Unusual Survival of Anomalous Left Coronary Artery From the Pulmonary Artery With Severe Rheumatic Mitral Stenosis in Septuagenarian Women: Foes Becoming Friends?

ALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is a rare disease but lethal with clinical expression from myocardial infarction, congestive heart failure to death during early infancy and unusual survival to adulthood. We report a 73-year-old woman with ALCAPA who presented with exertional dyspnea (NYHA functional class II) over past 2 years. Physical examination revealed soft S, long mid diastolic rumbling murmur and apical pan-systolic murmur.

Prevalence of Metabolic Syndrome and Its Clinical and Angiographic Profile in Patients With Naive Acute Coronary Syndrome in North Indian Population.

Background: Data of isolated metabolic syndrome as risk factor in patients presenting with acute coronary syndrome (ACS) especially in context to Indian subcontinent are sparse. Therefore, we studied the prevalence of metabolic syndrome (MetS), and its clinical and angiographic profile in naive ACS patients in North Indian population.

Methods: A single-center, prospective, observational study of 324 patients was conducted at LPS Institute of Cardiology, G.

Prospective Randomized Comparison of Monopolar TURP, Bipolar TURP and Photoselective Vaporization of the Prostate in Patients with Benign Prostatic Obstruction: 36 Months Outcome.

Objectives: To assess durability of efficacy of monopolar transurethral resection of the prostate (TURP), bipolar TURP, and photoselective vaporization of the prostate (PVP) using 120W Green light laser at 36 months follow up.

Method: The 186 patients who presented with benign prostatic obstruction and planned for surgery were randomized into three groups: Group A - monopolar TURP; group B - bipolar TURP; and group C - PVP. International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5) score, quality of life (QoL) score, maximum flow rate (Qmax), prostate volume and postvoid residual urine (PVRU) were analyzed up to 36 months follow up.

Epicardial Adipose Tissue Thickness and Its Association With the Presence and Severity of Coronary Artery Disease in Clinical Setting: A Cross-Sectional Observational Study.

Background: Obesity is an important risk factor for atherosclerotic cardiovascular disease (ASCVD). Estimation of visceral adipose tissue is important and several methods are available as its surrogate. Although correlation of epicardial adipose tissue (EAT) with visceral adipose tissue as estimated by magnetic resonance imaging (MRI) and/or CT is excellent, it is costlier and cumbersome.

Percutaneous Mitral Valvotomy in a Case of Situs Inversus Totalis and Juvenile Rheumatic Critical Mitral Stenosis: Case Report.

Situs inversus totalis is a rare congenital disorder where the heart being a mirror image is situated on the right side of the body. Distorted cardiac anatomy makes fluoroscopy-guided percutaneous mitral valvotomy (PMV) technically challenging and there are only few reports of PMV in situs inversus totalis. Here we report a case where PMV was successfully done for situs inversus totalis with rare coincidence of juvenile rheumatic severe mitral stenosis in a 12-year-old boy with a few modifications of standard Inoue technique.

Transitional cell carcinoma: A rare development in congenital ureteropelvic junction obstruction kidney.

A 54-year-old male chronic smoker presented with hematuria 13 years after being diagnosed with an asymptomatic left non-functioning kidney secondary to congenital ureteropelvic junction obstruction. On evaluation, he was diagnosed with renal collecting system mass occupying the lower pole region, for which radical nephroureterectomy with bladder cuff excision and nodal dissection was carried out. Histopathology revealed upper tract transitional cell carcinoma.

Hydroxyapatite crystals as a bone graft substitute in benign lytic lesions of bone.

Background: Bone grafts are required to fill a cavity created after curettage of benign lytic lesions of the bone. To avoid the problems associated at donor site with autologous bone graft, we require allograft or bone graft substitutes. We evaluated the healing of lytic lesions after hydroxyapatite (HA) grafting by serial radiographs.

Safety of 12 core transrectal ultrasound guided prostate biopsy in patients on aspirin.

Objective: To prospectively assess safety outcome of TRUS guided prostate biopsy in patients taking low dose aspirin.

Materials And Methods: Consecutive patients, who were planned for 12 core TRUS guided prostate biopsy and satisfied eligibility criteria, were included in the study and divided into two Groups: Group A: patients on aspirin during biopsy, Group B: patients not on aspirin during biopsy, including patients in whom aspirin was stopped prior to the biopsy. Parameters included for statistical analysis were: age, serum prostate specific antigen (PSA), prostate volume, hemoglobin (Hb %), number of hematuria episodes, number of patient reporting hematuria, hematuria requiring intervention, number of patient reporting hematospermia and number of patient reporting rectal bleeding.

Basal Cell Adenoma of Parotid Gland: Case Report and Review of Literature.

Basal cell adenoma (BCA) of the salivary gland is a rare neoplasm consists of a monomorphic population of basaloid epithelial cells, and it accounts for approximately 1-2 % of all salivary gland tumors. Its most frequent location is the parotid gland. It usually appears as a firm and mobile slow-growing mass.

Malignant Rheumatic Heart Disease Presenting as Quadrivalvular Stenosis.

Rheumatic disease may involve the pulmonary valve, but is exceedingly rare. Simultaneous involvement of all four valves is more likely to be the result of combination of causes, such as congenital, rheumatic, infective or degenerative disease. A unitary cause for quadrivalvular involvement would be either rheumatic or myxomatous degeneration.

Superolateral Dislocation of the Mandibular Condyle: A Series of Seven Cases.

Introduction: Anterior and anteromedial dislocations of the mandibular condyle are seen frequently in mandibular fractures. Less frequent are dislocations of the condylar head in the lateral, medial and posterior direction whereas superior dislocation into the middle cranial fossa is rare. We report a series of seven cases encountered over the years, which, incidentally, is the largest case series reported till date with lateral and superolateral dislocation of the condyle after a traumatic injury.

Comparative study of fresh femoral neck fractures managed by multiple cancellous screws with and without fibular graft in young adults.

Objectives: Aim of our study was to assess the role of addition of fibular strut graft to multiple cancellous screws in functional outcome, union and complications associated with those managed by only multiple cancellous screws in fresh femoral neck fractures.

Methods: A randomized control trial study was conducted on the patients of femoral neck fractures managed with multiple cancellous screws (group A) and multiple cancellous screws with fibular graft (group B). Patients aged between 20 and 50 years, having Gardens type III or IV fracture with duration of injury less than two weeks were included in the study.

Rare Electrocardiographic Manifestation of Cystic Bronchiectasis in a 34-Year-Old Male.

Himalayan P-waves (amplitude > 5 mm) are often known to be classically associated with congenital heart diseases with right to left shunt like tricuspid atresia, Ebstein anomaly, combined tricuspid and pulmonic stenosis, ischemic heart disease, restrictive cardiomyopathy, etc., where they indicate a dilated right atrium and tend to be persistent. This type of P-waves is rarely seen in long-standing bronchiectasis and is usually transient.

An Unconventional Route of Left Ventricular Pacing.

We present a case of a rare complication of transvenous right ventricular pacing by temporary pacing wire causing iatrogenic interventricular septal perforation and left ventricular pacing in a 69-year-old man who was referred for recurrent syncope with sinus arrest.

Dorsal versus ventral onlay buccal mucosal graft urethroplasty for long-segment bulbar urethral stricture: A prospective randomized study.

Objectives: To compare safety and efficacy of ventral versus dorsal onlay buccal mucosal graft urethroplasty in patients with long-segment incomplete bulbar urethral stricture.

Methods: This was a single center, prospective, randomized trial. Patients with long-segment (>2 cm) incomplete bulbar urethral stricture and meeting eligibility criteria were enrolled in the study.

Optical Imaging: Future Tool in Detection of Pre-cancerous and Cancerous Lesions of Cervix and Its Comparison to Colposcopy.

Objectives: To study the diagnostic potential of optical imaging and its comparison with colposcopy, in detecting early cervical dysplasia.

Methods: The study was conducted on 200 patients attending the outdoor of UISE maternity hospital with symptoms suspicious of cervical lesions. All patients were subjected to colposcopy, followed by histo-pathological examination.

Subvalvar Mitral Aneurysm: A Rare Cause of Mitral Leak.

Submitral aneurysm (SMA) results from outpouching of the left ventricular wall which is congenital and occurs adjacent to the posterior leaflet of the mitral valve. Although it is predominantly described among the natives of Africa, it is considered rare in the Indian subcontinent. It presents clinically as palpitation, congestive cardiac failure in the presence of mitral regurgitation, arrhythmias and embolic phenomenon.

ALCAPA in an Octogenarian Woman: An Enigma.

ALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is an exceedingly rare disease but lethal with clinical expression from myocardial infarction, congestive heart failure to death during early infancy and rare survival to adulthood. A 75-year-old woman with ALCAPA syndrome presented with angina (Canadian Cardiovascular Society functional class II) over past 8 months. Physical examination was within normal limits except pan-systolic murmur at the apex.

A prospective comparative study of channel photoselective vaporization of prostate vs. channel transurethral resection of prostate in patients with advanced carcinoma prostate.

Objective: To compare short term efficacy and safety of channel photoselective vaporization of prostate (PVP) and channel transurethral resection of prostate (TURP) in patients with bladder outlet obstruction (BOO) secondary to advanced carcinoma prostate.

Methods: This prospective, non-randomized comparative study was conducted between April 2012 and December 2014. Patients with locally advanced/metastatic carcinoma prostate, who underwent either channel PVP or channel TURP for troublesome LUTS/ acute retention of urine were included in the study.

Plant thorn synovitis of elbow in children.

Four rare cases of plant thorn synovitis of left elbow were admitted at our institution, which were initially misdiagnosed as partially treated septic arthritis of elbow or Juvenile inflammatory arthritis. All of them were of paediatric age group. Symptoms included pain, swelling, and decreased range of motion of affected joint.