Primary percutaneous coronary aspiration of thrombus from infarct related artery

We are reporting the case of a 48-year-old man hypertensive, and smoker presenting with acute inferoposterior ST elevation myocardial infarction [STEMI] with right ventricular infarction. He underwent diagnostic angiogram which revealed total occlusion of mid right coronary artery [RCA] by thrombus. Multiple runs of aspiration were performed using Export Aspiration Catheter-6F and thrombus was aspirated from RCA. Postaspiration stenting was deferred due to absence of any significant obstructive lesion. Some thrombus had migrated to distal right posteriolateral branch [RPLB]. He was started on glycoprotein [GP] IIb IIIa inhibitors which had to stopped after a few hours due to upper gastrointestinal bleed. After 48 hours a re-look angiogram demonstrated good flow in RCA with resolution of the residual thrombus

Acute myocardial infarction with left bundle branch block [LBBB]: significance of sgarbossa criteria

A middle aged female presented in emergency department with chest discomfort. Her old electrocardiogram [EKG] showed left bundle branch block [LBBB] signs. EKG performed in the emergency room revealed left bundle branch block with 4-6 mm discordant ST segment elevation in leads VI-V3 and 1mm concordant ST segment elevation in lead V4. Diagnosis of acute anterior wall STEMI was made based on Sgarbossa criteria. She underwent angiography which showed total occlusion of proximal left anterior descending artery which was stented. She had uneventful post-stenting course in hospital and was discharged. The case highlights the significance of Sgarbossa criteria which can be applied to diagnose acute myocardial infarction in the presence of LBBB so that prompt thrombolytic or primary angioplasty can be preformed

Assessment of hypothyroidism in diffuse nonscarring alopecia

Alopecia, clinically as well as etiologically, is a heterogeneous group. Several hormonal etiologies may cause alopecia including hyperthyroidism, hypothyroidism etc. Thyroid diseases show a wide range of clinical signs in skin, hair and nails. Several reports document a significant correlation between thyroid diseases especially hypothyroidism with alopecia. Thyroid function test is one of the useful indices to assess the cause of alopecia. The aim of our study was to evaluate the frequency of alopecia in hypothyroid cases by performing the thyroid function tests [T3, T4, TSH]. Twenty diagnosed patients of hypothyroidism were assessed for alopecia [according to the Hamilton and Norwood grading scale] and thyroid function tests. 20 healthy controls were recruited for comparison. Out of 20 hypothyroid patients, 10 [50%] showed alopecia of variable grades. On laboratory investigations, significantly decreased levels of T3 and increased levels of TSH were noticed. Alopecia is quite frequent in hypothyroid patients. Similarly, thyroid profile is one of the useful diagnostic index for screening patients with alopecia