Indian Guidelines for Indications and Timing of Intervention for Common Congenital Heart Diseases: Revised and Updated Consensus Statement of the Working Group on Management of Congenital Heart Diseases. Abridged Secondary Publication.

Justification: A number of guidelines are available for management of congenital heart diseases from infancy to adult life. However, these guidelines are for patients living in high income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for congenital heart diseases, as often these patients present late in the course of the disease and may have co-existing morbidities and malnutrition.

Guidelines for the management of common congenital heart diseases in India: A consensus statement on indications and timing of intervention.

Introduction: A number of guidelines are available for management of congenital heart diseases from infancy to adult life. However, these guidelines are for patients living in high-income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for congenital heart diseases, as often these patients present late in the course of the disease and may have co-existing morbidities and malnutrition.

Indian guidelines for indications and timing of intervention for common congenital heart diseases: Revised and updated consensus statement of the Working group on management of congenital heart diseases.

A number of guidelines are available for the management of congenital heart diseases (CHD) from infancy to adult life. However, these guidelines are for patients living in high-income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for CHD, as often these patients present late in the course of the disease and may have coexisting morbidities and malnutrition.

Cryopreserved whole blood for the quantification of monocyte, T-cell and NK-cell subsets, and monocyte receptor expression by multi-color flow cytometry: A methodological study based on participants from the canadian longitudinal study on aging.

Immunophenotyping by multi-color flow cytometry is arguably the best tool to identify and quantify distinct cell lineages from the peripheral blood and other biological fluids/tissues. Effective in both clinical and research settings, it can be used to estimate the frequency of a given cell type or measure its phenotypic or functional properties. Normally, immunophenotyping is performed in fresh or fractionated blood (i.

The relation between DNA methylation patterns and serum cytokine levels in community-dwelling adults: a preliminary study.

Background: The levels of circulating cytokines fluctuate with age, acute illness, and chronic disease, and are predictive of mortality; this is also true for patterns of DNA (CpG) methylation. Given that immune cells are particularly sensitive to changes in the concentration of cytokines in their microenvironment, we hypothesized that serum levels of TNF, IL-6, IL-8 and IL-10 would correlate with genome-wide alterations in the DNA methylation levels of blood leukocytes. To test this, we evaluated community-dwelling adults (n = 14; 48-78 years old) recruited to a pilot study for the Canadian Longitudinal Study on Aging (CLSA), examining DNA methylation patterns in peripheral blood mononuclear cells using the Illumina HumanMethylation 450 K BeadChip.

A comprehensive assessment of immunophenotyping performed in cryopreserved peripheral whole blood.

Background: Monitoring the frequency and phenotype of white blood cell subsets using flow cytometry (immunophenotyping) has proven to be an incredibly powerful tool in the assessment of health. Although improved technologies have aided in the practical implementation of immunophenotyping in clinical and epidemiological studies, the transportation of blood from the site of collection to a central laboratory for analysis within a reasonable timeframe may not be feasible. Hence, the purpose of the following study was to investigate the validity of cryopreserved whole blood as a simple to prepare and cost-effective biospecimen for multi-colour immunophenotyping in a large epidemiological study-namely, The Canadian Longitudinal Study on Aging (CLSA).

Homozygous familial hypercholesterolaemia in two boys aged 5 and 10 years.

Familial hypercholesterolaemia (FH) is an autosomal dominant lipid disorder. Homozygous FH (HFH), though rare, presents in early childhood. Two different presentations of HFH are reported.

Tulip deformity with Cera atrial septal defect devices: a report of 3 cases.

Device closure of secundum atrial septal defect (ASD) is the treatment of choice when anatomy is favourable. Amplatzer device has remained the gold standard for closure of ASD. Cobra deformity is a well-reported problem with devices.

Oral flecainide is effective in management of refractory tachycardia in infants.

Background: Propranolol and digoxin have been used as first line drugs for treatment of supraventricular tachycardia (SVT) in infants. Flecainide and other drugs have been effective as a second line treatment for controlling refractory SVT.

Material And Methods: This is a prospective study without randomization and control.

Percutaneous transluminal coronary angioplasty following Kawasaki Disease.

Kawasaki disease (KD) can result in coronary artery disease in the form of ectasia, aneurysm and stenosis. The final complication can be myocardial infarction. We report a child who presented with severe left ventricular dysfunction following KD and was detected on angiography to have total left anterior descending artery occlusion.

Pentalogy of Cantrell with left ventricular diverticulum: a case report and review of literature.

Pentalogy of Cantrell is a rare congenital anomaly involving deficiency of the following structures: anterior diaphragm, supraumbilical abdominal wall, diaphragmatic pericardium, lower sternum, and associated congenital intracardiac abnormality. We describe a 3-month-old child with this syndrome having left ventricular diverticulum along with omphalocele who presented to us with a pulsating mass in the epigastrium. The defect was evaluated and defined by computed tomography scan.

Gastrointestinal bleed with clopidogrel and aspirin.

Anti-platelet drugs have been used to prevent thrombosis of systemic to pulmonary artery shunts. Aspirin has traditionally been used. Clopidogrel is being studied as an alternative and in combination with aspirin for shunt patients.

Posttransplant complex inferior venacava balloon dilatation after hepatic vein stenting.

Orthotopic and living related liver transplantation is an established mode of treatment of end-stage liver disease. One of the major causes of postoperative complications is vascular anastomotic stenosis. One such set of such complications relates to hepatic vein, inferior vena cava (IVC), or portal vein stenosis, with a reported incidence of 1-3%.

Post-op systemic hypertensive crises in an infant with total anomalous pulmonary venous connection.

Systemic hypertension is not usually a complication following repair of total anomalous pulmonary venous connection (TAPVC). We report an infant with supracardiac TAPVC with hypertensive crises post-operatively resulting in pulmonary edema. We feel this might have been related to the pre-operative hemodynamics as described.

Neonatal cardiac interventions: an Indian perspective.

Palliative interventions in newborn have been performed ever since balloon atrial septostomy was started. The scope and potential of these interventions have been extended to therapeutic interventions and also to replace palliative surgeries. The advancements have happened over the last two decades mainly due to the advancements in cardiac anesthesia of the newborn and primarily due to available hardware improving.

Right superior vena cava drainage into the left atrium associated with a coronary-cameral fistula occluding an atrial-septal defect: first echocardiographic, angiographic, and surgical description.

Right superior vena cava (SVC) drainage into the left atrium causing hypoxemia is a very rare congenital malformation. This anomaly can result in complications of chronic cyanosis and paradoxical embolism. It rarely is associated with any other congenital malformation.

Balloon dilation of the pulmonary valve in premature infants with tetralogy of Fallot.

Infants with tetralogy of Fallot (ToF) presenting with desaturation may require augmentation of the pulmonary blood flow, usually in the form of a Blalock-Taussig shunt. Shunts may result in a preferential increase in blood flow to one lung. They also may be associated with significant morbidity and possibly mortality of premature infants.

Voriconazole in newborns.

Voriconazole is a newer systemic antifungal agent effective against Candida and Aspergillus. There are few reports of its safe use in newborns. We report the first case series of safe Voriconazole use in critically ill newborns with cardiac disease along with several other cardiac drugs without any significant drug interaction or side-effect.

Innominate artery compression of trachea.

Innominate artery may cross the trachea and cause airway obstruction is a rare cause of vascular obstruction of airway. We describe a child with stridor, inability to extubate in whom the diagnosis was suspected on fluoroscopy and confirmed by angiography. Reimplantation of the innominate artery resulted in excellent results with longterm follow up.