Such a Very new information on coronary artery disease..sir It means our lazy life style may proceed d risk of cardiovascular disease.....thank u so much for sharing such kind of post sir.
Nice and useful update.
Useful and informative. Thanks for sharing post. Sir.
Very nice update indeed.
Useful post sir.
Very nice update sir.
Useful update sir.
Very useful post sir...
Nice update sir
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*Angina* ☝ *All about*☝ is chest pain, discomfort, or tightness that occurs when an area of the heart muscle receives decreased blood oxygen supply. It is not a disease itself, but rather a likely symptom of coronary artery disease, the most common type of heart disease. The lack of oxygen-rich blood to the heart is usually a result of narrower coronary arteries due to plaque build-up; a condition called atherosclerosis. History The condition was named “hritshoola” in ancient India and was described by Sushruta (6th century BC). Types Stable (or chronic) angina Stable angina occurs when the heart is working harder than usual, for instance, during exercise. It has a regular pattern and can be predicted to happen over months or even years. Rest or medication relieves symptoms. Unstable angina Unstable angina does not follow a regular pattern. It can occur when at rest and is considered less common and more serious because rest and medication does not relieve it. This version can signal a future heart attack within a short time – hours or weeks. Variant and microvascular angina Variant (Prinzmetal’s) angina and microvascular (smallest vessels) angina are rare and can occur at rest without any underlying coronary artery disease. This angina is usually due to abnormal narrowing or relaxation (spasm) of the blood vessels, reducing blood flow to the heart. It is relieved by medicine. Risk factors The following risk factors increase your risk of coronary artery disease and angina: Tobacco use. Chewing tobacco, smoking and long-term exposure to second-hand smoke damage the interior walls of arteries including arteries to your heart allowing deposits of cholesterol to collect and block blood flow. Diabetes. Diabetes is the inability of your body to produce enough insulin or respond to insulin properly. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, which is a form of sugar from foods. Diabetes increases the risk of coronary artery disease, which leads to angina and heart attacks by speeding up atherosclerosis. High blood pressure. Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. Over time, high blood pressure damages arteries. High blood cholesterol or triglyceride levels. Cholesterol is a major part of the deposits that can narrow arteries throughout your body, including those that supply your heart. A high level of the wrong kind of cholesterol, known as low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol), increases your risk of angina and heart attacks. A high level of triglycerides, a type of blood fat related to your diet, also is undesirable. History of heart disease. If you have coronary artery disease or if you’ve had a heart attack, you’re at a greater risk of developing angina. Older age. Men older than 45 and women older than 55 have a greater risk than do younger adults. Lack of exercise. An inactive lifestyle contributes to high cholesterol, high blood pressure, type 2 diabetes and obesity. However, it is important to talk with your doctor before starting an exercise program. Obesity. Obesity raises the risk of angina and heart disease because it’s associated with high blood cholesterol levels, high blood pressure and diabetes. Also, your heart has to work harder to supply blood to the excess tissue. Stress. Stress can increase your risk of angina and heart attacks. Too much stress, as well as anger, can also raise your blood pressure. Surges of hormones produced during stress can narrow your arteries and worsen angina. Causes Angina is usually caused by coronary heart disease. When the arteries that supply your heart muscle with blood and oxygen become narrowed, the blood supply to your heart muscle is restricted. This can cause the symptoms of angina. Angina symptoms are often brought on by physical activity, an emotional upset, cold weather or after a meal. The episodes usually subside after a few minutes. Symptoms Symptoms associated with angina include: Chest pain or discomfort Pain in your arms, neck, jaw, shoulder or back accompanying chest pain Nausea Fatigue Shortness of breath Sweating Dizziness The chest pain and discomfort common with angina may be described as pressure, squeezing, fullness or pain in the center of your chest. Some people with angina symptoms describe angina as feeling like a vise is squeezing their chest or feeling like a heavy weight has been placed on their chest. For others, it may feel like indigestion. Diagnosis and test A correct diagnosis for chest pain is important because it can predict the likelihood of having a heart attack. The process will start with a physical exam as well as a discussion of symptoms, risk factors, and family medical history. A physician who is suspicious of angina will order one or more of the following tests: Electrocardiogram (EKG) – records electrical activity of the heart and can detect when the heart is starved of oxygen. Stress test – blood pressure readings and an EKG while the patient is increasing physical activity. Chest X-ray – to see structures inside the chest. Coronary angiography – dye and special X-rays to show the inside of coronary arteries (dye is inserted using cardiac catheterization). Blood tests – to check levels of fats, cholesterol, sugar, and proteins. Treatment and medications Angina treatments aim to reduce pain, prevent symptoms, and prevent or lower the risk of heart attack. Medicines, lifestyle changes, and medical procedures may all be employed. Lifestyle changes recommended to treat angina include: stopping smoking controlling weight regularly checking cholesterol levels resting and slowing down avoiding large meals learning how to handle or avoid stress eating fruits, vegetables, whole grains, low-fat or no-fat dairy products, and lean meat and fish Medicines called nitrates (like nitroglycerin) are most often prescribed for angina. Nitrates prevent or reduce the intensity of angina attacks by relaxing and widening blood vessels. Other medicines may be used such as: Beta blockers Calcium channel blockers ACE (angiotensin-covering enzyme) inhibitors Oral anti-platelet medicines Anticoagulants High blood pressure medications may also be prescribed to treat angina. These medicines are designed to lower blood pressure and cholesterol levels, slow the heart rate, relax blood vessels, reduce strain on the heart, and prevent blood clots from forming. In some cases, surgical medical procedures are necessary to treat angina. A heart specialist may recommend angioplasty. Coronary artery bypass grafting is another standard procedure; this is surgery where the narrowed arteries in the heart are bypassed using a healthy artery or vein from another part of the body. Prevention Unfortunately you can’t reverse coronary heart disease, which causes angina, but you can delay your arteries narrowing. To do this it’s important to: Stop smoking Control high blood pressure Reduce your cholesterol level Be physically active Achieve and maintain a healthy weight Control your blood glucose if you have diabetes Eat a healthy, balanced dietand only drink moderate amounts of alcohol. Some medications can also be used to help prevent angina episodesDr. Shailendra Kawtikwar4 Likes9 Answers
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Amazing Benefits Of Shallots (Chota Pyaz) For Skin, Hair And Health stylecraze.com Oct 9, 2017 12:00 PM ￼ Shallots are long, thin bulbs like vegetable. They are smaller in size and grow in clusters of bulbs in the root system. The bulbs have a mild pungent taste and a distinct smell as compared to onions and garlic. This is a popular ingredient used by the chefs around the world. Besides adding flavour to your dishes, shallots have various health benefits and a high nutrient content. They’re also great for your hair and are widely used as an ingredient in hair treatment products. Shallots belong to the onion and allium family. They contain vital nutrients like vitamins B & C, calcium, iron and potassium. There are many varieties of shallots such as French Grey Shallot or Griselle Genus Allium Oschaninii, Pink Shallot or Jersey Shallot, Banana Shallot, Green shallot. Shallots are also known as ‘Chota Pyaz’ in Hindi, ‘Sambar Ullipayalu’ in Telugu, ‘Chinna Vengayam’ in Tamil, ‘Cheriya Ulli’ in Malayalam, ‘Sambar Eerulli’ in Kannada, ‘Sambara Cha Kanda’ in Marathi, ‘Gundhun’ in Bengali. Benefits of Shallots: 1. Iron: Shallots contain iron which is required for proper functioning of your red blood cells. Healthy red blood cells contain a good amount of hemoglobin that helps them transfer oxygen from the lungs to the other tissues of your body. It is also essential for your proper metabolism, brain function and to make your tissues strong. 1 cup of shallots can provide 1.9 milligrams of iron that gives 24 percent of the daily required iron intake for men and 11% for women. 2. Fiber: Shallots help in a healthy digestion. Due to its dietary fiber content, it absorbs water and fills your stomach after a meal. It slowly releases sugar in your bloodstream and helps soften the stool, thus preventing constipation. It is also useful in reducing the blood cholesterol levels, preventing many heart diseases. One cup of shallots can provide 5.1 grams of dietary fiber that is 20 percent of the daily required fiber for women and 13% for men. 3. Potassium: Shallots are a rich source of potassium. One cup of shallots can provide 534 milligrams of potassium that is 11% of your daily required intake. Potassium is useful to regulate the body’s fluid levels. It also aids in the proper functioning of nerve and muscle cells. This helps the metabolism by breaking down carbohydrates into required body fuel. Potassium helps in maintaining a healthy heart by lowering blood pressure. Deficiency of potassium can lead to cramps and weakness in the muscle. 4. Cooking with Shallots: Shallots are commonly used in cooking, hence they are cultivated extensively. They are used as a condiment in various Asian cuisines in a finely sliced or deep-fried form. Shallots are costlier than onions and are popularly used in cuisines like Malaysian and Thai. Benefits of shallots’ nutrients can be gained by adding them directly to your dish, sautéing, adding to pastas. Fresh shallots can be combined with fruits and vegetables for salsas. Add them to your salads, pizzas, sandwiches and wraps as caramelized shallots. You can also grill, roast, bake, fry, blanch, pickle or boil them. Shallots can also be substituted with onions. 5. Heart Health: One of the most spoken of health benefits of shallots is that they are excellent for the blood and help prevent heart disease. Cycloallin, an anticoagulant, is found in shallots that are useful to protect your body against heart disease. It contains allicicn that can block platelet clot formation in your blood vessels to decrease peripheral vascular diseases (PVD), coronary artery disease (CAD), and stroke. They are helpful in producing an anti-coagulant, which thins the blood to cure symptoms of cardiovascular disease, heart attack, atherosclerotic disease, and stroke. 6. Strong Immune System: Shallots can strengthen your immune system efficiently. Consume them daily to prevent and cure cold, flu and other illnesses. 7. Low in Calories: Shallots contain very less amount of calories and loads of nutrients. Calories in a shallot depend on its cooking procedure. If you’re on a diet, you can add shallots to bland foods and enjoy the delicious flavor without piling on calories. 2 tbsp shallots provide just 14 calories. There are 19 calories present in 100 grams of boiled shallots. 8. Anti-oxidants: Shallots contain more nutrition than onions. They have more anti-oxidants, minerals, vitamins and flavonoid anti-oxidants like quercetin and kemferfol. 9. Healing Power: Along with various antioxidants, shallots contain sulphur anti-oxidant compounds like diallyl trisulfide, diallyl disulfide, and allyl propyl disulfide. Shallots also have anti-viral, anti-bacterial, and anti-fungal properties. 10. Reduces Cholesterol: Allicin present in shallots can be useful to reduce cholesterol production. They inhibit HMG-coa reductase enzyme into your liver cells. 11. Lowers High Blood Pressure: Allicin in shallots is helpful in decreasing blood vessel stiffness, as they release vasodialator chemical nitric oxide (NO) that lowers the high blood pressure. 12. Anti-diabetic: Shallots contain phyto-chemical such as allium and Allyl disulphide that have anti-diabetic properties. Shallot is a useful remedy to lower blood sugar levels in diabetics. It prevents the degradation of insulin and increases the metabolism of glucose. 13. Treats Intestinal Worm: Shallots are found effective in curing and treating intestinal worms in the stomach. Shallot juice helps clear thread worms that occur in children. Grind some shallots to make a juice and drink every morning on an empty stomach. 14. Cold or Fever: Shallots are smeared on a baby’s body during cold or fever since it is a medicinal plant that can effectively cure regular cold or fever. ￼ Image: Shutterstock 15. Reduce Phlegm: Shallots are an effective remedy to dilute the phlegm that causes coughing. 16. Reduces Nervous Irritability: Shallots contain many vitamins and minerals like vitamin A, thiamin, vitamin C pyridoxine, folates, etc. Pyridoxine (B-6) present in shallots is useful to raise the GABA chemical levels in your brain to soothe nervous irritability. 17. Prevents Cancer: 100 g of fresh shallots contain 1190 IU that is 35% RDA of vitamin A. Vitamin A is an effective antioxidant that is useful in preventing lung and oral cavity cancers. Shallots are also helpful in preventing liver cancer and destroy their cells. They help the liver in eliminating toxins from your body and contain saponins that kill the cancer cells. Shallots also help reduce the chances of stomach cancer. 18. Rich in Vitamin A: Shallots are the richest source of vitamin A that is required for your good health. Vitamin A (an antioxidant) helps protect you from the harmful free radical damage. They can also be useful in maintaining membranes, prevent infections, lead to good eye health, promote healthy immune system, and for proper growth and development. 19. Low in Fat: Shallots contain very low amount of fat. Hence, they can be effectively used for low-fat diets. 20. Low in Sodium: Shallots are very low in sodium. Our body requires some amount of sodium for survival, but too much can cause high blood pressure. Many flavoring ingredients are high in sodium content, but shallots can be consumed by high blood pressure or kidney patients as a suitable alternative. 21. Flavonoids: Shallots have two sets of compounds including sulphur compounds like allyl propyl disulphide (APDS) and flavonoids like quercetin. Consume flavonoid in your daily diet to reduce the risk of cancer, heart related diseases and diabetes. They are antiviral, anti-allergenic, anti-cancer, antibacterial, and anti-inflammatory. 22. Osteoporosis: Consume shallots in your daily diet for the proper growth of the bone tissue and reduce the risk of osteoporosis by 20 %. 23. Younger Looking Skin: Shallots contain sulphur that helps in giving you younger looking skin. 24. Stomach Infection: Shallots are also advantageous in inhibiting stomach problems. Consume shallots in your regular diet to prevent your stomach from various infections. 25. Alzheimer’s Disease: Shallots help in promoting beneficial brain functions. This is proven to be effective for Alzheimer’s disease. 26. Hair Growth: Shallots are the oldest and most efficient home remedy for hair growth. They are rich in sulphur that helps in the production of collagen tissues. This is useful for the re-growth of hair. Chop shallots into small pieces and squeeze out its juice. Apply it evenly on the scalp and keep for 15 minutes. Rinse off with a mild shampoo that helps in hair growth. 27. Baldness and Hair Loss: If you suffer from bald patches you can use the following remedy: Grind pepper powder, shallot and salt into a fine pasteApply on affected areasThis is an effective way to treat bald patches. 28. Cures Scalp Infection: You can utilize shallot juice to treat scalp infections. Fungal infections damage the hair and also lead to severe hair loss. Shallots can also be useful in opening the clogged pores of your hair follicles. 29. Overcoming Dandruff: You can easily use shallot juice to cure dandruff problems. Mix shallot with lemon juice, buttermilk, and honey. Apply this mixture on your hair and leave on for 30 minutes. Rinse well with a mild anti-dandruff shampoo to cure dandruff naturally. And that is how you can use shallot for hair. 30. Insect Stings: To treat insect sting, rub the affected area with shallot juice. This will help soothe the pain. Shallots can be applied by crushing or cutting and applied on mosquitoes, bee or wasp stings. 31. Warts: Shallots can be used as a poultice. This will drop off the warts on its own. 32. Bronchitis: Mix shallot juice with honey and consume a teaspoon of this mixture thrice daily. This is an effective expectorant that can give you relief from bronchitis, influenza, cold, cough and sore throat. It is also helps liquefy the phlegm and helps in clearing them. 33. Strengthen Capillaries: Consume 5 shallots every day on an empty stomach for 14 days. This is an effective remedy to strengthen capillaries. 34. Eliminate Toxins: Fry four pieces of sliced shallots in ghee. Eat this frequently for 14 days to help your liver in eliminating toxins from the body. 35. Tooth Health: Chew shallots for 3 minutes every day in the morning. This will destroy the bacteria in your teeth. 36. Good Eyesight: The juice of shallots with its flowers promotes good eyesight. This can be used as eye drops. Shallots are rich in sulfur, cysteine, and lecithin that protect the lens of your eyes from cataract formation. Include shallots in your diet to promote good eye health. 37. Get Rid of Headache: Applying shallots on the head can give you relief from headaches. For this, you can make a poultice of shallots and apply on your head for instant relief. 38. Stimulates Hair Growth: Rub shallot juice everyday on your scalp to get rid of dandruff and promote hair growth. 39. Bruise Dressing: You can also use shallots for dressing your bruises. Burns are often dressed with shallots and salt. 40. Treat Boils: Drink shallot juice mixed in water or carrot juice. This can also be applied to the boils. Nutrition Chart of Shallots: Shallots(Allium cepa var. aggregatum), raw, Nutrition value per 100 g.(Source: USDA National Nutrient data base)PrincipleNutrient ValuePercentage of RDAEnergy72 Kcal3.6%Carbohydrates16.80 g13%Protein2.50 g5%Total Fat0.10 g0.5%Cholesterol0 mg0%VitaminsFolates34 µg9%Niacin0.200 mg1.5%Pantothenic acid0.290 mg6%Pyridoxine0.345 mg26.5%Riboflavin0.020 mg2%Thiamin0.060 mg5%Vitamin A1190 IU35%Vitamin C8 mg13%ElectrolytesSodium12 mg1%Potassium334 mg7%MineralsCalcium37 mg4%Copper0.088 mg10%Iron1.20 mg15%Magnesium21 mg5%Manganese0.292 mg13%Phosphorus60 mg8.5%Selenium1.2 µg2%Zinc0.40 mg4% Now you know that shallots are a healthy option for your overall health. So avail its numerous benefits and nutritional properties and tell us how you benefited from them!Dr. Tapan Kumar Sau6 Likes17 Answers
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55yrs old male came with c/c of chest pain which rafiates left arm from last 2days. no significant medical history. his B/P 110/70, pulse 84/min. ECG done. please suggest managmentDr. Yasar Aziz1 Like9 Answers
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Association Between the Frank Sign and Cardiovascular Events Saleh Nazzal, MD; Arnon Blum, MD DISCLOSURES South Med J. 2018;111(8): Abstract Clinicians have attempted to find early preclinical physical diagnosis signs to detect vascular diseases at the preclinical stage and to prevent clinical deterioration in time. An interesting example of such signs is the Frank sign, which was first described by Dr Sonders T. Frank in 1973. Our goal was to summarize the clinical trials and observational studies that had examined the association between the Frank sign and cardiovascular diseases. Summarizing the 57 studies we found showed that this association could be used for early diagnosis of coronary and vascular diseases in the preclinical stage and that they were found in different populations around the world. Autopsy studies also found a strong association between the Frank sign and cardiovascular causes of death in both sexes. Cardiovascular causes of death included ischemic and hypertensive heart disease, calcific valvular stenosis, ruptured dissecting aneurysm of the thoracic aorta, and ruptured atheromatous aneurysm of the abdominal aorta. The Frank sign was correlated with increased intima-media thickness and stroke and was found in patients with peripheral vascular disease and with cardiovascular risk factors. The Frank sign could serve as a physical sign to help clinicians diagnose cardiovascular diseases. Introduction In the last decade physicians have learned to rely on advanced technology to detect subclinical stages of atherosclerosis. Cardiovascular diseases are among the most common causes of morbidity and mortality worldwide. They constitute approximately 31% of all deaths globally every year, or 17.5 million individuals annually. Clinicians have attempted to find early preclinical physical diagnosis signs to detect vascular diseases at the preclinical stage and to prevent clinical deterioration in time. There remains, however, great debate about the accuracy and reliability of such "natural" means. An interesting example is the Frank sign, which was first described by Dr Sonders T. Frank in 1973. It is a diagonal earlobe crease at a 45° angle, in varying depths, that starts from the tragus and extends to the edge of the auricle. Frank made a clinical observation that 19 of 20 patients with the crease had at least one of the known cardiovascular risk factors. The Frank sign can be classified by the length of the crease. It is considered complete when it crosses the entire earlobe, whereas it is considered incomplete when it is visible only partly through the earlobe (Figure 1). The Frank sign also can be evaluated by its depth. Mild is graded when it is visible as a superficial wrinkling on the earlobe, moderate when it is seen as a sulcus with visible base, and severe when the sulcus is so deep that the base is not visible (Figure 2). In addition, a stronger association between the Frank sign and coronary heart disease was found when the sign existed in both ears, not only in one ear.[5–7] Figure 1. The Frank sign classification according to length: complete (A) and incomplete (B). Figure 2. The Frank sign classification according to depth: (A) mild is graded when it is visible as a superficial wrinkling on the earlobe, (B) moderate is graded when it is seen as a sulcus with visible base, and (C) severe is graded when the sulcus is so deep that the base is not visible. The Frank sign has been documented in sculptures from the time of ancient Rome. The earliest work of art is believed to date to the Roman emperor Hadrian (76–138 CE; Figure 3); it was described by Patrakis, who found an association between the Frank sign in this ancient statue and the medical history of Hadrian, who experienced recurrent events of epistaxis and hypertension. Recently, Charlier and Deo identified bilateral earlobe creases in the 1880 death mask of French novelist Gustave Flaubert (1821–1880), who died at age 59 years from brain hemorrhagic stroke, and Galassi et al identified numerous instances of the Frank sign in Renaissance art. Figure 3. Roman emperor Hadrian (76–138 CE). The arrow points to the Frank sign. Our goal was to summarize the clinical trials and observational studies that had examined the association between the physical sign, the Frank sign, and cardiovascular diseases. We searched PubMed and MEDLINE from 1973 to July 2017 using combinations of the following key words: earlobe crease, ear lobe crease, ear-lobe, crease, ear crease, ear creases, and Frank's sign. Randomized controlled trials, original papers, review articles, and case reports were included in the present review. We found 57 papers that summarized clinical observations and clinical retrospective and prospective studies that looked into this interesting association between a physical sign detected during a medical physical examination and the clinical events that follow. In a study that examined 215 Indian patients from different communities, the bilateral Frank sign was significantly associated in patients with documented coronary artery disease (CAD; P < 0.001). The prevalence of the Frank sign increased with advancing age. The combined presence of the Frank sign and ear canal hair represented a more sensitive index of CAD.[5,6] The association between the Frank sign and CAD was studied prospectively among 956 patients with ischemic heart disease who underwent coronary intervention. The Frank sign was associated with ischemic heart disease mainly in patients with more than four cardiovascular risk factors. An increased rate of cardiovascular complications was found following coronary intervention in patients who had a bilateral Frank sign. The first controlled study that examined the relation between the Frank sign and cardiovascular disease found that 47% of 531 patients who had acute myocardial infarction also had the Frank sign (unilateral or bilateral), which is significantly greater than the 30% rate of the Frank sign observed among 305 age-matched control subjects with no clinical evidence of CAD (P < 0.001). A Spanish study found that the association between the Frank sign and CAD was mainly positive and relevant among subjects between the ages of 30 and 60 years. A prospective study that examined 222 patients with CAD found that the prevalence of the Frank sign among patients with coronary disease was significantly higher than those without (82% vs 38.5%). Patients with the Frank sign were prone to develop intraoperative cardiovascular complications (42.6% with vs 4.9% without) and postoperative cardiovascular complications (24.9% with vs 4.9% without). Another prospective study of 286 patients with CAD who underwent coronary angiography because they demonstrated typical symptoms of angina pectoris found that of the 286 patients, 200 had critical stenosis in at least one coronary artery (>50% stenosis). There was a significant higher prevalence of the Frank sign in patients with CAD (72% vs 21%, P < 0.001). The Frank sign was detected in older patients and patients with an increased severity of coronary disease but not with other classic risk factors of coronary disease such as diabetes mellitus, hypertension, smoking, obesity, and hyperlipidemia. Prospective cohort studies found that the Frank sign was associated with increased all-cause and cardiac morbidity and mortality. Patients with the Frank sign had more coronary events and were cautioned to reduce cardiac risk factors, even if they did not have any diagnostic evidence of CAD at the time of examination. The Copenhagen City Heart Study tested the hypothesis that visible age-related signs may be associated with risk of coronary disease, myocardial infarction, and death independent of chronological age. Male pattern baldness, the Frank sign, and xanthelasmata predicted an increased risk of ischemic heart disease and myocardial infarction independent of chronological age and other well-known cardiovascular risk factors. In a Brazilian study of 1464 patients, Tranchesi Júnior et al found that the Frank sign was present in 220 of 338 patients (65%) with CAD (>70% stenosis of ≥1 coronary artery documented by angiography) and that this prevalence was significantly greater compared with patients with the Frank sign but without coronary disease (28% of 1086 patients, P < 0.0001). Both the Frank sign and CAD increased with advanced age (P < 0.0001 for both). This association remained statistically significant in all decades, except for patients older than 70 years. The presence of the Frank sign also was associated with the extent of coronary disease as measured by the number of narrowed major arteries (P = 0.015). The observed sensitivity of the sign for the diagnosis of coronary disease was 65%, with a specificity of 72%, a positive predictive value of 42%, and a negative predictive value of 87%. The Frank sign also was related to the severity of CAD. In stenosis in one to three coronary arteries, the prevalence of the Frank sign increased from 55% (when patients had 1-vessel CAD) to 78% (when patients had 3-vessel CAD, P = 0.015). This association was found in different populations around the world; a significant association between the Frank sign and CAD was found in populations in Croatia, Japan, and Turkey.[20,21] In 2011 an Israeli review described the diagonal earlobe crease as an indicator of ischemic heart disease, and similar results were found by a Chinese group 1 year later. The association between CAD and the Frank sign was studied in 430 individuals without a history of coronary heart disease using coronary computed tomography. The Frank sign was present in 71% of the patients with documented CAD (a 50% stenosis at least in one of the coronary arteries). The prevalence of coronary significant lesions in 307 patients with the Frank sign was 77%, significantly greater compared with 55% of 123 patients without the Frank sign (P < 0.001). The sensitivity, specificity, and positive and negative predictive values for the Frank sign to diagnose any CAD were 78%, 43%, 77%, and 45%, respectively. Adding the Frank sign to the cardiovascular risk assessment of patients with angina pectoris improved the prediction of CAD beyond the Diamond-Forrester classificationDr. Gaurav Chhaya1 Like5 Answers
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Identify the clinical sign & it's clinical importance?Raveen Murugan1 Like5 Answers