Assessment and comparison of distal radial artery diameter in anatomical snuff box with conventional radial artery before coronary catheterization

Background: The distal radial artery (dRA) approach at anatomical snuff box has gained attention of the interventional cardiologist in last few years. The procedural success rate by this novel approach depends on size of the radial artery and therefore the study was planned to study the size of distal radial artery. Methods: Total of 1004 patients of >18 years of age undergoing coronary catheterization were included in the study. The vessel diameter was measured from media to media in the anatomical snuff box a day prior to coronary catheterization. Results: The mean diameter of right radial artery at conventional access site was 2.56 ± 0.35 mm and at distal access site 2.23 ± 0.39 mm (p < 0.001). Females had significantly smaller radial artery diameter as compared to males at right conventional access site (2.42 ± 0.36 mm vs 2.60 ± 0.34 mm; p < 0.001) and distal access site (2.09 ± 0.38 mm vs 2.27 ± 0.39 mm; p < 0.001). The diameter of the right dRA was not significantly correlated with age (r2 linear ¼ 0.002, p ¼ 0.0475) but was positively correlated with height and weight (r2 linear ¼ 0.076, p ¼ <0.001 and r2 linear ¼ 0.005, p ¼ <0.001) and negatively correlated with BMI (r2 linear ¼ 0.076, p ¼ 0.519). Conclusions: This study has shown the size of right dRA 2.27 þ 0.39 mm in males and 2.09 þ 0.38 mm in females. Diabetes, hypertension, height and weight are important predictors of dRA diameter

Telemedicine during coronavirus disease-19 pandemic: a paradigm shift in cardiovascular care / La telemedicina durante la pandemia del COVID-19: un cambio de paradigma en la atención cardiovascular

Abstract Introduction: Severe acute respiratory syndrome due to coronavirus disease (COVID-19) has overwhelmingly affected the health-care systems globally. Delivering cardiovascular care has become unusually difficult both for caregivers and physicians in these unprecedented times. Methods: We briefly reviewed how cardiac care can be delivered to patients while limiting the exposure of both patients and healthcare workers through telemedicine services. We made a comparison at our institute of outpatient services through routine and telemedicine visits. Results: We found that telemedicine can be an equally effective alternative cardiac care during the times of pandemic with no significant difference in patients profile admitted through telemedicine services. Conclusions: We concluded that telemedicine can prove to be an effective tool in delivering cardiac care by limiting exposure of both patients and physicians with better triage of cardiac patients in the situation of COVID-19 pandemic and may complement to regular cardiac care in routine times.

Resumen Introducción: El síndrome respiratorio agudo grave dado por el COVID-19 ha afectado de manera abrumadora a los sistemas de salud a nivel mundial. La prestación de servicios de atención cardiovascular se ha tornado inusualmente difícil tanto para los cuidadores como para los médicos en estos tiempos inéditos. Métodos: Realizamos una revisión breve de cómo se puede brindar atención cardíaca a los pacientes a la vez que se limita la exposición tanto de pacientes como del personal de la salud a través de los servicios de telemedicina. Comparamos los servicios ambulatorios habituales con las visitas de telemedicina en nuestro instituto. Resultados: Encontramos que la tele medicina puede ser una alternativa igualmente efectiva de atención cardíaca durante tiempos de pandemia, sin ninguna diferencia significativa en el perfil de los pacientes ingresados a través de los servicios de telemedicina. Conclusiones: Concluimos que la telemedicina puede convertirse en una herramienta efectiva para proporcionar atención en salud cardíaca al limitar la exposición tanto de pacientes como de médicos con un mejor triage de pacientes cardíacos en el contexto de la pandemia por COVID-19, y puede llegar a ser un complemento de la atención cardíaca habitual en tiempos normales.

Neonatal presentation of Joubert syndrome

Joubert syndrome is a rare genetic disorder with autosomal recessive or rarely X-linked recessive inheritance. Authors are reporting a case of a newborn girl with Joubert syndrome who presented with respiratory distress, hypotonia, hyporeflexia, abnormal eye movements, and facial dysmorphism. Brain MRI revealed vermian hypoplasia, 'molar tooth sign' with 'bat wing appearance' of the fourth ventricle, deepened interpeduncular fossa, and elongated superior cerebellar peduncles. The clinical diagnosis of this syndrome is difficult due to its variable presentation and non-specific presentation. Magnetic Resonance Imaging (MRI) has an important role in the diagnosis of Joubert syndrome. This not only helps in early diagnosis but also helps in appropriate counseling and proper rehabilitation of the baby.

Collodion baby-congenital ichthyosis: clinical review

Collodion baby is a rare form of congenital ichthyosis in which the entire body is covered by a parchment-like membrane. These neonates are at the risk of dehydration, sepsis, electrolyte disturbances, and temperature instability. It is inherited in autosomal recessive manner. We report a case of Collodion baby, born of a consanguineous marriage. Here, we present a short review of this condition and the various methods available for the prenatal diagnosis. A literature search was done using PubMed, Medline, and Google Scholar databases using the mesh terms 'Ichthyosis', 'collodion baby', 'collodion membrane', 'Congenital ichthyosiform erythroderma', and 'Lamellar ichthyosis'.