Background: Rheumatic fever principally influences kids in developing states, particularly where deficiency is common. Atrial fibrosis is a mutual characteristic of clinical atrial fibrillation (AF) and is accompanying with AF in a diversity of experiment sittings, Aim and Objectives: The current work aimed to assess whether there are any clinical or echo-cardiographic parameters that expect the existence of AF among cases with rheumatic mitral valve disorder (RMVD), Subjects and Methods: The current study was a comparative cross-sectional was conducted on 100 RMVD cases at cardio-vascular medicine department Tanta university hospitals within 6-mths starting from September 2019. Cases have been allocated into 2 groups: Group-I: 50 cases with sinus rhythm. Group-II: 50 cases with AF, Results: A significant change was found among study groups regarding Fibrosis characteristics, There is a highly significant difference between the three different types regarding mitral valve area (MVA), LA-diameter, LA volume, LA-diameter/BSA and LA volume index, Age, area of mitral valve, LA-diameter and LA volume were found to be significant predictors for AF, Conclusion: Echo-cardiography factors could recognize cases at higher danger of advancing AF among RMVD cases who may benefit from preventive measures.

Objective: To assess the safety and efficacy of intracoronary (IC) versus Intralesional (IL) administration of   tirofiban during primary (PCI) in patients with acute ST segment elevation myocardial infarction. Patients and Methods: This research involved 95 patients who were randomly assigned to recieve either IC bolus plus maintenance or IL bolus plus maintenance of tirofiban. Both groups were compared for pre and post intervention for cardiac marker, myocardial perfusion, and Major composite adverse cardiac event incidence at 3 months were recorded.  Results: Incidence of major adverse cardiac events was not different between groups, but Post procedure TIMI flow III and MBG III were significant in IL group with p = 0.03*, and 0.022* respectively favoring distal intracoronary strategy. Peak CK-MB values were lower in IL tirofiban group than IC group, 172.79±18.37, 184.58 ± 19.93 respectively with significant (p=0.021). ST segment resolution and 3 months LVEF in IL group were significantly higher in IL group than in IC group (p= 0.016*) respectively. Conclusion: local intracoronary tirofiban infusion via perforated balloon technique at the time of PPCI was associated with reduced thrombus burden, improved immediate angiographic outcome, and 3-month EF, compared with intracoronary GPI bolus injection via the guiding catheter.