The deleterious effect of intracardiac pacing leads on right ventricular function.

Aim: The aim of this study was to evaluate the progression of tricuspid regurgitation (TR) in patients with pacemaker leads across the tricuspid valve and assess the clinical effect on right ventricular (RV) function.

Methods: Patients who had undergone permanent pacemaker implantation at our institution over an 8-year period were identified. Those who had an echo (for any indication) pre- and postdevice implantation were included in this study, and their data assessed.

Alpha-Methylacetoacetic Aciduria in an Rh-Negative Pregnant Omani Woman With Breech Presentation Delivered With Favourable Outcome.

Background: Alpha-methylacetoacetic aciduria, an autosomal recessive disorder of isoleucine and ketone body metabolism, is caused by a mutation in the acetyl coenzyme A acetyltransferase-1 gene (ACAT1; 607809) on chromosome 11q22. Ketoacidotic episodes in such patients are triggered by stress situations with increased energy demands. Pregnancy, surgical procedures, and prolonged fasting are potential triggers for metabolic crisis in such cases.

Management and prevention of pelvic adhesions.

Postsurgical adhesion formation is an important clinical problem within all surgical specialties. In gynecology, adhesions resulting from gynecologic procedures are a major clinical, social, and economic concern because they may result in pelvic pain, infertility, or bowel obstruction. In addition, it may lead to additional surgery to resolve the adhesion-related complications.