ABSTRACT
How does one decide on the best non-invasive test to investigate stable coronary ischaemia? This is a very common question faced by many medical practitioners. Chronic stable angina is a common presentation encountered in general practitice. Upon clinical assessment and risk stratification the patient needs to be investigated further to confirm the diagnosis. The first investigational modality involves a non-invasive test. It is important that practitioners possess a practical knowledge of the array of different tests that are available so that the best suited one for each patient can be chosen. This article aims to compare the efficacy and accuracy and the practical utility of the different non-invasive tests for coronary ischaemia and aid the practitioner in making sound decisions in this regard.
Subject(s)
Angina, Stable/diagnosis , Coronary Angiography , Diagnosis, Differential , Echocardiography, Stress , Exercise Test , Humans , Myocardial Perfusion Imaging , Tomography, X-Ray ComputedABSTRACT
The mid-canal of Kandy, a 8-km effluent canal that runs through the city, collects massive quantities of domestic, municipal, and agricultural waste products. In this study, 37 samples from canal water and 13 from nearby drinking water wells were analyzed for their total Pb, Cd, V, Fe, and ferrous ion content. The following average values for the canal water were recorded: Pb, 269 micrograms/liter; Cd, 138 micrograms/liter; V, 18 micrograms/liter; total Fe, 4 mg/liter. These values indicate the relative levels of metal input from the effluent sources of the city of Kandy, the second largest city in Sri Lanka. The analysis of water from drinking wells near the canal showed high concentrations of metals, in some cases exceeding the maximum tolerance limits as recommended by WHO. The environmental impact of polluted city canals running through densely populated cities, particularly in developing countries, can assume serious proportions.
