Browsing by Author "Gupta, A."
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Item Clinical and angiographic profiles and six months outcomes of smokers with acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary angioplasty(Cardiological Society of India, 2018-09) Gupta, A.; Verma, S.K.; Sharma, R.; Parakh, N.; Ramakrishnan, S.; Roy, A.; Singh, S.; Sharma, G.; Karthikeyan, G.; Naik, N.; Yadav, R.; Mishra, S.; Seth, S.; Narang, R.; Goswami, K.C.; Bhargava, B.; Bahl, V.K.Background Outcomes of primary percutaneous coronary intervention (PCI) for acute STEMI (ST-segment elevation myocardial infarction) in smokers are expected to be better than non-smokers as for patients of acute STEMI with or without fibrinolytic therapy. Objectives This comparative study was designed to evaluate the outcomes of primary PCI in patients with acute STEMI in smokers and non-smokers. Clinical and angiographic profile of the two groups was also compared. Methods Over duration of two year, a total of 150 consecutive patients of acute STEMI eligible for primary PCI were enrolled and constituted the two groups [Smokers (n = 90), Non-smokers (n = 60)] of the study population. There was no difference in procedure in two groups. Results In the present study of acute STEMI, current smokers were about a decade younger than non-smokers (p value = 0.0002), majority were male (98.9% vs 56.6%) were male with a higher prevalence of hypertension and diabetes mellitus (61.67% vs 32.28% and 46.67% vs 14.44%, p = 0.001) respectively. Smokers tended to have higher thrombus burden (p = 0.06) but less multi vessel disease (p = 0.028). Thirty day and six month mortality was non-significantly higher in smokers 4.66% vs 1.33% (p = 0.261) and 5.33% vs 2.66% (p = NS) respectively. Rate of quitting smoking among smokers was 80.90% at 6 months. Conclusion The study documents that smokers with acute STEMI have similar outcomes as compared to non smokers with higher thrombus burden and lesser non culprit artery involvement. Smokers present at much younger age emphasizing the role of smoking cessation for prevention of myocardial infarction.Item Correlation of cholesterol ratios and conventional isolated lipid parameters as cardiovascular risk markers to anthropometric and hemodynamic variables in healthy overweight/obese subjects(Mrs Dipika Charan of MedScience (India) Publications, 2022-12) Kanawjia, P; Srivastava, C; Gupta, A.Background: Isolated lipid derangements are no longer considered as an ideal tool to predict cardiovascular (CV) morbidity. Hence, novel parameters, that is, lipid ratios are being resorted to label CV risk. However, which of the ratios stand out as the most specific, sensitive, and earliest predictor in individual cases is still to be elucidated. Aims and Objectives: The aim of the study was to study correlation of cholesterol ratios and conventional isolated lipid parameters as CV risk markers to anthropometric and hemodynamic variables in healthy overweight/obese subjects. Materials and Methods: This was an analytical, observational, and pilot study enrolling 30 overweight/obese subjects as cases and 30 non-obese subjects as controls segregated on basis of body mass index (BMI) and WHR. All subjects with secondary cause of abnormal blood flow were excluded from the study. Blood pressure measurement and venous blood sampling for serum glucose and fasting lipid parameters were duly done. Results: Of all the isolated lipid values and the three lipid ratios (Total Chl a [T. Chl]/high density lipoprotein [HDL], low-density lipoprotein [LDL]/HDL, triglyceride [TG]/HDL), the two groups differing significantly only in T. Chl/HDL ratio which, in turn, significantly strongly positively correlated to both LDL/HDL and TG/HDL ratio ([r = 0.684, P = 0.000] [r = 0.433, P = 0.001]), respectively. All the physical hemodynamic parameters (systolic blood pressure, diastolic blood pressure, and pulse pressure) were significantly different in both groups but none of them correlated with the lipid parameters. Of the two (waist hip ratio and BMI) anthropometric measures, only BMI had significant positive moderate strength correlation to lipid parameters and ratios. Conclusion: T. Chl/HDL ratio seems to be the ideal lipid marker in early prediction of CV disease in apparently healthy obese subjects. Lipid derangements in apparently healthy mild-to-moderate grade obese subjects may not universally present with hemodynamic derangements.Item Leech infestation: Our experience at Government Medical College, Rajouri(Mrs Dipika Charan of MedScience (India) Publications, 2022-11) Khan, MA; Gadgotra, P; Gupta, V; Gupta, A.Leech invasion into a bodily cavity or orifice is known as hirudiniasis. This article’s objective is to explain an uncommon cause of epistaxis brought on by a leech infestation in the nasal cavity, nasopharynx, or oropharynx in the hilly Rajouri district of Jammu and Kashmir, as well as how to manage it. This retrospective case series consisted of seven cases. All the cases present with unilateral epistaxis. Anterior rhinoscopy with or without endoscope reveal smooth, grayish-black mobile leech inside nasal cavity, nasopharynx, or oropharynx which was removed by suction or forcep.Item Marking the Micro Details in Potentially Malignant Disorders of Oral Cavity(People’s University, Bhopal., 2023-06) Rathore, A; Kumar, A; Siddique, MAB; Mehrotra, R; Choudhary, DS; Gupta, A.Background- The malignancy of the oral cavity constitutes the most important group of malignancies in South and Southeast Asia.The risk increases with the use of tobacco products. Materials & Methods- Micronuclei frequency scoring was used as a biomarker to identify different potentially malignant disorders. Results- Mean micronuclei index was found higher using Hematoxylin and Eosin stain than Papanicolaou's stainand May Grunwald's stain. Conclusion- We concluded that the micronuclei frequencies in oral exfoliated epithelial cells using three different stains- Hematoxylin and Eosin stain, Papanicolaou's stain, May Grunwald's stain may be useful in predicting the malignant potential of premalignant lesions.Item Studies on persistent organic pollutants residue in water, sediment and fish tissues of river Sutlej, India(Triveni Enterprises, 2019-03) kaur, N.; Singh, P.; Bedi, J.S.; Gupta, A.Aim: To study the level of persistent organic pollutants in the environment of River Sutlej and rule out its detrimental effects on aquatic fauna. Methodology: Two different sites were selected for the study, one was before the confluence of a polluted tributary (Site I) another was after the confluence of polluted tributary (Site II). Analysis of water, sediment, gills and muscles of selected fish species was done to detect the level of persistent organic pollutants using Gas Chromatography. Results: Among POP's, PCB-28 was detected during monsoon period(0.55 ng ul-1) at Site I, while as it was detected both during monsoon (0.65 ng ul-1) and post-monsoon (0.49 ng ul-1) period at Site II in the water samples. Similarly, PCB-28 was detected in gills of Cirrhinus mrigala during pre (0.26 ng g-1) and post-monsoon (0.27 ng g-1) periods at Site I, while at Site II it was detected only during monsoon period (0.17 ng g-1). In Aoricthysaor gills, only PCB-28 was detected during pre-monsoon (0.34 ng g-1) and monsoon periods (0.19 ng g-1) at Site II. In Heteropneustes fossilis PCB-28 was detected during pre-monsoon period (0.26 ng g-1) at Site I, while at Site II it was found during pre-monsoon (0.21 ng g-1) and monsoon (0.17 ng g-1) periods. In Catla Catla gill samples among PCB's only PCB-28 was detected during pre-monsoon (0.32 ng g-1), monsoon (0.29 ng g-1) and post-monsoon periods (0.24 ng g-1) at Site II while Mirex (0.01 ng g-1) was detected at Site I during post-monsoon period. Interpretation: The study concluded that continuous monitoring of pesticide residue is warranted in the river Sutlej to rule out any detrimental effect of pesticide pollution on aquatic fauna.Item Unmasking Brugada Syndrome with Oral Flecainide Provocation. A Case Series of Three Patients(Science Domain International, 2019-07) Singla, R.; Udyavar, A.; Gupta, A.; Bade, A.; Munde, K.; Bansal, N. O.The present case series discuss three patients who had brugada type 2/ type 3 like ECG pattern that was converted to type 1 pattern with oral flecanide challenge test. Brugada syndrome is associated with a high incidence of sudden cardiac death, typical ECG pattern being ST-segment elevation in the right precordial leads with T wave inversion. Pharmacological provocation should only be performed when the baseline ECG is not diagnostic of Brugada Syndrome. PR prolongation in the baseline ECG is also a contraindication because of the risk of inducing AV block. Drug challenge is performed under strict monitoring of BP and 12-lead ECG and facilities for cardio version and resuscitation are available. Atypical RBBB pattern/type 2/3 Brugada pattern on ECG in patients of syncope or family history of sudden cardiac arrest is commonly encountered by a cardiologist. This can be performed to provoke type 1 brugada pattern on ECG. Diagnosed cases of Brugada may be treated with ICD with proper indication if needed and thus prevent sudden cardiac death.