Evidence for cardiac rehabilitation in the modern era

Management of cardiovascular disease (CVD) has rapidly improved during recent decades and is still changing with the introduction of novel medication and advanced invasive procedures and devices. Notwithstanding these developments, cardiac rehabilitation (CR) is still a cornerstone of secondary prevention. Its effectiveness in improving the physical condition of chronic coronary syndrome (CCS) patients is beyond doubt, but its effectiveness on extending life expectancy is still a matter of debate. This chapter provides insights into the latest evidence (mainly presented in a recent meta-analysis of randomized controlled trials (RCTs) or controlled cohort studies) on the role of CR on morbidity and mortality in patients after an acute coronary event.

Life style patterns and adherence to pharmacotherapy after acute coronary syndrome: one year follow up study from a tertiary care center in Kashmir, India

Background: Acute coronary syndrome is the leading cause of cardiac mortality and morbidity world over. Modification of life style pattern and adherence to pharmacotherapy plays a vital role in primary and secondary prevention of coronary events. This study was aimed at assessing the penetration of life style modifications and adherence to pharmacotherapy after acute coronary event in our population.Methods: Acute coronary syndrome patients enrolled in the study were examined, interviewed and all the demographic and clinical data was recorded at index event and at 3, 6 and 12 month intervals.Results: A total of 260 patients were enrolled in the study and followed for 12 months. Mean age of patients was 55.6±8.27 years. Males 78.6% and females 21.5%. Hypertension was risk factor in 67.7%, diabetes in 26.2%, smoking in 63.8%, BMI ≥25 in 67.3% and family history of coronary artery disease in 8.8% of the cases at index event. Uncontrolled hypertension was observed in 30.11%, 38.63% and 44.88% patients at 3, 6 and 12 months follow up. Uncontrolled diabetes at 3, 6 and 12 months was found in 58.82%, 66.17% and 73.52% patients. 5.42%, 15.06% and 21.08% cases continued to smoke at 3, 6 and 12 months respectively. Drug non-compliance overall was noted in 9.61%, 17.69% and 23.84% cases at 3, 6 and 12 month follow up.Conclusions: This study highlights the under prevalence of modifiable risk factor change in practice and drug non-compliance after an acute coronary event.

Smart Traffic Controller Implementation using FPGA

Every second heart attack patient in India takes 7 hours to reach a hospital, which is almost 14 times more than the ideal time within which a heart patient should be treated that is 30 minutes, government data shows.A two-year data from the ongoing Management of Acute Coronary Event (MACE) Registry of the Indian Council of Medical Research (ICMR) shows at some places it even takes 15 hours. A lot of precious time is still being wasted in traffic. Also some lines in the traffic junction are prone to traffic than the other lines and all the lines are held green for the same time irrespective of the density of traffic. The FPGA (Basys-3) based traffic controller sets the light green of a line if it detects ambulance (using sound sensor) in that particular line. Also if the density (determined using IR sensor) in one of the lines is high that particular line is held green for longer time.