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Sinha SK, Razi M, Rekwal L, Himanshu K, Aggarwal P, Krishna V. Novel technique of successful percutaneous coronary intervention with ultra low volume contrast administration using Side Branch wire as a marker. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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102
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Sinha SK, Razi M, Himanshu K, Samrat S. Importance of Veno-arterial (VA) loop in Percutaneous Transvenous Mitral commissurotomy (PTMC). Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sinha SK, Himanshu K, Tripathi S, Aggarwal P, Razi M. TAP-stenting as bail-out strategy for iatrogenic dissection of left main bifurcation. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sinha SK, Krishna V, Pandey U, Razi M, Sharma AK, Thakur R. Trifurcation Stenting of left anterior descending artery by “Kurdistan” Technique using Two Guide Catheters. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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105
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Sinha SK, Rekwal L, Aggarwal P, Razi M, Krishna V. Do we need three coronary arteries? Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sinha SK, Aggarwal P, Abhishekh NK, Rekwaal L, Singh A, Krishna V. Super-dominant left circumflex coronary artery (LCx) — an unusual variant of left dominance. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sinha SK, Razi M, Singh A, Himanshu K, Aggarwal P. “Vieussens ring”- an unusual form of inter-coronary collateral from conus artery to diagonal artery. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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108
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Sinha SK, Krishna V, Razi M, Samrat S. Embolization of covered stent during bailout of a coronary perforation — a double jeopardy. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sinha SK, Abdaali N, Jha MJ, Mishra V, Asif M, Razi M, Thakur R, Varma CM, Pandey U, Krishna V. Right Ventricular Apical Pacing (RVAP) vs. Right Ventricular Septal Pacing (RVSP): short and intermediate-term effect on echocardiographic indices, left ventricular function and clinical outcome. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sinha SK, Kumar B, Jha MJ, Afdaali N, Singh AK, Thakur R. Isolated severe aortic stenosis in a tricuspid aortic valve in a 8-year-old boy. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2016.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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111
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Sinha SK, Krishna V, Razi M, Thakur R, Aggarwal P, Tewari P, Rekwal L. Middle Aortic Syndrome with Mesenteric artery stenosis- successful percutaneous endovascular reconstruction. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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112
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Sinha SK, Aggarwal P, Rekwal L, Singh A. Acute stent malfunction in a fibrocalcific lesion. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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113
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Sinha SK, Mahrotra A, Razi M, Aggarwal P, Rekwaal L, Tripathi S. Can nominal burst pressure guarantee against dissection during percutaneous transluminal coronary angioplasty? Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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114
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Sinha SK, Razi M, Himanshu K, Aggarwal P. Balloon assisted trapping (BAT) and retrieval of fractured and impacted coronary angioplasty balloon catheter: simple solution to a complex problem. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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115
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Sinha SK, Singh K, Goel A, Jha MJ, Khanra D, Varma CM. Criss-cross heart associated with Taussig-Bing anomaly – double rarities in a single patient. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2016.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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116
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Sinha SK, Jha MJ, Khanra D, Singh AK, Thakur R. Retrieval of dislodged stents from left main during percutaneous coronary intervention by trapping technique. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2016.0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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117
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Sinha SK, Tripathi S, Singh A, Rekwaal L, Abhishekh NK. Peripheral embolisation and retrieval of an everolimus-eluting stent during intervention in a tortuous right coronary artery. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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118
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Sinha SK, Himanshu K, Aggarwal P, Razi M. Twin Circumflex Coronary Artery with anomalous origin from left main trunk — a rare variant. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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119
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Sinha SK, Krishna V, Aggarwal P, Rekwaal L. Depigmented scar — a rare local complication of transradial catheterisation. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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120
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Sinha SK, Himanshu K, Razi M, Aggarwal P, Krishna V. Importance of pin-vise during Coccoon duct Occluder (CDO) deployment during Patent Ductus Arteriosus (PDA) closure. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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121
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Sinha SK, Krishna V, Kejriwal M, Aggarwal P, Abhishekh NK. Single coronary artery from right coronary sinus presenting with acute coronary syndrome. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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122
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Sinha SK, Krishna V, Tripathi S, Rekwaal L, Singh A, Aggarwal P, Chaturvedi V. Dual left circumflex artery - one from left main and one from left anterior descending artery in a patient with anterior wall myocardial infarction — a case report. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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123
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Sinha SK, Razi M, Himanshu K, Aggarwal P, Krishna V. Tiger Diagnostic Catheter-Facilitated coronary sinus cannulation (Mother-in child system) and implantation of Left ventricular lead during cardiac resynchronization therapy system. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2019.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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124
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Sinha SK, Bhagat K, Asif M, Singh K, Sachan M, Mishra V, Afdaali N, Jha MJ, Kumar A, Singh S, Sinha R, Khanra D, Thakur R, Varma CM, Krishna V, Pandey U. Fragmented QRS as a Marker of Electrical Dyssynchrony to Predict Inter-Ventricular Conduction Defect by Subsequent Echocardiographic Assessment in Symptomatic Patients of Non-Ischemic Dilated Cardiomyopathy. Cardiol Res 2016; 7:140-145. [PMID: 28197282 PMCID: PMC5295578 DOI: 10.14740/cr495w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2016] [Indexed: 11/21/2022] Open
Abstract
Background Left ventricular (LV) dyssynchrony frequently occurs in patients with heart failure (HF). QRS ≥ 120 ms is a surrogate marker of electrical dyssynchrony, which occurs in only 30% of HF patients. In contrary, in those with normal QRS (nQRS) duration, LV dyssynchrony has been reported in 20-50%. This study was carried out to investigate the role of fragmented QRS (fQRS) on the surface electrocardiography (ECG) as a marker of electrical dyssynchrony to predict the presence of significant intraventricular dyssynchrony (IVD) by subsequent echocardiographic assessment. Methods A total of 226 consecutive patients with non-ischemic cardiomyopathy were assessed for fQRS on surface ECG as defined by presence of an additional R wave (R prime), notching in nadir of the S wave, notching of R wave, or the presence of more than one R prime (fragmentation) in two contiguous leads corresponding to a major myocardial segment. Tissue Doppler imaging (TDI) was performed in the apical views (four-chamber, two-chamber and long-axis) to analyze all 12 segments at both basal and middle levels. Time-to-peak myocardial sustained systolic (Ts) velocities were calculated. Significant systolic IVD was defined as Ts-SD > 32.6 ms as known as “Yu index”. Result Of the total patients, 112 had fQRS (49.5%), while 114 had nQRS (50.5%) with male dominance (M/F = 71:29). Majority of patients were in NYHA class II (n = 122, 54%) followed by class III (n = 83; 37%), and class IV (n = 21; 9%). There were no significant differences among both groups for baseline parameters except higher QRS duration (102.42 ± 14.05 vs. 91.10 ± 13.75 ms; P = 0.001), higher Yu index (35.64 ± 12.79 vs. 20.45 ± 11.17; P = 0.01) and number of patients with positive Yu index (78.6% vs. 21.1%; P = 0.04) in group with fQRS compared with group with nQRS. fQRS complexes had 84.61% sensitivity and 80.32% specificity with positive predictive value of 78.6% and negative predictive value of 85.9% to detect IVD. On detailed segmental analysis for fQRS distribution, inferior segment had maximum (37%), followed by anterior (23%), lateral (19%), inferior and lateral (11%), anterior and inferior (8%), and anterior and lateral (2%). Among 104 patients with significant dyssynchrony, 88 patients (84.6%) had fQRS in the dyssynchronic segment. Conclusion Fragmentation of QRS complex is an important predictor of electro-mechanical dyssynchrony. It is also helpful in localizing the dyssynchronous segment. In future, larger studies may be carried out to investigate the role of fQRS as a predictor of response to cardiac resynchronization therapy (CRT) in this subgroup of HF patients with narrow QRS.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Kush Bhagat
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mohammad Asif
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Karandeep Singh
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mohit Sachan
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vikas Mishra
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Nasar Afdaali
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mukesh Jitendra Jha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ashutosh Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Shravan Singh
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Rupesh Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Dibbendhu Khanra
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Chandra Mohan Varma
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vinay Krishna
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Umeshwar Pandey
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
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Sinha SK, Goel A, Madaan A, Thakur R, Krishna V, Singh K, Sachan M, Pandey U, Varma CM. Prevalence of Metabolic Syndrome and Its Clinical and Angiographic Profile in Patients With Naive Acute Coronary Syndrome in North Indian Population. J Clin Med Res 2016; 8:667-73. [PMID: 27540441 PMCID: PMC4974837 DOI: 10.14740/jocmr2655w] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Data of isolated metabolic syndrome as risk factor in patients presenting with acute coronary syndrome (ACS) especially in context to Indian subcontinent are sparse. Therefore, we studied the prevalence of metabolic syndrome (MetS), and its clinical and angiographic profile in naive ACS patients in North Indian population. METHODS A single-center, prospective, observational study of 324 patients was conducted at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, India with newly diagnosed ACS patients with MetS, as per modified NCEP-ATP III criteria. They were divided into two groups with and without MetS, and their clinical and angiographic profiles were studied. RESULTS Prevalence of MetS in our study was 37.65%. Patients with MetS were significantly older than without MetS (60.3 ± 8.4 vs. 57.6 ± 7.9), and had females preponderance (35.24% vs. 24.25%), less tobacco abuse (30.32% vs. 42.57%), more non-ST-segment elevation ACS (58.19% vs. 36.14%), less ST-segment elevation myocardial infarction (STEMI) (41.80% vs. 63.86%), more cardiogenic shock (27.04% vs. 17.32%), recurrent ischemia (14.75% vs. 7.42%) and on angiogram, lesser single vessel disease (21.13% vs. 53.96%), more double vessel disease (39.34 vs. 24.26%), triple vessel disease (19.67% vs. 10.39%), left main (13.11% vs. 4.45%) and complex coronary lesions (tubular 40.98% vs. 31.68%; diffuse 26.23% vs. 18.32%). However, there was a trend of lower but insignificant mortality with MetS (5.44% vs. 6.55%). CONCLUSION There was high prevalence of MetS among patients with ACS in North Indian population with more advanced coronary artery disease. To the best of our knowledge, this is the first study from North India documenting clinical and angiographic profile of patients with MetS and ACS.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Amit Goel
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Amit Madaan
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vinay Krishna
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Karandeep Singh
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mohit Sachan
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Umeshwar Pandey
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Chandra Mohan Varma
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
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Rami RY, Arun AC, Sinha SK, Kochhar R. Endoscopic biopsy: a simple guide for beginners. ACTA ACUST UNITED AC 2016; 36:270. [PMID: 27509709 DOI: 10.7869/tg.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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127
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Sinha SK, Razi M, Thakur R, Jha MJ, Goel A, Mishra V, Kumar A. Acute dislocation of fully deployed stent after use of non-compliant balloon: an enigma. Folia Cardiologica 2016. [DOI: 10.5603/fc.2016.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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128
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Kumar P, Sinha SK, Pandey U, Thakur R, Varma CM, Sachan M, Goel A. Patent Ductus Arteriosus With Eisenmenger Syndrome: Difficult Diagnosis Made Easily With Saline Contrast Echocardiography. Cardiol Res 2016; 7:117-118. [PMID: 28197278 PMCID: PMC5295518 DOI: 10.14740/cr447w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2016] [Indexed: 11/11/2022] Open
Abstract
The diagnosis of patent ductus arteriosus (PDA) with Eisenmenger syndrome is difficult. We report a case of 35-year-old male who came to our outpatient department (OPD) for evaluation of repeated hemoptysis and dyspnea on exertion. He had already completed two courses of ATT. On examination, grade 3 ejection systolic murmur was audible over precordium. Transthoracic echocardiography (TTE) showed enlargement of right atrium (RA) and right ventricular (RV) with severe tricuspid regurgitation (TR). On agitated saline contrast injection, agitated saline was seen in pulmonary artery followed by filling of abdominal aorta without filling of ascending aorta, thus confirming the diagnosis of right to left shunt with PDA.
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Affiliation(s)
- Prakash Kumar
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | | | - Umeshwar Pandey
- LPS Institute of Cardiology, GSVM Medical College, Kanpur, India
| | - Ramesh Thakur
- LPS Institute of Cardiology, GSVM Medical College, Kanpur, India
| | | | - Mohit Sachan
- LPS Institute of Cardiology, GSVM Medical College, Kanpur, India
| | - Amit Goel
- LPS Institute of Cardiology, GSVM Medical College, Kanpur, India
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Razi M, Madaan A, Goel A, Sinha SK. Troubleshooting during pacemaker implant in persistent left superior vena cava with absence of right superior vena cava (isolated persistent left superior vena cava). Avicenna J Med 2016; 6:47-50. [PMID: 27144141 PMCID: PMC4849188 DOI: 10.4103/2231-0770.179550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Persistent left superior vena cava (PLSVC) with absence of right SVC (isolated PLSVC) is a rare congenital anomaly that occurs as a result of a degenerative condition in the left anterior cardinal vein. It is generally an incidental finding while performing invasive procedures such as antiarrhythmic device implantation. We report on a rare case of permanent pacemaker implantation in a patient with this anomaly from right subclavian route, albeit most of the earlier reported cases are from left subclavian approach. A wide spectrum of clinicians should be aware of this anomaly, its variations, and possible complications.
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Affiliation(s)
- Mahmadulla Razi
- Department of Cardiology, L.P.S. Institute of Cardiology, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - Amit Madaan
- Department of Cardiology, L.P.S. Institute of Cardiology, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - Amit Goel
- Department of Cardiology, L.P.S. Institute of Cardiology, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - Santosh Kumar Sinha
- Department of Cardiology, L.P.S. Institute of Cardiology, GSVM Medical College, Kanpur, Uttar Pradesh, India
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Affiliation(s)
- Vikas Mishra
- Department of Cardiology, LPS Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, Uttar Pradesh, India E-mail:
| | - Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, Uttar Pradesh, India E-mail:
| | - Mahmadulla Razi
- Department of Cardiology, LPS Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, Uttar Pradesh, India E-mail:
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Sinha SK, Thakur R, Jha MJ, Goel A, Kumar V, Kumar A, Mishra V, Varma CM, Krishna V, Singh AK, Sachan M. Epicardial Adipose Tissue Thickness and Its Association With the Presence and Severity of Coronary Artery Disease in Clinical Setting: A Cross-Sectional Observational Study. J Clin Med Res 2016; 8:410-9. [PMID: 27081428 PMCID: PMC4817582 DOI: 10.14740/jocmr2468w] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2016] [Indexed: 11/17/2022] Open
Abstract
Background Obesity is an important risk factor for atherosclerotic cardiovascular disease (ASCVD). Estimation of visceral adipose tissue is important and several methods are available as its surrogate. Although correlation of epicardial adipose tissue (EAT) with visceral adipose tissue as estimated by magnetic resonance imaging (MRI) and/or CT is excellent, it is costlier and cumbersome. EAT can be accurately measured by two-dimensional (2D) echocardiography. It tends to be higher in patients with acute coronary syndrome than in subjects without coronary artery disease (CAD) and in those with stable angina. It also carries advantage as index of high cardiometabolic risk as it is a direct measure of visceral fat rather than anthropometric measurements. The present study evaluated the relationship of EAT to the presence and severity of CAD in clinical setting. Methods In this prospective, single-center study conducted in the Department of Cardiology, LPS Institute of Cardiology, Kanpur, India, 549 consecutive patients with acute coronary syndrome or chronic stable angina were enrolled. Sensitivity, specificity, and receiver operating characteristic (ROC) curve were estimated to find cut-off value of EAT thickness for diagnosing CAD using coronary angiographic findings as gold standard. Results Patients were diagnosed as CAD group (n = 464, 60.30 ± 8.36 years) and non-CAD group (n = 85, 54.42 ± 11.93 years) after assessing coronary angiograms. The EAT was measured at end-systole from the PLAX views of three cardiac cycles on the free wall of the right ventricle. Lesion was significant if > 50% in left main and > 70% in other coronary arteries. The mean EAT thickness in CAD group was 5.10 ± 1.06 and in non-CAD group was 4.36 ± 1.01 which was significant (P = 0.003). Significant correlation was demonstrated between EAT thickness and presence of CAD (P < 0.003). Higher EAT was associated with severe CAD and presence of multivessel disease. By ROC analysis, EAT > 4.65 mm predicated the presence of significant coronary stenosis by 71.6% sensitivity and 73.1% specificity. Conclusion EAT thickness measured using transthoracic echocardiography (TTE) significantly correlates with the presence and severity of CAD. It is sensitive, easily available, and cost-effective and assists in the risk stratification and may be an additional marker on classical risk factors for CAD.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mukesh Jitendra Jha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Amit Goel
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Varun Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ashutosh Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vikas Mishra
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Chandra Mohan Varma
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vinay Krishna
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Avinash Kumar Singh
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mohit Sachan
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
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Sinha SK, Thakur R, Jha MJ, Sayal KS, Sachan M, Krishna V, Kumar A, Mishra V, Varma CM. Percutaneous Mitral Valvotomy in a Case of Situs Inversus Totalis and Juvenile Rheumatic Critical Mitral Stenosis: Case Report. J Clin Med Res 2016; 8:351-5. [PMID: 26985259 PMCID: PMC4780502 DOI: 10.14740/jocmr2473w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2016] [Indexed: 11/29/2022] Open
Abstract
Situs inversus totalis is a rare congenital disorder where the heart being a mirror image is situated on the right side of the body. Distorted cardiac anatomy makes fluoroscopy-guided percutaneous mitral valvotomy (PMV) technically challenging and there are only few reports of PMV in situs inversus totalis. Here we report a case where PMV was successfully done for situs inversus totalis with rare coincidence of juvenile rheumatic severe mitral stenosis in a 12-year-old boy with a few modifications of standard Inoue technique. He had exertional dyspnea of NYHA class III with initial mitral valve area (MVA) of 0.6 cm2 and severe pulmonary arterial hypertension with features suitable for PMV. Femoral vein was accessed from the left side to align the septal puncture needle and balloon to facilitate left ventricular entry. Septal descent and puncture by Brockenbrough needle was performed in the right anterior oblique view with the needle facing 5 o’clock position. Accura balloon was negotiated across mitral valve in left anterior oblique and procedure was successfully executed. Echocardiography showed a well-divided anterior commissure with an MVA of 2.0 cm2 and mild mitral regurgitation. In summary, PMV is safe and feasible in the rare patient with situs inversus totalis with few modifications of the Inoue technique.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
- Corresponding Author: Santosh Kumar Sinha, Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India.
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mukesh Jitendra Jha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Karandeep Singh Sayal
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mohit Sachan
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vinay Krishna
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ashutosh Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vikas Mishra
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Chandra Mohan Varma
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
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Sinha SK, Thakur R, Krishna V, Varma CM, Goel A, Jha MJ, Kumar A, Mishra V, Tiwari P, Sinha R. Malignant Rheumatic Heart Disease Presenting as Quadrivalvular Stenosis. Cardiol Res 2015; 6:357-361. [PMID: 28197258 PMCID: PMC5295550 DOI: 10.14740/cr437w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2015] [Indexed: 11/11/2022] Open
Abstract
Rheumatic disease may involve the pulmonary valve, but is exceedingly rare. Simultaneous involvement of all four valves is more likely to be the result of combination of causes, such as congenital, rheumatic, infective or degenerative disease. A unitary cause for quadrivalvular involvement would be either rheumatic or myxomatous degeneration. A 16-year-old young boy presented with progressive exertional dyspnea for the past 3 years. On evaluation, he was in atrial fibrillation with congestive heart failure. On examination, evidence of stenosis of the mitral, aortic and tricuspid valves with a history of rheumatic fever in childhood was revealed. Transthoracic echocardiography showed the quadrivalvular involvement. Only few reports are available in the literature describing rheumatic quadrivalvar damage and that too in third and fourth decade. This is probably first to be reported in juvenile age group.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vinay Krishna
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Chandra Mohan Varma
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Amit Goel
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mukesh Jitendra Jha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ashutosh Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vikas Mishra
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Pradyot Tiwari
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Rupesh Sinha
- LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
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Sinha SK, Thakur R, Mishra V, Goel A, Kumar A, Jha MJ, Varma CM, Tiwari P, Kumar Singh A. Rare Electrocardiographic Manifestation of Cystic Bronchiectasis in a 34-Year-Old Male. Cardiol Res 2015; 6:336-338. [PMID: 28197254 PMCID: PMC5295575 DOI: 10.14740/cr431w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2015] [Indexed: 11/11/2022] Open
Abstract
Himalayan P-waves (amplitude > 5 mm) are often known to be classically associated with congenital heart diseases with right to left shunt like tricuspid atresia, Ebstein anomaly, combined tricuspid and pulmonic stenosis, ischemic heart disease, restrictive cardiomyopathy, etc., where they indicate a dilated right atrium and tend to be persistent. This type of P-waves is rarely seen in long-standing bronchiectasis and is usually transient. It can be easily confused with congenital heart disease. Here we report a case of Himalayan P-waves in patient with bronchiectatic lung disease which is a rare entity.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G. S. V. M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G. S. V. M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vikas Mishra
- Department of Cardiology, LPS Institute of Cardiology, G. S. V. M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Amit Goel
- Department of Cardiology, LPS Institute of Cardiology, G. S. V. M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ashutosh Kumar
- Department of Cardiology, LPS Institute of Cardiology, G. S. V. M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mukesh Jitendra Jha
- Department of Cardiology, LPS Institute of Cardiology, G. S. V. M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Chandra Mohan Varma
- Department of Cardiology, LPS Institute of Cardiology, G. S. V. M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Pradyot Tiwari
- Department of Cardiology, LPS Institute of Cardiology, G. S. V. M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Avinash Kumar Singh
- Department of Cardiology, LPS Institute of Cardiology, G. S. V. M. Medical College, Kanpur, Uttar Pradesh 208002, India
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Kumar P, Singhal G, Sinha SK, Pandey U, Thakur R, Varma CM. Ebstein Anomaly With Right Atrial Clot. Cardiol Res 2015; 6:319-323. [PMID: 28197250 PMCID: PMC5295571 DOI: 10.14740/cr409w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2015] [Indexed: 12/01/2022] Open
Abstract
Ebstein anomaly (EA) is a rare congenital malformation of the tricuspid valve (TV), often associated with other cardiac malformations, especially atrial septal defect/patent foramen ovale (PFO) which is present in 80-90% of patients and predisposes to paradoxical embolization. We describe the case of a 17-year-old female, who presented with worsening exertional dyspnea, fatigue and pedal edema and atrial fibrillation (AF). Transthoracic echocardiography showed EA with severely dilated right atrium (RA), small functional right ventricle (RV), low velocity flow across TV with spontaneous echo contrast and giant clot in RA. Fortunately for the patient, contrast and transesophageal echocardiography revealed an intact interatrial septum with no PFO preventing any paradoxical embolism from large clot in RA, more so in the background of AF. Important differential diagnosis of congenitally unguarded TV orifice was ruled out due to presence of septal and anterior leaflets of TV and associated chordae.
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Affiliation(s)
- Prakash Kumar
- LPS Institute of Cardiology, GSVM Medical College, Kanpur, UP, 208002, India
| | - Gaurav Singhal
- LPS Institute of Cardiology, GSVM Medical College, Kanpur, UP, 208002, India
| | - Santosh Kumar Sinha
- LPS Institute of Cardiology, GSVM Medical College, Kanpur, UP, 208002, India
| | - Umeshwar Pandey
- LPS Institute of Cardiology, GSVM Medical College, Kanpur, UP, 208002, India
| | - Ramesh Thakur
- LPS Institute of Cardiology, GSVM Medical College, Kanpur, UP, 208002, India
| | - Chandra Mohan Varma
- LPS Institute of Cardiology, GSVM Medical College, Kanpur, UP, 208002, India
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Sinha SK, Varm CM, Thakur R, Krishna V, Goel A, Kumar A, Jha MJ, Mishra V, Singh Syal K. An Unconventional Route of Left Ventricular Pacing. Cardiol Res 2015; 6:324-328. [PMID: 28197251 PMCID: PMC5295572 DOI: 10.14740/cr423w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2015] [Indexed: 11/12/2022] Open
Abstract
We present a case of a rare complication of transvenous right ventricular pacing by temporary pacing wire causing iatrogenic interventricular septal perforation and left ventricular pacing in a 69-year-old man who was referred for recurrent syncope with sinus arrest.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, 208002, India
| | - Chandra Mohan Varm
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, 208002, India
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, 208002, India
| | - Vinay Krishna
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, 208002, India
| | - Amit Goel
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, 208002, India
| | - Ashutosh Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, 208002, India
| | - Mukesh Jitendra Jha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, 208002, India
| | - Vikas Mishra
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, 208002, India
| | - Karandeep Singh Syal
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, 208002, India
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Sinha SK, Verma CM, Thakur R, Kumar V, Sachan M, Kumar A, Jha MJ, Mishra V. Subvalvar Mitral Aneurysm: A Rare Cause of Mitral Leak. Cardiol Res 2015; 6:297-299. [PMID: 28197245 PMCID: PMC5295526 DOI: 10.14740/cr408w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2015] [Indexed: 11/11/2022] Open
Abstract
Submitral aneurysm (SMA) results from outpouching of the left ventricular wall which is congenital and occurs adjacent to the posterior leaflet of the mitral valve. Although it is predominantly described among the natives of Africa, it is considered rare in the Indian subcontinent. It presents clinically as palpitation, congestive cardiac failure in the presence of mitral regurgitation, arrhythmias and embolic phenomenon. Echocardiography is the precise diagnostic tool. We report this case of a 24-year-old man who was referred for evaluation of palpitation. This underlines the importance of considering SMA in the differential diagnosis of mitral regurgitation in young patients in our subcontinent where rheumatic etiology usually predominates.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Chandra Mohan Verma
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Varun Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Mohit Sachan
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Ashutosh Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Mukesh Jitendra Jha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Vikas Mishra
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
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Sinha SK, Verma CM, Krishna V, Thakur R, Kumar B, Goel A, Kumar S, Kumar A, Jha MJ. ALCAPA in an Octogenarian Woman: An Enigma. Cardiol Res 2015; 6:289-291. [PMID: 28197243 PMCID: PMC5295524 DOI: 10.14740/cr400w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2015] [Indexed: 12/05/2022] Open
Abstract
ALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is an exceedingly rare disease but lethal with clinical expression from myocardial infarction, congestive heart failure to death during early infancy and rare survival to adulthood. A 75-year-old woman with ALCAPA syndrome presented with angina (Canadian Cardiovascular Society functional class II) over past 8 months. Physical examination was within normal limits except pan-systolic murmur at the apex. Electrocardiography displayed poor R progression in precordial leads and signs of left ventricular hypertrophy. Echocardiography established presence of continuous flow entering the pulmonary trunk and normal systolic function. Coronary angiogram showed absence of left coronary artery originating from aorta, dilated and tortuous right coronary artery (RCA) and abundant Rentrop grade 3 intercoronary collateral communicating with left coronary artery originating from pulmonary trunk which was also confirmed on CT angiogram thus establishing diagnosis of ALCAPA. Survival in eight decade with this anomaly is still an enigma.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh, 208002, India
| | - Chandra Mohan Verma
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh, 208002, India
| | - Vinay Krishna
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh, 208002, India
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh, 208002, India
| | - Barun Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh, 208002, India
| | - Amit Goel
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh, 208002, India
| | - Surendra Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh, 208002, India
| | - Ashutosh Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh, 208002, India
| | - Mukesh Jitendra Jha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh, 208002, India
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Sinha SK, Verma CM, Krishna V, Thakur R, Kumar P, Goel A, Kumar A, Razi M. Wondering PTCA Wire: Retrieval by Tangling Technique. Cardiol Res 2015; 6:257-259. [PMID: 28197236 PMCID: PMC5295539 DOI: 10.14740/cr392w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 11/23/2022] Open
Abstract
A 38-year-old man underwent coronary angiography in our institution due to acute myocardial infarction as part of pharmaco-invasive strategy following thrombolysis. The patient showed total occlusion of mid left anterior descending (LAD) artery which was tortuous and calcified. The planned treatment was percutaneous coronary intervention (PCI) of culprit artery with wire being “jailed” in obtuse marginal branch of left circumflex artery (LCX) as left main was short and because of lesion characteristics. After successful stent implantation in the LAD, the “jailed” wire fractured as guiding catheter got deeply intubated as stent was being deployed in LAD. Initially, two balance middle weight (BMW) wires were used to retrieve but failed. Wire was wondering as it moved to proximal LCX, left main, partly into aortic sinus, sometimes proximal LAD and finally to LCX again during retrieval. Then it was decided to use tangling technique with the help of three BMW wires acting as rescue wires. The proximal ends of all three wires were inserted together in a torque device which were firmly screwed and rotated 40 - 50 times in circular pattern. During this rotational motion, the broken segment was tangled within these rescue wires and all four wires were removed together.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Chandra Mohan Verma
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Vinay Krishna
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Prakash Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Amit Goel
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Ashutosh Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Mahmadulla Razi
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
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Sinha SK, Madaan A, Thakur R, Pandey U, Bhagat K, Punia S. Massive Coronary Air Embolism Treated Successfully by Simple Aspiration by Guiding Catheter. Cardiol Res 2015; 6:236-238. [PMID: 28197232 PMCID: PMC5295560 DOI: 10.14740/cr373w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2015] [Indexed: 11/20/2022] Open
Abstract
Coronary air embolism remains a recognized complication of coronary catheterization despite a strong emphasis on prevention. It is almost always iatrogenic. It occurs mostly when catheters used for vascular procedures have not been adequately aspirated and flushed. Current treatment consists of supportive measures with 100% oxygen and analgesia and use of aspiration catheter. Here we report a case of massive coronary air embolism of left anterior descending artery and left circumflex artery because of loose Y-adapter connection during percutaneous coronary intervention. Patient suddenly developed hypotension, chest pain, ST elevation and finally asystole. Simple vigorous aspiration was done through guiding catheter restoring the flow and finally successful intervention. Thus simple aspiration can also do the wonder as bail-out measures in the standard treatment of air embolism.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Amit Madaan
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Umeshwar Pandey
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Kush Bhagat
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
| | - Surendra Punia
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, G. T. Road, Kanpur, Uttar Pradesh 208002, India
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141
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Raj P, Sinha SK, Ramji S, Sarin YK. Hereditary Multiple Gastrointestinal Atresia associated with Choledochal Cyst: A Rare Entity with Management Dilemma. J Neonatal Surg 2014. [DOI: 10.47338/jns.v3.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Multiple intestinal atresias are rare and its treatment is challenging. Here, we present a case of multiple gastrointestinal atresia associated with choledochal cyst posing us a surgical challenge.
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142
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Sinha SK, Pandey U, Verma C, Kumar V, Godara M. Case images: unconventional route for performing coronary angiography. Turk Kardiyol Dern Ars 2014; 42:224. [PMID: 24643162 DOI: 10.5543/tkda.2014.75606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College, Kanpur Up, India
| | - Umeshwar Pandey
- Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College, Kanpur Up, India
| | - Chandramohan Verma
- Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College, Kanpur Up, India
| | - Varun Kumar
- Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College, Kanpur Up, India
| | - Manoj Godara
- Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College, Kanpur Up, India
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143
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Sinha SK, Thakur R, Pandey U, Razi M. Angiographic sheath fracture and its embolization to the right atrium during coronary angiography and its successful percutaneous retrieval - an unusual complication. Turk Kardiyol Dern Ars 2013; 41:783. [PMID: 24351959 DOI: 10.5543/tkda.2013.36079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Ramesh Thakur
- Department of Cardiology, Lps Institute of Cardiology, India
| | - Umeshwar Pandey
- Department of Cardiology, Lps Institute of Cardiology, India
| | - Mahmadulla Razi
- Department of Cardiology, Lps Institute of Cardiology, India
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144
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Rana SV, Sharma SK, Ola RP, Kamboj JK, Malik A, Morya RK, Sinha SK. N-acetyltransferase 2, cytochrome P4502E1 and glutathione S-transferase genotypes in antitubercular treatment-induced hepatotoxicity in North Indians. J Clin Pharm Ther 2013; 39:91-6. [PMID: 24188272 DOI: 10.1111/jcpt.12105] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 09/30/2013] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Tuberculosis (TB) is a major cause of illness and death in developing countries. Hepatotoxicity is a serious side effect of antituberculosis treatment (ATT). NAT2, CYP2E1 and glutathione S-transferase (GST) gene polymorphisms may play an important role in ATT-induced hepatotoxicity. So, elucidating the genetics involved in anti-TB drug-induced hepatotoxicity in patients would be of utmost clinical significance. Therefore, the objective of the study was to elucidate the role of NAT2, CYP2E1 and GST gene polymorphisms in ATT-induced hepatotoxicity in North Indian patients. METHODS Three hundred patients with pulmonary and extra-pulmonary TB were enrolled. Total genomic DNA was isolated from each patient's peripheral lymphocytes using phenol-chloroform method, and genetic polymorphic analysis for N-acetyltransferase 2 (NAT2), cytochrome P4502E1 (CYP2E1) and GST was performed by polymerase chain reaction (PCR) with restriction fragment length polymorphism (RFLP). RESULTS AND DISCUSSION Of the 300 patients, 185 were males and 115 females. Among them, 33 males and 22 females developed ATT-induced hepatotoxicity. There were significant increases in alanine aminotransferase, aspartate aminotransferase and bilirubin levels in patients with ATT-induced hepatotoxicity at 1 month of treatment. NAT2 5/7 and 6/7 were significantly higher in hepatotoxicity patients as compared to the non-hepatotoxicity group. c1/c1 allele of CYP2E1 gene was lower (50·9%) in ATT-induced hepatotoxicity patients as compared to non-hepatotoxicity patients (61·2%), whereas c1/c2 and c2/c2 alleles were higher, but not statistically significant. GSTM1 was significantly higher in hepatotoxicity patients as compared to non-hepatotoxicity patients, whereas GSTT1 and GSTT1/M1 were lower, but not statistically significant. WHAT IS NEW AND CONCLUSION This study indicates that patients with slow-acetylator genotypes (NAT2 5/7, 6/7) and GSTM1 allele of GST enzyme were at higher risk of ATT-induced hepatotoxicity.
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Affiliation(s)
- S V Rana
- Department of Super Specialty Gastroenterology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
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145
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Shrivastava PK, Shrivastava A, Sinha SK, Shrivastava SK. Dextran Carrier Macromolecules for Colon-specific Delivery of 5-Aminosalicylic Acid. Indian J Pharm Sci 2013; 75:277-83. [PMID: 24082343 PMCID: PMC3783745 DOI: 10.4103/0250-474x.117420] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 03/03/2013] [Accepted: 03/13/2013] [Indexed: 11/30/2022] Open
Abstract
Present manuscript describes the sustained and targeted delivery of 5-aminosalicylic acid to the distal ileum and proximal colon, using dextran (40 kDa) as a carrier for targeting 5-aminosalicylic acid at the colonic site by attaching p-aminobenzoic acid and benzoic acid as linkers. Prepared conjugate were characterized by UV, HPLC, FT-IR, and 1H NMR. The degree of substitution was estimated by complete hydrolysis of conjugates in borate buffer and in vitro hydrolysis study of conjugates was performed in different biological media. It was observed that 5-aminosalicylic acid alone have produced high incidence of gastric ulcer with high ulcer index whereas lower ulcer index was found for the dextran conjugates of 5-aminosalicylic acid. The release pattern of conjugates in 3% w/v rat caecal content was confirmed the colon specificity of 5-aminosalicylic acid conjugates.
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Affiliation(s)
- P K Shrivastava
- Pharmaceutical Chemistry Research Laboratory, Department of Pharmaceutics, Indian Institute of Technology, Banaras Hindu University, Varanasi-221 005, India
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146
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Rana SV, Sharma S, Sinha SK, Parsad KK, Malik A, Singh K. Pro-inflammatory and anti-inflammatory cytokine response in diarrhoea-predominant irritable bowel syndrome patients. ACTA ACUST UNITED AC 2013; 33:251-6. [PMID: 23923350 DOI: 10.7869/tg.2012.66] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM Irritable bowel syndrome (IBS) is referred to as a functional bowel disorder which is diagnosed by a number of characteristic symptoms (Rome II criteria) in the absence of detectable structural abnormalities. Low-grade inflammation of the intestine may be one of the reasons for development of diarrhoea-predominant IBS (IBS-D). We undertook this study to estimate the serum levels of pro-inflammatory (IL-6, TNF-alpha) and anti-inflammatory (IL-10) cytokines in IBS-D patients. METHODS A total of 108 diarrhoea patients were screened. Out of these only 63 adult IBS-D patients were enrolled. Age and sex matched 62 apparently healthy controls with no GI symptoms were also recruited. Out of 63 IBS-D patients, 37 were males while there were 32 males among the controls. The patients with IBS-D were diagnosed according to the Rome II criteria. Levels of serum IL-6, TNF-alpha and IL-10 were measured in all subjects using ELISA. RESULTS Mean (+/- SD) age of IBS-D patients (42.6 +/- 19.5 years) was comparable (p = 0.64) to that of controls (43.5 +/- 18.7 years). The mean (+/- SD) levels of IL-6 in IBS-D patients (32.2 +/- 12.01 pg/ml) was significantly higher (p < 0.001) than in controls (7.48 +/- 2.55 pg/ml). The levels of TNF-alpha in IBS-D patients (16.3 +/- 5.2 pg/ml) were also significantly higher (p < 0.05) than in controls (7.94 +/- 2.19 pg/ml). There was no significant difference in the serum levels of IL-10 (p = 0.23) between IBS-D patients (5.75 +/- 2.1 pg/ml) and controls (5.84 +/- 1.9 pg/ml). CONCLUSION Our results indicate that mild inflammation is involved in IBS-D patients as proinflammatory cytokines were increased although no difference in anti-inflammatory cytokine was observed.
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Affiliation(s)
- S V Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.
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147
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Rana SV, Sharma S, Malik A, Kaur J, Prasad KK, Sinha SK, Singh K. Small intestinal bacterial overgrowth and orocecal transit time in patients of inflammatory bowel disease. Dig Dis Sci 2013; 58:2594-8. [PMID: 23649377 DOI: 10.1007/s10620-013-2694-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Accepted: 04/18/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) consists of Ulcerative colitis (UC) and Crohn's disease (CD). These two conditions share many common features-diarrhea, bloody stools, weight loss, abdominal pain, fever and fatigue. Small intestinal bacterial overgrowth (SIBO) is frequent in patients with CD but it has not been studied in UC Indian patients. AIM The study was planned to measure orocecal transit time (OCTT) and SIBO in UC and CD patients. METHODS One hundred thirty-seven patients of IBD (95 UC and 42 CD) and 115 healthy controls were enrolled. OCTT and SIBO were measured by lactulose and glucose hydrogen breath test respectively. Concentration of hydrogen and methane were measured by SC microlyser from Quintron, USA. RESULTS Mean±standard deviation (SD) of OCTT in patients of IBD was significantly higher as compared to controls. Furthermore, OCTT was significantly higher in CD patients as compared to UC patients. It was also observed that occurrence of SIBO was significantly higher in IBD patients as compared to controls. The occurrence of SIBO in CD (45.2%) was significantly higher as compared to patients in UC (17.8%) group. Percentage of methane positive IBD patients (2.9%) was significantly lower as compared to methane positive controls (24.4%). CONCLUSION OCTT was significantly delayed in IBD patients as compared to controls and in CD patients as compared to UC patients. OCTT was significantly higher in SIBO positive IBD patients as compared to SIBO negative patients. Thus, we can suggest that delayed OCTT would have been the cause of increased SIBO in these patients.
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Affiliation(s)
- S V Rana
- Department of Super Specialty Gastroenterology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
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148
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Chen SW, Guo H, Seu KA, Dumesnil K, Roy S, Sinha SK. Jamming behavior of domains in a spiral antiferromagnetic system. Phys Rev Lett 2013; 110:217201. [PMID: 23745918 DOI: 10.1103/physrevlett.110.217201] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Indexed: 06/02/2023]
Abstract
Using resonant magnetic x-ray photon correlation spectroscopy, we show that the domains of a spiral antiferromagnet enter a jammed state at the onset of long-range order. We find that the slow thermal fluctuations of the domain walls exhibit a compressed exponential relaxation with an exponent of 1.5 found in a wide variety of solidlike jammed systems and can be qualitatively explained in terms of stress release in a stressed network. As the temperature decreases, the energy barrier for fluctuations becomes large enough to arrest further domain wall fluctuations, and the domains freeze into a spatial configuration within 10 K of the Néel temperature. The relaxation times can be fitted with the Vogel-Fulcher law as observed in polymers, glasses, and colloids, thereby indicating that the dynamics of domain walls in an ordered antiferromagnet exhibit some of the universal features associated with jamming behavior.
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Affiliation(s)
- S-W Chen
- Department of Physics, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, USA
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Rana SV, Sharma S, Kaur J, Sinha SK, Singh K. Comparison of lactulose and glucose breath test for diagnosis of small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Digestion 2012; 85:243-7. [PMID: 22472730 DOI: 10.1159/000336174] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 01/03/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Validity of the lactulose breath test (LBT) to diagnose small intestinal bacterial overgrowth (SIBO) has been questioned. Therefore, a study was planned to compare LBT with glucose breath test (GBT) to diagnose SIBO in irritable bowel syndrome (IBS) patients and controls. METHODS 175 diarrhea-predominant IBS patients and 150 apparently healthy controls were enrolled. IBS was diagnosed according to Rome II criteria. Breath samples were collected every 10 min up to 180 min. Breath H₂ and CH₄ were measured using an SC MicroLyzer. SIBO was positive with a sustained increase in breath H₂ or CH₄ or both ≥10 ppm over a baseline value within <90 min in case of LBT and within <120 min in GBT. RESULTS SIBO was positive in 60/175 (34.3%) patients by lactulose and in 11/175 (6.2%) patients by GBT. In controls, LBT was positive for SIBO in 45/150 (30%) patients and in 1/150 (0.66%) patients by GBT. Positive LBT for SIBO was not significantly different in patients and controls; while using GBT, SIBO was significantly higher (p < 0.01) in patients as compared to controls. By using GBT as gold standard for SIBO, sensitivity, specificity, positive predictive value and negative predictive value of LBT in IBS patients was 63.6, 67.7, 11.7 and 96.6% respectively. CONCLUSION LBT is not a good test to discriminate SIBO in IBS patients from controls.
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Affiliation(s)
- S V Rana
- Department of Super Specialty of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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Kaur J, Sinha SK, Srivastava RK. Integration of tobacco cessation in general medical practice: need of the hour. J Indian Med Assoc 2011; 109:925-928. [PMID: 23469577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Tobacco use is the single most preventable cause of death and disability. Tobacco use causes almost one million deaths annually in India, which is much more than the combined mortality due to malaria/TB and HIV/AIDS. It is estimated to cause one billion deaths in the 21st century, eighty per cent of which will occur in the developing countries like India. Tobacco use is increasing in the country. Global Adult Tobacco Survey, 2010, estimated that more than one-third of adults (35%) in the country use tobacco, out of which 21% use smokeless tobacco, 9% smoke and 5% use both. The prevalence of overall tobacco use among men was 47.9% and among women was 20.2%. Global Youth Tobacco Survey, India, 2009, estimate 14.6% of 13-15 years school going children use tobacco. There is urgent need for addressing the tobacco epidemic in India. Though effective interventions for tobacco cessation such as brief counselling, nicotine replacement therapy, non-nicotine pharmacotherapy are available, their use by general practitioners is restricted due to lack of adequate dissemination of information in their use. Use of these simple assessment tools and practice of these effective interventions by general medical and healthcare practitioners will go a long way in addressing the rising tobacco epidemic in India and making general healthcare more comprehensive.
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Affiliation(s)
- Jagdish Kaur
- Ministry of Health & Family Welfare, Government of India, New Delhi 110011
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