FACTORS CONTRIBUTING FOR NONCOMPLIANCE OF FOLLOW-UP CARE AMONG POST CARDIAC PATIENTS

Objective: Compliance in following healthy diet, physical activity schedule, cessation of smoking and alcohol, medication adherence and regular follow up is very essential component in the management of patients with cardiovascular disease to prevent reoccurrence and reduce mortality. Hence the study was conducted with the aim to assess the factors contributing for noncompliance of follow-up care among post cardiac patients. Methods: Cross-sectional research design was employed with 50 samples who matched the inclusion criteria were selected by convenience sampling technique. Demographic variables data were collected by using structured questionnaire followed by assessed the factors contributing for noncompliance using checklist. Results: The findings of the current study revealed that all physical, psychological, economical, social and spiritual factors were highly influenced the noncompliance. Of these, the highest percentage 80% reported lack of accessibility as well financial support and around 70% percentage reported side effects of medication and low health literacy. Conclusion: Health care providers need to be focussed on interventional strategies especially health education in discharge plan to ensure that these patients adhere to follow up including medication adherence, following physical activity plan, dietary modification, lifestyle changes and regular follow up visit to prevent readmission and lead a successful life

Cystatin C Levels in Coronary Artery Disease and Its Correlation with Coronary Angiogram

BACKGROUND: Coronary artery disease is the leading cause of mortality and morbidity throughout the world. Its common cause is atherosclerotic disease of the coronary arteries. Electrocardiogram, echocardiogram, cardiac biomarkers and coronary angiogram aid in diagnosis and management of coronary artery disease. A number of cardiac biomarkers are available to identify myocyte necrosis. Cystatin is a lysosomal proteinase inhibitor and cysteine protease inhibitor. Its present in all tissues and body fluids. Its an established biomarker of kidney function. Recently, Cystatin C is found to be associated with coronary artery disease and also predicting the severity of the disease in patients with normal renal function. This study aims to analyse serum cystatin C levels in coronary artery disease patients and its correlation with coronary angiogram. AIMS AND OBJECTIVES: To analyse cystatin C levels in unstable angina, STEMI and NSTEMI patients and its coronary angiographic correlation. SECONDARY OBJECTIVES: 1. In STEMI/NSTEMI patients, to analyse if cystatin C levels correlate with the severity of the disease. 2. In unstable angina patients, to analyse if cystatin C levels can help in early risk stratification, which in turn aid in early intervention. 3. To analyse if cystatin C can be used as a cardiac biomarker. MATERIALS AND METHODS: This is a prospective cohort study, conducted at The Institute of Internal Medicine, Madras Medical College and Rajiv Gandhi Government General Hospital for a period of one year from June 2018 to May 2019. After obtaining clearance and approval from the Institutional Ethical Committee, 50 patients who were diagnosed to have coronary artery disease and who fulfilled the inclusion and exclusion criteria were included in the study. 10 non coronary artery disease patients like Rheumatic heart disease patients, ASD, etc., undergoing pre-operative coronary angiogram were taken as control. Informed consent was obtained from all the patients included in the study. A diagnosis of acute coronary artery syndrome was made clinically, with ECG, echocardiogram, and troponin T. Then their renal function tests was done. From those patients in whom the renal function tests were normal, 4 ml venous blood drawn and tested for serum cystatin C levels. Later coronary angiography was performed in these patients. The serum cystatin C levels and their coronary angiographic reports were analysed. Similarly cystatin C levels were tested before undergoing pre -operative coronary angiogram in the control group. RESULTS: Among the coronary artery disease patients, 52% of them had elevated cystatin C levels while only 10 % of the control had increased cystatin C levels. Pearson chi square analysis done for this data and the result is 5.939. P value is 0.015 which is significant. It means cystatin C levels have significant relationship with coronary artery disease. Also among the 26 cystatin positive CAD cases who underwent coronary angiogram, 6 had single vessel disease, 10 had double vessel disease, 10 had triple vessel disease. All the control group had normal coronary angiogram. On applying pearson chi square analysis, result was 9.1026 and p value is 0.028. Thus as serum cystatin C level increases, the severity of coronary artery disease also increases. CONCLUSION: Cystatin C levels is found to be significantly elevated in coronary artery disease patients with normal renal function. Serum cystatin C levels is found to be significantly associated with severity of CAD as proved by coronary angiography. That’s as serum cystatin C level rises, the incidence of double and triple vessel disease increases. Thus serum cystatin C is a predictor of coronary artery atherosclerotic burden. Its also significantly increased in younger CAD patients. It also correlates with serum troponin levels

Safety and Pharmacological Profile of Naga Chenduram.

The study and to evaluate the Safety and pharmacological profile of the test drug NAGA CHENDURA in animal models.Review of various information (Siddha and modern) relevant to the study.Preparation of the drug as per classical Siddha literature.Physicochemical, Chemical, elemental and analysis of the particle size of test drug.From the literature evidence, Physico chemical analysis, chemical analysis, Toxicological evaluation and Pharmacological studies, the drug Naga chenduram has Styptic activity, Anti- inflammatory, Analgesic activity. It is concluded that the drug Naga chenduram can be used in the management of hemorrhoids and the related anorectal disorders

APPLICATION FOR DESIGN OF STRUCTURAL ELEMENT USING VISUAL BASIC CODING

The increasing reliance of engineers on computer software in the performance of their tasks requires engineers, the future professional engineers, must be knowledgeable of sound engineering concepts, updated on the latest computer technology used in the industry and aware of the limitations and capabilities of the computer in solving engineering problems. Computer Methods in Civil Engineering to developed structural design program for design of structural element using Visual Basic. By creating my own software applications will demonstrate my creativity and integrate concepts, methods and skills in mathematics, basic engineering and specialized civil engineering subjects. This paper presents the learning objectives, requirements, methodology and outputs of my knowledge on Computer Methods in Civil Engineering

c-3,t-3-Dimethyl-4-oxo-r-2,c-6-diphenyl­piperidine-1-carboxamide

In the title compound, C26H26N2O2, the piperidinone ring adopts a distorted boat conformation. The two phenyl rings substituted at positions 2 and 6 of the piperidinone ring occupy axial and equatorial orientations, which are approximately perpendicular to each other [89.14 (8)°]. The phenyl­carbamoyl group adopts an extended conformation. The crystal structure is stabilized by inter­molecular C—H⋯O inter­actions

1,1′-[4-(4-Methoxy­phen­yl)-2,6-dimethyl-1,4-dihydro­pyridine-3,5-di­yl]diethanone

In the title compound, C18H21NO3, which belongs to the family of calcium channel blockers, the dihydropyridine ring assumes a flattened boat conformation. The two carbonyl units adopt a synperiplanar conformation with respect to the double bonds in the dihydro­pyridine ring. The methoxy­phenyl ring is almost perpendicular to the prydine ring [dihedral angle = 89.01 (7)°]. In the crystal, the mol­ecules are connected by inter­molecular N—H⋯O hydrogen bonds

EFFECTIVENESS OF CINNAMON TEA IN REDUCING WEIGHT AMONG LATE OBESE ADOLESCENCE

Objective: The objective of the study is to determine the effectiveness of cinnamon tea in reducing weight among late obese adolescent.Methods: Pre experimental research design was adopted to conduct the study with 30 samples who met the inclusion criteria. Cinnamon tea was given for the samples for 15 days and  theirweight and BMI was measured before as well as after the intervention. Data were analyzed by using descriptive and inferential statistics.Results:Out of 30 samples in pretest, 70% of them had overweight and 30% of them had class I obesity with the BMI mean value of 28.75 and2.72 standard deviation. In posttest 20% of them were normal weight, 66.67% of them were overweight and 13.33% of them were Class I obesity.The posttest BMI mean was 27.45 with 3.34 standard deviation. Paired t test revealed that Cinnamon tea was found to be effective in reducing weight at the level of *P<0.05.Conclusion:the findings of the present study revealed that the prescribed cinnamon tea resulted in an improvement reduction of weight. However, we need further studies with larger samples to investigate the effect of cinnamon in reducing the different factors like weight, BMI, hip waist circumference level in obese adolescents.Keywords: Obesity, Childhood obesity, Adolescent, Cinnamon, BMI, Weight, Cinnamon teaÂ

tert-Butyl 3-[2,2-bis­(ethoxy­carbon­yl)vin­yl]-2-bromo­methyl-1H-indole-1-carboxyl­ate

In the title compound, C22H26BrNO6, the indole ring system is planar [maximum deviation 0.029 (2) Å]. The tert-butyl bound carboxyl­ate group forms a dihedral angle of 17.54 (8)° with the indole ring system. In the crystal, mol­ecules are linked into centrosymmetric R 2 2(10) dimers by paired C—H⋯O hydrogen bonds

TECHNOLOGY ADOPTION USING MEDICAL IMAGE PROCESSING TOOLS IN GLOBAL HEALTH SECTOR DEVELOPMENT

Medical Imaging is a major development in the field of medicine for past 100 years. The tool helps the physicians not only to detect the diseases but also the intensity of the disease can be captured. The paper discusses about the prevailing health system and insurance schemes, the treatment facilities for disease like cancer. The availability of medical imaging tools like x-ray, mammogram, ultrasound, CT and MRI scans and its innovations for the public health diagnosis the diseases in various methods with the aid of modern machines and techniques. The techniques vary in terms of cost, methodology in detecting the diseases and even the accuracy. The people could not continue the treatment because of high cost and sometimes scarcity of medicines. As the treatment are costlier irrespective of various classes of people approach the social security organizations and because of continuous usage the equipments worn out. Though these tools are considered as boon in the field of medical imaging each has its own drawback. The result of the paper states that the physicians can detect the early stage of disease with the aid of these tools and can come up with treatment that will avoid serious health issues or sometimes death. Also the government of concern country is responsible for all the public and seek opportunity for developing health sector often