Publications by authors named "Shailesh F"

Article Synopsis
  • The study analyzed 238 patients with gray-zone fractional flow reserve (FFR) values between 0.75 and 0.80 to compare outcomes of revascularization versus just medical therapy.
  • Results showed that patients who underwent percutaneous coronary intervention (PCI) had significantly lower rates of major adverse cardiovascular events (MACE) compared to those who deferred treatment.
  • The findings suggest that revascularization (PCI) significantly lowers the risk of severe outcomes, such as heart attack and death, when compared to only medical management in patients with gray-zone FFR.
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Article Synopsis
  • Uninterrupted vitamin K antagonists (VKAs) during atrial fibrillation ablation show better outcomes than bridging with heparin, while studies on uninterrupted new oral anticoagulants (NOACs) are limited and small-scale.
  • A meta-analysis of 3544 patients from 8 studies found that the rates of stroke, transient ischemic attacks, and major bleeding were similar between patients using uninterrupted NOACs and those using VKAs during the procedure.
  • The research indicates that uninterrupted NOACs are as safe and effective as VKAs for patients undergoing ablation for atrial fibrillation.
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Slow pathway modification has become the mainstay for the treatment of atrio-ventricular nodal re-entrant tachycardia (AVNRT) ablation because of high success rate and low incidence of complications. Our patient had a rare complication of slow pathway modification by radiofrequency ablation (RFA) in form of delayed complete heart block, occurring 10 days after the procedure and resolving in 6 weeks to normal conduction. Complete AV block is a rare immediate complication of RFA but can present weeks later.

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Subacute thyroiditis (SAT) and giant cell arteritis (GCA) are rare diseases. Occurrence of both of these diseases is incidental or one disease presenting with symptoms of other disease is very rare. Our patient presented with symptoms of giant cell arteritis and was diagnosed with subacute thyroiditis.

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The United States Food and Drug Administration (FDA) approved Vemurafenib in August 2011, for treatment of melanoma with BRAF V600 mutation. It has shown improvement in the median overall survival of melanoma patients. The most common adverse effects of vermurafenib are arthralgia, rash, alopecia, photosensitivity and fatigue.

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Phenazopyridine is a urinary analgesic; commonly seen side-effects of this drug include, orange discoloration of urine, methemoglobinemia, yellowish skin discoloration, hepatitis and acute renal failure. Various case reports with phenazopyridine associated acute renal failure secondary to acute tubular necrosis have been reported in the literature. Acute kidney injury in these patients is caused by either direct injury to renal tubular epithelial cells or secondary to pigment induced nephropathy from hemolytic anemia.

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Hemolysis is commonly seen in patients with mechanical heart valves and is secondary to destruction of red blood cells by mechanical action of artificial valve. It is very unusual after repair of native heart valve. Here we present a case of hemolytic anemia in association with mitral valve repair.

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Mexiletine is a commonly used Class IB (Vaughan William classification) antiarrhythmic drug. We report a case of mexiletine-induced psychosis that was successfully managed by decreasing the dose and using alternative medications for management of ventricular tachycardia.

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