Background: Echocardiography plays a vital role in assessing patients undergoing surgical ventricular restoration (SVR). Apart from measuring EF, wall motion abnormalities and valvular dysfunction, measurement of aorto septal angle (DJR angle), has both diagnostic and prognostic value.Methods: We analysed the echocardiogram of 25 consecutive patients who underwent SVR in our center. Systolic and diastolic frames of transthoracic echocardiograms, in parastemal long axis view are taken and the aorto septal angle is measured manually. Preoperative and postoperative angles of the same patients are compared to note the difference. This angle is compared with patients with normal left ventricular function as control.Results: In our series of 441 SVR, severe the ventricular dysfunction higher was the aorto septal angle. On the seventh postoperative day echocardiogram, the angle narrows by about 10 to 20 degrees. In the long term follow up the angle becomes near normal.Conclusions: Measuring aorto septal angle may be one of future cardiovascular surgeons armamentarium in patient selection and management of ventricular dysfunctions. Further research in this angle may reveal exciting results.Objectives: Over a period of five months ail patients requiring CABG were subjected to off PUMP CABG regardless of their risk factors such as poor LV, cardiogeuic sHock, etc. This was done to ascertain how many of them required pump support.Methods: 108 unselected consecutive patients are operated on beating heart by a single team of surgeons between Jan 2005. May 2005. 22 patients were ≥ 65 years of age, 46 patients were diabetics, LV function was poor (LVEF ≤ 30%) in 17 patients, redo surgery was performed in 3 patients, 7 patients undervent emergency revascularisation. 19 patients had COAD, preoperative renal dysfunction (creatinine clearance ≤ 40ml/min) was present in is patients and arrytllrnias (AF/frequent VPC) presem in 9 patients. Strategies used to prevent conversion to on pump were i> Pre operative pharmacological manipulation ii> Intraopertaive prevention of arrylhmias iii> Technical manipulation in large heart by using star fish positioner iv> RV filling was achieved by tilling head end downwards instead of fluid infusion v> In gross cardiomegaly requiring grnfting to left circumflex branches, left thoracab was preferred vi> Special technique was used to dissect intramyocardial arteries on beating heart. Results: Out of 108 patients, only 3 patients were convened to pump support (2.72%, one case of redo). There was no evidence of periopertaive myocardial infarction based on ECG and cardiac enzyme, changes. One patient had reexploration for bleeding and one patient expired due to sepsis and there was no neurological problem. Survivors were discharged from the hospital between 7-8 days post operatively.Conclusions: In patients willI CAD. OPCAB can be performed with an acceptable mortality and morbidity. By using a definite set of strategies, conversion to pump support in OPCAB patient can be reduced to less than 3%. 113Coron...
Background: Echocardiography plays a vital role in assessing patients undergoing surgical ventricular restoration (SVR). Apart from measuring EF, wall motion abnormalities and valvular dysfunction, measurement of aorto septal angle (DJR angle), has both diagnostic and prognostic value.Methods: We analysed the echocardiogram of 25 consecutive patients who underwent SVR in our center. Systolic and diastolic frames of transthoracic echocardiograms, in parastemal long axis view are taken and the aorto septal angle is measured manually. Preoperative and postoperative angles of the same patients are compared to note the difference. This angle is compared with patients with normal left ventricular function as control.Results: In our series of 441 SVR, severe the ventricular dysfunction higher was the aorto septal angle. On the seventh postoperative day echocardiogram, the angle narrows by about 10 to 20 degrees. In the long term follow up the angle becomes near normal.Conclusions: Measuring aorto septal angle may be one of future cardiovascular surgeons armamentarium in patient selection and management of ventricular dysfunctions. Further research in this angle may reveal exciting results.
Conclusion: CMV seropositivity in both the donor and recipient is associated with increased treatment for one year rejection after heart transplantation, perhaps due to increased risk from latent infection. Recipients from D+/R+ pairs may warrant increased surveillance for acute rejection.
BACKGROUND Diabetes mellitus and the complications associated with it has become a reason of concern due to health problems related to them. AIM To study and compare the pulmonary function parameters like FVC, FEV1, FEV1%, PEFR, FEV 25-75% in patients with type 2 diabetes mellitus and control group. SETTINGS AND DESIGN This study was planned to assess pulmonary functions in type 2 diabetic patients. METHODS AND MATERIALS We evaluated 60 diabetic male subjects in the age group 41-60 years. For controls, 60 age matched healthy male subjects were taken. PFT was carried out with Computerised Medspiror. STATISTICAL ANALYSIS The various data was collected, compiled, statistically analysed by unpaired t-test and conclusion drawn. RESULTS The present study results showed a significant decrease in the mean values of FVC, FEV1, PEFR and FEF 25-75% in diabetic subjects as compared to controls. FEV1% was significantly increased in diabetic persons. CONCLUSION Chronic hyperglycaemia leads to non-enzymatic glycosylation of extracellular matrix leading decrease in lung compliance, which is responsible for restrictive type of pulmonary impairment of lung functions.
Background: Coronavirus Disease 2019 (COVID-19) has been speculated to enhance mucormycosis infection due to its immune-altering pathophysiology. Early identification of high-morbidity conditions is crucial for optimal treatment and improved outcomes. Methods: A retrospective study was conducted on 63 patients with clinical and microbiological evidence of rhino-ocular-cerebral mucormycosis, who had a history of COVID-19 infection. The clinical, demographic, and imaging data were retrieved and analyzed. Descriptive statistics (mean [SD] and frequency [%]) were used to describe important characteristics across audit cycles. Results: Out of 63 patients, 54 (85.71%) patients had associated comorbidities, with diabetes mellitus being common comorbidity and all patients had received injectable and/or oral corticosteroids. Imaging showed nasal and paranasal sinus, perisinus, maxillary alveolar arch, and hard palate involvement in 62 (98.41%), 33 (52.38%), 5 (7.94%) and 5 (7.94%) patients, respectively. Orbital involvement was seen in 24 (38.10%) patients. Skull base involvement was seen in 11 (17.46%) patients, and intracranial extension of disease was present in 11 (17.46%) patients. A total of 16 patients were on mechanical ventilation, of whom 3 succumbed. The mean (standard deviation [SD]) intensive care unit (ICU) stay was 13.2 days (6.8) for 5 patients who succumbed and 6.4 days (4.6) for 30 patients who survived (P value = 0.008). Conclusion: Cross-sectional imaging not only provides the extent of disease spread but also plays a vital role in providing a surgical roadmap to treating surgeons and in predicting prognosis in patients with invasive fungal infections.
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