Scrub typhus presenting as mitral valve infective endocarditis.

Scrub typhus presenting as infective endocarditis of the mitral valve is rare. There are few reports of infective endocarditis by scrub typhus with just one previous report of involvement of the aortic valve. An 18-year-old woman presented with prolonged fever for 1 month.

Morphological organisation of the digestive tract in the stream catfish Pseudecheneis sulcatus (McClelland).

We describe the histological organisation and mucin content in the digestive tract of the stream catfish Pseudecheneis sulcatus. The aim is to find the modifications of the digestive tract in relation to food resources of its habitat. The oesophageal mucosa consists of stratified squamous epithelium with many mucous-secreting cells.

The Unique Role of Intravascular Lithotripsy (IVL) in Debulking the Nodular Calcium in Left Main Coronary Artery Bifurcation.

Nodular calcium poses a great challenge during coronary intervention. The presence of nodular calcium is associated with poor post-procedural outcomes. Without debulking the nodular calcium, it is extremely difficult to pass the coronary hardwires including the balloons and drug-eluting stents across the lesion.

Unmasking a Rare Case of Long-Standing Minimal Pericardial Effusion in Dermatomyositis.

We report an extremely rare case of long-standing (> six months) minimal pericardial effusion attributed to dermatomyositis. The patient was inadvertently administered antitubercular drug therapy for three months after which the patient developed significant weight loss, extreme anorexia, nausea, and vomiting refractory to conventional management. The key message in the manuscript is that even indolent dermatomyositis can present solely as an unexplained pericardial effusion in an individual.

Snare-Assisted Retrieval of an Embolized Long Coronary Guidewire From the Aortic Arch.

We report an extremely rare case of gooseneck snare-assisted retrieval of an embolized coronary guidewire from the aortic arch in an elderly male scheduled for a transradial coronary angiogram for unstable angina. In this case, the proximal end of the embolized coronary guidewire could not be retrieved from the brachial artery nor the roomy aortic root using a flower petal snare. The key takeaway from this case is that an embolized coronary guidewire can be successfully retrieved with a gooseneck snare from its proximal end in a moderately spacious area like the aortic arch.

The Unique Role of Cutting Balloon Angioplasty in Debulking Multiple Nodular Calcium in Osteoproximal and Mid-left Anterior Descending Coronary Artery.

We report a rare case of multiple nodular calcium in the left anterior descending coronary artery in an octogenarian presenting with unstable angina. Dilatation with the noncompliant and scoring balloon could not yield the nodular calcium and it was only the cutting balloon that could yield the nodular calcium and successful coronary angioplasty could be accomplished with good angiographic results with distal Thrombolysis in Myocardial Infarction (III) flow. This case demonstrates the unique role of cutting balloons in the angioplasty of coronary lesions with multiple nodular calcium.

Electrophoretic Deposition of 58S Bioactive Glass- Polymer Composite Coatings on 316L Stainless Steel: An Optimization for Corrosion, Bioactivity, and Cytocompatibility.

This study presents a facile fabrication of 58S bioactive glass (BG)-polymer composite coatings on a 316L stainless steel (SS) substrate using the electrophoretic deposition technique. The suspension characteristics and deposition kinetics of BG, along with three different polymers, namely ethylcellulose (EC), poly(acrylic acid) (PAA), and polyvinylpyrrolidone (PVP), have been utilized to fabricate the coatings. Among all coatings, 58S BG and EC polymers are selected as the final composite coating (EC6) owing to their homogeneity and good adhesion.

An Interesting Case of Balloon-Assisted Deployment of a Dislodged Coronary Stent.

We report a first and interesting case of balloon-assisted deployment of a dislodged coronary stent. While performing a calcified left circumflex coronary artery (LCX) intervention, the drug-eluting coronary stent was dislodged in the osteoproximal segment of the calcified and tortuous LCX. The dislodged stent was rewired, progressively dilated with multiple balloons and, finally, a larger, balloon-mounted stent was pushed forward, positioned across the coronary lesion and deployed, resulting in distal thrombolysis in myocardial infarction (TIMI) III flow with good angiographic results.

A Rare Case of Radial Arteriovenous Fistula (AVF) Post-Transradial Percutaneous Coronary Intervention.

We report a rare case of radial arteriovenous fistula in a middle-aged person after a successful transradial percutaneous coronary intervention. Early release of manual radial compression was the culprit behind the development of radial arteriovenous fistula. Early surgical repair of the radial arteriovenous fistula resulted in the complete resolution of distal forearm symptoms in the abovementioned patient.

The Closure of Grade 1 Coronary Perforation by the Snowplow Phenomenon.

We report an extremely rare case of spontaneous closure of grade 1 coronary perforation by the snowplow phenomenon during the revascularization of a subtotal occlusion in the left anterior descending coronary artery. Coronary artery perforation is usually a nightmare during coronary intervention in the cardiac catheterization laboratory. While large coronary perforation requires the deployment of a covered stent, small perforations require heparin reversal, prolonged balloon inflation, deployment of small coils, or gel foam closure.

Polymorphic Ventricular Tachycardia in Acute Cervical Spinal Cord Injury: A Rare Occurrence in the Setting of Normal QTc.

Cardiovascular manifestations like bradycardia, hypotension, fluctuation of blood pressure, and supraventricular arrhythmia are common in acute spinal cervical injury above the C6 level and are the major cause of mortality and morbidity in them. Ventricular tachycardia (VT) and fibrillation have only been reported in a few cases, but polymorphic VT (PMVT) has not been reported. We report a very rare case of acute cervical spinal cord injury patient who developed PMVT in the setting of normal QT interval degenerating to ventricular fibrillation, causing cardiac arrest before surgery.

Unveiling a Rare Side Effect: A Report of a Unique Case of Second-Degree Type 2 Sinoatrial Node Exit Block Induced by Adenosine Infusion.

Adenosine is a widely used pharmacologic agent in the field of cardiology, predominantly for the termination of supraventricular tachycardias and diagnostic purposes. Most of the side effects are short-lasting due to its very short half-life. Fatal complications of adenosine are rare but can include ventricular fibrillation, ventricular tachycardia, and asystole.

An Unusual Case of Right Anterior Descending Coronary Artery.

The left anterior descending coronary artery (LAD) arises from the left coronary sinus about 10-12 mm above the annular plane and traverses down the interventricular groove. With deep septal and diagonal branches, it supplies the left side of the heart. Here, we describe an extremely rare case of anomalous origin of the LAD from the right coronary artery, which courses epicardially over the right side of the heart with its ramifying branches, which can be described as the "right anterior descending coronary artery (RAD).

Exercise-Induced Ventricular Tachycardia: A Case Report.

Exercise-induced ventricular tachycardia (EIVT) is a very rare condition that can occur in both structurally normal and abnormal hearts. It is important to recognize and understand the triggers, symptoms, and implications of this condition. In this report, we present a case of a young patient who experienced symptoms of palpitation, presyncope, and syncope during exertion.

The Rescuing Role of Aggressive Thrombosuction in Elective Coronary Angioplasty.

Thrombosuction plays a controversial role during primary percutaneous intervention (PCI). Landmark trials have demonstrated no additional role of thrombosuction during primary percutaneous intervention towards improving mortality and outcome during primary percutaneous intervention. We describe a rare elective coronary angioplasty where only aggressive thrombosuction (almost 150-200 mL) of blood from the coronary artery established the antegrade coronary flow and saved an octogenarian from impending sudden cardiac death (SCD).

U-shaped and L-shaped Left Main Coronary Artery: Rare Congenital Anomalies.

Congenital anomalies in the shape of the coronary arteries are extremely uncommon to encounter in routine clinical practice in interventional cardiology. In this study, we describe two uncommon shape anomalies of the left main coronary artery, that is, U-shaped left main coronary artery and L-shaped left main coronary artery. These anomalies were observed in two consecutive patients who presented with atypical chest pain and exertional shortness of breath.

Supracardiac Total Anomalous Pulmonary Venous Connection in Adolescence.

Background Supracardiac total anomalous pulmonary communication (TAPVC) constitutes a rare congenital cardiac anomaly. Most babies with supracardiac TAPVC are diagnosed in infancy and undergo complete surgical repair during infancy. Delayed presentation of supracardiac TAPVC is rare, and the surgical outcomes are not well known.

A Case of Bradycardia-Induced Torsades De Pointes in a Patient Presenting to the Emergency Room With Cardiac Arrest.

Torsades de pointes (TdP) is a less common type of ventricular tachycardia (VT) characterized by polymorphic VT of changing amplitude and characteristic twists around the isoelectric baseline. It is almost always associated with QT interval prolongation. Unless immediately intervened, it can lead to ventricular fibrillation followed by cardiac arrest.

An Unusual Case of Long-Segment Dissection of the Left Anterior Descending Coronary Artery During Osteoproximal Chronic Total Occlusion Intervention.

Coronary artery dissection can occur after post-balloon inflation; however, a very long-segment coronary dissection (>50 mm) is a rare occurrence during routine coronary interventions. Here, we report an extremely rare case of long-segment coronary dissection in the left anterior descending coronary artery (LAD) induced during antegrade revascularization of chronic total occlusion of osteoproximal LAD with stiffer Gaia II wire. The patient had excruciating angina with hemodynamic collapse and acute pulmonary edema; the patient was rescued with long-segment coronary revascularization.

Primary Percutaneous Coronary Intervention of Acute Thrombotic Occlusion of a Low-Lying Tortuous Right Coronary Artery With a Multipurpose Catheter in an Octogenarian.

Right coronary artery intervention is usually accomplished with a Judkins right (JR) coronary guide catheter. Abnormal right coronary artery take-off from the right coronary sinus poses difficulty in engaging the right coronary artery with a conventional JR guide catheter. We report a rare case of primary percutaneous intervention of the right coronary artery which was performed with a multipurpose catheter as the patient had an extremely low-lying coronary artery from the coronary sinus where conventional catheters could not engage the right coronary artery in an octogenarian with acute inferior wall ST-elevation myocardial infarction in cardiogenic shock.

Recent advances in methanol production from methanotrophs.

Methanol, the simplest aliphatic molecule of the alcohol family, finds diverse range of applications as an industrial solvent, a precursor for producing other chemicals (e.g., dimethyl ether, acetic acid and formaldehyde), and a potential fuel.

A Single Coronary Artery From the Left Coronary Sinus: The Continuing Conundrum.

It is extremely rare to come across a single coronary artery during routine interventional cardiology practice. The incidence of single coronary arteries increases across congenital heart diseases. We report an extremely rare case of a single coronary artery arising from the left coronary sinus in an octogenarian presenting with anterior wall non-ST elevated myocardial infarction (NSTEMI) secondary to atherosclerotic occlusion of the proximal left main coronary artery (LMCA).

A Ball Valve Thrombus in a Young Obese Male With Hyperlipidemia.

A ball valve thrombus is a common entity in rheumatic mitral stenosis where a large clot forms in the left atrial appendage, the clot detaches from the left atrial appendage, swirls in the left atrium in a clockwise manner, obstructs the mitral inflow producing cyclic acute pulmonary edema, and likely causes left ventricular outflow tract obstruction producing transient syncope or embolism to the brain producing dense hemiplegia. Besides rheumatic mitral stenosis, ball valve thrombus has been described in post-mitral valve replacement patients and restrictive cardiomyopathy. Left atrial myxoma sometimes rocks across the mitral valve producing the effect of a ball valve thrombus.

Cracking the Left Main Coronary Artery Nodular Calcium With a Scoring Balloon.

Nodular calcium in the coronary artery poses a great challenge during coronary intervention. Although rotational atherectomy is the preferred modality of treatment of nodular calcium, we treated the left main coronary artery (LMCA) nodular calcium with a scoring balloon during primary angioplasty of an octogenarian with anterior wall myocardial infarction and EKG suggestive of LMCA occlusion. During primary coronary angioplasty, the scoring balloon alone also sometimes suffices in achieving good angiographic results and thrombolysis in myocardial infarction grade III (TIMI III) flow.

On the absence of collective motion in a bulk suspension of spontaneously rotating dielectric particles.

A suspension of dielectric particles rotating spontaneously when subjected to a DC electric field in two dimensions next to a no-slip electrode has proven to be an ideal model for active matter [Bricard , , 2013, , 95-98]. In this system, an electrohydrodynamic (EHD) instability called Quincke rotation was exploited to create self-propelling particles which aligned with each other due to EHD interactions, giving rise to collective motion on large length scales. It is natural to question whether a suspension of such particles in three dimensions will also display collective motion and spontaneously flow like bacterial suspensions do.