Successful percutaneous transcatheter closure of coronary artery fistulas [CAFs]

Coronary artery fistulas [CAFs] are vascular anomalies which in rare cases can cause hemodynamic problems with indication for intervention. Cogenital CAFs is a very rare malformation that may involve any or all coronary artery branches and any cardiac chamber. Elective closure of coronary artery fistulas by percutaneous transcatheter techniques is generally accepted in the presence of symptoms, but controversies exist in the management of asymptomatic patients. We described two patients: A 49 years old female developed episodes of increasing exertional chest pain and dyspenea over 3 years, another 32 years old was referred for coronary angiograph because of dyspenea on exertion with-increasing its severity since one year age. Although non invasive imaging may be helpful, we demonstrated that cardiac catheterization and coronary angiography is necessary for the precise delineation of coronary anatomy and CAF. Mentioned above treatment is advocated for symptomatic patients and for those asymptomatic patients who are at risk for future complication. Form available data and our results Transcatheter closure [TCC] of coronary artery fistula [CAF] is an acceptable alternative to surgery in most patients

Isolation and antimicrobial susceptibility of bacteria from chronic suppurative otitis media patients in Kerman, Iran

Chronic supportive otitis media [CSOM] is one of the commonest illnesses in ENT practice. This study was conducted to find out the various aerobic microorganisms associated with CSOM and their current antimicrobial susceptibility patterns to commonly used antimicrobials. Samples were collected from 117 clinically diagnosed cases of CSOM and processed according to standard protocols. Out of 117 CSOM cases, 105 [86%] showed positive bacterial culture. The Staphylococcus aureuswas the commonest aerobic isolate in CSOM. The sensitivity of Staphylococci spp. to commonly used antimicrobials varied from 27.2% for cefixime to 95.5% for gentamicin and coagulase positive. Pseudomonasisolates showed complete [100%] resistance to amoxicillin/clavulanate [co-amoxiclave], cloxacillin and cefixime, and high sensitivity to ciprofloxacin [95%] and cephalexin [90%]. An appropriate knowledge of antibacterial susceptibility of microorganisms would contribute to a rational antibiotic use and the success of treatment for chronic supportive otitis media

[Giant cell reparative granuloma [G.C.R.G] of the maxillary sinus [Brown tumor]: a case report and review of literature]

The patient is a 17 years old girl, with severe pain and swelling in right maxillary sinus region and facial deformity from 2 weeks prior to referring. CT scan demonstrated a large tumoral mass in right maxillary sinus extended to petereigomaxillary fossa, orbital floor, lachrymal system and nasoethmoid region. Hard palate had been destroyed and bulged in to the oral cavity. Tumor was resected completely by radical cald-well-luck approach. Hystopathology of tumor was giant cell reparative granuloma [GCRG], which is a very rare tumor in paranasal sinuses. Since the association of these tumors with hyperparathyroidism has been reported in literature, the patient was evaluated for hyperparathyroidism and elevated serum parathyroid hormone [PTH: 390 pg/ml] and other hematological tests confirmed secondary hyperparathyroidism