Anomalies of coronary artery origin: About two cases

Anomalies of coronary artery origin are congenital malformations characterized by the abnormal birth of a coronary artery from the controlateral coronary aortic sinus (birth of the left coronary artery from the right sinus or birth of the right coronary artery from the left sinus). The artery concerned has an abnormal initial path between the aorta and the pulmonary artery; this segment is most often intramural, in the aortic wall. They are rare with a prevalence (0.1% to 0.3% of the population). They pose a high risk of sudden stress death related to exercise myocardial ischemia. The most common mode of discovery is aborted sudden death, but sometimes fortuitously. The contribution of multi-round CT is described for the positive diagnosis of these anatomical variations, sometimes delicate in coronary angiography, but also for the distinction between “benign” and “malignant” forms, potentially responsible for myocardial ischemia. Treatment is usually surgical in symptomatic forms. We report the cases of two patients with coronary connection abnormalities discovered in adulthood

Hemoptysis after subclavian vein puncture for pacemaker implantation: A case report

Background: Subclavian venous access for pacemaker lead insertion is a common procedure and is normally considered safe in the hands of an expert. However, subclavian venepuncture is not without complications, starting from mild subcutaneous hematoma to pneumothorax. We here present a case of hemoptysis occurring after difficult subclavian vein puncture, which subsequently improved on conservative management only. Case Summary: A 65-year-old gentleman, post aortic valve replacement had persistent high-grade AV block and was taken up for a dual chamber pacemaker implantation. Immediately following venous access, he had a bout of hemoptysis, which recovered on its own. Post procedure chest x-ray was suggestive of alveolar hemorrhage which cleared gradually in next three-four days. Discussion: Post subclavian venepuncture hemoptysis is known; but it is a rare complication, arising either because of lung parenchyma injury or arterial injury. This is mostly benign and improves on conservative management only; however rarely it may be massive and life threatening where transcatheter arterial embolization may be required

Socio-demographic and epidemiological consideration of Africa’s COVID-19 response: what is the possible pandemic course?

Africa is said to be the next possible hotspot for COVID-19. However, we believe this is still preventable

Residence times of shallow groundwater in West Africa: implications for hydrogeology and resilience to future changes in climate

Although shallow groundwater (<50 mbgl) sustains the vast majority of improved drinking-water supplies in rural Africa, there is little information on how resilient this resource may be to future changes in climate. This study presents results of a groundwater survey using stable isotopes, CFCs, SF6, and 3H across different climatic zones (annual rainfall 400–2,000 mm/year) in West Africa. The purpose was to quantify the residence times of shallow groundwaters in sedimentary and basement aquifers, and investigate the relationship between groundwater resources and climate. Stable-isotope results indicate that most shallow groundwaters are recharged rapidly following rainfall, showing little evidence of evaporation prior to recharge. Chloride mass-balance results indicate that within the arid areas (<400 mm annual rainfall) there is recharge of up to 20 mm/year. Age tracers show that most groundwaters have mean residence times (MRTs) of 32–65 years, with comparable MRTs in the different climate zones. Similar MRTs measured in both the sedimentary and basement aquifers suggest similar hydraulic diffusivity and significant groundwater storage within the shallow basement. This suggests there is considerable resilience to short-term inter-annual variation in rainfall and recharge, and rural groundwater resources are likely to sustain diffuse, low volume abstraction