Aims :To evaluate safety and efficacy of distal right radial access (DRRA) compared to right radial access (RRA), for coronary procedures, in patients with smaller diameter radial arteries (SDRA) (radial artery diameter (RAD) < 2.1 mm). Methods and results This is a retrospective analysis of safety and efficacy of DRRA Vs. RRA in patients undergoing coronary procedures at our cardiac catheterization laboratories over a 10- month period between September 2017 and June, 2018 (first 5 calendar months with RRA-first; next 5 calendar months with DRRA-first). All patients underwent pre-procedure ultrasound of arm arteries. All patients had RAD<2.1 mm (mean RAD 1.63 ± 0.27 mm; RAD≤1.6 mm in 73.5%). Baseline characteristics were similar between groups. Primary end-point of puncture success was significantly lower in DRRA vs RRA group [79.5% vs 98.5%, p < 0.0001]. Puncture success was also lower in the subgroup of patients with RAD <1.6 mm Vs. ≥ 1.6 mm in the DRRA group ( p < 0.0001). The secondary end-point of puncture time was significantly higher (2.1 ± 1.4 min vs. 1.0 ± 0.45 min, p < 0.00001) in the DRRA Vs. RRA group. The occurrence of vascular access site complications (including access site hematomas), radial artery occlusion (RAO) and distal RAO at day 1 and day 30 were similar between RRA and DRRA groups.Non-vascular access-site complication was seen only in the DRRA group. Conclusion DRRA is a safe and effective access for coronary procedures; though technically challenging in patients with SDRA (RAD<2.1 mm; mean RAD 1.63 ± 0.27 mm), with lower puncture success and higher puncture time compared to RRA.

ObjectiveThe study aimed to explore the relationship of the telomere length with type 2 diabetes mellitus (DM) among patients with ischemic heart disease (IHD).MethodThis 2-year cross-sectional study included 130 male patients diagnosed with IHD through echocardiography and coronary angiography, wherein consecutive IHD patients with type 2 DM (65) and without type 2 DM (65) were selected. Baseline characteristics including age, gender, body mass index, and blood pressure were recorded. Laboratory investigations such as random blood sugar (RBS), fasting lipid profile, serum creatinine, and serum urea levels were measured. Quantitative real-time polymerase chain reaction was used for the measurement of the telomere length. The logistic regression analysis was used to predict the relationship of the telomere length with age and type 2 DM among patients with IHD.ResultsAll the patients in the study were men, and most of them (diabetics = 22; nondiabetics = 20) were aged between 56 and 65 years. Age (p = 0.003), telomere length (p < 0.001), RBS (p < 0.001), serum creatinine (p < 0013), and serum urea (p < 0.04) were significantly higher in the diabetic subset than in the nondiabetic subset. No significant relationship was observed between age and the telomere length (p = 0.813); however, the mean telomere length was significantly high among the patients with type 2 DM than those without type 2 DM (p = 0.005). The logistic regression analysis showed that the telomere shortening (p = 0.00019) and RBS (p < 0.0001) were the significant risk factors for type 2 DM in patients with IHD.ConclusionThe telomere shortening was significantly correlated with type 2 DM among the patients with IHD. However, multicentric studies with larger samples are required to validate the current observation.

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Background: The unmonitored surge in the usage of Internet recently has led to Internet Addiction. Internet is a classical instrument known to stimulate addictive behaviour which is on the verge of developing into a considerable public health emergency in the future in a densely populated country like India. Adolescents are more susceptible to this as they spend more time browsing the web. This cross sectional study intends to find out the co-morbidities associated with Internet Addiction in students of health sciences in India.Methods: The study was conducted in an Indian Medical and Dental College. 900 students were randomly selected to fill up the questionnaire. 618 students fulfilled the selection criteria. Young’s Internet Addiction Test was used for assessing the prevalence of Internet Addiction. The Rosenberg self-esteem scale was used to measure the self-esteem.Results: 19.5% students were not addicted to Internet. 61% of students were mildly addicted while 19.5% students were moderately addicted. Significant association was found between academic performance and Internet Addiction. Also, Internet Addiction had no significant association with Self- Esteem and Obesity.Conclusions: Proper screening methods should be used for prompt detection and management of Internet Addiction and awareness should be made about the same. It should be given more attention and students should be made to understand about healthy and safe practices to use internet. There is a need of an improved questionnaire which can provide us better understanding of internet usage by people in terms of amount of time and purpose of using the internet.