Depression as a Risk Factor for Coronary Artery Disease: Myth or Verity

Objectives: To determine the frequency of depression in patients with ischemic heart disease, subgroup analysis of prevalence of depression in patients with heart failure, acute STEMI and non STEMI-ACS and the effect of hospital stay and treatment of primary cardiac illness on depression scores.Methodology: All patients with heart failure, acute STEMI and non STEMI-ACS, presenting to cardiology clinics over a period of March-August, 2016 with a pre-calculated sample size were enrolled into the study by consecutive sampling. HAM-D questionnaire was administered at the time of hospital admission and discharge. SPSS was used for data analysis.Results: A total of 102 patients were included in the study out of which 47 (46%) were females and 55 (54%) were males. The mean age of the study population was 49.5±12 years. At the time of admission, 91/102 (89.2%) patients were found to be depressed, 32 (31.4%) had mild depression, 29 (28.4%) had moderate depression, 10 (9.8%) had severe depression and an alarming number (20 i.e. 19.6%) patients had very severe depression. At the time of discharge, 82/102 (80.3%) patients were found to be depressed, 35 (34.3%) had mild depression, 31 (30.4%) had moderate depression, 12 (11.8%) had severe depression and only 4 (3.9%) had very severe depression. The mean change in HAM-D score during hospital admission was -3.24±4 (Maximum +26, minimum -23). The difference in depression scores during hospital stay tended to inversely correlate with length of hospital stay. A greater proportion of patients with the diagnosis of STEMI had a severe or very severe depression.Conclusion: Depression was found to be alarmingly prevalent in acute coronary syndrome affectees and hospital stay and treatment led to a mean fall in the depression scores

Precipitants of Acute Decompensated Heart Failure and their Correlation with the Severity of Decompensation in a Resource Poor Country

Objective: 1. To determine the frequency of various factors (patient related, disease related and physician related), causing immediate precipitation of congestive cardiac failure in a tertiary care hospital. 2. To establish correlation between these variables and severity of decompensated heart failure. Patients and Methods: This cross-sectional study was carried out over a period of March-August, 2016. All patients admitted to cardiology ward and Coronary Care Unit (CCU) of Pakistan Institute of Medical Sciences during the study period were enrolled in the study using consecutive sampling technique. An arbitrarily predetermined sample size of 115 patients was taken. Precipitants were classified as patient related, disease related and physician related. Data was recorded and analyzed using SPSS version 22. Qualitative variables were reported as percentages and quantitative variables by using mean ± standard deviation. Spearman correlation coefficient was used to determine the correlation between variables and outcome measures. Results: A total of 115 patients were enrolled in this study. The mean age of the population was 51.13±13.6 years. Among these 38.3% of the population was obese. The patients remained admitted to the hospital for the index episode of decompensation for a mean period of 4.14±1.2 days. Infections were found to be the leading precipitant contributing to 57.6% of all decompensation episodes. This was followed by drug non-compliance (17.4%) and arrhythmias (8.7%). Ischemia was noted in 5.2%. Heart failure severity at presentation was found to correlate significantly with the presence of hypertension (Spearman coefficient 0.62, p-value 0.04), baseline hemoglobin (Spearman coefficient -0.58, p-value 0.03), creatinine levels (Spearman coefficient 0.71, p-value 0.05) and precipitant of heart failure (Spearman coefficient 0.257, p-value 0.007). Conclusion: A sizeable majority of heart failure hospitalizations can be prevented by inculcating measures directed at effective infection control at community and health care level and educating patients regarding recognition of early signs of infection that may target the most important immediate precipitant for acute decompensated heart failure.  &nbsp

Miniaturized and flexible FSS-based EM shields for conformal applications

This article reports on very efficient and highly miniaturized wideband polygon-shaped frequency selective surface (PFSS) shields for the planar and conformal applications in the X-band. These shields have been analyzed for both lossy as well as for low-loss substrates. The conformal configurations of PFSS are particularly investigated for inward, outward, and double-curved profiles useful for a variety of applications. The conformal designs have been tested for two different radii of curvatures. The models have been simulated using a hybrid simulation approach for electrically large geometries. The equivalent circuit model as well as the analytical model are determined. The proposed PFSS designs offer stable angular response up to 60° for planar and all conformal geometries on both lossy and low-loss prototypes. Shielding effectiveness of at least 55 dB and 48 dB has been measured for flat/nonconformal and conformal configurations, respectively

Viability of Liquefied Natural Gas (LNG) in Pakistan

This paper describes the viability of liquefied natural gas (LNG) for the domestic consumers, although Pakistan has commenced the import of LNG since 2015, but still a gap in supply and demand is constantly increasing. Currently, 1.2 BCF per day of re-gasified LNG is being injected into the gas pipeline network which is basically imported for the power plant sector in Punjab province. Yet the deficit of gas supply and demand is more than 2 BCF per day. The present study of local gas field projections tell that they will lose their strength to 1/3rd by 2025. It can be easily forecasted that by then, other sectors including industrial, commercial and maybe domestic will be forced to consume re-gasified LNG. Survey has been conducted from domestic consumers of Karachi and Hyderabad using a self-developed questionnaire and basic statistical tools are used to achieve the objectives. Findings of the study state that domestic consumers have little trust upon the gas suppliers as well as regulating authority (OGRA) in Pakistan. Domestic consumers have sufficient knowledge of natural gas situation in the country and are satisfied with the government subsidy on the natural gas billing, whereas they are not willing to accept LNG even at billing rate twice the current billing. Keywords: Domestic Consumers, Liquefied Natural Gas, Resources JEL Classifications: L95, O13, O38, P18, P43, Q4

Planar SIW leaky wave antenna with electronically reconfigurable E-and H-plane scanning

This paper reports on a novel technique of switching radiation characteristics electronically between E-and H-planes of planar Substrate Integrated Waveguide Leaky Wave Antennas (SIW-LWAs). The leaky wave mode is achieved through increasing the pitch of bounding metallic via posts on one side of SIW transmission section. The radiation switching is achieved by extending the top and bottom metallic planes to a distance of 1 mm along the leakage side. The extended section acts as a parallel plate section which is conveniently connected or disconnected from the leaking side of SIW through PIN diodes. The ‘ON’ state of PIN diodes extends the metal guides and results in the H-plane leakage whereas ‘OFF’ state of PIN diodes truncates the extended metal earlier and alter the leakage line boundary condition towards E-plane. The whole concept is validated by series of simulations followed by the realization and testing of the SIW-LWA. The measured radiation pattern scans about 54° in the E-plane between 10.0 GHz to 11.7 GHz, and 58° in the H-plane from 9 GHz to 10.6 GHz. The proposed topology is a suitable candidate for remote sensing and airborne applications

Laser Prototyping of Low Temperature Co-fired Ceramics for System-In-Package Applications

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Depression as a Risk Factor for Coronary Artery Disease: Myth or Verity

Objectives: To determine the frequency of depression in patients with ischemic heart disease, subgroup analysis of prevalence of depression in patients with heart failure, acute STEMI and non STEMI-ACS and the effect of hospital stay and treatment of primary cardiac illness on depression scores.Methodology: All patients with heart failure, acute STEMI and non STEMI-ACS, presenting to cardiology clinics over a period of March-August, 2016 with a pre-calculated sample size were enrolled into the study by consecutive sampling. HAM-D questionnaire was administered at the time of hospital admission and discharge. SPSS was used for data analysis.Results: A total of 102 patients were included in the study out of which 47 (46%) were females and 55 (54%) were males. The mean age of the study population was 49.5±12 years. At the time of admission, 91/102 (89.2%) patients were found to be depressed, 32 (31.4%) had mild depression, 29 (28.4%) had moderate depression, 10 (9.8%) had severe depression and an alarming number (20 i.e. 19.6%) patients had very severe depression. At the time of discharge, 82/102 (80.3%) patients were found to be depressed, 35 (34.3%) had mild depression, 31 (30.4%) had moderate depression, 12 (11.8%) had severe depression and only 4 (3.9%) had very severe depression. The mean change in HAM-D score during hospital admission was -3.24±4 (Maximum +26, minimum -23). The difference in depression scores during hospital stay tended to inversely correlate with length of hospital stay. A greater proportion of patients with the diagnosis of STEMI had a severe or very severe depression.Conclusion: Depression was found to be alarmingly prevalent in acute coronary syndrome affectees and hospital stay and treatment led to a mean fall in the depression scores

Efficient Design Methodology for a Complex DRA-SIW Filter-Antenna Subsystem

International audienc

Study of aortic valve using multi slice computed tomography in patients presenting with chest pain

Objective: To determine aortic root dimensions in younger patients presenting with chest pain. Study Design: Descriptive cross sectional study Study Setting: CT Angiography Department of Armed Forces Institute of Cardiology & National Institute of Heart Diseases, Rawalpindi. Duration of study:6 months (from 12th September 2018 to 11th March 2019) Methods: MSCT angiography was performed over all the patients who met the inclusion and exclusion criteria after written informed consent .MSCT acquisition was performed in a single breath-hold of about 5–10 seconds, ECG gated synchronized data acquisition with 60-100ml contrast was done.Multiphase data sets were reconstructed followed by data analysis. Required measurements were recorded with software caliper and tracer. All data were analyzed in SPSS 23. Results: Recruited in the study were a total of 330 patients who fulfilled the inclusion criteria. Mean age (years) was45.5±7.9 and there were 236 (71.5%) male and 94 (28.5%) female patients in the study. Bicuspid aortic valve was found in 0.9%(n=3) of population whereas 99.1%(n=320) were tricuspid. The mean aortic valve area was 4.01±0.70cm2, mean aortic annular size was 21.9±2.37mm,Sinotubular junction diameter on average was found to 23.9±3.45mm, and mean sinotubular junction height was 21.09±2.77mm.The diameter at sinuses of Valsalva was found to be 33.0±3.99mm. Conclusion: The mean aortic root dimensions and general morphology of aortic valve was determined in our population to establish normal reference values, which will later help in therapeutic strategies in patients suffering from aortic valve disease. MSCT was utilized in the assessment of these parameters, also proves Continuous..