Impact of capacity building and tele ECG based decision support on change in thrombolysis rate and inhospital and one year mortality in patients with STEMI, using hub and spoke model; multi-phasic intervention trial.

Background: We report the impact of capacity building and teleconsultation on change in the thrombolysis rates and one-year mortality in patients with STEMI using a hub and the spoke model of STEMI care.

Methods: Twenty secondary care public hospitals were linked with a teaching hospital as a hub centre and the impact of the intervention on change in ischemic time, thrombolysis rates and all-cause in-hospital and one-year mortality was compared.

Results: 29 patients with STEMI were treated during pre-intervention from April 2020 to June 2020 and 255 patients during the post-intervention period from July 2020 to Oct 2021 in spoke centres.

A Comprehensive Insight and Mechanistic Understanding of the Lipidomic Alterations Associated With DCM.

Dilated cardiomyopathy (DCM) is one of the major causes of heart failure characterized by the enlargement of the left ventricular cavity and contractile dysfunction of the myocardium. Lipids are the major sources of energy for the myocardium. Impairment of lipid homeostasis has a potential role in the pathogenesis of DCM.

Isolated pulmonary valve endocarditis with pulmonary annular abscess in a patient of Noonan syndrome.

Right-sided endocarditis is a rare entity, with various series reporting an incidence of 5%-10%. Pulmonary valve (PV) is not only the least commonly involved valve in infective endocarditis (IE), with an incidence of 1.5%-2%, but 'isolated' pulmonic valve endocarditis (PVE) without tricuspid valve involvement is even rarer with limited published data.

Role of omega 3 and omega 6 poly unsaturated fatty acids (PUFA) and vitamin D deficiency as risk determinants of metabolic syndrome in obesity: Worksite based case-control observational study.

Background And Aims: Risk factors for metabolic syndrome among obese population are not clear. The role of Eicosapentaenoic acid (EPA), Arachidonic acid (AA) Poly Unsaturated Fatty Acids (PUFA), their ratio and vitamin D deficiency as risk factors of metabolic syndrome (MS) was explored in obese worksite workers.

Methods: The 145 obese worksite workers were enrolled and MS was diagnosed using adult treatment panel III criteria.

Structured Lifestyle Modification Interventions Involving Frontline Health Workers for Population-Level Blood Pressure Reduction: Results of a Cluster Randomized Controlled Trial in India (DISHA Study).

Background Population-wide reduction in mean blood pressure is proposed as a key strategy for primary prevention of cardiovascular disease. We evaluated the effectiveness of a task-sharing strategy involving frontline health workers in the primary prevention of elevated blood pressure. Methods and Results We conducted DISHA (Diet and lifestyle Interventions for Hypertension Risk reduction through Anganwadi Workers and Accredited Social Health Activists) study, a cluster randomized controlled trial involving 12 villages each from 4 states in India.

Assessment of the impact of heart failure on household economic well-being: a protocol.

Heart failure (HF), which is an emerging public health issue, adversely affects the strained health system in India. The adverse impact of HF on the economic well-being has been narrated in various anecdotal reports from India, with affected individuals and their dependents pushed into the vicious cycle of poverty. There is limited research quantifying how HF impacts the economic well-being of households from low- and middle-income countries.

Long term outcomes in patients with RF/RHD: Eight-year follow-up of HP-RF/RHD (Himachal Pradesh Rheumatic Fever/Rheumatic Heart Disease) registry in a Northern Indian state.

Background: The long-term outcome data in patients with rheumatic fever/rheumatic heart disease (RF/RHD) is limited. We report the cumulative incidence of adverse outcomes in a cohort of RHD patients from a northern state of India at a median follow-up of 5.4 years.

Nasal Polyposis and Its Association with Cardiac Functions.

Objective: The aim of the study was to ascertain the effect of nasal polyposis on cardiac functions.

Material And Methods: A prospective randomized interventional open-label endpoint-controlled study was conducted in an academic tertiary care hospital. Thirty-one patients with chronic rhinosinusitis with nasal polyposis were enrolled and administered fluticasone furoate nasal spray for 3 weeks before randomly segregation into surgical or medical group.

Impact of School-Based Health Behavioral Intervention on Awareness, Practice Pattern of Healthy Lifestyle, and Cardiometabolic Risk Factors among School Children of Shimla: A Cluster-Randomized, Intervention Study.

Objectives: To assess the impact of multicomponent intervention on knowledge and practice of health behaviors among school children. The secondary objective was to assess mean change in cardiometabolic risk factors such as anthropometric measurements and biochemical profile.

Methods: A cluster-randomized, controlled trial was conducted among adolescents aged 13-18 y from government and private senior secondary schools in Shimla city.

Gender differences in the epidemiology of Rheumatic Fever/Rheumatic heart disease (RF/RHD) patient population of hill state of northern India; 9 years prospective hospital based, HP-RHD registry.

Objectives: We report the gender-based differences in the prevalence, severity, pattern of valvular involvement, and complications in patients with Rheumatic Fever/Rheumatic heart disease (RF/RHD).

Methods: The 2475 consecutive patients with RF/RHD diagnosed using clinical and echocardiographic criteria were registered prospectively from January 2011 till December 2019. The association of gender with the pattern of valvular involvement, nature, and severity of valvular dysfunction and cardiovascular complications was analyzed using a logistic regression model, and odds ratios with 95% CI were estimated.

The role of natriuretic peptide estimation in severe COVID-19.

Since its inception in Wuhan in December 2019, Coronavirus disease 2019 (COVID-19) has shattered the economies and health-care infrastructures worldwide. Even the best of health-care systems (United States, Italy) have been overwhelmed and collapsed because of this unprecedented pandemic. India is preparing itself for the onslaught of Coronavirus.

Yoga-Based Cardiac Rehabilitation After Acute Myocardial Infarction: A Randomized Trial.

Background: Given the shortage of cardiac rehabilitation (CR) programs in India and poor uptake worldwide, there is an urgent need to find alternative models of CR that are inexpensive and may offer choice to subgroups with poor uptake (e.g., women and elderly).

School-based surveillance for detection of children with acute pharyngitis, rheumatic fever/rheumatic heart disease in Shimla district, Himachal Pradesh, India-A cluster randomized controlled trial.

Background: The lack of surveillance system is a major barrier in prevention and control of rheumatic fever/rheumatic heart disease (RF/RHD). Efficacy of school-based surveillance was evaluated for detection of acute pharyngitis and RF/RHD in Shimla district, HP.

Methods: The schools in district Shimla were randomly assigned to intervention and controlled arm (442 vs.

Clinical Characteristics, Complications, and Treatment Practices in Patients With RHD: 6-Year Results From HP-RHD Registry.

Background: Despite the high prevalence of rheumatic heart disease (RHD) in developing countries such as India, data on characteristics, complications, and treatment practices are lacking. The HP-RHD (Himachal Pradesh Rheumatic Heart Disease) registry aimed at reporting these parameters in patients with RHD from a northern state of India.

Methods: A total of 2,005 consecutive patients of RHD were enrolled over a period of 6 years (2011 to 2016) in the present study.

Study of Left Ventricular Mass and Its Determinants on Echocardiography.

Introduction: Increased Left Ventricular Mass (LVM) is an independent risk factor for cardiovascular morbidity and mortality.

Aim: This study was done to find the prevalence and determinants of LVM in the Northern Indian population.

Materials And Methods: A prospective cross-sectional observational study was carried out in a tertiary care centre in Himachal Pradesh, India and the study population included all consecutive patients fulfilling the inclusion criteria attending cardiology OPD on seeking medical attention with various symptoms for dyslipidaemia, hypertension but not on medication over a period of one year.

Gender differences in the management of acute coronary syndrome patients: One year results from HPIAR (HP-India ACS Registry).

Introduction: Data from high-income countries suggest that women receive less intensive diagnostic and therapeutic management than men for acute coronary syndrome (ACS). There is a paucity of such data in the Indian population, which is 69% rural and prior studies focused mostly on urban populations. The objective of the present study was to identify the gender based differences in ACS management, if any, in a predominantly rural population.

Smartphone-based tele-electrocardiography support for primary care physicians reduces the pain-to-treatment time in acute coronary syndrome.

Background The Himachal Pradesh state acute coronary syndrome registry recorded a median delay of 13 h between the time of onset of pain to the time of making the diagnosis and giving treatment for acute coronary syndrome. We conducted a pilot study on providing 24-h tele-electrocardiography (Tele-ECG) services in the district Kangra of Himachal Pradesh, with the aim to reduce the time taken for diagnosis of acute coronary syndrome. Methods The intervention group for the study included eight rural community health centres, each with one to three primary care physicians, who were all unskilled in electrocardiogram interpretation.