ABSTRACT
Delayed Cardiac Perforation by Permanent Pacemaker lead beyond one year of implantation is rare. It is also rarer in passive fixation lead, compared to active fixation lead. There is no Universal consensus regarding management of such cases with percutaneous versus surgical removal of the lead followed by re-implantation. Here we report a case of Right Ventricular (RV) perforation by a passive fixation permanent lead, in an 81-year-old lady, 14 months after implantation, who presented with Pacemaker capture failure but in hemodynamically stable condition. Pacemaker lead had migrated up to the Lower Lobe of Left Lung, Perforating Right Ventricle, pericardium and Left Pleura. We managed this case with open lead removal under direct vision by Lower Median Sternotomy, followed by implantation of an Epicardial Lead and Pacemaker
ABSTRACT
Background: The objective of present study was to assess the proportion of maternal near miss and maternal death and the causes involved among patients attending obstetrics and gynaecology department of Agartala Govt. Medical College of North Eastern India.Methods: Potentially life-threatening conditions were diagnosed, and those cases which met WHO 2009 criteria for near miss were selected. Maternal mortality during the same period was also analyzed. Patient characteristics including age, parity, gestational age at admission, booked, mode of delivery, ICU admission, duration of ICU stay, total hospital stay and surgical intervention to save the life of mother were considered. Patients were categorized by final diagnosis with respect to hemorrhage, hypertension, sepsis, dystocia (direct causes) anemia, thrombocytopenia, and other medical disorders were considered as indirect causes contributing to maternal near miss and deaths.Results: The total number of live births during the study period (January 2017 to June, 2018) was 9378 and total maternal deaths were 37 with a maternal mortality ratio of 394.5/1 lakh live births. Total near miss cases were 96 with a maternal near miss ratio of 10.24/1000 live births. Maternal near miss to mortality ratio was 2.6. Of the 96 maternal near miss cases - importantly 20.8% were due to haemorrhage, 19.8% were due to hypertension, 13.5% were due to sepsis, and 11.5% were due to ruptured uterus. In maternal death group (n-37), most important causes were hypertensive (40.5%) followed by septicemia (21.6%), haemorrhage (10.8).Conclusions: Haemorrhage, hypertensive disorders and sepsis were the leading causes of near miss events as well as maternal deaths.
ABSTRACT
The present study was undertaken to examine calmodulin-dependent effect of thyroid hormones (THs) on synaptosomal protein phosphorylation in mature rat brain. Effect of L-triiodothyronine (L-T3) on in vitro protein phosphorylation was measured in a hypotonic lysate of synaptosomes prepared from adult male rat cerebral cortex, incubated in presence and absence of calcium ion (Ca2+) and calmodulin. L-T3 significantly enhanced incorporation of 32P into synaptosomal proteins as compared to basal level of phosphorylation in the presence of Ca2+ and calmodulin. Under these conditions, increase in protein phosphorylation was 47, 74 and 52% for 10 nM, 100 nM and 1 M L-T3, respectively. Chelation of Ca2+ using ethylene glycol-bis (2‑aminoethylether)-N, N, N’, N’-tetraacetic acid (EGTA) inhibited the effects of Ca2+/calmodulin on TH-stimulated protein phosphorylation levels. This study suggests that a high proportion of L-T3-stimulated protein phosphorylation involves Ca2+/calmodulin-dependent pathways in adult rat cerebrocortical synaptosomes.
ABSTRACT
Thyroid hormones (TH) have important functions in maturation, differentiation and metabolism during developmental periods in almost all types of tissues including brain of vertebrate animals. In humans' thyroid malfunction in early developmental stages cause severe neuropsychological abnormalities due to defective gene expression via nuclear receptor activation. However, role of TH in adult mammalian brain is lacking and unclear mainly because it was considered for a long time as a TH unresponsive tissue. Although adult brain contains a substantial number of TH nuclear receptors, no functional properties could be attributed. Recent findings suggest that T3 is distributed, concentrated, metabolized and binds to specific membrane sites within adult brain. In mature humans TH also reversibly regulates various neuropsychological symptoms produced in mature condition. This review discusses development of recent concepts and literature on role of TH and its importance in neuronal function in adult mammalian brain.