Systemic thrombolysis with tenecteplase in stent thrombosis patients as a life saving measure in odd situations: an observational study from tertiary care hospital

Background: Coronary artery stent thrombosis specifically acute stent thrombosis is always a nightmare for interventionist. Stent thrombosis is one of a severe and catastrophic complication of percutaneous coronary intervention (PCI). Repeat PCI is commonly considered the preferred strategy to manage patients with stent thrombosis. Thrombolytic therapy is considered only partially effective.Methods: This was a single centre largest ever observational study on this topic comprising of total 110 patients with history of previous stent implantation and now presented with an acute ST segment elevation myocardial infarction due to a probable stent thrombosis successfully treated with systemic thrombolysis with tenecteplase were studied over the period of 2 years (April 2017 to March 2019).Results: On analyzing data clinical success was reported in 92 (83.6%) patients, electrocardiographic success is seen in 102 (92.7%) patients while angiographic success was reported in 80(72.7%) patients. Cerebrovascular accident were reported in 2 (1.8%) patients which died later on.Conclusions: This study which is the first ever largest observational study on this topic demonstrates that, in patients with probable stent thrombosis and a short time to reperfusion in some specific extraordinary situations where timely percutaneous coronary intervention is not possible, systemic thrombolysis by fibrin specific Tenecteplase can be done as a life saving procedure which is associated with good immediate results

Critical current density and magnetic phase diagram of BaFe1.29Ru0.71As2 Single Crystals

The critical current density has been measured on single crystals of Ru substituted BaFe2As2 superconductor at several temperatures and in fields up to 16 T. The magnetisation versus field isotherms reveal the occurrence of a clear second magnetisation peak (SMP) also known as fish-tail effect for both H parallel and perpendicular to c-axis of the crystal. The in-field resistance and magnetisation data are used to put forth a vortex phase diagram. The nature of the vortices have been determined from scaling behaviour of the pinning force density extracted from the Jc-H isotherms. The scaled JC versus reduced temperature behaviour seems to fit to a power law that indicates unambiguously that pinning in this system arises due to the spatial variation in the mean free path, viz. delta-l pinning

Antioxidant efficacy and cytotoxicity of ethanol extract of Clerodendrum infortunatum against different cell lines

572-581Clerodendrum infortunatum belongs to the Lamiaceae family and is a perennial shrub. It is widely known for their important medicinal values among the Mizo tribe. In the present study, the preliminary phytochemical screening, quantification of phenols, flavonoids and alkaloids, antioxidant activities by DPPH, O2- and ABTS assays and cytotoxicityby MTT assay against AGS (gastric cancer), HeLa (cervical) and HT-29 (colon) cell lines compared with normal cell line (Chang liver) were performed. Furthermore, the GC-MS profiling was also conducted. The results imply the presence of saponin, alkaloid, cardiac glycoside, phenol and flavonoid. The quantification shows that phenol content (64.35 mg/ g) was highest followed by flavonoid (61.93 mg/ g) and alkaloid (13.33 mg/ g). Its scavenging efficiency against DPPH with IC50 value was 47.99, against O2- with IC50 was108 µg/mL and against ABTS cations with IC50 was 50.05 µg/mL, respectively. The ethanol extract exhibited a maximum cytotoxicity against HeLa with IC50 value of 53.55 µg/mL, AGS with IC50 value 82.44 µg/mL and HT-29 with IC50 value of 142.2 µg/mL. However, the extract showed comparatively less toxicity against normal cell lines. Moreover, 14 active compounds were confirmed in the GC-MS analysis of the extract. HPLC study also infers the occurrence of the flavonoids rutin and quercetin. Therefore, the results of C. infortunatum ethanolic extract clearly specified that it has a very high antioxidant activity as well as cytotoxic properties; which proved that this ethnomedicinal plant can be used as an alternative agent to treat a variety of illnesses

Sphincter saving anorectoplasty (SSARP) for the reconstruction of Anorectal malformations

<p>Abstract</p> <p>Background</p> <p>This report describes a new technique of sphincter saving anorectoplasty (SSARP) for the repair of anorectal malformations (ARM).</p> <p>Methods</p> <p>Twenty six males with high ARM were treated with SSARP. Preoperative localization of the center of the muscle complex is facilitated using real time sonography and computed tomography. A soft guide wire is inserted under image control which serves as the route for final pull through of bowel. The operative technique consists of a subcoccygeal approach to dissect the blind rectal pouch. The separation of the rectum from the fistulous communication followed by pull through of the bowel is performed through the same incision. The skin or the levators in the midline posteriorly are not divided. Postoperative anorectal function as assessed by clinical Wingspread scoring was judged as excellent, good, fair and poor. Older patients were examined for sensations of touch, pain, heat and cold in the circumanal skin and the perineum. Electromyography (EMG) was done to assess preoperative and postoperative integrity of external anal sphincter (EAS).</p> <p>Results</p> <p>The patients were separated in 2 groups. The first group, Group I (n = 10), were newborns in whom SSARP was performed as a primary procedure. The second group, Group II (n = 16), were children who underwent an initial colostomy followed by delayed SSARP. There were no operative complications. The follow up ranged from 4 months to 18 months. Group I patients have symmetric anal contraction to stimulation and strong squeeze on digital rectal examination with an average number of bowel movements per day was 3–5. In group II the rate of excellent and good scores was 81% (13/16). All patients have an appropriate size anus and regular bowel actions. There has been no rectal prolapse, or anal stricture. EAS activity and perineal proprioception were preserved postoperatively. Follow up computed tomogram showed central placement the pull through bowel in between the muscle complex.</p> <p>Conclusion</p> <p>The technique of SSARP allows safe and anatomical reconstruction in a significant proportion of patients with ARM's without the need to divide the levator plate and muscle complex. It preserves all the components contributing to superior faecal continence, and avoids the potential complications associated with the open posterior sagittal approach.</p