Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread around the world. As of end June 2021, there were approximately 181 million confirmed cases and more than 3.9 deaths across globe. The colossal impact disease 2019 (COVID-19) is driving biggest vaccination campaign in human history. All 3 vaccines authorized for emergency use by US Food Drug Administration (Pfizer-BioNTech, Moderna, Janssen/Johnson & Johnson) have been thoroughly studied found be safe effective...

Transcatheter aortic valve replacement (TAVR) techniques are rapidly evolving, and results of published trials suggest that TAVR is emerging as the standard care in certain patient subsets a viable alternative to surgery others. As relatively new procedure continues gain its acceptance, rare procedural complications will continue appear. Our case about an 89-year-old male with extensive past medical history who presented progressive exertional dyspnea angina secondary severe stenosis....

Introduction: Breast carcinoma is the most common malignancy in women. Unlike IDC, which typically metastasizes to lung, liver or bone, ILC has been found metastasize GI tract, peritoneum and retroperitoneum. Nonspecific symptomology may be considered secondary other diseases this can delay definite diagnosis treatment of metastatic disease. Knowledge pattern disease spread essential for accurate early initiation systemic treatment, thus avoiding unnecessary interventions. We are reporting...

Abstract Introduction Invasive aspergillosis is a serious complication in immunocompromised patients. It an opportunistic disease, which predominantly occurs the lungs, although dissemination to virtually any organ possible. immunocompetent patient with extension mediastinum has rarely been reported. Here, we present case of no apparent immunodeficiency state, who presented Aspergillus endocarditis and fulminant invasive extensive involvement mediastinal structures, ultimately was...

As a medical resident we have always been taught that there is some sort of cross reactivity between sulfonamide antibiotics and nonantibiotic sulfonamides. Even the manufacturer’s package inserts contain precautionary statement about possible Cross-reactivity. The most common approach to this problem avoidance all sulfa containing drugs. However, are few data supporting contraindication. Thus may be withholding appropriate therapies from patients unnecessarily. To provide critical...

We report a 35 year old female patient referred to our ultrasound department rule out congenital anomalies. The fetus was found have completely formed brain, base of the skull and facial structures but lacking cranium. therapeutically aborted. correlated antenatal sonographic findings with gross pathological features CT Scan fetal head. Despite an extensive search, aborted brain were not in literature.

The best combination of access site and anticoagulant used during primary percutaneous coronary intervention (PCI) in patients presenting with ST segment elevation myocardial infarction is not known.We conducted a retrospective cohort study all >18 years age who underwent PCI 2 large regional centers Massachusetts between 2012 2014. was divided into 3 groups: bival/fem, hep/rad, or off-protocol, based on anticoagulation used. We multiple logistic regression model to compare major...

Context: Chest pain is widely considered a key symptom in the diagnosis of myocardial infarction, although not all patients with MI present chest pain. Objectives: To determine frequency which without and finding elements history atypically presesnting that may be helpful to clinician identifying atypical MI. Design: Descriptive type study. Place Duration Study: The study was conducted for duration 3.5 months (16-07-07 30-10-07) CCU large Tertiary Care Hospital i.e. Holy Family Rawalpindi...

Abciximab reduces major adverse cardiac events in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention (pPCI). Standard protocol is intravenous abciximab bolus during PCI plus infusion for 12-18 h post pPCI. Intracoronary (IC) administration results high local drug concentrations and hence it should have higher antiplatelet effect. In this study, we assess the short-term efficacy safety of IC compared to IV ACS pPCI.We clinical outcomes...

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Warfarin is a commonly used oral anticoagulant in the treatment of many major chronic illnesses. Early diagnosis and discontinuation warfarin are crucial for better prognosis. We sharing an interesting case warfarin-induced skin necrosis to increase physician awareness as induced difficult differentiate from some other dermatologic conditions. This also illustrates that high degree suspicion combined with clinical history, laboratory findings sometimes biopsy required make diagnosis.

Journal of the American Society Nephrology 31(10S):p 815-816, October 2020. | DOI: 10.1681/ASN.20203110S1815d

Journal of the American Society Nephrology 31(10S):p 723-724, October 2020. | DOI: 10.1681/ASN.20203110S1723d

Plasma proBNP levels are increased in patients with acute myocardial infarction. Previous studies have shown conflicting data on the effect of transient ischemia plasma BNP levels. We designed current study to examine during a percutaneous coronary intervention (PCI). This was as marker ischemia.We enrolled 49 consecutive history angina or abnormal stress test who presented for cardiac catheterization. obtained all at 1) arterial access (proBNP-1), 2) end procedure (proBNP-2) and 3) 4 hours...

Background: The combination of ankle brachial index (ABI) and other risk stratification tools has been evaluated previously. However baseline ABI in patients admitted for chest pain prior to stress testing predict increased probability abnormal test MACE (major cardiovascular adverse events) not studied. Methods: Patients (n= 342) with normal or unchanged electrocardiogram negative troponin T who were referred myocardial perfusion study enrolled this prospective observational followed one...