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  Citation statistics : Table of Contents
   2016| May-August  | Volume 2 | Issue 2  
    Online since October 7, 2016

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Deciphering the dilemma of parametric and nonparametric tests
Rakesh Kumar Rana, Richa Singhal, Pamila Dua
May-August 2016, 2(2):95-98
The potential source of complexity while analyzing the data is to choose on whether the data collected could be analyzed properly by the application of parametric tests or nonparametric tests. This concern cannot be underrated as there are certain assumptions which should be fulfilled before analyzing the data by applying either of the two types of tests. This article describes in detail the difference between parametric and nonparametric tests, when to apply which and the advantages of using one over the other.
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The story of heart transplantation: From cape town to cape comorin
Aakshi Kalra, Sandeep Seth, Milind Padmaker Hote, Balram Airan
May-August 2016, 2(2):120-125
Norman Shumway is widely regarded as the father of heart transplantation although the world's first adult human heart transplant was performed by Christiaan Barnard, on December 3, 1967, at the Groote Schuur Hospital in Cape Town, South Africa. Adrian Kantrowitz performed the world's first pediatric heart transplant on December 6, 1967 and Norman Shumway performed the first adult heart transplant in the United States on January 6, 1968, at the Stanford University Hospital. In India, PK Sen attempted the first heart transplant in humans soon after Christaan Barnaard but the first and subsequent patients died. The first successful heart transplant in India was by Dr. P Venugopal in 1994 at AIIMS, New Delhi. This was followed soon after by Dr. KM Cherian who also did the first pediatric and first heart lung transplant in India.
  4 5,510 385
Epigenetic role of micrornas in diabetic cardiomyopathy
Satish K Raut, Akhilesh Kumar, Madhu Khullar
May-August 2016, 2(2):79-85
Cardiovascular complications in diabetic individuals account for significant morbidity and mortality. Clinical and epidemiological studies have also shown significantly increased incidence and prevalence of cardiovascular complications in diabetes. Heart failure (HF) in diabetes in the absence of known cardiac complications such as myocardial infarction and coronary artery disease further supports the existence of diabetic cardiomyopathy (DbCM). Myocyte hypertrophy and myocardial fibrosis are the established pathological features of the DbCM and are associated with differential expression of genes involved in cardiac hypertrophy and fibrosis. Recent studies show the role of tiny noncoding regulatory RNAs, known as microRNAs (miRs), in the transcriptional and post-transcriptional regulation of gene expression. A large number of miRs have been identified that regulate diverse aspects of cardiac development and function and also play key role in regulating various signaling pathways involved in the pathogenesis of HF. The present review provides an overview of the role of miRs in diabetes-associated heart disease.
  3 3,120 306
Iron deficiency in chronic systolic heart failure(indic study)
Sunil Verma, Pamila Dua, Archana Saini, Praloy Chakraborty
May-August 2016, 2(2):99-102
Background: Chronic systolic heart failure (HF) is characterized by the left ventricular dysfunction, exercise intolerance and is associated with neurohormonal activation that affects several organs such as kidney and skeletal muscle. Anemia is common in HF and may worsen symptoms. Iron deficiency (ID) is also common in HF patients with or without anemia. Iron is the key cofactor in oxidative metabolism in skeletal muscle and the Krebs cycle. There is a paucity of data regarding iron metabolism in chronic systolic HF in India. Methods: IroN Deficiency In CHF study (INDIC) is an observational study that investigated forty chronic heart failure patients for the presence of ID. Serum ferritin (micrograms per liter), serum iron (micrograms per liter), total iron binding capacity (micrograms per liter), transferring (milligrams per deciliter), and transferrin saturation were measured to assess iron status. Results: There were 67.5% (27/40) patients who had ID with a mean serum ferritin level of 76.4 μg/L. Of the 27 iron deficient patients, 22 (55%) had an absolute ID, and 5 had a functional ID. Eight out of 27 of the iron deficient patients were anemic (20% of the total cohort, 30% of the iron deficient patients). Anemia was seen in 6 other patients, which was possibly anemia of chronic disease. There was a trend for more advanced New York Heart Association (NYHA) class (NYHA III and NYHA IV) patients with ID (37.4% vs. 30.77%, P = 0.697). Conclusion: In our study, ID was very common, affecting more than half of the patients with systolic HF. Absolute ID was the most common cause of ID and patients with ID had a tendency to have advanced NYHA class. Our study also demonstrated that ID can occur in the absence of anemia (iron depletion).
  2 3,400 296
Lipid association of India expert consensus statement on management of dyslipidemia in Indians 2016 - part 1
SS Iyengar, Raman Puri, SN Narasingan
May-August 2016, 2(2):134-135
  1 2,437 245
Desmin-related cardiomyopathy presenting as restrictive cardiomyopathy: A case report with review of literature
Kalpana Kumari, Sudheer Arava, TC Nag, Ruma Ray
May-August 2016, 2(2):128-130
Isolated cardiac involvement due to deposition of desmin is a rare cause of restrictive cardiomyopathy due to pathogenic mutation in desmin related genes. A 25 year female presented with clinical diagnosis of restrictive cardiomyopathy for which an endomyocardial biopsy was performed. Histology including ultrastructural examination showed features of desmin cardiomyopathy.
  1 2,931 228
Medical Research in India: Time to Act
KK Talwar, Samir Malhotra
May-August 2016, 2(2):71-74
The country has more than 400 medical colleges. In the area of patient care, India is recognized as a leading country. It is time that we have an objective look into our contribution in medical research. The state of medical research in the majority of medical colleges has been far below the desired level. We need to take measures to improve the quality of medical research in India: Training in Research methodology, Physician - Scientist Interaction and Public and Industrial Investment.
  1 3,260 317
Case of cyanotic congenital heart disease
Shanmugam Krishnan, Preetam Krishnamurthy, S Ramakrishnan, Saurabh Gupta
May-August 2016, 2(2):114-119
A adult patient presented with cyanosis since early childhood. The clinical approach to such a patient, including review of the ecg, chest xray and echocardiogram is presented. Various aspects of the bedside approach to adult cyanotic heart disease are discussed
  - 14,570 1,777
Nuclear cardiology quiz
Abhishek Behera, Divya Yadav, Abhinav Singhal, Chetan Patel
May-August 2016, 2(2):126-127
  - 2,164 202
RNA sequencing analysis identifying new human collagen genes involved in cardiac remodeling
Pooja Singh, Suganthi Ramchandran, Sudip Sen
May-August 2016, 2(2):110-113
  - 2,387 200
From Neeti to Niyat
Sandeep Seth, Shymal K Goswami, SK Maulik
May-August 2016, 2(2):69-70
  - 2,375 224
Annual meeting of international society for heart research (Indian section) at IGIB New Delhi
Shantanu Sengupta
May-August 2016, 2(2):131-131
  - 1,924 158
The Checklist
Mahima Singh
May-August 2016, 2(2):132-133
  - 1,804 157
55/65 rule for India risk prevention
Balram Bhargava, Raghav Bhargava
May-August 2016, 2(2):136-136
  - 1,863 218
Streptokinase versus recombinant tissue-type plasminogen activator for thrombolysis of mechanical prosthetic heart valve thrombosis
Nilkanth Chandrakant Patil, Shrenik Doshi, Sandeep Singh, Ganeshan Karthikeyan, Vinay K Bahl
May-August 2016, 2(2):103-109
Aims and Objectives: This study was designed to compare streptokinase (STK) versus recombinant tissue-type plasminogen activator (rt-PA) for thrombolysis in patients with prosthetic heart valve thrombosis (PHVT). Background: Optimal management of PHVT remains controversial. Thrombolytic therapy is a reasonable alternative to surgery. Numerous thrombolytic protocols with STK, urokinase, and rt-PA have been used over the past 40 years. So far there is a lack of consensus on the ideal thrombolytic agent for PHVT. There are no major studies comparing efficacy of STK versus rt-PA. Methods and Results: Sixty patients who underwent thrombolysis for PHVT over 1 year were studied. Forty-eight patients were thrombolysed with STK, whereas 12 patients received rt-PA. Overall 68.33% (41/60) patients showed complete response (CR), whereas 85% (51/60) showed some improvement in hemodynamics, with no significant difference in efficacy according to age, sex, duration from surgery, New York Heart Association Class III–IV, presence of atrial fibrillation, type of valve, or history of stroke. Overall 10% patients developed major complications with mortality of 5%. CR to thrombolytic therapy was numerically better with STK (72.9% vs. 50%; P = 0.12) and mortality was significantly higher in rt-PA (16.6% vs. 2%, P = 0.038). Mean duration of successful thrombolysis was significantly longer with STK as compared to rt-PA (22.96 ± 19.2 vs. 3 h). Conclusion: STK use as compared to rt-PA was associated with numerically more successful thrombolysis and significant lower mortality, hence may be optimal for elective thrombolysis.
  - 2,865 239
Cardiology update 2016
Sunil Kumar Verma, Harish Gupta
May-August 2016, 2(2):75-78
In the latter half of 2016, the important trials were ATMOSPHERE, INOVATE-HF, and IMPEDANCE-HF. The inclusion of angiotensin receptor–neprilysin inhibitor (valsartan/sacubitril) and sinoatrial node modulator (ivabradine) in the guidelines was a significant change. HOPE-3 was a major trial in 2016 expanding the dimension of statin use. ixCELL-DCM trial evaluated stem cells in dilated cardiomyopathy. Mobile-health and medication event monitoring system technology showed increasing use of technology in both prevention and treatment in cardiology. RIDDLE-non-ST-segment elevation myocardial infarction (NSTEMI) studied the immediate versus delayed intervention in NSTEMI. In STEMI, DANAMI 3-DEFER trial evaluated the concept of immediate stent implantation or deferred stent implantation 48 h after the index procedure with standard primary percutaneous coronary intervention. EARLY-BAMI tested intravenous metoprolol in acute STEMI with the use of magnetic resonance imaging. The utility of “Chest Pain Choice” tool demonstrated shared decision-making between physician and patients in the context of chest pain. Risk factors profile and demographic and angiographic features of aorto-ostial atherosclerotic coronary artery disease are evaluated extensively. Transcatheter aortic valve replacement results in comparison to surgery and its association with volume, and in-hospital outcomes are also analyzed. The VANISH trial addressed a very critical issue in post-MI ICMP. Factors associated with erosion related to Amplatzer septal occluder in atrial septal defect closure are described in detail.
  - 2,957 350
Algorithms for cardiovascular disease prevention
Sandeep Seth, S Ramakrishnan, Ambuj Roy, G Karthikeyan, Sunil K Verma, Balram Bhargava, SK Maulik
May-August 2016, 2(2):86-94
Prevention of coronary artery disease requires control of risk factors. It is not enough to take out guidelines, it is necessary to implement the guidelines. There are a number of studies which have shown that quite often guidelines are not followed.In this article, we have abstracted the essence of the guidelines into simple to follow algorithms so that they are easy to remember and also teach. For Cardiovascular risk reduction, general measures include stopping smoking, perform 150 minutes of moderate activity per week and take a low fat and low salt diet. For hypertension: All classes of drugs are suitable but generally (NICE 2011) Angiotensin receptor blockers or Angiotensin converting enzyme inhibitors for young (<55 years), Beta blockers ( only if other compelling indications). In elderly (>55 years, many with isolated systolic hypertension) Calcium channel blockers, diuretics if needed , are prefered. Combinations are used if monotherapy does not work. For dyslipidemia: Statin benefit groups are defined and manifest coronary artery disease and Diabetics above 40 years should get high dose statins. Lipid levels are only tested to look for compliance or further intensification of regime. Diabetes: Metformin is the drug of choice, Sulfonylureas can be used in combination. Glyptins are also safe and can be used. Other drugs should be used with the help of the endocrinologist.
  - 3,250 353