DEFINITIONAortic aneurysm refers to pathologic dilatation of aortic segment that has the tendency to expand and rupture. The extent of dilatation is debatable but one criterion is an increase in the diameter of at least 50% greater than that expected for the same aortic segment in unaffected individuals of same age and sex. Aortic aneurysms are described in terms of their size, location, morphology, and cause.

Sharma et al APW with IAA With Eisenmenger Syndrome e159by guest on May 12, 2018

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Background: Contrast induced nephropathy remains important cause of hospital-acquired acute kidney injury and affects between 2% of the general population to 50% of high-risk subgroups following coronary intervention. Objectives: To determine the incidence and to study the various risk factors associated with CIN. Patients and Methods: In our study, total of 212 patients (154 males and 58 females) who received non ionic iso osmolar contrast media during percutaneous transluminal coronary intervention (PCI) were included. We diagnosed CIN by a relative increase of >25% or an absolute increase of >0.5 mg/dl in serum creatinine levels two days after procedure. Results: The incidence of CIN in our study was 15.1%. In univariate analysis: age >75 years, hypertention diabetes mellitus (DM), heart failure, hypotension, CKD [creatinine  >1.5mg/dl] and increased contrast volume were associated with increased  risk of CIN whereas,  gender, anemia and use of IABP failed to reach statistical significance. As the number of risk factor and/or volume of contrast increases, the incidence of CIN increases exponentially. Conclusion: Since there is no established treatment for CIN, all possible efforts should be taken to prevent it from occurring by identifying patients at risk. CIN is related with many risk factors, so whenever multiple risk factors are present in an individual patient, lowest dose of contrast should be used and adequate hydration should be given. Key Words: Contrast-induced nephropathy, Non ionic iso-osmolar contrast media, percutaneous coronary intervention.

Background: Coronary artery disease (CAD) is one of the most important manifestation of diabetes mellitus. Objectives: To assess the extent of CAD in diabetic and non diabetic patients undergoing coronary angiography. Materials and Methods: 793 patients with suspected CAD, 202 diabetics and 591 non-diabetics were enrolled in the study. All patients underwent coronary angiography. Results: Normal coronaries were more common in non diabetic patients. Age at first presentation in diabetics was earlier as compared to non-diabetics. Diabetic female patients presented as early as third decade of life. Single vessel involvement was significantly more in non diabetics [40.27%] as compared to diabetic patients[19.8%][P= <0.001], while there were statistically no significant differences in double vessel disease in both groups [P= 0.572]. Triple vessel disease were more common in diabetic than non diabetic patients [P= <0.001]. Left main disease, left circumflex coronary artery disease, coronary calcification, diffuse disease and CTOs were more common in diabetic patients. Conclusion: The severity and extent of CAD and incidence of triple vessel disease was significantly high in diabetics when compared to non diabetics.

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Background: There are few studies that compared CTCA in patients presenting with chest pain, probably ischaemic (i.e., atypical) with negative or inconclusive TMT in outpatient department. Objective: To assess 64-slice CTCA findings in patients with suspected ischaemic chest pain and negative or inconclusive TMT. Methodology: Enrolled patients underwent TMT and classified as TMT negative or inconclusive patients. These patients underwent CTCA and findings were analysed. Results: 50 patients completed the study protocol. Of these, 31 (62%) were TMT negative and 19 (38%) were TMT inconclusive. CTCA showed obstructive CAD in 19 (38%) patients; 7 (36%) with negative TMT and 12 (63%) with inconclusive TMT. Overall, CTCA was more predictive of diagnosing obstructive lesion in TMT inconclusive group as compared to TMT negative group. Conclusion: In patients with atypical chest pain with negative or non-diagnostic TMT, CTCA provides an important diagnostic tool for rapid triaging of such patients.