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Background: Ayurveda is an ancient medicine system of the Indian subcontinent. The word Ayurveda is a conjugation of two Sanskrit words 'ayus', meaning 'life' and 'veda', meaning 'science', thus ayurveda literally means the 'science of life'. Moreover, Moreover, Ahara vidhi literally means method of taking diet. It includes diet and dietary guidelines. The concept of diet in Ayurveda has a broader view beyond ingestion of food, unlike modern dietetics which is restricted to concept of calorie consumption, Ayurveda recommends methods of taking food, its quality and quantity based upon individual’s capacity to digest (Agni). Materials: Questionnaire on the basis of Literature available in Ahara vidhi -Dietary Guidelines in Ayurveda Classics was developed. Methods: Proper guideline of development of questionnaire has been followed. Results: After the Development of Dietary Questionnaire the questioner sent to the expert to check the face validity and content validity of the Questionnaire with proper concept of statistical Analysis. Discussion: In this article, various aspects of concept of diet in Ayurveda are discussed. Conclusion: Ayurveda diet practices and principles are helpful to improve the human health.

BackgroundThe response to COVID-19 has required cancellation of all but the most urgent procedures; there is therefore a need for the reintroduction of a safe elective pathway.MethodsThis was a study of a pilot pathway performed at Barts Heart Centre for the admission of patients requiring elective coronary and structural procedures during the COVID-19 pandemic (April–June 2020). All patients on coronary and structural waiting lists were screened for procedural indications, urgency and adverse features for COVID-19 prognosis and discussed at dedicated multidisciplinary teams. Dedicated admission pathways involving preadmission isolation, additional consent, COVID-19 PCR testing and dedicated clean areas were used.Results143 patients (101 coronary and 42 structural) underwent procedures (coronary angiography, percutaneous coronary intervention, transcatheter aortic valve intervention and MitralClip) during the study period. The average age was 68.2; 74% were male; and over 93% had one or more moderate COVID-19 risk factors. All patients were COVID-19 PCR negative on admission with (8.1%) COVID-19 antibody positive (swab negative). All procedures were performed successfully with low rates of procedural complications (9.8%). At 2-week follow-up, no patients had symptoms or confirmed COVID-19 infection with significant improvements in quality if life and symptoms.ConclusionWe demonstrated that patients undergoing coronary and structural procedures can be safely admitted during the COVID-19 pandemic, with no patients contracting COVID-19 during their admission. Reassuringly, patients reflective of typical practice, that is, those at moderate or higher risk, were treated successfully. This pilot provides important information applicable to other settings, specialties and areas to reintroduce services safely.

Sentiment basically represents a person’s attitude, expressing thoughts or an expression triggered by a feeling. Sentiment analysis is the study of sentiments on a given piece of text. Users can express their sentiment/thoughts on internet which may have impact on the user reading it [7]. This expressed sentiment are usually available in unstructured format which needs to be converted. Sentiment analysis is referred to as organizing text into a structured format [7]. The challenge for sentiment analysis is insufficient labelled information, this can be overcome by using machine learning algorithms. Therefore, to perform sentiment analysis we have employed Deep Neural Network.

Garbhini individual where in garbha dwells or halts of garbha is termed as garbhini.paricharya the word \"paricharya\" is derived from the root \"chara-gatau\" with prefix \"pari\". charya that means to service or nuthegarbhiniparicharya is the care given to pregnant woman in necessary all respectful manner it?s very important for future social impact assessment. The month wise paricharya described in the Ayurveda that helps proper (samyaka) healthy growth and development of foetus and gives health and care to mother. Our Ayurvedacharyas know very well that not only the food and environment play a vital role in the development of foetus but also maternal psychic impressions have their impact on a growing foetus.

Mind is one of nine Karana Dravyas. This is an internal instrument helping Purusa to feel happiness or sorrowfulness in this SthulaSarira. It is always associated with Purusa either in SthulaSarira (Karma Purusa) or SuksmaSarira (LingaSarira) till Purusa gets liberated from bondage. The mind plays a key role in connecting or relating SukshmaSariraPurusha to SthulaSarira (Karma Purusha). Despite the role of action of connecting, each other, the credit of being called ?doer? goes only to Purusha and not Mind.

Background— Compared with transfemoral access, transradial access (TRA) for percutaneous coronary intervention is associated with reduced risk of bleeding and vascular complications. Studies suggest that TRA may reduce mortality in patients with ST-segment–elevation myocardial infarction. However, there are few data on the effect of TRA on mortality, specifically, in patients with non–ST-segment–elevation myocardial infarction. Methods and Results— We analyzed 10 095 consecutive patients with non–ST-segment–elevation myocardial infarction treated with percutaneous coronary intervention between 2005 and 2011 in all 8 tertiary cardiac centers in London, United Kingdom. TRA was a predictor for reduced bleeding (odds ratio=0.21; 95% confidence interval [CI]: 0.08–0.57; P =0.002), access-site complications (odds ratio=0.47; 95% CI: 0.23–0.95; P =0.034), and 1-year mortality (hazard ratio [HR]=0.72; 95% CI: 0.54–0.94; P =0.017). Between 2005 and 2007, TRA did not appear to reduce mortality at 1 year (HR=0.81; 95% CI: 0.51–1.28; P =0.376), whereas between 2008 and 2011, TRA conferred survival benefit at 1 year (HR=0.65; 95% CI: 0.46–0.92; P =0.015). The mortality benefit with TRA at 1 year was not seen at the low-volume centers (HR=0.80; 95% CI: 0.47–1.38; P =0.428) but specifically seen in the high volume radial centers (HR=0.70; 95% CI: 0.51–0.97; P =0.031). In propensity-matched analyses, TRA remained a predictor for survival at 1 year (HR=0.60; 95% CI: 0.42–0.85; P =0.005). Instrumental variable analysis demonstrated that TRA conferred mortality benefit at 1-year with an absolute mortality reduction of 5.8% ( P =0.039). Conclusions— In this analysis of patients with non–ST-segment–elevation myocardial infarction, TRA appears to be a predictor for survival. Furthermore, the evolving learning curve, experience, and expertise may be important factors contributing to the prognostic benefit conferred with TRA.

Background— Primary percutaneous coronary intervention (PPCI) is the treatment of choice for ST-segment–elevation myocardial infarction. Resources are limited during out of working hours (OWH). Whether PPCI outside working hours is associated with worse outcomes and whether outcomes have improved over time are unknown. Methods and Results— We analyzed 11 466 patients undergoing PPCI between 2004 and 2011 at all 8 tertiary cardiac centers in London, United Kingdom. We defined working hours as 9 am to 5 pm (Monday to Friday). We analyzed in-hospital bleeding and all-cause mortality ≤3 years, comparing OWH versus in-working hours. A total of 7494 patients (65.3%) were treated during OWH. Multivariable analyses demonstrated that PPCI during OWH was not a predictor for bleeding (odds ratio, 1.47; 95% confidence interval [CI], 0.97–2.24; P =0.071) or 3-year mortality (hazard ratio, 1.11; 95% CI, 0.94–1.32; P =0.20). This was confirmed in propensity-matched analyses. Time-stratified analyses demonstrated that PPCI during OWH was a predictor for bleeding (odds ratio, 2.00; 95% CI, 1.06–3.80; P =0.034) and 3-year mortality during 2005 to 2008 (hazard ratio, 1.23; 95% CI, 1.00–1.50; P =0.050), but this association was lost during 2009 to 2011. During 2005 to 2008, transradial access was predominantly used during in-working hours and PPCI during OWH was predictive of reduced transradial access use (odds ratio, 0.83; 95% CI, 0.71–0.98; P =0.033), but this association was lost during 2009 to 2011. Conclusions— In this study of unselected patients with ST-segment–elevation myocardial infarction, PPCI during OWH versus in-working hours had comparable bleeding and mortality. Time-stratified analyses demonstrated a reduction in adjusted bleeding and mortality during OWH over time. This may reflect the improved service provision, but the increased adoption of transradial access during OWH may also be contributory.

Background— It is estimated that up to two thirds of patients presenting with ST-segment–elevation myocardial infarction have multivessel disease. The optimal strategy for treating nonculprit disease is currently under debate. This study provides a real-world analysis comparing a strategy of culprit-vessel intervention (CVI) versus multivessel intervention at the time of primary percutaneous coronary intervention in patients with ST-segment–elevation myocardial infarction. Methods and Results— We compared CVI versus multivessel intervention in 3984 patients with multivessel disease undergoing primary percutaneous coronary intervention between 2004 and 2011 at all 8 tertiary cardiac centers in London. Multivariable-adjusted models were built to determine independent predictors for in-hospital major adverse cardiovascular events (MACEs) and all-cause mortality at 1 year. To reduce confounding and bias, propensity score methods were used. CVI was associated with reduced in-hospital MACE (4.6% versus 7.2%; P =0.010) and mortality at 1 year (7.4% versus 10.1%; P =0.031). CVI was an independent predictor for reduced in-hospital MACE (odds ratio, 0.49; 95% confidence interval [CI], 0.32–0.75; P P =0.011) in the complete cohort; and in 2821 patients in propensity-matched cohort (in-hospital MACE: odds ratio, 0.49; 95% CI, 0.32–0.76; P =0.002; and 1-year survival: hazard ratio, 0.64; 95% CI, 0.45–0.90; P =0.010). Inverse probability treatment weighted analyses also confirmed CVI as an independent predictor for reduced in-hospital MACE (odds ratio, 0.38; 95% CI, 0.15–0.96; P =0.040) and survival at 1 year (hazard ratio, 0.44; 95% CI, 0.21–0.93; P =0.033). Conclusions— In this observational analysis of patients with ST-segment–elevation myocardial infarction undergoing primary percutaneous coronary intervention, CVI was associated with increased survival at 1 year. Acknowledging the limitations with observational analyses, our findings support current recommended practice guidelines.

Current guidelines discourage percutaneous coronary intervention (PCI) of non-infarct-related arteries at the time of primary PCI in patients with ST-elevation myocardial infarction (STEMI) without cardiogenic shock. The optimal strategy for treating non-culprit disease is currently under debate.

Background Research trials have shown improved short-term outcome with DES over BMS in Saphenous vein graft (SVG) PCI, primarily by reducing target vessel revascularisation (TVR) for in-Stent Restenosis (ISR). Because of the high event rates in these patients it is not clear if these benefits are maintained long term. We compared the outcomes in patients undergoing SVG stent implantation treated with DES or BMS, over a prolonged follow-up period. Methods Clinical information was analysed from a prospective database on 512 patients who underwent PCI for SVG lesions between 2003 and 2010 at a London centre. Information was entered at the time of procedure and outcome assessed by all-cause mortality information provided by the Office of National Statistics via the BCIS/CCAD national audit. The primary end point used was major adverse cardiac events (MACE), defined as death, myocardial infarction (MI), stroke and target vessel revascularisation (TVR). Results There were 293 patients who underwent PCI with BMS and 219 treated with DES. The mean follow-up period was 1086±418 days for the BMS group and 1046±390 days for the DES group. Baseline characteristics were the same between the groups other than diabetes, which was more common in the DES treated group (24% vs 15%, p Conclusions In our cohort of patients who had PCI for treatment of SVG disease the use of DES resulted in lower MACE rate compared to BMS over a 5-year follow-up.

In primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI), the relative safety of drug-eluting stents (DES) versus bare metal stents (BMS) continues to be debated. Whilst DES use is associated with reduced target lesion revascularization rates, stent

Background Previous studies have demonstrated a relationship between pre-existing anaemia and inpatient mortality after percutaneous coronary intervention (PCI). There is limited data looking at the impact of baseline Haemoglobin and long term outcome after primary PCI. Methods Clinical information was analysed from a prospective database on 2357 STEMI patients who underwent Primary PCI between January 2004 and May 2010 at a London centre. Information was entered at the time of procedure and outcome assessed by all-cause mortality information provided by the Office of National Statistics via the BCIS/CCAD national audit. Anaemia was defined according to WHO definition of Hb greater than or equal to 12 g/dl for females and 13 g/dl for males. Results 471 (20%) patients were anaemic at presentation. The anaemic cohort, were older (72.2 vs 62.4, p Conclusion Patients presenting with anaemia undergoing primary PCI appear at significantly higher risk of an adverse outcome. This risk increases further in population receiving RBC transfusions during index hospitalisation.

Background The incidence of Infective endocarditis (IE) in dialysis patients is higher than the general population. Dialysis patients who develop endocarditis are thought to have a poorer prognosis. We examined the risk factors and outcome of IE in a dialysis cohort. Methods A retrospective analysis of all patients developing IE on dialysis (using the Duke criteria) was undertaken between 1998 and 2008. Patients were identified using a prospectively collected clinical database. Results Thirty patients developed IE out of a total dialysis population of 1500 (incidence 2% year; normal population 0.003–6%). The overall 1-year survival was 50%. Ninety three per cent (28/30) patients were on long-term haemodialysis (HD) and 7% (2/30) on peritoneal dialysis (PD). Mean patient age was 59 years (range: 32–87), and mean duration of HD prior to IE was 34 months. Primary HD access was an arteriovenous fistula in 32% (9/28), a dual-lumen tunnelled catheter in 54% (15/28), and a dual-lumen non-tunnelled catheter in 14% (4/28). Staphylococcus aureus (SA) (including MRSA) was present in 47% (14/30). The aortic valve was affected in 47% (14/30) of patients, mitral valve in 27% (6/30) of patients, and both valves in 10% (3/30). Thirty-six per cent of patients had an abnormal valve before the episode of IE. In 20% (6/30) valve surgery was performed and survival was 83% at discharge and was maintained at 1 year (abstract 095 figure 1). In 80% (24/30) antibiotic therapy alone was employed and survival was 83% (20/24) at discharge, but only 38% (9/24) at 1 year. Age >60, septic emboli and MRSA were all adverse prognostic factors. Patients receiving surgery were younger (mean 56 vs 61) and less likely to be infected with SA (surgery 29% vs antibiotics 70%). Conclusions This is one of the largest reported series of IE in dialysis patients. The incidence of IE remains high and the prognosis poor in dialysis patients, although patients selected for early valve surgery have good 1-year survival.

Background Primary percutaneous coronary intervention (PPCI) is the treatment of choice for ST-segment elevation myocardial infarction (STEMI) provided PPCI is performed in a timely manner. There is conflicting data regarding the outcomes of patients treated in-hours vs out of-hours, we sought to determine whether in-hospital and long-term outcomes are different among in-hours vs out of hours PPCI patients. Method Clinical information was analysed from a prospective data base on 1692 STEMI patients who underwent Primary PCI between January 2004 and March 2009 at a London centre. Information was entered at the time of procedure and outcome assessed by all-cause mortality information provided by the Office of National Statistics via the BCIS/CCAD national audit. In hours (IH) was defined as PPCI occurring on weekdays from 0800 to 1700 and out of hours (OFH) was defined as PPCI occurring from 1701 to 0759 during weekdays and anytime on weekends. Results Of the 1692 patients in the study, 46% (779/1692) underwent out of hours PPCI and 54% (913/1692) in hours. There were no differences in baseline clinical or angiographic characteristics between the two groups (see Abstract 123 Table 1). In the overall study group, door-to-balloon times (D2B) were not different (66 min±26 vs 68 min±34, p=0.77). The out of hours patients tended to present later with significantly longer symptom to balloon times (p=0.007). There was a significant difference in MACE between the two groups in favour of those patients treated in hours (7% OFH vs 4% IH, p=0.03) at 30 days, at 1 year (12% OFH vs 7% IH, p=0.002) and at 3 years (13% vs 9%, p=0.02) MACE was driven by increase in mortality, myocardial infarction and TVR in the out of hours group. Conclusion STEMI patients have worse clinical outcomes if treated out of hours by PPCI. This observation does not appear related to PCI centre door to balloon times. Further research is needed to understand and improve the causes of the worse outcomes out of hours.

Background The western world consists of an ageing population. As a consequence, the number of Octogenarians (>80 s) undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is increasing. Currently, little is known about their clinical characteristics or outcomes after primary PCI for STEMI. We therefore analysed such variables to establish an optimal treatment strategy for octogenarians. Methods Clinical information was analysed from a prospective database of 1717 STEMI patients who underwent PCI between October 2004 and February 2009 at a London centre. Information was entered at the time of procedure and outcome assessed by all-cause mortality provided by the Office of National Statistics via the BCIS/CCAD national audit. The primary end point was major adverse cardiac events (MACE), defined as death, myocardial infarction (MI), stroke and target vessel revascularization (TVR). Results A total of 267 Octogenarians (15.6% of the study population) with an average age of 82.5 years (range: 80–94), were treated with primary PCI. Of these, 51% (137/267) were male, 34% (88/259) had 3VD, 20% (54/267) had a previous history of MI, 17% (45/267) were diabetic and 12% (31/267) presented in cardiogenic shock. The Octogenarians had significantly greater co-morbidities than their younger counterparts (see Abstract 126 Table 1). Excluding those presenting in cardiogenic shock, 30-day and 1-year mortality rates within the octogenarian cohort were 4% and 10%, respectively. These were significantly higher than mortality rates within the younger subgroup (30-day 2%, 1-year 4% p Conclusion Octogenarians constitute an increasingly important subgroup of STEMI patients and mortality amongst them is higher than younger counterparts. Little is known about their optimal treatment as they are underrepresented in randomised clinical trials, however the mortality figures in those patients not presenting in cardiogenic shock is encouraging.

Background Stent thrombosis (ST) is a recognised cause of ST Elevation Myocardial infarction (STEMI) in patients with previous percutaneous coronary interventions (PCI). The incidence is increasing and to date outcomes are not well characterised. We therefore sought to compare STEMI caused by ST vs de novo coronary thrombosis to evaluate procedural risk and clinical outcome. Method Clinical information was analysed from a prospective database on 1718 patients who underwent Primary PCI following STEMI between October 2003 and March 2009 at a London centre. Information was entered at the time of procedure and outcome assessed by all-cause mortality information provided by the Office of National Statistics via the BCIS CCAD national audit. Results Stent thrombosis (ST) accounted for 6.9% (119/1718) of all STEMIs with a frequency that has increased over time (5.4% in 2005 to 9.8% 2008). Drug-eluting stents (DES) accounted for 42% of ST overall and 67% over the past 3 yrs. ST occurred early (0-30d) in 30% (36/119), late (30d-1 yr) in 31% (37/119) and very late (> 1 yr) in 39% (46/119) of pts. Pts with ST compared to native artery occlusion had higher rates of previous MI (50.9% vs 12%, p Conclusion Stent thrombosis accounts for an increasing proportion of STEMI and is associated with worse outcomes compared with native artery occlusion. New strategies are needed to address this growing problem.