The Clinical and Serological Profile of Pediatric Dengue.

Objective: To classify suspected dengue into dengue, dengue with warning signs and severe dengue, based on clinical features as per the revised WHO guidelines with special emphasis on serology.

Methods: It was a prospective cross-sectional study for five years from 2011-2016 in a tertiary care medical college hospital in Bangalore. All cases of fever of three to five days duration with symptoms like dengue were enrolled for the study.

Omega-3 fatty acids do not alter P-wave parameters in electrocardiogram or expression of atrial connexins in patients undergoing coronary artery bypass surgery.

Aims: We previously reported omega-3 polyunsaturated fatty acids (n-3PUFAs) supplementation does not reduce atrial fibrillation (AF) following coronary artery bypass graft (CABG) surgery. The aim of the present study is to evaluate the impact of n-3 PUFAs on electrocardiogram (ECG) atrial arrhythmic markers and compare with expression of gap-junction proteins, Connexins.

Methods And Results: Subset of clinical trial subjects with right atrial sampling during CABG surgery included.

Treatment of tachycardia: bradycardia syndrome in a patient with obstructive sleep apnoea.

Obstructive sleep apnoea (OSAS) affects 4% of men and 2% of women aged 30-65 years. It is diagnosed in the presence of excessive daytime sleepiness and an apnoea-hypopnoea index (AHI) of ≥5 on polysomnography. Rhythm disturbances are common in OSAS and continuous positive airway pressure (CPAP) has been shown to be beneficial.

Takotsubo cardiomyopathy case series: typical, atypical and recurrence.

Takotsubo cardiomyopathy (TCM) is characterised by a transient left ventricular (LV) dysfunction, ECG changes that can imitate acute myocardial infarction and positive cardiac biomarkers in the absence of obstructive coronary artery disease. The exact pathogenesis of TCM is unclear but emotional or physical stress is a common denominator. We present three cases encompassing a spectrum of the disease: A typical TCM with apical LV dyskinesis, an atypical TCM with mid-ventricular regions affected and a TCM recurrence.

Cardiovascular effects of marine omega-3 fatty acids.

Much evidence shows that the marine omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid have beneficial effects in various cardiac disorders, and their use is recommended in guidelines for management of patients after myocardial infarction. However, questions have been raised about their usefulness alongside optimum medical therapies with agents proven to reduce risk of cardiac events in high-risk patients. Additionally, there is some evidence for a possible pro-arrhythmic effect in subsets of cardiac patients.

Omega-3 fatty acid supplementation does not reduce risk of atrial fibrillation after coronary artery bypass surgery: a randomized, double-blind, placebo-controlled clinical trial.

Background: Omega-3 polyunsaturated fatty acids (n-3 PUFA) have been reported to reduce the risk of sudden cardiac death presumed to be due to fatal ventricular arrhythmias, but their effect on atrial arrhythmias is unclear.

Methods And Results: Patients (n=108) undergoing coronary artery bypass graft surgery were randomly assigned to receive 2 g/d n-3 PUFA or placebo (olive oil) for at least 5 days before surgery (median, 16 days; range, 12 to 21 days). Phospholipid n-3 PUFA were measured in serum at study entry and at surgery and in right atrial appendage tissue at surgery.

Migraine following trans-septal access for catheter ablation of cardiac arrhythmias.

There is increasing recognition that migraine with aura may be associated with intra-cardiac shunting because of a patent foramen ovale. Radio-frequency ablation to treat cardiac arrhythmias is an increasingly popular means of treating cardiac arrhythmias. Trans-septal puncture is routinely performed to gain access to the left atrium in order to ablate arrhythmias originating in the left heart.

Risk assessment for sudden cardiac death in dialysis patients: how relevant are conventional cardiac risk factors?

Patients with end stage renal disease on long term dialysis support have a very high risk of sudden cardiac death (SCD) presumably due to serious ventricular arrhythmias. Implantable cardioverter defibrillators (ICD) can be life saving in patients with SCD but their role in dialysis patients is unclear. Much of the current evidence on this important clinical issue limits to retrospective analysis of patients who received an ICD for conventional cardiac indication.

Apolipoprotein E alleles and bicuspid aortic valve stenosis in monozygotic twins.

Aortic valve disease is a common valvular heart disease but the underlying pathology that leads to the severe dysfunction of the aortic valve is unclear. There is increasing interest in the role of hypercholesterolaemia in the causation and progression of aortic valve disease. Apolipoprotein E is an essential component of cholesterol and previous studies have reported conflicting results on the association between various apolipoprotein E alleles and aortic valve disease.

Prolonged combination anti-platelet therapy following per-cutaneous coronary intervention (PCI) is impractical in the elderly.

A prolonged course of anti-platelet therapy is increasingly recommended following per-cutaneous coronary intervention based on the evidence from several clinical trials. However, the practicality and risk of such therapy in unselected patient population is as yet unclear. This study shows that such prolonged regimes of anti-platelet therapy are not practical in the elderly sub-group of patients.