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.

A study of mental health status of men who have sex with men in Ahmedabad city.

Background: Men who have sex with men (MSM), a unique group of people, feel, and believe they will face hardships in society once their identity is disclosed, but this does not deter them from dressing and behaving like the opposite sex in public life or fighting for their rights.

Objectives: To study the mental health status of MSM and their determinants.

Materials And Methods: Descriptive cross-sectional study was conducted among 410 MSM in the drop in centers of non-governmental organization working for MSM in Ahmedabad city through purposive sampling.

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.

Utility of fine needle aspiration cytology in the evaluation of breast lesions.

Background: Fine Needle Aspiration Cytology (FNAC) is a simple, minimally invasive, cost effective, outpatient based and a rapid diagnostic method for breast lesions. The aim of the present study was to correlate cytological findings with histopathological findings and to determine the accuracy of FNAC in the diagnosis of breast lesions.

Material And Methods: A total of 222 breast aspirates were studied.

Working through challenges of subclavian, innominate, and aortic arch regions during transradial approach.

Objectives: The aim of this review is to discuss different methods of working through subclavian, innominate, and aortic arch anatomical challenges to increase the success rate of transradial approach (TRA).

Background: Anatomical challenges in the subclavian, innominate, and aortic arch regions are important reasons for failure of TRA. There is limited modern literature describing methods to overcome these challenges and reduce TRA failure.

Working through complexities of radial and brachial vasculature during transradial approach.

Objectives: The aim of this review is to discuss different methods of working through radial artery (RA) and brachial artery (BA) vascular complexities to increase the success rate of transradial approach (TRA).

Background: Anatomical complexities of RA and BA vasculature are an important reason for failure of TRA. There are few current data describing methods to overcome these challenges and reduce TRA failure.

Percutaneous transvenous mitral commissurotomy: a modified over-the-wire technique for difficult left ventricle entry.

Percutaneous transvenous mitral commissurotomy (PTMC) is an acceptable and preferred alternative to surgical commissurotomy in suitable patients with severe rheumatic mitral stenosis. Various over-the-wire techniques have been described in the past for difficult left ventricle (LV) entry during PTMC. Here, we report two cases of successful PTMC with difficult LV entry with a new modified over-the-wire technique.

Balloon-assisted tracking: a must-know technique to overcome difficult anatomy during transradial approach.

Objective: To examine the use and outcomes of balloon-assisted tracking (BAT) technique for dealing with complexities of arm and chest vasculature during transradial approach (TRA) at a single high volume radial center.

Background: TRA has been used for coronary angiography and percutaneous coronary interventions (PCI) around the world. Different techniques have been described to address the anatomical issues and tortuosities for successful completion of coronary angiography and PCI.

A case of symptomatic Rathke's cyst.

Rathke's cleft cyst is a benign growth found on the pituitary gland in the brain, specifically a fluid-filled cyst in the posterior portion of the anterior pituitary gland. It occurs when the Rathke's pouch does not develop properly, and ranges in size from 2 to 40 mm in diameter. Asymptomatic cysts are common, detected during autopsies of 2-26% of individuals who have died of unrelated causes.

Origin of all three coronaries separately from right sinus of valsalva - A rare anomaly.

Anomalous coronary artery origin from opposite sinus is uncommon and separate origin of all three coronary arteries from right sinus of valsalva is exceptionally rare. The anomaly may cause ischemia due to atherosclerosis or due to altered ostial configuration, its exit angulations from the aorta, route of the artery, and intussuception. Various imaging modalities such as echocardiography, coronary angiography, computed tomography, and magnetic resonance imaging have been used to diagnose origin and course of anomalous coronary arteries.

Study of 63 cases of methyl alcohol poisoning (hooch tragedy in Ahmedabad).

Background: Many outbreaks of methyl alcohol poisoning have been reported from India. Early and aggressive management with bicarbonate, ethanol and hemodialysis in patients having significant toxicity will decrease mortality and improve patient's outcome. Our experience of retro bulbar steroid injection indicates that it may improve visual outcome.

Prenatal ultrasound diagnosis of holoprosencephaly and associated anomalies.

Holoprosencephaly is a rare spectrum of cerebral and facial malformations resulting from incomplete division of the embryonic forebrain (prosencephalon) into distinct lateral cerebral hemisphere. Holoprosencephaly spectrum in the fetus is often associated with other anomalies, particularly of the face and extremities. Here we present three different cases of patients with holoprosencephaly who failed to attain routine sonography during 11-20 weeks owing to some unavoidable circumstances.

Nitroglycerin plus diltiazem versus nitroglycerin alone for spasm prophylaxis with transradial approach.

Objectives: The aim of this study was to compare the efficacy of nitroglycerin and diltiazem versus nitroglycerin alone in preventing radial artery spasm (RAS) during transradial coronary procedures.

Background: Spasm after transradial access decreases procedural success. Multiple spasmolytics are used to prevent spasm.

Drug-induced Stevens-Johnson syndrome: case series from tertiary care centre in Gujarat.

Purpose: The aims of the present article were to study clinical features and to analyse them in different drug class associated with Stevens-Johnson syndrome (SJS) in a tertiary care hospital in Gujarat, India.

Materials And Methods: A prospective hospital-based study was carried out over a period of 3 years (June 2007 to September 2009) at Sheth Vadilal Hospital, Ahmedabad, India. The diagnosis of SJS was made mainly on the basis of the clinical findings, which included extensive erythema multiforme, purpuric lesions with bullae and detachment of skin involving at least two mucous membranes.

Atypical presentation of visceral leishmaniasis in a HIV-positive patient from a nonendemic area.

Visceral leishmaniasis (VL), though widely prevalent in India, is not seen in the Rajasthan where the dry, hot and arid climatic conditions create a hostile environment for the growth of the parasite or its vector, the sandfly. We present a case of VL in a patient co-infected with HIV from this region. A 34-year-old known case of a HIV-positive patient presented to the skin department of our hospital with multiple, nontender, erythematous, papulonodular lesions all over the body for 6 months with history of weight loss and low-grade fever.

Coinfection by Aspergillus and zygomycetes species in a case of acute rhinosinusitis.

Invasive mycotic infections can be effectively treated if rapid identification of fungus is obtained. We reported a case of coinfection by Aspergillus and Rhizopus sp. involving nose, paranasal sinuses, orbit, and brain in a 68-year-old known hypertensive male.