Concomitant Transcatheter Transfemoral Double Native Valve Replacement for Severe Aortic Stenosis and Severe Mitral Stenosis with Mitral Annular Calcification

Concomitant mitral and aortic valve stenosis in a patient with mitral annular calcification and porcelain aorta poses a unique problem to the surgical team. Transcatheter aortic and mitral valve replacements in native valves offer a viable option for such selected group of patients. We present the case of a 54-year-old male who presented with severe aortic stenosis (AS) and severe mitral stenosis (MS) but was deemed high risk for surgery owing to intense calcification of the aorta and mitral annular calcification, and successfully underwent transcatheter double native valve replacement.

Correlation of TEM, SHV and CTX-M extended-spectrum beta lactamases among Enterobacteriaceae with their in vitro antimicrobial susceptibility.

Purpose: The present study was carried out to characterize the ESBL types and evaluated their in vitro activity against a collection of Gram negative bacteria (GNB) from a multicentric Indian surveillance study. Material and Methods: During January 2005 to June 2006, six tertiary care centres in India forwarded 778 non-duplicate GNB to our reference laboratory. Three hundred GNB from this collection were selected based on clinical significance and were used in the present study. Tested isolates included Escherichia coli (167), Klebsiella spp. (122) and Enterobacter spp. (11). ESBL screening and confirmation was performed for all the isolates. Minimum inhibitory concentration of imipenem, meropenem, ertapenem, levofloxacin, amikacin, piperacillin/tazobactam and ceftriaxone was determined by the E-test method. Molecular typing of the ESBLs was performed by polymerase chain reaction among the 121 selected isolates. Results: The study showed excellent susceptibility among the strains to imipenem (100%), meropenem (100%) and ertapenem (98.7%); good susceptibility to amikacin (89.7%) and piperacillin/tazobactam (85.3%) was observed. TEM and CTX-M were predominantly found in E. coli (39.2%) while, among the Klebsiella spp., TEM, SHV and CTX-M occurred together in 42.6% of the isolates. Conclusion: More than one ESBL was produced by many strains, and this was correlated with increased resistance levels. Carbapenems continue to show good in vitro activity and ertapenem is a potential alternative to imipenem and meropenem. Continued antimicrobial resistance surveillance is warranted in light of these findings.

ABO blood grouping from tooth material.

Human identification is a mainstay of civilization and identification of unknown individuals has always been of paramount importance to society. Establishing individuality is an imperative aspect in any investigating procedure. The use of biological evidence for identification of an individual is a relatively recent development, but it is expensive and time consuming. The Forensic importance of dental tissue has been well recognized because of the fact that tooth is hardest of all human tissues and they can be preserved intact for a long period of time after death. Blood group has been one of the corner stones for identification of biological materials in Forensic investigations, and ABO blood grouping is widely used in Forensic laboratories. In this study an attempt is made to determine ABO blood group from the dental pulp and the dentin extracted from dead body by absorption –elution method.

Grinspan's syndrome a review and a case report

Lichen Planus has been reported to be associated with several disorders. A rare and interesting association between oral erosive lichen planus, diabetes mellitus and vascular hypertension has been described, the triad is referred to as 'Grinspan's Syndrome'. This report presents a case with the symptomatic triad fulfilling the diagnostic criteria of Grinspan's Syndrome