Transcatheter Aortic Valve Replacement in Bicuspid Aortic Valve: A Case Report.

Among other valvular heart disease Aortic stenosis (AS) is the most common in the developed world. Transcatheter Aortic Valve Replacement (TAVR) is most acceptable treatment option for patient with severely calcified aortic stenosis with high and intermediate risk group. Among several challenges, one of the main challenges is to deal with bicuspid aortic valve (BAV). Non-circular annulus, bulky leaflets leading to perivalvular leaks and risk for rupture and often very severe calcification may contribute to periprocedural strokes leading to poor clinical outcome. This case, a 68-year-old woman with a history of type 2 diabetes mellitus (DM), hypothyroidism, bicuspid aortic valve and severe aortic stenosis, bronchial asthma, who had repeatedly refused any suggestion for open heart surgery, was our volunteer candidate for TAVR. After successful TAVR the peak pressure gradient decreased from 100mmHg to 17mmHg. So, TAVR could be a viable option for highly selected patients with severe aortic stenosis and bicuspid aortic valve who have favourable anatomy.

Comparison study of the energy and instability of ion-acoustic solitary waves in magnetized electron-positron-ion quantum plasma.

Notably, solitary waves that emerge from the nonlinear properties of plasmas are the main focus of many current studies of localized disturbances in both laboratory and astrophysical plasmas. By applying the reductive perturbation method, we derive the nonlinear homogeneous quantum Zakharov-Kuznetsov (QZK) equation in three-component collisionless quantum plasma consisting of electrons, positrons, and ions in the presence of an external static magnetic field. The solitary wave structures are dependent on the Bohm potential, magnetic field, obliqueness, species Fermi temperatures, and densities. The soliton's electric field and energy are also derived and investigated, which were found to be reduced as the magnetic field increases. The instability growth rate is also derived by using the small-k perturbation expansion method. The previous parameters affect the instability growth rate as well. A comparison of the energy and instability growth rate behaviour against system parameters is carried out. Large energy and large instability growth rate occur at large values of positron density or lower values of ion density. At zero or small rotation angle, both decrease as the magnetic field increases. Our findings could help us understand the dynamics of magnetic white dwarfs, pulsar magnetospheres, semiconductor plasma, and high-intensity laser-solid matter interaction experiments where e-p-i plasma exists.

Adverse In-Hospital Outcome of Transradial PCI in Comparison to Transfemoral PCI in NSTEMI Patients during Index Hospitalization: A Single Center Study in Bangladesh.

NSTEMI patients, in comparison to STEMI patients, are more at risk of bleeding, access site complication and MACE after PCI during index hospitalization. Because they get, multiple adjuvant anti-thrombotic agents before PCI than do the STEMI patients undergoing primary PCI. Transradial access (TRA) is proven to decrease those adverse in-hospital outcomes compared to transfemoral access (TFA) in STEMI patients. But very few studies were conducted in this regard considering NSTEMI patients. We observed prospectively the adverse in-hospital outcomes of total 180 NSTEMI patients who had undergone PCI through TRA (Group I = 80) and TFA (Group II = 100) during index hospitalization between October 2017 to September 2018 in National Institute of Cardiovascular Disease (NICVD), Dhaka, Bangladesh. Samples were selected purposively. Patients were followed up 2 hours after PCI and thereafter every day until discharge. Demographic and risk factor variables were almost same in both groups. TRA, compared with TFA, yielded less major bleeding (0% versus 3%, p=0.12) which was statistically non-significant. Minor bleeding was significantly less in Group I (2.5% versus 13.0%, p=0.04). Overall bleeding was also significantly less in Group I (2.5% and 10.0%; p=0.002). Access site complication was non-significantly less in Group I (0% versus 1%, p=0.91). TRA caused non-significant reduction in MACE (2.5% versus 5%; p=0.38) but significant reduction of total adverse in-hospital outcome (5% versus 20%, p=0.006%). In this study TRA seems to have less adverse in-hospital outcome than TFA in NSTEMI patients undergoing PCI during index hospitalization.

Effects of sustained-release trimetazidine on chronically dysfunctional myocardium of ischemic dilated cardiomyopathy - Six months follow-up result.

BACKGROUND: Ischemic cardiomyopathy is a growing burden in third world countries. So far, benefits of trimetazidine in this group of patients have been suggested by clinical trials mainly conducted in Europe. We evaluated the effect of trimetazidine on ischemic dilated cardiomyopathy in our population. METHODS AND RESULTS: 98 patients (aged 58.5±9.2 years), admitted with decompensated heart failure with previous history of MI and/or documentation of significant CAD with previous CAG, were chosen for the study. Patients were randomized into two groups - one provided with trimetazidine 35mg sustained released tablet, twice daily and the other with a placebo, along with other conventional medications. Patients were included if they had dilated LV (LVIDd>57mm) and left ventricular ejection fraction (LVEF) ≤40%. After 6 months, significantly higher number of patients in trimetazidine group were in NYHA class I (22% vs. 8%, p=0.03) and class II (56% vs. 34%, p=0.01); higher number of patients in placebo group were in NYHA class III class IV. Anginal episodes and use of sublingual nitrate per week were significantly lower in the trimetazidine group. Left ventricular diastolic dimension (59.7±5.2 vs. 65.1±6.1, p=0.001) was significantly different in the two groups as was the increase of LVEF (11% vs. 5.6%, p=0.001). Hospitalization for worsening heart failure was significantly lower in trimetazidine group (13 vs. 22, p=0.047). CONCLUSION: Trimetazidine seems to be beneficial in patients with ischemic dilated cardiomyopathy in South Asian population and larger scale study with extended follow-up is needed.

Insecticidal susceptibility status of Anopheles stephensi (Liston) in selected areas of Calcutta (West Bengal).

Susceptibility tests were carried out with insecticides like Organochlorine Organophosphorus and Synthetic pyrethroids using the WHO test kits against Anopheles stephensi larvae and adults, collected from malaria endemic wards of Calcutta in December, 1995 and January, 1996 Anopheles stephensi adults were found resistant to DDT, Propoxure, Malathion but susceptible to Fenthion and Deltamethrin.