Variations in coronary artery diameter: a retrospective observational study in Indian population

Objective: The diameter of coronary arteries varies greatly among general population. The knowledge of variations in coronary arteries helps the clinicians to define abnormalities and plan the treatment. Hence, the present study was aimed to study common primary variations of coronary arteries by angiography in Indian population. Methods: The data for this unicenter, retrospective, observational study was collected from general hospital, Maharashtra, as patient data sheets and coronary angiograms (CAG) reports for a period of 1 year and 8 months. The CAG were studied for variations in main trunk diameter of coronary arteries and range of diameters of coronary arteries. Results: A total of 400 conventional CAGs were observed, of which 17 angiograms showed anatomical variations. The diameter of left coronary artery was more than right coronary artery (RCA) in 90.5% and less in 9.5% of CAGs. Statistically significant difference was observed on comparing the mean diameter of RCA (3.40(0.81 mm) and left coronary artery (4.52(0.95 mm; p<0.001). The range of diameter of RCA (1.8 to 6.2 mm) and left coronary artery differed significantly (2 to 7.3 mm; p <0.001). Conclusion: From the results, it was evident that the diameter of left coronary artery was larger than right coronary artery in majority of CAGs

Influence of ice rheology and dust content on the dynamics of north-polar cap of Mars

The evolution and dynamics of the north-polar cap (residual-ice-cap/layered-deposits complex) of Mars is simulated with a thermomechanical ice-sheet model. We consider a scenario with ice-free initial conditions at 5 Ma before present due to the large obliquities which prevailed prior to this time. The north-polar cap is then built up to its present shape, driven by a parameterized climate forcing (surface temperature, surface mass balance) based on the obliquity and eccentricity history. The effects of different ice rheologies and different dust contents are investigated. It is found that the build-up scenarios require an accumulation rate of approximately 0.15–0.2 mm a−1 at present. The topography evolution is essentially independent of the ice dynamics due to the slow ice flow. Owing to the uncertainties associated with the ice rheology and the dust content, flow velocities can only be predicted within a range of two orders of magnitude. Likely present values are of the order of 0.1–1 mm a−1, and a strong variation over the climatic cycles is found. For all cases, computed basal temperatures are far below pressure melting

Evolution of the north-polar cap of Mars : a modelling study

Celestial-mechanical computations show that, even stronger than for Earth, Mars is subject to Milanković cycles, that is, quasi-periodic variations of the orbital parameters obliquity, eccentricity and precession. Consequently, solar insolation varies on time-scales of 104–105 years. It has long been supposed that this entails climatic cycles like the terrestrial glacialinterglacial cycles. This hypothesis is supported by the light-dark layered deposits of the north- and south-polar caps indicating a strongly varying dust content of the ice due to varying climate conditions in the past. This study aims at simulating the dynamic and thermodynamic evolution of the north-polar cap (NPC) of Mars with the ice-sheet model SICOPOLIS. The boundary conditions of surface accumulation, ablation and temperature are derived directly from the solar-insolation history by applying the newly developed Mars Atmosphere-Ice Coupler MAIC. We consider steady-state scenarios under present climate conditions as well as transient scenarios over climatic cycles. It is found that the NPC is most likely not in steady state with the present climate. The topography of the NPC is mainly controlled by the history of the surface mass balance. Ice flow, which is of the order of 1 mma−1, plays only a minor role. In order to build up the present cap during the last five million years of relatively low obliquities, a present accumulation rate of ≥ 0.25 mm water equiv. a−1 is required. Computed basal temperatures are far below pressure melting for all simulations and all times

Estimation of tuberculosis incidence at subnational level using three methods to monitor progress towards ending TB in India, 2015–2020

Objectives We verified subnational (state/union territory (UT)/district) claims of achievements in reducing tuberculosis (TB) incidence in 2020 compared with 2015, in India.Design A community-based survey, analysis of programme data and anti-TB drug sales and utilisation data.Setting National TB Elimination Program and private TB treatment settings in 73 districts that had filed a claim to the Central TB Division of India for progress towards TB-free status.Participants Each district was divided into survey units (SU) and one village/ward was randomly selected from each SU. All household members in the selected village were interviewed. Sputum from participants with a history of anti-TB therapy (ATT), those currently experiencing chest symptoms or on ATT were tested using Xpert/Rif/TrueNat. The survey continued until 30 Mycobacterium tuberculosis cases were identified in a district.Outcome measures We calculated a direct estimate of TB incidence based on incident cases identified in the survey. We calculated an under-reporting factor by matching these cases within the TB notification system. The TB notification adjusted for this factor was the estimate by the indirect method. We also calculated TB incidence from drug sale data in the private sector and drug utilisation data in the public sector. We compared the three estimates of TB incidence in 2020 with TB incidence in 2015.Results The estimated direct incidence ranged from 19 (Purba Medinipur, West Bengal) to 1457 (Jaintia Hills, Meghalaya) per 100 000 population. Indirect estimates of incidence ranged between 19 (Diu, Dadra and Nagar Haveli) and 788 (Dumka, Jharkhand) per 100 000 population. The incidence using drug sale data ranged from 19 per 100 000 population in Diu, Dadra and Nagar Haveli to 651 per 100 000 population in Centenary, Maharashtra.Conclusion TB incidence in 1 state, 2 UTs and 35 districts had declined by at least 20% since 2015. Two districts in India were declared TB free in 2020