Intravascular lithotripsy for severe coronary calcification: a systematic review.

Introduction: Coronary artery calcification remains a challenge in percutaneous coronary interventions, due to the higher risk of suboptimal result with subsequent poor clinical outcomes. Intravascular lithotripsy is a novel way of treating severe coronary calcification as it has the ability to modify calcium both circumferentially as well as transmurally, facilitating stent expansion and apposition. We conducted a systematic overview of the published literature on intravascular lithotripsy (IVL) assessing the efficacy and feasibility of IVL in treating severe coronary calcification.

Elective versus urgent in-hospital transcatheter aortic valve implantation.

Background: Transcatheter aortic valve implantation (TAVI) is maturing as a treatment option and is now often undertaken during an unscheduled index hospital admission. The aim of this study was to look at procedural and mid-term outcomes of patients undergoing elective versus urgent in-hospital transcatheter aortic valve implantation.

Methods: We identified a total of 1,157 patients who underwent TAVI between November 2007 and November 2019 at the Sussex Cardiac Centre in the UK.

Coronary Artery Aneurysm: Evaluation, Prognosis, and Proposed Treatment Strategies.

Coronary artery aneurysm is a rare disorder, which occurs in 0.3%-4.9% of patients undergoing coronary angiography.

Routine iso-osmolar contrast media use and acute kidney injury following percutaneous coronary intervention for ST elevation myocardial infarction.

Background: Temporal changes in contrast-induced acute kidney injury (CI-AKI) incidence following primary percutaneous coronary intervention (PPCI) are poorly defined. Additionally, the benefits of iso-osmolar contrast media (IOCM) compared to low osmolar CM (LOCM) are uncertain.

Methods: Using data from a regional PPCI service, temporal changes in baseline risk and annual incidence of CI-AKI were studied.

Bioprosthetic mitral valve thrombosis and subsequent obstruction from non-Hodgkins lymphoma despite anticoagulation.

Malignancy can cause a hypercoagulable state, it rarely causes prosthetic valve thrombosis, with only limited cases reports due to lymphoma. Although no standardised approach for treatment exists, the combination of early diagnosis, surgical intervention and adjuvant chemotherapy are likely to provide the best chances of survival. We describe an interesting case of a bioprosthetic mitral valve thrombosis leading to valve obstruction in a patient with non-Hodgkin's lymphoma despite being on anticoagulation.

Twelve-month outcomes of patients unsuitable for prolonged DAPT presenting with an acute coronary syndrome and treated with polymer-free biolimus A9 drug-coated stents.

Introduction: Prolonged dual anti-platelet therapy (DAPT) is undesirable in certain patients. The biolimus-A9 drug-coated stent (BA9-DCS) has a rapid drug-elution profile allowing shortened DAPT.

Methods: The demographics, procedural data, and clinical outcomes for 505 patients presenting with an ACS to three UK centres and treated with a BA9-DCS stent (PCI-DCS) were collected, and compared to a consecutive ACS cohort of unselected patients treated in the same period with drug-eluting stents (PCI-DES).

Lesson of the month 1: Case reports of arrhythmogenic cardiomyopathies in military personnel.

In military recruits, sudden cardiac death rates have been reported as varying from 2 to 13 per 100,000 per year which are mostly related to exercise. However, the development of structural heart changes that may be associated with ventricular arrhythmias have not been reported among this cohort, despite them undergoing endurance training similar to athletes. Here, we report two cases where military personnel were found to have life-threatening cardiac arrhythmias associated with structural heart disease, highlighting the importance of early recognition and treatment of these arrhythmias.

Early repolarization syndrome: A cause of sudden cardiac death.

Early repolarization syndrome (ERS), demonstrated as J-point elevation on an electrocardiograph, was formerly thought to be a benign entity, but the recent studies have demonstrated that it can be linked to a considerable risk of life - threatening arrhythmias and sudden cardiac death (SCD). Early repolarization characteristics associated with SCD include high - amplitude J-point elevation, horizontal and/or downslopping ST segments, and inferior and/or lateral leads location. The prevalence of ERS varies between 3% and 24%, depending on age, sex and J-point elevation (0.

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The effectiveness of prophylactic proton pump inhibitors for prevention of non-steroidal anti inflammatory drugs associated gastric and duodenal ulcers in elderly.

Unlabelled: Aims was undertaken to ensure concomitant usage of proton pump inhibitors (PPIs) with Non-Steroidal Anti-inflammatory Drugs (NSAIDs) in Elderly, in order to avoid upper gastrointestinal (GI) symptoms and ulcers.

Methods: Reviewing of 386 patients' prescription on the EMIS (Egton Medical Information Systems) Web, on April 2014. Checking who have not been prescribed PPIs with NSAIDs, offering them appointment for prescription and discussion about risks and benefits of PPIs.

Brugada syndrome: a review of the literature.

Brugada syndrome is an example of a channelopathy caused by an alteration in the transmembrane ion currents that together constitute the cardiac action potential. Approximately 20% of the cases of Brugada syndrome have been shown to be associated with mutations in the gene coding for the sodium ion channel in the cell membranes of the muscle cells of the heart. Patients with Brugada syndrome are prone to develop ventricular tachyarrhythmias that may lead to syncope, cardiac arrest or sudden cardiac death.

Persistent left superior vena cava with absent right superior vena cava: review of the literature and clinical implications.

Persistent left superior vena cava (PLSVC) is the most common venous anomaly of the thorax affecting 0.5-2% of the general population. PLSVC with absent right SVC, which is also referred to as isolated PLSVC, occurs in 0.

A catastrophic cause of chest pain.

Chest pain can be a manifestation of aortic pathology and must be considered in any patient with a history of chest trauma, hypertension, atherosclerosis, connective tissue disorder and/or radiographically abnormal aortic contours. Acute intramural haematoma can resemble acute myocardial infarction and can be life-threatening if not correctly diagnosed. Electrocardiogram (ECG) must be carried out in all patients as it helps distinguish acute myocardial infarction (for which antiplatelets and anticoagulants may be life-saving) from intramural haematoma (for which these drugs may be detrimental).

Pregnancy-related Spontaneous Coronary Artery Dissection: Two Case Reports and a Comprehensive Review of Literature.

Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome, particularly seen in women during pregnancy or in the puerperium. It has a high acute phase mortality. The etiology is uncertain.

Sero-prevalence of hepatitis B virus infection in Balochistan Province of Pakistan.

Background/aim: The objective was to evaluate the sero-prevalence of hepatitis B surface antigen (HBsAg) and IgM antibodies to hepatitis core antigen in Balochistan Province of Pakistan.

Design Of The Study: A cross-sectional, population-based study. Place and time of the study: The study was conducted in Balochistan from 1 st January 2004 to 31 st December, 2008.

An audit of the use and complications of glycoprotein IIb/IIIa inhibitors in percutaneous coronary intervention against national UK standards.

Coronary thrombosis is a pivotal event in the pathogenesis of acute coronary syndromes and ischemic complications resulting from coronary intervention. Activation of the platelet glycoprotein (GP) IIb/IIIa receptor is the final common pathway leading to platelet aggregation, coronary thrombus formation, and myocardial ischemia. Inhibitors of platelet GP IIb/IIIa are potent agents to prevent progression to myocardial infarction and death.

High frequency of false positive results in HIV screening in blood banks.

Background: This study was carried out to determine the frequency of false-positive results during serological screening for the presence of antibodies against HIV-I/2 in blood banks.

Methods: A cross-sectional study was conducted from January-December 1999 as screening of voluntary non-renumerated blood donor pool for HIV in the public sector blood banks, in all the six divisions of Balochistan. 5000 subjects were screened for the presence of antibodies against HIV-I/ 2.

Bi-annual surge of Crimean-Congo haemorrhagic fever (CCHF): a five-year experience.

Objective: To determine the peak time of outbreak of Crimean-Congo haemorrhagic fever (CCHF) and to highlight the disease-specific areas in the Balochistan province of Pakistan.

Design: A hospital-based case-series study.

Place And Duration: A five-year study was conducted by the Department of Pathology in collaboration with the Department of Medicine, Sandeman Provincial Teaching Hospital, Quetta, Balochistan, Pakistan, from 1 March 1997 to 28 February 2002.

Knowledge, attitude and practices regarding Crimean-Congo haemorrhagic fever among healthcare workers in Balochistan.

Background: The objective of this study was to determine the knowledge, attitude and practices regarding Crimean-Congo Haemorrhagic Fever (CCHF) among healthcare workers at a tertiary care referral hospital in Balochistan.

Methods: A cross-sectional survey was conducted in April-May 2000 among the doctors, nurses and laboratory technicians of Sandeman Provincial Teaching Hospital, Quetta, Balochistan. A questionnaire was formulated which included the demographic data of the respondents and their knowledge, attitude and practices towards CCHF.

High frequency of false positive results in HIV screening in blood banks.

Background: This study was carried out to determine the frequency of false--positive results during serological screening for the presence of antibodies against HIV-1/2 in blood banks.

Methods: A cross-sectional study was conducted from January--December 1999 as screening of voluntary non-remunerated blood donor pool for HIV in the public sector blood banks, in all the six divisions of Balochistan. 5000 subjects were screened for the presence of antibodies against HIV-1/2.

Utility of thick smears of bone marrow aspirate in pyrexia of unknown origin.

Objective: To determine the diagnostic efficacy of Giemsa stained thick smear of bone marrow aspirate for evidence of malaria in febrile individuals in whom the diagnosis was otherwise unknown.

Design: Descriptive case-series study.

Place And Duration Of Study: This study was conducted at the Department of Medicine, Sandeman Provincial Hospital, Quetta, in the Balochistan province of Pakistan, between January 1994 and December 1998.

Awareness of HIV and AIDS among fishermen in coastal areas of Balochistan.

Objective: The aim of this study is to determine the knowledge, attitude, behaviour and practices regarding HIV/AIDS among the fishermen community in the coastal areas of Balochistan.

Design: A cross-sectional survey.

Place And Duration Of Study: This study was conducted between September-October 2000 at Gidani, a coastal area of Balochistan.