Prognostic significance of Arrhythmias in ST Elevation Myocardial Infarction

1. 44% of patients with STEMI had anyone type of clinically significant arrhythmia.patients with anterior wall STEMI had higher incidence of arrhythmia(n=84 of 177) (47.5%)than STEMI in other location(39%) 2. Tachyarrhythmia is more common than bradyarrhythmia accounts for 53% (n=70)of arrhythmic population (n=132) 3. Atrialfibrillation is the most frequent type of with incidence rate of 10% (n=30) followed by complete heart block 7.6% (n=23), VF, 6% (n=18) VT 5.7% (n=17). 13 (4.3%) patients had RBBB. nine had LBBB (3%). 4. Male sex, diabetes mellitus, smoking, systemic hypertension anterior wall involvement were the important riskfactors significantly associated with incidence of arrhythmia 5. Occurance of arrhythmia during acute STEMI increase the risk of mortality by 3.5 fold, heart failure by 3 fold, cardiogenic shock by 2.9 fold, and significantly reduces the ejection fraction (EF% 6. In hospital events were higher among patients with tachyarrhythmias. than bradyarrhythmias. The observed mortality rate was 60% (n=42 of 70 patients). Ventricular tachycardia and fibrillation were the major contributors. 7. The mortality rate among patients with bradyarrhythmia was 17.7% .patients with LBBB had higher mortality (22.2%) than RBBB (7.6%). 8. In addition to diabetes mellitus, smoking , anterior wall MI, incidence of arrhythmia after acute STEMI is an independent predictor of poor prognosis. 9. Event rate during 30 day follow up was (7.5%) heart failure, 1.5% mortality (3 of 200 patients) 10. Incidence of arrhythmia and its complication in patients with STEMI still remains high in resource poor settings Early recognition and treatment with appropriate drug, electrical cardioversion may improve the outcome

Analysis of Clinical profile, angiographic pattern of Coronary Ectasia in Coronary Artery Disease patients

INTRODUCTION : Coronary Artery ectasia defined as coronary arterial luminal dilatation with diameter exceeding 1.5 times the adjacent normal segment. It is considered as form of positive remodeling in contrast to obstructive Coronary Artery Disease wherein negative remodeling is responsible for luminal narrowing (Stenosis). Atherosclerosis is considered to be the most common contributory mechanism but studies the relationship between CAE and the traditional risk factors of atherosclerosis were given controversial results .Similarly novel inflammatory markers also giving conflicting result. Some follow up studies considered it as benign condition. But few studies observed significantly worse outcome. In view of unclear etiology and pathogenesis, conflicting results of outcome data, no clear consensus or guidelines available regarding management of this entity which warrants further research in this area. Hence we planned our study “Analysis of Clinical profile, angiographic pattern Coronary Ectasia in Coronary Artery Disease patients”. MATERIALS AND METHODS : Adult patients >18 yrs. of age with the diagnosis of CAD (both Chronic Stable Angina and Acute Coronary Syndrome) undergoing Angiography in Department of Cardiology Govt Rajaji Hospital were taken as the study population. After excluding the patients who is having pre-existing valvular heart disease, congenital heart disease and arrhythmias, and history of CABG, & PCI the data were collected regarding the conventional risk factors and inflammatory markers neutrophil count ,Neutrophil lymphocyte ratio, Meanplatelet volume, Red cell Distribution width also assessed. In hospital and follow-up data were collected and analysed among the patient with isolated (ectasia isolated CAE) without CAD, those with coexisting associated CAD (Mixed CAE +CAD ) and then it was compared to the population who had only obstructive CAD (pure CAD). RESULTS : Among the total 2434 angiogram done total prevalence coronary ectasia was found be 5.6%. Out of the total 136 patients with CAE, isolated ectasia (dilated coronaropathy) was seen in 17.6% (n=24 ), remaining 82.4% had associated obstructive CAD (n=112). Isolated ectasia patients were relatively younger compared to other 2 groups (44±8.6 Vs 54.32±8.72 Vs 56±7.8 P<0.001) had male dominance with (7: 1). But diabetes mellitus was less frequent in this group compared to others. But traditional risk factors are not significantly different among mixed CAE +CAD group when compared to pure CAD group. On the other hand inflammatory markers were significantly higher among isolated CAE and Mixed group when compared to pure CAD group Neutrophil count (P value <0.001), NLR group 3.98±0.89 & 3.58±0.56 when compared to pure CAD group 2.82±0.60. Mean platelet volume is not different among the 3 groups. Out come data showed that nil hospital mortality is in isolated ectasia group, and in hospital mortality is not different between mixed and pure CAD groups. Similarly follow up data proved similarity between pure CAD group and mixed CAE +CAD group except for increased frequency of angina among mixed group. CONCLUSION : Isolated ectasia is a unique phenomenon , seen in relatively younger population , having inverse association (less frequent) with Diabetes mellitus , neutrophil mediated active inflammation and this has nil effect on mortality . But Coronary artery ectasia if associated obstructive CAD has evidence of high inflammatory activity than pure CAD, but does not worsen the prognosis of coexisting CAD except for increased frequency of unstable angina

Superpower graphs of finite groups

Funding: Ajay Kumar is supported by CSIR-UGC JRF, New Delhi, India, through Ref No.: 19/06/2016(i) EU-V/Roll No. 417267. Lavanya Selvaganesh is partially supported by SERB, India, through Grant No. MTR/2018/000254 under the scheme MATRICS. T. Tamizh Chelvam is supported by CSIR Emeritus Scientist Scheme of Council of Scientific and Industrial Research (No.21(1123)/20/EMR-II), Government of India.For a finite group G, the superpower graph S(G) of G is an undirected simple graph with vertex set G and two vertices are adjacent in S(G) if and only if the order of one divides the order of the other in G. The aim of this paper is to provide tight bounds for the vertex connectivity, discuss Hamiltonian-like properties of superpower graph of finite non-abelian groups having an element of exponent order. We also give some general results about superpower graphs and their relation to other graphs such as the Gruenberg–Kegel graph.Peer reviewe

Super graphs on groups, I

Let G be a finite group. A number of graphs with the vertex set G have been studied, including the power graph, enhanced power graph, and commuting graph. These graphs form a hierarchy under the inclusion of edge sets, and it is useful to study them together. In addition, several authors have considered modifying the definition of these graphs by choosing a natural equivalence relation on the group such as equality, conjugacy, or equal orders, and joining two elements if there are elements in their equivalence class that are adjacent in the original graph. In this way, we enlarge the hierarchy into a second dimension. Using the three graph types and three equivalence relations mentioned gives nine graphs, of which in general only two coincide; we find conditions on the group for some other pairs to be equal. These often define interesting classes of groups, such as EPPO groups, 2-Engel groups, and Dedekind groups. We study some properties of graphs in this new hierarchy. In particular, we characterize the groups for which the graphs are complete, and in most cases, we characterize the dominant vertices (those joined to all others). Also, we give some results about universality,  perfectness, and clique number.Publisher PDFPeer reviewe

p-clean properties in amalgamated rings

Let A be a ring. Then A is called p-clean ring if each element in A express as the sum of an idempotent and pure element. Let f : A → B be a ring homomorphism and J be an ideal of B. The amalgamation of A with B along J with respct to f is a new ring structure introduced and studied by Anna et al. in 2009. This construction is a generalization of the amalgamated duplication of a ring along an ideal and other classical constructions such as the A + XB[X] and A + XB[[X]] constuctions. In this paper, the transfer of the notion of p-clean rings to the amalgamation of rings along ideal is studied. In particular, the necessary and sufficient conditions for  amalgamation to be a p-clean ring are studied

Bounds and extremal graphs of second reformulated Zagreb index for graphs with cyclomatic number at most three

Mili\v{c}evi\'{c} \textit{et al.}, in 2004, introduced topological indices known as Reformulated Zagreb indices, where they modified Zagreb indices using the edge-degree instead of vertex degree. In this paper, we present a simple approach to find the upper and lower bounds of the second reformulated Zagreb index, $EM_2(G)$, by using six graph operations/transformations. We prove that these operations significantly alter the value of reformulated Zagreb index. We apply these transformations and identify those graphs with cyclomatic number at most 3, namely trees, unicyclic, bicyclic and tricyclic graphs, which attain the upper and lower bounds of second reformulated Zagreb index for graphs

A Note On Strongly Gorenstein X-Flat Modules

Mao and Ding introduced the concept of injective modules. D. Bennis and N. Mahdou introduced and studied the concept of strongly Gorenstein projective and injective modules. In this article, we have introduced and examined strongly Gorenstein-flat modules, which are the generalizations of strongly flat modules. Further, we have linked them with the strongly Gorenstein-projective module