Pulmonary embolectomy with use of pediatric bronchoscope for the detection of residual emboli: an innovative surgical technique

Pulmonary embolectomy in the treatment of massive pulmonary embolus has been in doubt since the introduction of thrombolytic therapy. Recent indications for surgical intervention are- contraindication to thrombolysis, failed medical treatment and severe Right Ventricular (RV) dysfunction. A 54-year male came to us with complaints of palpitation, tachypnea and repeated syncope . Transthoracic echocardiography and Computed Tomography pulmonary angiogram demonstrated- Biatrial mass with right atrial mass extending into right ventricle and main pulmonary artery. Pulmonary embolectomy was performed. Residual emboli of bilateral pulmonary arteries were detected with a fiberoptic pediatric bronchoscope and removed. Bronchoscopic evaluation appears to be safe and useful for direct visual detection of emboli.     

Star anise (Illicium verum): Chemical compounds,antiviral properties,and clinical relevance

Medicinal herbs are one of the imperative sources of drugs all over the world. Star anise (Illicium verum), an evergreen, medium‐sized tree with star‐shaped fruit, is an important herb with wide distribution throughout southwestern parts of the Asian continent. Besides its use as spice in culinary, star anise is one of the vital ingredients of the Chinese medicinal herbs and is widely known for its antiviral effects. It is also the source of the precursor molecule, shikimic acid, which is used in the manufacture of oseltamivir (Tamiflu®), an antiviral medication for influenza A and influenza B. Besides, several other molecules with numerous biological benefits including the antiviral effects have been reported from the same plant. Except the antiviral potential, star anise possesses a number of other potentials such as antioxidant, antimicrobial, antifungal, anthelmintic, insecticidal, secretolytic, antinociceptive, anti‐inflammatory, gastroprotective, sedative properties, expectorant and spasmolytic, and estrogenic effects. This review aimed to integrate the information on the customary attributes of the plant star anise with a specific prominence on its antiviral properties and the phytochemical constituents along with its clinical aptness.     

A case of giant left ventricular lipoma: unusual presentation

Primary cardiac tumors are rare and usually benign. The incidence of cardiac lipomas is 8 % of benign cardiac tumors [1]. Several surgical options have been reported to obtain an appropriate operative view because of their poor visualization when the tumors are located in the Left Ventricle (LV). We report a rare case of massive left ventricular lipoma occupying pericardial space. A 23-year-old female had back pain since 6 months. She visited a local orthopedician, who ordered for computed tomography scan of chest and back. Computed tomography showed a large epicardial mass located along the anterior surface of the heart, from the diaphragm level through the aortic arch level. The mass showed an attenuation value identical with that of subcutaneous adipose tissue and contained some areas with high density. The mass was not enhanced by contrast media. Percutaneous biopsy was done, histologic examination of the specimen demonstrated mature adipose tissue. An encapsulated adipose mass weighing 865 g, which originated from the left ventricle anteriorolateral surface without any invasion to the pericardium, was near completely excised, except for a small portion which was encasing obtuse marginal artery. Microscopic examination revealed mature adipose tissue with partial necrosis, confirming the diagnosis of lipoma.