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Tanwar S. Navigating the Seas of Publications in A Medical Journal: The Role of an Editor. Cureus 2024; 16:e55233. [PMID: 38558698 PMCID: PMC10981382 DOI: 10.7759/cureus.55233] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
The world of scientific publishing is a dynamic ecosystem where groundbreaking research and discoveries find their way into the public domain. Scientific journals play a pivotal role in disseminating new knowledge, shaping the healthcare landscape, and influencing clinical practice. Behind the scenes, editors serve as gatekeepers, meticulously reviewing and selecting articles to ensure the highest standards of quality and relevance. This article offers insights into the role of editors regarding publications in medical journals, shedding light on the challenges, responsibilities, and evolving trends in this crucial process.
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Affiliation(s)
- Shweta Tanwar
- Epidemiology and Public Health, Indian Council of Medical Research, New Delhi, IND
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2
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Kumar B, Tanwar S, Ganta S, Saxena K, Patel K, Asha K. INVESTIGATING THE EFFECT OF NICOTINE FROM CIGARETTES ON THE GROWTH OF ABDOMINAL AORTIC ANEURYSMS: REVIEW. Georgian Med News 2023:183-188. [PMID: 38325321] [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: 02/09/2024]
Abstract
Separating aneurysmal arterial disease from atherosclerosis and further occlusive artery conditions, it is a vascular degenerative disorder. Within the vascular tree, there is a regionalization of the propensity to produce aneurysms and the different locations result in different clinical processes. As the predominant risk factor for ubrenal abdominal aortic aneurysm (AAA), smoking is one of the most common manifestations of aneurysmal illness. For AAA compared to atherosclerosis, smoking is a far bigger risk factor. Along with contributing to the pathophysiology of AAA, smoking raises the likelihood that established AAA will rupture as well as its rate of expansion. The development of improved models for animals that are reliant on smoke or smoke constituents is helping to determine the mechanistic connection between AAA and smoking. According to the processes, there are long-lasting changes in the function of inflammatory and vascular smooth muscle cells. Focused on AAA, this review looks at the medical, epidemiology and mechanical evidence that links smoking to aneurysms.
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Affiliation(s)
- B Kumar
- 1School of Pharmacy & Research, Dev Bhoomi Uttarakhand University, Dehradun, India
| | - S Tanwar
- 2Department of Pharmacy, Vivekananda Global University, Jaipur, India
| | - Sh Ganta
- 3Department of Community Medicine, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - K Saxena
- 4Department of Computer Science and Engineering, Noida Institute of Engineering and Technology, Greater Noida, Uttar Pradesh, India
| | - K Patel
- 5Department of Gynaecology, Parul University, PO Limda, Tal. Waghodia, District Vadodara, Gujarat, India
| | - K Asha
- 6Department of Life Sciences, School of Sciences, JAIN (Deemed-to-be University), Karnataka, India
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Pateriya RV, Tanwar S, Sharma AL. A Critical Review on Orthosilicate Li2MSiO4 (M= Fe, Mn) Electrode Materials for Li Ion Batteries. J Phys Condens Matter 2023; 35. [PMID: 37160130 DOI: 10.1088/1361-648x/acd3cd] [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] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/09/2023] [Indexed: 05/11/2023]
Abstract
The development of novel electrode materials with good electrochemical performances is necessary for the expanded and varied applications of lithium-ion batteries, and this development heavily relies on cathode materials. Due to excellent thermal stability, abundance, low cost, and environmental friendliness, orthosilicate cathode materials Li2MSiO4 (M= Fe, Mn) has received a lot of attention recently. The present review article gives a glimpse into the characteristics, advantages, and recent progress of orthosilicate cathode materials. This review starts with a brief history and working mechanism of batteries, the advantages of cathode materials followed by types of cathode materials, various synthesis methods, and different techniques used for their characterization. The most current initiatives to enhance orthosilicate Li2MSiO4 type electrochemical performances were introduced in this review. We provide a critical assessment of the efficient modification techniques for the orthosilicate Li2MSiO4 type cathode materials in particular. These potential cathode materials' synthesis, structure, morphologies, and particularly electrochemical performances have been thoroughly examined. This evaluation, we hope, will clarify the sustained advancement of high-efficiency and reasonably priced Li-ion batteries
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Affiliation(s)
- Ravi Vikash Pateriya
- Department of Physics, Central University of Punjab, Main Campus, Bathinda, 151001, INDIA
| | - Shweta Tanwar
- Central University of Punjab, Department of Physics, Bathinda, Punjab, 151001, INDIA
| | - A L Sharma
- Centre for Physical Sciences, Central University of Punjab, Central University of Punjab, Bathinda, Bathinda, 151001, INDIA
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Tanwar S, Singh N, Sharma A. Fabrication of Activated Carbon coated MSe2 (M=Mo, Co, and Ni) Nanocomposite Electrode for High-Performance Aqueous Asymmetric Supercapacitor. Colloids Surf A Physicochem Eng Asp 2023. [DOI: 10.1016/j.colsurfa.2023.131235] [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: 03/11/2023]
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5
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Kour S, Tanwar S, Kour P, Sharma A. Hierarchical Template-free Chestnut-like Manganese Cobaltite for High-Performance Symmetric and Asymmetric Supercapacitor. Colloids Surf A Physicochem Eng Asp 2022. [DOI: 10.1016/j.colsurfa.2022.130674] [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: 11/27/2022]
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Kumar A, Tanwar S, Gupta S, Chetiwal R, Kumar R. Advanced metastatic pancreatic neuroendocrine tumor treated successfully with peptide receptor radionuclide therapy: a case report. Exploration of Targeted Anti-tumor Therapy 2022; 3:392-397. [PMID: 36045912 PMCID: PMC9400745 DOI: 10.37349/etat.2022.00089] [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] [Received: 02/14/2022] [Accepted: 04/12/2022] [Indexed: 11/19/2022] Open
Abstract
Neuroendocrine tumor (NET) is a rare tumor that has been observed in different sites such as lungs and throughout the gastrointestinal tract. Clinical features are usually non-specific and vary considerably depending upon the location of the tumor. Symptoms are similar to those of common conditions such as peptic ulcer disease, gastritis, irritable bowel syndrome, asthma, etc. Thus, an initial diagnosis of a NET usually occurs at an advanced stage. This report describes a case of pancreatic NET (PNET, grade 2) with liver metastasis in a 37-year-old male which was found to be inoperable due to extensive direct involvement of the proximal jejunal branches and superior mesenteric vein. Peptide receptor radionuclide therapy (PRRT) with lutetium-177 dotatate (177Lu-DOTATATE) was administered due to the inoperability of primary PNET. Complete resolution of symptoms occurred with three cycles of PRRT.
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Affiliation(s)
- Amit Kumar
- Department of Medicine, ESIC Postgraduate Institute of Medical Sciences and Research, Basaidarapur, New Delhi 110015, India
| | - Shweta Tanwar
- Scientist C, Indian Council of Medical Research, New Delhi 110029, India
| | - Sudhish Gupta
- Department of Medicine, ESIC Postgraduate Institute of Medical Sciences and Research, Basaidarapur, New Delhi 110015, India
| | - Rajesh Chetiwal
- Department of Medicine, ESIC Postgraduate Institute of Medical Sciences and Research, Basaidarapur, New Delhi 110015, India
| | - Rohit Kumar
- Department of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak, Haryana 124001, India
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Kumar A, Chaudhry D, Goel N, Tanwar S. Epidemiology of Intensive Care Unit-acquired Infections in a Tertiary Care Hospital of North India. Indian J Crit Care Med 2022; 25:1427-1433. [PMID: 35027805 PMCID: PMC8693113 DOI: 10.5005/jp-journals-10071-24058] [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] [Indexed: 11/23/2022] Open
Abstract
Background The majority of nosocomial infections in the hospital setting are found in intensive care units (ICUs). The present study was undertaken to determine the incidence, risk factors, causative microorganisms, and outcome of various ICU-acquired infections. Materials and methods The patients admitted to the ICU of a teaching hospital in North India were prospectively studied. Detailed history, clinical examination, acute physiology and chronic health evaluation score II, simplified acute physiology score II, sequential organ failure assessment score, and baseline investigations were recorded. Patients were assessed daily till 14th day for nosocomial infection as per Centers for Disease Control and Prevention (CDC) guidelines and were followed till death or discharge. Incidence, risk factors, and outcome parameters were calculated using Student t-test, Chi-square test, and stepwise multivariate logistic regression model. Results The overall incidence rate of ICU infections was 27.9%. The most common ICU-acquired infection was ventilator-associated pneumonia followed by catheter-related bloodstream infection and catheter-associated urinary tract infection. Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae were implicated in most of the infections. ICU length of stay (LOS) >7 days, neurological dysfunction, endotracheal intubation, ischemic heart disease, and use of antacids/H2 blockers were significantly associated with ICU-acquired infections. The mortality rate was 32.8 and 28.8% in patients with and without ICU infections, respectively (p = 0.531). The ICU LOS (19.23 ± 12.79 days) was significantly higher in the ICU infections group (p <0.001). Conclusion Ventilator-associated pneumonia was the most common nosocomial infection in our study. Gram-negative microorganisms were the predominant causative agents for various ICU-acquired infections. Mortality was not found to be affected but ICU LOS was significantly prolonged as a consequence of the development of ICU-acquired infection. How to cite this article Kumar A, Chaudhry D, Goel N, Tanwar S. Epidemiology of Intensive Care Unit-acquired Infections in a Tertiary Care Hospital of North India. Indian J Crit Care Med 2021;25(12):1427-1433.
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Affiliation(s)
- Amit Kumar
- Department of Medicine, ESIC Postgraduate Institute of Medical Sciences and Research, New Delhi, India
| | - Dhruva Chaudhry
- Department of Pulmonary and Critical Care Medicine, Pt BD Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Nidhi Goel
- Department of Microbiology, Pt BD Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Shweta Tanwar
- Indian Council of Medical Research, New Delhi, India
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Tanwar S, Kumar A, Chetiwal R, Kumar R. Nosocomial infections-related antimicrobial resistance in a multidisciplinary intensive care unit. MGM J Med Sci 2022. [DOI: 10.4103/mgmj.mgmj_110_21] [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: 11/04/2022] Open
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9
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Tanwar S, Kumar A, Chetiwal R. Comparative assessment of morphological alterations in the dentin surface by sodium fluoride, 980 nm diode laser, and their combined application for use in the treatment of dentin hypersensitivity: An in vitro scanning electron microscopy study. Saint Int Dent J 2022. [DOI: 10.4103/sidj.sidj_19_21] [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: 11/04/2022] Open
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10
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Kumar A, Chetiwal R, Tanwar S, Gupta S, Kumar R. Thrombolysis in the de winter electrocardiography pattern: A therapeutic dilemma. J Pract Cardiovasc Sci 2022. [DOI: 10.4103/jpcs.jpcs_4_22] [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: 11/04/2022] Open
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11
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Chetiwal R, Kumar A, Tanwar S, Gupta S. Acute respiratory distress syndrome complicating scrub typhus in pregnancy. Indian J Med Spec 2022. [DOI: 10.4103/injms.injms_106_21] [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: 11/04/2022]
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Tanwar S, Arya A, Gaur A, Sharma AL. Transition metal dichalcogenide (TMDs) electrodes for supercapacitors: a comprehensive review. J Phys Condens Matter 2021; 33:303002. [PMID: 33892487 DOI: 10.1088/1361-648x/abfb3c] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/23/2021] [Indexed: 06/12/2023]
Abstract
As globally, the main focus of the researchers is to develop novel electrode materials that exhibit high energy and power density for efficient performance energy storage devices. This review covers the up-to-date progress achieved in transition metal dichalcogenides (TMDs) (e.g. MoS2, WS2, MoSe2,and WSe2) as electrode material for supercapacitors (SCs). The TMDs have remarkable properties like large surface area, high electrical conductivity with variable oxidation states. These properties enable the TMDs as the most promising candidates to store electrical energy via hybrid charge storage mechanisms. Consequently, this review article provides a detailed study of TMDs structure, properties, and evolution. The characteristics technique and electrochemical performances of all the efficient TMDs are highlighted meticulously. In brief, the present review article shines a light on the structural and electrochemical properties of TMD electrodes. Furthermore, the latest fabricated TMDs based symmetric/asymmetric SCs have also been reported.
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Affiliation(s)
- Shweta Tanwar
- Department of Physics, Central University of Punjab, Bathinda-151401, Punjab, India
| | - Anil Arya
- Department of Physics, Central University of Punjab, Bathinda-151401, Punjab, India
| | - Anurag Gaur
- Department of Physics, National Institute of Technology, Kurukshetra-136119, Haryana, India
| | - A L Sharma
- Department of Physics, Central University of Punjab, Bathinda-151401, Punjab, India
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Devi C, Swaroop R, Arya A, Tanwar S, Sharma AL, Kumar S. Fabrication of energy storage EDLC device based on self-synthesized TiO2 nanowire dispersed polymer nanocomposite films. Polym Bull (Berl) 2021. [DOI: 10.1007/s00289-021-03737-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tanwar S, Mattoo B, Kumar U, Dada R, Bhatia R. Does human serotonin-1A receptor polymorphism (rs6295) code for pain and associated symptoms in fibromyalgia syndrome? Reumatismo 2021; 73:24-31. [PMID: 33874644 DOI: 10.4081/reumatismo.2021.1312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 02/23/2021] [Indexed: 11/22/2022] Open
Abstract
Genetic predisposition may play an important role in the development of fibromyalgia syndrome (FMS). Serotonin is known to be involved in pain modulation and serotonin-1A receptor plays a considerable role in determining the central 5-HT tone. Consequently, variation in 5-HT1A receptor gene (HTR1A) may be responsible for inter-individual variability in pain sensitivity and other clinical symptoms of FMS. Therefore, the objectives of this research work were to study the gene polymorphism of 5-HTR1A gene and to explore the correlation between rs6295 genotype (-1019C/G HTR1A) and duration of pain, pain intensity and pain related depression and anxiety, if any, in FMS. 5-HTR1A genotype for the C(-1019)G polymorphism was typed in 62 patients with FMS and 42 healthy subjects. Present pain intensity, components of pain and pain related depression and anxiety were assessed using the numerical pain rating scale, McGill pain questionnaire and Hamilton depression and anxiety rating scale respectively. 5-HTR1A gene was represented by three different genotypes, homozygous C/C, heterozygous C/G and homozygous G/G. Analysis of the 5-HTR1A gene showed a frequency of 58%, 31% and 11% for the C/C, C/G and G/G genotypes, respectively in FMS group. This proportion was 69%, 23% and 8% in healthy subjects. No significant correlation was observed between 5-HTR1A gene polymorphism and pain and related symptoms in FMS patients. To the best of our knowledge this is the first study which investigated the correlation between the 5-HTR1A gene polymorphism and pain intensity, the affective component of pain, pain related depression and anxiety in FMS.
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Affiliation(s)
- S Tanwar
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), New Delhi.
| | - B Mattoo
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), New Delhi.
| | - U Kumar
- Department of Rheumatology, All India Institute of Medical Sciences (AIIMS), New Delhi.
| | - R Dada
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), New Delhi.
| | - R Bhatia
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), New Delhi.
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Sen N, Tanwar S, Jain A, Gokhroo R, Shah N. Yoga could reduce the burden and symptoms of atrial fibrillation as well as medication related side effects and the complications with cardiac ablation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0450] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is a common cardiac arrhythmia that affects around three million people worldwide. Thromboembolic stroke, myocardial ischemia and congestive heart failure with significant financial burden are bad outcomes of AF. It is associated with significant morbidity and is also an independent risk factor for mortality. The treatment of AF and its associated complications increases healthcare resource utilization and contributes to increasing costs of healthcare, particularly costs associated with recurrent hospitalization.
Methods
538 patients of atrial fibrillation are enrolled in our multicentric study from 2012 to 2017 that brought to light the therapeutic impact a noninvasive, medication-free intervention has on a costly disease.The unique approach of this study involved patients serving as their own controls; for the first 12 weeks, patients continued standard AF medical or catheter ablation therapy, followed by 16 weeks of 30-min alternate day yoga sessions (Savasana / Sun Salution Yoga Posture, Ujjayi Breath and Anulom –Vilom Pranayam). Patients were also encouraged to practice yoga at home on a daily basis.We divided into two group Yoga and Non Yoga and compared the data after 16 weeks of training.
Results
Yoga training reduced symptomatic AF episodes (14.8±4 vs. 8.2±3.2, p<0.005), symptomatic non-AF episodes (12.8±2.8 vs. 9.2±2.2; p<0.004), asymptomatic AF episodes (2.4±0.4 vs. 1.3±0.20; p<0.005), and depression and anxiety (p<0.005) used Goldberg anxiety score 2.5 fold improved as compared to non yoga group while improving, QoL parameters including physical functioning, vitality, social functioning, and mental health as assessed using the SF-36 (p=0.017, p<0.001, p<0.001, p=0.019, and p<0.003, respectively). There were significant decreases in heart rate and systolic (11±3 mmhg) and diastolic (6±2 mmhg) blood pressure after yoga training (p<0.002). This may directly result in decreased hospitalization (38% in yoga vs 16% in non yoga group) and healthcare costs reduction in yoga group. Yoga is also an intervention free from medication-related side effects or the complications observed with cardiac ablation.
Conclusions
The primary outcome was a composite of the reductions in symptomatic AF, symptomatic non-AF, and asymptomatic AF episodes as recorded by a diary and correlated with a non-looping event monitor with low cost. Strikingly, the results validate the ability of yoga practice to reduce patient-reported AF symptoms. It also demonstrated a statistically significant impact on quality of life (QoL), mental health, physical functioning, depression, and anxiety with avoid of side effects of medication or ablation.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Sen
- HG SMS Hospital, Jaipur, India
| | | | - A Jain
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | - R.K Gokhroo
- J L N Medical College, Cardiology, Ajmer, India
| | - N Shah
- Kokilaben Dhirubhai Ambani Hospital and Research Institute, Mumbai, India
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Tien T, Tan YC, Baptiste P, Tanwar S. Haemobilia in a previously stented hilar cholangiocarcinoma: successful haemostasis after the insertion of fcSEMS. Oxf Med Case Reports 2020; 2020:omaa010. [PMID: 32128221 PMCID: PMC7048067 DOI: 10.1093/omcr/omaa010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/06/2020] [Revised: 01/14/2020] [Accepted: 01/25/2020] [Indexed: 12/23/2022] Open
Abstract
Haemobilia describes blood loss from the biliary tract and classically presents as Quincke's triad: upper gastrointestinal bleeding (UGIB), jaundice and right upper quadrant abdominal pain. We discuss the case of a 70-year-old male with a previously stented Bismuth 1 hilar cholangiocarcinoma who presented with haematemesis. He had a similar presentation a month ago where a forward viewing gastroscope identified fresh and altered blood in the distal stomach but no clear source of bleeding. During this admission, a side-viewing duodenoscope identified bleeding from the periampullary region, which was managed by inserting a fully covered self-expanding metal stent (fcSEMS) within his pre-existing uncovered SEMS to tamponade the haemorrhage. This case highlights the importance of using a side-viewing duodenoscope for patients with UGIB on a background of a stented cholangiocarcinoma and inserting a fcSEMS within an uncovered SEMS is feasible and effective in managing these patients.
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Affiliation(s)
- T Tien
- Department of Gastroenterology, Whipps Cross Hospital, Barts Health NHS Trust, London, UK
| | - Y C Tan
- Department of Gastroenterology, Whipps Cross Hospital, Barts Health NHS Trust, London, UK
| | - P Baptiste
- General Practice, NHS Waltham Forest Clinical Commissioning Group, London, UK
| | - S Tanwar
- Department of Gastroenterology, Whipps Cross Hospital, Barts Health NHS Trust, London, UK
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Tanwar S, Sen N. Differential Status of Coronary Artery Disease in Pre versus Post-Menopausal Women in India. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.171] [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: 11/24/2022] Open
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18
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Sen N, Tanwar S. Dehydroepiandrosterone level, testosterone /estradiol ratio and correlation with coronary inflammatory markers predict 5 years risk of cardiovascular disease in men. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.104] [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: 10/25/2022] Open
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19
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Tanwar S, Sen N. Effects on Blood Pressure of Black Salt (Himalayan Salt) Versus Table Salt in Prehypertensive Indians. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.173] [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: 11/28/2022] Open
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20
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Sen N, Tanwar S. Cardio diabetic metabolic risk scenario difference between migrated to urban women versus rural women in north India. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.103] [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: 11/29/2022] Open
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21
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Sen N, Tanwar S. Evaluation of blood pressure reduction and improve left ventricular diastolic function among hypertensive patients with diabetes type 2: Azilsartan versus other angiotensin receptor blockers. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.005] [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: 11/26/2022] Open
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Sen N, Tanwar S. Advance role of left ventricular global strain to reduce cardiovascular morbidity and mortality among diabetic cardiomyopathy patients with heart failure. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.245] [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: 11/15/2022] Open
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Tanwar S, Sen N. Prevalence of Hypertension and Comparison between Rural versus Urban Indian Women who had Hypertension during Pregnancy after 24 Months of Follow Up. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.172] [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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Sen N, Tanwar S. Integrated approach of yoga, meditation and enhanced external counter pulsation with pharmacological therapy in severe chronic heart failure patients. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.246] [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: 10/25/2022] Open
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Tanwar S, Sen N, Jain A, Mehta A, Kalra B, Bansal M. P4356Assessment of global and regional right ventricular systolic function in restrictive pulmonary disease by novel speckle tracking 3D echocardiography comparison with cardiac magnetic resonance imaging. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0763] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Chronic restrictive pulmonary disease may alter right and left ventricular function by changing intrathoracic pressure. Pulmonary hyperinflation may increase right atrial pressure, leading to reduced venous return and subsequent reductions in RV pre-load. In CRPD patients, hyperinflation has been directly correlated with reduced atrial chamber size, global RV dysfunction, and reduced LV filling. Accurate assessment of global and regional right ventricular (RV) systolic function is challenging.
Purpose
The aims of this study were to confirm the reliability and feasibility of a three-dimensional (3D) speckle-tracking echocardiography (STE) system, using comparison with cardiac magnetic resonance imaging (CMR), and to assess the contribution of regional RV function to global function.
Methods
In a retrospective, cross-sectional study setting, RV volumetric data were studied in 200 patients who were referred for both CMR and 3D echocardiography within 1 month. Three-dimensional STE-derived area strain, longitudinal strain, and circumferential strain were assessed as global, inlet, outflow, apical, and septal segments.
Results
136 patients (68%) had adequate 3D echocardiographic data. RV measurements derived from 3D STE and CMR were closely related (RV end-diastolic volume, R2=0.89; RV end-systolic volume, R2=0.82; RV ejection fraction [RVEF], R2=0.68; P<0.003 for all). RVEF and RV end-diastolic volume from 3D STE were slightly but significantly smaller than CMR values (mean differences, −3% and −8 mL for RVEF and RV end-diastolic volume, respectively). Among conventional echocardiographic parameters for RV function (tricuspid annular plane systolic excursion, fractional area change, S' of the tricuspid annulus, RV free wall two-dimensional longitudinal strain), only fractional area change was significantly related to RVEF (r=0.30, P=0.005). Among segmental 3D strain variables, inlet area strain (r=−0.49, P<0.004) and outflow circumferential strain (r=−0.39, P<0.005) were independent factors associated with CMR-derived RVEF.
Conclusions
Severity of restrictive pulmonary disease influences RV systolic dysfunction, which is reflected in speckle tracking 3D echocardiographic parameters. Regional RV wall motion showed that heterogeneous segmental deformations affect global RV function differently; specifically, inlet area strain and outflow circumferential strain.RV volume and RVEF determined by STE were comparable with CMR measurements.
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Affiliation(s)
| | - N Sen
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | - A Jain
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | - A Mehta
- Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - B Kalra
- Artemis Hospital, Cardiology, gurgaon, India
| | - M Bansal
- Medanta Heart Institute, Cardiology, Gurgaon, India
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Sen N, Tanwar S, Jain A, Sharma J, Gokhroo RK, Mehta A, Kalra B. P6293Assessment of testosterone/estradiol ratio, DHEA-S level and correlation with coronary inflammatory markers IL-1 & 6, TNF-1 and hsCRP predict 5 years risk of cardiovascular disease in men. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0891] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Previous data showed the adrenal sex hormone dehydroepiandrosterone (DHEA) which is present in serum mainly as the sulfate DHEA-S is the most abundant steroid hormone and another hormones like testosterone, estradiol are related to cardiovascular risk in men. Literatures revealed vascular and metabolic actions of DHEA/-S, evidence for an association between DHEA/-S levels and cardiovascular events is controversy.
Objectives
Our aim is to review and clear the contradictory point regarding cardiovascular risk and correlation of testeosterone/ estradiol ratio, DHEA-S level with coronary inflammatory markers in men.
Methods
Large population based cohort study done at multi centre of cardiology from 2013- 2018 in India. We enrolled total 23631 normal healthy male population age between 40 to 60 years and divided into two groups based on testosterone/estradiol ratio (Group A (n=2450) lower value of T/E ratio and Group B (n=21181) normal or higher T/E ratio. We did cohort analysis for 5 years and evaluated DHEA-S level and correlated it with coronary inflammatory markers and cardiovascular risk.
Results
In group A (low T/E ratio) we found low level of DHEA-S (98% of individual) and higher value of interleukins IL-1 (68%),IL-6 (74%) and tumor necrosis factor TNF-1 (71%) and high sensitive C-reactive protein (hsCRP) (73% of individual). Data revealed two fold increase of high blood pressure and LDL cholesterol level as compared to group B (normal or high T/E ratio and normal or high value of DHEA-S). 2.5 fold higher rate of coronary heart disease (CHD) found in group A versus in group B. We did not found as much significant difference in stroke, carotid and peripheral artery disease. T/E ratio and DHEA-S levels were inversely associated with the age-adjusted risk of a CHD event; the hazard ratios and 95% confidence intervals per standard deviation (SD) increase were 0.76 (0.66 to 0.91) and 0.82 (0.72 to 0.93), respectively.
Conclusions
Decrease ratio of testosterone/estradiol levels correlate decreased levels of DHEA-S which may increase the risk of CHD in men. For future aspect, correction of T/E ratio, DHEA-S and increase its awareness should be at mass level for prevention of CHD.
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Affiliation(s)
- N Sen
- HG SMS Hospital, Jaipur, India
| | | | - A Jain
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | | | - R K Gokhroo
- J L N Medical College, Cardiology, Ajmer, India
| | - A Mehta
- Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - B Kalra
- Artemis Hospital, Cardiology, gurgaon, India
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Sen N, Tanwar S, Jain A, Shetty D, Cherian G, Kalra B, Mehta A. P1463Cardiology, cardiovascular clinical and economical beneficiary outcomes of tele-cardiology, e-audio-visual cardiology and m-cardiology: TEAM study at multi cardiac centre in India. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0228] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Telemedicine has beneficiary aspect to manage health and reduce the burden of illness. It represent health promotion with support of many ways like tele (distance mode), e (electronic mode), audio visual mode and m (mobile or smart phones) mode etc.
Objectives
To evaluate the cardiovascular land economical outcomes of tele-cardiology, e-cardiology, audio-visual cardiology and m-cardiology in large population and to review with increase awareness and application of telemedicine.
Methods
We enrolled 12872 patients from different cardiac centres in india and registered in TEAM (Tele-cardiology, E-cardiology, Audio-visual cardiology and M-cardiology) registry from 2008 to 2018. We included tele diagnosis, tele assistance, tele monitoring, tele therapy, electronic remot media, audio visual media and mobile apps for management of different category of cardiovascular disease like coronary heart and structural heart disease, hypertension, heart failure and congenital heart disorders. We compared TEAM registry with usual group (n=13229) at the platform of beneficiary outcomes regarding diagnostic, therapeutic significance, economical burden, mortality and rate of hospitalization.
Results
Our data revealed that 34% more correction of the diagnosis of congenital heart diseases, 29% reduction of unnecessary transport of acute coronary syndrome and non cardiac chest pain from primary to higher cardiac centre. 38% patients of ST elevation of myocardial infarction were benefited by facilliated angioplasty and 50% mortality risk reduction in TEAM registry as compare usual group. In heart failure patients, 12 months clinical outcomes revealed that there was a significant reduction in rehospitalizations in the TEAM group compared with the usual-care group (19.6% versus 33.7%,) and also found 29% stroke reduction in TEAM group. Usual group showed 2.5 fold higher economical burden than TEAM registry.
Conclusion
Total approach of telemedicine in cardiology service may diagnose correctly at root level, prevent clinical instability, reduce rehospitalization and lower the cost of managing heart patients.
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Affiliation(s)
- N Sen
- HG SMS Hospital, Jaipur, India
| | | | - A Jain
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | - D Shetty
- Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India
| | - G Cherian
- Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India
| | - B Kalra
- Artemis Hospital, Cardiology, gurgaon, India
| | - A Mehta
- Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
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Sen N, Tanwar S, Jain A, Kalra B, Chandra N. P615Role of three-dimensional (3D) speckle-tracking echocardiography (STE) system, using comparison with cardiac magnetic resonance imaging (CMR) and to assess the contribution of regional RV function to. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0224] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Chronic obstructive pulmonary disease may alter right and left ventricular function by changing intrathoracic pressure. Pulmonary hyperinflation may increase right atrial pressure, leading to reduced venous return and subsequent reductions in RV pre-load. In COPD patients, hyperinflation has been directly correlated with reduced atrial chamber size, global RV dysfunction, and reduced LV filling. Accurate assessment of global and regional right ventricular (RV) systolic function is challenging.
Purpose
The aims of this study were to confirm the reliability and feasibility of a three-dimensional (3D) speckle-tracking echocardiography (STE) system, using comparison with cardiac magnetic resonance imaging (CMR), and to assess the contribution of regional RV function to global function.
Methods
In a retrospective, cross-sectional study setting, RV volumetric data were studied in 302 patients who were referred for both CMR and 3D echocardiography within 1 month. Three-dimensional STE-derived area strain, longitudinal strain, and circumferential strain were assessed as global, inlet, outflow, apical, and septal segments.
Results
208 patients (69%) had adequate 3D echocardiographic data. RV measurements derived from 3D STE and CMR were closely related (RV end-diastolic volume, R2=0.88; RV end-systolic volume, R2=0.81; RV ejection fraction [RVEF], R2=0.69; P<0.004 for all). RVEF and RV end-diastolic volume from 3D STE were slightly but significantly smaller than CMR values (mean differences, −2.8% and −7.8 mL for RVEF and RV end-diastolic volume, respectively). Among conventional echocardiographic parameters for RV function (tricuspid annular plane systolic excursion, fractional area change, S' of the tricuspid annulus, RV free wall two-dimensional longitudinal strain), only fractional area change was significantly related to RVEF (r=0.29, P=0.003). Among segmental 3D strain variables, inlet area strain (r=−0.48, P<0.002) and outflow circumferential strain (r=−0.37, P<0.003) were independent factors associated with CMR-derived RVEF.
Conclusions
Regional RV wall motion showed that heterogeneous segmental deformations affect global RV function differently; specifically, inlet area strain and outflow circumferential strain.RV volume and RVEF determined by STE were comparable with CMR measurements. Severity of COPD influences RV systolic dysfunction, which is reflected in speckle tracking 3D echocardiographic parameters.
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Affiliation(s)
- N Sen
- HG SMS Hospital, Jaipur, India
| | | | - A Jain
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | - B Kalra
- Artemis Hospital, Cardiology, gurgaon, India
| | - N Chandra
- All India Institute of Medical Sciences (AIIMS), Cardiology, New Delhi, India
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Sen N, Tanwar S, Jain A, Mehta A, Shah N, Gokhroo RK, Dhall A. P630Role of Indian yoga with pranayam prevent ventricular remodeling and reduce mortality rate according to LV ejection fraction in post PCI patients of STEMI. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0238] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Coronary revascularization is fruitful management to relieve angina and reduce mortality as compare to medical management in significant coronary artery stenosis. Although measurement of left ventricular ejection fraction (LVEF) after acute myocardial infarction (MI) is a performance measure, little is known about the relationship between EF and post-discharge mortality among MI patients in contemporary clinical practice.
Objectives
To assessment of mortality according to left ventricular ejection fraction and compare between yoga group and non yoga group, so that we can evaluate the importance of yoga and pranayam.
Methods
2,470 patients (25 to 68 years of age) with STEMI were registered and managed with percutaneous coronary intervention at three centres from 2010 to 2012. Method was used to assess the association between left ventricular ejection fraction (LVEF) measured during the index hospitalization and 5-year mortality from date of registry. The relationship was examined with EF as a categorical variable, utilizing four clinically relevant categories (EF ≤34%, 35 to 45%, 46 to 54%, and ≥55%), and also with EF as a continuous variable. We divided two groups, group A was yoga with pranayam (n=1470) and group B was normal group (n=1000).
Results
Among STEMI patients we found a graded inverse association between EF category and mortality. For patients relevant categories (EF ≤34%, 35 to 45%, 46 to 54%, and ≥55%) mortality after 5 years was assessed by 21%, 14.3%, 12.2% and 11% in yoga, pranayam group (p<0.004). For patients relevant categories (EF ≤34%, 35 to 45%, 46 to 54%, and ≥55%) mortality after 5 years was assessed by 25%, 17.5%, 14.4% and 13% in normal group (p<0.004). LVEF was increased in yoga & pranayam group by 11±3% versus 4±1% non yoga group.
Conclusion
Yoga and Pranayam; breathing exercise may help to reduce metabolic stress, reduce oxygen demand and prevent ventricular remodeling. Low LVEF after STEMI remains an important risk factor for post-discharge mortality, even after extensive adjustment for patient and hospital characteristics. Routine yoga and pranayam; breathing exercise may reduce the mortality after myocardial infarction.
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Affiliation(s)
- N Sen
- HG SMS Hospital, Jaipur, India
| | | | - A Jain
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | - A Mehta
- Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - N Shah
- Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - R K Gokhroo
- J L N Medical College, Cardiology, Ajmer, India
| | - A Dhall
- Delhi Heart & Lung Hospital, Cardiology, New Delhi, India
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30
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Sen N, Tanwar S, Jain A, Kalra B, Bansal M, Mehta A, Gokhroo RK. P4365Role of 3D speckle-tracking echocardiography system, using comparison with cardiac magnetic resonance imaging and to assess the contribution of regional RV function to global function in COPD patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0770] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Chronic obstructive pulmonary disease may alter right and left ventricular function by changing intrathoracic pressure. Pulmonary hyperinflation may increase right atrial pressure, leading to reduced venous return and subsequent reductions in RV pre-load. In COPD patients, hyperinflation has been directly correlated with reduced atrial chamber size, global RV dysfunction, and reduced LV filling. Accurate assessment of global and regional right ventricular (RV) systolic function is challenging.
Purpose
The aims of this study were to confirm the reliability and feasibility of a three-dimensional (3D) speckle-tracking echocardiography (STE) system, using comparison with cardiac magnetic resonance imaging (CMR), and to assess the contribution of regional RV function to global function.
Methods
In a retrospective, cross-sectional study setting, RV volumetric data were studied in 302 patients who were referred for both CMR and 3D echocardiography within 1 month. Three-dimensional STE-derived area strain, longitudinal strain, and circumferential strain were assessed as global, inlet, outflow, apical, and septal segments.
Results
208 patients (69%) had adequate 3D echocardiographic data. RV measurements derived from 3D STE and CMR were closely related (RV end-diastolic volume, R2=0.88; RV end-systolic volume, R2=0.81; RV ejection fraction [RVEF], R2=0.69; P<0.004 for all). RVEF and RV end-diastolic volume from 3D STE were slightly but significantly smaller than CMR values (mean differences, −2.8% and −7.8 mL for RVEF and RV end-diastolic volume, respectively). Among conventional echocardiographic parameters for RV function (tricuspid annular plane systolic excursion, fractional area change, S' of the tricuspid annulus, RV free wall two-dimensional longitudinal strain), only fractional area change was significantly related to RVEF (r=0.29, P=0.003). Among segmental 3D strain variables, inlet area strain (r=−0.48, P<0.002) and outflow circumferential strain (r=−0.37, P<0.003) were independent factors associated with CMR-derived RVEF.
Conclusions
Regional RV wall motion showed that heterogeneous segmental deformations affect global RV function differently; specifically, inlet area strain and outflow circumferential strain.RV volume and RVEF determined by STE were comparable with CMR measurements. Severity of COPD influences RV systolic dysfunction, which is reflected in speckle tracking 3D echocardiographic parameters.
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Affiliation(s)
- N Sen
- HG SMS Hospital, Jaipur, India
| | | | - A Jain
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | - B Kalra
- Artemis Hospital, Cardiology, gurgaon, India
| | - M Bansal
- Medanta Heart Institute, Cardiology, Gurgaon, India
| | - A Mehta
- Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - R K Gokhroo
- J L N Medical College, Cardiology, Ajmer, India
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Sen N, Tanwar S, Jain A, Kalra B, Mehta A. P1509The novel application of speckle tracking during dobutamine stress echo for assessment of coronary artery diseases. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0271] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Major cause of death across the world is coronary artery disease. The choice of treatment strategy should be primarily based on the hemodynamic significance of coronary artery stenosis. Two-dimensional speckle tracking provides valuable information for regional wall motion abnormalities. The purpose of this study was to determine the diagnostic value of left ventricular longitudinal strain and torsion to diagnose coronary artery disease during dobutamine stress echocardiography.
Purpose
The purpose of this study was to evaluate the diagnostic value of speckle tracking imaging-derived myocardial deformation parameters at rest and during dobutamine stress to determine the hemodynamic significance of coronary artery stenosis in patients with moderate and high probability of CAD.
Methods
We studied 204 patients (mean age 54.2±9.8 years, 128 male and 76 female) with known or suspected coronary artery disease, excluding those with prior history of transmural infarction. All of them underwent dobutamine stress echo and coronary angiography within one month. Wall-motion score index, left ventricular global longitudinal strain and torsion were measured at rest and peak stress. Optimal cut-offs were derived from receiver operating characteristic curves for strain and torsion values. Additionally, the respective differences between rest and stress were also calculated.
Results
During dobutamine stress echocardiography we revealed mean left ventricular ejection fraction was 53±6.2%. Coronary angiography revealed significant stenotic lesions in 124 patients (60.7%). Values regarding sensitivity, and specificity for wall motion score index difference were 76% and 84% respectively (area under curve 0.84). Global longitudinal strain difference (median 0.6%) illustrated 83% sensitivity and 74% specificity for disease detection (area under curve 0.82, cut-off value ≤0.5%). The respective values for torsion difference (median 5.1°) were 84% and 79% (area under curve 0.80, cut-off value ≤5.9°). Combination of wall motion score index difference and torsion difference for disease detection showed 89% sensitivity and 77% specificity (area under curve 0.84).
Conclusions
Left ventricular strain and strain rate analyses during DSE can be used in the assessment of hemodynamic significance of coronary artery stenosis in patients with moderate and high risk for CAD. The implementation of speckle tracking during dobutamine stress echo could serve as an adjunct method for coronary artery disease assessment, providing quantitative diagnostic information.
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Affiliation(s)
- N Sen
- HG SMS Hospital, Jaipur, India
| | | | - A Jain
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | - B Kalra
- Artemis Hospital, Cardiology, gurgaon, India
| | - A Mehta
- Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
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Sen N, Jain A, Tanwar S, Gokhroo R. PO173 Assessment of Angina After Percutaneous Coronary Intervention In Obese Versus Non Obese Patient. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.152] [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: 11/28/2022] Open
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33
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Sen N, Jain A, Tanwar S, Gokhroo R. PO088 Combination of Ivabradine With Low Dose of Bisoprolol Versus Optimized Dose of Bisoprolol Alone In Chronic Heart Failure Patients With Chronic Lung Disease and Risk Reduction of Stroke. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.107] [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: 11/17/2022] Open
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34
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Sen N, Jain A, Tanwar S, Gokhroo R. PO172 Cardiovascular Outcomes of Clopidogrel Versus Prasugrel and Ticagrelor In Women With Sub Clinical Hypothyroidism and ST Elevation Myocardial Infarction. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.151] [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: 11/24/2022] Open
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35
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Tanwar S, Sen N, Jain A, Gokhroo RK, Mehta A. P1535Multicentric analysis of adverse cardiovascular events in cocaine abuse patients in india. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1535] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Tanwar
- HG SMS Hospital, Preventive Cardiology, Jaipur, India
| | - N Sen
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | - A Jain
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | - R K Gokhroo
- J L N Medical College, Cardiology, Ajmer, India
| | - A Mehta
- Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
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36
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Sen N, Tanwar S, Jain A. P4488Evaluation of heart rate variability and cardiac autonomic control on exposure to Indian music and slow music yoga asana before sleep at night. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4488] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- N Sen
- Narayana Hrudayalaya, Cardiology, Jaipur, India
| | - S Tanwar
- HG SMS Hospital, Cardiology, Jaipur, India
| | - A Jain
- Narayana Hrudayalaya, Cardiology, Jaipur, India
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37
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Trembling PM, Apostolidou S, Gentry-Maharaj A, Parkes J, Ryan A, Tanwar S, Burnell M, Menon U, Rosenberg WM. Association between skirt size and chronic liver disease in post-menopausal women: a prospective cohort study within the United Kingdom Trial of Ovarian Cancer Screening (UKCTOCS). BMC Public Health 2018; 18:409. [PMID: 29587697 PMCID: PMC5870222 DOI: 10.1186/s12889-018-5308-x] [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] [Received: 09/25/2017] [Accepted: 03/13/2018] [Indexed: 11/25/2022] Open
Abstract
Background We investigated the association between self-reported skirt size (SS) and change in SS, and incidence of chronic liver disease (CLD) in a prospective cohort study of women recruited to the UKCTOCS trial. Methods Women recruited to UKCTOCS in England without documented CLD self-reported their current UK SS during trial participation and were asked to recall their SS when aged in 20s (via completion of a questionnaire 3–5 years after recruitment). Participants were followed up via electronic health record linkage and hazard ratios (HR) calculated for incident liver-related events (LRE). Results Three hundred twenty-two (0.3%) of 94,124 women experienced a first LRE. Compared to SS ≤ 16, rates of LRE were higher in the SS ≥ 18 groups (both when aged in 20s and at questionnaire completion). Event rates were higher if there was no change in SS or an increase in SS, compared to a decrease in SS. In the models adjusted for potential confounders, HRs for LRE were higher in the groups of women reporting SS ≥ 18 both when aged in 20s (HR = 1.39 (95% CI; 0.87–2.23)) and at questionnaire completion (HR = 1.37 (95% CI; 1.07–1.75)). Compared to a decrease in SS, HRs were higher in the no change (HR = 1.78 (95% CI; 0.95–3.34)) and increase (HR = 1.80 (95% CI; 1.01–3.21)) groups. Conclusion CLD is associated with high SS and an increase in SS over time. These data suggest SS can be used in simple public health messages about communicating the risk of liver disease. Trial Registration UKCTOCS is registered as an International Standard Randomised Controlled Trial, number ISRCTN22488978. Registered 06/04/2000. Electronic supplementary material The online version of this article (10.1186/s12889-018-5308-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- P M Trembling
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK.
| | - S Apostolidou
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - A Gentry-Maharaj
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - J Parkes
- Public Health Sciences and Medical Statistics, Faculty of Medicine, University of Southampton, Southampton, UK
| | - A Ryan
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - S Tanwar
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK
| | - M Burnell
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - U Menon
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - W M Rosenberg
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK
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38
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Tanwar S, Sen N, Cherian G. P2489Integrated approach of allopathy plus alternative therapy in primary and secondary pervention for common cardiovascular disorders. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2489] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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39
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Bhatia R, Mattoo B, Tanwar S, Jain S, Kumar U, Bhatia R. Transcranial magnetic stimulation of dorsolateral prefrontal cortex in chronic pain management. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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40
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Trembling PM, Lampertico P, Parkes J, Tanwar S, Viganò M, Facchetti F, Colombo M, Rosenberg WM. Performance of Enhanced Liver Fibrosis test and comparison with transient elastography in the identification of liver fibrosis in patients with chronic hepatitis B infection. J Viral Hepat 2014; 21:430-8. [PMID: 24750297 PMCID: PMC4298014 DOI: 10.1111/jvh.12161] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Assessment of liver fibrosis is important in determining prognosis, disease progression and need for treatment in patients with chronic hepatitis B (CHB). Limitations to the use of liver biopsy in assessing fibrosis are well recognized, and noninvasive tests are being increasingly evaluated including transient elastography (TE) and serum markers such as the Enhanced Liver Fibrosis (ELF) test. We assessed performance of ELF and TE in detecting liver fibrosis with reference to liver histology in a cohort of patients with CHB (n = 182), and compared the performance of these modalities. Median age was 46 and mean AST 70 IU/L. Cirrhosis was reported in 20% of liver biopsies. Both modalities performed well in assessing fibrosis at all stages. Area under receiver operator characteristic (AUROC) curves for detecting METAVIR fibrosis stages F ≥ 1, F ≥ 2, F ≥ 3 and F4 were 0.77, 0.82, 0.80 and 0.83 for ELF and 0.86, 0.86, 0.90 and 0.95 for TE. TE performed significantly better in the assessment of severe fibrosis (AUROC 0.80 for ELF and 0.90 for TE, P < 0.01) and cirrhosis (0.83 for ELF and 0.95 for TE, P < 0.01). This study demonstrates that ELF has good performance in detection of liver fibrosis in patients with CHB, and when compared, TE performs better in detection of severe fibrosis/cirrhosis.
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Affiliation(s)
- P M Trembling
- Institute for Liver and Digestive Health, Division of Medicine, University College LondonLondon, UK
| | - P Lampertico
- AM and A Migliavacca Center for Liver Disease, 1st Division of Gastroenterology, Department of Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di MilanoMilan, Italy
| | - J Parkes
- Public Health Sciences and Medical Statistics, Faculty of Medicine, University of SouthamptonSouthampton, UK
| | - S Tanwar
- Institute for Liver and Digestive Health, Division of Medicine, University College LondonLondon, UK
| | - M Viganò
- AM and A Migliavacca Center for Liver Disease, 1st Division of Gastroenterology, Department of Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di MilanoMilan, Italy,UO Epatologia, Ospedale San Giuseppe, Università degli Studi di MilanoMilan, Italy
| | - F Facchetti
- AM and A Migliavacca Center for Liver Disease, 1st Division of Gastroenterology, Department of Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di MilanoMilan, Italy
| | - M Colombo
- AM and A Migliavacca Center for Liver Disease, 1st Division of Gastroenterology, Department of Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di MilanoMilan, Italy
| | - W M Rosenberg
- Institute for Liver and Digestive Health, Division of Medicine, University College LondonLondon, UK
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41
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Abstract
The availability of the direct-acting antiviral agents (DAAs) boceprevir and telaprevir provides improved treatment outcomes for many patients infected with hepatitis C virus (HCV) genotype 1. However, HCV infection must first be identified before a decision on treatment can be made and currently many patients remain unaware that they have the virus. Given the lack of prompt diagnosis, disease severity should be determined as a baseline reference for treatment, and novel non-invasive techniques for evaluating fibrosis are now available. For patients receiving a DAA regimen, response-guided therapy based on the detection, absence or level of HCV RNA at specified time points is required to achieve an optimal treatment outcome. Knowledge of the test used to measure HCV RNA and its analytical sensitivity, as well as how to interpret the results correctly, are therefore required to administer therapy appropriately. Furthermore, effective treatment management includes appropriate handling of side effects. This increased complexity associated with DAA regimens has resulted in confusion over many aspects of care, including treatment monitoring, viral load result interpretation and the optimal duration of therapy. These issues are discussed here in addition to the benefits of referring patients infected with HCV to a specialist centre.
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Affiliation(s)
- W M Rosenberg
- MA, MBBS, DPhil, FRCP, UCL Institute for Liver & Digestive Health, Division of Medicine, University College London, Royal Free Campus, Rowland Hill Street, Hampstead, London NW3 2PF, UK.
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42
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Abstract
Bouveret's syndrome, first described in 1896 by Léon Bouveret, is rare, limited to approximately 200 published case reports to date [Ariche et al.: Scand J Gastroenterol 2000;35:781–783]. It is a subgroup of gallstone ileus in which a cholecystoduodenal fistula allows the passage of a gallstone that obstructs the duodenum, causing gastric outlet obstruction. This case is unique as it describes Bouveret's syndrome in a patient with combined cholecystoduodenocolic fistulae. Gastric outlet obstruction was successfully managed endoscopically with lithotripsy. Both fistulae were subsequently managed conservatively without any complications.
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Affiliation(s)
- S Tanwar
- Colchester Hospital University, Colchester, UK
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