Comparison of noninvasive cardiac output monitoring by electrical cardiometry with transthoracic echocardiography in postoperative paediatric cardiac surgical patients - A prospective observational study.

Aim: The present study was conducted to validate cardiac output (CO) and cardiac index (CI) obtained from electrical cardiometry (EC) ICON with transthoracic echocardiography (TTE) in postoperative pediatric cardiac surgical patients.

Materials And Methods: A prospective observational study was conducted in 25 pediatric patients with age < 10 years who underwent elective cardiac surgery.

Data Analysis: BlandAltman plot was constructed for interchangeability and Polar plot was constructed to know trending ability.

Comparision of cardiac output measured by transthoracic echocardiography with continuous cardiac output measured by pressure recording analytical method.

Background: Low cardiac output is a common complication following cardiac surgery and it is associated with higher mortality in the pediatric population. A gold standard method for cardiac output (CO) monitoring in the pediatric population is lacking. The present study was conducted to validate cardiac output and cardiac index measured by transthoracic echocardiography and Pressure recording analytical method, a continuous pulse contour method, MostCare in postoperative pediatric cardiac surgical patients.

MnO nano-octahedrons embedded in nitrogen-doped graphene oxide as potent anode material for lithium-ion batteries.

Unlabelled: MnO nano-octahedrons embedded in N-doped graphene oxide (MNGO) nanosheets were synthesized using a simple, energy-efficient, and rapid microwave-digested hydrothermal route in a single step. The structural and morphological aspects of synthesized materials were evaluated by XRD, IR, Raman, FE-SEM, and HR-TEM techniques. Then, the composite MNGO was tested for its Li-ion storage properties and compared with reduced graphene oxide (rGO) and MnO materials.

EUS-guided left lobe liver biopsy: Safer modality with similar diagnostic yield as right lobe: a pilot study.

Percutaneous liver biopsy is traditionally done on the right lobe of the liver. Endoscopic ultrasound-guided liver biopsy (EUS-LB) can be performed on either the left or right lobe or as a combined bi-lobar biopsy. Earlier studies did not compare the benefit of bi-lobar biopsies to single-lobe biopsy for reaching a tissue diagnosis.

Inadequate response to adenosine infusion during cardiac stress magnetic resonance imaging.

Aim: To determine the factors associated with an inadequate response to adenosine infusion during cardiac stress magnetic resonance imaging (MRI).

Study Design: It is a retrospective cohort study.

Introduction: Stress cardiac MRI is a highly accurate and non-invasive method to diagnose coronary artery disease (CAD).

Comparison of epidural analgesia with ultrasound-guided bilateral erector spinae plane block in aorto-femoral arterial bypass surgery.

Objective: Thoracic Epidural Analgesia (TEA) was compared with ultrasound-guided bilateral erector spinae plane (ESP) block in aorto-femoral arterial bypass surgery for analgesic efficacy, hemodynamic effects, and pulmonary rehabilitation.

Design: Prospective randomized.

Setting: Tertiary care centre.

The within-host fitness of HIV-1 increases with age in ART-naïve HIV-1 subtype C infected children.

As the immune system develops with age, children combat infections better. HIV-1, however, targets an activated immune system, potentially rendering children increasingly permissive to HIV-1 infection as they grow. How HIV-1 fitness changes with age in children is unknown.

SARS-CoV-2 in Kidney Transplant and Waitlisted Patients During the First Peak: The Welsh Experience.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) global pandemic has led to many health care services, including transplantation, being temporarily suspended. For transplantation to safely recommence, there is a need to understand the effects of SARS-CoV-2 in transplant and waitlist patients. We identified 21 patients with proven SARS-CoV-2 infection (13 transplant; 8 waitlist) during the first peak of coronavirus disease 2019 in Wales.

Pharmacological preconditioning with intralipid in patients undergoing off-pump coronary artery bypass surgery.

Aims And Objectives: The objective of the study was to determine the preconditioning myocardial protective effects of intralipid (IL) in off-pump coronary artery bypass (OPCAB) surgery by measuring highly sensitive troponin T (hsTnT) and cardiac-specific creatine kinase (CK-MB) as markers of myocardial injury.

Materials And Methods: : Thirty patients, scheduled to undergo elective OPCAB surgery, were randomly assigned to the IL group (n = 15) or control (C) group (n = 15); the IL group received an infusion of 20% IL 2 ml/kg, 30 min prior to revascularization and the control group received an equivalent volume of normal saline. Serum levels of hsTnT and CK-MB were measured before surgery and at 6 h, 24 h, 48 h, and 72 h postoperatively.

Comparison of continuous cardiac output monitoring derived from regional impedance cardiography with continuous thermodilution technique in cardiac surgical patients.

Background: Cardiac output (CO) assessment is a corner stone in advanced haemodynamic management, especially in critical ill patients. The present study was conducted to validate cardiac index and cardiac output by NICaS™ with the thermodilution technique using pulmonary artery catheter in post-operative cardiac surgical patients.

Materials And Methods: This was a prospective observational clinical study conducted at a tertiary care hospital.

Comparison of pectoral Nerve (PECS1) block with combined PECS1 and transversus thoracis muscle (TTM) block in patients undergoing cardiac implantable electronic device insertion - A pilot study.

Background: Pectoral nerve (PECS1) block has been used for patients undergoing cardiac implantable electronic device (CIED) insertions, however, PECS1 block alone may lead to inadequate analgesia during tunneling and pocket creation because of the highly innervated chest wall. Transversus thoracis muscle plane (TTM) block targeting the anterior branches of T2-T6 intercostal nerves can be effectively used in combination with PECS1 for patients undergoing CIED insertion. The present study hypothesized that combined PECS1 and TTM blocks would provide effective analgesia for patients undergoing CIED insertion compared to PECS1 block alone.

Self-assembled toron-like structures in inverse nematic gels.

A novel form of nematic gel (N-gel) wherein bright flower-like domains (BFDs) rich in gelator fibres are embedded in a matrix of liquid crystal (LC) molecules has been reported. These gels which we denote as inverse N-gels are unlike typical N-gels in which the LC is encapsulated within an aggregated network of gelator molecules. The self-organization of the helical gelator fibres within the BFDs leads to the creation of localized toron-like structures that are topologically protected due to their skyrmion director profile.

GRANULOMATOUS DISEASE OF UNUSUAL SITES CAUSING HYPERCALCEMIA: TWO CASE REPORTS.

Objective: Hypercalcemia with suppressed parathyroid hormone (PTH) levels is mostly due to granulomatous disease (GD) or neoplastic disease. In GD, autonomous activity of extra-renal 1α-hydroxylase enzyme is usually the underlying cause. We describe a pair of cases where hypercalcemia resulted from GD of unusual sites posing significant diagnostic challenges.

Role of urinary PO analysis during conventional versus conventional and modified ultrafiltration techniques in adult cardiac surgery.

Background: Medullary hypoxia is the initial critical event for kidney injury during cardiopulmonary bypass, and therefore urinary PO with its potential of detecting medullary oxygenation for its management. Therefore, we tested the role of urinary PO in predicting kidney injury in those undergoing conventional versus combined (conventional and modified) ultrafiltration during cardiac surgery in adults.

Methodology: We prospectively evaluated 32 adults between 18 and 65 years of age undergoing elective on-pump cardiac surgery with ejection fraction >35% by conventional (group C) versus combined ultrafiltration (group CM).

Portal venous pulsatility fraction, a novel transesophageal echocardiographic marker for right ventricular dysfunction in cardiac surgical patients.

Background: Right ventricular (RV) has a vital role in maintaining optimal tissue perfusion. Assessment of portal venous flow characteristics can be alternative and emerging technique to assess RV function.

Aims: To investigate if portal venous pulsatility fraction (PF) could serve as effective and complementary tool in identifying RV dysfunction.

Transesophageal echocardiographic evaluation of pulmonary vein diastolic wave deceleration time - As a predictor of left atrial pressure.

Background: The deceleration time of the pulmonary venous diastolic flow has been well-correlated with invasive pulmonary capillary wedge pressure in several studies regardless of left ventricular systolic function. This study was conducted to correlate deceleration time of pulmonary venous diastolic wave, DT, and left atrial pressure (LAP), obtained noninvasively from mitral early diastolic inflow velocity-to-early diastolic mitral annulus velocity ratio (E/e'), and to assess the ease of each method in patients with coronary artery disease undergoing off-pump coronary artery bypass grafting (OPCAB) by transesophageal echocardiography.

Methods: Forty-five adult patients with coronary artery disease, with left ventricular ejection fraction of ≥50% posted for elective OPCAB were enrolled in the study.

Repair of Sinus Venosus Defects With Partial Anomalous Pulmonary Venous Connection in Children by Modified Right Vertical Infra Axillary Thoracotomy.

Objective: To evaluate the safety and reproducibility of modified right vertical infra axillary thoracotomy (RVIAT) for repair of sinus venosus defects with right-sided partial anomalous pulmonary venous connection (PAPVC) in children.

Methods: Between March 2017 and February 2018, we performed intracardiac repair for sinus venosus defects with right-sided PAPVC in 14 children through modified RVIAT. Median age and weight were 9.

Clusters of B Fibers Reveal Origin of Blue Phase Stability in a Binary Mixture of Chiral Rod-like and Achiral Bent-Core Molecules.

Liquid crystal (LC) blue phases (BPs) have gained relevance because of their potential applicability as tunable photonic band gap materials. However, their narrow temperature range often restricts technical usage. Doping with an LC made of achiral bent-core (BC) molecules is one of the strategies employed to increase BP stability.

ANSiscope™: Can it be the crystal ball of cardiac anesthesia?

Background: : Autonomic dysfunction (AD) is infrequently evaluated preoperatively despite having profound perioperative implications. The ANSiscope™ is a monitoring device that quantifies AD. This study aims to determine the potential of the device to predict hypotension following anesthetic induction, occurrence of arrhythmias, and inotrope requirement for patients undergoing off-pump coronary artery bypass surgery (OPCAB).

Evaluation of risk scores in predicting perioperative blood transfusions in adult cardiac surgery.

Objective: Allogeneic blood product transfusions are associated with an increased morbidity and mortality risk in cardiac surgery. At present, a few transfusion risk scores have been proposed for cardiac surgery patients. The present study is aimed to develop a new score and to compare with preexisting scores - Transfusion Risk and Clinical Knowledge (TRACK) and Transfusion Risk Understanding Scoring Tool (TRUST) score.

Early prediction of acute kidney injury using serum phosphorus as a biomarker in pediatric cardiac surgical patients.

Background: Acute kidney injury (AKI) is a strong predictor of morbidity and mortality after cardiac surgery. Lack of valid early biomarkers for predicting AKI has hampered the ability to take therapeutic measures for preventive cause. Hyperphosphatemia that occurs in AKI due to renal excretion defect was not studied in this context and could be simple marker of AKI.

Efficacy of bilateral pectoralis nerve block for ultrafast tracking and postoperative pain management in cardiac surgery.

Background: Good postoperative analgesia in cardiac surgical patients helps in early recovery and ambulation. An alternative to parenteral, paravertebral, and thoracic epidural analgesia can be pectoralis nerve (Pecs) block, which is novel, less invasive regional analgesic technique.

Aims: We hypothesized that Pecs block would provide superior postoperative analgesia for patients undergoing cardiac surgery through midline sternotomy compared to parenteral analgesia.

Inhaled levosimendan versus intravenous levosimendan in patients with pulmonary hypertension undergoing mitral valve replacement.

Context: Inhaled levosimendan may act as selective pulmonary vasodilator and avoid systemic side effects of intravenous levosimendan, which include decrease in systemic vascular resistance (SVR) and systemic hypotension, but with same beneficial effect on pulmonary artery pressure (PAP) and right ventricular (RV) function.

Aim: The aim of this study was to compare the effect of inhaled levosimendan with intravenous levosimendan in patients with pulmonary hypertension undergoing mitral valve replacement.

Settings And Design: The present prospective randomized comparative study was conducted in a tertiary care hospital.

Comparison of continuous thoracic epidural analgesia with bilateral erector spinae plane block for perioperative pain management in cardiac surgery.

Objective: Continuous thoracic epidural analgesia (TEA) is compared with erector spinae plane (ESP) block for the perioperative pain management in patients undergoing cardiac surgery for the quality of analgesia, incentive spirometry, ventilator duration, and intensive care unit (ICU) duration.

Methodology: A prospective, randomized comparative clinical study was conducted. A total of 50 patients were enrolled, who were randomized to either Group A: TEA (n = 25) or Group B: ESP block (n = 25).