The Transradial Approach for Cardiac Catheterization and Percutaneous Coronary Intervention: A Review

Cardiac catheterization and percutaneous coronary intervention play an important role in the management of coronary artery disease. Although the transfemoral approach has been the traditionally dominant method, there has been an increased utilization of the transradial approach. Multiple observational studies and randomized clinical trials have shown fewer bleeding complications, reduced morbidity and mortality, improved quality of life, and better economic outcomes when the transradial approach is utilized when compared to the transfemoral approach. Despite its many benefits, utilization of this approach in certain countries including the United States has been less than optimal due to a lower adoption rates mostly driven by lack of training opportunities and decreased awareness of clinical benefits of the transradial approach. In this review, the history, observational trends, efficacy, and technical aspects of transradial cardiac catheterization and percutaneous coronary intervention are discussed

MANET Congestion Control Mechanism - Challenges and Survey

The transport layer plays a crucial role in the Mobile Adhoc Network (MANET) protocol stack by controlling traffic flow, managing congestion, and enabling end-to-end delivery. With the help of congestion control mechanisms, numerous protocols are formed to enhance MANET performance. This paper focuses on a thorough analysis of the challenges the MANET protocol stack is facing as a result of congestion control issues such high overload, long delays, and increased packet loss. Finally, note that in order to increase MANET performance, research needs to concentrate on specific congestion control mechanisms

Transcatheter aortic valve replacement in Bicuspid Aortic Valve Disease: An Insight

As per the current scenario, role of Transcatheter aortic valve replacement (TAVI) is controversial in bicuspid aortic valve stenosis. All the randomized clinical trials comparing outcomes of TAVI with surgery till date, have excluded patients with bicuspid aortic valve. Some of the observational studies have reported outcomes of TAVI in bicuspid aortic valve stenosis patients who are not surgical candidate. The recent advances in TAVI and its expansion into intermediate groups, which includes younger age groups sparks a debate on the efficacy and safety of TAVI in Bicsuspid aortic valve (BAV). The purpose of the present article is to review the available literature regarding the feasibility, safety and outcomes of TAVI in bicuspid aortic valve stenosis

Transcatheter Aortic Valve Replacement is Associated With a Higher Rate of Permanent Pacemaker Implantation Compared to Surgical Aortic Valve Replacement: A Propensity Matched Analysis (Poster).

Background Occurrence of conduction abnormalities requiring permanent pacemaker implantation (PPI) is a serious complication after both transcatheter (TAVR) & surgical (SAVR) aortic valve replacement. Methods Nationwide Inpatient Sample was queried from August 2011 to December 2012 using ICD-9 codes 35.05 & 35.06 for TAVR and 35.21 & 35.22 for SAVR. Patients undergoing other valve surgeries, bypass grafting & those with prior pacemakers or defibrillators were excluded. Propensity matching was performed (1:1) to match TAVR & SAVR cohorts on age, gender, right bundle branch block (RBBB), first degree AV block, bifascicular or trifascicular block, hospital region, teaching hospital status & hospital bed size. Logistic regression was performed to identify predictors of PPI. Differences in the two cohorts were tested using chi-square test. Results Total 2,990 patients (1,495 in TAVR group & 1,495 in SAVR group) were included, with mean age 80.2 +/- 9.0 years, 50.4% females & 83.2% Caucasians. RBBB (OR 2.3, 95% CI 1.4-4.0, p = 0.002) & bifascicular or trifascicular block (OR 6.9, 95% CI 2.8-17.0, p Conclusions PPI rates are higher after TAVR (with predominantly balloon expandable valves) compared to SAVR, after matching on demographic, EKG & hospital characteristics. This suggests greater damage to cardiac conduction system with TAVR compared to SAVR

MANET Hidden and Exposed Terminal - Challenges and Survey

Mobile Adhoc Network (MANET)is a self organized wireless Network which was created to communicate among  the nodes without support of the any Infrastructure. While transmission of the packets between the nodes, many challenges the every nodes faces. One of the Major challenges is Hidden and Exposed nodes issues in the MANET. This causes the packet drop or packet failure while the transmitting the packets. Also which  reflects in degrades the throughput of the MANET and performance of the MANET nodes when the heavy traffic ,retransmission of the dropped packets delayed the communication. This article discussed about hidden and Exposed terminal problem and challenges in MANET and also dissimilar survey in MANET

Seasonal Variations and Trends in Hospitalization for Peptic Ulcer Disease in the United States: A 12-Year Analysis of the Nationwide Inpatient Sample

BACKGROUND: Peptic ulcer disease (PUD) is a major public health burden significantly impacting the cost of hospitalization in the United States (US). We examined the trends, characteristics, complications, cost, and seasonality of PUD-related hospitalizations from 2000 to 2011. METHODS: With the use of the Nationwide Inpatient Sample from 2000 through 2011, we identified PUD-related hospitalizations using the International Classification of Diseases (ICD-9), 9th Revision, and the Clinical Modification code 531.00 to 534.91 as the principal discharge diagnosis. The total number of hospitalizations for each calendar month of the year were added over a 12-year period, and this number was divided by the number of days in that particular month to obtain the mean hospitalizations per day for each month. RESULTS: The study found that 351,921 hospitalizations with the primary discharge diagnosis of peptic ulcer disease (PUD) occurred in the US between 2000 and 2011. This number dropped significantly from 49,524 to 17,499 between 2000 and 2011, and the rate of PUD-related mortality decreased from 4.3% to 3.1%. The mean age of the study population was 66.2 +/- 17.4 years; 52.3% were males, and 56.8% were white. The number of hospitalizations in the US peaked in the spring season (916/day), and reached a nadir in the fall season (861/day). The mean cost of PUD hospitalization increased significantly from $11,755 in 2001 to$13,803 in 2011 (relative increase of 17%; p \u3c 0.001). CONCLUSION: The incidence of PUD and its mortality has decreased significantly in the last decade, but its economic burden on the healthcare system remains high. A seasonal pattern of PUD hospitalization showed a peak in PUD-related admissions in the spring season and a trough in the fall season

Sex‐Specific Associations of Oral Anticoagulant Use and Cardiovascular Outcomes in Patients With Atrial Fibrillation

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139084/1/jah32481-sup-0001-TableS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139084/2/jah32481.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139084/3/jah32481_am.pd