Enhancing the pulmonary annulus renders the pulmonary valve incompetent in cases of tetralogy of Fallot. A pressure-loaded right ventricle may change to a volume-loaded ventricle, which may dilate and eventually dysfunction. This study evaluated a new technique of fashioning a monocusp valve from untreated autologous pericardium suspended on a transannular patch. It was assessed in 40 children undergoing complete repair of tetralogy of Fallot between January 2005 and December 2007. 24 patients had a transannular patch alone (group A) and 16 received a transannular patch with the autologous pericardial monocusp valve (group B). All patients were followed up for 1 year with transthoracic echocardiography to determine pulmonary insufficiency. There was no significant difference in cardiopulmonary bypass or aortic crossclamp times, postoperative chest tube drainage, duration of inotropic usage, intensive care unit or hospital stay between groups. Univariate analysis showed significantly lower grades of pulmonary insufficiency in group B. This technique for creating an autologous pericardial monocusp valve is an inexpensive, simple, and reliable procedure that effectively reduces pulmonary insufficiency at the 1-year follow-up.

Carotid intimal-medial thickness (CIMT) predicts future vascular events in the general population. However, the correlation of traditional cardiovascular risk factors and stages of chronic kidney disease (CKD) with CIMT is not studied extensively. To determine the correlation of CIMT with traditional cardiovascular risk factors like age, body mass index (BMI), dyslipidemia and various stages of CKD patients, CIMT was measured by means of high-resolution B-mode ultrasonography in 70 CKD patients and compared with the 30 healthy controls. The mean CIMT in patients was 0.86 ± 0.21 mm vs 0.63 ± 0.17 mm in healthy age- and sex-matched controls (P <0.001). There was a significant univariate positive correlation between CIMT and age (r = 0.605, P <0.001), BMI (r = 0.377, P = 0.001), total cholesterol (r = 0.236, P ≤0.018) and serum triglyceride (r = 0.387, P ≤0.001). No statistically significant correlation was found between mean CIMT and estimated glomerular filtration rate (eGFR) (r = -0.02, P = 0.30), very low-density lipoprotein and high-density lipoprotein-cholesterol. Atherosclerotic changes very well correlate with the traditional cardiovascular risk factors like age, BMI, serum total cholesterol and serum triglyceride level in CKD patients. Even though CIMT was marginally more in the late stages of CKD patients, no statistically significant correlation was found with CIMT and eGFR.

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Introduction: Diabetes Mellitus is a major chronic disease associated with many complications and high morbidity. The need for lifestyle modification and regular adherent treatment makes the management of the disease difficult. This study examines the scope of m-Health in the management of type 2 diabetes mellitus in terms of glycemic control. Methods: A randomized controlled study was performed among the patients attending the outpatient department of a tertiary care hospital in Mysuru city. A mobile application named DIAGURU, mainly focusing on lifestyle modification and medication management was used for a period of 6 months from April 2019 to September 2019 by 150 patients in the study group while another 150 participants served as controls. The change in glycosylated haemoglobin levels was assessed after six months. Results: The mean HbA1C levels at the starting of the study was found to be 7.36% ± 1.04 in the study group and 7.84% ± 1.33% in the control group. A repeat HbA1c test after six months showed a mean level of 7.10% ± 0.96% among the participants who received the intervention and 7.97% ± 1.37% among the control group. The values were showing a trend of reduction in the intervention group, with a median reduction HbA1c of − 0.2% (− 0.3% to − 0.2%). Among the participants who did not receive our intervention, a median increase of 0.1% (0%-0.2%) in HbA1c was noticed. Mann Whitney U test was performed, and it showed a statistically significant association with a p value less than 0.001. Conclusion: From this study, we conclude that an intervention with a mobile application aimed at lifestyle modification and medication management in addition to regular medical treatment for type 2 diabetes mellitus patients resulted in a better glycemic control compared to a control group who did not receive the adjuvant intervention. CTRI registration number: CTRI/2020/02/023115.

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