Publications by authors named "Jai Parekh"

We present a first in human experience of transseptal balloon-assisted translocation of a mitral anterior leaflet (BATMAN) to facilitate transcatheter mitral valve replacement in a patient with severe mitral annular calcification who was at high risk of left ventricular outflow tract obstruction.

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Article Synopsis
  • The study evaluates the use of temporary-permanent pacemakers (TPPM) in patients undergoing transcatheter aortic valve replacement (TAVR) who are at high risk for needing a permanent pacemaker (PPM).
  • Out of 978 TAVR patients analyzed, 111 received TPPM, with 89 included in the final results, showing a median age of 78 and various rates of preexisting heart conditions.
  • Findings suggest that TPPM is a safe and effective pacing method that can help in early recovery and reduce the need for PPM in some cases, with only 1.1% experiencing lead dislodgment and a median hospital stay of 3 days.
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Purpose: To evaluate the effectiveness and safety of a crosslinked hyaluronate (HA) canalicular filler (Lacrifill Canalicular Gel) compared with a commercially available hydrogel canalicular plug (Form Fit).

Setting: 5 sites in the United States.

Design: Prospective, multicenter, controlled, double-masked, randomized 2:1 (filler:plug).

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Mixed aortic valve disease (MAVD), defined by the concurrent presence of aortic stenosis (AS) and insufficiency is frequently seen in patients who have undergone transcatheter aortic valve implantation (TAVI). However, studies comparing the outcomes of TAVI in MAVD versus isolated AS have demonstrated conflicting results. Therefore, we aim to assess the outcomes of TAVI in patients with MAVD in comparison with those with isolated severe AS.

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The use of transcatheter percutaneous edge-to-edge mitral valve repair with the MitraClip (Abbott) for the treatment of mitral regurgitation has rapidly expanded since it received Food and Drug Administration approval. Currently, patients with more complex mitral valve anatomies are undergoing this procedure with progressively improving clinical outcomes. This review focuses on the advanced steering maneuvers needed for the technical success of the MitraClip procedure and discusses several scenarios where such advanced steering maneuvers may be needed.

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Eustachian valve (EV) is usually a rudimentary structure in adults. It is an embryological remnant of sinus venosus that directs oxygenated blood from the inferior vena cava across the foramen ovale and into the left atrium. Intravenous drug use is most commonly associated with infective endocarditis of the right-sided heart structures.

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Coronavirus Disease 2019 (COVID-19) has infected more than 3.0 million people worldwide and killed more than 200,000 as of April 27, 2020. In this White Paper, we address the cardiovascular co-morbidities of COVID-19 infection; the diagnosis and treatment of standard cardiovascular conditions during the pandemic; and the diagnosis and treatment of the cardiovascular consequences of COVID-19 infection.

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One of the most common cause of arbovirus encephalitis in the United States of America (USA) is West Nile virus (WNV). In immunocompetent hosts, 70-80% of infected individuals have subclinical disease. However, in less than 1% of people infected by WNV it can become fulminant neuroinvasive disease associated with neurological morbidity.

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Statins can cause a wide spectrum of muscular adverse effects ranging from asymptomatic elevation of Creatine Kinase (CK), myalgia and exercise intolerance to rhabdomyolysis. Most of these effects generally resolve on stopping the medication. However, statins can be associated with a unique autoimmune myopathy wherein symptoms persist or even progress after statin discontinuation and require immunosuppressive therapy.

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Article Synopsis
  • A 61-year-old male with a history of emphysema, obstructive sleep apnea, and hypertension experienced worsening shortness of breath and swelling, leading to an ER visit.
  • He showed symptoms of heart failure, including elevated jugular veins and fluid retention, and tests revealed a significantly reduced left ventricular ejection fraction (LVEF) suggestive of left ventricular non-compaction (LVNC).
  • The patient was treated according to heart failure guidelines, monitored for arrhythmias, and discharged with a wearable defibrillator, with plans for future evaluation for an implantable defibrillator for primary prevention.
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Objective: To describe the efficacy, superiority and safety profile of the first-in-class angiotensin receptor-neprilysin inhibitor "Sacubitril/Valsartan" as compared to angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blocker (ARB) in heart failure (HF) patients, reviewing data available from both clinical and pre-clinical studies. Evidences on health care utilization outcomes such as hospitalizations and emergency department visits were also evaluated.

Material (data Source): Sources: Medical literature on 'Sacubitril/Valsartan' and 'Angiotensin Receptor-Neprilysin Inhibitor' was identified by searching databases (including, but not limited to, PubMed, Embase and HighWire) for articles published since 1991, bibliographies from published literature, clinical trial registries/databases and websites (including those of regional regulatory agencies and the manufacturer).

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Aging is characterized by progressive deterioration of physiological integrity, decline in homeostasis, and degeneration of the tissues that occurs after the reproductive phase of life is complete, leading to impaired function. This deterioration is an important risk factor for chronic lung pathologies such as chronic obstructive pulmonary disease (COPD). COPD is a disease that develops gradually.

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A 23-year-old, previously healthy female presented with lower abdominal pain and mildly elevated creatinine one month following a right ureter stent for non-specific ureteral thickening causing obstruction. On admission, computed tomography (CT) revealed moderate hydronephrosis of the left kidney that would require stent placement as well. During stent placement, it was noted that the gross appearance of the ureters resembled ureteritis cystica.

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A 66-year-old woman presented with 2 days of fever and severe diarrhoea. She has a history of ulcerative colitis (UC), well controlled with medication. She also has a history of Ehlers-Danlos syndrome, infective endocarditis following aortic valve replacement and pulmonary embolism.

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A 61-year-old male was admitted from the outpatient setting for treatment of severe hyperglycemia. Five months earlier, his hemoglobin A1c had been 5 mmol/mol. At presentation, hemoglobin A1c was 11.

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Only a few case reports to date have described patients with three or more cancers. However, the incidence of multiple primary malignancies is increasing due to the improved survival of cancer patients, the prolonged lifespan of the general population, and better diagnostic techniques. This report describes a 73-year-old woman with primary breast, rectal squamous cell, and renal cell carcinomas.

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We present the case of a 61-year-old Caucasian gentleman who presented with a one-day history of fever, chills, and altered mental status. His symptoms were initially thought to be secondary to cellulitis. Blood cultures grew , a rare pathogen to cause bacteremia.

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Acromegaly is a rare condition with an approximate incidence of 3-4 new cases per million per year and occurs as a result of excess secretion of growth hormone (GH). It is associated with several cardiovascular manifestations of which dilated cardiomyopathy with systolic and diastolic dysfunction is relatively rare but associated with increased mortality. There are very few documented cases of acromegaly with dilated cardiomyopathy in Indian female patients in literature, thus justifying the uniqueness of our case.

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Objective: To describe the efficacy and safety profile of the new angiotensin receptor blocker (ARB), "Azilsartan Medoxomil", reviewing data available from both clinical and pre-clinical studies.

Material: We completed a review of the English literature from PubMed using the keywords- azilsartan medoxomil, angiotensin receptor blockers (ARB), angiotensin converting enzyme inhibitors (ACEi) and hypertension.

Data Evaluation: Many clinical trials have been conducted comparing the efficacy of azilsartan with other ARB's and also with the ACEi ramipril.

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The antiemetic properties of marijuana are well known, but there is increasing evidence of its paradoxical hyperemetic effects on the gastrointestinal tract and central nervous system, known as 'cannabinoid hyperemesis syndrome' (CHS). We report a case of CHS encountered in our outpatient clinic. We also completed a review of the literature using PubMed in patients over 18 years of age with CHS.

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Purpose: The objective of this study was to collect and evaluate retrospective safety information about the use of besifloxacin ophthalmic suspension 0.6% for the treatment of bacterial keratitis.

Methods: This was a retrospective, postmarketing surveillance study conducted at 10 clinical centers in the United States.

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