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the finding of hookworm eggs in feces. This work presents the most up-to-date data on enteric feline parasite prevalence in the metropolitan Bangkok area from which fecal samples were directly collected from cats. Consequently, this study emphasizes that diagnosis of parasitic infections and the routine use of antiparasitic medications should be encouraged by veterinarians and to owners in order to reduce the reservoir of potentially zoonotic parasites.Australian Wool Innovation Limited (AWI) commissioned three cross-sectional surveys of sheep producers' sheep parasite control practices over a 15-year period from 2003 to 2018. The aims were to document current sheep parasite incidence and control practices, to measure change in sheep parasite control practices over time and to inform extension messages for sheep industry advisors and sheep farmers. The surveys were conducted in 2004, 2012 and 2019 measuring sheep parasite control practices in the years 2003, 2011 and 2018. The surveys focused on incidence and control of the three major sheep parasite groups; gastrointestinal nematodes, blowflies and lice. The 2003 and 2011 surveys were paper-based and the 2018 survey was accessed via a link to an online survey. This article is the first in a series of four presenting the results of the three surveys and will cover methods, demographics, production systems and general parasite management. Response rates to the surveys declined each year from the peak responsce treatment for introduced sheep from 2011 (50%) to 2018 (21%). Farmers rated themselves, other farmers or member of their staff as most important sources of information on parasite control in both 2011 and 2018. There was a significant increase in the proportion of respondents visiting the ParaBoss suite of websites from 2011 to 2018 confirming their growing importance for information delivery and decision support.Dicrocoelium dendriticum is a helminth which lives in the bile ducts and gall bladder of mammalian definitive hosts. Dicrocoeliosis is thought to be endemic in some countries and it has an increasing prevalence in Northern Iraq, potentially due to increased importation of infected animals, particularly sheep, in high numbers from neighboring countries. The parasite's ability to infect rodents, wild animals, livestock and humans means this parasite is of significant interest in veterinary and human medicine. While D. dendriticum causes relatively mild clinical disease in animals, infection leads to liver condemnation at slaughter and subsequent economic losses to farmers. In this study, the livers of 91,486 sheep slaughtered at Sulaymaniyah New Slaughterhouse (Northern Iraq) were visually inspected for D. dendriticum infection between November 2013 and March 2014, with 1269 livers rejected due to D. dendriticum in this period, representing 29.4% of all condemned livers. The highest rate of rejection due to D. dendriticum infection was seen in December, possibly linked to increased numbers of intermediate host snails during the wet season. Routine inspection of condemned livers revealed adult flukes of D. dendriticum and eggs were seen in the faeces of imported sheep, indicating these animals may be a vector for introduction of D. dendriticum to this region. Due to the complex life cycle and wide range of animals which it infects, we cannot establish the exact route of introduction into Iraq; however, our study suggests that slaughterhouse workers, farmers and local health authorities should be aware of the presence of D. dendriticum, and the potential risks it represents to both human and animal health. Our data also suggest that some level of quarantine or border checks may be useful to prevent further introduction of D. dendriticum or other pathogens into Iraq, although this may prove difficult until accurate diagnostic assays are developed.Novel oral anticoagulants, with dabigatran in particular have failed in their quest to replace the traditional anticoagulation in the form of vitamin K antagonist in patients with mechanical valvular implants. Cenicriviroc clinical trial However, the same had not been tried in bioprosthetic valve recipients until recently in a large trial where rivaroxaban was found to be non-inferior to warfarin on head-to-head basis. This commentary discusses the various aspects related to oral anticoagulation in bioprosthetic valve recipients in the light of recent clinical evidence.

Genetic contribution in acute rheumatic fever (ARF)/rheumatic heart disease (RHD) has been suggested but not according to severity of the valve involvement. This study attempts to identify the relevance of CTLA-4 polymorphism with severity of the disease.

In a case-control design, 291 healthy controls and 83 patients were genotyped for association between RHD and single-nucleotide polymorphisms-1661A/G of CTLA-4.

Segregation of patients on the basis of severity i.e., MVL (Mitral Valve Lesion) and CVL (Combined Valve Lesion) revealed that the frequency of CTLA-4-1661G allele depleted as the disease progressed to CVL (p<0.05). Patients in the age group of 31-45 years were significantly more susceptible (p<0.046). Whereas, female patients were more susceptible than the male patients.

Our study suggests the risk associated with decreased frequency of CTLA-4-1661G allele in the CVL group and in females.

Our study suggests the risk associated with decreased frequency of CTLA-4 -1661G allele in the CVL group and in females.MicroRNAs (miRNA) are prerequisite for cardiovascular functions. miRNA miR-208 b is a cardio-specific miRNA with tissue (atrial) levels elevated in atrial fibrillation (AFib) and blood levels significantly elevated in myocardial infarction. We calculated serum levels of miR-208 b in paroxysmal and persistent AFib, embolic cerebrovascular accident patients with AFib as possible etiology and controls. There was a statistically significant change of miR-208 b levels in paroxysmal (p = 0.044) and persistent (p = 0.040) AFib patients, but not for embolic CVA patients. miR-208 b could serve as a new serum marker for paroxysmal AFib.We prospectively studied whether left atrial (LA) fibrosis is a determinant of atrial fibrillation (AF) in mitral stenosis in patients who underwent balloon mitral valvotomy. There were 2 groups Group A (n = 16), with AF and Group B (n = 27), without AF. Fibrosis was assessed by MRI. Patients underwent cardioversion before MRI. There were 27 females and 16 males, aged 29 ± 6 years. The LA areas in Groups A and B were 54.3 ± 4.4 mm2 and 39.4 ± 2.3 mm2 (p less then 0.05) and the LA volume index was 46.2 ± 2.9 ml/m2 vs 33 ± 3 ml/m2 respectively (p less then 0.0001). The presence of LA scarring was not statistically different in the two groups.Acromegaly is associated with increased cardiovascular morbidity and mortality. 49 acromegaly patients were evaluated for presence of cardiovascular risk factors and manifestations using 2D-Echocardiography, strain, strain-rate, carotid intima media thickness (CIMT) and flow mediated dilatation (FMD) and correlated with disease activity. 32 patients with growth hormone (GH) level >1 ng/ml were considered active. Patients with active disease have more LV dysfunction as assessed by strain(p-0.031) and strain rate(p-0.001); trend towards lower ejection fraction(p-0.11) with significant correlation to GH(cc -0.252,p-0.05). Patient with active disease have reduced FMD(p- 0.042); with no difference in prevalence of cardiovascular risk factors and CIMT inrelation to disease activity.This series reports the safety and feasibility of MitraClip (Abbott Vascular) in 7 high surgical risk Indian patients with symptomatic mitral regurgitation (MR). The clip was deployed successfully in all patients, and more than one clip was required in 5. All had reduction in MR to ≤2+. Mean mitral valve gradient was 3.0 ± 0.8 mmHg. At 12 months follow up, all were alive, and the MR grade was 1+ in 6 patients and 2+ in one. Mean MV gradient was 3.4 ± 1.0 mmHg. The modified Kansas City Quality of life (KCQ) analysis revealed significant improvement in their quality of life (p less then 0.0001).

Our objectives were to evaluate the outcomes of left main percutaneous coronary interventions in Acute Coronary Syndrome population.

This is a retrospective& observational study. Primary endpoint is a composite of death, stent thrombosis/MI, target lesion revascularization. Secondary endpoints include individual components of the primary events analyzed separately.

Seventy five patients, two year follow - up data was analyzed. The primary event analysis showed that the Elective Double Stent (EDS) group had a higher primary events (36% vs. 14%, p value - 0.008, Hazard ratio - 0.76 (0.51-1.15, 95% CI), in secondary event analysis stent thrombosis (ST)/Myocardial infarction (MI) rates were higher in EDS group (8% Vs 36%, p Value - 0.008, Hazard ratio- 0.63(0.35-1.14, 95%CI), there is no difference in target lesion revascularization (TLR)and death rates in both the groups.

The provisional strategy is better than EDS in treatment of left main bifurcation lesions in the ACS population.

The provisional strategy is better than EDS in treatment of left main bifurcation lesions in the ACS population.

The time from symptom onset to arrival at healthcare facility, and door to reperfusion time in treatment of acute coronary syndrome (ACS) can be improved significantly if the patient or the relatives can record a 12-lead ECG at home and transmit it to the physician for prompt interpretation. To make this widely applicable, the 12-lead ECG recording device has to be simple and user friendly. In this regard, torso ECG (T-ECG) electrode positions that are less cumbersome than the conventional ECG (C-ECG) electrode positions are an alternative worthy of consideration.

and setting To study the utility of T-ECG versus C-ECG in ACS patients.

and intervention We proposed torso electrode positions in which upper limb electrodes were placed in the respective deltopectoral grooves below the lateral end of the clavicle; the right lower limb electrode was placed 2 finger breadths above the umbilicus and the left lower limb electrode, 2 finger breadths to the left of the umbilicus. We then studied the ECGs recorded, ions of ST elevation and ST depression were also accurately diagnosed by the T-ECG.

The ECG recorded by our novel proposed torso electrode positions is comparable to a conventional ECG for the diagnosis of ACS.

The ECG recorded by our novel proposed torso electrode positions is comparable to a conventional ECG for the diagnosis of ACS.

In 2017, the American College of Cardiology/American Heart Association revised guidelines for diagnosis and management of hypertension in adults. The regional impact of the updated guidelines on the prevalence of hypertension in India is unknown.

Data from nationally representative Indian households were analyzed to estimate the regional prevalence of hypertension according to the old and the new guidelines in men (age 18-54 years) and women (age 18-49 years). The old guidelines defined hypertension as a systolic blood pressure of ≥140mmHg or diastolic blood pressure of ≥90mmHg or treatment. The new guidelines define hypertension as a systolic blood pressure of ≥130mmHg or diastolic blood pressure of ≥80mmHg or treatment. We calculated the increase in the prevalence of hypertension among the states and union territories of India (hereafter "states").

Among 679,712 participants (85.6% women), the median age was 31 years (interquartile range 24, 40) and was comparable among men and women (33 vs. 31 years, respectively).