Ultrasonographic Assessment Of Carotid Artery Intima Media Thickness And Its Predictivity Of Coronary Artery Disease And Its Relation With Age And Gender

Introduction: IMT of carotid artery, can be assessed by B–mode ultrasound in a simple way, because of its superficial location, runs parallel to the surface of the neck, serve it as a suitable diagnosing method for coronary atherosclerosis. The purpose of this study was to investigate the predictive value of IMT of CCA, ICA, carotid bifurcation for CAD and relation of IMT with age and gender of patients. Methods: Two hundred patients (age from 30 ye80 y) who were subjected to coronary angiography in Haldiram Moolchand Cardiology Hospital, Bikaner (Rajasthan), also sub–jected for B–mode ultrasound scan of carotid. The mean value of six measurements of IMT of far wall of the CCA, ICA, carotid bifurcation was calculated in each patient. Result: R2 value by regression analysis was significantly (p–0.000) higher for collectively all four arterial segments in significant CAD. R2 value for club model (CCA, ICA, Carotid bifurcation) was found 0.549 whereas for individual segment it was 0.422. Mean IMT of arteries significantly increasing with age and greater for men (0.686 ± 0.261) as comparison to women (0.594 ± 0.253). Conclusion: present study that the IMT of carotid arteries which were taken in this study as different parameters were significantly correlated not only to CAD but also its severity. An increase in IMT of CCA and its arterial segments were found associated with age and gender of the patients.

Prevalence and associated factors of domestic violence against married rural women of Gurugram, Haryana

Background: The global health burden from domestic violence against women in reproductive age group is about 9.5 million disability adjusted life years (DALYs). Women suffering from violence have more chances of suffering from physical, emotional, and mental problems such as anxiety, depression and post-traumatic stress disorder. The objectives of the present study are to find the prevalence and awareness of domestic violence in an urban slum of Gurugram and to elicit associated risk factors and the reasons for tolerance of domestic violence.Methods: A community based, cross sectional study was conducted among married women (18-45 years) using a semi structured questionnaire in a rural area of Gurugram by systematic random sampling. Sample size collected was 900. Study population was enquired about the awareness regarding domestic violence, self-experience about domestic violence and about the form of violence experienced and the reasons for their tolerance. Data was entered and analyzed using Epi Info ver 7.Results: Total 980 subjects were enquired about their awareness and self-experience of domestic violence. Overall prevalence of domestic violence in the study population was 28%. Prevalence of domestic violence was statistically significantly associated with education, employment, duration of marriage (p value <0.05).The prevalence was highest of emotional violence (40.5%), followed by physical (33.4%), economic (21.4%) and sexual violence (4.7%).Conclusions: Public health professionals should emphasis on measures to raise public awareness so that women can talk freely about domestic violence and its consequences and help in mitigating this medico-social problem.

A Comparison of Peri-Procedural Myocardial Infarction between Paclitaxel-Coated Balloon and Drug-Eluting Stent on De Novo Coronary Lesions

PURPOSE: This study compared the impact of paclitaxel-coated balloons (PCB) or drug eluting stents (DES) on peri-procedural myocardial infarction (PMI) on de novo coronary lesion in stable patients. MATERIALS AND METHODS: In this observational study, we compared the incidence of PMI amongst patients with single vessel de novo coronary lesions who underwent treatment with a PCB or DES. Propensity score-matching analysis was used to assemble a cohort of patients with similar baseline characteristics. PMI was classified as myocardial infarction occurring within 48 hours after percutaneous coronary intervention with a threshold of 5 x the 99th percentile upper reference limit of normal for creatine kinase-myocardial band (CK-MB) or troponin T (TnT). RESULTS: One hundred four patients (52 receiving PCB and 52 receiving DES) were enrolled in this study. The peak mean values of CK-MB and TnT were significantly higher in the DES group. There was a significantly higher rate of PMI in the DES group (23.1% vs. 1.9%, p=0.002). Total occlusion of the side-branch occurred in two patients treated with DES, while no patients treated with PCB. In multivariable analysis, DES was the only independent predictor of PMI compared with PCB (odds ratio 42.85, 95% confidence interval: 3.44–533.87, p=0.004). CONCLUSION: Treatment with a PCB on de novo coronary lesion might be associated with a significant reduction in the risk of PMI compared to DES.

Serial Morphological Changes of Side-Branch Ostium after Paclitaxel-Coated Balloon Treatment of De Novo Coronary Lesions of Main Vessels

PURPOSE: The effects on the side-branch (SB) ostium, following paclitaxel-coated balloon (PCB) treatment of de novo coronary lesions of main vessels have not been previously investigated. This study was aimed at evaluating the serial morphological changes of the SB ostium after PCB treatment of de novo coronary lesions of main vessels using optical coherence tomography (OCT). MATERIALS AND METHODS: This prospective, single-center observational study enrolled patients with de novo lesions, which were traversed by at least one SB (≥1.5 mm) and were treated with PCB. The SB ostium was evaluated with serial angiographic and OCT assessments pre- and post-procedure, and at 9-months follow-up. RESULTS: Sixteen main vessel lesions were successfully treated with PCB, and 26 SBs were included for analysis. Mean SB ostial lumen area increased at 9-months follow-up (0.92±0.68 mm2 pre-procedure, 1.03±0.77 mm2 post-procedure and 1.42±1.18 mm2 at 9-months). The SB ostial lumen area gain was 0.02±0.24 mm2 between pre- and post-procedure, 0.37±0.64 mm2 between post-procedure and 9-months, and 0.60±0.93 mm2 between pre-procedure and 9-months. The ostial lumen area increased by 3.9% [interquartile range (IQR) of -33.3 to 10.4%] between pre- and post-procedure, 52.1% (IQR of -0.7 to 77.3%) between post-procedure and 9-months and 76.1% (IQR of 18.2 to 86.6%) between pre-procedure and 9-months. CONCLUSION: PCB treatment of de novo coronary lesions of main vessels resulted in an increase in the SB ostial lumen area at 9-months.

Prediction of Coronary Atherosclerotic Ostial Lesion with a Damping of the Pressure Tracing during Diagnostic Coronary Angiography

PURPOSE: When performing coronary angiography (CAG), diagnostic catheter intubation to the ostium can cause damping of the pressure tracing. The aim of this study was to determine the predictors of atherosclerotic ostial stenosis in patients showing pressure damping during CAG. MATERIALS AND METHODS: In total, 2926 patients who underwent diagnostic CAG were screened in this study. Pressure damping was defined as an abrupt decline of the coronary blood pressure with a blunted pulse pressure after engagement of the diagnostic catheter. According to CAG and intravascular ultrasound (IVUS), we divided damped ostia into two groups: atherosclerotic ostial lesion group (true lesion group) and non-atherosclerotic ostium group (false lesion group). Clinical and angiographic characteristics were compared between the two groups. RESULTS: The overall incidence of pressure damping was 2.3% (68 patients and 76 ostia). Among the pressure damped ostia, 40.8% (31 of 76 ostia) were true atherosclerotic ostial lesions (true lesion group). The true lesion group had more frequent left main ostial damping and more percutaneous coronary interventions (PCIs) performed on non-ostial lesions, compared to the false lesion group. On multivariate logistic regression analysis, left main ostial damping [hazard ratio (HR) 4.11, 95% confidence interval (CI) 1.24-13.67, p=0.021] and PCI on non-ostial lesion (HR 5.34, 95% CI 1.34-21.27, p=0.018) emerged as independent predictors for true atherosclerotic ostial lesions in patients with pressure damping. CONCLUSION: Left main ostial damping and the presence of a non-ostial atherosclerotic lesion may suggest a significant true atherosclerotic lesion in the coronary ostium.

Comparison of Paclitaxel-Coated Balloon Treatment and Plain Old Balloon Angioplasty for De Novo Coronary Lesions

PURPOSE: This study compared the angiographic outcomes of paclitaxel-coated balloon (PCB) versus plain old balloon angioplasty (POBA) treatment for de novo coronary artery lesions. At present, there is no available data comparing the efficacy of PCB versus POBA for the treatment of de novo coronary lesions. MATERIALS AND METHODS: This multicenter retrospective observational study enrolled patients with de novo coronary lesions with a reference vessel diameter between 2.5 mm and 3.0 mm and lesion length or =50%) in POBA, compared to PCB (30.4%, n=7 vs. 4.1%, n=2, p<0.001). Target vessel revascularization was higher in the POBA group (13.0%, n=3 vs. 0%, p=0.033). CONCLUSION: PCB treatment of de novo coronary lesions showed better 9-month angiographic outcomes than POBA treatment alone.