Open Access Case Study

Angiosarcoma of Large Intestine: A Case Report

S. M. Sahabi, N. Abubakar, K. Abdullahi, U. Mohammed, L. T. Olayinka, K. O. Ekochin, B. M. Bashir

Cardiology and Angiology: An International Journal, Page 1-4
DOI: 10.9734/CA/2017/31373

Angiosarcomas are collectively one of the rare forms of soft tissue neoplasms. That of the large intestine is much rarer. We report a case of large intestinal angiosarcoma. This is a case of a 30-year-old man who presented with intestinal obstruction, and after resection, it was histologically diagnosed as Angiosarcoma of large bowel.


Open Access Method Article

Mean Arterial Pressure Classification: A Better Tool for Statistical Interpretation of Blood Pressure Related Risk Covariates

Ramendra Nath Kundu, Subir Biswas, Mithun Das

Cardiology and Angiology: An International Journal, Page 1-7
DOI: 10.9734/CA/2017/30255

Purpose: Both Systolic blood pressure (SBP) and diastolic blood pressure (DBP) are equally important to analyze the associations between blood pressure and its associated risk covariates. Quantitative analyses however, sometime provide separate results for SBP and DBP. It is more evident in people with systolic or diastolic hypertension. It sometime becomes difficult to interpret while performing statistical analyses. Mean arterial pressure (MAP) which is a time-weighted average of the arterial pressure over the whole cardiac cycle is a very useful tool for biological and medical science. But, till date to the best of our knowledge, no classifications available like blood pressures. So, in this paper a classification of MAP was formulated following the blood pressure classification as recommended by World Health Organization (WHO) and European Society of Hypertension and European Society of Cardiology (ESH/ESC). The resultant value of MAP was then classified into several categories like, optimal, normal, high normal and so on. The present article is therefore, an attempt to postulate the MAP classification as innovative method for better statistical analyses, screening and analyses in association studies related to blood pressures.

Materials and Methods: SBP & DBP were measured on right arm in sitting posture by means of aneroid sphygmomanometer and stethoscope. Pulse pressure and MAP was computed as per the standard formula. Necessary statistical analyses were performed using SPSS (version 14.0).

Results: It was found that MAP was a better predictor of blood pressure associated with risk covariates like Body Mass Index (BMI) and Waist Circumference (WC) as compare to SBP and DBP separately. Both correlation and stepwise regression analyses shows that the MAP is no less significant than SBP and DBP by considering blood pressure as dependent and BMI & WC as independent variables.

Conclusion: A researcher can therefore use this MAP classification for data analysis as it will yield only one statistical result instead of two separate results (i.e. SBP and DBP) as to observe the relation of blood pressure (MAP) with different risk covariates. The vascular complications associated with hypertension including stroke, cardiovascular disease, chronic renal failure etc. require regular screening to avoid serious organ damage. Classification of MAP would therefore be more effective than blood pressure classifications not only in clinical practice but in public health as well. MAP classification would immensely help in translating large epidemiological data in to meaningful statistical interpretations.


Open Access Original Research Article

The Effect of Long-term Aerobic Exercises on Autonomic Imbalance in Postmenopausal Women

Alaa El Din R. Abdel Rheim, Hanaa M. Ibrahim, Adel Hussein Saad, Manal Ahmed Amin

Cardiology and Angiology: An International Journal, Page 1-9
DOI: 10.9734/CA/2017/30551

Objective: Study the effects of aerobic exercises on autonomic imbalance associated with menopausal women.

Methods: The study included twenty postmenopausal women (age 50.7± 0.86 mean ± SEM years old). All of them underwent 6 months of aerobic training program (3 sessions per week where every session is about one hour). Before and after the training program we measured the following parameters: 1) Heart rate variability indices using 24 hours ambulatory monitoring (Cardio Holter), both of time and frequency domain parameters were measured. 2) Serum levels of nitric oxide and catecholamines (adrenaline and noradrenaline). 3) Number of hot flashes per day.

Results: Six months of aerobic training program produced significant increase of all heart rate variability indices as compared with the starting levels: 1) Time domain parameters in the form of standard deviation of all normal RR intervals (SDNN), P<0.0001, and root mean square of successive RR intervals (rMSSD), P<0.001, where RR is the time between two successive R waves in the ECG. 2) Frequency domain parameters in the form of power in the low frequency range (LF), P<0.001 and power in the high frequency range (HF), P<0.0001. Chemical analysis revealed significant increase in serum level of nitric oxide, P < 0.0001 alongside with significant decrease in catecholamines levels (P<0.0001) for both adrenaline and noradrenaline) compared with the starting levels. Number of hot flashes per day was significantly decreased as compared to the starting number, P<0.001.

Conclusions: Regular moderate intensity aerobic exercises can induce significant improvement of the disturbed autonomic balance in postmenopausal women most probably through increasing NO production. The exercise would most likely have to be sustained in order to reduce long term risk.


Open Access Original Research Article

A Four-year Study of Chronic Patients’ Information Integration in Dental and Medical Documentation in a Secondary Care Setting

Raouf M. Afifi, Ashraf Elghali Saad, Sameh Sh. Zaytoun, Yousef Afifi

Cardiology and Angiology: An International Journal, Page 1-11
DOI: 10.9734/CA/2017/30903

Integrated health documentation captures, imports and exports relevant extract of patient’s longitudinal health information record. Especially documenting patients’ chronic disease data in dental documentation system is crucial.

Aim: Analyze chronic patients’ health information integrity in dental documentation during orodontal procedures and correlates affecting this relationship.

Methods: Dental records of chronic disease patients in Qena University Hospital (QUH) between 2012 and 2015 were compared with paired medical records to achieve study aim. Medical information studied included an array of health condition inquiries.

Results: The patients’ age averaged 55±15y, (range 21-84=63y); 58.2% (n=189) were male. Most dental examinations were attended by resident/registrar dentists (72.1%). A total of 1644 discordant data representation between dental and medical pair of records has been identified. More than half (53.7%; n=995) of disease items as in medical records were missing, and 0.8% (n=35) of disease items not among the patients’ history were “falsely” endorsed in dental records 2(df=1)= 2385.5   p<0.0001]. Patients’ age was associated with proneness to neglecting health data while submitting to orodontal care [Fisher’s exact = 15.2, p<0.0001]. Male dentists tended to report more discordant data incidents (97% vs. 90%) [χ2(1)= 7.3, p=0.007]. Less professional staff, and less experienced, tend to report discordantly more frequently than senior peers (96.6% vs. 84.2%, respectively) [Fisher’s exact 8.3, p=0.028].

Conclusions: This study reveals the presence of miscommunication of health information of chronic disease patients between dental and medical records. Both patients’ criteria and the practitioners’ data management attitude may be incriminated. A standardized documentation system saves chronic disease patients the health and economic consequences of discordant data representation in records.


Open Access Original Research Article

Type 2 Diabetes and Myocardial Infarction in Central India: A Study and Review

Abha Pandit

Cardiology and Angiology: An International Journal, Page 1-14
DOI: 10.9734/CA/2017/30952

Background: Clinical experience in specific geo-demographic contexts in diabetes and myocardial infarction (MI) deserves examination in the context of current medical knowledge and redefinition for enlightened evidence based medical practice.

Aim: Study aims to examine regional significance of known risk factors in incidence and outcome of MI in diabetics in comparison with non-diabetics.

Methods: Cases of myocardial infarction managed over 18 month period at medical college setting in central India in 35 to 75 year age range and free from major systemic co-morbidities were comparatively studied by categorizing as diabetic and non-diabetics. Demographic, clinical and laboratory information as well as complications and outcome profiles were assessed.

Results: MI in diabetics occurred at younger age, was common among women, overweight subjects and those with positive family history of ischaemic heart disease. Smokers and hypertensive’s had high prevalence in MI cases among non-diabetics group. Poor glycaemic control and dyslipidaemia were common features in diabetic MI that was largely anterior suggesting extensive coronary atherosclerosis. Although statistically insignificant, most post infarct complications were more frequent among diabetics. Hospital stay was significantly longer for diabetic MI cases.                                                                                          

Conclusion: Study observations emphasize preventive role for dietary and lifestyle modification, weight reduction in diabetics and deterrence of smoking in non-diabetics as crucial. Management of hypertension is a necessary measure while good glycaemic control and correction of dyslipidaemia is pertinent in diabetics to reduce incidence and possibly severity of MI relevant in central Indian context. Angiotensin Converting Enzyme (ACE) inhibitors, beta adrenergic blockers and statins besides emergent glycaemic control with insulin have particular therapeutic relevance in diabetic MI.