To assess the association between obstetricians' years of experience after training and maternal complications their patients during first 40 post-residency practice.Retrospective cohort analysis.Obstetrical discharges from acute care hospitals in Florida New York academic 1992 2009.6,704,311 deliveries performed by 5175 obstetricians.Three composite measures complication rates per physician year vaginal cesarean births separately combined, adjusted for secular trends.Obstetricians' declined...

Isolated left main coronary artery (LMCA) ostial disease is a rare variant of LMCA disease. Earlier studies on this are limited by small number patients enrolled. The aim the present study was to analyze incidence, risk factors, clinical profile and long term outcome with isolated disease.15,553 who underwent angiogram in single tertiary care cardiac hospital were analyzed for 351(2.2%) found have significant out which 28(0.18%) had These 28 compared 323 non-ostial non-isolated patients.The...

A 5-month-old baby, weighing 4 kg presented with a 3-month history of failure to thrive and recurrent lower respiratory tract infection (RTI). She was delivered at term 2.8 kg the perinatal period uneventful. Saturation clinical examination normal there were no abnormal auscultation findings or murmur. Chest x-ray had cardiac pulmonary contours while previous x-rays evidence RTI involving right lung. An echocardiogram showed congenital heart disease (CHD) shunts left ventricular volume overload …

Ventricular septal rupture (VSR) is a rare but feared complication after myocardial infarction (MI). The objective of this study was to investigate the effects thrombolytic therapy on patterns VSR following MI.30 consecutive patients admitted single tertiary level cardiac hospital with diagnosis acute MI and developed in were included. effect formation its clinical outcome studied.Out 30 patients, 15 received therapy.10 early (<12h) 5 late (>12h). median time post significantly shorter...

Thrombus formation in left ventricular outflow tract ( LVOT ) of a normal heart is very rare occurrence. A 23‐year‐old male who presented with syncope, on evaluation found to have obstructing mass the . His was otherwise normal. investigations were not contributory except for significant eosinophilia. Due recurrence syncope he underwent emergency surgery extraction mass, which histopathological examination be organizing thrombus. eosinophil count normalized after surgery. Tests...

A 4-month-old male infant presented with recurrent cough for 2 months. He had a shortened right upper limb absent thumb and continuous murmur in the left parasternal area. The X-ray showed an radius first metacarpal phalyngeal bones on side. Echocardiogram revealed aortopulmonary window small secundum atrial septal defect. Aortopulmonary was successfully treated by device closure. Holt–Oram syndrome is extremely rare association.

Description of the Case Report: A 44-year-old female with a past medical history unspecified skin cancer presented exertional dyspnea for 1 day before admission and syncope 7 months admission. Physical exam was noted soft low low-pitched diastolic murmur at cardiac apex, not appreciated on prior exam. Echocardiography revealed 3.3x4.7 cm pedunculated, homogenous mass in left atrium obstructing mitral valve. Serum BNP measured as 326. An echocardiogram from less than 29 reviewed showed no...

Introduction: Early recognition of cardiac arrest with bystander cardiopulmonary resuscitation (CPR), and early defibrillation when appropriate, can improve outcomes after Out Hospital Cardiac Arrest (OHCA). Data from the national registries indicate there are both regional as well racial ethnic differences in rates CPR witnessed OHCA cases significantly lower non-white persons. However, Hispanic border populations underrepresented these studies. University Medical Center (UMC) El Paso,...

Wernicke's encephalopathy, the acute phase of Wernicke-Korsakoff syndrome, is characterised as a triad altered mental status, ocular signs and ataxia. Our patient presented with hyperemesis gravidarum, which rare aetiology Wernicke’s encephalopathy. The did not have any oculomotor abnormalities, are more common classically described in triad. sudden visual loss both eyes can be attributed to optic neuropathy. case highlights unique ophthalmic presentation retinal haemorrhages disc oedema...

A 45-year-old man presented with swelling on the right side of chest, which he had for previous 3 months. Examination revealed pulsatile in infraclavicular area.

Coronary artery perforation is a rare but catastrophic complication of percutaneous coronary intervention (PCI). Grade III and rupture invariably results in pericardial effusion tamponade requiring urgent pericardiocentesis. Advances have increased the opportunity to treat perforation. We are reporting case 55 years old hypertensive female who presented with effort angina. angiogram revealed significant stenosis left anterior descending artery. Post PCI, she had Ellis type cardiogenic shock....

A 56-year-old man with multiple risk factors undergoing evaluation for chest pain developed ST elevations in leads during exercise stress test. These were not classical of ischaemic pattern. The coronary angiogram showed normal coronaries. false-positive elevation was due to an error the computer-synthesised averaging algorithm.

Background: We are presenting a rare case of large non-familial left atrial myxoma in fourteen year old girl which presented clinically similar to severe mitral stenosis was the first clinical differential diagnosis considered initially. She had symptoms progressively worsening orthopnea and exertional dyspnea since last 2-3 months (NYHA class III symptom status). The final made after echocardiography surprising diagnosed have causing obstruction valve preventing normal inflow across valve....

Mini‐Abstract A 46‐year‐old male with known rheumatic heart disease presented in cardiac arrest. He was successfully resuscitated. Two‐dimensional echocardiography showed severe calcific mitral stenosis pinhole opening of the valve. The valve area planimetry 0.14 cm 2 . Three‐dimensional confirmed severity stenosis. Patient underwent successful replacement tricuspid annuloplasty, Left atrial size reduction, and maze procedure on emergency basis. is rarely encountered clinical practice.

A 35-year-old man presented with effort angina for 3 months. He was a chronic smoker and had history of anterior wall myocardial infarction 6 months before admission. not thrombolysed managed conservatively at that time and, since then, he on medical treatment. Examination did reveal any significant findings. Electrocardiogram showed q waves T wave inversions in chest leads. Echocardiogram regional motion abnormality the septum ejection fraction 45%. Coronary angiogram revealed total...

A 60-year-old woman presented with breathlessness for 6 months. On examination, she had dilated veins in the neck and chest direction of blood flow downwards suggesting superior vena cava (SVC) obstruction (figure 1A). Chest auscultation revealed diminished breath sounds on right side. X-ray showed mediastinal widening soft-tissue density lesion upper-right hemithorax 1B). Transthoracic echocardiogram globular mass atrium (RA) obstructing tricuspid valve 1C online supplementary video 1)....