimen useful for pathological conditions affecting heart. Detail description of causes, symptoms, treatment part of Hridroga is available in the Ayurvedic texts. Ayurveda explains in detail regarding how Ayurveda is afflicted with vitiated Vata, Pitta and Kapha with its symptoms and clinical management. To prevent these conditions and also treat them with more precise approach the review of these concepts is helpful. This article includes the etiological factors, Dosha specific symptoms, types and clinical management of Hridroga (heart disorders) as explained in Ayurvedic texts.
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Mobile application-based technology was used to study medication compliance and influence on cardiovascular lifestyle in ischemic heart disease (IHD) patients who undergo percutaneous transluminal coronary angioplasty (PTCA). The Mobile-app was made available at Google play store; the app was downloaded and instructions to use were thought to patients by the research team during hospitalization in the study group. A total of two hundred patients with ischemic heart disease who underwent PTCA were enrolled into the study. The control group had telephonic follow up at periodic interval. Both groups had clinical follow ups at appropriate time intervals. Higher medication compliance, smaller number of adverse events and regular follow ups were significantly more in mobile-app group than in control group.
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Ambient fine particulate matter (PM2.5) is a mixture consisting of a wide range of chemical constituents including carbonaceous aerosols, water soluble ions and inorganic elements, and has become the major air pollutant in most cities in China. Evidence suggests that exposure to ambient PM2.5 induces damage on the cardiovascular system and can increase risk of the development and mortality of ischemic heart diseases (IHD). However, the effects of exposure to specific PM2.5 constituents on IHD remain unclear, and its underlying mechanisms are yet to be investigated. Here we reviewed studies investigating the association of short- and long-term exposure to specific PM2.5 constituents with IHD, which may provide useful clues for future relevant studies.
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Introduction: Atrial fibrillation (AF) is the common arrhythmia seen in clinical practice. It is characterized by worm-like writhingmovements of atrial muscle resulting in loss of atrial transport function.Materials and Methods: A total of 50 cases of AF, admitted in Medical and Cardiology wards of Mahatma Gandhi MemorialGeneral Hospital, Warangal, from 2006 to 2008 formed the study material.Results: A clinical study of 50 patients (aged from 20 to 80) with electrocardiographically documented AF.Conclusion: Atrial fibrillation due to rheumatic aetiology is more common in younger age group, while that due to other causeslike hypertension, ischemic heart disease common in older age. Chronic AF due to pulmonary disease is most commonlyobserved in males
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Background: Proof of a circadian rhythm in the occurrence of cerebral infarction and other types of stroke might provide clues to factors which immediately precipitate these events, which in turn might lead to more rational treatments. The aims of the current study were to find out the circadian variation of stroke onset and to determine the risk factors related to circadian variation.Methods: This cross-sectional study was conducted in a tertiary hospital of Bangladesh from July to December 2014 among 67 diagnosed cases of ischemic and hemorrhagic stroke of first attack. Times of onset of stroke and wake-sleep state were recorded.Results: The mean age of the study subjects was 62.1 years, 64.2% were male. Among them, 59.7% had an ischemic stroke and 40.3% had a hemorrhagic stroke. The occurrence of stroke was most common during 6 am to 12 pm (47.8%), followed by 12 am to 6 am (25.4%), 12 pm to 6 pm (17.9%), and 6 pm to 12 am (9.0%). Circadian variation of stroke was homogenous and statistically insignificant in association with age group when categorized as below 65 years and 65 years or above years, sex, smoking habit, and presence or absence of diabetes mellitus, atrial fibrillation, and dyslipidemia. But hypertension and ischemic heart disease (IHD) were significantly associated with circadian variation of stroke. The occurrence of ischemic stroke and hemorrhagic stroke was most common from 6 am to 12 pm (47.5% and 48.1%) respectively. When considered separately, significant circadian variation noted for ischemic stroke and hemorrhagic strokes were also noted.Conclusions: The study contributes further evidence for the circadian variation in the occurrence of ischemic stroke and hemorrhagic stroke. Attempts to prevent their occurrence must take into account this circadian variation.
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Background: Ischemic heart disease is a multifactorial disease. Various behavioural risk factors like smoking, physical inactivity, unhealthy diet and alcohol are known to be important risk factors for IHD.Methods: A case control study was conducted at Kerebilachi village, Davanagere. 40 known cases of Ischemic heart diseases and 80 controls were studied. The association of various risk factors with IHD was assessed. Data was entered in the Microsoft excel and analysed using SPSS v20.Results: Smoking, diabetes, hypertension, physical inactivity and obesity were important risk factors considered in this study. Significant association was observed with smoking (OR 6.15, CI: 2.646 -14.289.), diabetes (OR 5.28, CI: 1.80-18.54), hypertension (OR.35, CI: 0.12-1.01) and obesity (OR 0.74, CI: 1.06—8.23).Conclusions: This study reinforces the importance of risk factors which are modifiable and preventable.
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Background: Most of the studies on cardiovascular risk factors are concentrated on adults. But atherosclerotic process begins in childhood and is influenced by genetics, diet and life style. Hence, present study was undertaken. The objectives of the study were to study lipid profile and other cardiovascular risk factors like hypertensive status, BMI(Body mass index) in children aged between 5years and 18 years born to parents having premature IHD(Ischemic heart disease), to study diet and life style factors in study group having family history of IHD, to study the sociodemographic profile of dyslipidemia.Methods: A 200 Cases of premature IHD were selected. Their children(n=200) in the age group of 5 to 18 years were selected and analysed for cardiovascular risk factors. They were compared with 200 normal children without any family history of IHD.Results: On comparison of mean lipid profile between cases and controls HDL cholesterol was very low amongst cases (p=0.001). The mean values of triglycerides and VLDL were very high amongst cases (p=0.001). The mean atherogenic index (AI) was high amongst cases (p=0.001). Prehypertension or hypertension was seen amongst 8.5% cases (p=0.004). Amongst the cases 19.5% had excess junk food intake (p=0.001). 51.5% of cases had sedentary life style (p=0.001).Conclusions: Children in our area born to parents with premature IHD have significant incidence of dyslipidaemia. There is an increased incidence of other cardiovascular risk factors like hypertension, excess junk food intake, sedentary life style in these children.
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Background: Coronary artery disease (CAD) is the major causes of death in the developed world. It has been reported that there is high prevalence of cardiac risk factors and associated morbidity in the adult population. These risk factors are known as the metabolic syndrome. Due to the alterations in lifestyle, low physical activity, the epidemic of obesity and insulin resistance, metabolic syndrome is a growing health problem in adults. Methods: In this study, 150 total numbers of cases were included. This study conducted in the Department of Medicine in K M Medical College & Hospital, Mathura. The duration of study was over period of one year. Results: In this study, 150 total numbers of cases were included. Out of 150 cases 65.4% were male and 34.6% were female.36% cases 51-60 age group predominantly found followed by >60 & <51. This study showed risk factor of Diabetic mellitus which were in 67 cases in IHD with metabolic syndrome group. While in IHD without metabolic syndrome group IHD higher risk found followed by other group. Conclusions: This study suggested that, Metabolic syndrome significantly increases the risk of coronary artery disease also. To prevent the development of metabolic syndrome, it is necessary to modify lifestyle.
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Background: Number of people dying from IHD has increased from 0.61 million in 1990 to 1.13 million in 2010, which is a disturbing fact. According to report by World Health Organization, India would be spending a whopping 237 billion US dollars, owing to direct spending on health care and indirectly due to loss of productivity due to IHD. Ischemia Reversal Program (IRP) is a combination of Panchakarma and allied therapy. This study was conducted to evaluate the effect of IRP on VO2max, Duke抯 treadmill score, systolic blood pressure (SBP), diastolic blood pressure (DBP), and dependency on conventional therapy in IHD patients.Methods: This observational study was conducted in January 2017, wherein the data of IHD patients (inducible ischemia on stress testing) who attended out-patient departments (OPDs) at Madhavbaug clinics in Maharashtra, India were identified. Data of patients who were administered IRP (60-75 minutes) with minimum 7 sittings over 90 days (� days) were considered. Variables were compared between day 1 and day 90 of the IRP.Results: Out of 38 enrolled patients, 25 were males while 13 females. There was significant improvement in Duke抯 score with subjects at moderate (50%) and high (31.6%) risk at baseline were significantly decreased to low (52.6%) and moderate (47.4%) after the 90th day of therapy. IRP also showed significant improvement in VO2max by 9.11 (from 20.29�72 to 29.40�71; p<0.001), SBP by 5.78 (from 128.78�.40 to 123�.23, p<0.03), DBP by 4.76 (from 80.53�10 to 75.76�85, p<0.005). Dependency on concomitant medicines was reduced.Conclusions: IRP was effective in IHD; it had dual benefits, i.e. anti-ischemic effect, as well as reducing the dependency on allopathic medicines.
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Background: Ischemic heart disease is one of the leading causes of global disease burden. Despite treatment with standard therapy, many patients with chronic stable angina pectoris remain symptomatic making it an urgent necessity to introduce new strategies. Hence this study was planned to compare the efficacy and tolerability of Ivabradine and Ranolazine; the two novel antianginal drugs. Methods: This was a single blind, randomised, controlled trial. Thirty patients each taking IVA 5 mg twice daily or RAN 500 mg twice daily were randomised into two groups. Patients filled a pretested questionnaire on frequency of angina attacks and adverse reactions experienced at baseline and 2, 4 and 8 weeks. The haemodynamic parameters, routine laboratory investigations were evaluated at the baseline and after intervention. Results: There was no significant difference in the frequency of angina attacks per week between the IVA and RAN study groups. There was a statistically significant difference (P < 0.01) in the number of patients reporting ADR from the IVA group as compared to RAN group. In the IVA group, the most common ADR was dizziness (36.6%); whereas nausea (30%) and dizziness (23.3%) was most common in RAN group. The routine haematological and biochemical evaluations did not show any significant difference between the baseline and post intervention. However, IVA significantly decreased the resting heart rate after eight weeks of intervention.. Conclusion: Both IVA and RAN are comparable and efficacious antianginal agents. However, RAN had a better safety and tolerability profile than IVA.
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Background: A wide and gradual variation exists periodically in the patterns of pharmacotherapy among patients admitted with CVDs in CCU. Periodic evaluation of drug utilization in the CCU is necessary for optimization of health care system, proper use of resources and making prescription policy.Methods: It was retrospective and prospective study. Study was carried out at Tertiary care hospital in Mangalore. Retrospective study period was from 1/07/2010 till 31/12/2010 and Prospective study duration was from 1/01/2016 till 30/06/2016. Patients from CCU were participants of this study.Results: Data of total 278 patients were taken, out of which 138 patients from 2010 and 140 patients in 2016 were analyzed respectively and were compared among drug therapy for IHD - Nitrates, dual antiplatelet therapy (aspirin and clopidogrel), dyslipidemic drugs and beta blockers remain drug of choice in both retrospective and prospective study. But, anticoagulant (heparin/ LMWH) use increased in prospective studies. In Heart failure - nitrates, antiplatelet, dyslipidemic drugs followed by inotropes and diuretics was used in both study. Cardiomyopathy was managed with diuretics, ACEIs, and nitrates in both retrospective and prospective study.Conclusions: In conclusion, predominance of male gender and poly-pharmacy were observed. However, it has identified areas to further rationalize and optimize patterns of polypharmacy and evidence based use of medications like beta blockers, anticoagulants/antiplatelet agents and antiarrythmisc. The results on the major determinants of cardiovascular drug use in CCU matched with the existing indications and cautions for use with each drug class.
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MTHFR A1298C and C677T SNPs are now recognised as important genetic mutations which would give rise to hyperhomocysteinemia. In this study, we analysed the prevalence of these two SNPs in 79 ischemic heart disease (IHD) patients awaiting coronary artery bypass grafting and 79 healthy subjects. MHFR polymorphisms were analysed using polymerase chain reaction followed by a restriction fragment analysis. Prevalence rates for MTHFR C677T polymorphism were 72.8%, 24.7%, and 2.5% for CC, CT, and TT genotypes, respectively, for the whole study population with 677CC genotype being the predominant genotype among both the IHD patients and the controls. The 677TT genotype was detected only among the IHD patients. There was no significant difference in MTHFR 677 genotype variations between IHD patients and the control group. Prevalence rates for the MTHFR A1298C polymorphism were 50%, 37.3%, and 12.7% for the AA, AC, and CC genotypes, respectively, for the whole study population with 1298AA genotype being the predominant genotype among controls and 1298AC the predominant genotype among IHD patients. There was a significant difference (p < 0.01) between IHD patients and controls when the MTHFR 1298 genotype variations were compared. Allele frequencies for the mutant T allele for C677T mutation at 0.149 are the highest reported from Sri Lanka. The frequency of the C for the A1298C mutation was 0.313. Results of this study indicate that MTHFR A1298C SNP is more prevalent in Sri Lankans when compared to C677T SNP and that the mutant forms of the MTHFR A1298C SNP are associated with ischemic heart disease.
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Background and Objectives: Atrial fibrillation (AF) is a frequently encountered cardiac arrhythmia which may be either symptomatic or asymptomatic. So, this study was conducted to know clinical presentation and to find out possible clinical and etiological profile of patients with AF.Material and Methods: This cross sectional study was conducted at Osh Regional Integrated Clinical Hospital, Osh Territorial City Clinical Hospital, The Kyrgyz Republic in collaboration with Janaki Medical College Teaching Hospital, Janakpurdham, Nepal. Sixty consecutive patients with AF were taken. Presenting complaints, past history, personal history was recorded. A thorough clinical examination was done, electrocardiogram, chest X-Ray posterio-anterior view, echocardiogram, thyroid function test and relevant test were done and analyzed.Results: Forty percent of the patients complained palpitation. Systemic thrombo-embolism was found in 15% of the patients. Other presenting complaints were cough, chest pain, shortness of breath, dizziness, swelling of the legs, tremors. Eighteen percent of patients presented with features of congestive cardiac failure and 30% of the patients gave history of rheumatic heart disease, 16.6% and 11.6% hypertension and ischemic heart disease respectively. Etiology-wise, rheumatic heart disease was the most common (46.6%) followed by hypertension (21.6%), ischemic heart disease (11.6%), dilated cardiomyopathy (6.6%), hyperthyroidism (5%), pneumonia (5%).Conclusion: Rheumatic heart disease, especially mitral stenosis is the most common cause of AF in this study. Systemic hypertension was next common etiology of AF, followed by ischaemic heart disease, dilated cardiomyopathy, thyroid disease. Heart failure, Systemic thromboembolism, decreased exercise tolerance are a major determinants for development of significant morbidity and mortality.
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Laparoscopic liver resection has been widely accepted nowadays for selective cases of liver diseases. Laparoscopic left lateral sectionectomy and minor LLR are considered standard practice worldwide and cautious introduction of major laparoscopic liver resections like hemihepatectomies, central sectionectomy etc.. in institutions having experienced liver surgeons. Because of increasing young liver donor, laparoscopic donor hepatectomy is becoming popular, which gives better cosmetic outcomes. Many clinical trials compared laparoscopic liver resection safety, long term outcomes with open procedures. More recently, advances in laparoscopic instruments and techniques encouraged Korean surgeons to choose a laparoscopic procedure as one of the treatment options for benign or malignant diseases of liver.
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Humans , Hepatectomy , Liver Diseases , Liver , Mastectomy, Segmental , Surgeons , Tissue DonorsABSTRACT
Acceleration of emissions reductions in household coal stoves and modest improvements in other sectors, however, have the potential to considerably lower outdoor pollution and reduce total exposures to about 70% of those today (Scenario 1). Reducing total exposures closer to these international benchmark levels will require moving away from coal and wood as household fuels and even more control on other sources (Scenario 2). The first package of moderate control measures (Scenario 1) considered in this assessment will result in a slow decline in impacts(Figure) and a cumulative health savings over trends in 2013, but leave annual per capita health impacts only about 25% lower than today after ten years. A more aggressive set of control measures (Scenario 2), however, will result in more health protection over the period and reduce annual impacts by approximately 60% from current levels in 2025 . In terms of impact per capita,this would represent nearly a 70% reduction over the period taking population growth into account.
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Background: The purpose of the study was to find the effect of loading dose of atorvastatin on the reduction of myocardial injury resulting from percutaneous coronary intervention (PCI). Methods: A total 100 consecutive patients were included in this study of which 50 patients were in the group I who were treated with a loading dose of atorvastatin and the rest 50 patients were in the group II who were treated without the loading dose of atorvastatin.The occurrence of myocardial injury was measured by serum cTn-I level in patients undergoing PCI with or without loading dose of atorvastatin.
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Objectives: Coronary collaterals appear to play important role in coronary artery disease morbidity and mortality. In this study it was intended to determine whether hypertension is associated with development of coronary collaterals in patients with severe coronary artery disease. Methods: This was an observational cross-sectional study carried out in the department of cardiology of National Institute of Cardiovascular Diseases, Dhaka, Bangladesh during the period from October 2010 to June 2011. A total of 334 patients were examined to include in the study. Among them 118 patient of severe coronary artery disease (CAD) were included who fulfilled the inclusion and exclusion criteria. From where 63 patients were CAD with hypertension (Group -I) and 55 patients were CAD without hypertension (Group -II). Based on Rentrop Grading the study patients were divided in two groups, patients with poor collaterals (Grade 0& 1) and good collaterals (Grade 2&3). Data compared the coronary collaterals in hypertensive patients with those without hypertension with severe coronary artery disease. Results: The data showed that good collateral circulations were higher with duration of hypertension. The difference were statistically significant in duration <5 years and duration >10 years in both groups (p<0.05). The pattern of vessel involvement in double vessel disease and triple vessel disease (p <.001) and dyslipidemia (p<0.004) appeared to be significant predictor of hypertension controlling for other factors in the model. People with hypertension are around four times more likely to have good collateral circulation, multiple vessel disease and around 12 times more likely to have dyslipidemia. Conclusion: It is concluded that the patients of hypertension develop higher grades of coronary collaterals which increases with duration of hypertension in patients of severe coronary artery disease. Involvements of coronary arteries were more extensive in patients of hypertension with coronary artery disease.
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Introducción: La cardiopatía isquémica es una de las principales causas de muerte en la mujer, tanto en Cuba, como a nivel mundial. Objetivo: El objetivo del estudio fue determinar si las concentraciones bajas de colesterol asociado a las lipoproteínas de alta densidad, representan un factor de riesgo a considerar, en mujeres con cardiopatía isquémica. Métodos: Se realizó un estudio observacional, transversal en 727 mujeres, durante el período de enero 2010 a diciembre 2012. Se determinó el por ciento de mujeres sin o con cardiopatía isquémica (CI), con diferentes rangos de c-HDL (normal o patológico). Además se formaron un grupo control (A) y dos grupos con CI sin o con antecedentes de infarto agudo del miocardio (B y C), para comparar el perfil lipídico. Además, diferentes factores de riesgo para la CI se relacionaron con la variable c-HDL. Resultados: Las mujeres con CI presentaron un promedio de edad y un índice cintura-cadera, dentro del rango de riesgo cardiovascular. Los niveles de triglicéridos y VLDL-c fueron significativamente superiores (p< 0,05*), relacionados con una disminución significativa (p< 0,05*) del HDL-c, en las mujeres con CI (grupos B y C) al compararlos con el grupo control. Además, se encontró asociación significativa (p< 0,05*), entre las cifras bajas de HDL-c, con la presencia de cardiopatía isquémica, hipertrigliceridemia y el antecedente de cirugía de revascularización miocárdica. Conclusiones: Las concentraciones bajas de HDL-c están asociadas con la presencia de cardiopatía isquémica e hipertrigliceridemia. Por tanto, el control de los niveles de HDL-c representa un objetivo terapéutico que contribuye a reducir eventos cardiovasculares mayores. Además la presencia de otros factores de riesgo como la edad y el sobrepeso, pudiera influir en el desarrollo de estos eventos.
Background: Ischemic heart disease is one of the main causes of death in women, both in Cuba and in the world. Objective: The objective of this study was to determine whether low cholesterol concentrations, associated with high density lipoproteins, represent a risk factor to consider in women with ischemic heart disease. Methods: An observational, transversal study was conducted in 727 women during the period from January 2010 to December 2012. The percent of women with or without ischemic heart disease (IHD) and different ranges of HDL - C levels (normal or pathological) was determined. Results: Women with IHD had a mean age and a waist-hip ratio within the range of cardiovascular risk. Triglycerides and VLDL-C levels were significantly higher (p <0.05 *), related to a significant decrease of HDL- C levels (p <0.05 *) in women with IHD (groups B and C) when compared with the control group. Also, a significant association (p<0, 05*) was found between the low levels of HDL- C levels, with presence of ischemic heart disease, hypertriglyceridemia and antecent of myocardial revascularization surgery. Conclusions: Low HDL-C levels are associated with the presence of ischemic heart disease and hypertriglyceridemia. Therefore, the control of HDL- C levels represents a therapeutic target which helps to reduce major cardiovascular events. Moreover, the presence of other risk factors such as age and overweight could influence the development of these events.