Lipomatous hamartoma of mitral valve

Primary cardiac tumors are very rare, and tumors arising from cardiac valves are extremely rare. We present a case of lipomatous hamartoma of the mitral valve in a young female. This is the 6th case of lipomatous hamartoma of the mitral valve to be reported. We discuss the operative and histopathological findings. </jats:p

Determinants of postpartum anemia among women from a rural population in southern India

PS Rakesh,1 Vijayaprasad Gopichandran,2 Dimple Jamkhandi,1 Krishna Manjunath,1 Kuryan George,1 Jasmin Prasad11Department of Community Health, Christian Medical College, Vellore, 2School of Public Health, SRM University, Kanchipuram District, Tamil Nadu, IndiaBackground: Even though the problem of anemia during pregnancy has been adequately emphasized, very little attention has been paid to postpartum anemia. The objective of the current study was to estimate the mean change in maternal hemoglobin from 36 weeks&#39; gestation to 6 weeks postpartum and to identify the factors associated with anemia during the postpartum period among women in a rural development block in Tamil Nadu, India.Methods: Ninety-three pregnant women were interviewed using a structured questionnaire at 36 weeks&#39; gestation and then at 2 and 6 weeks postpartum. Blood samples were collected from the participants at 36 weeks&#39; gestation and at 6 weeks postpartum. Paired t-tests assessing the difference in mean hemoglobin prepartum and postpartum, univariate analysis, and multiple logistic regression to identify factors associated with postpartum anemia were done using Statistical Package for the Social Sciences version 12 for Microsoft Windows software.Results: The proportion of study subjects who were anemic (hemoglobin &lt;11 g/dL) at 36 weeks&#39; gestation was 26.8% and at 6 weeks postpartum was 47.3% (hemoglobin &lt;12 g/dL). The mean hemoglobin at 36&ndash;38 weeks&#39; gestation was 11.70&plusmn;1.43 g/dL and at 6 weeks postpartum was 12.10&plusmn;1.27 g/dL. Anemia at 36 weeks&#39; gestation (odds ratio [OR] 10.47, 95% confidence interval [CI] 2.37&ndash;42.34), heavy blood loss perceived by the mother during delivery (OR 12.91, 95% CI 2.01&ndash;61.25), younger maternal age (&lt;21 years, OR 2.45, 95% CI 1.28&ndash;23.86), and inadequate iron supplementation during the postpartum period (OR 3.53, 95% CI 1.18&ndash;11.37) were identified as significant factors associated with anemia at 6 weeks postpartum.Conclusion: Anemia during the third trimester of pregnancy, heavy bleeding perceived by the mother during delivery, younger maternal age, and inadequate iron supplementation during the postpartum period were associated with postpartum anemia.Keywords: anemia, hemoglobin, iron deficiency, postpartu

Determinants of quality of life among people with epilepsy attending a secondary care rural hospita in south India

Context: Epilepsy is associated with profound physical, psychological, and social consequences. Aims : To assess the quality of life (QOL) among people with epilepsy attending the outpatient department of a secondary care hospital and to determine the various social and demographic factors affecting it. Materials and Methods: The QOL of 100 people with epilepsy attending the outpatient department of a community-based secondary care hospital was assessed using the WHOQOL-BREF (WHOQOL: World Health Organization QOL) questionnaire. Univariate analysis and logistic regression was done to determine the factors associated with poor QOL. Results: The QOL scores for all the domains ranged between 15.7 and 74.55 with a mean score of 51.49 [standard deviation (SD) 12.3]. The mean scores in the physical, psychological, social, and environmental domains were 55.7, 37.92, 57.75, and 50.56, respectively. Age more than 30 years [odds ratio (OR): 4.33, 95% confidence interval (CI): 1.73-10.82], female gender (OR: 2.90, 95% CI: 1.16-7.28), and currently married (OR: 3.82, 95% CI: 1.21-12.11) were the factors significantly associated with lower QOL scores. Conclusions: The QOL among people with epilepsy was lower in the psychological domain. Age more than 30 years, female gender, and being married were identified as the factors associated with poor QOL scores among people with seizure disorders

Transesophageal echocardiography estimation of coronary sinus blood flow for the adequacy of revascularization in patients undergoing off-pump coronary artery bypass graft

Aims and Objectives: Physiologically coronary sinus (CS) drains the left coronary artery (LCA) territory. Stenosis of the branches of LCA may decrease the coronary sinus blood flow (CSBF). Any intervention that aims at restoring the flow of the stenosed vessel increases coronary artery flow that should consequently increase the CSBF. Hence, this study was undertaken to assess the CSBF before and after each branch of LCA to determine the adequacy of surgical revascularization in patients undergoing elective off pump coronary artery bypass grafting (OPCAB) using transesophageal echocardiography (TEE). Materials and Methods: Thirty consecutive patients scheduled for elective OPCAB were enrolled. CSBF was assessed before and after each branch of LCA revascularization using TEE. Left internal mammary artery (LIMA) Doppler was also obtained post LIMA to left anterior descending (LAD) grafting. Results: Hemodynamic and echocardiographic variables were compared by means of Student′s t-test for paired data before and after revascularization. The CSBF per beat (1.28 ± 0.71), CSBF per minute (92.59 ± 59.32) and total velocity time integral (VTI) (8.93 ± 4.29) before LAD grafting showed statistically significant increase to CSBF per beat (1.70 ± 0.89), CSBF per minute (130.72 ± 74.22) and total VTI (11.96 ± 5.68) after LAD revascularization. The CSBF per beat (1.67 ± 1.03), CSBF per minute (131.91 ± 86.59) and total VTI (11.00 ± 5.53) before obtuse marginal (OM) grafting showed statistically significant increase to CSBF per beat (1.91 ± 1.03), CSBF per min (155.20 ± 88.70) and total VTI (12.09 ± 5.43) after OM revascularization. In 9 patients, color flow Doppler of LIMA could be demonstrated which showed diastolic predominant blood flow after LIMA to LAD grafting. Conclusion: Demonstration of CSBF was simple and monitoring the trend of CSBF values before and after each graft of LCA territory will guide to determine the adequacy of surgical revascularization

Surgical Ventricular Restoration for Post infarction Left Ventricular Aneurysm

Surgical ventricular restoration is a procedure designed to restore or remodel the left ventricle. Surgical ventricular restoration by means of the Dor procedure is a surgical option in patients with coronary artery disease, postinfarction left ventricular aneurysm (LV aneurysm) or ischemic dilated cardiomyopathy with or without ventricular tachycardia. Postinfarction left ventricular remodeling is characterized by LV dilatation and abnormal geometry leading to systolic and diastolic dysfunction. Development of a left ventricular aneurysm is a serious long-term complication of Acute Myocardial Infarction. We report a 69 year old male presented with haemodynamically significant ventricular tachycardia, successfully underwent DOR Procedure with complete recovery.</p