34 research outputs found
Trans-radial interventions – From ‘Bandwagon’ to ‘Movement’: Where we were; where we are and where do we go from here…
No full textHow to tackle complications in radial procedures: Tip and tricks
No full textAbstractTransradial interventions (TRI) are becoming increasingly popular because of accumulating recent evidence suggesting improved survival and reduced morbidity. Complications, though rare, do occur, especially for operators on their learning curve. The complications are best prevented by utilization of proper technique. Forearm hematoma are preventable and easy to treat, but a delay in detecting and managing them can lead to disastrous consequences compartment syndrome being the most dreaded one. This review deals with tips and tricks to prevent as also treat the common and rare complications
Distal Radial Artery Access (DRA) Vs. Transradial Access (TRA): Current Evidence
No full textIntroduction: Transradial access (TRA) is currently recommended over the transfemoral (TFA)route as default, for percutaneous coronary interventions (PCI) and coronary angiography in allpatients, by the European and American Guidelines, because of reduced risk of bleeding, vascularcomplications and mortality especially in acute and high -risk patients.
Aims and objectives: Distalradial artery access (DRA) via the anatomical snuffbox is a safe and feasible alternative to standardtransradial access (TRA). This review aims to study and discuss the endpoints in recent studiescomparing DRA with TRA for coronary procedures to conclude the merits and demerits of DRA Vs.TRA.
Material and Methods: The evidence from several randomized and non-randomized studiesand meta-analyses comparing DRA with TRA is reviewed. Results: Though access failures andcrossovers are reported to be higher with DRA compared to TRA; most studies have shown nodifference in vascular complications in patients undergoing procedures via DRA or TRA.
Results ofsome randomized controlled trials between DRA Vs. TRA for coronary procedures, including PrimaryPercutaneous Coronary Intervention in ST-elevation myocardial infarction (STEMI) are available andare discussed; while others are underway for evaluation of radial artery occlusion (RAO) and otherend-points.
Conclusion: DRA takes more time, and fails more often compared to TRA; though timeto hemostasis is less and forearm hematoma is unreported with DRA. The Jury is still out on RAObetween DRA Vs. TRA; but the meticulous application of RAO prevention practices is the key toachieving low RA
Weakly compatible maps in 2-non-Archimedean Menger PM-spaces
No full textThe aim of this paper is to introduce the concept of weakly compatible maps in 2-non-Archimedean Menger probabilistic metric (PM) spaces and to prove a theorem for these mappings without appeal to continuity. We also provide an application
Convergence of Infinite Family of Multivalued Quasi-Nonexpansive Mappings Using Multistep Iterative Processes
No full textWe prove strong and weak convergence results using multistep iterative sequences for countable family of multivalued quasi-nonexpansive mappings by using some conditions in uniformly convex real Banach space. The results presented extended and improved the corresponding result of Zhang et al. (2013), Bunyawat and Suantai (2012), and some others from finite family, one countable family, and two countable families to k-number of countable families of multivalued quasi-nonexpansive mappings. Also we used a numerical example in C++ computational programs to prove that the iterative scheme we used has better rate of convergence than other existing iterative schemes
Feasibility and utility of pre‐procedure ultrasound imaging of the arm to facilitate transradial coronary diagnostic and interventional procedures (PRIMAFACIE‐TRI)
No full textA Low-Cost Point-of-Care Testing System for Psychomotor Symptoms of Depression Affecting Standing Balance: A Preliminary Study in India.
No full textInternational audienceThe World Health Organization estimated that major depression is the fourth most significant cause of disability worldwide for people aged 65 and older, where depressed older adults reported decreased independence, poor health, poor quality of life, functional decline, disability, and increased chronic medical problems. Therefore, the objectives of this study were (1) to develop a low-cost point-of-care testing system for psychomotor symptoms of depression and (2) to evaluate the system in community dwelling elderly in India. The preliminary results from the cross-sectional study showed a significant negative linear correlation between balance and depression. Here, monitoring quantitative electroencephalography along with the center of pressure for cued response time during functional reach tasks may provide insights into the psychomotor symptoms of depression where average slope of the Theta-Alpha power ratio versus average slope of baseline-normalized response time may be a candidate biomarker, which remains to be evaluated in our future clinical studies. Once validated, the biomarker can be used for monitoring the outcome of a comprehensive therapy program in conjunction with pharmacological interventions. Furthermore, the frequency of falls can be monitored with a mobile phone-based application where the propensity of falls during the periods of psychomotor symptoms of depression can be investigated further
Correlation of the telomere length with type 2 diabetes mellitus in patients with ischemic heart disease
No full textObjective: The study aimed to explore the relationship of the telomere length with type 2 diabetes mellitus (DM) among patients with ischemic heart disease (IHD). Method: This 2-year cross-sectional study included 130 male patients diagnosed with IHD through echocardiography and coronary angiography, wherein consecutive IHD patients with type 2 DM (65) and without type 2 DM (65) were selected. Baseline characteristics including age, gender, body mass index, and blood pressure were recorded. Laboratory investigations such as random blood sugar (RBS), fasting lipid profile, serum creatinine, and serum urea levels were measured. Quantitative real-time polymerase chain reaction was used for the measurement of the telomere length. The logistic regression analysis was used to predict the relationship of the telomere length with age and type 2 DM among patients with IHD. Results: All the patients in the study were men, and most of them (diabetics = 22; nondiabetics = 20) were aged between 56 and 65 years. Age (p = 0.003), telomere length (p < 0.001), RBS (p < 0.001), serum creatinine (p < 0013), and serum urea (p < 0.04) were significantly higher in the diabetic subset than in the nondiabetic subset. No significant relationship was observed between age and the telomere length (p = 0.813); however, the mean telomere length was significantly high among the patients with type 2 DM than those without type 2 DM (p = 0.005). The logistic regression analysis showed that the telomere shortening (p = 0.00019) and RBS (p < 0.0001) were the significant risk factors for type 2 DM in patients with IHD. Conclusion: The telomere shortening was significantly correlated with type 2 DM among the patients with IHD. However, multicentric studies with larger samples are required to validate the current observation. Keywords: Diabetes, Ischemic heart disease, qRT-PCR, Telomere, Telomere lengt
Comparison of distal radial access versus standard transradial access in patients with smaller diameter radial Arteries(The distal radial versus transradial access in small transradial ArteriesStudy: D.A.T.A - S.T.A.R study).
No full textAIMS: To evaluate safety and efficacy of distal right radial access (DRRA) compared to right radial access (RRA), for coronary procedures, in patients with smaller diameter radial arteries (SDRA) (radial artery diameter (RAD) < 2.1 mm). METHODS AND RESULTS: This is a retrospective analysis of safety and efficacy of DRRA Vs. RRA in patients undergoing coronary procedures at our cardiac catheterization laboratories over a 10- month period between September 2017 and June, 2018 (first 5 calendar months with RRA-first; next 5 calendar months with DRRA-first). All patients underwent pre-procedure ultrasound of arm arteries. All patients had RAD<2.1 mm (mean RAD 1.63 ± 0.27 mm; RAD=1.6 mm in 73.5%). Baseline characteristics were similar between groups. Primary end-point of puncture success was significantly lower in DRRA vs RRA group [79.5% vs 98.5%, p < 0.0001]. Puncture success was also lower in the subgroup of patients with RAD <1.6 mm Vs. = 1.6 mm in the DRRA group (p < 0.0001). The secondary end-point of puncture time was significantly higher (2.1 ± 1.4 min vs. 1.0 ± 0.45 min, p < 0.00001) in the DRRA Vs. RRA group. The occurrence of vascular access site complications (including access site hematomas), radial artery occlusion (RAO) and distal RAO at day 1 and day 30 were similar between RRA and DRRA groups.Non-vascular access-site complication was seen only in the DRRA group. CONCLUSION: DRRA is a safe and effective access for coronary procedures; though technically challenging in patients with SDRA (RAD<2.1 mm; mean RAD 1.63 ± 0.27 mm), with lower puncture success and higher puncture time compared to RRA
