Use of nitinol shape memory alloy staples (NiTi clips) after cervical discoidectomy: minimally invasive instrumentation and long-term results.

Background: Anterior cervical discoidectomy with or without fusion is a well established surgical remedy for cervical prolapsed intervertebral disc (PIVD) disease. If fusion is done by an iliac bone graft then internal fixation is commonly used to keep the graft in position. This study was conducted to determine the efficacy and tolerability of shape memory alloys, especially NiTi (nickel titanium) clips in the stabilization of grafts following anterior cervical discoidectomy.

Clinical efficacy of phosphodiesterase-5 inhibitor tadalafil in Eisenmenger syndrome--a randomized, placebo-controlled, double-blind crossover study.

Objectives: In a randomized double-blind crossover trial, we compared the efficacy of phosphodiesterase-5 (PDE-5) inhibitor tadalafil with placebo in patients of Eisenmenger Syndrome (ES). The primary end point was the change in 6-minute walk test distance (6 MWD). Secondary end points were the effect of the drug on systemic oxygen saturation (SO(2) ), pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), effective pulmonary blood flow (EPBF), and World Health Organization (WHO) functional class.

Delayed brain abscess after embolization of arterio-venous malformation: report of two cases and review of literature.

Infections of central nervous system are rare complications of endovascular procedures. Review of literature revealed only four reported cases of brain abscesses after embolization of intracranial arteriovenous malformations (AVMs). We report two new cases of delayed brain abscess after embolization of AVM.

Factors influencing occurrence of postpartum haemorrhage in pregnant women with hepatitis E infection and deranged coagulation profile.

Coagulopathy is an important complication associated with hepatitis E virus (HEV) infection in pregnant women. Postpartum haemorrhage (PPH) remains a serious risk while managing the labour of these women. The aim of this paper is to study the factors influencing the occurrence of PPH in pregnant women with hepatitis E infection with coagulopathy.

Endoscopic management of liver abscess with biliary communication.

Background And Study Aims: The formation of a communication between liver abscesses and intrahepatic bile ducts is an uncommon cause of bile leak. The surgical management of biliary fistulas is associated with high morbidity and mortality. We performed a prospective study of the endoscopic management of liver abscess communicating with bile ducts.

Successful double lumen tube insertion in a patient with unanticipated laryngeal and tracheal web.

A 45-year-old female patient admitted for surgical management of carcinoma esophagus, presented with difficulty in insertion of left-sided 37 F and 35 F double lumen tube (Mallinckrodt® Broncho-Cath). Fiberoptic bronchoscopy revealed a subglottic web in the larynx just below the vocal cords and a tracheal web just above the carina. Differential lung ventilation could be achieved with a 35 F internal diameter double lumen tube (Portex® Blueline® Endobronchial tube).

Cytomegalovirus infection in non-immunosuppressed critically ill patients.

Cytomegalovirus (CMV) is an important and common cause of mortality and morbidity in immunocompromised patients such as those with HIV/AIDS, transplant recipients on immunosuppressive therapy, and malignant hematological disease. After primary infection with CMV the virus becomes latent in multiple organs and can later be reactivated during severe dysregulation of the immune system. A large population carry dormant virus and are thus at risk for reactivation.

Pharmacomechanic approach for restoration of flow in occluded ectatic right coronary artery with huge thrombus burden.

Advancements in both pharmacological and mechanical approaches have taken place to deal with thrombus-containing lesions in the coronary tree. We describe a case wherein a totally occluded large ectatic right coronary artery with a large thrombus burden was successfully revascularized by a combined pharmacological-mechanical approach, resulting in complete disappearance of the thrombi without distal embolization.

Nonmotor symptom complex of Parkinson's disease--an under-recognized entity.

Parkinson's disease (PD) is the second most common neurodegenerative disorder, after Alzheimer's disease. The cardinal clinical features of PD include asymmetric onset of bradykinesia, rigidity, and resting tremor. Most patients of idiopathic PD present with one or more of the cardinal motor features.

Giant coronary sinus.

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A randomized controlled trial comparing lactulose, probiotics, and L-ornithine L-aspartate in treatment of minimal hepatic encephalopathy.

Background: Minimal hepatic encephalopathy (MHE) impairs daily functioning and health-related quality of life (HRQoL). The modalities of treatment of MHE have not been adequately studied.

Aims: To compare lactulose, probiotics, and L-ornithine L-aspartate (LOLA) in treatment of MHE and effect on HRQoL by Sickness Impact Profile questionnaire.

Prevalence of metabolic syndrome in patients with angiographically proven coronary artery disease presenting to a tertiary care hospital in Delhi, India.

Background: Coronary artery disease is fast emerging as the major concern for afflicting people across the globe. The Indian subcontinent is highly predisposed to this condition due to distinctive risk factor profile of this population. This fact has led to a condition where the current preventative and management protocols that have worked well in the non-Asian Indian Caucasian populations, have failed to bring about the anticipated control over the incidence and progression of CAD in Asian Indians.

Compression of the left main coronary artery by a pulmonary artery aneurysm in a patient with tetralogy of Fallot and an absent pulmonary valve.

A case of a 16-year-old female with tetralogy of Fallot and absent pulmonary valve is presented, who on coronary angiography and computerized tomography (CT) angiography had severe compression of the left main coronary artery by the dilated main pulmonary artery. The patient was successfully managed by surgical correction of the intracardiac defect, with right ventricular outflow tract reconstruction by the Contegra(®) bovine jugular vein conduit. 

Profile of hepatic encephalopathy in children with cirrhosis and response to lactulose.

Background/aim: Hepatic encephalopathy (HE) is associated with a poor prognosis. There is paucity of data on the treatment of HE with lactulose in children with cirrhosis.

Patients And Methods: Retrospective analysis of consecutive cirrhotic patients (<18 years) with HE was done.

Acetylcholinesterase inhibitor treatment for myasthenia gravis.

Background: In myasthenia gravis, antibody-mediated blockade of acetylcholine receptors at the neuromuscular junction abolishes the naturally occurring 'safety factor' of synaptic transmission. Acetylcholinesterase inhibitors provide temporary symptomatic treatment of muscle weakness, but there is controversy about their long-term efficacy, dosage and side effects.

Objectives: To evaluate the efficacy of acetylcholinesterase inhibitors in all forms of myasthenia gravis.