bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Comparing of Short Clinical Cardiovascular Outcomes with Wraparound and Nonwraparound Left Anterior Descending Artery in Patients with Anterior ST-Segment Elevation Myocardial Infarction
Authors: Shemirani Hassan , Zavar Reihaneh , Khosravi Alireza , Tavakoli Maryam 
Published: October 2021

Background:
The relation between left anterior descending artery (LAD) anatomy and clinical outcomes in patients with anterior ST-segment elevation myocardial infarction (STEMI) has not been fully investigated. The aim of this study was to determine the frequency and severity of short-term cardiovascular outcomes in patients with Anterior ST-Segment Elevation Myocardial Infarction (STEMI) undergoing primary percutaneous intervention (PCI), based on wraparound and non-wraparound left anterior descending artery (LAD).

Methods:
In a cross-sectional study, 126 patients with anterior STEMI who were admitted to Shahid Chamran Hospital in Isfahan during 2020 were studied. Patients were evaluated for anatomical features of LAD coronary artery and clinical outcomes determined and compared based on wraparound LAD and non-wraparound LAD during hospitalization and up to one month after PCI.

Results:
The prevalence of wraparound LAD in the studied patients was 73% and left ventricular systolic dysfunction in admission was greater and more severe in patients with wraparound LADs compared with those with non-wraparound. Severe LV systolic dysfunction in the wraparound and non-wraparound groups was 39.6% and 8.8%, respectively (P < 0.001). Also, the frequency of arrhythmias in the wraparound group (21.7%) was higher than the non-wraparound group (5.9%) (P = 0.037).

Conclusion:
The patients with anterior STEMI and wraparound LAD have a worse clinical outcome and more severe left ventricular systolic dysfunction. Therefore, it seems that the study of the anatomical condition of the LAD artery at the time of angiography is of great importance in the way of observation and care, and treatment of patients.
Influence of COVID-19 Pandemic on Cardiac Services in Bahrain
Authors: Bardooli Fawaz Khalil , Hasan Jasim , Hussain Tajammul , Abdulrahman Abdulkarim , Al Shaikh Shereen 
Published: October 2021

Background:
There are different protocols initiated to maintain the workflow in cardiovascular units around the world. Variable responses were seen in different populations. We adapted certain protocols during coronavirus disease-2019 (COVID-19) pandemic because we want to know the key element that maintains an acceptable standard of cardiovascular care during future pandemics.

Methods:
Four hundred and fifty-four cardiac patients were admitted during COVID-19 era. Patients from March to July 2020 were included in this study. Those patients were divided into two periods: strict-COVID-19 from March 19, 2020, to May 18, 2020 (132 patients) and mid-COVID-19 from May 19, 2020, to July 18, 2020 (322 patients). These were compared to admissions at the pre-COVID-19 era from January 19, 2020, to March 18, 2020 (600 patients). All patients' data were collected through the quality department from the electronic medical records.

Results:
Throughout the COVID-19 pandemic, the admission number and ST-elevation myocardial infarction (STEMI) cases were dramatically reduced during the strict-COVID-19 time yet recovered back in the mid-COVID-19 period. The admission rate was reduced from 600 to 132, while the STEMI cases dropped from 91 in pre-COVID-19 to 41 in strict-COVID-19 and then back to 81 cases in mid-COVID 19 period (P > 0.05/P = 0.02 between pre and mid-COVID-19 periods).

Conclusion:
Our cardiac center continues to serve our population without a complete lockdown period due to multiple key elements adapted during this pandemic. The flexibility in the protocols of managing acute cardiac cases has maintained the mortality rate stable through all COVID-19 periods and return to working efficiently to near-normal levels.
Morphological Changes of Coronary Arteries in Cases of Sudden Death due to Cardiac Causes - An Autopsy-Based 10-Year Retrospective Study
Authors: Udasimath Shivakumarswamy , Nagesha K. R. , Ramaiah Puruhotham 
Published: October 2021

Introduction:
Ischemic heart disease (IHD) is the most common cause of cardiac deaths worldwide, mainly due to atherosclerosis. Prevalence of atherosclerosis evaluation, in an autopsy-based study, can be a valuable tool on subjects who died of cardiac causes. With this hypothesis, we conducted this 10-year retrospective study on the hearts of subjects who died due to cardiac causes.

Materials and Methods:
This study was conducted from January 2010 to May 2020 at Department of Pathology, Hassan Institute of Medical Sciences, Hassan, Karnataka. Autopsy was conducted at our hospital in the deceased patients who died of suddenly due to cardiac causes. Standard procedures were followed for the removal of intact heart. Heart specimens were sent to our department for histopathological analysis. After fixation in 10% formalin, specimens of the heart were examined in detail. Heart specimens were weighed and measured. The three main coronary arteries were identified and dissected out according to the standard guidelines. These arteries were carefully examined for any histological evidence of atherosclerosis and associated pathological lesions. After detailed study, the lesions were graded according to the classification given by the American Heart Association from Grade I to Grade VI and coronary luminal narrowing by White and Edwards method.

Results:
Evaluation of a total of 682 autopsy cases was done. In the evaluation, 574 cases were due to sudden cardiac caused deaths. 436 (76.03%) subjects had evidence of atherosclerosis in coronary arteries. In our study, 468 (81.53%) were male and remaining 106 (18.46%) were female. The most commonly involved coronary artery was left anterior descending coronary artery (LADA, 412 cases, 71.74%). Triple-vessel disease was found in 118 cases (20.55%) of subjects.

Conclusion:
In Indian population, atherosclerosis of the coronary arteries begins at a younger age. Therefore, thorough screening for the same should begin at an early age. Our study showed alarmingly high prevalence of atherosclerosis in coronary arteries, especially in the LADA. Coronary atherosclerosis is an important risk factor for IHDs in both sexes, even though the incidence of atherosclerosis is more common in males when compared to females.
Cognitive and affective empathy in men with alcohol dependence
Authors: Nachane Hrishikesh Bipin , Nadadgalli Gomati V. , Umate Maithili S. 
Published: October 2021

Background:
Empathy plays a role not only in pathophysiology but also in planning management strategies for alcohol dependence; however, few studies have looked into it. No data are available regarding the variation of empathy with abstinence and motivation. Assessment based on cognitive and affective dimensions of empathy is needed.

Aim:
This study aimed to assess cognitive and affective empathy in men with alcohol dependence and compared it with normal controls. Association of empathy with disease-specific variables, motivation, and abstinence was also done.

Methods:
This was a cross-sectional observational study conducted in the outpatient department of a tertiary care center. Sixty men with alcohol dependence and 60 healthy controls were recruited and assessed using the Basic Empathy Scale for cognitive and affective empathy. The University of Rhode Island Change Assessment Scale was used to assess motivation. Other variables were assessed using a semi-structured pro forma. Comparative analysis was done using unpaired t-test and one-way ANOVA. Correlation was done using Pearson's correlation test.

Results:
Cases with alcohol dependence showed lower levels of cognitive, affective, and total empathy as compared to controls. Affective and total empathy were higher in abstinent men. Empathy varied across various stages of motivation, with a significant difference seen between precontemplation and action stages. Empathy correlated negatively with number of relapses and positively with family history of addiction.

Conclusions:
Empathy (both cognitive and affective) is significantly reduced in alcohol dependence. Higher empathy correlates with lesser relapses. Abstinence and progression in motivation cycle is associated with remission in empathic deficits.
Cluster analysis of risky behaviors among the youth in Western Iran
Authors: Khazaie Habibolah , Najafi Farid , Hamzeh Behrooz , Chehri Azita , Rahimi-Movaghar Afarin , Amin-Esmaeili Masoumeh , Moradi-Nazar Mehdi , Khazaie Sepideh , Zakiei Ali , Kamasi Saeed , Pasdar Yahya 
Published: October 2021

Background and Aims:
The objectives of the study were (i) cluster analysis of risky behaviors; (ii) determining correlates; and (iii) comparing clusters with regard to the attitude toward mental health help seeking.

Methods:
The current cross-sectional study is a part of the first phase of the Persian Youth Cohort. From October 2014 to January 2017, 2990 individuals from Ravansar City in western Iran completed structured interviews and national and international standard questionnaires. The obtained data were analyzed using two-stage cluster analysis, multinomial logistic regression analysis, and Chi-square test.

Results:
This model provided three distinct clusters: (i) low-risk group with mild distress, (ii) high-risk group with high distress, and (iii) violent group with medium distress. Some sociodemographic and lifetime psychiatric disorders were the correlates of unhealthy clusters (P < 0.05). Compared to the reference cluster, a higher number of members in unhealthy clusters were suffering from medium to severe disability. Nevertheless, the participants in these clusters were less inclined to mental health help seeking.

Conclusions:
More than half of the youth were suffering from suicidal and violent behaviors. Since high-risk participants are less inclined to mental health help seeking, the health policymakers can successfully utilize the results in planning general health programs.
Concordance of assessment of insight by different measures in obsessive-compulsive disorder
Authors: Grover Sandeep , Ghosh Abhishek , Kate Natasha , Sarkar Siddharth , Chakrabarti Subho , Avasthi Ajit 
Published: October 2021

Aims:
This study aimed to examine the (a) prevalence of various levels of insight among patients with obsessive-compulsive disorder (OCD) and (b) correlation of insight specifier (Diagnostic and Statistical Manual [DSM]-5) and other established measures of insight in OCD.

Methods:
One hundred and twenty-five outpatients with a diagnosis of OCD were assessed by Brown Assessment of Beliefs Scale (BABS) and DSM-IV's insight specifier. The insight specifier of DSM-5 was determined by item one (“conviction”) of BABS. Dimensional Yale-Brown Obsessive-Compulsive Severity Scale was used to assess the frequency and severity of dimensional obsessive-compulsive (OC) symptoms.

Results:
The mean age of the participants was 31.2 (±11) years. Seventy-seven (61.6%) of the participants were men. There was a high correlation (r = 0.73) between the insight specifiers of DSM-5 and DSM-IV. Insight categories of DSM-5 had modest correlations with BABS total score and BABS-based insight categories. Significant associations were observed between the level of insight and comorbid psychotic illness, hoarding and symmetry dimensions of OC symptoms, severity of depressive, and OC symptoms. The first two associations were consistent across group comparisons (insight-groups based on DSM-IV and BABS) and correlation (with total BABS score).

Conclusions:
Majority of the patients with OCD have good insight and application of different tools influence the assessment of insight in OCD. The DSM-5 insight specifier has strong and significant correlation with the DSM-IV's insight classification and categorization of insight by BABS.
Antisuicidal efficacy of ketamine infusion in suicidal patients of depressive disorder
Authors: Pathak Umesh , Ahuja Sunil Kumar , Dwivedi Rajeev , Mishra Nimisha , Kumar Pradeep , Mishra Dheerendra Kumar , Singh Rajesh 
Published: October 2021

Background:
The efficacy of ketamine in the rapid alleviation of depressive and suicidal symptoms has been observed over the past few years around the globe. Exploration of rapid antisuicidal efficacy of ketamine in Indian subpopulation can be a good preventive pharmacological option for unprecedented rise in suicides in India.

Aim:
To assess efficacy of ketamine infusions on suicidal patients of depressive disorder. Severity of depression and suicidality were quantified daily over 1 week.

Materials and Methods:
This was a randomized control study, comprised sixty patients of age group 18–60 years, with a diagnosis of depressive episode, having the Modified Scale for Suicidal Ideations (MSSI) score >20 with exclusion of severe medical or surgical illness, pregnancy, and breast-feeding females. Patient were assigned to ketamine and normal saline group. Three infusions were given over 1 week on day 0, day 2, and day 4. Assessments were made at baseline using the 17-item Hamilton Depression Rating Scale (HAM-D17) and MSSI, for depression and suicidality, respectively. Assessments were repeated at 6 h after first infusion and then every day for 1 week.

Results:
There were significant reductions in HAM-D17 score and MSSI score within 6 h of the first dose in the ketamine group as compared to the normal saline group. Significant sustained improvement was seen on further days till 1 week in the ketamine group as compared to the normal saline group.

Conclusion:
Ketamine might be a reasonable choice to fulfil the efficacy gap created by the delayed antisuicidal onset of standard treatments.
Prevalence of anemia and iron deficiency among patients with heart failure admitted in a tertiary care hospital of sub-Himalayan region in North India
Authors: Katna Akhil , Dhiman Himanshu , Sharma Rajesh , Raina Sujeet , Kumar Mukul , Yadav R S 
Published: October 2021

Objective:
Anemia and iron deficiency (ID) are common in patients with chronic systolic heart failure (HF). The study was planned to find out the prevalence of anemia and ID in patients of chronic HF among patients admitted in a tertiary care hospital from Himachal Pradesh, India.

Methods:
This was a hospital-based open cohort observational descriptive study conducted on patients diagnosed with chronic HF. The study period was of 1 year. HF was defined on the basis of 2016 ESC Guidelines for diagnosis and treatment of acute and chronic HF. Anemia was diagnosed on the basis of WHO definitions (<13 g/dl in males and <12 g/dl in females). ID was diagnosed as serum ferritin <100 μg/dl (absolute ID) or serum ferritin 100–299 μ/dl and transferring saturation <20% (functional ID).

Results:
A total 61 patients (41 females and 20 males) were included in the study over 1 year. Out of 61 patients, 48 (78.7%) were found to be iron deficient. Thirty-four patients were having absolute ID, whereas 14 were having functional ID. Anemia was found in 29 patients (47.5%). Nineteen patients were having ID without anemia.

Conclusion:
Anemia and ID are common in patients with HF in the sub-Himalayan region in North India. Hemogram and iron profile should be included in the investigation protocol during management of HF in Indian patients.
Comparison of Global Registry of Acute Coronary Events and Thrombolysis in Myocardial Infarction Risk Scores in non-ST-Elevation Acute Coronary Syndrome
Authors: Routray Satyanarayan , Satpathy Chhabi , Mohanty Nirmal Kumar , Dash Bijay Kumar , Satapathy Rajendra Prasad 
Published: October 2021

Context:
The Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) scores in predicting coronary disease severity in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) have not been proved.

Aims:
We aimed to compare the GRACE score with TIMI risk score for prediction of the angiographic severity of coronary artery disease (CAD) in patients with NSTE-ACS.

Settings and Design:
This was an observational cross-sectional study.

Subjects and Methods:
Total 202 NSTE-ACS (NSTE myocardial infarction and unstable angina) patients were included. The GRACE and TIMI scores were estimated. Coronary angiogram was done and the Gensini score and vessel score were used to assess the severity of CAD.

Statistical Analysis Used:
SPSS software version 27.0 was used for statistical analysis. For comparison of two means, independent sample t-test/Mann–Whitney U-test was used, while for more than two means, one-way ANOVA/Kruskal–Wallis test was used. The receiver operating characteristic (ROC) curve was applied for the predictability of GRACE and TIMI scores for severity of disease.

Results:
A positive association between the Gensini score and vessel score was observed with both the GRACE (P = 0.001) and TIMI (P = 0.001) scores. The area under the ROC curve for the GRACE score was 0.765 (95% confidence interval [CI] = 0.676–0.854), significantly superior to the area under the ROC curve of the TIMI score (0.715; 95% CI = 0.618–0.812). Risk factors such as higher age, hypertension, smoking history, dyslipidemia, ECG changes such as ST deviation and T inversion, and Killip classification showed a statistically significant association with severity of disease.

Conclusions:
Both the GRACE and TIMI risk scores were a good predictor of angiographic severity of CAD in patients with NSTE-ACS, and the GRACE score was found to be superior to the TIMI risk score.
The Prevalence, Causes, and Management Strategies for Stress Among Health-Care Professionals of Delhi-National Capital Region
Authors: Mehrotra Rahul , Gupta Mayank , Bhagwati Mohit , Jain Dinesh 
Published: October 2021

Background:
Stress at workplace has an adverse impact not only on the employees in terms of health, well being, and job dissatisfaction, but also affects the organization in terms of quality of output, absenteeism, and attrition which ultimately has detrimental financial implications. Health care professionals comprise of an important group that are majorly affected by workplace stress because of the nature of their work environment.

Methods:
The current study was undertaken to ascertain the presence of self perceived stress among healthcare workers in multispecialty hospitals of the National Capital Region of Delhi and to find the expected remedial measures that could be implemented to mitigate stress. In a questionnaire based study, a self administered questionnaire was used to assess stress and related factors using convenience-sampling technique. The response data were extracted and analyzed using Microsoft Excel, which was used for data analysis, tabulation, and graphical presentation.

Results:
Total 110 responses were received. Three quarter of the respondents identified significant stress in their life, with the highest stress reported by nursing staff at 98%, doctors at 67%, and administrative staff at 56%. The study shows a significant association of self reported stress with age of the respondents (P < 0.001). Respondents among age group of 15–25 years reported the highest prevalence of stress (P < 0.001). Women reported a higher level of stress than men, (P < 0.001), and nurses reported the highest level of stress followed by doctors and then administrative staff. Different methods to relieve stress were also discussed and it was found that two thirds (67%) of our study respondents would like to meditate at work.

Conclusion:
Stress is common among all categories of healthcare workers. Meditation can be a safe, effective, and feasible modality which can be offered at the workplace to safeguard the mental health of the health care workers and reduce their levels of stress.
Clopidogrel Resistance in Cardiovascular Disease Patients and its Association with Gene Polymorphisms
Authors: Parameshwara S , Manjula B , Bhaktha Geetha , Kallaganad Gurupadappa , Ranjith Kumar G K 
Published: October 2021

Aims:
To determine the genotypic and allelic frequencies of multidrug resistance protein 1 (MDR1), CYP2C19, and P2Y12 gene and their polymorphisms in the Shimoga population who admitted for treatment in McGann teaching district hospital-Shimoga Institute of Medical Sciences (SIMS), Shimoga.

Materials and Methods:
It is a cross-sectional study that was conducted in McGann teaching district hospital, SIMS, Shimoga. Patients who were admitted to the Intensive coronary care unit due to cardiovascular disease (CVD) were recruited for the study. Sociodemographic data with venous blood samples (5 ml) were collected along with informed consent. Genotyping of the MDR1, CYP2C19, and P2Y12 polymorphisms were done using the polymerase chain reaction (PCR) restriction fragment length polymorphism method. Descriptive and inferential statistics were done using the Statistical Package for the Social Sciences software. The genotypic and allelic frequency was calculated using the Hardy-Weinberg equilibrium.

Results:
Out of 40 CVD cases, 60% were male and 40% were female and the mean age was found to be 57.13 ± 11.57 years. The percentage of the obese group was more compared to other groups of body mass index. Risk factors such as diabetes, hypertension, food custom, smoking, and tobacco consumption were not significant while alcohol consumption was seen to be significant among the study population at a 5% level of significance. The genotypic frequencies for a heterozygous and mutant type of MDR1 (C3435T) and CYP2C19*2 (G681A) were found to be 35%, 2.5%, 57.5%, and 5%, respectively. Whereas the gene polymorphism of CYP2C19*3 and P2Y12 was not observed in the present study population.

Conclusions:
This is the first gene polymorphism study with respect to clopidogrel resistance in the Shimoga population. We have demonstrated the presence of polymorphism in the MDR1 and CYP2C19 genes in this study population. A further elaborate study should be conducted for a better understanding of genetic with nongenetic factors involved in poor response toward clopidogrel drug using a large population.