Perioperative challenges and management strategies for non-cardiac surgery in patients with rheumatic heart diseases: A narrative review.

Rheumatic heart diseases (RHDs) impose a substantial global burden, primarily affecting individuals under 25 years of age in low- and medium-income countries (LMICs) and poor and marginalized groups in high-income countries.[123] The underlying cause is a group A beta-hemolytic streptococcus, which triggers an immune-mediated attack on the heart and joints. Although acute rheumatic fever (ARF) is treatable, its occurrence and complications remain high in impoverished areas.

Living in disadvantaged neighborhoods linked to less intervention for severe aortic stenosis.

To investigate the association between area deprivation index (ADI) and aortic valve replacement (AVR) in patients with severe aortic stenosis (AS). Patients aged 40-95 years with severe AS confirmed by echocardiography were included. The 9-digit zip code of patient residence address was used to identify the ADI ranking, based on which patients were divided into 5 groups (with Group E being most deprived).

Effect of ureteric access sheath on outcomes of retrograde intrarenal surgery for renal stone disease: a randomized controlled trial.

Background: The need of ureteric access sheath (UAS) in retrograde intrarenal surgery (RIRS) has been controversial for gaining high success in terms of stone free rate (SFR), reducing operative times and complications. There has been lack of high level of evidence in the literature on this topic.

Materials And Methods: This prospective randomized controlled trial (RCT) was conducted in the Department of Urology, PGIMER, Chandigarh from July 2019 to Dec 2021.

TAVR explant with aortic root replacement using a homograft for an aortic rupture.

This case report describes the explantation of an Evolut PRO valve 9 months after implantation in a 69-year-old male presenting with an aortic rupture adjacent to the stent frame of the prosthesis. Imaging was consistent with aortic sinus pseudoaneurysm and a large haemopericardium. Degeneration of the aortic root compounded by the transcatheter prosthesis in addition to the aortic rupture required replacement of the aortic root.

Direct relationship between transvalvular velocity and cardiac dysfunction, morbidity, and mortality in patients with aortic stenosis.

Objective: Current guidelines recommend intervention in subjects with severe symptomatic aortic stenosis (AS), even though any degree of AS is associated with a higher risk of mortality. We investigated the association between the degree of AS, delineated by transvalvular flow velocity, and patient morbidity and mortality.

Methods: Medically managed patients aged 40-95 years with maximum flow velocity (V ) by echocardiography between 2013 and 2018 were stratified into five groups (A-E) based on the 75th, 90th, 97.

Comprehensive review of hybrid aortic arch repair with focus on zone 0 TEVAR and our institutional experience.

Even with increasing operator experience and a better understanding of the disease and the operation, intervention for aortic arch pathologies continues to struggle with relatively higher mortality, reintervention, and neurologic complications. The hybrid aortic arch repair was introduced to simplify the procedure and improve the outcome. With recent industry-driven advances, hybrid repairs are not only offered to poor surgical candidates but have become mainstream.

Screening Tool to Identify Patients with Advanced Aortic Valve Stenosis.

(1) Background: The clinical burden of aortic stenosis (AS) remains high in Western countries. Yet, there are no screening algorithms for this condition. We developed a risk prediction model to guide targeted screening for patients with AS.

One and Five-Year Mortality Risk Prediction in Patients with Moderate and Severe Aortic Stenosis.

(1) Background: Our goal was to develop a risk prediction model for mortality in patients with moderate and severe aortic stenosis (AS). (2) Methods: All patients aged 40−95 years, with echocardiographic evidence of moderate and severe AS at a single institution, were studied over a median of 2.8 (1.

Utility of WhatsApp in emergency urological practice: An interrater reliability study.

Introduction: The messaging application 'WhatsApp' is used in clinical practice, often for communication between a medical trainee and a consultant. We designed this study to find the interrater reliability of the data transmitted through this application and validating its use in urological practice.

Materials And Methods: Clinical details and computerized tomographic (CT) images of 30 patients visiting the urology emergency were posted in a closed WhatsApp group involving three consultants (SKD, APS, and KC).

Atrophic Kidney-Like Lesion - Case Report of A Provisional Entity with Brief Review of Literature.

Atrophic kidney-like lesion is a recently recognized entity, post 2016 World Health Organization Classification of tumors of the urinary system. The behavior of this tumor is not fully known as only a handful of cases with limited follow-up are available. This entity closely mimics thyroid-like follicular carcinoma of the kidney, which has different prognosis.

Alternate accesses for transcatheter aortic valve replacement: A network meta-analysis.

Background: When transfemoral (TF) access is contraindicated in patients undergoing transcatheter aortic valve replacement (TAVR), alternate access strategies are considered. The choice of one alternate access over the other remains controversial.

Methods: Following a comprehensive literature search, studies comparing any combination of TF, transapical (TA), transaortic (TAo), transcarotid (TC), and trans-subclavian (TS) TAVR were identified.

Comparison of efficacy of three commonly used alpha-blockers as medical expulsive therapy for distal ureter stones: A systematic review and network meta-analysis.

Introduction: The efficacy of alpha-blockers as medical expulsive therapy (MET) is well established. However, it is not known which of the three most commonly used alpha-blockers (tamsulosin, alfuzosin and silodosin) is the most efficacious. With this study we aimed to assess the efficacy of the three commonly used alpha-blockers as MET for distal ureter stones.

Relationship of surgeon experience and outcomes of surgery for degenerative mitral valve disease.

Objective: To assess the impact of surgeon experience on the outcomes of degenerative mitral valve disease.

Methods: We reviewed all patients who had surgery for degenerative mitral valve disease between 2011 and 2016. Experienced surgeon was defined as performing ≥ 25 mitral valve operations/year.

Variants of the aortic arch in adult general population and their association with thoracic aortic aneurysm disease.

Background: Query a single institution computed tomography (CT) database to assess the prevalence of aortic arch anomalies in general adult population and their potential association with thoracic aortopathies.

Methods: CT chest scan reports of patients aged 50-85 years old performed for any indication at a single health system between 2013 and 2016 were included in the analysis. Characteristics of patients with and without aortic arch anomalies were compared by t test and Fisher exact tests.

Xanthogranulomatous pyelonephritis: a rare presentation of disbelieved renal cell cancer recurrence after nephron-sparing surgery.

Xanthogranulomatous pyelonephritis is a rare, painful inflammatory subtype of chronic renal infection, which can lead to severe parenchymal destruction. It imitates virtually every other renal inflammatory disease. We report a 51-year-old male presenting with left flank pain, on evaluation found to have a renal mass with a history of nephron-sparing surgery in the same kidney performed 6 months previously.

Intraoperative retrograde TEVAR to control endoleak after emergent total arch replacement and frozen elephant trunk repair for ruptured Kommerell's diverticulum.

We report an emergent complex hybrid repair of a type A intramural hematoma with a tear of the aortic arch at the site of Kommerell's diverticulum and an aberrant right subclavian artery. We identified a type IA endoleak intraoperatively, which was managed immediately with proximal extension. Performing this operation in the hybrid operating room facilitated optimal surgical management.

A Rare Cause of Acute Abdomen: Testicular Torsion in an Inguinal Undescended Testis.

Testicular torsion is well-known urologic emergency. It warrants urgent diagnosis and surgical intervention for successful outcomes. The incidence of undescended testis in new born is 2%-8% and reduces to <1% by 1 year of age.

Reloadable Silk-Hydrogel Hybrid Scaffolds for Sustained and Targeted Delivery of Molecules.

Tunable repeated drug administration is often inevitable in a number of pathological cases. Reloadable 3D matrices for sustained drug delivery are predicted as a prospective avenue to realize this objective. This study was directed toward sonication-induced fabrication of novel reloadable Bombyx mori silk fibroin (SF) (4, 6, and 8 wt %) hydrogel, injected within 3D porous (8 wt %) scaffolds.

Fabrication and Mechanical Characterization of Hydrogel Infused Network Silk Scaffolds.

Development and characterization of porous scaffolds for tissue engineering and regenerative medicine is of great importance. In recent times, silk scaffolds were developed and successfully tested in tissue engineering and drug release applications. We developed a novel composite scaffold by mechanical infusion of silk hydrogel matrix into a highly porous network silk scaffold.

Moderate Aortic Stenosis and Coronary Artery Bypass Grafting: Clinical Update for the Perioperative Echocardiographer.

Incidental aortic stenosis in the setting of coronary artery bypass surgery may be a perioperative challenge. The accurate assessment of the degree of aortic stenosis remains an important determinant. Although severe aortic stenosis is an indication for valve replacement, current guidelines advise a balanced approach to the management of moderate aortic stenosis in this setting.