SUBCLINICAL SYSTOLIC DYSFUNCTION AMONG NEWLY DIAGNOSED HYPERTENSIVES WITH PRESERVED LEFT VENTRICULAR EJECTION FRACTION USING TWO DIMENSIONAL STRAIN IMAGING METHOD: HOSPITAL BASED OBSERVATIONAL STUDY

Background: Heart failure is the major cause of morbidity and mortality in hypertension. Early detection of sub- clinical systolic heart failure thus is an important step in prevention of clinical heart failure. There are limited studies evaluating the presence and determinants of subclinical heart failure along axial, circumferential and radial axis among hypertensives with normal Left Ventricular Ejection Fraction (LVEF) using strain imaging methods. Present study aimed to detect the subclinical global and regional systolic dysfunction in longitudinal, circumferential and radial axis and its determinants in hypertensive patients with normal LVEF. Material and Method: 2-dimensional echocardiographic (2DE) images of the Left Ventricle (LV) were acquired in apical 4-chamber and parasternal short-axis view at mid ventricular levels to assess global and regional strain in lon- gitudinal, radial and circumferential axis in 72 hypertensive patients with normal LVEF and 57 healthy controls us- ing speckle tracking method. LV Mass and LVEF were measured using 2D guided M Mode scan and diastolic func- tion was assessed in early diastole with tissue Doppler imaging. Results: The regional strain in longitudinal axis was significantly reduced at Apex and Apico lateral segment of LV in hypertensive population compared to normotensive group (-17.99± 5.21 Vs-19.77±4.17; p<0.01 and -14.78 ±5.69 Vs -17.40± 5.23; p<0.01) respectively. However the mean Global Longitudinal and circumferential systolic Strain was not significantly reduced in the hypertensive group when compared to the normotensive group. Conclusions: The regional LV systolic function in longitudinal axis at apex and apico lateral wall was significantly reduced while the global systolic function in longitudinal and circumferential axis was preserved in hypertensive patients compared to normotensive healthy individuals

EFFECTS OF TADALAFIL ON CARDIOPULMONARY HAEMODYNAMICS IN PATIENTS OF CHRONIC PULMONARY DISEASES WITH PULMONARY HYPERTENSION: A PILOT STUDY

Background and Objectives: Effect of tadalafil on cardiopulmonary haemodynamics in patients of chronic pulmonary diseases residing at an altitude has not been studied adequately. The present study reports the effect of tadalafil on cardiopulmonary haemodynamics in patients of chronic pulmonary diseases with PH residing at an altitude ranging between 1000 meters to 2500 meters above mean sea level. Methods: Seventy six patients of chronic pulmonary diseases with PH diagnosed by echocardiography were randomized to receive tadalafil 40 mg once a day or to the control group. The effect of tadalafil on cardiopulmonary haemodynamics was assessed after 3 months of tadalafil exposure. The echo Doppler derived indices of cardiopulmonary haemodymics recorded were; TR gradient, pulmonary flow acceleration time, pulmonary vascular resistance, myocardial performance index, RV eccentricity index, tricuspid annular plane systolic excursion and cardiac output. The arterial oxygen saturation was measured by Pulse oxymeter. Results and Interpretation: Tadalafil significantly improved the indices of RV performance; pulmonary flow velocity time integral (14.54 ± 3.17cm versus 12.25 ± 2.25cm, p <0.0002), tricuspid annular plane systolic excursion (18.53±4.0mm versus 17.11±3.94mm, p<0.002), RVFS 30.6% vs. 24.8% p<0.003. There was no significant change in the TR gradient although PFAT increased significantly with tadalafil; (89.8±11.7 vs. 76.2±8.2 msec. p<0.001). There was a trend of lower PVR with tadalafil buts not statistically significant 3.6±0.9 vs. 3.1±1.0. Tadalafil also improved the arterial oxygen saturation, SPO2 (90.91±1.76% versus 88.40±1.79%, p<0.0001) significantly. Conclusions: Tadalafil improved RV function significantly but its effect on PVR was modest.  

Challenges in QCD matter physics - The Compressed Baryonic Matter experiment at FAIR

Substantial experimental and theoretical efforts worldwide are devoted to explore the phase diagram of strongly interacting matter. At LHC and top RHIC energies, QCD matter is studied at very high temperatures and nearly vanishing net-baryon densities. There is evidence that a Quark-Gluon-Plasma (QGP) was created at experiments at RHIC and LHC. The transition from the QGP back to the hadron gas is found to be a smooth cross over. For larger net-baryon densities and lower temperatures, it is expected that the QCD phase diagram exhibits a rich structure, such as a first-order phase transition between hadronic and partonic matter which terminates in a critical point, or exotic phases like quarkyonic matter. The discovery of these landmarks would be a breakthrough in our understanding of the strong interaction and is therefore in the focus of various high-energy heavy-ion research programs. The Compressed Baryonic Matter (CBM) experiment at FAIR will play a unique role in the exploration of the QCD phase diagram in the region of high net-baryon densities, because it is designed to run at unprecedented interaction rates. High-rate operation is the key prerequisite for high-precision measurements of multi-differential observables and of rare diagnostic probes which are sensitive to the dense phase of the nuclear fireball. The goal of the CBM experiment at SIS100 (sqrt(s_NN) = 2.7 - 4.9 GeV) is to discover fundamental properties of QCD matter: the phase structure at large baryon-chemical potentials (mu_B > 500 MeV), effects of chiral symmetry, and the equation-of-state at high density as it is expected to occur in the core of neutron stars. In this article, we review the motivation for and the physics programme of CBM, including activities before the start of data taking in 2022, in the context of the worldwide efforts to explore high-density QCD matter.Comment: 15 pages, 11 figures. Published in European Physical Journal

Yoga-Based Cardiac Rehabilitation After Acute Myocardial Infarction: A Randomized Trial.

BACKGROUND: Given the shortage of cardiac rehabilitation (CR) programs in India and poor uptake worldwide, there is an urgent need to find alternative models of CR that are inexpensive and may offer choice to subgroups with poor uptake (e.g., women and elderly). OBJECTIVES: This study sought to evaluate the effects of yoga-based CR (Yoga-CaRe) on major cardiovascular events and self-rated health in a multicenter randomized controlled trial. METHODS: The trial was conducted in 24 medical centers across India. This study recruited 3,959 patients with acute myocardial infarction with a median and minimum follow-up of 22 and 6 months. Patients were individually randomized to receive either a Yoga-CaRe program (n = 1,970) or enhanced standard care involving educational advice (n = 1,989). The co-primary outcomes were: 1) first occurrence of major adverse cardiovascular events (MACE) (composite of all-cause mortality, myocardial infarction, stroke, or emergency cardiovascular hospitalization); and 2) self-rated health on the European Quality of Life-5 Dimensions-5 Level visual analogue scale at 12 weeks. RESULTS: MACE occurred in 131 (6.7%) patients in the Yoga-CaRe group and 146 (7.4%) patients in the enhanced standard care group (hazard ratio with Yoga-CaRe: 0.90; 95% confidence interval [CI]: 0.71 to 1.15; p = 0.41). Self-rated health was 77 in Yoga-CaRe and 75.7 in the enhanced standard care group (baseline-adjusted mean difference in favor of Yoga-CaRe: 1.5; 95% CI: 0.5 to 2.5; p = 0.002). The Yoga-CaRe group had greater return to pre-infarct activities, but there was no difference in tobacco cessation or medication adherence between the treatment groups (secondary outcomes). CONCLUSIONS: Yoga-CaRe improved self-rated health and return to pre-infarct activities after acute myocardial infarction, but the trial lacked statistical power to show a difference in MACE. Yoga-CaRe may be an option when conventional CR is unavailable or unacceptable to individuals. (A study on effectiveness of YOGA based cardiac rehabilitation programme in India and United Kingdom; CTRI/2012/02/002408)

Plant hormone-mediated regulation of stress responses

10.1186/s12870-016-0771-yBMC Plant Biology1618

To compare the effect of Telmisartan with Metoprolol on arterial stiffness in hypertension: Prospective randomized parallel group trial

Background: Hypertension is often complicated by increased arterial stiffness and is an independent predictor of adverse cardiovascular (CV) outcome. Beta blockers and angiotensin receptor blockers (ARBs) are commonly used antihypertensive agents. The effect of beta blockers and ARBs on arterial stiffness has not been compared adequately. The aim of the present study is to compare the effect of telmisartan with metoprolol on arterial stiffness in hypertensive patients in prospective open label randomized parallel group intervention study. Methods: 100 patients of hypertension, not on any antihypertensive agents, were enrolled after obtaining informed consent. Baseline recording of data related to demographics, CV risk factors, anthropometry and BP were made. Arterial stiffness was measured noninvasively by recording pulse wave velocity (PWV) using periscope (Genesis medical system). Left ventricular (LV) mass was measured using 2D guided M-mode echocardiography. Blood sugar, renal function, lipids and uric acid estimations were done in fasting state. Patients were randomized to receive metoprolol and telmisartan using stratified randomization technique. Dose of the study drugs were titrated to achieve target BP of <140/90 mmHg. Data related to PWV, BP, anthropometry and blood biochemistry was repeated after 6 months of treatment with study drugs. Results: Telmisartan resulted in significantly greater reduction in arterial stiffness index (ASI) in left and right lower limb arterial bed (39.9 ± 11.7 vs. 46.8 ± 17.0 m/s, p < 0.02) and (36.4 ± 9.6 vs. 44.86 ± 15.1 m/s, p < 0.002) respectively and systolic blood pressure (SBP) (−4.9 mmHg with 95% C.I. of −8.0–1.7 mmHg, p < 0.003) compared to metoprolol. Reduction in diastolic blood pressure (DBP) in telmisartan and metoprolol groups was not different statistically (−1.0 mmHg with 95% C.I. of −3.3–1.2 mmHg, p < 0.3). The change in LV mass was not significantly different between the study groups (135.5 ± 37.6 vs. 143.2 ± 41.5, p < 0.3)

Promoting medicinal plants cultivation as a tool for biodiversity conservation and livelihood enhancement in Indian Himalaya

The present paper discusses the development of a participatory approach to promote medicinal and aromatic plant (MAP) cultivation as a tool for biodiversity conservation and livelihood enhancement in Champawat district of Uttarakhand state in India. People perception analysis revealed that farmers were dependent solely on the wild collection of MAPs before the initiation of the National Agriculture Innovation Project. However, they later engaged in cultivation practices. During the course of study, the propagation protocols of 11 selected MAPs of that area were developed and a cost-benefit analysis was performed. A series of meetings and exposure visits were organized and a memorandum of understanding was simultaneously signed between farmers and traders for promoting a buy-back system of MAPs. One hundred thirty-two farmers adopted MAP cultivation in 14 hectares of land. This approach provides opportunities for farmers to build skills, knowledge, and self confidence, and conserve MAP diversity in their natural habitat

Chronic disease concordance within Indian households: A cross-sectional study

Background: The household is a potentially important but understudied unit of analysis and intervention in chronic disease research. We sought to estimate the association between living with someone with a chronic condition and one’s own chronic condition status. Methods and findings We conducted a cross-sectional analysis of population-based household- and individual-level data collected in 4 socioculturally and geographically diverse settings across rural and urban India in 2013 and 2014. Of 10,703 adults ages 18 years and older with coresiding household members surveyed, data from 7,522 adults (mean age 39 years) in 2,574 households with complete covariate information were analyzed. The main outcome measures were diabetes (fasting plasma glucose ≥ 126 mg/dL or taking medication), common mental disorder (General Health Questionnaire score ≥ 12), hypertension (blood pressure ≥ 140/90 mmHg or taking medication), obesity (body mass index ≥ 30 kg/m2), and high cholesterol (total blood cholesterol ≥ 240 mg/dL or taking medication). Logistic regression with generalized estimating equations was used to model associations with adjustment for a participant’s age, sex, education, marital status, religion, and study site. Inverse probability weighting was applied to account for missing data. We found that 44% of adults had 1 or more of the chronic conditions examined. Irrespective of familial relationship, adults who resided with another adult with any chronic condition had 29% higher adjusted relative odds of having 1 or more chronic conditions themselves (adjusted odds ratio [aOR] = 1.29; 95% confidence interval [95% CI] 1.10–1.50). We also observed positive statistically significant associations of diabetes, common mental disorder, and hypertension with any chronic condition (aORs ranging from 1.19 to 1.61) in the analysis of all coresiding household members. Associations, however, were stronger for concordance of certain chronic conditions among coresiding household members. Specifically, we observed positive statistically significant associations between living with another adult with diabetes (aOR = 1.60; 95% CI 1.23–2.07), common mental disorder (aOR = 2.69; 95% CI 2.12–3.42), or obesity (aOR = 1.82; 95% CI 1.33–2.50) and having the same condition. Among separate analyses of dyads of parents and their adult children and dyads of spouses, the concordance between the chronic disease status was striking. The associations between common mental disorder, hypertension, obesity, and high cholesterol in parents and those same conditions in their adult children were aOR = 2.20 (95% CI 1.28–3.77), 1.58 (95% CI 1.15–2.16), 4.99 (95% CI 2.71–9.20), and 2.57 (95% CI 1.15–5.73), respectively. The associations between diabetes and common mental disorder in husbands and those same conditions in their wives were aORs = 2.28 (95% CI 1.52–3.42) and 3.01 (95% CI 2.01–4.52), respectively. Relative odds were raised even across different chronic condition phenotypes; specifically, we observed positive statistically significant associations between hypertension and obesity in the total sample of all coresiding adults (aOR = 1.24; 95% CI 1.02–1.52), high cholesterol and diabetes in the adult-parent sample (aOR = 2.02; 95% CI 1.08–3.78), and hypertension and diabetes in the spousal sample (aOR = 1.51; 95% CI 1.05–2.17). Of all associations examined, only the relationship between hypertension and diabetes in the adult-parent dyads was statistically significantly negative (aOR = 0.62; 95% CI 0.40–0.94). Relatively small samples in the dyadic analysis and site-specific analysis call for caution in interpreting qualitative differences between associations among different dyad types and geographical locations. Because of the cross-sectional nature of the analysis, the findings do not provide information on the etiology of incident chronic conditions among household members. Conclusions: We observed strong concordance of chronic conditions within coresiding adults across diverse settings in India. These data provide early evidence that a household-based approach to chronic disease research may advance public health strategies to prevent and control chronic conditions. Trial registration Clinical Trials Registry India CTRI/2013/10/004049; http://ctri.nic.in/Clinicaltrials/login.ph

Adjusted association between living with a parent with a given chronic condition and having that same or another chronic condition (<i>n</i> = 1,660).

<p>Adjusted association between living with a parent with a given chronic condition and having that same or another chronic condition (<i>n</i> = 1,660).</p