Assessing Utility of Clinical Exome Sequencing in Diagnosis of Rare Idiopathic Neurodevelopmental Disorders in Indian Population.

Background: Neurological diseases are phenotypically and genotypically heterogeneous. Clinical exome sequencing (CES) has been shown to provide a high diagnostic yield for these disorders in the European population but remains to be demonstrated for the Indian population.

Objective: The study aimed to understand the utility of clinical exome sequencing for the diagnosis of neurodevelopmental disorders.

Preparation of Platelet-rich Fibrin Membrane over Scaffold of Collagen Sheet, its Advantages over Compression Method: A Novel and Simple Technique.

Introduction: Platelet-rich fibrin (PRF) is compressed by using various tools to make platelet-rich fibrin membrane (PRFM). Preservation of platelets and plasma content of PRFM depends on the compression method used. To overcome limitations of compression method, we prepared PRFM over scaffold of collagen sheet without using any compression device.

Clinical study of spinal tuberculosis presenting with neuro-deficits in Western India.

Background/objectives: Spinal tuberculosis (TB) is a destructive extra-pulmonary disease manifestation of Mycobacterium tuberculosis infection. It is responsible for many cases of paraparesis and quadriparesis in developing countries where patients seek treatment late. The aim of this study was to understand and analyze the clinical and radiological profile of patients with spinal TB and correlate it with the anatomical site affected by it.

Perforated balloon technique: A simple and handy technique to combat no-reflow phenomenon in coronary system.

Objective: Examining the efficacy and outcomes of intracoronary (IC) instillation of adenosine using a novel perforated balloon technique (PBT) to combat no-reflow phenomenon during percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS).

Background: Occurrence of no-reflow during PCI is a serious adverse prognostic event and inability to re-establish better flow is associated with poor outcomes. Several pharmacological and non-pharmacological interventions have been used to treat this situation.

Persistent cerebellar dysfunction following acute lithium toxicity: A report of two cases.

Neurological disturbances caused by lithium range from simple side effects such as benign tremor to acute reversible neurotoxicity. Rarely, lithium is reported to cause irreversible, permanent neurological sequelae most commonly manifested as cerebellar dysfunction, although other presentations have also been described. We report two cases of persistent cerebellar syndrome following acute lithium toxicity and discuss them in the light of existing literature on the subject.

Study of clinical and radiological profile and outcome in patients of intracranial hemorrhage.

Background: Incidence of intracerebral hemorrhage (ICH) is twice as high as in Western countries. Prognostic factors for predicting function outcome and mortality play a major role in determining the treatment outcome.

Methods: A prospective study of male and female patients ≥12 years with primary nontraumatic intracranial hemorrhage were included.

Transradial bilateral common iliac ostial stenting using simultaneous hugging stent (SHS) technique.

Current literature has limited reports of iliac artery interventions performed via transradial approach (TRA). We report four successive cases of bilateral common iliac ostial stenting using simultaneous hugging stent (SHS) technique through bilateral TRA. This technique allows the patient and the operator to exploit the benefits of TRA while treating this complex substrate.

Comorbid Functional Shoulder Pain and Zolpidem Dependence Treated with Pramipexole.

Pramipexole is a dopamine agonist with higher affinity for D3 receptors. Treatment with pramipexole in clinical conditions such as restless legs syndrome, fibromyalgia, and parkinsonism has been found to significantly improve measures of pain and sleep along with the other symptoms. There is no research data available that explores the usefulness of pramipexole in somatoform/functional pain syndromes.

Ketamine-induced affective switch in a patient with treatment-resistant depression.

There is growing evidence to support the rapid, albeit short-lived antidepressant effect of subanesthetic dose of ketamine, a noncompetitive glutamate N-methyl-D-aspartate receptor antagonist in treatment-resistant unipolar and bipolar depression. Ketamine is known to cause transient mood elevation or euphoria, psychotomimetic effects, and dissociative symptoms, but its use in unipolar or bipolar depression has not been reported to induce an affective switch amounting to persistent or prolonged hypomania/mania or manic-like syndrome. We report the case of a 52-year-old male with first episode, continuous, nonpsychotic, treatment-resistant, unipolar major depression of 10 years duration, who manifested a switch from depression to mania while being treated with subanesthetic dose of ketamine, given intramuscularly.

"Combo" technique for the use of 7F guide catheter system during transradial approach.

Even a regular lumen of radial artery may create difficulty in smooth negotiation and propagation of a 7F guide catheter while performing intervention through transradial approach. We describe successive five cases of a simple and innovative "Combo" technique, which helps relatively atraumatic tracking of a 7F guide catheter through the course of arm and chest vasculature for successful completion of procedure without significant damage and local pain.

Strategies to Traverse the Arm and Chest Vasculature.

This article discusses different methods of working through arm and chest vasculature to increase the success rate of the transradial approach (TRA). Despite lower rates of bleeding and vascular complications as compared with the transfemoral approach, adoption of the TRA has been slow, particularly because of higher failure rates. Anatomic complexities of arm and chest vasculature play an important role in cases of TRA failure.

Radial Artery Access, Hemostasis, and Radial Artery Occlusion.

Radial artery access is usually achieved using a micropuncture system. Hydrophilic introducers are used to improve comfort, probably by reducing spasm. A vasodilator cocktail should be administered to prevent severe spasm and anticoagulation; usually, unfractionated heparin is administered to prevent subsequent radial artery occlusion (RAO).

Off-label medicine use in pediatric inpatients: a prospective observational study at a tertiary care hospital in India.

Background. In the absence of standard pediatric prescribing information, clinicians often use medicines in an off-label way. Many studies have been published across the globe reporting different rates of off-label use.

Successful retrieval of broken coiled guidewire from left atrium during balloon mitral valvotomy: a rare complication.

Abstract Balloon mitral valvotomy (BMV) is the procedure of choice for rheumatic mitral stenosis with favorable valve morphology. Fracture of 0.025 inch coiled guidewire during BMV is a very rare complication.

Percutaneous balloon pulmonary valvuloplasty: a modified over-the-wire Inoue balloon technique for difficult right ventricular anatomy.

Percutaneous balloon pulmonary valvuloplasty (BPV) is the mainstay of treatment for significant pulmonary stenosis with doming leaflets. Various techniques have been described in the literature including the use of Inoue Percutaneous Transseptal Mitral Commissurotomy (PTMC) catheter with standard 0.025″ guidewire.