Coronavirus and cardiovascular manifestations-getting to the heart of the matter

Coronavirus disease has unarguably been the largest pandemic of recent times. Over 150 million cases have occurred worldwide, and more than 3 million have succumbed to the disease. Cardiac manifestations can have varied presentations from an asymptomatic troponin rise to fulminant myocarditis. The pathogenesis of myocardial damage could be direct or indirect, including inflammation, coronary spasm, plaque rupture, and cytokine storm. Thromboembolism is also an important feature of cardiovascular affliction with both arterial and venous systems being affected. Hence, anticoagulation has also been a matter of debate. Fulminant myocarditis is the most severe form and can lead to circulatory shock with a high mortality. Management of cardiac patients with coronavirus disease 2019(COVID-19) infection is not considerably different from non-COVID-19 cardiovascular disease, but interaction between cardiovascular drugs and antiCOVID-19 therapy requires careful attention. More recently, vaccines have emerged as a ray of hope for the disease. But simultaneously, there have been reports of thromboembolism following vaccination. In this review, we discuss the various aspects of coronavirus disease affecting of heart and its management.     

Clinical and radiographic evaluation of bone tumors

Timely diagnosis of osseous tumors is essential in providing proper management. Appropriate imaging studies are essential to this process, however, if inconclusive, they can be superceded by information obtained through the patient history and physical examination. Disclaimer: Dr. Bhandari's salary was provided, in part, by a scholarship from the R.K Frasier Research Foundation     

Effect of Pre-sowing Treatments on Seed Germination Behavior of <Emphasis Type="Italic">Hedychium spicatum</Emphasis> Buch.-Ham ex Smith

Propagation through seeds is considered useful for maintaining of genetic diversity. Seed germination behavior of a threatened species, Hedychium spicatum in relation to different plant growth regulators (PGRs) was studied under mist chamber conditions. Duration of pre-sowing of seeds in different concentrations of different PGRs was observed to have important role in improving seed germination and help in reducing mean germination time. Among various treatments, incubation of seeds in indole-acetic acid (100 µg ml^?1) for 24 h showed highest germination of 95.83 ± 3.6 % with mean germination time of 84.00 ± 7.0 days. On the contrary non-treated seeds exhibited only 37.50–60.42 % germination. Imbibition by the seeds was fast in first 2 h and then it increased gradually up to 24 h thus confirming that 24 h is sufficient to imbibe the PGRs. PGRs are also found useful in reducing time for initiation of germination, time for maximum germination, mean germination time and germination rate. The result recommends indole-acetic acid (concentration of 100 µg ml^?1) with 24 h of pre-sowing incubation for better germination.     

Reconstructive challenges in war wounds

War wounds are devastating with extensive soft tissue and osseous destruction and heavy contamination. War casualties generally reach the reconstructive surgery centre after a delayed period due to additional injuries to the vital organs. This delay in their transfer to a tertiary care centre is responsible for progressive deterioration in wound conditions. In the prevailing circumstances, a majority of war wounds undergo delayed reconstruction, after a series of debridements. In the recent military conflicts, hydrosurgery jet debridement and negative pressure wound therapy have been successfully used in the preparation of war wounds. In war injuries, due to a heavy casualty load, a faster and reliable method of reconstruction is aimed at. Pedicle flaps in extremities provide rapid and reliable cover in extremity wounds. Large complex defects can be reconstructed using microvascular free flaps in a single stage. This article highlights the peculiarities and the challenges encountered in the reconstruction of these ghastly wounds.KEY WORDS: Delayed reconstruction, reconstructive challenges, war wound, wound debridement