The effectiveness of relaxation exercises on fatigue in hemodialysis patients: a meta-analysis study

SUMMARY OBJECTIVE: This study was conducted to determine the effect of relaxation exercise on fatigue symptoms in hemodialysis patients. METHODS: This is a meta-analysis study. The literature review was carried out by searching studies published between 2011 and 2020. This meta-analysis was recorded on PROSPERO in the National Health Research Institute (Registration no: CRD42022313646). RESULTS: Seven studies meeting the inclusion criteria were included in the meta-analysis. The effect size of the studies included in the meta-analysis was found to be g=1.232 (p=0.028), which indicated a "huge effect size." The scale used in the subgroup analyses, the application time of the relaxation exercise, and the number of relaxation exercise applications were evaluated, and a significant difference was found at p<0.05. CONCLUSION: Relaxation exercises can be used as an effective method for reducing fatigue in hemodialysis patients.

Riesgo de eventos embólicos en pacientes con miocardiopatía chagásica y fibrilación auricular a pesar de terapia antitrombótica: ¿es la anticoagulación suficiente? / Risk of Embolic Events in Patients with Chagasic Cardiomyopathy and Atrial Fibrillation Despite Antithrombotic Therapy: Is Anticoagulation Enough?

RESUMEN Introducción: La miocardiopatía chagásica (MC) difiere de otras causas de insuficiencia cardíaca en múltiples aspectos, destacándose el riesgo de embolias sistémicas. Sin embargo, pocos estudios han evaluado el riesgo de eventos embólicos en pacientes anticoagulados con MC en comparación con otras miocardiopatías. Objetivo: Nuestro objetivo fue analizar la incidencia de embolias sistémicas en una cohorte de pacientes anticoagulados con diagnóstico de fibrilación auricular (FA) con y sin MC. Material y métodos: Se realizó un estudio de cohorte retrospectivo en hospital de cuarto nivel en Colombia durante el periodo 2014-2020. Se incluyeron todos los pacientes con diagnóstico de miocardiopatía de cualquier etiología y FA que estuvieran en régimen de anticoagulación. El resultado primario fue la incidencia de eventos embólicos. Se realizó un análisis de supervivencia mediante modelos de riesgos proporcionales de Cox ajustados. Un valor de p <0,05 se consideró significativo. Todas las pruebas estadísticas fueron de dos colas. Resultados: Se evaluaron 149 pacientes anticoagulados con miocardiopatía (mediana de edad: 71 años; mujeres: 30,20%). La incidencia acumulada de eventos embólicos fue significativamente mayor en los pacientes con MC (17,50%) en comparación con aquellos con otras miocardiopatías (4,95%), a pesar de que estos últimos tenían una puntuación CHA2DS2-VASc significativamente mayor (p=0,013). Tras el análisis multivariado, los pacientes con MC tuvieron un riesgo significativamente mayor de eventos embólicos independientemente de la puntuación CHA2DS2-VASc y del tipo de anticoagulante prescrito (HR 5,65; IC 95% 1,46-21,83; p=0,012). Conclusiones: La MC se asoció con un riesgo significativamente mayor de eventos embólicos, a pesar del tratamiento anticoagulante en ambos grupos. Se requiere más investigación para comprender el origen de este riesgo observado y traducir este conocimiento en indicaciones específicas de anticoagulación para pacientes con MC.

ABSTRACT Background: Chagasic cardiomyopathy (CC) differs from other heart failure causes in multiple aspects, highlighting the risk of systemic embolisms. However, few studies have evaluated the risk of embolic events in anticoagulated patients with CC compared with other cardiomyopathies. Objective: We aimed to analyze the incidence of systemic embolisms in a cohort of anticoagulated patients diagnosed with atrial fibrillation (AF) with and without CC. Methods: A retrospective cohort study was carried out at a fourth level hospital in Colombia during the period 2014-2020. All patients diagnosed with cardiomyopathy of any etiology and AF, who were on an anticoagulation regimen were included. The primary outcome was the incidence of embolic events. A survival analysis was performed using adjusted Cox proportional hazard models. A p-value <0.05 was considered significant. All statistical tests were two-tailed. Results: A total of 149 anticoagulated patients with cardiomyopathy were evaluated (median age: 71 years; women: 30.20%). The cumulative incidence of embolic events was significantly higher in patients with CC (17.50%) compared with those presenting other cardiomyopathies (4.95%), despite that the latter had a significantly higher CHA2DS2-VASc score (p=0.013). After multivariate analysis, patients with CC had a significantly higher risk of embolic events regardless of the CHA2DS2-VASc score and the type of anticoagulant prescribed (HR 5.65; 95% CI 1.46-21.83; p=0.012). Conclusions: Chagasic cardiomyopathy was associated with a significantly higher risk of embolic events, despite anticoagulation therapy in both groups. More research is required to understand the origin of the risk observed in order to translate this knowledge into specific indications for anticoagulation in patients with CC.

Establishing normal gallbladder volume: a comparative study of dual energy computed tomography and ultrasound measurements in a North Indian population

Background: The gallbladder, a critical component of the biliary system, plays a vital role in bile storage and digestion. Dysfunction in the gallbladder often results in gallstone formation, leading to significant healthcare burdens worldwide. Gallstone disease and gallbladder carcinoma are major health concerns, particularly in regions like India, where prevalence is high and poorly understood. Methods: This study aims to establish the normal baseline volume of the gallbladder using dual-energy computed tomography (DECT) and compare it with measurements obtained via ultrasound (USG). The cross-sectional study conducted at Era's Lucknow medical college and hospital involved 265 individuals aged 18-80 years with non-gallbladder-related abdominal conditions. Results: Final results showed the mean gallbladder volume to be 29.33�70 cm3 by DECT and 27.40�58 cm3 by USG, with DECT measurements being on average 1.93 cm3 higher. A significant association was found between gallbladder volume and obesity, but not gender. Conclusions: The findings suggest DECT provides slightly higher and potentially more accurate measurements of gallbladder volume compared to USG. These insights contribute to a better understanding of gallbladder physiology and the implications of its volume in various pathologies, emphasizing the need for further studies with larger sample sizes to validate these observations.

Pelvic organ prolapse quantification profile of women in Ile-Ife, Nigeria: determinants and symptom correlation

Background: The true incidence of pelvic organ prolapse (POP) using validated method of examination in a wider range of population of women needs evaluation in our setting. This study determined the prevalence of the different POP quantification (POPQ) stages of POP and correlated these stages with clinical symptoms alongside the determinants of POP among women in Ile-Ife, Nigeria.Methods: This was a cross-sectional study of consecutive, consenting four hundred women (aged 22-74years) attending the gynaecology, general outpatient, family planning, and well-woman clinics at Obafemi Awolowo university teaching hospitals complex, Ile-Ife, Nigeria between January 2016 and December 2016. Relevant biodata was documented in a purpose designed and pre-tested questionnaire, and the international consultation on incontinence questionnaire vaginal symptoms (ICIQ-VS) was administered. Data were analysed using IBM SPSS version 20.0. The prevalence of the different POPQ stages was determined. Logistic regression analysis was then performed to identify the significant determinants.Results: The study showed a prevalence of POPQ of 13% (stage 0), 85.3% (stage I), 1.3% (stage II) and 0.5% (stage III). Age, parity, menopausal status, chronic constipation, childbirth position, caesarean section and lifting of heavy objects were the identified significant determinants.Conclusions: There is a significant correlation between POPQ stage and the symptom 慺eeling of lump in the vagina�. Chronic constipation and lifting of heavy objects are modifiable significant risk factors in our study population.

Comparison of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in women with preterm premature rupture of membranes and women with preterm delivery

Background: Considering the adverse effect of PROM on birth outcomes and the condition of mother and fetus, early identification of risk factors of PROM and their control can reduce the occurrence of adverse outcomes for mother and fetus and improve their health. This study was conducted with the aim of comparing PLR and NLR in women with PROM and women with preterm delivery. Methods: This case-control study was conducted on 155 women with PPROM as case group and 155 women with preterm delivery as control group. Age, gestational age, type of delivery, baby's birth weight, gravida, parity, APGAR score, rate of hospitalization in Neonatal Intensive Care Unit (NICU), occurrence of neonatal sepsis and development of respiratory distress syndrome (RDS) were recorded from women's medical records. Also, the results of blood tests and PLR and NLR values were calculated for each pregnant woman. Collected data were analyzed by statistical methods in SPSS version 24. Results: The average gestational age and weight of babies at birth time in the case group were significantly lower than those with preterm delivery. The mean of NLR in case group with 4.8±2.5 was significantly higher than control group with 4.2±2.2. The mean of PLR in case group with 111.5±47.6 was significantly higher than control group with 100.98±43.4. Conclusions: The high values of PLR and NLR in the women with PROM compared to women with preterm delivery can be a marker to identify the risk of PPROM in pregnant women.

The prevalence of atopic dermatitis and the effect of breastfeeding on atopic dermatitis among Saudi infants aged up to six months in the Al Madinah region

Background: Atopic dermatitis (AD) is a common skin condition in infants, and breastfeeding has been proposed as a potential protective factor. The study aims to investigate the prevalence of AD in infants based on guardians' reports and the impact of exclusive breastfeeding (EBF) and formula feeding on the incidence of AD among Saudi infants in the Al Madinah region. Methods: A cross-sectional survey of 200 mothers with infants was conducted using a structured questionnaire. Data collected included demographics, breastfeeding practices, infant characteristics, allergies, and AD diagnosis. Statistical analysis employed chi-square. Results: There were a total of 200 infants, out of which 145 (72.5%) had AD, as confirmed by pediatricians. Gender was significantly associated with the prevalence of AD. Based on their nutritional source, 62 (42.8%) were on EBF, and 83 (57.2%) were non-EBF. Infant nutrition was found to be significantly associated with the hospitalization time of infants because of AD. Other AD risk factors, such as parental allergies, feeding frequencies, and frequency of AD episodes, were not significantly associated with the type of feeding. Conclusions: This study found that AD is quite prevalent in the Al Madinah region of Saudi Arabia. AD was more prevalent in male infants than in females. It suggests that EBF may be a protective factor against hospitalization of Saudi infants because of AD.

Tuberculous bronchoesophageal fistula presenting with miliary tuberculosis: a case report

A 35-year-old Asian woman with no pre-existing illnesses presented with a chronic cough during eating, mucoid sputum production, low-grade fever, and significant weight loss over the past few months. She had no history of high-risk behavior, foreign body aspiration, or ingestion of toxic substances. Physical examination revealed mild pallor without other significant findings. Vital signs were normal. Laboratory tests indicated mild anemia, leukocytosis, and elevated ESR. Sputum AFB and viral/autoimmune markers were negative. The tuberculin skin test was positive. Imaging studies, including fluoroscopy with contrast and a CT scan of the thorax, identified an esophagobronchial fistula and miliary tuberculosis, with multiple diffuse lung nodules and associated changes. The CT scan showed a thick-walled fistulous tract connecting the esophagus to the right main bronchus at three points, along with miliary nodules and bronchiectatic changes. AFB staining of bronchial secretions was negative, but PCR and cultures confirmed M. tuberculosis. The patient was initiated on weight-adjusted antituberculosis therapy and nasogastric feeding. The patient showed significant symptomatic improvement after two months of antituberculosis treatment. This case underscores the importance of thorough diagnostic evaluation in atypical presentations of tuberculosis and highlights the potential for esophagobronchial fistulas to complicate pulmonary tuberculosis.

Meckel's diverticulum complicating gallstone ileus-a surgical odyssey: case report and literature review

Meckel's diverticulum is a common anomaly of the gastrointestinal tract, often presenting with various complications. Here, we present a case of a 50-year-old female with a history of hysterectomy and cesarean sections, who presented with symptoms consistent with gallstone ileus. Upon investigation, a Meckel's diverticulum with an associated cholecystoduodenal fistula was identified. Surgical intervention involved resection of the affected intestinal segment and anastomosis, without additional intervention targeting the gallbladder or fistula repair. A systematic review revealed four reported cases of Meckel's diverticulum complicating gallstone ileus in the literature. Our case underscores the importance of considering Meckel's diverticulum in the differential diagnosis of gallstone ileus and highlights the efficacy of a tailored surgical approach.

Awareness and perception regarding the e-waste management among a population in northern Kerala

Background: Electronic waste, or e-waste, refers to all items of electrical and electronic equipment (EEE) and its parts that have been discarded by its owner as waste without the intent of re-use. Improper e-waste management can lead to adverse human health effects and environmental pollution. The aim of our study was to assess the knowledge, attitude and practice regarding e-waste management and the factors affecting it. Methods: This cross-sectional study was conducted from December 2023 to February 2024 in three block panchayats of Malappuram district in Kerala with a sample size of 266 selected using multistage sampling. Data was entered in Microsoft Office and was analysed using statistical package for the social sciences (SPSS) software. Factors affecting the outcome variables was assessed using Chi-square test or Fisher exact test depending on the sample distribution. Results: Study results showed that 28.9% of the participants had good awareness, 27.1% had average awareness and 44% of the population had poor awareness and on e-waste management. 89.5% of population had a very good perception towards e waste management. Age, gender, type of family they come from, educational factors, occupational factors and socioeconomic class were the factors affecting e-waste management. Conclusions: Increasing public awareness and educating stakeholders about the hazards of e-waste is crucial. Promotion of campaigns and programs to inform individuals about the proper disposal methods, recycling options, and the importance of reducing e-waste generation through responsible consumption can significantly improve the management of e-waste.

Assessing the prevalence of hypocalcemia after total thyroidectomy at a tertiary care hospital

Background: Thyroidectomy is a common surgical procedure for various thyroid disorders, but it often leads to complications such as hypocalcemia. Understanding the prevalence and predictors of hypocalcemia post-total thyroidectomy is crucial for improving patient outcomes. Methods: This prospective cross-sectional study was conducted at a tertiary care hospital with 100 patients undergoing thyroid surgery, including total thyroidectomy, completion thyroidectomy, and thyroidectomy with neck dissection. We analyzed the incidence of transient and permanent hypocalcemia, examining correlations with surgery type, demographic variables, and postoperative day of onset. Data were collected through patient records and postoperative follow-ups. Results: The study revealed that 30% of patients experienced hypocalcemia postoperatively. Hypocalcemia was most prevalent among patients undergoing thyroidectomy with neck dissection (58.33%), compared to those undergoing total thyroidectomy (18.18%) and completion thyroidectomy (40.00%). The majority of hypocalcemia cases (66.67%) occurred on the second postoperative day. Most hypocalcemia instances were transient (86.67%), with a smaller fraction being permanent (13.33%). Conclusions: Hypocalcemia remains a significant complication following thyroid surgery, particularly in surgeries involving neck dissection. Early identification and management of at-risk patients could mitigate the severity of this complication. Our findings underscore the importance of vigilant monitoring and tailored postoperative care to minimize the impact of hypocalcemia on patient recovery and quality of life.

Assessment of demographic attributes and health profile of schedule caste of 5 villages of Aligarh District, Uttar Pradesh, India

Background: Demography is the scientific study of human populations. It takes into account the quantitative aspects of their general characteristics. In this paper health profile and different attributes of demography like age, gender, caste, marital status, educational status, temperament and occupation etc of scheduled caste people of 5 villages of Aligarh district were assessed and documented. Methods: A pretested, predesigned questionnaire containing the demographic attributes was filled by researchers by face-to-face examination of the population through scheduled caste sub plan mobile health care OPD’s. Surveys were conducted from 2nd June to 25th September 2022. Results: Collected and analyzed data exhibits that there were marked difference with the age groups 0-15, 26-45 and 66-85, gender, caste, with religion of Hindu (90.83%) and Muslim (7.33%), educational status regarding illiterate (59.81) and graduate or above (1.65%), Mizaj, dietary habit and there were no significant differences regarding marital status, occupation and addiction behavior were noticed. Conclusions: It can be concluded that majority of the scheduled caste population was living in interiors of rural areas with low socio-economic and health status. Most visited gender were females which indicate poor nutrition, lack of immunity and excessive burden on them. Majority of the population belongs to Balghami Mizaj. Most preferred diets were mixed and main occupation of the scheduled caste population was agriculture. This study will make policy makers and health workers derive practical conclusions which will help in the upliftment of the scheduled caste populations.

Implementing dietary counselling in family practice for diabetes control and prevention

The importance of dietary counselling in family practice for managing and preventing diabetes is the focal point of this review, highlighting its integral role in chronic disease management. With diabetes increasingly prevalent worldwide, there is a critical need for effective management strategies, with dietary interventions playing a key role. Family practitioners, often the initial point of contact for patients, have a unique opportunity to implement these dietary changes, which are pivotal in influencing diabetes outcomes and averting long-term complications. Despite facing challenges such as limited time and the need for specialized knowledge, dietary counselling in family practice stands as a proactive measure focused on prevention and early intervention. It adopts a patient-centered approach, where dietary habits and preferences are assessed, and personalized, evidence-based advice is provided. The inclusion of dietitians in primary care teams, utilization of technology for support, and advocacy for policy reforms are recommended to enhance the effectiveness of dietary counselling. Despite various obstacles, integrating dietary counselling into routine care remains a significant advantage, promoting healthier lifestyle choices and effectively managing the increasing burden of chronic diseases.

Exploring human mammaglobin: as a possible diagnostic and prognostic indicator in breast cancer tissue

Breast cancer is a major global health issue, with high diagnosis rates worldwide, especially in less developed areas, leading to significant mortality rates. This review focuses on the molecular characteristics of breast cancer, emphasizing the role of human mammaglobin-A (hMAM-A) as a diagnostic and prognostic marker. hMAM-A, a dimeric protein from the secretoglobin family, is produced exclusively by breast tissue and shows elevated levels in breast cancer cases, making it a highly accurate marker for disease detection. The review also examines various factors influencing breast cancer, such as age, tobacco use, menopausal status, and hormone replacement therapy (HRT). Younger age at diagnosis is associated with poorer outcomes, highlighting the importance of early detection. Tobacco smoke increases mortality rates in breast cancer patients. Menopausal status affects molecular subtypes and risk factors, impacting treatment and prognosis. HRT has a complex relationship with breast cancer risk. The review concludes by discussing the need for novel biomarkers, including hMAM-A, to improve breast cancer diagnosis and management.

An insight into self-medication patterns of analgesics among medical students: a comprehensive analysis of factors and determinants

Background: Self-medication is widely practiced globally as a major form of self-care for pain management. Unfortunately, with the COVID-19 pandemic, prescription-only drugs are now increasingly being self-prescribed. This study was conducted to study self-medication practices of analgesics and associated factors among medical students of Lahore. Methods: A cross sectional study was conducted among 432 participants. The participants were all current MBBS students (age group=18-25 years) studying in various medical colleges of Lahore, Pakistan. Data were analyzed using SPSS. The significance value was set at p<0.05. The study was conducted from September, 2021 to October, 2021. Results: Self-medication practices were found to be high among medical students of Lahore, 296 (68.5%) out of total participants (432). Of all the analgesics, acetaminophen was the most preferred for relief of pain of various etiologies (64.58%). The most common reason of self-medication was headache (50.69%). Reason for self-medication for the majority of study population was that disease was not severe enough and did not merit to consult a doctor (36.34%). Conclusions: Education on self-medication should be introduced at the undergraduate level to create awareness among students. The study also indicates the need for establishing health clinics in universities so that the students may benefit from the professional advice of trained health staff in the clinics rather than practicing self-prescription. Periodic survey about self-medication practices is required to improve awareness, prevent health issues related to adverse drug reactions of self-medication practices, and prevent economic burden on healthcare system in Pakistan.

The role of color Doppler and multidetector CT angiography in evaluation of peripheral arterial diseases of lower limb

Background: Characterized by atheromatous narrowing and hardening of arteries supplying blood to the legs and feet. Diabetes, along with other risk factors such as hypertension and smoking, exacerbates the prevalence and severity of PAD, leading to decreased blood flow and subsequent tissue injury. The prevalence of PAD in diabetics rises with age, underscoring the importance of early detection and management strategies. Methods: This study aims to evaluate the efficacy of color Doppler and MDCT Angiography in assessing lower limb peripheral arterial diseases. Conducted over twenty-four months, the cross-sectional study involved clinically suspected symptomatic cases aged 30 years and above, presenting at a tertiary care center. Patients underwent thorough clinical examination and demographic assessment before undergoing Color Doppler flowmetric studies and MDCT angiography. Results: Results revealed that color Doppler, with its ability to measure wall thickness and vascular flow, demonstrated promising diagnostic efficacy compared to MDCT angiography. Additionally, follow-up records of patients undergoing medical or surgical interventions provided valuable insights into the practical utility of these imaging modalities in guiding clinical management decisions. Conclusions: Overall, this study underscores the importance of non-invasive imaging techniques in diagnosing and evaluating the progression of peripheral arterial diseases. It suggests that Color Doppler Ultrasound, with its accessibility, low cost, and radiation-free nature, could serve as a suitable alternative to MDCT Angiography for assessing arterial characteristics in patients with PAD.

A rare case report on cervical pregnancy

Cervical pregnancy is a rare type of ectopic pregnancy and it represents <1% of all ectopic pregnancies. Tubal ectopic, Interstital, caesarean scar pregnancy, cornual, ovarian, Intramural are other types of ectopic pregnancy. Timely diagnosis and Treatment are key to management any type of ectopic pregnancy. Cervical ectopic pregnancy is the implantation of blastocyst in the intracervical canal. Cervical pregnancy are high risk cases as they may present with an unexpected life-threatening hemorrhage secondary to the erosion of cervical blood vessels, which may require hysterectomy to save the patient. Here is case of 22yr old primi patient with 6 weeks and 2 days of cervical ectopic pregnancy planned for dilatation and evacuation followed by medical management span; Improved ultrasound resolution and earlier detection of these pregnancies have led to the development of more conservative treatments that attempt to limit morbidity and preserve fertility.

Left ventricular hypertrophy: hypertensive or hypertrophic cardiomyopathy? What a dilemma! A case report / Hipertrofia ventricular izquierda: ¿cardiopatía hipertensiva o miocardiopatía hipertrófica? ¡Vaya dilema! Reporte de caso

Abstract In the presence of the left ventricle hypertrophy (LVH), the differential diagnosis with hypertrophic cardiomyopathy (HCM) or some phenocopy must be always considered, which can be easily suspected when the hypertrophy is markedly asymmetric. However, when the hypertrophy is homogeneous, especially if the patient has concomitant hypertension, it may be a challenge to distinguish between hypertensive and HCM, although some clinical features may help us to suspect it. In addition, patients with HCM may present with exertional angina due to microcirculation involvement in the setting of the hypertrophy itself or dynamic obstruction in the left ventricular outflow tract, but in some cases, the presence of concomitant coronary artery disease must be suspected as the cause of angina, especially if the patient has an intermediate or high-risk probability of having ischemic heart disease. We present the case of a 46-year-old Afro-American man with poorly controlled hypertension who was found to have severe LVH, and who presented with symptoms of exertional angina during follow-up. We will review the clinical features that can help us in the differential diagnosis in this context.

Resumen Ante la presencia de hipertrofia del ventrículo izquierdo (HVI), siempre se debe considerar el diagnóstico diferencial con la miocardiopatía hipertrófica (MCH) o alguna fenocopia, que puede sospecharse fácilmente cuando la hipertrofia es marcadamente asimétrica. Además, los pacientes con MCH pueden presentar angina de esfuerzo debido a la afectación de la microcirculación en el contexto de la propia hipertrofia o si ésta condiciona obstrucción dinámica al tracto de salida del ventrículo izquierdo, pero en algunos casos debe sospecharse la presencia de enfermedad coronaria concomitante como causa de la angina, especialmente si el paciente tiene una probabilidad de riesgo intermedio o alto de padecer cardiopatía isquémica. Presentamos el caso de un varón de 46 años de afroamericana con hipertensión arterial mal controlada a quien se le detectó una HVI severa, y que durante el seguimiento presentó síntomas de angina de esfuerzo. Revisaremos las características clínicas que nos pueden ayudar en el diagnóstico diferencial en este contexto.

A case report on choledochoduodenal fistula: how to suspect this unusual entity?

A choledochoduodenal fistula is an abnormal connection between the common bile duct and the duodenum, which are associated with a history of problems in the common bile duct. It has appeared in 0.74% of patients submitted for biliary tract surgery. The most frequent symptoms of non-obstructive enteric biliary fistulas are: epigastric pain, cholangitis (80.91%), jaundice (54,.26%), fever (50.69%), nausea and/or vomiting (10.30%), abdominal distension (0.39%), asymptomatic (0.11%), and diarrhea (0.11%). Diagnostic imaging methods provide the data of greatest interest in revealing the presence of air in the bile duct. This method, as well as barium reflux under the biliary tree in contrasted studies and in ERCP, reveal the fistulous tract and its location. Neither the prevalence, nor the clinical characteristics that pertain to its presentation, are well known among our population. Possible treatments for this illness include conservative treatment with medication, endoscopic sphincterotomy, and surgical therapy.

Relation of radial artery occlusion after trans-radial percutaneous coronary intervention with the duration of hemostatic compression

Background: Trans-radial percutaneous coronary intervention (PCI) in cardiac procedures accesses coronary arteries through the wrist's radial artery. Post-PCI, hemostatic compression on the radial artery prevents bleeding and aids healing. Radial artery occlusion (RAO), a possible complication, involves blockage of the radial artery. This study aimed to assess the relationship between radial artery occlusion after trans-radial percutaneous coronary intervention with the duration of hemostatic compression. Methods: This prospective observational study was conducted in the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh, spanning from September 2018 to August 2019. The study enrolled 140 patients who underwent percutaneous coronary intervention (PCI) through the trans-radial approach (TRA), randomly assigned to two groups: Group I (2-hour hemostatic compression after PCI) and Group II (6-hour hemostatic compression post-procedure). Data analysis was performed using SPSS version 23.0. Results: In this study, early radial artery occlusion was observed in 4.3% of patients in group I and 12.8% in group II (P=0.04), while late radial artery occlusion occurred in 2.8% of patients in group I and 11.4% in group II, with a statistically significant difference (P=0.04). Multivariate logistic regression analysis identified a 6-hour hemostatic compression duration (P=0.01), post-procedural nitroglycerine use (P=0.03), and procedure time (P=0.03) as predictors of radial artery occlusion. Conclusions: Reduced hemostatic compression duration is linked to a decreased occurrence of both early and late radial artery occlusion following trans-radial intervention.