Angiographic patency of streptokinase in STEMI patients: smokers vs. non-smokers

Background: Acute coronary syndrome is one of the leading causes of death. Smoking is known to be associated  with many influencing factors for accelerating Myocardial Infarction (MI). In a country like India, Streptokinase (SK) is used as a leading therapeutic option for the treatment of ST elevation myocardial Infarction (STEMI). SK combines with plasminogen; this SK-plasminogen complex is responsible for fibrinolysis. The aim of this study was to determine angiographic patency after SK infusion in STEMI patients and comparison between smokers and non-smokers.Methods: In this observational, prospective and single-centre study conducted between September 2011 and April 2012, a total of 398 patients who were diagnosed with STEMI were included. Patients were divided in two groups i.e. smokers and non-smokers. The patients were treated with thrombolytic (streptokinase) therapy and evaluated for TIMI 3 flow by performing angiography within 72hours of thrombolysis with SK.Results: Of total 398 patients, 348 (87.4%) were male. The ratio of non-smokers and smokers was 1:2. Smokers were younger than the non-smokers (48.8±10.2 vs. 54.57±9.51). Post thrombolytic therapy, patients were evaluated for TIMI flow grades. Total of 202 patients achieved TIMI 3 flow, of which 157 were smokers and 45 were non-smokers.Conclusions: Smokers have relatively hypercoagulable state than non-smokers. Better outcome in smokers group may be because of younger age and lesser comorbidities. Smokers should be motivated and guided properly to quit smoking

Clinical course and prognosis of dilated cardiomyopathy in children

Background: Epidemiology and clinical course of dilated cardiomyopathy (DCM) in children and infants are not well established. Thus, this study aims to investigate the clinical course and prognosis of DCM in childrenMethods: This was a single-center, prospective, observational study conducted at a tertiary-care center in India between February 2011 and September 2012. A total of 31 patients admitted to the paediatric department diagnosed with DCM were included in the study. Patients were divided into three groups based on the age at the time of diagnosis: 0-3 years, >3-12 years and >12-16 years. Among the study population, 28 patients were followed up for a mean period of 1.44 years and three patients were lost to follow-up.Results: Of the 31 patients, 11 patients were male with a mean age of 8.9±6 years and 20 patients were female with a mean age of 8.3±6 years. All patients were presented with same characteristics of New York heart association (NYHA) class III-IV dyspnoea and fatigue. Among 28 patients who were followed-up for a mean period of 1.44 years, 20(71.4%) patients died and eight patients were on follow up. Of the eight patients, five patients were with NYHA class III symptoms and three patients were with NYHA class I-II symptoms.Conclusions: Dilated cardiomyopathy in children is a very serious disease with a grave prognosis. Patients with NYHA III-IV symptoms have a very high mortality rate and potential use of other therapies remains to be fully evaluated in paediatric population

Trepopnoea due to aneurysm of the descending thoracic aorta compressing the heart: an unusual occurrence

Energetski pregled zgrade služi za prikupljanje podataka s ciljem utvrđivanja učinkovitosti i/ili neučinkovitosti potrošnje energije i vode te donošenja zaključaka i preporuka za poboljšanje energetske učinkovitosti. Analizom prikupljenih podataka odabiru se konkretne ekološke i energetske optimalne mjere za poboljšanje energetskih svojstava zgrade te mjere nužne za zadovoljavanje minimalnih tehničkih uvjeta. Sve predložene mjere moraju biti u skladu s hrvatskim propisima te normama. Za postizanje i održavanje toplinske ugodnosti potrebno je nadoknaditi sve toplinske gubitke (transmisijske i ventilacijske) a istodobno potrošiti što manje energije. Transmisijski gubici direktno su ovisni o gradbenim materijalima vanjske ovojnice zgrade odnosno vrijednosti koeficijenta prolaska topline. Stoga je u ovom radu izvršena analiza koeficijenta prolaske topline, troškova gradbenih materijala i potrebne energije za grijanje.An energy audit of a building is used to collect data with determination and / or inefficiency of energy and water consumption and to draw conclusions and recommendations for increasing energy costs. By analyzing the data collected, specific environmental and energy optimal measures are selected to improve the energy performance of buildings, which measures are necessary to satisfy the minimum technical requirements. All proposed measures must comply with the Croatian regulations of that standard. In order to achieve and maintain thermal comfort, it is necessary to compensate for all heat losses (transmission and ventilation) while consuming as little energy as possible. Transmission losses are directly dependent on the building materials of the outer envelope of the building or the value of the heat transfer coefficient. Therefore, in this paper, an analysis of the heat transfer coefficient, the cost of building materials and the energy required for heating was performed