An epidemiological profile of vitiligo in Calcutta is presented. Prevalence data were gathered from 15,685 individuals drawn from the general population; pedigree data were collected through 293 vitiligo patients. The overall prevalence of vitiligo is about 5 per 1,000 individuals. There are no significant sex or age differences in prevalence rates. About a 4.5-fold increase in prevalence is observed among close biological relatives of affected individuals. There is, however, no clearcut correspondence between relative risks and kinship coefficients. There are no significant differences in the frequencies of various types of vitiligo between probands with and without positive family history. The overall mean and modal ages of onset are about 22 years and 15 years, respectively. The mean ages among males (24.8 years) and females (19.3 years) are significantly different.
Data on 298 pedigrees, each collected through an affected proband, have been analyzed to study familial aggregation and genetics of vitiligo. The extent of familial aggregation is statistically significant at the 5% level. The disease does not appear to be inherited in a simple dominant or recessive fashion. The heritability of liability to the disease is 46% +/- 4.82%. Neither common family environment nor a major locus with additional sources (environmental and/or polygenic) can be excluded as a cause of familial aggregation. Association of the disease with six polymorphic genetic marker loci have been studied. Significant associations with ACP1 and RH loci have been found. This and earlier studies indicate that the disease is associated with genetic loci on different chromosomes, which points to a polygenic nature of the disease.
BACKGROUND The trans-radial approach for performing coronary angiography was practiced for long time. This procedure has some advantages over femoral approach. Due to technical complexity this route is rarely selected for coronary angiography worldwide. The objectives of this study were 1. to assess the feasibility of trans-radial angiography for selective catheterization of the coronary arteries, and 2. to determine the causes of procedural failure. MATERIALS AND METHODS 100 patients of acute coronary syndrome or significant symptomatic angina or abnormal stress test or myocardial perfusion scan were selected for coronary angiography by trans-radial route at R. G. Kar Medical College between 1 st March 2013-28 th February 2014. The number of failure cases is evaluated to find out the causes along with the complications that occurred during procedure in all cases. Results were then analyzed. RESULTS Radial artery spasm is the main cause trans-radial failure along with anatomical abnormality of radial and subclavian artery. It is more common in female patients. This approach is cost effective because of reduced hospital stay and was found to be very safe with high degree of success with very low rate of complications. CONCLUSION Trans-radial approach for coronary angiography is safe and cost-effective procedure in experienced hands.
BACKGROUND Pulmonary hypertension (PH) complicating left ventricular systolic dysfunction carries worse prognosis than LVSD alone. Though nonlinear relation between the severity of the LVSD and the presence of PH exists, diastolic dysfunction (DD) may play some major driving role in determining the degree of PH and henceforth may predict incremental prognostic information. This is a comparative analysis of the parameters of different DD groups in determining the prognostication with special context to PH. MATERIALS AND METHODS Prospective analysis was conducted in patients with LVSD (EF-45%) in the Department of Cardiology, R G Kar Medical College, Kolkata, for a period of two years. Clinical characteristics, biochemical parameters and quantitative Doppler measurement of pulmonary systolic pressure (PSP), indices of diastolic function were recorded and followed up for at least one year. RESULTS Out of a total 256, only 94 patients met the pre-specified criteria and different parameters were analysed. The patients are classified as mild, moderate and severe DD groups. There was significant difference in mean ± SD of Heart rate, BMI and BNP level. Among the Doppler parameters only E/e is significantly (p value 0.01) different in these groups along with LVEF and PASP. 26 out of a total of 94 patients died in follow up period with Kaplan Meier survival curve for all cause death showing significant log rank test (χ 2 15.94), with p value ˂0.001 between these 3 groups. In multivariate regression analysis, age, PASP and TAPSE (Tricuspid Annular Peak Systolic Excursion) remain significant predictors of mortality whereas the ROC (Receiver Operating Curve) shows the E/e ratio as additional risk factor (AUC is 0.768). CONCLUSIONS Assessment of diastolic function provides added prognostic information in HFrEF. Though presence of PH increased the risk for clinical endpoints, the magnitude of diastolic dysfunction contributes to development of PH and has an impact on prognosis and overall mortality.
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