Analysis of preoperative and postoperative blood gas indices and airflow dynamics with tracheal stenosis undergoing tracheal reconstruction.

Prolonged ventilation remains the most common cause of tracheal stenosis. Tracheal reconstruction is the gold standard treatment in these cases. The success of surgery is based on results of the pulmonary function test (PFT) which relies on patients' performance and their cooperation. The objective of the study was to investigate the impact of tracheal reconstruction in cases of tracheal stenosis on blood gas indices as well as airflow indices and whether arterial blood gas (ABG) can be a better surrogate of adequacy of tracheal reconstruction. This was a retrospective observational study of 61 patients with tracheal stenosis between the ages of 21 and 65 years who underwent tracheal reconstruction. The preoperative and postoperative values of various blood gas indices like partial pressure of oxygen (pO2), partial pressure of carbon dioxide (pCO2), and potential of hydrogen (pH) and airflow indices like forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) were evaluated and found that all the parameters showed significant improvement after tracheal reconstruction with P < 0.0001. Tracheal reconstruction resulted in improvement of oxygenation and airflow parameters which led to relief of symptoms. Hence, ABG can be used as a surrogate marker for denoting the success of the surgery.

Bronchial carcinoid: a neuroendocrine manifestation-presented as bronchospasm and hypertension during resection.

Bronchopulmonary carcinoid tumors are rare, slow-growing malignant neuroendocrine tumors. Early diagnosis is pivotal as surgical resection is the main stay of treatment. A 40-year-old female with typical bronchial carcinoid presented with complaints of breathlessness on mild to moderate exertion, intermittent productive cough, low-grade fever, and loss of appetite since 1 year. Right lobectomy was performed with regional lymph node resection; during resection of the tumor, manipulation led to a massive surge and fluctuations in blood pressure which were managed with deepening of the plane of anesthesia and administration of nitroglycerin infusion. She was discharged home in a good condition. Typical carcinoid tumor involves the central airways causing bronchial obstruction; however, in the present case, non-specific symptomatic presentation led to late detection. The outcome of typical carcinoids even with lymph node metastasis is excellent with complete resection; however, close follow-up is recommended due to a high incidence of recurrence.

Bioaccessibility and health risk assessment of arsenic in arsenic-enriched soils, Central India.

Incidental soil ingestion is expected to be a significant exposure route to arsenic for children because of the potentially high arsenic contents found in certain soils. Therefore, it is prudent to get information on oral bioaccessibility of arsenic following incidental soil ingestion and its relevance in health risk assessment for future remediation strategies. Soil samples were collected from eight villages of Ambagarh Chauki block, Chhattisgarh, Central India. The soils from seven villages had total arsenic content more than the background level of 10mgkg(-1) (ranged from 16 to 417mgkg(-1)), whereas the total arsenic content of soil from Hauditola was 7mgkg(-1). Bioaccessible arsenic assessed by the simplified bioaccessibility extraction test (SBET) ranged from 5.7 to 46.3%. Arsenic bioaccessibility was significantly influenced by clay content (R(2)=0.53, p<0.05, n=8), TOC (R(2)=0.50, p<0.05, n=8), Fe content (R(2)=0.47, p<0.05, n=8) and soil pH (R(2)=0.75, p<0.01, n=8). Risk assessment of the study sites showed that hazard index of arsenic under incidental soil ingestion was below 1 in all the study sites, except Kaudikasa. However, carcinogenic risk probability for arsenic to children from the villages Meregaon, Thailitola, Joratarai and Kaudikasa was below acceptable level (<1×10(-4)), suggesting potential health risk for children from these sites could not be overlooked. With high carcinogenic risk value (3.8E-05) and HI index (>1) for arsenic in soils of Kaudikasa, attention should be paid for development of remediation measure.

Endobronchial hydatid cyst causing variable intrathoracic airflow limitation selectively during expiration acting as a ball valve.

Lung hydatid cyst is a frequently encountered site of echinococcus infection after the liver. Rupture of endobronchial hydatid cyst may lead to hydatemesis or may spread to the normal lung or can cause anaphylactic reactions. Performing bronchoscopy in cases with bronchial hydatid is controversial. The thoracic hydatid cyst may destroy the native lung parenchyma or may cause mass effect on the surrounding structures. Ball valve obstruction of the bronchial hydatid cyst is not documented in the literature and here the authors present such a case as the recognition of the ball valve mechanism is important as it may cause tension pneumothorax. Supplementary information: The online version contains supplementary material available at 10.1007/s12055-023-01541-4.

Unmasking of severe mitral regurgitation after pericardiectomy.

Mitral valve prolapse in the young is the most common cause of mitral regurgitation (MR). Constrictive pericarditis (CP) is a chronic and end-stage manifestation of the inflammatory process of the pericardium. Apart from equalization of diastolic pressure of the chambers as well as increased ventricular interdependence, the thickened pericardial sheath in end-stage pericarditis fails to accommodate the intrathoracic venous return due to restricted cardiac chamber filling. Intracardiac valvular pathologies might co-exist in CP. This report presents a case in which effusive CP was associated with MR and highlights the pivotal role of intraoperative transesophageal echocardiography (TEE) in the decision-making of such co-existent lesions.

Effect of intravenous levosimendan or milrinone on left atrial pressure in patients undergoing off-pump coronary artery bypass grafting-A prospective double-blind, randomized controlled trial.

Background: Maintaining a low left atrial pressure (LAP) in off-pump coronary artery bypass grafting (OPCAB) is desirable. This study was done to compare the effects of intravenous levosimendan or milrinone on LAP at different stages of OPCAB. Materials and Methods: After institutional ethics committee clearance, this two-arm double-blind randomized control trial was done in 44 adult patients with triple vessel coronary artery disease undergoing OPCAB at cardiac OT of IPGME&R, Kolkata. The patients were randomly allocated into two groups receiving intraoperative either levosimendan or milrinone. Pulmonary capillary wedge pressure (PCWP) was compared as the primary outcome parameter, whereas other echocardiographic and hemodynamic parameters were also assessed during six stages of OPCAB, that is, after sternotomy, proximal(s), left anterior descending artery (LAD), obtuse marginal (OM), posterior descending artery (PDA) grafting, and before sternal closure. Numerical parameters were compared using Student's unpaired two-tailed t-test. Results: PCWP was found to be significantly lower (P < 0.05) in the levosimendan group during proximal (P = 0.047), LAD (P = 0.018), OM (P < 0.0001), PDA grafting (P = 0.028), and before sternal closure (P = 0.015). Other parameters indicate LAP, that is, from mitral early diastolic inflow velocity to mitral annular early diastolic velocity ratio (E/e'), which indicated significantly lower LAP in levosimendan group during LAD, OM, and PDA grafting and before sternal closure. Conclusion: Levosimendan may be used as a primary inotrope in terms of better reduction in left atrial pressure during different stages of OPCAB, translating to a decrease in left ventricular end-diastolic pressure, therefore maintaining optimum coronary perfusion pressure, which is the primary goal of the surgery.

Arsenic-induced health crisis in peri-urban Moyna and Ardebok villages, West Bengal, India: an exposure assessment study.

Drinking of arsenic (As)-contaminated groundwater has adverse effects on health of millions of people worldwide. This study aimed to determine the degree of severity of As exposure from drinking water in peri-urban Moyna and Ardebok villages, West Bengal, India. Arsenic concentrations in hair, nail and urine samp les of the individuals were determined. Arsenical dermatosis, keratosis and melanosis were investigated through medical evaluation. We have evaluated the association between As exposure from drinking water, and keratosis and melanosis outcomes. The results showed that 82.7 % of the sampled tube wells contain As concentrations above 10 µg/L, while 57.7 % contain As concentrations above 50 µg/L. The hair, nail and urine As concentrations were positively correlated with As concentrations in drinking water. In our study population, we observed a strong association between As concentrations ranging 51-99 µg/L and keratosis and melanosis outcomes, although the probability decreases at higher concentration ranges perhaps due to switching away from the use of As-contaminated tube wells for drinking and cooking purposes. High As concentrations in hair, nail and urine were observed to be associated with the age of the study population. The level of As concentrations in hair, nail and urine samples of the study population indicated the degree of severity of As exposure in the study region.

Human exposure to arsenic through foodstuffs cultivated using arsenic contaminated groundwater in areas of West Bengal, India.

The widespread incidence of chronic arsenicosis in the Bengal Delta has led to intensive research on arsenic (As) enrichment in groundwater as well as accumulation in foodstuffs, as there are potential health risks associated with exposure to As from both sources. This study deals with human As exposure through the drinking of groundwater, consumption of locally grown foodstuffs (e.g., crops and vegetables) and cooked food in Nadia district, West Bengal. Groundwater and foodstuffs were collected and analyzed with FI-HG-AAS to estimate the total As content. Urine samples collected from human subjects were analyzed to assess the As exposure. Two major crops, boro and aman rice, showed a considerable amount of As, with mean values of 194 and 156 µg kg(-1), respectively. Significant levels of As were also found in other common crops and vegetables cultivated in this area (for example, the mean As in Arum and radish was 780 and 674 µg kg(-1), respectively). Total intake of As from foodstuffs by adults (560 µg day(-1)) and children (393 µg day(-1)) in the area was found to be at alarming levels. Arsenic exposure was demonstrated by the presence of As in urine (ranging between 154 and 276 µg L(-1)), with overall As retention of 50-60 %. The results of this study further indicate the potential risk of As exposure to local inhabitants through the food chain which is associated with continuous consumption of As-contaminated foodstuffs. Therefore, more action needs to be taken to control the contamination pathways (such as the water-soil-crop system) to protect humans from continuous ingestion of As through foodstuffs.

The potential for reductive mobilization of arsenic [As(V) to As(III)] by OSBH(2) (Pseudomonas stutzeri) and OSBH(5) (Bacillus cereus) in an oil-contaminated site.

Microbial reduction of arsenate [As(V)] plays an important role in arsenic (As) mobilization in aqueous environments. In this study, we investigated reduction of arsenate by different bacterial isolates such as OSBH(1) (GU329913), OSBH(2) (GU329914), OSBH(3) (GU329915), OSBH(4) (GU329916) and OSBH(5) (GU329917), isolated from the oil sludge of a sewage treatment plant operated by the China Petroleum Refinery Company in Kaohsiung, southern Taiwan. Bacterial strains of pure culture were identified by 16S rRNA analysis (≥99 % nucleotide similarity). Morphological and 16S rRNA analysis show that the isolate OSBH(1) is similar to E. coli, OSBH(2) is similar to P. stutzeri, OSBH(3) is similar to P. putida, OSBH(4) is similar to P. aeruginosa, and OSBH(5) is similar to B. Cereus. The As(V) was transformed to As(III) in the presence of isolates OSBH(2) and OSBH(5) by a detoxification process. The potential reduction rates of As(V) were higher in the presence of isolate OSBH(5) compared to the isolate OSBH(2). The microbial growth (cell/mL) of isolate OSBH(5) was significantly higher in culture medium compared to OSBH(2). The bacterial isolates such as OSBH(1), OSBH(3) and OSBH(4) were found to be incapable of transforming the As(V). It is concluded that the activity of the oil-degrading bacterial isolates described in this work contributes to the mobilization of As in the more toxic As(III) form that affects biotic life.

Health risks for human intake of aquacultural fish: Arsenic bioaccumulation and contamination.

Aquacultural tilapia (Oreochromis mossambicus L.) and shrimp (Penaeus monodon L.) from groundwater-cultured ponds in southwestern Taiwan were analyzed to estimate arsenic (As) bioaccumulation and the potential health risk to human intake. Most of aquacultural ponds exhibited higher arsenic than maximum allowed concentrations (50 µg L(-1)) in pond water of Taiwan. Arsenic levels in tilapia in Budai, Yichu and Beimen were 0.92 ± 0.52 µg g(-1), 0.93 ± 0.19 µg g(-1) and 0.76 ± 0.03 µg g(-1), respectively and in shrimp was 0.36 ± 0.01 µg g(-1) in Beimen. Total arsenic in tilapia is highly correlated (R(2) = 0.80) with total arsenic concentration of pond water. Total arsenic in fish showed high correlation with that in bone (R(2) = 0.98), head (R(2) = 0.97) and tissue (R(2) = 0.96). Organic arsenic species (DMA) was found higher relative to inorganic species of As(III) and As(V). The average percent contribution of inorganic arsenic to total arsenic in fish samples was 12.5% and ranged between 11.7 to 14.2%. Bioaccumulation factors (BAFs) for total arsenic in fish ranged from 10.3 to 22.1, whereas BAF for inorganic arsenic ranged from 1.33 to 2.82. The mean human health cancer risk associated with the ingestion of inorganic arsenic in the fish was estimated at 2.36 × 10(-4) ± 0.99 × 10(-4), which is over 200 times greater than a de Minimus cancer risk of 1 × 10(-6). The mean human health hazard quotient associated with ingesting inorganic arsenic in the fish was 1.22 ± 0.52, indicating that expected human exposure exceeds the reference dose for non-cancer health effects by 22%. These results suggest that the inhabitants in this region are being subjected to moderately elevated arsenic exposure through the consumption of tilapia and shrimp raised in aquaculture ponds.

Arsenic-enriched groundwaters of India, Bangladesh and Taiwan--comparison of hydrochemical characteristics and mobility constraints.

Arsenic (As) enrichment in groundwater has become a major global environmental disaster. Groundwater samples were collected from 64 sites located in the districts of 24-Parganas (S), and Nadia in West Bengal, India (Bhagirathi sub-basin), and 51 sites located in the districts of Comilla, Noakhali, Magura, Brahman baria, Laxmipur, Munshiganj, Faridpur and Jhenaida in Bangladesh (Padma-Meghna sub-basin). Groundwater samples were also collected from two As-affected areas (Chianan and Lanyang plains) of Taiwan (n = 26). The concentrations of major solutes in groundwater of the Padma-Meghna sub-basin are more variable than the Bhagirathi sub-basin, suggesting variations in the depositional and hydrological settings. Arsenic concentrations in groundwaters of the studied areas showed large variations, with mean As concentrations of 125 µg/L (range: 0.20 to 1,301 µg/L) in Bhagirathi sub-basin, 145 µg/L (range: 0.20 to 891 µg/L) in Padma-Meghna sub-basin, 209 µg/L (range: 1.3 to 575 µg/L) in Chianan plain, and 102 µg/L (range: 2.5 to 348 µg/L) in Lanyang plain groundwater. The concentrations of Fe, and Mn are also highly variable, and are mostly above the WHO-recommended guideline values and local (Indian and Bangladeshi) drinking water standard. Piper plot shows that groundwaters of both Bhagirathi and Padma-Meghna sub-basins are of Ca-HCO(3) type. The Chianan plain groundwaters are of Na-Cl type, suggesting seawater intrusion, whereas Lanyang plain groundwaters are mostly of Na-HCO(3) type. The study shows that reductive dissolution of Fe(III)-oxyhydroxides is the dominant geochemical process releasing As from sediment to groundwater in all studied areas.

Role of organic matter and humic substances in the binding and mobility of arsenic in a Gangetic aquifer.

Arsenic (As) enrichment in groundwater has led to extensive research, particularly on the factors responsible for its release into groundwater. In the Gangetic plain, organic matter driven microbial reduction of Fe-oxyhydroxides is considered as the most plausible mechanism of As release into groundwater. However, the role of organic matter in the aqueous environment is not well known and particularly that of organometallic complex. In this study, we have characterized bulk sediment and groundwater samples, collected from Barasat, West Bengal, India, to understand the effect of organic matter in the binding and mobility of As in the subsurface environment. The results showed a moderate correlation (R(2) = 0.49, p < 0.05) between dissolved organic carbon (DOC) and As in groundwater, suggesting that DOC has a role in releasing As into groundwater. The relative fluorescent intensity (RFI) of the dissolved humic substances in groundwater showed a maximum value of 65 QSU (mean: 47 ± 8 QSU). FT-IR spectra of the extracted humic acid fractions of the sediment showed COO-, C = O, OH, and C = C (aromatic ring) functional groups, which may act as a chelating agents with the metal(loid)s. FT-IR spectra of the HA-As complex exhibited specific peaks at 1242 and 832 cm(-1) in the fingerprint region. This is similar to the extracted humic acid fractions of the Gangetic sediment, suggesting binding of As with humic substances.

Biogeochemical characteristics of Kuan-Tzu-Ling, Chung-Lun and Bao-Lai hot springs in southern Taiwan.

Hot springs are the important natural sources of geothermally heated groundwater from the Earth's crust. Kuan-Tzu-Ling (KTL), Chung-Lun (CL) and Bao-Lai (BL) are well-known hot springs in southern Taiwan. Fluid and mud (sediments) samples were collected from the eruption points of three hot springs for detailed biogeochemical characterization. The fluid sample displays relatively high concentrations of Na(+) and Cl(-) compared with K(+), Mg(2+), Ca(2+), NO(2) (-), and SO(4) (2-), suggesting a possible marine origin. The concentrations of Fe, Cr, Mn, Ni, V and Zn were significantly higher in the mud sediments compared with fluids, whereas high concentrations of As, Ba, Cu, Se, Sr and Rb were observed in the fluids. This suggests that electronegative elements were released during sediment-water interactions. High As concentration in the fluids was observed to be associated with low redox (Eh) conditions. The FTIR spectra of the humic acid fractions of the sediments showed the presence of possible functional groups of secondary amines, ureas, urethanesm (amide), and silicon. The sulfate-reducing deltaproteobacterium 99% similar to Desulfovibrio psychrotolerans (GU329907) were rich in the CL hot spring while mesophilic, proteolytic, thiosulfate- and sulfur-reducing bacterium that 99% similar to Clostridium sulfidigenes (GU329908) were rich in the BL hot spring.

Biogeochemical interactions among the arsenic, iron, humic substances, and microbes in mud volcanoes in southern Taiwan.

Fluid and mud samples collected from Hsiaokunshui (HKS), Wushanting (WST), Yenshuikeng (YSK), Kunshuiping (KSP), Liyushan (LYS), and Sinyangnyuhu (SYNH) mud volcanoes of southwestern Taiwan were characterized for major ions, humic substances (HS) and trace elements concentrations. The relationship between the release of arsenic (As) and activities of sulfate-reducing bacteria has been assessed to understand relevant geochemical processes in the mud volcanoes. Arsenic (0.02-0.06 mg/L) and humic substances (4.13 × 10(-4) to 1.64 × 10(-3) mM) in the fluids of mud volcanoes showed a positive correlation (r = 0.99, p < 0.05) except in Liyushan mud volcano. Arsenic and iron in mud sediments formed two separate groups i) high As, but low Fe in HKS, WST, and SYNH; and ii) low As, but high Fe in the YSK, KSP, and LYS mud volcanoes. The Eh(S.H.E.) values of the mud volcano liquids were characterized by mild to strongly reducing conditions. The HKS, SYNH, and WST mud volcanoes (near the Chishan Fault) belongs to strong reducing environment (-33 to -116 mV), whereas the LYS, YSK, and KSP mud volcanoes located near the coastal plain are under mild reducing environment (-11 to 172 mV). At low Eh values mud volcanoes, saturation index (SI) values of poorly crystalline phases such as amorphous ferric hydroxide indicate understaturation, whereas saturation is reached in relatively high Eh(S.H.E.) values mud volcanoes. Arsenic contents in sediments are low, presumably due to its release to fluids (As/Fe ratio in YSK, KSP, and LYS sediment: 4.86 × 10(-4)-6.20 × 10(-4)). At low Eh(S.H.E.) values (mild to strong reducing environment), arsenic may co-precipitate with sulfides as a consequence of sulfate reduction (As/Fe ratios in WST, HKS, and SYNH sediments: 0.42-0.69).

Metallic components of traffic-induced urban aerosol, their spatial variation, and source apportionment.

This study proposes a practical method to estimate elemental composition and distribution in order to attribute source and quantify impacts of aerosol particles at an urban region in Kolkata, India. Twelve-hour total particulates were collected in winter (2005-2006) and analyzed by energy-dispersive X-ray fluorescence technique to determine multi-elemental composition, especially trace metals. The aerosols consist of various elements including K, Ca, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Se, and Pb which exhibit significant concentration at various sites (p < 0.05). The concentration of different metallic elements were found in the order of Zn > Pb > Ni > Cu > Cr > Co. Statistical multivariate analysis and correlation matrix analyses were performed for factor identification and consequent source apportionment. Contour profiles demonstrate spatial variation of elemental compositions indicating possible source contribution along with meteorological influences. Spatial differences were clearly most significant for Zn, Ni, Pb, and Cu reflecting the importance of anthropogenic inputs, primarily from automobile sources.

Assessment of ventricular function in patients of atrial septal defect by strain imaging before and after correction.

Background: Atrial septal defect (ASD) is a common congenital heart disease associated with volume overload of Right ventricle (RV) with variable effect on Left ventricle (LV). Two-dimensional (2D) Strain analysis is a new tool for objective analysis of myocardial function. This prospective study evaluated the systolic function of right and left ventricle by conventional 2D echo and strain echo and measured changes in cardiac hemodynamics that occurred in patients of ASD before and after correction. Patients and Methods: 2D echo and strain analysis of each patient before and at 48 hrs, 3 months and 6 months after correction was performed. Routine 2D echo parameters and global longitudinal strain of both ventricles were measured. Result: Improvement in LV ejection fraction (P = 0.0001) and myocardial performance index (MPI) (P < 0.0001) occurred at the end of 6 months, whereas decrease in RV MPI (P < 0.0001) and tricuspid annular plane systolic excursion (P < 0.0001) became statistically significant after 3 months of ASD correction. In comparison to conventional 2D echo, global longitudinal strain of RV decreased significantly only after 48 hours of ASD correction while there was no improvement in left ventricular global longitudinal strain after 6 month of correction. Conclusion: There was improvement in RV function with subtle change in LV function by strain imaging and most of these changes were completed within 6 months of ASD correction and nearly correlated with conventional 2DEchocardiography.

Difference in attenuation among Mn, As, and Fe in riverbed sediments.

We report, for the first time, a detailed study at river water and hyporheic zone systems through collection and analyses of shallow sediments and selected source rocks, pore water, and river water from forty-two locations at the Chianan Plain (CP), SW Taiwan. The study was focused to understand the possible changes in the river water and sediment chemistry as a consequence of high arsenic (mean±SD=71.28±16.24µg/L, n=46) groundwater discharge to three major rivers in the plain. The study shows, except few locations, As concentration in river sediments corresponds to average As concentration in soil and upper crustal abundance and of source rock. Sequential extraction indicates that As is mostly bound to FeOOH. No enrichment of arsenic in river sediments or depletion of aqueous As and iron in pore water was observed down to the maximum sampling depth of 1.7m although manganese is enriched in sediments. Dissolved As concentrations in the river sediments are much lower compared to the hotspots in the CP aquifers. This suggests that no As attenuation processes are active or they cannot be detected in this zone. Mn precipitates at higher redox level compared to Fe and As and thus attenuates in the studied zone.

Current concepts of diagnosis and management of pericardial cysts.

Pericardial cysts are rare with an incidence of about 1 in every 100,000 persons and one in 10 pericardial cysts may actually be a pericardial diverticulum. Pericardial cysts and diverticula share similar developmental origin and may appear as an incidental finding in chest roentgenogram in an asymptomatic patient. CT scan is considered as best modality for diagnosis and delineation of the surrounding anatomy. Cardiac MRI is recommended in the evaluation of the compressive effects caused by the pericardial cysts. The authors recommend echocardiography for serial follow up and image guided aspiration of the pericardial cyst in presence of compressive effects leading to cardiovascular and airway symptoms. A systematic approach is desirable for management of pericardial cysts depending on size, shape and compression effects, symptoms and easy access to serial Echocardiographic follow up. However, pericardial diverticulum may not be differentiated from cysts by the above testing, and only identified at surgery.

Assessment of ventricular function in patients of atrial septal defect by strain imaging before and after correction

Background: Atrial septal defect (ASD) is a common congenital heart disease associated with volume overload of Right ventricle (RV) with variable effect on Left ventricle (LV). Two-dimensional (2D) Strain analysis is a new tool for objective analysis of myocardial function. This prospective study evaluated the systolic function of right and left ventricle by conventional 2D echo and strain echo and measured changes in cardiac hemodynamics that occurred in patients of ASD before and after correction. Patients and Methods: 2D echo and strain analysis of each patient before and at 48 hrs, 3 months and 6 months after correction was performed. Routine 2D echo parameters and global longitudinal strain of both ventricles were measured. Result: Improvement in LV ejection fraction (P = 0.0001) and myocardial performance index (MPI) (P < 0.0001) occurred at the end of 6 months, whereas decrease in RV MPI (P < 0.0001) and tricuspid annular plane systolic excursion (P < 0.0001) became statistically significant after 3 months of ASD correction. In comparison to conventional 2D echo, global longitudinal strain of RV decreased significantly only after 48 hours of ASD correction while there was no improvement in left ventricular global longitudinal strain after 6 month of correction. Conclusion: There was improvement in RV function with subtle change in LV function by strain imaging and most of these changes were completed within 6 months of ASD correction and nearly correlated with conventional 2DEchocardiography.