Nasal glioma- a diagnostic challenge

Summary  In this unusual case there was a difficulty in diagnosis on the basis of histopathological reporting. On the grounds of clinical suspiscion one has to try to find out the proper diagnosis by advanced diagnostic methods like immunohistochemistry.     

Catheter ablation of the atrioventricular node using radiofrequency energy

Background: Catheter ablation of the atrioventricular (AV) junction using stored direct current (DC) energy from a standard DC Cardioverter defibrillator was first reported in 1982. Since then many patients have been treated using this procedure for refractory supraventricular arrhythmias, usually atrial fibrillation and flutter. Undesirable thermal effects such as barotrauma and arcing are largely responsible for complications associated with the use of DC energy. This report details our experience of catheter ablation of the AV junction using radiofrequency (RF) energy in a series of 30 consecutive patients. Methods: RF ablations were performed using steerable Mansfield (Webster Laboratories) 4 mm tipped electrodes and locally assembled RF energy delivery system. Results: The procedure was successful in 27/30 (90%) patients using RF energy, while three patients required DC energy to achieve successful AV junction ablation. General anaesthesia was required in nine patients, six of whom required this for cardioversion to sinus rhythm so that an adequate His Bundle spike could be recorded and three for DC ablation. Dual chamber permanent pacemakers with automatic mode switching were implanted in four patients who had paroxysmal atrial fibrillation or flutter and the remainder had ventricular rate responsive pacemakers. Conclusions: In patients with drug refractory paroxysmal atrial fibrillation and flutter and in patients with established atrial fibrillation where control of the ventricular rate is difficult, catheter ablation of the AV junction using RF energy is a safe and effective procedure with a high success rate.     

Ultrasensitive and bifunctional ZnO nanoplates for an oxidative electrochemical and chemical sensor of NO2: implications towards environmental monitoring of the nitrite reaction

Herein, we focused on the one pot synthesis of ZnO nanoplates (NP edge thickness of ∼100 nm) using a chemical emulsion approach for chemical (direct) and electrochemical (indirect) determination of NO₂. The structural and morphological elucidation of the as-synthesized ZnO NPs was carried out by X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive analysis of X-ray (EDAX), thermogravimetric analysis (TGA) and BET-surface area measurements. The XRD studies of the as-synthesised NPs reveal that ZnO NPs have a Wurtzite type crystal structure with a crystallite size of ∼100 nm. Such ZnO NPs were found to be highly sensitive to NO₂ gas at an operating temperature of 200 °C. Electrocatalytic abilities of these ZnO NPs towards NO₂/NO₂⁻ were verified through cyclic voltammetry (CV) and linear sweep voltammetry (LSV) using aqueous 1 mM NO₂⁻ (nitrite) in phosphate buffer (pH 7) solution. The results revealed enhanced activity at an onset potential of 0.60 V vs. RCE, achieved at a current density of 0.14 mA cm⁻². These ZnO NPs show selective NO₂ detection in the presence of other reactive species including CO, SO₂, CH₃OH and Cl₂. These obtained results show that this chemical route is a low cost and promising method for ZnO NPs synthesis and recommend further exploration into its applicability towards tunable electrochemical as well as solid state gas sensing of other toxic gases.

Herein, we focused on the one pot synthesis of ZnO nanoplates (NP edge thickness of ∼100 nm) using a chemical emulsion approach for chemical (direct) and electrochemical (indirect) determination of NO₂.      

Detection of periodontal microorganisms in coronary atheromatous plaque specimens of myocardial infarction patients: A systematic review and meta-analysis

BackgroundMicrobial translocation from inflamed periodontal pockets into coronary atheroma via systemic circulation is one of the proposed pathways that links periodontitis and myocardial infarction (MI). The purpose of this systematic review is to determine the reported prevalence of periodontal microorganisms in coronary atheroma and/or aspirated clot samples collected from MI patients with periodontal disease.MethodologyThe “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) guidelines were followed. Six databases were systematically searched using Medical Subject Headings/Index and Entree terms. After a thorough screening, fourteen publications spanning over ten years (2007–2017) were eligible for this systematic review and meta-analysis.ResultsOut of 14 included studies, 12 reported presence of periodontal bacterial DNA in coronary atherosclerotic plaque specimens. Overall, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were the most frequently detected periodontal bacterial species. Meta-analysis revealed that the prevalence of P. gingivalis was significantly higher than A. actinomycetemcomitans in coronary atheromatous plaque samples. Apart from periodontal microbes, DNA from a variety of other microbes e.g. Pseudomonas fluorescens, Streptococcus species, Chlamydia pneumoniae were also recovered from the collected samples.ConclusionConsistent detection of periodontal bacterial DNA in coronary atheroma suggests their systemic dissemination from periodontal sites. It should further be investigated whether they are merely bystanders or induce any structural changes within coronary arterial walls.     

Initial and long-term results of percutaneous transluminal balloon angioplasty for chronic total occlusions: an analysis of 184 procedures

Background: Coronary angioplasty, although of proven use in partial occlusion, has not been shown to be of similar benefit in chronic total occlusion. Aims: To assess the utility of coronary angioplasty in chronically totally occluded vessels in patients undergoing angioplasty and to determine the success of TIMI-I flow before angioplasty compared to those patients with TIMI-O flow. Methods: A group of 178 consecutive patients (from 1984 to 1992), who underwent angioplasty of a chronic occlusion, were analysed. There were 136 males and 42 females with a mean age of 56.9 years. Results: Initial technical success was achieved in 65%. Patients with TIMI-I flow before angioplasty had a higher chance of success (700%) compared to those with TIMI-O flow (53%), p < 0.04. During hospitalisation six patients suffered myocardial infarction (MI), two required surgery and one patient died. During a mean follow-up of 2.8 years the overall survival rate was 95% for the group as a whole. Freedom from coronary surgery was significantly greater in patients with successful angioplasty (93%) than those without (66%, p < 0.002). The above two populations also showed a significant difference in the incidence of angina (35%vs 56%, p < 0.0003). However, the incidence of MI (6%vs 5%, p > O.5) and cardiac survival (98%vs 94%, p > 0.l) did not differ significantly in the two groups. Restenosis occurred in 63% of the 95 patients (82%) who returned for follow-up angiography. Eighteen of the 59 patients (28%) with restenosis had a reocclusion. Conclusion: The success rate for angioplasty of chronic total occlusions is acceptable. Long-term clinical benefit in patients with successful angioplasty is suggested by the high freedom from angina and the lesser need for coronary surgery. No major impact on either the incidence of MI or cardiac survival was noted when patients who had coronary surgery were included, although it must be emphasised that the sample size in this study was insufficient to detect a difference in these outcome variables.