Perioperative management of a patient with Dandy Walker malformation with tetralogy of Fallot undergoing total correction and fresh homologous pericardial pulmonary valve conduit implantation: Report of a rare case.

Perioperative management of a patient with Dandy-Walker malformation (DWM) with tetralogy of Fallot (TOF), patent ductus arteriosus, and pulmonary artery stenosis is a great challenge to the anesthesiologist. Anesthetic management in such patients can trigger tet spells that might rapidly increase intracranial pressure (ICP), conning and even death. The increase in ICP can precipitate tet spells and further brain hypoxia.

Primary percutaneous coronary intervention in an anomalous single coronary trunk arising anomalously from ascending aorta.

A 45-year-old male patient presented with acute anterior wall myocardial infarction. Angiography revealed a single coronary trunk arising from the ascending aorta above the coronary sinuses and giving rise to right coronary artery, left circumflex artery and critical stenosis in the left anterior descending artery. This report also highlights the feasibility of performing percutaneous coronary intervention (PCI) in this rare anomaly and discusses the important technical considerations to be kept in mind while attempting such a case.

Management of overt hepatic encephalopathy.

Hepatic encephalopathy (HE) is an important complication of cirrhosis with significant morbidity and mortality. Management of HE primarily involves avoidance of precipitating factors and administration of various ammonia-lowering therapies such as non-absorbable disaccharides, antimicrobial agents like rifaximin and l-ornithine l-aspartate. The non-absorbable disaccharides which include lactulose and lactitol are considered the first-line therapy for the treatment of HE and in primary and secondary prophylaxis of HE.

Detection of comorbid illnesses during pre-anaesthesia evaluation in a university teaching hospital: A prospective observational study.

Background: Consultation for surgery and anaesthesia is often the first point of contact with a healthcare provider for a majority of patients in developing countries. In India, where patients have poor access to healthcare, they are likely to present with uncontrolled/untreated/undetected coexisting diseases. However, there is little published literature on this aspect.

Bispectral index monitoring for diagnosis and assessment of severity of hepatic encephalopathy in cirrhotic patients.

Background: Recent evidence suggests that bispectral index may aid in the diagnosis of hepatic encephalopathy. We evaluated its utility to diagnose, grade and monitor clinical course of hepatic encephalopathy in patients with cirrhosis.

Methods: 200 patients (70.

Malnutrition in cirrhosis increases morbidity and mortality.

Background And Aims: Malnutrition is frequent in patients with cirrhosis and is associated with complications like ascites, hepatic encephalopathy, infections, and death. We determined the prevalence of malnutrition by various methods and its clinical importance in patients with cirrhosis.

Methods: Consecutive patients of cirrhosis from August 2013 to February 2015 were assessed.

Features of hepatitis C virus infection, current therapies and ongoing clinical trials in ten Asian Pacific countries.

Estimated hepatitis C virus (HCV) infection rates in the general populations were 1.3, 0.9, 0.

Extent of disease is a major outcome predictor in patients with ulcerative colitis and pregnancy.

Background And Aims: There exists a two-way interaction between pregnancy and inflammatory bowel disease (IBD) wherein pregnancy may influence disease activity of the underlying IBD, and conversely, the status of the disease may have a direct effect on the outcome of pregnancy. Disease activity at the time of conception is considered the major determinant of the outcome of pregnancy. We evaluated the effect of disease extent on the outcome of pregnancy.

CYBA (p22phox) variants associate with blood pressure and oxidative stress markers in hypertension: a replication study in populations of diverse altitudes.

CYBA (p22(phox)) is an integral constituent of the NADPH oxidases and is consequently a main component of oxidative stress, which is strongly associated with hypertension. This study investigates the contribution of CYBA polymorphisms toward the complex etiology of hypertension in two ethnically different populations, one located at a high altitude and the other at a low altitude. The significance of CYBA single nucleotide polymorphisms and their correlation with clinical and biochemical phenotypes were investigated in age- and ethnicity-matched unrelated permanent high-altitude residents (>3500 m) comprising 245 controls and 241 patients.

Knowledge and attitude of doctors and nurses regarding indication for catheterization and prevention of catheter-associated urinary tract infection in a tertiary care hospital.

Background And Aims: Catheter-associated urinary tract infection (CAUTI) is one of the most common health care acquired infection encountered in clinical practice. The present study was planned to assess the knowledge and attitude of health care providers regarding the indications for catheterization and methods of preventing CAUTI.

Methods: A prospective questionnaire-based survey was done from March 2011 to August 2011.

Effect of psychosocial environment in children having mother with schizophrenia.

The process of child׳s mental development depends heavily on the social interrelationship between the mother and her child. Schizophrenia in mothers potentially disrupts mother-infant relationship and adaptation to motherhood. Literature is limited on evaluating the emotional and behavioral problems of children of mother having schizophrenia with nearly none from the Indian subcontinent.

Occipital condyle syndrome in a young male: a rare presentation of cranio-vertebral tuberculosis.

Occipital condyle syndrome (OCS) is a rare syndrome characterized by severe, unilateral, occipital headache and ipsilateral 12th nerve palsy. Tumors are a common cause of OCS. Inflammatory lesions causing OCS is however rare.

Occiput/C1-C2 fixations using intra-laminar screw of axis - A long-term follow-up.

Background: The surgical management of the craniocervical junction is challenging. Rigid posterior fixation of occiput/C1-C2 can be performed using a variety of surgical techniques including C2 pedicle/pars interarticularis, transarticular and intralaminar screw fixations.

Methods: Forty-one patients were treated with occipital plate/C1 lateral mass and C2 intra-laminar screw fixations for basilar invagination and congenital atlantoaxial subluxation, post-traumatic instability, tuberculous and rheumatoid arthritis-associated atlantoaxial dislocation.

Pulmonary endarterectomy for saddling pulmonary embolism by Aspergillus fungus in an immunocompetent patient.

We present a case of tricuspid valve Aspergillus endocarditis with saddle shaped massive pulmonary embolism occurring in an immunocompetent host. The patient was managed uniquely by pulmonary endarterectomy (PEA) and combination antifungal chemotherapy with Liposomal amphotericin-B + caspofungin.

Sleeping beauty: kleine-levin syndrome.

Kleine-Levin syndrome (KLS) alias sleeping beauty syndrome, is a rare sleep disorder. Clinically presenting as episodes of hypersomnolence, behavioral and cognitive disturbances, hyperphagia and hypersexuality. KLS may have an idiopathic onset or may be precipitated by neurological event or infection.

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. This is the second update of a review published in The Cochrane Library Issue 2, 2011.

Antiepileptic drugs for the primary and secondary prevention of seizures in viral encephalitis.

Background: Viral encephalitis is characterised by diverse clinical and epidemiological features. Seizures are an important clinical manifestation and associated with increased mortality and morbidity. Patients may have seizures during the acute illness or they may develop after recovery.

Colorectal carcinoma up to the second decade of life: An 8-year experience in a tertiary care center.

Aims And Objectives: To evaluate the demographic pattern, incidence, and histological characteristics of colorectal carcinomas (CRCs) in very young adults diagnosed in the center.

Materials And Methods: We retrieved and reviewed slides and data pertaining to all the cases of CRCs and "segregated into decade wise age-groups" from the archives of Department of Pathology. Patients with age ≤20 years diagnosed during the last 8 years (2006-2013) were further evaluated.

Current concepts of optimal cerebral perfusion pressure in traumatic brain injury.

Traumatic brain injury (TBI) consists of varied pathophysiological consequences and alteration of intracranial dynamics, reduction of the cerebral blood flow and oxygenation. In the past decade more emphasis has been directed towards optimizing cerebral perfusion pressure (CPP) in patients who have suffered TBI. Injured brain may show signs of ischemia if CPP remains below 50 mmHg and raising the CPP above 60 mmHg may avoid cerebral oxygen desaturation.