Blood oxygen level-dependent (BOLD) magnetic resonance imaging in patients with dypiridamole induced ischaemia; a PET comparative study.

Background: Blood oxygen level-dependent (BOLD) MRI relies on changes in deoxyhaemoglobin level in tissues under stress for signal variation and may be used for detection of ischaemic myocardium.

Methods: 15 patients with stress induced myocardial ischaemia on PET scanning underwent rest and dypiridamole stress MRI using a double breath-hold T2-weighted, ECG gated sequence to produce BOLD contrast images and cine-MRI for wall thickening assessment. Signal change on BOLD MRI and wall thickening were compared between rest and stress images in ischaemic and non-ischaemic myocardial segments.

Impact of specialist care in patients with newly diagnosed heart failure: a randomised controlled study.

Aim: To assess the feasibility and impact of specialist care in patients with newly diagnosed heart failure in primary and secondary care.

Methods: Patients with suspected heart failure referred for open access echocardiography to a hospital-based echocardiography service were assessed from June 2002 through to June 2003. Patients with confirmed left ventricular systolic dysfunction (LVSD) were randomised to specialist care (cardiology registrar and heart failure nurses) or referred back to their general practitioner (GP).

Efficacy of nitroglycerin inhalation in reducing pulmonary arterial hypertension in children with congenital heart disease.

Background: There has been a renewed interest in nitric oxide donor drugs, such as nitroglycerin, delivered by the inhalational route for treatment of pulmonary arterial hypertension (PAH). We investigated the acute effects of inhaled nitroglycerin on pulmonary and systemic haemodynamics in children with PAH associated with congenital heart disease.

Methods: Nineteen children with acyanotic congenital heart disease and a left to right shunt with severe PAH, undergoing routine diagnostic cardiac catheterization were included in this study.

An unusual endobronchial foreign body.

A 24-year-old male presented with features of pneumonia of right lower lobe. Chest radiograph after treatment showed cystic opacities in the right lower zone along with a radio-opaque foreign body at the right cardiophrenic angle. The foreign body was successfully removed via the fibreoptic bronchoscope.

Status of inhalation therapy in bronchial asthma in adults above twelve years of age in armed forces.

Objective: The aim of this study was to evaluate the status of inhalation therapy in bronchial asthma in terms of frequency of its use, role of general physicians and general practitioners in prescribing inhalation therapy, role of inhaled steroids and B2 agonists, concurrent use of oral drugs, technique of using inhaler devices, use of spacer devices and peak flow monitoring.

Material And Methods: 150 patients (76 males, 74 females) of bronchial asthma over 12 years of age referred to chest clinic of a tertiary care hospital for inadequate control were interviewed on the basis of a questionnaire and screening of prescription and case records wherever available.

Results: 127 (84.

Platelet Functions in Cardiopulmonary Bypass Surgery.

Background: Haemorrhage after Cardio Pulmonary Bypass (CPB) Surgery is a well recognised complication that leads to significant morbidity and mortality. The incidence varies between 5-25% depending upon the clinical situation. Several factors are implicated as causative but none have been precisely proved.

Study of Drug Resistant Pulmonary Tuberculosis.

Background: Drug resistance has emerged as a major problem in management of pulmonary tuberculosis (PT) with increase in its incidence.

Methods: Sixty patients who presented to a tertiary referral chest centre with drug resistant PT were included in the study out of 835 clinically diagnosed cases of PT treated between January 2000 and May 2002. They were studied to see the incidence, pattern of drug resistance and response to treatment.

Fluoroscopic Guided Fallopian Tube Recanalisation.

Background: Fluoroscopic fallopian tube recanalisation is a procedure that relieves proximal fallopian tube obstruction with minimal trauma. Commercially available fallopian tube catheterization sets are costly and cumbersome to use. The modified technique used is easy, less traumatic and lessens the procedure and fluoroscopy time.

Endobronchial non-Hodgkin's lymphoma.

A 23-year-old male presented with clinical and radiological features of left lung collapse. Fibre-optic bronchoscopy revealed a smooth globular mass almost completely occluding the left main bronchus. Needle aspiration and endobronchial biopsy from the mass revealed it to be a case of anaplastic large cell lymphoma, a subtype of non-Hodgkin's lymphoma.

Analysis of arterial blood gases--a comprehensive approach.

The arterial blood gases is one of the most important investigation for assessment of clinical oxygenation and acid-base status in critically ill patients. It provides us with information about ventilation, oxygenation and acid-base status, the three closely interrelated physiology parameters, which maintain the pH homeostasis. Its correct interpretation and application necessitates the knowledge of basic applied physiology in relation to these parameters.

Techniques in Cardiology : PDA Closure in Children.

Background: Transcatheter closure of patent ductus arteriosus (PDA) with various devices has been evaluated worldwide and in selected cases can be performed successfully, thus avoiding the morbidity associated with surgical closure.

Methods And Results: A 2 year old female child presented with PDA and aortic angiography showed large PDA (tubular). This defect can be closed nonsurgically by coils and devices.

Intrapleural streptokinase in complicated parapneumonic effusions and empyema.

Background: The management of complicated parapneumonic effusions (CPE) and empyema by chest tube drainage usually fails because of thick viscous fluid and multiple pleural space loculations. The use of intrapleural fibrinolytic agents facilitates pleural drainage and can obviate the need for more invasive surgical interventions in these types of effusions.

Objective: To evaluate the role of intrapleural fibrinolytic therapy with streptokinase (STK) as an adjunctive therapy in the management of CPE and empyema.

Biomedical Waste Management : An Infrastructural Survey of Hospitals.

Background: The Ministry of Environment & Forests notified the Biomedical Waste (management & handling) Rules, 1998" (BMW Mgt) in July 1998. In accordance with the rules, every hospital generating BMW needs to set up requisite BMW treatment facilities on site or ensure requisite treatment of waste at common treatment facility. No untreated BMW shall be kept stored beyond a period of 48 hours.

Angioplasty for chronic total coronary occlusions: safety and efficacy.

Objective: To determine the short term results and safety of angioplasty in chronic coronary occlusions.

Methods: Eighty consecutive patients undergoing percutaneous transluminal coronary angioplasty (PTCA) for chronic coronary occlusions were prospectively analyzed for acute success rate and safety of the procedure.

Results: The mean age was 46.

Graded balloon atrial septostomy in severe pulmonary hypertension.

Background: The prognosis of patients with severe primary pulmonary hypertension is poor. The role of balloon atrial septostomy as a palliative procedure in these patients is not well defined. We retrospectively analyzed our data regarding the safety, clinical outcome and survival benefit of graded balloon atrial septostomy in patients with severe pulmonary hypertension.

Lung function in mitral stenosis.

Objectives: The aim of this study was to look to for a relationship between pulmonary artery pressure (PAP), left atrial pressure (LAP), mitral valve area (MVA) and transmitral gradient (Gr) on the one hand and the spirometric data on the other, in cases of mitral stenosis.

Methods: The spirometry values measured were forced vital capacity (FVC), forced expiratory volume in one second and as percent of FVC (FEV1, FEV1/FVC%), forced expiratory flow between 25% to 75% of FVC (FEF 25-75%), at 50% of FVC (FEF 50%) 75% of FVC (FEF 75%) and peak expiratory flow rate (PEFR). The PAP, LAP, MVA and Gr were measured at echocardiography and cardiac catheterisation.

Primordial prevention of coronary heart disease in India: challenges and opportunities.

Demographic shifts, lifestyle changes, and adverse effects of childhood nutrition portend an epidemic of coronary heart disease in the Indian subcontinent, which is currently experiencing health transition. Indian susceptibility includes atherogenic blood lipid levels and a metabolic complex of central obesity, glucose intolerance, hyperinsulinemia, and dyslipidemia due to insulin resistance. These characteristics are demonstrated dramatically in urban Indians and in Indian migrants to the west.

Double switch for congenitally corrected transposition of the great arteries.

Objective: To evaluate the early and medium term results of operations for congenitally corrected transposition of the great arteries (CCTGA) wherein the left ventricle becomes the systemic ventricle.

Methods: Fourteen patients with CCTGA who underwent anatomic repair from 1994 to 1998 were placed in one of two groups: those without pulmonic stenosis (PS) (N = 7) and those with PS (N = 7). Main associations in the group without PS were: severe left atrioventricular (AV) valve regurgitation (N = 4), ventricular septal defect (VSD) (N = 4), criss-cross AV connection (N = 1), and hypoplasia of the morphologic RV (N = 1).

MANAGEMENT OF LUNG ABSCESS WITH PERCUTANEOUS CATHETER DRAINAGE.

Percutaneous catheter drainage was used to treat 12 among 34 cases of lung abscesses, who were refractory to medical therapy, severely ill and high risk cases for surgery. A complete clinical and radiological recovery was achieved in all the cases who underwent catheter drainage, thereby obviating the need for surgery. None of the cases had catheter or procedures related complications.

Coronary angioplasty in high risk patients: comparison of elective intraaortic balloon pump and percutaneous cardiopulmonary bypass support--a randomized study.

Forty patients undergoing percutaneous transluminal coronary angioplasty (PTCA) with severely impaired left ventricular ejection fraction (LVEF) < 30% were randomized between prophylactic intraaortic balloon pump (IABP) support (N = 20) and percutaneous cardiopulmonary bypass (PCPB) support (N = 20). The indications for both groups were left ventricular (LV) dysfunction and a large area of myocardium (> 50%) being perfused by the target vessel. The IABP and PCPB supported groups were comparable in LVEF (20% +/- 6.