ABSTRACT
Background: Transcatheter device closure of ostium secundum atrial septal defect is a safe & effective intervention in older children, & is usually done under transesophageal echocardiography guidance. However, the procedure under transthoracic echocardiography guidance, especially in smaller children, is done only at few centers, the data of which is scarce. Methods: A prospective study was undertaken to assess the mid-term efficacy and outcome of transcatheter device closure of ostium secundum atrial septal defect under transthoracic echocardiographic guidance, in children <15 Kg. Results: Eighty three children with ostium secundum atrial septal defect were included in the study. Median age of the study population was 3.5 years (1.9-5.6 years), and median weight of 11.6 Kg (7.6 - 14.9 Kg). The primary and secondary procedural success rates were 94% and 96.4% respectively. Post procedure patients were followed up for 12-30 months. Device related major complications were encountered in 4 (4.8%) cases. The total occlusion rates of the defect at 24 hours, 1 month and 3 months post procedure were 94%, 98.8% and 100% respectively. Conclusion: The transcatheter device closure of ostium secundum atrial septal defect under transthoracic echocardiography guidance, in children <15 Kg, has a high short and mid-term safety and efficacy.
ABSTRACT
Background: Stroke is a medical emergency with mortality rate higher than most forms of cancer. Acute ischemic stroke is a complex entity with variable clinical manifestations depending on the site and extent of infarction. Besides standard treatment given to the patients, neuroprotection is being targeted to antagonize molecular events that lead to irreversible ischemic injury. Methods: In this study, role of Citicoline in acute ischemic stroke was studied. It was open label study of 12 weeks duration undertaken in Medicine department (emergency unit) of Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Amritsar. Total 40 patients were randomly divided into Group 1 and Group 2. Group 1 received standard treatment for acute ischemic stroke and Group 2 received citicoline in addition to standard treatment. Patients were assessed at admission and after every 24 hours till hospital discharge. Follow up of the patients was done at three weeks, six weeks and twelve weeks after discharge using National Institute of Health Stroke Scale (NIHSS), Modified Rankin Scale (MRS) and Modified Barthel Index (MBI). The data was statistically analysed using Mann Whitney test. Results: No significant difference was found between two groups with respect to MRS and MBI score throughout the study period. Statistically significant improvement was seen in citicoline group on NIHSS score by 2nd and 3rd day of admission and then on 12th week. Conclusions: Citicoline was found to be safe but with no statistically significant difference in treatment outcome between two groups.
ABSTRACT
Forty patients of Thalassemia Major children were treated with wheat grass tablets (WGT). The mean hemoglobin in the pre WGT was 8.54 +/- 0.33 g% whereas in WGT period was 9.13 +/- 0.14 g% (p < 0.001). The mean blood transfused as packed cells in pre WGT period was 326.82 +/- 74.10ml/kg/year whereas during WGT period it was 256.39 +/- 45.47 ml/kg/ year. The percentage difference in the amount of packed cells transfused in pre WGT and WGT period was 18.02 +/- 22.96 (p < 0.001). The decrease in the blood transfusion requirements was by 25% or more in 20 (60.6%) cases. The mean interval between the consecutive blood transfusions in Pre WGT period was 18.78 ± 4.48 days whereas in WGT period was 24.16 ± 4.78 days (p < 0.001). Wheat grass has the potential to increase the Hb levels, increase the interval between blood transfusions and decrease the amount of total blood transfused in Thalassemia Major patients.