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STATISTICAL PAGES
Chi-square test and its application in hypothesis testing
Rakesh Rana, Richa Singhal
January-April 2015, 1(1):69-71
DOI:10.4103/2395-5414.157577
In medical research, there are studies which often collect data on categorical variables that can be summarized as a series of counts. These counts are commonly arranged in a tabular format known as a contingency table. The chi-square test statistic can be used to evaluate whether there is an association between the rows and columns in a contingency table. More specifically, this statistic can be used to determine whether there is any difference between the study groups in the proportions of the risk factor of interest. Chi-square test and the logic of hypothesis testing were developed by Karl Pearson. This article describes in detail what is a chi-square test, on which type of data it is used, the assumptions associated with its application, how to manually calculate it and how to make use of an online calculator for calculating the Chi-square statistics and its associated P-value.
78,420 4,512 22
CURRICULUM IN CARDIOLOGY - STATISTICAL PAGES
Decoding the Bland–Altman plot: Basic review
Aakshi Kalra
January-April 2017, 3(1):36-38
DOI:10.4103/jpcs.jpcs_11_17
The Bland–Altman plot is a method for comparing two measurements of the same variable. The concept is that X-axis is the mean of your two measurements, and the Y-axis is the difference between the two measurements. The chart can then highlight anomalies, for example, if one method always gives too high a result, then all points are above or below the zero line. It can also reveal that one method overestimates high values and underestimates low values. If the points on the Bland–Altman plot are scattered all over the place, above and below zero, then it suggests that there is no consistent bias of one approach versus the other. It is, therefore, a good first step for two measurement techniques of a variable.
33,732 3,208 14
CURRICULUM IN CARDIOLOGY - STATISTICS
Linear regression analysis study
January-April 2018, 4(1):33-36
DOI:10.4103/jpcs.jpcs_8_18
Linear regression is a statistical procedure for calculating the value of a dependent variable from an independent variable. Linear regression measures the association between two variables. It is a modeling technique where a dependent variable is predicted based on one or more independent variables. Linear regression analysis is the most widely used of all statistical techniques. This article explains the basic concepts and explains how we can do linear regression calculations in SPSS and excel.
29,073 3,124 10
REVIEW ARTICLES
Types of sampling in research
Pooja Bhardwaj
September-December 2019, 5(3):157-163
DOI:10.4103/jpcs.jpcs_62_19
Sampling is one of the most important factors which determines the accuracy of a study. This article review the sampling techniques used in research including Probability sampling techniques, which include simple random sampling, systematic random sampling and stratified random sampling and Non-probability sampling, which include quota sampling, self-selection sampling, convenience sampling, snowball sampling and purposive sampling.
22,790 1,636 2
STATISTICAL PAGES
Commonly used t-tests in medical research
RM Pandey
May-August 2015, 1(2):185-188
DOI:10.4103/2395-5414.166321
Student's t-test is a method of testing hypotheses about the mean of a small sample drawn from a normally distributed population when the population standard deviation is unknown. In 1908 William Sealy Gosset, an Englishman publishing under the pseudonym Student, developed the t-test. This article discusses the types of T test and shows a simple way of doing a T test.
22,175 1,581 6
ORIGINAL ARTICLES
Lung transplant: The Indian experience and suggested guidelines – Part 1 selection of the donor and recipient
T Sunder, T Paul Ramesh, K Madhan Kumar, M Suresh, Sarvesh P Singh, S Seth
May-August 2018, 4(2):88-95
DOI:10.4103/jpcs.jpcs_46_18
Background: The selection of the correct donor lung is crucial for a successful lung transplant. Since the median survival after lung transplant is 5 years and the morbidity and mortality of lung transplant is higher than other transplants, it is crucial to preselect the correct recipient. Methodology: In India, Dr. P. Venugopal at the All India Institute of Medical Sciences, New Delhi, performed the first successful heart transplant, while Dr. K. M. Cherian performed the first heart–lung transplant at Chennai. At Apollo Hopsitals, Chennai, the first heart transplant was performed by Dr. M. R. Girinath. Subsequently, the Department of Heart and Lung Transplantation at Apollo Hospitals, Chennai, have performed a large number of heart and lung transplants and its experience is summarized. Results: The Department of Heart and Lung Transplantation at Apollo Hospitals, Chennai, has done 101 lung and 62 heart transplants as part of their lung and heart lung transplant program. There were 21 heart–lung transplants and 25 double lung transplants. The results are discussed and indications, contraindications for lung and heart–lung transplant as well as recipient and donor workup are discussed in this first part of a set of three articles. Conclusions: Careful selection of a recipient and donor leads to a successful lung and heart–lung transplant program.
18,649 592 3
CURRICULUM IN CARDIOLOGY - STATISTICS
Correlation analysis in biological studies
May-August 2018, 4(2):116-121
DOI:10.4103/jpcs.jpcs_31_18
Correlation is a statistical procedure to test the relationship between quantitative variables and categorical variables. In other words, it describes the degree of relation between two variables. It is one of the most commonly used statistical techniques. The present article is based on selected statistical textbook, review of the literature, and our own research experience study.
18,384 749 5
ORIGINAL ARTICLES
Heart failure in India: The INDUS (INDia Ukieri Study) study
Vivek Chaturvedi, Neeraj Parakh, Sandeep Seth, Balram Bhargava, S Ramakrishnan, Ambuj Roy, Anita Saxena, Namit Gupta, Puneet Misra, Sanjay Kumar Rai, K Anand, Chandrakant S Pandav, Rakesh Sharma, Sanjay Prasad
January-April 2016, 2(1):28-35
DOI:10.4103/2395-5414.182988
16,233 1,817 17
LESSONS FROM HISTORY
Hippocrates and the hippocratic oath
Saurabh K Gupta
January-April 2015, 1(1):81-86
DOI:10.4103/2395-5414.157583
For a long-time men had a philosophic view of health and disease, and this lasted till almost 2500 years back. Hippocrates, the great Greek physician, is believed to have seperated the "art of healing" and philosophy. An astute observer, Hippocrates during his practice employed principles that laid the foundation of modern medicine. The medical fraternity worldwide unanimously bestowed the title of "father of medicine" to this great man. Apart from being a physician, he was instrumental in bringing about the concept of ethics in the realm of medicine. The famous document "Hippocratic Oath" while being respected by almost all has generated a great amount of debate among historians. Nonetheless, almost all medical schools across the world have the Oath ceremony where medical graduates agree to the commandments of the Hippocratic Oath, either in its original or modified form. Although a statement of promise this Oath does not have any legal implications as might be seen by a person outside the medical community. This article outlines the contributions made by Hippocrates to the medical world with an emphasis on the Hippocratic Oath.
16,828 602 -
BEDSIDE MEDICINE
A case of right sided heart failure
Siddharthan Deepti, Saurabh Kumar Gupta
May-August 2015, 1(2):130-137
DOI:10.4103/2395-5414.166328
A patient of dominant right sided heart failure for 7 years is presented and discussed, starting from the history and examination findings and going on to all the investigations. The clinical findings, along with the electrocardiogram, chest X-ray, echocardiogram, and cardiac computed tomography are used to arrive at a diagnosis of chronic constrictive pericarditis. The differential diagnosis at each stage of presentation are presented and discussed.
13,044 860 -
REVIEW ARTICLES
Prosthetic heart valve thrombosis: Diagnosis and newer thrombolytic regimes
Shanmugam Krishnan
January-April 2016, 2(1):7-12
DOI:10.4103/2395-5414.182993
Prosthetic heart valve thrombosis incidence is high in developing countries and contributes to significant late mortality postvalve surgery. Many guidelines advocate surgery as the first line therapy though thrombolysis is often used in many centers. In this article, we review the newer regimens of fibrin-specific thrombolytics. Newer regimens of very low-dose, slow infusion lead to equal efficacy with lower complication in majority of patients. Patients with the New York Heart Association (NYHA) Class I–II who have low thrombus burden should receive thrombolysis with low-dose slow infusion while those with high thrombus burden should be planned for surgery. Patients presenting with NYHA Class IV should be treated with classical dose thrombolysis.
11,447 1,896 1
CURRICULUM IN CARDIOLOGY - BEDSIDE CASE
Case of cyanotic congenital heart disease
Shanmugam Krishnan, Preetam Krishnamurthy, S Ramakrishnan, Saurabh Gupta
May-August 2016, 2(2):114-119
DOI:10.4103/2395-5414.191526
A adult patient presented with cyanosis since early childhood. The clinical approach to such a patient, including review of the ecg, chest xray and echocardiogram is presented. Various aspects of the bedside approach to adult cyanotic heart disease are discussed
11,336 1,523 -
REVIEW ARTICLES
Deciphering the dilemma of parametric and nonparametric tests
Rakesh Kumar Rana, Richa Singhal, Pamila Dua
May-August 2016, 2(2):95-98
DOI:10.4103/2395-5414.191521
The potential source of complexity while analyzing the data is to choose on whether the data collected could be analyzed properly by the application of parametric tests or nonparametric tests. This concern cannot be underrated as there are certain assumptions which should be fulfilled before analyzing the data by applying either of the two types of tests. This article describes in detail the difference between parametric and nonparametric tests, when to apply which and the advantages of using one over the other.
11,466 969 2
MISCELLANEOUS - HISTORY
Development of mechanical heart valves - an inspiring tale
P Rajashekar
September-December 2015, 1(3):289-293
DOI:10.4103/2395-5414.177309
The historical evolution of the prosthetic heart valves from the first attempts with the Hufnagel's valve in the treatment of the aortic insufficiency to the Starr-Edwards' ball valve and later the tilting disc valves (Bjork-Shiley etc.,) and finally the bileaflet valves (St. Jude) are discussed. The Indian contribution with Chitra valve is also described.
11,025 1,356 3
REVIEW ARTICLES
Implications of 2017 hypertension guidelines for Indian patients
Rajiv Narang, S Srikant
January-April 2018, 4(1):3-5
DOI:10.4103/jpcs.jpcs_19_18
The new US blood pressure guideline lowers the definition of high blood pressure to 130/80 mm Hg.The new guideline adopts a key component of the 2013 cholesterol guideline and incorporates overall cardiovascular risk. The AAFP has decided to not endorse the recent hypertension guideline because it gave undue importance to the SPRINT trial and cardiovascular risk which was not validated and would lead to overtreatment. The guidelines are discussed in this article.
10,585 1,295 5
CURRICULUM IN CARDIOLOGY - CASE DISCUSSION
Ruptured sinus of valsalva aneurysm: Clinical case presentation and management
Nitin Kumar Parashar, Dinkar Bhasin, Patil Surajkumar Marotrao, Faraz Ahmed Farooqui, Sunil Kumar Verma, Anita Saxena
May-August 2017, 3(2):109-114
DOI:10.4103/jpcs.jpcs_27_17
A 27-year-old female presented with generalized body swelling and progressive shortness of breath for the past 4 months. On examination, she had a loud continuous murmur, elevated jugular venous pressure, and gross ascites. The examination findings, electrocardiogram, chest radiography, and echocardiogram are discussed in a step-wise manner to arrive at a diagnosis and plan of management of a patient with ruptured sinus of Valsalva aneurysm is discussed along with review of relevant literature.
10,075 1,156 -
REVIEW ARTICLES
Organ donation – Current Indian scenario
Senthilkumar Nallusamy, Shyamalapriya , Balaji , Ranjan , Yogendran
September-December 2018, 4(3):177-179
DOI:10.4103/jpcs.jpcs_59_18
Organ donation is one of the greatest medical marvels of the twentieth century which has saved the lives of several patients. The disparity between the huge demands for the organs and their poor supply is the main issue. The total organ donation shortage in our country can be met even if only few victims involved in fatal accidents serve as organ donors. Organ donation and successful retrieval of life saving organs is a complex process involving co-ordination of multiple transplant teams. This article reviews the different kinds of organ donors, evolution and present status of organ donation program in India, legal aspects of organ donation, process of pledging organs by a living person and the efforts taken to promote awareness about organ donation.
10,500 638 2
BEDSIDE MEDICINE
May-August 2015, 1(2):128-129
DOI:10.4103/2395-5414.166317
Kussmaul's has provided us with three important signs: Pulses paradoxus, Kussmaul's sign and Kussmaul Breathing. This article discusses Kussmaul's sign, its discovery, first description, pathophyiology and exceptions.
10,150 547 -
REVIEW ARTICLES
Heart failure guidelines for India: Update 2017
Sandeep Seth, S Ramakrishnan, Neeraj Parekh, G Karthikeyan, Sandeep Singh, Gautam Sharma
September-December 2017, 3(3):133-138
DOI:10.4103/jpcs.jpcs_1_18
Heart failure (HF) is a major health problem in India with a postadmission mortality of 20%–30%. Medication adherence ranges from 25% to 50%, and the tolerance of guideline-based medication is low for Indian patients. We took out guidelines on HF in 2015, and this update covers the changes which have occurred in HF management in the past 2 years. As a number of new drugs such as angiotensin receptor-neprilysin inhibitor and ivabradine have been approved for use in India, devices such as implantable cardioverter-defibrillators and cardiac resynchronization therapy are becoming more accessible and more left ventricular assist devices and transplants are being done in India, there is need for clear guidelines for the use of each which are practical for India.
9,118 1,478 5
CURRICULUM IN CARDIOLOGY - CASE DISCUSSION
A case of rheumatic heart disease with history of complicated pregnancy
Nirmal Ghati
January-April 2018, 4(1):41-48
DOI:10.4103/jpcs.jpcs_13_18
A 24-year-old female with rheumatic heart disease presents with a 6 years history of symptoms, with an eventful pregnancy, medical management, and subsequent surgery. The history and management is discussed.
9,306 560 -
ORIGINAL ARTICLES
Heart transplant in India: Lessons learned
Balram Airan, Sarvesh Pal Singh, Sandeep Seth, Milind Padmakar Hote, Manoj Kumar Sahu, Palleti Rajashekar, Velayoudham Devagourou, Sambhunath Das, Neeraj Parakh, Ruma Ray, Sudheer Arava
May-August 2017, 3(2):94-99
DOI:10.4103/jpcs.jpcs_25_17
Introduction: Heart Transplant in India started in 1994. We were initially doing 1-2 per year but the numbers have picked up since 2014 and we have done 25 in the past 3 years. We describe our experience of the last 4 years in this paper. Results: Initially, we experienced a relatively higher rate of rejections, fungal infections and graft failure. As we changed protocols, stopped using induction therapy except in high risk, maintained higher levels of immune suppression and tapered steroids faster in the first year, the complications reduced. All patients who had rejections and all the later transplants were maintained on a regime of tacrolimus, mycophenolate mofetil and steroids along with six months of valgancyclovir, voriconazole and co-trimoxazole. Steroids were tapered by six months to 0.1 mg/kg per day in all patients. Conclusions: In our recent patients, infection was the most common adverse event followed by rejection and PGD. In the latter half of our experience, we found that the complications reduced, suggesting that experience leads to less complications.
9,090 442 3
REVIEW ARTICLES
F-test of overall significance in regression analysis simplified
Onchiri Sureiman, Callen Moraa Mangera
May-August 2020, 6(2):116-122
DOI:10.4103/jpcs.jpcs_18_20
Regression analysis is using the relationship between a known value and an unknown variable to estimate the unknown one. Here, an estimate of the dependent variable is made corresponding to given values of independent variables by placing the relationship between the variables in the form of a regression line. To determine how well the regression line obtained fits the given data points, F-test of overall significance is conducted. The issues involved in the F-test of overall significance are many and mathematics involved is rigorous, especially when more than two variables are involved. This study describes in details how the test can be conducted and finally gives the simplified approach of test using an online calculator.
9,267 249 -
Alpha blockers: A relook at phenoxybenzamine
Sambhunath Das, Pankaj Kumar, Usha Kiran, Balram Airan
January-April 2017, 3(1):11-17
DOI:10.4103/jpcs.jpcs_42_16
Phenoxybenzamine (PBZ) is an alpha adrenergic antagonist, used for the management of hypertension. PBZ acts by blocking alpha-adrenergic receptors, leading to vasodilatation and low systemic vascular resistance. This helps in control of blood pressure in pheochromocytoma, improvement of systemic oxygen delivery, and optimization of the Qp/Qs in pediatric cardiac surgery such as hypoplastic left heart syndrome and improving perfusion parameters during open heart surgery. The uses have further extended to causalgia, Raynaud's phenomenon, autonomic hyperreflexia, and even for patency of radial artery conduit in coronary artery bypass grafting surgery. However, its prolonged hypotensive effect limits the regular use. In this review, we discussed the mechanism of action, pharmaco-physiology of PBZ, perioperative uses in different clinical setting and controversies for its uses; publications in different scientific journals from the previous years.
8,609 499 -
MY APPROACH
Treatment of tuberculosis pericarditis
May-August 2015, 1(2):179-181
DOI:10.4103/2395-5414.166337
Tuberculosis (TB) is responsible for approximately 70% of the cases of large pericardial effusion and the most cases of constrictive pericarditis in developing countries. Early diagnosis and institution of appropriate therapy are critical to prevent mortality. Treatment of TB pericardial effusion consists of 4-drug therapy (isoniazid, rifampicin, pyrazinamide, and ethambutol) for 2 months followed by 2 drugs (isoniazid and rifampicin) for 4 months. Systematic reviews and meta-analyses suggest that although overall corticosteroids are associated with a beneficial effect on the variables analyzed, the wide confidence interval and a small number of events make it impossible to draw firm conclusions. Pericardiectomy is the definitive treatment for constrictive pericarditis, but is unwarranted either in very early constriction where it could be transitory.
7,914 489 1
MISCELLANEOUS - BEDSIDE CASE
A case of valvular heart disease
Vijay Bohra, S Ramakrishnan, Neeraj Parakh
September-December 2015, 1(3):276-280
DOI:10.4103/2395-5414.177291
A 29-year-old female had presented with dyspnea on exertion since she was 10 years old, with sudden worsening for 5 months along with palpitations on exertion for the past 5 months. The examination findings, electrocardiogram, chest X-ray, and echocardiogram are discussed in a stepwise manner to arrive at a diagnosis and plan the management of a patient with rheumatic heart disease with multivalvular lesions. Relevant literature is also reviewed.
7,134 902 -