Heart failure (HF) is a major cause of morbidity and mortality in high income countries. Shortage of population based HF studies from Low and Middle Income countries (LMIC) make global prevalence estimates difficult. In this editorial we discuss the possibility of generating HF data in LMICs by initiating HF surveillance systems integrated into the existing health surveillance system..

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Despite the high risk population of coronary artery disease, the use of XIENCE V in 'real world' Indian patients was associated with very low clinical event rates upto three years of follow up.

Background: Currently, invasive physiologic assessment such as fractional flow reserve is widely used worldwide with different adoption rates around the globe. Patient characteristics and physician preferences often differ in the Asia-Pacific (APAC) region with respect to treatment strategy, techniques, lesion complexity, access to coronary physiology and imaging devices, as well as patient management. Thus, there is a need to construct a consensus document on recommendations for use of physiology-guided percutaneous coronary intervention (PCI) in APAC populations. This document serves as an overview of recommendations describing the best practices for APAC populations to achieve more consistent and optimal clinical outcomes.

Background: Perineural dexamethasone has been shown to improve analgesia in single injection supraclavicular block. Systemic mechanism of action of dexamethasone along with safety concerns of perineural route of administration has prompted the investigation of intravenous route as an alternative. Aims: We aim to compare the effects of dexamethasone as an additive to local anesthetic when used via perineural and intravenous route in terms of duration of analgesia and onset of motor and sensory block. Settings and Design: The study was done as a prospective comparative observational study conducted in a tertiary care hospital in India among 50 patients during a period of 1 year. Materials and Methods: Twenty-five patients aged 18–60 years, belonging to the American Society of Anesthesiologists physical status Classes I and II, receiving supraclavicular block with 0.5% bupivacaine and perineural dexamethasone were compared with similar number of patients receiving the block along with intravenous dexamethasone. Duration of analgesia, onset of sensory block, and onset of motor block were studied. Statistical Analysis: The results were analyzed using Chi-square test for qualitative variables and unpaired t -test for quantitative variables. Results: The duration of analgesia in the group receiving perineural dexamethasone (Group DP) 817.2 ± 88.011 min was comparable to the group receiving intravenous dexamethasone (Group DI) 858.00 ± 86.168, with a P = 0.104. Time to onset of sensory block in Group DP (10.20 ± 1.443 min) was significantly faster than that of Group DI (11.60 ± 1.443) with a P = 0.001. Time to onset of motor block in Group DP (13.92 ± 1.754 min) was significantly earlier than that of Group DI (14.96 ± 1.274 min) with a P = 0.02. Conclusion: It is concluded from this study that intravenous and perineural dexamethasone equally prolongs the duration of analgesia in supraclavicular block. However, perineural dexamethasone resulted in a faster onset of motor and sensory blockade.

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In fibrous dysplasia/McCune-Albright syndrome (FD/MAS), bone and bone marrow are, to varying degrees, replaced by fibro-osseous tissue typically devoid of hematopoietic marrow. Despite the extensive marrow replacement in severely affected patients, bone marrow failure is not commonly associated with FD/MAS. We present a 14-year-old girl with FD/MAS, who developed pancytopenia and extramedullary hematopoiesis (EMH) with no identified cause, in the setting of iatrogenic thyrotoxicosis and hyperparathyroidism. Pancytopenia, requiring monthly blood transfusions, persisted despite multiple strategies to correct these endocrinopathies. Due to worsening painful splenomegaly, likely as a result of sequestration, splenectomy was performed. Following splenectomy, pancytopenia resolved and patient has since been transfusion-independent. We report the first detailed case of bone marrow failure and EMH in FD/MAS. The etiology of marrow failure is likely multifactorial and related to the loss of marrow reserve due to extensive polyostotic FD, exacerbated by iatrogenic thyrotoxicosis and hyperparathyroidism. Mini Abstract: A patient with fibrous dysplasia developed bone marrow failure and extramedullary hematopoiesis. The etiology likely involved loss of hematopoetic marrow space and uncontrolled endocrinopathies. Splenectomy was therapeutic.

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