Guillain-Barre Syndrome as Presenting Feature in a Patient with Systemic Lupus Erythematosus.

Guillain-Barré syndrome. GBS as initial manifestation of lupus is exceedingly rare and has been reported in a few cases in the literature. We report here a 35 year old woman who presented with 10 day history of progressive muscle weakness and paraesthesias in all four limbs. She was diagnosed as SLE with renal involvement and was treated with steroids and cyclophosphamide.

Artery of Percheron Infarction in a Patient with Atrial Fibrillation: A Rare Stroke Syndrome.

The artery of Percheron uncommon anatomic variant that provides bilateral arterial supply to the paramedian thalami and the rostral midbrain. Occlusion of this artery results in bilateral thalamic and mesencephalic infarctions. The clinical diagnosis is difficult because of the large clinical variability. We report the clinical and MR imaging findings in a patient who developed infarction in the typical distribution of the artery of Percheron.

Asymptomatic Presentation of Large Cardiac Hydatid.

Hydatid cyst is a tissue parasitic infection caused by tapeworm Echinococcus granulosus. Common location for hydatid cysts are the liver (65%) and the lungs (25%). Cardiac hydatid cyst is seen rarely, occurring in about 0.5-2% of all cases of hydatid disease. We present this case of 45 years female who presented with short duration of dry cough and atypical chest pain. Chest X ray showed cardiomegaly with round bulge at the right heart border and curvilinear calcification in left upper abdomen in the region of spleen. Transthoracic echocardiography (TTE) depicted cystic lesion in Right Ventricle free wall causing compression of right atrial and ventricular cavity. Cardiac CT confirmed this cyst as hydatid cyst. Patient underwent successful excision of right ventricular hydatid cyst.

Heart Failure and the Iron Deficiency.

Iron deficiency anemia is a significant problem worldwide and more so in developing countries, like India. The prevention and treatment of iron deficiency is a major public health goal in India It is now well recognized that iron deficiency has detrimental effects in patients with coronary artery disease, heart failure, and pulmonary hypertension, and possibly in patients undergoing cardiac surgery. Around one-third of all patients with HF, and around one-half of patients with pulmonary hypertension, are affected by iron deficiency.1.

Catheter Assisted Management of Massive Pulmonary Embolism.

Pulmonary thromboembolism is common and missed by clinicians. We report a case of massive pulmonary embolism which was life threatening treated by the catheter assisted technique. Anticoagulation is the mainstay of therapy for most patients, with thrombolytic therapy reserved for some patients.1 Recent studies have suggested a role for systemic or catheter-directed thrombolytic therapy in selected patients.2 We present a case of a patient who presented with an PE, was successfully treated with catheter-directed thrombolysis.

Retrospective Study of Clinical and Epidemiological Parameters of Patients Undergoing Percutaneous Coronary Intervention with Their Follow-Up.

AIM: To study clinical and epidemiological parameters of patients undergoing percutaneous coronary intervention (PCI) and to follow them up for understanding the outcomes of the procedure. MATERIAL AND METHODS: This is a retrospective data analysis of 862 patients who underwent PCI from January 2016 to November 2017. RESULTS: Out of 862 patients, 611 (70.88%) were male & 251 (29.12%) were female, with the mean age being 55. 243 (28.19%) were diabetic, 470 (54.52%) were hypertensive, 158 (18.32%) patients were tobacco chewer, 215 (24.92%) were smokers and 111 (12.87%) were alcoholic. 636 (73.78%) patients had STEMI, 153 (17.74%) had NSTE-ACS, 61 (7.07%) had CSA.578 (67.05%) were SVD, 262 (30.39%) were DVD and 19 (2.20%) were TVD. Out of SVD, 350 (60.55%) patients had LAD involvement and among DVD patients, LAD and RCA were most commonly involved in 107 (40.83%) patients. On follow-up of mean 604.42 days (minimum 236 days, maximum 909 days), 2 (0.23%) episodes of subacute stent thrombosis occurred and 11 (1.27%) patients had ISR but no mortality was reported. CONCLUSION: The study shows affection of young population predominately and genders inequality, suggesting primarily male disease. PCI is often sought in ACS and CSA is predominately treated medically. Thrombolysis remains the first treatment received by STEMI patients. SVD is the most common angiographic diagnosis with LAD predominately affected vessel. This real world-data on clopidogrel with aspirin as dual antiplatelet therapy and second-generation stent shows negligible event of stent thrombosis and ISR. LIMITATION: Due to non-invasive follow-up, the exact amount of stent restenosis cannot be calculated. IMPACT ON DAILY PRACTICE: This real world-data on clopidogrel with aspirin as dual antiplatelet therapy and second-generation stent shows negligible event of stent thrombosis and ISR. This can help reduce the cost burden on society and help better distribution of health budget.