A study to evaluate the clinical outcome of drug-eluting vs. bare-metal stents for acute coronary syndrome patients during commercial use in real setting

Background: This study compared clinical outcome of Drug Eluting Stents (DES) versus Bare Metal Stents (BMS) in coronary arteries in patients with Acute Coronary Syndromes.Methods: A retrospective, observational study was carried out in an inpatient setting of the private tertiary care hospital. Patients with >18 years, diagnosed for Acute Coronary Syndromes (ACS), required intervention in coronary artery with implantation of Drug Eluting Stents (DES) or Bare Metal Stents (BMS) were recruited in the study. The data had been collected from file or database of the hospital. All subjects were followed for major adverse cardiac event.Results: A total of 202 patients who underwent percutaneous coronary intervention (PCI) were enrolled into DES group (n=101) and BMS group (n=101). All patients were followed up at 1 month, 3 months, 6 months & 12 months for Major Adverse Cardiac Events (MACE). Clinical outcomes during 12 months were compared between DES group & BMS group. Overall MACE rates were reported non-significantly high in BMS group patients (14.85%) compare to DES group patients (8.91%) (p=0.458). However, DES group had lower rates of death (0.99% vs 1.98%, p=0.57), rate of MI (3.96% vs 4.95% p=0.73), rate of revascularization (1.98% vs 3.96% p=0.42) & rate of sub acute thrombosis (1.98% vs 3.96% p=0.42) and higher rate of bleeding (1.98% vs 0.99% p=0.57) compare to cohort-II.Conclusions: The use of DES in the setting of Acute Coronary Syndrome is associated with lower Major Adverse Cardiac Event (MACE) rate compared to BMS without compromising the overall safety over the course of one-year follow-up. The long-term safety of drug-eluting stents needs to be ascertained in large, randomized trials

A Study to Compare Major Adverse Cardiac Event in Patient Undergoing PCI with Drug Eluting Stents Vs Bare Metal Stents

This study compared Major Adverse Cardiac Event in patient with Acute Coronary Syndromes undergoing PCI with Drug Eluting Stents Vs Bare Metal Stents. A retrospective, observational study was carried out in an inpatient setting of the private tertiary care hospital. Patients with >18 years, diagnosed for Acute Coronary Syndromes (ACS), required intervention in coronary artery with implantation of Drug Eluting Stents (DES) or Bare Metal Stents (BMS) were recruited in the study. The data had been collected from file or database of the hospital. All subjects were followed for major adverse cardiac event. Result. A total of 202 patients who underwent percutaneous coronary intervention (PCI) were enrolled into DES group (N=101) and BMS group (N=101).  All patients were followed up at 1 month, 3 months, 6 months & 12 months for Major Adverse Cardiac Events (MACE). Clinical outcomes during 12 months were compared between DES group & BMS group. There was no significant difference in baseline parameters including demographic, risk factors of ACS, diagnosis, angiographic parameters between both groups. Overall MACE rates were reported non-significantly high in BMS group patients (14.85%) compare to DES group patients (8.91%) (P=0.458). However, DES group had lower rates of death (0.99% vs 1.98%, P=0.57), rate of MI (3.96% vs 4.95% P=0.73), rate of revascularization (1.98% vs 3.96% p=0.42) & rate of sub acute thrombosis (1.98% vs 3.96% P=0.42) and higher rate of bleeding (1.98% vs 0.99% p=0.57) compare to cohort-II. Conclusion. The use of DES in the setting of Acute Coronary Syndrome is associated with lower Major Adverse Cardiac Event (MACE) rate compared to BMS without compromising the overall safety over the course of one-year follow-up. The long-term safety of drug-eluting stents needs to be ascertained in large, randomized trials.DOI: http://dx.doi.org/10.11591/ijphs.v1i2.125

A Study to Compare Major Adverse Cardiac Event in Patient Undergoing PCI with Drug Eluting Stents Vs Bare Metal Stents

This study compared Major Adverse Cardiac Event in patient with Acute Coronary Syndromes undergoing PCI with Drug Eluting Stents Vs Bare Metal Stents. A retrospective, observational study was carried out in an inpatient setting of the private tertiary care hospital. Patients with >18 years, diagnosed for Acute Coronary Syndromes (ACS), required intervention in coronary artery with implantation of Drug Eluting Stents (DES) or Bare Metal Stents (BMS) were recruited in the study. The data had been collected from file or database of the hospital. All subjects were followed for major adverse cardiac event. Result. A total of 202 patients who underwent percutaneous coronary intervention (PCI) were enrolled into DES group (N=101) and BMS group (N=101). All patients were followed up at 1 month, 3 months, 6 months & 12 months for Major Adverse Cardiac Events (MACE). Clinical outcomes during 12 months were compared between DES group & BMS group. There was no significant difference in baseline parameters including demographic, risk factors of ACS, diagnosis, angiographic parameters between both groups. Overall MACE rates were reported non-significantly high in BMS group patients (14.85%) compare to DES group patients (8.91%) (P=0.458). However, DES group had lower rates of death (0.99% vs 1.98%, P=0.57), rate of MI (3.96% vs 4.95% P=0.73), rate of revascularization (1.98% vs 3.96% p=0.42) & rate of sub acute thrombosis (1.98% vs 3.96% P=0.42) and higher rate of bleeding (1.98% vs 0.99% p=0.57) compare to cohort-II. Conclusion. The use of DES in the setting of Acute Coronary Syndrome is associated with lower Major Adverse Cardiac Event (MACE) rate compared to BMS without compromising the overall safety over the course of one-year follow-up. The long-term safety of drug-eluting stents needs to be ascertained in large, randomized trials

ASSESSING THE IMPACTS OF CITY SPRAWL ON URBAN FREIGHT TRANSPORT IN DEVELOPING COUNTRIES

Introduction: In the 21st century, cities in developing countries have witnessed faster growth as compared with cities in developed countries. Countries like India, China and Brazil have one of the most densely populated cities in the world. The transport infrastructure in these cities struggles to deal with the increasing population and geographic sprawl. Though some efforts are made to improve the transportation systems in these cities, urban freight transport is largely overlooked as the focus remains on passenger transport. Methods: This study aims to assess the impacts of the city’s geographic sprawl on urban freight transport using the example of the textile industry in Surat, India. The sprawl of the city and its textile industry is measured based on historical maps, Google imagery, and establishment surveys. Changes in urban freight trip lengths are determined using the data of a commercial vehicle drivers’ survey. Results: In the last two decades, the city expanded geographically by almost three times. The relocation of textile manufacturing units led to a 40% increase in trip lengths and additional 56 tons of carbon dioxide generation per year. Due to the city sprawl, the overall efficiency of the urban freight transport system reduced. There is a need for a holistic planning approach towards urban freight movement and related urban infrastructure for sustainable freight flows. This can serve as a policy framework to decide on the location of a logistics hub or as guidelines to allocate manufacturing enterprises in the proximity of the urban area, thus enabling sustainable development of the city

An Application of Cellular Automata (CA) and Markov Chain (MC) Model in Urban Growth Prediction: A case of Surat City, Gujarat, India

The main purpose of this study is to detect land use land cover change for 1990-2000, 2000-2010, and 2010-2020 using multispectral Landsat images as well as to simulate and predict urban growth of Surat city using Cellular Automata-based Markov Chain Model. Maximum likelihood supervise classification was used to generate LULC maps of the years 1990,2000,2010, and 2020 and the overall accuracy of these maps were 90%, 95%, 91.25%, and 96.25%, respectively. Two transition rules were commuted to predict the LULC of 2010 and 2020. For validation of these LULC maps, the Area Under Characteristics curve was used, and these maps' accuracy was 95.30% and 86.90%. This validation predicted LULC maps for the years 2035 and 2050. Transition rules of 2010-2035 showed that there will be a probability that 36.33% of vegetation area and 40.27% of the vacant land area will be transited into built-up by the year 2035, and it will be 49.20 % of the total area. Also, 57.77% of the vegetation area and 60.24% of the built-up area will be transformed into urban areas by the year 2050, almost 62.60 %. Analysis of LULC maps 2035 and 2050 exhibits that there will be abundant growth in all directions except the South Zone and Southwest Zone. Therefore, this study helps urban planners and decision-makers decide what to retain, where to plan for new development and type of development, what to connect, and what to protect in coming years

Application of Remote Sensing and Geographic Information System in Identification of Urban Growth nodes: A Case of Surat City, India

With the passage of time, the city's growth behavior will not change unless and until the government intervenes, and thus its identity will shift from monocentric to polycentric to meet the needs of citizens. As a result, this study is being conducted to identify emerging growth nodes within a selected area of Surat City, as well as their growth drivers over a 30-year period. Quantified built-up area within a patch size of 1km x 1km was used to compute patch density at five-year intervals from 1991 to 2021. In addition, the spatial changes that occurred within patches over the same time period were examined. Both analyses aid in determining the emerging growth nodes over a 30-year period. From 1991 to 2021, the city was driven by socioeconomic criteria such as land price, availability of good health and educational facilities, water and sewerage networks, fire stations, proximity factors such as proximity to major roads, bridges, bus stations, metro, railway stations, airport, environmental factors such as the development of riverfront and linear park, bio-diversity park, and government interventions in terms of Town Planning Schemes. This study thus aids urban planners and decision-makers in selecting which growth nodes to plan for new development and type of development, what to connect, and what to protect in the years to come

Investigation of mass discharge rate and segregation from hopper by discrete element method

Hoppers of different shape and angle are widely used in different industries particularly in handling of solids as storage units and in unit operations, e.g. mixing, tableting, etc. It is a challenge to choose a right hopper to achieve desired flow and insignificant segregation due to difference in material properties. General approach for the selection of optimum hopper for a given unit operation is based on the trial-and-error experimental approach. To address this optimum hopper selection, combined experimental and numerical approach is presented in this study. The objective of this study is to analyze the effect of mixture composition and hopper angle on the flow rate and segregation behavior. The numerical simulation of granular flow out of various conical hoppers was also performed using the discrete element method (DEM). The materials considered include different particle size glass bead particles in different proportions by mass. The experimental study is done to validate the DEM results, particularly, mass flow rate. The results analyzed include temporal development of mass fraction of a given particle size during discharge. In addition, the mass flow rate is also computed. The results indicate that fines percentage in the mixture, ratio of smallest particle size to largest in the mixture, and hopper angle plays significant role in determining the segregation and mass flow rate. The flow pattern found to be influenced by the hopper angle and mean particle size of mixture. The results of discharge rate from DEM are also compared with existing empirical correlations and finite element method based elastoplastic model. The DEM prediction shows a good agreement with the existing correlations for a wide range of hopper angles, and with the experimental data

Transverse sacralization of lumbar vertebrae: prevalence according to Castellvi classification

Background: Sacralization of L5 is a congenital anomaly, in which the lumbar vertebra, mainly its transverse process, gets fused or semi-fused with the sacrum or the ilium or to both. This fusion can occur in one or both sides of the body. Sacralization leads to fusion of the L5 (fifth lumbar vertebra) and S1 (first sacral vertebra) and the inter-vertebral disc between them may be narrow. Sacralization of lumbar vertebra may be asymptomatic but is not always clinically insignificant. While sacralization may not affect at all, it can cause problems in some cases. Sacralization may be at times associated with problems in biomechanics and affect the ways of movement and posture control. Sacralization may also be an important consideration in disc surgeries. This study has been carried out to find out prevalence of sacralisation of transverse process of fifth lumbar vertebrae.Methods: The present study of transverse sacralisation of fifth lumbar vertebra was carried out on 35 randomly selected patients. The sample consisted of patients undergoing CT scan for abdominal complains. Bone window of all patients were evaluated to look for lumbosacral transitional vertebra.Results: The prevalence of transverse sacralization of lumbar vertebra turned out to be 25.7% out of which Castellvi type IIb was found to be most common, accounting for 33.3% cases. 5.7% comprised the group of normal variant (Castellvi’s type I) and 68.6% were normal. Conclusions: It is important to determine lumbosacral transitional vertebra as it can affect spinal movement and put excess stress on the lumbar vertebrae and in between disc. Moreover it can have a bearing on counting of vertebral levels specially during planning of spinal surgey.

Comparative Study for Understanding the Spatial Growth Pattern of Pune and Jaipur City from 1990 to 2020

Understanding the urban form, conducting spatial change analysis of an urban area using time-series data, and identifying urban growth drivers play a crucial part in framing policies for sustainable planning practices. In this research, an inverse S-curve function is employed to examine Urban Land Densities (ULD) derived from concentric divisions of urban regions in Pune and Jaipur. The inverse S-curve quantitatively describes variations in Urban Land Density (ULD) from the urban center to the outskirts. Consequently, the parameters identified during the curve-fitting process offer information about the urban form of the cities, shedding light on their rate of expansion, level of compactness, and the nature of sprawl. Built-up area is determined from the Landsat datasets for the years 1991, 1996, 2001, 2006, 2011,2016, and 2021. The analysis confirmed that Pune revealed an increase in sprawling, expansive, and low-density development. As a city that has grown linearly, Jaipur has experienced more constrained growth than Pune. Additionally, the fitted ULD equation provided an accurately fitted radius for Jaipur, but not for Pune, highlighting the equation's shortcomings. The direction analysis and understanding of the change in the slopes of the S curve further led to identifying growth drivers, broadly classified into proximity, government intervention, socioeconomic, and physical factors. The study can help achieve future research objectives in simulating and modeling urban growth and creating policies to deal with related problems