Characteristics of Bilateral Adrenal Lesions: Experience from an Indian Tertiary Care Centre.

Introduction: The aetiologies in unilateral and bilateral adrenal lesions can be different with different clinical implications and management guidelines, the latter having aetiologies like hyperplasia, infections, infiltrative lesions and neoplasia. Bilateral tumours are more likely to have hereditary/syndromic associations. There is limited data on the clinical and pathological profile of bilateral adrenal lesions.

Minimally invasive versus conventional sternotomy for Mitral valve repair: protocol for a multicentre randomised controlled trial (UK Mini Mitral).

Introduction: Numbers of patients undergoing mitral valve repair (MVr) surgery for severe mitral regurgitation have grown and will continue to rise. MVr is routinely performed via median sternotomy; however, there is a move towards less invasive surgical approaches.There is debate within the clinical and National Health Service (NHS) commissioning community about widespread adoption of minimally invasive MVr surgery in the absence of robust research evidence; implementation requires investment in staff and infrastructure.

Outcomes in minimally invasive double valve surgery.

Objective: To review current literature evidence on outcomes of minimally invasive double valve surgeries (MIS).

Methods: A comprehensive electronic literature search was done from inception to 20th June 2020 identifying articles that discussed outcomes of minimally invasive approach in double valve surgeries either as a solo cohort or as comparative to conventional sternotomies. No limit was placed on time and place of publication and the evidence has been summarized in narrative manner within the manuscript.

Endoscopic Tricuspid Valve Surgery is a Safe and Effective Option.

Objective: Isolated tricuspid surgery through median sternotomy can be associated with a high morbidity and mortality. Reports of minimally invasive isolated tricuspid valve operations are rare, but the outcomes are encouraging. We present our experience of endoscopic isolated tricuspid valve surgery.

Evaluation of Circulating Plasma VEGF-A, ET-1 and Magnesium Levels as the Predictive Markers for Proliferative Diabetic Retinopathy.

Diabetic retinopathy (DR) is the most common cause for preventable blindness in India. The onset of micro and macrovascular complications in T2DM is multifactorial and difficult to predict. The status of micronutrients, several inflammatory cytokines, elevated triacylglycerols, oxidative stress etc.

Thyroid status in premenopausal and postmenopausal women - A biochemical study on insulin resistance in non obese, overweight and obese type 2 diabetics.

Background: Insulin resistance with altered thyroid status in women is observed in type 2 diabetics and varies with advancing age and estrogen profile. We compared thyroid status between premenopausal and postmenopausal women in obese, non obese and overweight type 2 diabetes.

Methodology: We included 301type 2 diabetics who were segregated into premenopausal (n = 100) 33.

Vaginal Fluid Urea and Creatinine in the Diagnosis of Premature Rupture of Membranes in Resource Limited Community Settings.

Diagnosis of premature rupture of membranes (PROM) is difficult in equivocal cases with traditional methods. This study aimed to evaluate the reliability of vaginal washing fluid urea and creatinine for diagnosis of PROM and to determine the cut off value. The current study was a prospective case control.

Bridging to lung transplantation for severe pulmonary hypertension using dual central Novalung lung assist devices.

This case describes the technique of using dual Novalungs (a pumpless extracorporeal system) to bridge a patient with idiopathic pulmonary hypertension to bilateral lung transplantation. A 41-year old lady with idiopathic pulmonary hypertension (with a possible veno-occlusive element) presented with symptoms of end-stage heart and lung failure. This was refractory to medical management with iloprost, sildenafil and bosentan.

Urinary 8-hydroxydeoxyguanosine as a marker of oxidative stress induced genetic toxicity in oral cancer patients.

Context: Recently, non-communicable diseases have snatched the lead from infectious diseases in causing mortality. Of these, oral cancer accounts for a significant proportion of deaths. Every year in India significant percentage of newly diagnosed malignancy is oral cancer attributed to various reasons.

Identification of mistakes and their correction by a small group discussion as a revision exercise at the end of a teaching module in biochemistry.

Background: Graduate medical students often get less opportunity for clarifying their doubts and to reinforce their concepts after lecture classes. The Medical Council of India (MCI) encourages group discussions among students. We evaluated the effect of identifying mistakes in a given set of wrong statements and their correction by a small group discussion by graduate medical students as a revision exercise.

A Comparative Study of Serum Uric Acid levels and Lipid Ratios in Coronary Artery Disease Patients.

Introduction: Coronary Artery Disease (CAD) appears to be common in the Indian population of different geographical origins, religions and languages. Measurement of lipid fractions and ratios are widely recommended for risk assessment. A few studies have shown that serum uric acid plays a role in the development of cardiovascular morbidity.

Association of inflammatory sialoproteins, lipid peroxides and serum magnesium levels with cardiometabolic risk factors in obese children of South Indian population.

The Incidence of childhood obesity and metabolic syndrome is increasing even in rural and semi-urban regions of India. Adipose tissue mass secretes several inflammatory proteins, which could potentially alter the metabolic processes, leading to several complications at the later stages of life. With limited studies on protein bound sialic acid (PBSA) as a marker of oxidative stress mediated inflammation in obese children, this study was aimed to assess and correlate PBSA with lipid peroxidation and other cardiometabolic risk factors like Insulin Resistance (IR), serum magnesium, and high sensitive C reactive Protein (hsCRP) levels in order to provide an insight into the degree of systemic inflammation and oxidative stress.

Role of TSH on Urinary Calcium Excretion In Post Menopausal Women of South Indian Population.

Background: Unforeseen aberrations in the hormonal status during the early postmenopausal period are responsible for several complications including osteoporosis. Thyroid Stimulating Hormone (TSH) receptors are isolated from various tissues including the bone. A low serum TSH level is known to stimulate osteoclastic activity in bone and accelerate bone resorption.

Serum lipid peroxides and magnesium levels following three months of treatment with pioglitazone in patients with type-2 diabetes mellitus.

Background: Higher levels of lipid peroxidation and hypomagnesaemia are frequently associated with Type 2 Diabetes mellitus (T2DM). Addressing these issues would definitely help us in preventing or prolonging the onset of pathogenesis of micro and macrovascular complications. Pioglitazone is used as a trusted insulin sensitizer and an adjuvant to the conventional oral hypoglycemic agents.

Status of serum magnesium in type 2 diabetes mellitus with particular reference to serum triacylglycerol levels.

Unlabelled: Magnesium (Mg) is the fourth most abundant cation in the body and the second most common intracellular cation. The association between hypomagnesemia and insulin resistance (IR) in diabetes mellitus has been documented earlier. However, we wanted to study whether the extracellular status of magnesium (Mg) could be a biochemical mediator between hypertriacylglycerolemia and diabetes mellitus.

A case series of myectomy: a review of its current application as an adjunct procedure.

In this article, we review the role played by myectomy in cardiac surgery. For this purpose, we looked at three cases of different etiology where myectomy in conjunction with treatment of the primary condition proved invaluable in the outcome of these patients. The primary conditions requiring treatment were subaortic membrane, hypertrophic obstructive cardiomyopathy with mitral valve regurgitation, and aortic stenosis.

Successful graft patency after factor VIIa use for bleeding in coronary artery surgery: an unusual complication of a coronary artery bypass surgery.

There is a growing literature regarding the use of recombinant activated factor VII (rFVIIa) (NovoSeven, NovoNordisk, Copenhagen, Denmark) to control refractory hemorrhage after cardiopulmonary bypass in cardiac surgery. This supporting evidence is mostly documented as case reports on patients, of which only six involve coronary artery grafting. We present our experience of a patient undergoing coronary artery bypass grafting, who suffered an anaphylactic reaction to protamine preventing safe reversal of systemic heparinization.

Complex off-pump coronary artery bypass surgery can be safely taught to cardiothoracic trainees.

Objectives: Off-pump coronary revascularisation is demanding technically as the surgeon is faced with a beating heart and not a bloodless field. The potential clinical advantages of off-pump coronary revascularisation have made this procedure an essential part of a cardiothoracic training program. The aim of this study is to investigate the impact of teaching trainees complex off-pump coronary artery surgery (arterial grafting, 'Y' grafts, sequential grafting and minimally invasive direct coronary artery bypass) on clinical outcomes.

Effects of cell saver autologous blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing cardiac surgery on- versus off-cardiopulmonary bypass: a randomised trial.

Objective: Off-pump CABG is potentially associated with reduced intraoperative blood loss and homologous blood transfusion in comparison to on-pump CABG. In this randomised controlled study we investigated the effects of autologous cell saver blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing CABG on- versus off-CPB.

Methods: Eighty patients were randomised into one of four groups: (A) on-CPB with cell saver blood transfusion (CSBT), (B) on-CPB without CSBT, (C) off-pump with CSBT and (D) off-pump without CSBT.

How safe is it to train residents to perform off-pump coronary artery bypass surgery?

Background: The technique of off-pump coronary artery bypass graft (OPCABG) surgery differs considerably from on-pump CABG. This study investigates the impact of surgical training on clinical outcome in patients undergoing OPCABG.

Methods: All 251 OPCABG cases performed by one service over an 18-month period were analyzed.

A new flavone glycoside from seeds of Daucus carota.

Phytochemical examination of seeds of Daucus carota L. resulted in the isolation of apigenin -4'-O-beta-D-glucoside, kaempferol-3-O-beta-D-glucoside and a new flavone glycoside which was characterised as apigenin-7-O-beta-D-galactopyranosyl-(1-->4)-O-beta-D-mannopyranoside.