RESUMEN
Coronary–cameral fistulas (CCFs) are mostly congenital in origin and rarely acquired. Clinical symptoms are decided by the hemodynamic significance of the coronary fistula. Even in asymptomatic patients, it is essential to know about coronary CCF particularly if the patient is to undergo cardiac surgery with cardioplegic cardiac arrest. Incidental finding of coronary CCF should never be ignored. Intraoperative myocardial protection and methods used are significantly influenced by such fistula.
RESUMEN
Peripheral nerves can be injured by a direct result of the anesthetic technique of regional anesthesia or it can be contributed/compounded by poor perioperative positioning and padding, tourniquets, and the nature of surgery and diseases affecting the microvasculature of nerves. We present a case of perioperative peripheral nerve injuries which could not be explained by anesthesia technique nor surgery per se.
RESUMEN
A patient having mitral stenosis with chronic atrial fibrillation, large left atrium, and spontaneous echo contrast is expected to have clot in LA or LAA. TEE is more sensitive to detect thrombus in LA and LAA than transthoracic echocardiography. However, false-negative results can still occur due to multilobed LAA, and a thrombus can be potentially missed.
RESUMEN
Acute pancreatitis (AP) is an acute inflammatory process of the pancreas with variable involvement of the pancreas, regional tissues around the pancreas, or remote organ systems. The aim of study was to evaluate Blood urea nitrogen (BUN) as an indicator of severity and single prognostic indicator in acute pancreatitis and to Compare BUN with Ranson’s and BISAP criteria in prediction of SAP and mortality. Methods: A prospective observational study, total 72 patients participated in this study. All Patients presenting to the Emergency and Outpatient Departments of Medicine, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar from October 2015 to September 2016 with suspicion of acute pancreatitis. Results: In the study, of these 66 (91.7%) were male and 6 (8.3%) were female. Mean age of the study subjects was 38.47 + 11.01. Mean age of patients with SAP was slightly higher than with non severe pancreatitis (41.89 vs. 37.33) but not statistically significant (p=0.55). 75% of the Pancreatitis was due to alcohol (54 out of 72), followed by gallstones in 13.88% (10/72). Conclusion: BISAP score within the first 24 hours of admission stratifies patients according to their risk of mortality and onset of organ failure.
RESUMEN
Catheter insertion in central vein can potentially cause accidental arterial injury. However it is very unusual to see such catheter in aorta causing aortic regurgitation. Pressure monitoring and Ultrasound guidance can reliably prevent accidental arterial puncture.
RESUMEN
High Doppler valve gradient is generally suggestive of valve thrombosis. However, it should be corroborated with the finding of restricted leaflet movement to confirm the diagnosis. In the present case, abnormally high gradient was not associated with limited leaflet movements or any valve thrombus.
RESUMEN
Leprosy can infect many tissues besides peripheral nerves and skin. Mycobacterium leprae can occasionally invade blood stream. Objectives The aim of the study was to determine the frequency of bacteremia in leprosy patients. Buffy coat smears and smears from peripheral blood samples and slit-skin smears of 20 patients with Hansen`s disease [6 with lepromatous, 8 with borderline lepromatous, and 3 each with borderline tuberculoid and pure neuritic leprosy] were stained with Ziehl-Neelsen method for acid-fast bacilli. Out of 20 patients, slit-skin smears were positive in 10 patients [5 each with lepromatous and borderline lepromatous leprosy] while buffy coat smears and blood smears were positive in 2 and 1 patients of lepromatous leprosy, respectively. Bacteremia rarely occurs in leprosy