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Greeshma S, Palangadan S, Leena devi KR, Vijayaraghavan G. An unusual case of recurrence of papillary fibroelastoma: a case report. Eur Heart J Case Rep 2023; 7:ytad020. [PMID: 36733685 PMCID: PMC9887676 DOI: 10.1093/ehjcr/ytad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/06/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023]
Abstract
Background Papillary fibroelastomas (PFEs) are uncommon primary cardiac tumours and their recurrence after resection is rare. Case summary A 32-year-old woman, who was evaluated for recurrent embolic stroke, was found to have lesions on mitral leaflets on echocardiography. The mitral leaflets were otherwise normal with no clinical or laboratory evidence of infective endocarditis. Transthoracic, as well as transesophageal echocardiography, revealed masses on mitral leaflets, which remained almost the same over 3 years. A tentative diagnosis of PFE on the mitral valve was made. She had undergone intra-cardiac excision of mitral valve mass along with ring annuloplasty in February 2020. In November 2021, during her regular follow-up visit, transthoracic echocardiography revealed the recurrence of the masses on mitral leaflets with severe mitral regurgitation. She underwent mitral valve replacement and excision of tumour masses. Histopathological examination confirmed the diagnosis of recurrent PFE. Discussion Recurrence of PFEs is rare. We report a rare case of histologically proven recurrence of PFE of the mitral valve. This highlights the importance of routine post-operative echocardiographic follow-up in patients with PFE.
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Affiliation(s)
- S Greeshma
- Kerala Institute of Medical Sciences, P.B. No.1, Anayara P.O, Trivandrum 695029, Kerala, India
| | - S Palangadan
- Kerala Institute of Medical Sciences, P.B. No.1, Anayara P.O, Trivandrum 695029, Kerala, India
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Kaul U, Das MK, Agarwal R, Bali H, Bingi R, Chandra S, Chopra VK, Dalal J, Jadhav U, Jariwala P, Jena A, Gupta R, Kerkar P, Guha S, Kumar D, Mashru M, Mehta A, Mohan JC, Nair T, Prabhakar D, Ray R, Rajani R, Sathe S, Sinha N, Vijayaraghavan G. Consensus and development of document for management of stabilized acute decompensated heart failure with reduced ejection fraction in India. Indian Heart J 2020; 72:477-481. [PMID: 33357634 PMCID: PMC7772598 DOI: 10.1016/j.ihj.2020.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/08/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022] Open
Abstract
Aim Ensuring adherence to guideline-directed medical therapy (GDMT) is an effective strategy to reduce mortality and readmission rates for heart failure (HF). Use of a checklist is one of the best tools to ensure GDMT. The aim was to develop a consensus document with a robust checklist for stabilized acute decompensated HF patients with reduced ejection fraction. While there are multiple checklists available, an India-specific checklist that is easy to fill and validated by regional and national subject matter experts (SMEs) is required. Methodology A total of 25 Cardiology SMEs who consented to participate from India discussed data from literature, current evidence, international guidelines and practical experiences in two national and four regional meetings. Results Recommendations included HF management, treatment optimization, and patient education. The checklist should be filled at four time points- (a) transition from intensive care unit to ward, (b) at discharge, (c) 1st follow-up and (d) subsequent follow-up. The checklist is the responsibility of the consultant or the treating physician which can be delegated to a junior resident or a trained HF nurse. Conclusion This checklist will ensure GDMT, simplify transition of care and can be used by all doctors across India. Institutions, associations, and societies should recommend this checklist for adaptability in public and private hospital. Hospital administrations should roll out policy for adoption of checklist by ensuring patient files have the checklist at the time of discharge and encourage practice of filling it diligently during follow-up visits.
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Affiliation(s)
- U Kaul
- Dept of Cardiology, Batra Hospital and Research Centre, 1, Mehrauli Badarpur Rd, Tughlakabad Institutional Area, New Delhi, India.
| | - M K Das
- Dept of Cardiology, CMRI Hospitals, 7/2 Diamond Harbour Road, Kolkata, West Bengal, India
| | - R Agarwal
- Dept of Cardiology, Jaswant Rai Speciality Hospital, Opp Sports Stadium, Civil Line Mawana Road Meerut, Uttar Pradesh, India
| | - H Bali
- Paras Hospital, Plot No. 2, HSIIDC Tech Park, Near NADA Sahib Gurudwara, Panchkula, Haryana, India
| | - R Bingi
- Vasavi Hospital, 15, 1st Stage, Opp. to 15E Bus Stop, 70th Cross Rd, Kumaraswamy Layout, Bengaluru, Karnataka, India
| | - S Chandra
- Dept of Cardiology, Virinchi Hospital, Virinchi Circle, Rd Number 1, Shyam Rao Nagar, Banjara Hills, Hyderabad, Telangana, India
| | - V K Chopra
- Max Superspeciality Hospital, 1, 2, Press Enclave Marg, Saket Institutional Area, Saket, New Delhi, India
| | - J Dalal
- Dept of Cardiology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Rao Saheb, Achutrao Patwardhan Marg, Four Bungalows, Andheri West, Mumbai, Maharashtra, India
| | - U Jadhav
- MGM Hospital, Plot No.35, Atmashanti Society, Sector 3, Vashi, Navi Mumbai, Maharashtra, India
| | - P Jariwala
- Yashoda Hospital, Raj Bhavan Rd, Matha Nagar, Somajiguda, Hyderabad, Telangana, India
| | - A Jena
- Kalinga Institute of Medical Sciences, Kushabhadra Campus, KIIT Campus, 5, KIIT Road, Patia, Bhubaneswar, Odisha, India
| | - R Gupta
- Preventive Cardiology, RUHS Hospital, Kumbha Marg, Sector 11 Rd, Pratap Nagar, Jaipur, Rajasthan, India
| | - P Kerkar
- KEM Hospital, Acharya Donde Marg, Parel, Mumbai, Maharashtra, India; Asian Heart Institute, Bandra Kurla Complex, G/N, Bandra (E), Mumbai, Maharashtra, India
| | - S Guha
- Dept of Cardiology, Calcutta Medical College, 88, College St, Calcutta Medical College, College Square, Kolkata, West Bengal, India
| | - D Kumar
- MEDICA Superspeciality Hospital, 127, Eastern Metropolitan Bypass, Nitai Nagar, Mukundapur, Kolkata, West Bengal, India
| | - M Mashru
- Dept of Cardiology, Sir H N Reliance Foundation Hospital and Research Centre, Prarthana Samaj, Raja Rammohan Roy Rd, Charni Road East, Khetwadi, Girgaon, Mumbai, Maharashtra, India
| | - A Mehta
- Sir Ganga Ram Hospital and Research Centre, Sarhadi Gandhi Marg, Old Rajinder Nagar, Rajinder Nagar, New Delhi, Delhi, India
| | - J C Mohan
- Dept of Cardiology, Jaipur Golden Hospital, 2, Naharpur Village Rd, Institutional Area, Sector 3, Rohini, Delhi, India
| | - T Nair
- Dept of Cardiology, PRS Hospital, NH 47, Killipalam, Thiruvananthapuram, Kerala, India
| | - D Prabhakar
- Apollo First Med Hospital, Poonamallee High Rd, New Bupathy Nagar, Kilpauk, Chennai, Tamil Nadu, India
| | - R Ray
- AMRI Hospital, Block-A, Scheme-L11 P-4&5, Gariahat Rd, Dhakuria, Kolkata, West Bengal, India
| | - R Rajani
- P D Hinduja Hospital & Medical Research Centre, SVS Rd, Mahim West, Shivaji Park, Mumbai, Maharashtra, India
| | - S Sathe
- Deenanath Mangeshkar Hospital and Research Centre, Deenanath Mangeshkar Hospital Road, Near Mhatre Bridge, Erandwane, Pune, Maharashtra, India
| | - N Sinha
- Sahara India Medical Institute, Sahara India Medical Institute, Sahara Hospital Rd, Viraj Khand - 1, Viraj Khand, Gomti Nagar, Lucknow, Uttar Pradesh, India
| | - G Vijayaraghavan
- Kerala Institute of Medical Sciences, 1, Vinod Nagar Rd, Anayara, Thiruvananthapuram, Kerala, India
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Gupta R, Das MK, Mohanan PP, Deb PK, Parashar SK, Chopra HK, Shrivastava S, Guha S, Goswami KC, Yadav R, Alagesan R, Amuthan V, Bansal M, Chakraborty RN, Chakraborti N, Chandra S, Chatterjee A, Chatterjee D, Chatterjee SS, Dutta AL, De A, Garg A, Garg VK, Goyal A, Goyal NK, Govind SC, Gupta VK, Hasija PK, Jabir A, Jain P, Jain V, Jayagopal PB, Kasliwal RR, Katyal VK, Kerkar PG, Khan AK, Khanna NN, Mandal M, Majumder B, Mishra SS, Meena CB, Naik N, Narain VS, Pancholia AK, Pathak LA, Ponde CK, Raghu K, Ray S, Roy D, Sarma D, Shanmugasundarum S, Singh BP, Tyagi S, Vijayaraghavan G, Wander GS, Wardhan H, Nanda NC. Cardiological society of India document on safety measure during echo evaluation of cardiovascular disease in the time of COVID-19. Indian Heart J 2020; 72:145-150. [PMID: 32768012 PMCID: PMC7250084 DOI: 10.1016/j.ihj.2020.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 01/08/2023] Open
Abstract
An echocardiographic investigation is one of the key modalities of diagnosis in cardiology. There has been a rising presence of cardiological comorbidities in patients positive for COVID-19. Hence, it is becoming extremely essential to look into the correct safety precautions, healthcare professionals must take while conducting an echo investigation. The decision matrix formulated for conducting an echocardiographic evaluation is based on presence or absence of cardiological comorbidity vis-à-vis positive, suspected or negative for COVID-19. The safety measures have been constructed keeping in mind the current safety precautions by WHO, CDC and MoHFW, India.
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Affiliation(s)
- Rakesh Gupta
- JROP Institute of Echocardiography, Ultrasound & Vascular Doppler, JROP Healthcare Pvt. Ltd., C-1/16, Ashok Vihar-II, Delhi, 110052, India; JROP Charak Heart City, MD City Hospital, Model Town Northex, Delhi, 110009, India.
| | - Mrinal Kanti Das
- C K Birla Group of Hospitals (BMB and CMRI), Kolkata, West Bengal, India
| | - P P Mohanan
- Westfort Hi-Tech Hospital, Thrissur, Kerala, India
| | | | - S K Parashar
- Metro Heart Hospital, Lajpat Nagar, New Delhi, India
| | | | | | - Santanu Guha
- Calcutta Medical College Hospital, Kolkata, West Bengal, India
| | | | - Rakesh Yadav
- All India Institute of Medical Sciences, New Delhi, India
| | | | - V Amuthan
- Jeyalakshmi Heart Center, Madurai, Tamilnadu, India
| | - M Bansal
- Medanta, The Medicity, New Delhi, India
| | - R N Chakraborty
- Medica Group of Superspeciality Hospitals, Kolkata, West Bengal, India
| | - N Chakraborti
- Medica Group of Superspeciality Hospitals, Kolkata, West Bengal, India
| | - S Chandra
- King George's Medical University, Lucknow, India
| | | | - D Chatterjee
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | | | | | - A De
- Apollo Gleneagles Hospital, Kolkata, India
| | - A Garg
- Jaipur Heart Institute, Jaipur, India
| | - V K Garg
- R D Gardi Medical College, Ujjain, India
| | - A Goyal
- Bani Park Hospital, Jaipur, India
| | - N K Goyal
- BLK Superspeciality Hospital, New Delhi, India
| | | | - V K Gupta
- Kishori Ram Hospital & Diabetes Care Centre, Bhatinda, India
| | | | - A Jabir
- Lisie Hospital Kochi, Kerala, India
| | - P Jain
- Lifeline Superspeciality Hospital, Jhansi, India
| | - V Jain
- Choithram Hospital &R.C., Indore, India
| | | | | | | | | | | | | | - M Mandal
- NRS Medical College, Kolkata, India
| | - B Majumder
- R.G. Kar Medical College & Hospital, Kolkata, India
| | - S S Mishra
- Hi-Tech Medical College and Hospital, Bhubaneshwar, India
| | - C B Meena
- SMS Medical College, Jaipur, Rajasthan
| | | | - V S Narain
- King George's Medical University, Lucknow, India
| | | | - L A Pathak
- Nanavati Heart Institute, Nanavati Superspeciality Hospital, Mumbai, India
| | - C K Ponde
- PD Hinduja National Hospital & RC, Mumbai, India
| | - K Raghu
- Care Hospital, Hyderabad, India
| | - S Ray
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | - D Roy
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | - D Sarma
- Jorhat Christian Medical Centre Hospital, Jorhat, Assam, India
| | | | | | - S Tyagi
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | | | - G S Wander
- Hero DMC Heart Institute, Ludhiana, India
| | - Harsh Wardhan
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | - N C Nanda
- University of Alabama at Birmingham, Birmingham, AL, USA
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Vijayaraghavan G. Professor Sivaramakrishna Iyer Padmavathi. J Clin Prev Cardiol 2020. [DOI: 10.4103/2250-3528.308974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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5
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Narendar R, Vijayaraghavan G. A study of right heart measurements in normal Indian adult population. Indian Heart J 2018. [DOI: 10.1016/j.ihj.2018.10.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Kandwal P, Vijayaraghavan G, Upendra BN, Jayaswal A. Single-stage vertebrectomy for hydatid disease involving L3 vertebra: Five year follow-up. Neurol India 2018; 66:1499-1501. [DOI: 10.4103/0028-3886.241355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Vijayaraghavan G. Cholesterol controversy. J Clin Prev Cardiol 2018. [DOI: 10.4103/jcpc.jcpc_45_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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8
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Soman S, Vijayaraghavan G, Muneer AR, Ankudinov AS. Aneurysm of the saphenous vein graft after coronary artery bypass surgery. J Indian Acad Echocardiogr Cardiovasc Imaging 2018. [DOI: 10.4103/jiae.jiae_17_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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9
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Abstract
Incidence of back pain among children and adolescents is gradually increasing. Children undergo extensive diagnostic workup that ultimately results in a nonconfirmative diagnosis. A good history and clinical examination can, to a large extent help differentiate non-specific from organic causes of backache. Diagnostic workup may be initiated if symptoms are severe and/or persistant. The authors review some of the common causes of back pain in pediatric population, clinical presentations, and the relevant investigations along with their management.
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Affiliation(s)
- Pankaj Kandwal
- Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249201, India.
| | - G Vijayaraghavan
- Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India
| | - Ankur Goswami
- Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Jayaswal
- Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India
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10
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Kandwal P, Goswami A, Vijayaraghavan G, Subhash KR, Jaryal A, Upendra BN, Jayaswal A. Staged Anterior Release and Posterior Instrumentation in Correction of Severe Rigid Scoliosis (Cobb Angle >100 Degrees). Spine Deform 2016; 4:296-303. [PMID: 27927520 DOI: 10.1016/j.jspd.2015.12.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 12/15/2015] [Accepted: 12/24/2015] [Indexed: 10/21/2022]
Abstract
PURPOSE Severe rigid curves present a big challenge to the treating spine surgeon. We evaluated the outcome of staged anterior release and posterior instrumentation for rigid scoliosis. METHODS Twenty-one patients with an average age of 14.4 years (range 11-17) having a rounded severe rigid scoliosis (Cobb angle >100 degrees) underwent surgical correction. Six patients had congenital scoliosis, 13 idiopathic scoliosis, and 2 syndromic. All patients underwent anterior release in Stage I with one or more Ponte osteotomies and in Stage II with all pedicle screw instrumentation, and 13 of the patients underwent an asymmetric pedicle subtraction osteotomy at the apex. Patients were assessed for deformity correction, operative time, blood loss, and any complications. RESULTS The preoperative Cobb angle of 116.6 degrees (range 101-124 degrees) improved to 74.0 degrees (range 54-86 degrees) after anterior release: 29.4% correction and the final postoperation Cobb angle after posterior instrumentation was 26.5 degrees (range 22-32 degrees), with final 76% correction. The average blood loss in anterior release was 585.95 mL (range 400-980 mL; % estimated blood volume = 19.5%), whereas the mean operative time was 223 minutes (165-315 minutes). One patient had prolonged chest drain and two, basal atelectasis following anterior release. The mean operative time for the posterior procedure was 340 minutes (range 280-420 minutes) and average blood loss was 2,066 mL (range 1,200-3,200 mL). The mean apical axial rotation of 56 degrees (range 26-79 degrees) improved to 28 degrees (range 9-42 degrees) (p < .05). There was loss of motor evoked potential signal in one and hook pullout, superficial infection, and local skin necrosis one case each. CONCLUSION The staged approach to the management of severe, rigid scoliosis helps get an excellent correction. Anterior release loosens up the rigid apex and provides with nearly 30% correction so that the extent of the osteotomies in the second stage from the back is substantially reduced, allowing for a final good correction.
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Affiliation(s)
- Pankaj Kandwal
- Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi 110029, India.
| | - Ankur Goswami
- Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi 110029, India
| | - G Vijayaraghavan
- Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi 110029, India
| | - K R Subhash
- Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi 110029, India
| | - Ashok Jaryal
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi 110029, India
| | - B N Upendra
- Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi 110029, India
| | - Arvind Jayaswal
- Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi 110029, India
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Vedantham S, Shrestha S, Shi L, Vijayaraghavan G, Karellas A. SU-D-206-06: Task-Specific Optimization of Scintillator Thickness for CMOS-Detector Based Cone-Beam Breast CT. Med Phys 2016. [DOI: 10.1118/1.4955660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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12
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Suman O, Muneer A, Mujeeb A, Vijayaraghavan G. Limiting factors for optimal medical therapy of patients with heart failure. Indian Heart J 2015. [DOI: 10.1016/j.ihj.2015.10.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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13
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Pannu CD, K D, Goswami A, Vijayaraghavan G. Complete Bilateral Calcified Psoas Abscess- Rare Sequelae of Untreated Pott’s Spine. JNMA J Nepal Med Assoc 2015. [DOI: 10.31729/jnma.2774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Although rare in the western world; psoas abscess is a frequent finding in Indian sub continent associated with Pott’s spine. Untreated Pott’s spine may lead to various sequelae like destruction of vertebra, kyphosis, paraplageia etc which in modern world is amenable to anti-tubercular drugs and surgical management. We report a case of untreated Pott’s spine with bilateral calcified psoas abscess with kyphosis. To the best of our knowledge no such case of complete bilateral calcified psoas abscesses has been reported earlier. We want to discuss this case with relevant literature review and its influence on treatment plan.
Keywords: aminoglycoside; antistaphylococcal; psoas.
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Suhail P, Vijayaraghavan G, Sureshkumar V. Prognostic value of plasma N-terminal pro-Brain natrituretic peptide and high sensitivity troponin T in patients with sepsis; correlation with C reactive protein level and 2D echocardiography. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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15
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Meera R, Suhail P, Ramakrishna Pillai V, Vijayaraghavan G. Ivabradine in AV nodal disease on dual chamber pacemaker. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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16
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Suhail Meera P, Vijayaraghavan G. Utility of dobutamine stress echo in pre op risk evaluation in liver transplant patients. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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17
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Suman O, Vijayaraghavan G, Saraeva N. Prognostic indicators of heart failure in Indian subjects. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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18
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Harikrishnan S, Jeemon P, Prabhakaran D, Vijayaraghavan G, Bahuleyan C, Suresh K, Nair T, Viswanathan S, Huffman M, Mohanan P. PM148 Differences in the presentation, management and outcomes among patients presenting to cardiologists and non-cardiologists in Kerala, India. Results from the Kerala Acute Coronary Syndrome Registry. Glob Heart 2014. [DOI: 10.1016/j.gheart.2014.03.1541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Melchor L, Brioli A, Wardell CP, Murison A, Potter NE, Kaiser MF, Fryer RA, Johnson DC, Begum DB, Hulkki Wilson S, Vijayaraghavan G, Titley I, Cavo M, Davies FE, Walker BA, Morgan GJ. Single-cell genetic analysis reveals the composition of initiating clones and phylogenetic patterns of branching and parallel evolution in myeloma. Leukemia 2014; 28:1705-15. [DOI: 10.1038/leu.2014.13] [Citation(s) in RCA: 178] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 11/26/2013] [Accepted: 12/11/2013] [Indexed: 02/07/2023]
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Soman SO, Vijayaraghavan G, Padmaja NP, Warrier AR, Unni M. Aspergilloma of the heart. Indian Heart J 2014; 66:238-40. [PMID: 24814126 DOI: 10.1016/j.ihj.2013.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/07/2013] [Accepted: 12/04/2013] [Indexed: 11/26/2022] Open
Affiliation(s)
- Suman Omana Soman
- Department of Cardiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India.
| | - G Vijayaraghavan
- Department of Cardiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
| | - N P Padmaja
- Department of Cardiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
| | - Anoop R Warrier
- Department of Infectious Disease, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
| | - Madhavan Unni
- Department of Radio Diagnosis, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
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Lopresti ML, Edmiston KL, Oconnor A, Gates E, Vijayaraghavan G, Sood R, Khanna S. Abstract P2-04-04: Breast cancer risk reduction in high risk women identified at the time of screening mammography. Integrating data from an established high risk clinic. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-04-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: At the time of screening mammography, patient data can be collected and entered into a Modified Gail Model Risk Assessment Tool to identify patients at increased risk of invasive breast cancer. In turn, these patients can be referred to high risk centers where risk reduction strategies and chemoprophylaxis can be considered. The objective of this study is to establish how many women are at high risk of invasive breast cancer in a screening population who should be referred to a high risk center for counseling.
Methods: This is an observational prospective study evaluating 1,000 women at a single institution presenting for mammographic screening or diagnostic evaluation. At the time of mammography, these women routinely complete a standard intake questionnaire addressing breast cancer risk factors put forward by the institutional clinic. Modified Gail model risk scores were calculated from these data sheets. Women with a 5 year risk of invasive breast cancer of 1.7% or greater were identified as well as women at particularly high risk (≥3.4% or double the 5-year risk). At the time of analysis patients with a history of breast cancer or who underwent diagnostic mammography were excluded. Retrospective data from our institutional high risk clinic from January 2007 to December 2009 was analyzed in respect to patient age at referral, Gail Model Score, personal history of breast cancer, history of benign breast biopsies, and recommendation for and acceptance of chemoprophylaxis.
Results: Of 1,000 women screened in the prospective analysis, 366 had ≥1.7% 5-year risk of invasive breast cancer. 26% (96) of these women were under 60 years old while 74% (270) were ≥60 years old. Among the latter group, 19.6% (53) were found to have ≥ 3.4% of developing invasive cancer. In these women with double the 5-year risk, 96.2% had a family history of breast cancer and 69.8% had a prior biopsy. Similarly, in women under 60, greater than half were high risk secondary to a prior biopsy or family history. In the retrospective analysis of 600 patients evaluated in the high risk clinic, 38.8% were eligible for chemoprevention based on age >35, Gail model risk score, and no contraindications to treatment. 45.7% accepted recommendation for chemoprophylaxis as opposed 54.3% who had declined. Age was not found to be a predictor of acceptance of treatment.
Conclusions: 1/3 of patients who receive annual screening are at high risk for breast cancer. These patients can be identified from data routinely obtained at the time of screening mammography. These women should be referred for high-risk counseling and consideration of chemoprevention at the time of screening mammography. Further prospective studies may be warranted to determine if this is an effective way to provide risk reduction strategies for high risk women.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-04-04.
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Affiliation(s)
- ML Lopresti
- Umass Memorial Medical Center, Worcester, MA
| | - KL Edmiston
- Umass Memorial Medical Center, Worcester, MA
| | - A Oconnor
- Umass Memorial Medical Center, Worcester, MA
| | - E Gates
- Umass Memorial Medical Center, Worcester, MA
| | | | - R Sood
- Umass Memorial Medical Center, Worcester, MA
| | - S Khanna
- Umass Memorial Medical Center, Worcester, MA
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Vijayaraghavan G, Sivasankaran S. Tropical endomyocardial fibrosis in India: a vanishing disease! Indian J Med Res 2012; 136:729-38. [PMID: 23287119 PMCID: PMC3573593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Indexed: 10/28/2022] Open
Abstract
Tropical endomyocardial fibrosis in India was a common medical problem in the coastal districts of south India, especially the Kerala State. The clinical and autopsy studies have shown left and right ventricular apical fibrosis, with varying degree of atrioventricular valve regurgitation. Left ventricular endomyocardial fibrosis presents with severe pulmonary hypertension and right ventricular endomyocardial fibrosis presents very high systemic venous pressure and congestive cardiac failure. Surgical management improved the natural history of the disease to some extent. Various infectious and toxic factors were postulated regarding its aetiology. During the last few years, incidence of the disease has decreased considerably. The only explanation identified is the significant improvement in the living standards of the people with the corresponding decline in the childhood malnutrition, infections, worm infestation and associated eosinophilia.
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Affiliation(s)
- G Vijayaraghavan
- Kerala Institute of Medical Sciences, Medical College, Thiruvananthapuram, India.
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Rajan R, Natarajan R, Vijayaraghavan G. RESULTS OF TENEKTEPLASE USE IN MASSIVE PULMONARY THROMBOEMBOLISM. CLINICAL CASE. Racionalʹnaâ farmakoterapiâ v kardiologii 2011. [DOI: 10.20996/1819-6446-2011-7-1-42-48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Meera R, Rachel D, Ramakrishnapillai V, Vijayaraghavan G. Heparin induced thrombocytopenia management with bivalirudin. Indian Heart J 2007; 59:354-355. [PMID: 19126942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
We report a case of Heparin Induced Thrombocytopenia (HIT) following percutaneous coronary intervention. The case is unique in that thrombocytopenia occurred very early after heparin administration and responded well to a regime of bivalirudin-a direct thrombin inhibitor readily available in India. Heparin, Thrombocytopenia, Bivalirudin Acute HIT, occurring within few hours of heparin therapy have been reported in patients previously exposed to unfractionated heparin (UFH) or low molecular weight heparin (LMWH) 1. Prompt recognition of the condition and timely intervention with direct thrombin inhibitors, can result in salvaging patients from this potentially fatal complication.
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Affiliation(s)
- R Meera
- Department of Cardiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala.
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Abstract
The association of adrenal pheochromocytoma and brown fat has been described in the pathology literature and scantily in the radiology literature. We present a case of diffuse collection of brown fat in both perinephric spaces associated with left adrenal pheochromocytoma, and describe the computed tomography and magnetic resonance imaging findings.
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Affiliation(s)
- S K Dundamadappa
- Department of Radiology, University of Massachusetts, Worcester, Massachusetts, USA.
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Ramesh N, Pillai RK, Abraham T, Padmaja NP, Hameed S, Vijayaraghavan G. Reno-protective effect of N-acetyl cysteine in patients with impaired renal function undergoing coronary angiography and interventions. J Assoc Physicians India 2006; 54:449-52. [PMID: 16909692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND The increasingly frequent use of contrast enhanced imaging for diagnosis or interventions in patients with CAD has generated concern about avoidance of contrast induced nephropathy (CIN). Reactive oxygen species have been shown to cause CIN. OBJECTIVES Angiographic contrasts worsen the renal function in patients with renal failure. We studied the reno-protective action of the antioxidant N-Acetyl cysteine (NAC) in patients undergoing coronary procedures. METHODS Retrospective analysis of 51 patients with elevated serum creatinine levels (> or = 15mg%) was done, 24 of whom received NAC prior to the procedure(NAC group) and 27 who did not (Non NAC group). NAC was administered in a dose of 400 mg twice daily for four doses starting on the day prior to the procedure. Both groups of patients were hydrated with 0.45% saline at 1 ml/kg/hr for 12 hours prior to and 12 hours following the procedure. Both groups were comparable with regard to age, sex, coronary risk profile, myocardial infarction history, left ventricular function and the drugs received. Serum urea and creatinine were measured on the day prior to and the day following the angiographic procedure. RESULTS Nine out of 51 patients developed more than 0.5mg% rise in serum creatinine level; 1 in the NAC group and 8 in the non NAC group (p<0.05), 24 hours after injection of the contrast medium. In the NAC group mean serum creatinine level decreased from 1.94 +/- 0.56 to 1.67 +/- 0.56 and blood urea from 47.58 +/- 20 to 41.58 +/- 15.1. In the non NAC group serum creatinine increased from 1.75 +/- 0.31 to 1.98 +/- 0.56 and blood urea from 44.96 +/- 15.5 to 52.85 +/- 20.1 (p<0.05). This corresponds to an increase in creatinine clearance from 30ml/min to 35.92ml/min in the NAC group and a decrease from 34.42ml/min to 29.87ml/min in the non NAC group. There was no significant difference in the levels of sodium and potassium before and after the procedure in both the groups. CONCLUSION We conclude that prophylactit administration of N-Acetyl Cysteine along with hydration diminishes the incidence of deterioration of renal function induced by contrast agents in patients with renal insufficiency during coronary angiographic procedures.
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Affiliation(s)
- N Ramesh
- Department of Cardiology, Kerala Institute of Medical Sciences, Trivandrum
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Vijayaraghavan G. Communications in cardiology: why digital? Indian Heart J 2001; 53:231-4. [PMID: 11428486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Affiliation(s)
- G Vijayaraghavan
- Department of Cardiology, Welcare Hospital, Dubai, United Arab Emirates
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Vijayaraghavan G. Pericardiocentesis: need for haemodynamic monitoring. J Assoc Physicians India 1992; 40:652-3. [PMID: 1307349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Abstract
A 17-year-old patient was found to have cyanosis. A right-to-left shunt was suspected clinically and confirmed by noninvasive techniques such as perfusion lung scan and contrast echocardiography. Angiography showed this shunt to be between the left pulmonary artery and the left atrium. We believe this to be the first report of a hitherto undescribed congenital anomaly.
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Affiliation(s)
- A M Karnik
- Department of Medicine, Faculty of Medicine, Safat, Kuwait
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Abstract
Postmortem, clinical, and experimental observations suggest an approximate elliptical shape for the mitral valve anulus, limiting the accuracy of single-diameter measurements in estimating annular area and circumference. A detailed method has been reported which uses six apical echocardiographic views at 30-degree rotational intervals to measure the mitral anulus, providing results comparable with pathologic and experimental reports. Annular data from nine normal subjects and 18 patients with dilated cardiomyopathy were analyzed to test a simplified measurement procedure. Assuming an elliptical shape, mitral annular area (MAA) and mitral annular circumference (MAC) were calculated by means of major (usually corresponding to the four-chamber view) and minor diameters from two orthogonal apical planes. Assuming a circular shape, MAA and MAC were also estimated by means of single annular diameters obtained from both an apical four-chamber and a parasternal long-axis view. Systolic and diastolic points were analyzed together, providing an n = 54 in the linear regressions. The two-plane results in MAA and MAC were nearly identical to those from the six-plane method, with very close correlation (r = 0.982 to 0.990). The single-plane results systematically overestimated MAA and MAC, with less correlation (apical, r = 0.943 to 0.963; parasternal, r = 0.852). Thus, while single-diameter measurements may correlate with global changes in annular size, the two-plane method represents a simplified but accurate method for estimating MAA and MAC in humans.
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Abstract
In a hand-driven, pulsatile in vitro model, the pressure-velocity relation across stenotic orifices was studied from simultaneous measurements recorded over a wide range of pressure and across different-sized orifices, individually and paired. Velocity spectra were recorded with continuous-wave Doppler ultrasound. In a rigid, noncompliant system, integrated instantaneous maximal velocities precisely register simultaneous integrated pressure gradients without measureable phase shift. Across stenotic orifices of 5 to 10 mm in diameter, the pressure-velocity relation is independent of orifice size for pressures extending from -30 to +240 mm Hg. The relation is quadratic and crosses 0. In this model, application of the simplified Bernoulli equation transforms the relation from curvilinear to linear with a bias toward the derived-pressure axis. In the presence of 2 different-sized orifices, the pressure-velocity relation remains constant, with a given pressure producing 2 identical velocities.
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Abstract
The effects of nitroglycerin on segmental asynergy were studied by 2-dimensional echocardiography. Forty-five patients with coronary artery disease and segmental wall motion abnormality at rest were examined, 31 with Q-wave and 14 with only ST-T abnormalities. Left ventricular (LV) echocardiograms were recorded from the LV apex in 4 planes, obtained by systematically rotating the transducer at 45 degrees intervals around the mitral office, using a mechanical device. Sixteen LV segments were analyzed in each patient on real-time display by 2 observers independently. The wall motion analysis was classified as normal, hypokinetic, akinetic or dyskinetic. Of 720 segments, 596 were agreed on by 2 observers in the assessment of wall motion before and after administration of nitroglycerin: 334 segments (56%) showed no change in wall motion, 206 (35%) showed improvement of wall motion and 56 (9%) showed worsening of myocardial asynergy after nitroglycerin. These data suggest that administration of nitroglycerin may result in unexpected worsening of segmental asynergy. This may be secondary to an adverse effect of a decrease in perfusion pressure in critically occluded arteries or may represent a coronary steal phenomenon.
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Bae JH, Wong M, Vijayaraghavan G, Shah PM. Experimental Study of Pressure - Velocity Relationship Across Stenotic Orifices by Continuous Wave Doppler Ultrasound. Korean Circ J 1985. [DOI: 10.4070/kcj.1985.15.1.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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34
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Bae JH, Vijayaraghavan G, Shah PM. Systolic Pressure Gradients in Aortic Valve Stenosis by Continuous Wave Doppler Echocardiography. Korean Circ J 1985. [DOI: 10.4070/kcj.1985.15.1.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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35
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Bae JH, Tei C, Vijayaraghavan G, Cherian G, Shah PM. A Simple Two-Dimensional Echocardiographic Sign of Tricuspid Regurgitation. Korean Circ J 1985. [DOI: 10.4070/kcj.1985.15.2.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Vijayaraghavan G, Sadanandan S. Immunological phenomena in tropical endomyocardial fibrosis. Indian Heart J 1984; 36:87-9. [PMID: 6724630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Vijayaraghavan G, Davies J, Sadanandan S, Spry CJ, Gibson DG, Goodwin JF. Echocardiographic features of tropical endomyocardial disease in South India. Br Heart J 1983; 50:450-9. [PMID: 6639816 PMCID: PMC481438 DOI: 10.1136/hrt.50.5.450] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Fifteen patients with tropical endomyocardial disease which had been proved angiographically were studied using M-mode and cross-sectional echocardiography to determine the extent to which specific features of this disease could be recognised by these non-invasive methods. Tethering of the posterior mitral valve leaflet to the ventricular wall in combination with areas of echo-dense material in the posterior left ventricular wall and associated papillary muscle appeared to be a constant diagnostic feature of this disease. Colour coding of regional echo amplitude showed high intensity echoes in a distribution corresponding closely to that of the fibrosis known to occur in this condition. Though M-mode echocardiography did not contribute diagnostic information, it was useful in defining the functional consequences of myocardial or mitral valve disease. Digitisation of records allowed a restrictive pattern of left ventricular filling to be observed. It was concluded that cross-sectional echocardiography, particularly when supplemented by colour coded amplitude processing, can make a confident non-invasive diagnosis of tropical endomyocardial disease and so could be useful in assessing its progression or response to treatment.
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Cherian G, Vijayaraghavan G, Krishnaswami S, Sukumar IP, John S, Jairaj PS, Bhaktaviziam A. Endomyocardial fibrosis: report on the hemodynamic data in 29 patients and review of the results of surgery. Am Heart J 1983; 105:659-66. [PMID: 6340450 DOI: 10.1016/0002-8703(83)90491-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Davies J, Spry CJ, Vijayaraghavan G, De Souza JA. A comparison of the clinical and cardiological features of endomyocardial disease in temperate and tropical regions. Postgrad Med J 1983; 59:179-85. [PMID: 6844203 PMCID: PMC2417463 DOI: 10.1136/pgmj.59.689.179] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study was designed to compare the clinical and cardiological features of endomyocardial disease in temperate and tropical regions. Eleven patients were studied in the U.K., 47 in India and 8 in Brazil. The patients in the U.K. were older, with a male predominance, and they had a systemic illness: the hypereosinophilic syndrome. Half of these patients presented in the early necrotic stage of the disease, and all had biventricular involvement. On the other hand, patients in the tropical countries were younger, with an equal sex incidence, and were from poor, malnourished communities with heavy parasite loads, especially filariasis in India. None presented in the early necrotic stage of the disease and a quarter had isolated right or left ventricular disease. In order to account for these differences between patients in temperate and tropical regions with endomyocardial disease, it was proposed that the nature of the underlying disease and the rate at which endomyocardial lesions develop, determine the clinical features of this disorder. In temperate climates eosinophil granule toxins may produce a rapidly progressive form of the disease in patients with the hypereosinophilic syndrome, whereas the disease may take longer to develop in patients in tropical climates, who have a less marked eosinophilia due to parasitic infections.
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Durairaj M, Vijayaraghavan G, Abraham KA, Balaji NK, Nampoory N, Sukumar IP, Cherian G. Cardiovascular manifestations of Marfan's syndrome. J Assoc Physicians India 1979; 27:677-81. [PMID: 541333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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42
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Vijayaraghavan G, Cherian G, Abraham KA. Cardiovascular effects of intravenous verapamil in normal subjects. Indian Heart J 1978; 30:159-62. [PMID: 700746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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43
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Rao AS, Vijayaraghavan G, Sukumar IP, John S, Cherian G. Tetralogy of Fallot with absence of pulmonary valve and left pulmonary artery. Report of a case with long survival. Indian Heart J 1978; 30:120-4. [PMID: 700736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Chandrasekhara Rao AS, Cherian G, Vijayaraghavan G, Basu B, Sukumar IP, John S. Congenital absence of a primary division of the pulmonary artery. J Assoc Physicians India 1977; 25:617-22. [PMID: 612659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Kuruvilla A, Vijayaraghavan G, Cherian G. Influence of beta blockade on the cardiac toxicity of cerberine. Indian J Exp Biol 1977; 15:663-4. [PMID: 606677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Balaji NK, Abraham KA, Sukumar IP, Vijayaraghavan G, John S, Cherian G. Congenital aortopulmonary septal defect. Indian Heart J 1977; 29:220-7. [PMID: 924476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Abstract
Clinical, radiological, electrocardiographic, haemodynamic, and cineangiographic features of left ventricular endomyocardial fibrosis are described in 8 patients seen during the 10-year period 1965-1975. Exertional dyspnoea was the commonest presenting symptom. Mild to moderate cardiomegaly was often present. The apex beat was never forcible. A loud third heart sound over the apex and an apical early systolic murmur with late systolic decresendo were characteristic of this desease. Chest X-rays films showed left atrial enlargement and pulmonary venous congestion. A pronounced rise in left ventricular end-diastolic pressure, severe pulmonary hypertension, and low cardiac index were seen in 6. Ventriculography showed an irregular, poorly contracting left ventricle with areas of dyskinesis and large end-systolic volume. Mitral regurgitation, when present, was not severe.
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Vijayaraghavan G, Cherian G, Krishnaswami S, SUKUMAR IP, John S. Rheumatic aortic stenosis in young patients presenting with combined aortic and mitral stenosis. Br Heart J 1977; 39:294-8. [PMID: 849390 PMCID: PMC483234 DOI: 10.1136/hrt.39.3.294] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This report describes 30 patients under the age of 30 years with rheumatic aortic stenosis, presenting with combined aortic and mitral stenosis. Three patients had additional tricuspid stenosis. Twenty-eight patients gave a history of rheumatic polyarthritis. The diagnosis was confirmed by right and left heart catheterisation in all. The murmur of aortic stenosis was not initially present in 8 out of 10 patients in congestive heart failure. Aortic valve calcification was not seen. Cineangiography showed a tricuspid aortic valve in all, unlike congenital aortic stenosis. A unique feature of this group was the raised pulmonary vascular resistance in 87 per cent of the patients. The present study shows that patients in India developing aortic stenosis after rheumatic fever do so early in the natural history of the disease.
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Kidao J, Vijayaraghavan G, Durairaj M, Sukumar IP, Cherian G. The second heart sound in secundum atrial septal defect a phonocardiographic study with haemodynamic correlations. Indian Pediatr 1977; 14:55-60. [PMID: 863498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Vijayaraghavan G, Cherian G. Hypertrophic obstructive cardiomyopathy prevention of outflow obstruction with propranolol. J Assoc Physicians India 1976; 24:631-6. [PMID: 1035908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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