Research Article
Open Access
Clinical Evaluation of Preoperative Skin Preparation with Aqueouspovidone-Iodine Alone and In Combination with Alcoholic Chlorhexidine Inpatients Undergoing Elective Surgery
Pages 64 - 67
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Abstract
Aim: Clinical evaluation of preoperative skin preparation with aqueous povidoneiodinealone and in combination with alcoholic chlorhexidine in patients undergoing electivesurgery Material and methods: This observational study was carried out in the Department of General Surgery Saraswathi Institute of Medical Scienecs ,Hapur. 120 Patients of all age groups undergoing elective surgery in the Department of General Surgery with a clean wound were included in this study. 120 patients divided into 2 equals groups. For Group 1 antiseptic regimen used is three coats of aqueous povidone-iodine IP5%w/v. For Group-2 antiseptic regimen used is a single coat of agent containing chlorhexidine gluconate 2.5% v/v in 70% propanol followed by two coats of aqueous povidone-iodine IP 5% w/v. The pre- operative antibiotic used is Cefotaxime 1 gram I.V given following a test dose;one hour prior to incision. Results: There are 7 patients in group-1 and 2 patients in group-2 who had positive culture which is found to be statistically significant. Post-operatively patients were followed upto the time of suture removal (usually 7-10 days) to know the percent of cases who developed wound infections. There were 7 cases in group-1 and 2 case in group-2 who developed postoperative wound infections. It is noted that out of 7 cases with growth ingroup-1, only 4 had post-operative wound infection and the other 3 were ward acquired. Similarly, the only infection in group-2 is hospital acquired. Conclusion: The present study confirms the superiority of povidone-iodine in combination with alcoholic chlorhexidine over povidone-iodine alone in pre-operative skin preparation and warrants recommendation of it as a preferred antiseptic in skin preparation for elective clean surgery.
Research Article
Open Access
A study of risk factors of hepatitis B infection Females of Rural Population of North India
Pages 61 - 63
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Abstract
Background and Objective: Health status of rural females is the most neglected in India. Hepatitis B is one of the highly infectious and sexually transmitted diseases which have a direct impact on the health of rural females as well on their siblings and family. So this study was undertaken to know the burden of Hepatitis B viral (HBV) infection in rural females so a prevention strategy can be made to curtail such dreaded infection in rural society. Method: A total number of 5035 female subjects of different age ranging from neonate to 90 years were grouped in 8 different groups designated as A to H. They were screened for detecting HBs Ag both by Rapid Diagnostic tests and ELISA technique Results: Maximum number of subjects belonged to age group 21-30 yrs of group C, followed by group D(31-40yrs) and B(11-20 yrs). Of 5035 subjects, 256(5.08%) were positive for HBsAg. The positivity was maximum in both the extremes of life, 7.8%% & 21.9 t & 19.5% percent respectively. In other group the HBs Antigen positivity varied from 2.5 to 5.8 percent. Interpretation and Conclusion: The high incidence of Hepatitis B Viral infection clearly reflects the uneducated and neglected health status of rural females. Prevention strategy and education can reduce the further transmission and thereby reducing morbidity and mortality with HBV infection
Research Article
Open Access
Mural vegetation in infective endocarditis – Is it a predictor for embolism?
Tamilarasu Kaliappan, Aashiq Ahamed Shukkoor2, Prem Krishna Anandan3,*, Nimmy Elizabeth George, Rajendiran Gopalan, Suvetha Kannappan
Pages 51 - 60
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Abstract
Background: Infective endocarditis is a microbial infection of endocardial surface of the heart and vegetation is the characteristic lesion of the disease. Mural endocarditis is a condition of rare diagnosis and may be difficult to find vegetation by standard views in transthoracic echocardiography (TTE). Identifying the mural vegetation not only helps to diagnose Infective endocarditis, but also predicts the risk for developing embolism. Aim of this study is to find the occurrence of embolism in patients with mural endocarditis.Method: A Retrospective, observational study was done for IE patients admitted from the year 2012 to 2018, in which total of 58 patients with definite diagnosis of infective endocarditis were identified. Among which 8 patients were excluded based on the exclusion criteria.
Results: Total 50 patients were identifi d with IE, which includes 7 with mural vegetation and 43 without mural vegetation. Cultures were positive in 71.4% and 88.3% IE patients with and without mural vegetation respec- tively. One patient was found to have corynebacterium species with mural vegetation and embolic stroke, which is a rare occurrence. Among 43 IE patients without mural vegetation, 88.3% patients showed presence of veg- etation in echocardiogram. Size of vegetation were 13 ± 6 and 14.6 ± 2.9 mm, respectively (p>0.005). All the patients with mural vegetation and 9.3% from without mural vegetation had cerebral embolic events (p < 0.005).Conclusion: ough mural vegetation is not common, but if present, it helps in diagnosis and also it may predict a propensity for embolism. Our results indicate that in patients with mural endocarditis, the propensity of embo- lism is more.
Research Article
Open Access
“Assessment of Nutritional Status in children with Congenital Heart disease -A Cross-sectional Study”
Pages 41 - 50
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Abstract
Congenital heart defects (CHDs) children are malnourished and also had increased morbidity and mortality due to persistent impairment of somatic growth, frequent hospitalisation and increased death rate. All major congenital anomalies comprise of heart defects is Twenty- eight percent Methods– 52 children are taken who are having CHD; detailed clinical examination and Nutritional status examination for Weight for Age, Weight for Height, Body Mass Index, MUAC were taken. Results - In this study on 52 children, 67.3% were in the age group 5-12 years whereas 32.7% belonged to age group 12mon-59mon.The male to female ratio were 1:0.9. 80.8% had ACHD; out of which VSD was the most common (36,5%).19.2% had CCHD, out of which TOF was the most common (13.5%) of ACHD. In children with ACHD, 76.5% had mild, 57.1% had moderate,50% had severe stunting according to height for age whereas in children with CCHD ,23.5% hadmild,42.9% had moderate,50% had severe stunting, statistically significant with p-value - 0.0464
Research Article
Open Access
Phantasmagoria of an ECG aberration in a young male with palpitations: The answer lies within
Aditya Kapoor, Ankit Kumar Sahu
Pages 31 - 40
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Abstract
We herein describe an inquisitive electrocardiographic finding encountered during treadmill testing which could have led to disastrous erroneous actions had it not been recognized timely in an ingenious manner. e need to promptly identify such veiled observations is of utmost importance as it can affect the outcomes in an undesirable way. Careful scrutiny of such information should always be matched with accompanying clinical scenario for opti- mal results.
Review Article
Open Access
Review of Registry and Randomised Comparisons of Zotarolimus-eluting and Sirolimus-eluting Coronary Stents in Western Denmark
Pages 21 - 30
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Abstract
The safety and efficacy of coronary stents utilised for treatment of ischaemic heart disease have been extensively evaluated. In comparison with bare metal stents, first-generation drug-eluting stents more than halved the need for target lesion revascularisation (TLR). However, the long-term safety has been questioned as the first-generation drug-eluting stents seemed to be associated with a small, but increased, risk of (very) late stent thrombosis. The latter may be related to an inflammatory reaction caused by the polymer used for drug release control. The second-generation zotarolimus- eluting Endeavor® stent was believed to represent a safer alternative. We present an overview of our results from a large randomised trial and a large registry, both of which compared clinical outcomes with the Endeavor® and the first-generation sirolimus-eluting Cypher® stent. Both studies indicated that the Endeavor® stent had higher risks of adverse outcomes. We discuss these data in the light of the current available data from other randomised comparisons of these two drug-eluting stents.
Review Article
Open Access
In-lab High Dose Clopidogrel Loading Before Percutaneous Coronary Intervention: Is It The Prime Time?
Milorad Tesic, MD and Goran Stankovic, MD, PhD
Pages 11 - 20
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Abstract
Clopidogrel pretreatment significantly improves outcome in patients undergoing percutaneous coronary intervention (PCI), but it is not well established if the ad hoc loading of clopidogrel before the PCI and after coronary angiography is efficient and safe for the patient. According to the results of PRAGUE-8 and ARMYDA-5 PRELOAD trials, in-lab loading with 600mg clopidogrel might be safe and effective alternative to pre-treatment given several hours before diagnostic angiography or PCI. Still there is concern about adequate platelet inhibition, which can be overcome either with new loading scenarios or introducing more potent, more predictable, faster onset antiplatelet drugs, such as prasugrel and ticagrelor. Although increasing evidence suggests a link between residual platelet reactivity and adverse clinical outcomes, large scale clinical trials are still necessary to determine whether changes in therapy based on results of platelet function testing improve clinical outcomes, and thus will determine whether broader use of platelet function testing in clinical practice is warranted.
Review Article
Open Access
Cardiac Mechanosensation and Clinical Implications
Pages 1 - 10
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Abstract
Almost any definition of biological life includes the term “movement”, which is inherently linked to the sensation of mechanically induced deformation. As such, mechanosensation (a cell’s perception of mechanical stimuli) as well as mechanotransduction (transmission of mechanically induced signals) belong to the most fundamental processes in biology. These processes are particularly important in cardiovascular physiology, as each cycle of contraction and relaxation causes dynamic deformations of the heart and the large blood vessels.
Cardiomyocytes are equipped with different mechanisms aimed to sense any form of mechanical deviation. For example, the titin springs extend and unfold elastic domains during diastolic distension and may serve as a length sensor, in contrast to the Z-discs, which experience particularly high forces during systole and may serve as a tension sensor. Activation of different sensors at the cellular level affects the composition of signalosomes attached to these structures, and these signalling complexes eventually translate the mechanical information into functional alterations via short term (i.e., activation of kinases) or long term (i.e., altered gene expression) effects. At the organ level, mechanosensation is involved in diverse feedback mechanisms such as the Bainbridge reflex, the Frank-Starling mechanism, and ischemic preconditioning. Therefore, it is not surprising that mutations in components of the cardiomyocyte stretch sensory apparatus cause cardiomyopathy and heart failure. Although significant progress has been made in this field during the last decade, the molecular mechanisms underlying mechanosensation still remain poorly understood.
The article offers an overview on the fundamental processes involved in cardiomyocyte stretch sensing and provides important links to clinical cardiology.
