ABSTRACT
INTRODUCTION: Increased Left Ventricular Mass (LVM) is an independent risk factor for cardiovascular morbidity and mortality. AIM: This study was done to find the prevalence and determinants of LVM in the Northern Indian population. MATERIALS AND METHODS: A prospective cross-sectional observational study was carried out in a tertiary care centre in Himachal Pradesh, India and the study population included all consecutive patients fulfilling the inclusion criteria attending cardiology OPD on seeking medical attention with various symptoms for dyslipidaemia, hypertension but not on medication over a period of one year. Focused history was taken; physical examination and investigations were done. Data collected was analysed using Epi-info software version 3.5.1. We calculated means of LVM index for categorical variables i.e., sex, tobacco consumption, alcohol consumption and sedentary lifestyle etc., and also calculated p-values as test of significance for mean difference across the exposure variable groups. The Pearson correlation coefficient was calculated and 2 tailed significance at p< 0.05 was taken as statistically significant. RESULTS: Mean age of study population was 42.30±9.8 years and 62.9% were males. The mean LVM index was significantly higher in men than in women 77.7 ± 11.4 vs.71.3 ± 15.7 (p-value <0.01). Strong positive correlation was observed between increased waist hip ratio and increased Left Ventricular Mass Index (LVMI). The Pearson correlation coefficient was 36.77 and it was statistically significant with p-value 0.04. CONCLUSION: We found positive and independent correlation of increased LVMI with increased Waist Hip Ratio (WHR). A positive independent correlation was also observed with higher fasting blood sugar levels.
ABSTRACT
The deep inferior epigastric perforator (DIEP) flap is based on the perforator arteries of the deep inferior epigastric artery. The rectus abdominis muscle provides an excellent myocutaneous flap, either pedicled or free, because of the rich vascularity provided by the epigastric vessels and separation of muscle belly from the surrounding tissue within the rectus sheath. The study was conducted on 30 adult cadavers. The length and width of the rectus abdominis muscle and length, direction, muscular branches of the perforator, branching pattern and termination of the inferior epigastric artery were observed. The diameter of inferior epigastric artery at the point of origin was between 2.1 and 3.5 mm. The artery dividing into two major branches was seen in 11 cases, the lateral branch being dominant in 3 cases, the medial branch in 3, both branches having equal caliber in 5 cases and in 19 cases there was one central axis with multiple side branches. The total number of perforators was 243. In 101 cases diameters were between 0.5 mm and 1.0 mm, and 139 cases exceeded 1.0 mm. The average running distance was 7.20 mm. Fifty-one percent perforators were present above the level of the umbilicus and 49% below. On each side 43% ideal perforators were present. A majority of ideal perforators (72%) was concentrated 4 cm superiorly, 7 cm inferiorly and 5 cm laterally to the umbilicus. Our data indicate that 43% of all perforators with diameters over 1 mm are ideal perforators, and most that are located about a 5 cm radius around the umbilicus can easily be dissected
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