, in front of my house is leaking. The underground water gets accumulated when the supply is full.
Please do needful to plug the same.
I would like to inform you illegal construction MCB 2712 St. no. 2 Baba Deep Singh Nager Bathinda Punjab. Mr. Arorra.This person is constructing new Building without authorization naksha and the without designed architecture. I am informing you as a responsible person rest the ball is in your court.
my self surinder jain, and I am resident of house No: Z4-5274 (217)-Street no 1/2 sarabha nagar, bhatti Road Bathinda. The rainy water disposal channel in front of my house is blocked since long. I requested the local municipal authorities, two time i complaint (no20173206) for this. but no body is came to clear the blockage and no result happen. this is rainy season and lot of mosquito and other insect are born in stopped water, please do some for our area.
I have complaint against my neighbours who have left tree cuttings and waste construction on the street. It is creating a lot of problems in these rainy days.
I want to complaint that thier is no worker to clean the soroundings near our house. The soroundings are very dirty near my house and I want that to be cleaned.
So I request you to pay attention to my complaint.
The underground drinking water pipeline, in front of my house is leaking. The underground water get accumulated when the supply is full.
I want to bring in your kind notice that in city bus stand the gents washrooms are in open and in very bad condition.As you know bus stand is a public place and very busy all the day.because of open condition of gents washrooms,there is problem for ladies to pass near the washrooms.Also very bad smell spreading all the area which is very shameful.Also there is no proper arrangement of wastage.You can check anywhere in city big heaps of wastage.I want to ask you why govt taking swachh bharat tax when there is no implication of mission.actually this is for income purpose only.no govt giving attention on swachhta.when swachhta is basic requirment for healthy living.I hope you will consider my request at earliest and arrange proper cleaniness at all places.Otherwise i will place my problem to higher authorities.
Bank of Maharashtra Bathinda.
i have complaint to u area partap nagar street no g11.sanjeev garg son of somnath garg.this person are contruct the first floor without nakaha and the without designd arctacture.plz i come in this area and come to this person home and chks all document.HERON Lovewell release facilitates navigation by introducing changes to the abridged Cancer Cases Identifier structure. Date ranges are added to AJCC concepts, and folders are rearranged into an intuitive order. The issue of inaccurate Frontiers Research Participant Registry patient counts ((see #2451)) is resolved. Searches will return the correct patient count when searching with the Frontiers Research Participant Registry concept.
This month, our tour of ​rivers and lakes in Kansas honors Lovewell Lake.
New Designs May Ease Bifurcation Stenting
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About 15 percent of PCI cases involve bifurcations, which roughly equals between 200,000-300,000 patients a year, said Alexandra Lansky, M.D., FACC, director of clinical services, center for interventional vascular therapy, New York-Presbyterian Hospital/Columbia University Medical Center, director of the angiographic core analysis laboratories and director of the Women’s Cardiovascular Health Initiative at the Cardiovascular Research Foundation. Bifurcations are not only complicated by their morphology, but also by the fact they are more prone to thrombosis, restenosis and target lesion revascularization.
She said current bifurcation stenting methods include the crush, culotte and T-stenting techniques, which use existing FDA-cleared stents. The crush involves deploying the side-branch stent with a portion extending into the main vessel, which is “crushed” against the sidewall of the vessel when the main artery stent is inflated. The culotte method, also referred to as the “kissing stent” or “kissing balloon” technique, involves deploying two stents in the main and side branch vessels and inflating them simultaneously so they compress into each other. The end result on fluoroscopy looks like a pair of pants, or culotte in French. T-stenting involves a stent in both the main and side branch and expanding a balloon wired through the main branch stent struts to create a lumen opening into the side branch.
These two-stent methods all distort the metal bodies of the stents, causing problems with apposition and turbulence in the vessels, both of which Dr. Lansky said are both linked to restenosis. The crush technique also causes multiple layers of DES stent struts against the lumen, which has been associated with much higher rates of stent thrombosis.
Another option is to only stent the main vessel and leave access to the side branch in case further intervention is needed, which is referred to as the provisional approach. She said three key studies – Nordic, BBC ONE, and CACTUS – evaluated the best techniques for stenting these lesions. “All of these studies showed the same thing – the best approach is to only stent the main vessel using the provisional approach,” Dr. Lansky said. None of the studies found a significant advantage in stenting the side branch vessel unless there was a compelling reason, such as 70 percent or more stenosis. Dr. Lansky said the studies all found higher restenosis rates associated with stenting both vessels.
“There is a need for a dedicated side branch stent, but it must be easy to use,” said Dr. John Ormiston, Auckland City Hospital and Mercy Angiography, Auckland, New Zealand, and serves on advisory boards for Devax, Abbott Vascular, and Boston Scientific, each of which is developing bifurcation stents.
He presented at ACC 2009 on the status of eight bifurcation stents in development. These include the Axxess stent by Devax, Boston Scientific’s TAXUS Petal, Minvasys’ Nile Croco, Medtronic’s dedicated bifurcation stent, Abbott’s Pathfinder, TriReme Medical‘s Antares II, Capella’s Sideguard, Stentys, and Tryon Medical’s Tryton Side Branch Stent. Y-Medical is also developing the Sidekick delivery system to allow side branch stents to be torqued into alignment.
Dr. Ormiston said many of these devices take different approaches. He said Stentys created a self-expanding nitinol stent with struts designed to be separated, making it much easier to make openings with a balloon to access the side branch. Medtronic’s stent uses two wires to snug it into position. He said Abbott’s system is designed to prevent the two deployment wires from wrapping and binding. The Antares has a torquable shaft to better position it.
AXXESS
Of these devices, Drs. Ormiston and Lansky said the Axxess is the furthest along in development and will likely be the first to market, followed by Tryton. Dr. Lansky said Devax has filed for CE mark approval. In June the FDA conditionally approved an investigational device exemption (IDE) for the AXXESS Biolimus A9-Eluting Bifurcation Stent System, allowing the company to initiate a pivotal clinical trial (DIVERGE II) in the U.S. The multicenter, blinded, controlled, randomized trial will compare.
Both Drs. Lansky and Ormiston work as investigators for the Drug-Eluting Stent Intervention for Treating Side Branches Effectively (DIVERGE) trial, which is testing the effectiveness and safety of the Axxess stent. Devax has already implanted more than 430 AXXESS stents in two clinical studies conducted outside the U.S. So far Dr. Lansky said the trial has shown restenosis and revascularization rates that are much lower than using existing stenting methods.
The Devax is a self-expanding, nitinol, main branch stent with a built-in bifurcation in the stent struts Dr. Lansky said the stent is skirt-shaped to fit in the area where the area where the vessel splits. The stent has gold markers on the ends of its structure to clearly show where the stent struts start and end, as well as to help when deploying additional stents in the main and side branches. She said the earliest the FDA might consider device approval would be around 2011.
Tryton
Dr. Lansky said Tryton is starting to plan for its FDA pivotal trial, but does not yet have FDA IDE trial approval. The Tryton Side Branch Stent is deployed in the side branch artery using a standard single-wire, balloon-expandable stent delivery system. When expanded it has a conventional strut scaffold in the side branch, but the struts trail off into three thin bands that narrow down to a single strut in the primary vessel. A conventional drug-eluting stent is then placed in the main vessel. The stent demonstrated excellent initial clinical results and is available for sale in Europe, where it received CE mark in 2008.
Antares
TriReme Medical’s Antares Coronary Stent System received CE mark for European sales last October. It is a thin strut (0.0035 inch) stainless steel stent with progressive surface finish. It permits deployment at or near bifurcation lesions