Search

Optimal cell spreading and interplay of vascular smooth muscle cells (VSMC), inflammatory cells, and cell adhesion molecules (CAM) are critical for progressive atherosclerosis and cardiovascular complications. The role of vitronectin (VTN), a major cell attachment glycoprotein, in the pathogenesis of atherosclerosis remains elusive. In this study, we attempt to examine the pathological role of VTN in arterial plaque progression and inflammation. We found that, relative expression analysis of VTN from the liver of Apolipoprotein E (ApoE) Knockout mice revealed that atherosclerotic progression induced by feeding mice with high cholesterol diet (HCD) causes a significant downregulation of VTN mRNA as well as protein after 60 days. Promoter assay confirmed that cholesterol modulates the expression of VTN by influencing its promoter. Mimicking VTN reduction with siRNA in HCD fed ApoE Knockout mice, accelerated athero‐inflammation with an increase in NF‐kB, ICAM‐1, and VCAM‐1 at the site of the plaque along with upregulation of inflammatory proteins like MCP‐1 and IL‐1β in the plasma. Also, matrix metalloprotease (MMP)‐9 and MMP‐12 expression were increased and collagen content was decreased in the plaque, in VTN deficient condition. This might pose a challenge to plaque integrity. Human subjects with acute coronary syndrome or having risk factors of atherosclerosis have lower levels of VTN compared to healthy controls suggesting a clinical significance of plasma VTN in the pathophysiology of coronary artery disease. We establish that, VTN plays a pivotal role in cholesterol‐driven atherosclerosis and aortic inflammation and might be a useful indicator for atherosclerotic plaque burden and stability.

The Indian Society of Gastroenterology (ISG) felt the need to organize a consensus on Helicobacter pylori (H. pylori) infection and to update the current management of H. pylori infection; hence, ISG constituted the ISG's Task Force on Helicobacter pylori. The Task Force on H. pylori undertook an exercise to produce consensus statements on H. pylori infection. Twenty-five experts from different parts of India, including gastroenterologists, pathologists, surgeons, epidemiologists, pediatricians, and microbiologists participated in the meeting. The participants were allocated to one of following sections for the meeting: Epidemiology of H. pylori infection in India and H. pylori associated conditions; diagnosis; treatment and retreatment; H. pylori and gastric cancer, and H. pylori prevention/public health. Each group reviewed all published literature on H. pylori infection with special reference to the Indian scenario and prepared appropriate statements on different aspects for voting and consensus development. This consensus, which was produced through a modified Delphi process including two rounds of face-to-face meetings, reflects our current understanding and recommendations for the diagnosis and management of H. pylori infection. These consensus should serve as a reference for not only guiding treatment of H. pylori infection but also to guide future research on the subject.

Introduction: Patient satisfaction is a psychological concept which is considered as a judgment of individuals regarding any object or event after gathering some experiences over time. It is one of the established yardsticks to measure the success of the services. Objectives: 1. To assess the level of inpatient satisfaction on hospital services. 2. To find out the determinants of inpatient satisfaction on hospital services. Method: It was a cross-sectional study conducted over a period of four months at VIMSAR, a tertiary care hospital in Odisha in eastern India. A total of 164 patients were enrolled in the study from the five most occupied indoor departments who were administered a pre-tested semi-structured standardised questionnaire by face to face interview method. Results: Majority (77.44%) of respondents were in the age group of 21-60 years. The sample consisted of 65.24 % males and 43.9% were from lower socio-economic class. Patient satisfaction level was found to be relatively low (~80%) for the service domains like housekeeping, general services and ancillary services. Fields like front desk services, medical care, nursing care and laboratory services enjoyed a better satisfaction score (~90%). Binary logistic regression analysis reflected age and socio-economic class to be the negative determinants of the level of satisfaction. Conclusion: About two thirds of the inpatients were satisfied with the services availed at the tertiary care hospital in the five specialities. There is scope of improvement in the areas like housekeeping, ancillary care and general care. Socio-demographic characteristics like age and socioeconomic class inversely related to inpatient satisfaction on hospital services.

Epilepsia partialis continua (EPC) is a rare form of status epilepticus and often refractory to antiepileptic drugs (AEDs). Persistent seizure activity may increase pro-inflammatory biomarkers locally, which may respond to adjunctive corticosteroid treatment, especially in central nervous system (CNS) infections. We report four children with refractory EPC and the effect of adjunctive corticosteroid in controlling EPC. The duration of EPC ranged between 3 days and 7 months. One patient had secondary generalized convulsive status epilepticus. Cranial computed tomography/magnetic resonance imaging was abnormal in three out of four patients; revealing old infarction in one, tuberculoma in one, and neurocysticercosis in one. Electroencephalography revealed spike and sharp wave discharges on the corresponding cerebral hemisphere. The EPC was refractory to 2-6 AEDs. Following corticosteroid treatment, EPC remitted in two patients with CNS infection, and those with infarction and cryptogenic EPC converted to discrete seizures. In AED-resistant EPC, a short course of corticosteroid may be helpful.

BACKGROUND Though epilepsy remains a significant problem for children and adolescents in our country, studies delineating the clinical profile and response to treatment in childhood epilepsy are lacking. The current study was carried out for obtaining a baseline profile and to predict the response to treatment in childhood epilepsy in India that may be helpful in planning management strategies from a public health point of view. METHODS Patients with clinical suggestion of active epilepsy (N = 141) from one month to 12 years, were enrolled into the study over a period of 1 year (February 2010 to January 2011) from the out-patient department and epilepsy clinic of Bangur Institute of Neurology. Detailed history was taken along with neurological examination. Electroencephalography (EEG) and neuroimaging (MRI / CT scan) were done on all patients. Each patient included in the study was kept in followup for a period of 6 months and their response to the treatment was recorded. RESULTS About 48.9 % (N = 69) patients had localisation related epilepsy while the rest had generalised epilepsy. Of those with generalised epilepsy, generalised tonicclonic seizures (GTCS) was by far the most common type. Of those with focal EEG activity, the highest proportion (50 %), were localised to the temporal lobe. Symptomatic aetiology accounted for 59.6 % (N = 84) of the patients. 20.6 % (N = 29) had poor response to treatment at 6 months follow-up. Abnormal neuroimaging (OR = 6.708) and abnormal EEG (OR = 6.357) were effective factors in predicting poor response to treatment. CONCLUSIONS Our study highlights the need to link specialised epilepsy services with primary health centres for early detection and treatment. EEG is an essential cost-effective modality in determining seizure localisation and response to treatment. KEYWORDS Paediatric, Epilepsy, Clinical Profile, Response to Treatment

To compare the efficacy of intravenous acetaminophen and intravenous diclofenac sodium in the management of skeletal vaso-occlusive crisis among children with sickle cell disease. Single blind randomized controlled trial. Tertiary care hospital. 104 children with sickle cell disease and skeletal vaso-occlusive crisis. Intravenous acetaminophen at 10mg/kg/dose 8 hourly and intravenous diclofenac sodium at 1mg/kg/dose 8 hourly in 1:1 ratio. Reduction in pain score (50%), number of doses needed to relieve pain after 24 hours of drug administration and decrease in pain score at 1 hour. A 50% reduction in pain score was seen in 35 (77.3%) and 10 (21.7%) children among acetaminophen and diclofenac sodium groups respectively (RR, 95% CI 3.6; 2.02–6.33, P< 0.001). The mean (SD) fall in pain score at 1 hour was significantly higher among intervention arm as compared to control arm [1.51 (0.5) and 1.06 (0.5); P

Subacute Sclerosing Panencephalitis (SSPE) is a very rare and deadly complication of measles infection, with its incidence being signicantly higher in developing countries. Our retrospective analysis of four patients highlights another ominous trend of this deadly disease, i.e, early age at onset leading to a rapid progress of symptoms. Four patients, presenting to the pediatrics department of a tertiary care hospital of eastern India, from February 2020 To December 2020, diagnosed as SSPE, by the modied Dyken's criterion, were analyzed. Paired CSF and serum samples were taken from all the patients and were analyzed for measles-specic IgG in serum (dilution 1:404) & CSF (dilution 1:2) using measles specic IgG ELISA (Enzyme-linked immunosorbent assay) kit. All the patients were under 6 years of age with a mean latency period of 2.5 years. All had contracted measles infection before receiving the scheduled rst dose of vaccine at 9 months of age. Treatment was initiated according to the institutional protocol, keeping in mind the affordability. However, follow-up of the patients reected the rapid progression of the disease. High morbidity and mortality is associated with SSPE in developing countries like India, where treatment availability and affordability becomes a major issue. In order to prevent this disease, it is necessary to prevent measles infection. Recent studies have recorded early disappearance of maternal measles-specic antibodies thus pointing towards the need to vaccinate early. Our case series emphasizes the need to revamp the current vaccination strategies in India with particular focus on re-scheduling the rst dose to 6 months of age.

This observational cross-sectional Study was done in the Institute of Cardiovascular Sciences in R. G. Kar Medical College and Hospital from February, 2015 to December 2016. Atotal of 220 hypertensive patients were included through simple random sample selection. Patients who full the inclusion and exclusion criteria were enrolled for the study after getting written informed consent. This study was carried out using the echocardiogram as the gold standard for the diagnosis of LVH. The new score proposed here, of which cutoff for the diagnosis of LVH was arbitrarily set at 2800mm-ms, is easily applicable in clinical practice and presented the best correlation with the LVMI, when compared to some classic electrocardiographic criteria.

The synovial sarcoma is a malignant soft-tissue tumor that most commonly occurs in the extremities of young adults. The chest wall’s primary synovial sarcoma is extremely rare, and only a few cases of the synovial sarcomas of the chest wall and pleura have been reported. Surgery is the mainstay of the treatment with adjuvant chemotherapy, and radiotherapy plays a significant role, especially in the larger tumors. Here, we report a very rare case of the synovial sarcoma of the anterior chest wall in a middle-aged gentleman and discuss the management and poor outcome despite the aggressive treatment.

Introduction: Tobacco is the leading causative factor for both oral potentially malignant disorders and oral cancer. Tobacco use is higher among lower income population. Low-income population of India are majorly employed as industrial workers. The aim of this study is to estimate the prevalence of oral lesions associated with tobacco related habits among industrial workers. Materials and Methods: Cross-sectional epidemiological investigation was conducted among 1000 industrial workers using simple random sampling technique. Information on patient demographics, tobacco related (smoke and smokeless) and other deleterious habits, and clinical examination details were recorded in a structured format. The data were analyzed using Statistical Package for Social Sciences version 20.0. Results were tabulated using frequency distribution and mean with a standard deviation. Multiple logistical regression was used to analyze oral lesions by different variables. Results: Among the 1000 industrial workers screened, smoking habit was observed in 13.20%, while 86.8% were using smokeless tobacco. The prevalence of tobacco related oral lesions among individuals with smoke/smokeless tobacco habit was 13.8%. The study documented tobacco related oral lesions such as leukoplakia (6.5%), oral submucous fibrosis (2%), smoker’s palate (2.7%), tobacco related pigmentation (1.9%), erythroplakia (0.3%), and oral squamous cell carcinoma (0.2%). Conclusion: The study documented potentially malignant disorders and oral cancer among users with tobacco related habits. The results also revealed that higher prevalence of potentially malignant disorders over oral cancer. Thus, preventive programs for early detection of oral precancer and oral cancer such as tobacco cessation, tobacco counselling programs are emphasized for industrial workers.

Objective: Supraflex (Sahajanand Medical Technologies Pvt. Ltd, Surat, India) is the latest generation of biodegradable polymer-coated sirolimus-eluting coronary stent designed on ultra-thin (60 µm) cobalt–chromium platform with flexible “S-link.” The present study was designed to establish the safety and clinical performance of Supraflex in real-world Indian patients with coronary artery disease. Methods: The study included 839 consecutive patients with coronary artery disease who were implanted with Supraflex from January 2014 to August 2017 at six different tertiary care centers in India. Follow-up was performed at 30 days, 6 months, and 12 months after the index procedure. The primary end-point of the study was the incidence of major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI), and target lesion revascularization (TLR) at the 12-month follow-up. The occurrence of stent thrombosis was analyzed as safety end-point. Results: A total of 1025 lesions were treated by implantation of 1098 Supraflex stents. At the 12-month follow-up, MACE was 4.92%, including 7 (0.86%) cardiac deaths, 16 (1.97%) MI, and 17 (2.09%) TLR. Only three incidences of stent thrombosis were found at the 12-month follow-up. Conclusion: The study results showed excellent safety and clinical effectiveness of Supraflex in a high proportion of high-risk real-world Indian patients with coronary artery disease. (Anatol J Cardiol 2020; 24: 364-9)

Background: Febrile convulsions are the most common provoked seizures affecting children. Low magnesium level leads to cell and membrane excitability thereby causing seizures. Objective: The objective of the study was to determine the role of serum sodium, calcium, magnesium, and zinc in children with simple febrile seizures (SFSs). Materials and Methods: This was a case–control study done in children admitted in the pediatric ward. Children with SFSs were taken as cases while children with fever but without seizures served as controls. After obtaining informed consent, details of each child were recorded, which included age, sex, seizure details (duration, type), nature of the febrile illness, and history of febrile seizures (FSs). Estimation of serum sodium, zinc, magnesium, and calcium was done. Results: The present study included 120 subjects, out of which 60 were cases and 60 were controls. The male-to-female ratio was 2:1. In our study, there was no significant difference in the levels of calcium, magnesium, and zinc in cases with FSs and controls. Although the serum zinc levels were in the normal range, majority of the children with SFS had serum zinc levels toward the lower range of normal which was statistically highly significant. Conclusion: Our study found that SFSs occurred more frequently in boys. The levels of serum calcium and magnesium were normal and did not correlate with SFS. Low serum zinc level had a direct correlation with SFS, although this level was within the defined normal range.

Background: Vitamin D status in sickle cell children (SC) has been widely discussed and its effect on clinical profile among SC is currently highly debatable. Objective: The objective of this study was to determine the clinical outcomes in terms of morbidities for Vitamin D supplementation among Vitamin D deficiency (VDD) SC. Materials and Methods: A total of 428 children as per predefined inclusion and exclusion criteria were enrolled in this present prospective study, after receiving written informed parental consent. Patients were supplemented with Vitamin D according to their serum status and followed up at 3 subsequent visits (0, 6, and 12 weeks). All the relevant statistics were done by SPSS v 25.0 (IBM, New York). Results: A total of 428 diagnosed cases of sickle cell anemia were enrolled, from which 272 (63.6%) were male and 156 (36.4%) were female, and 393 cases were found to be VDD (92%). The mean age of the study population was 88.39 (46.27) months. Vitamin D supplementation was significantly associated with decrease in number of vaso-occlusive crisis, duration of hospitalization, and duration of pain hours (p

Background: Depression, a multi-dimensional disorder adversely affects the interpersonal, social and occupational spheres of students’ life. It is the 11th leading cause of global disease burden. Aims and Objectives: To assess the prevalence of depressive symptoms among various professional course students including medical, dental, and engineering students in Patna, Bihar. Materials and Methods: The present investigation was a questionnaire-based cross-sectional descriptive study. A total of 3,100 students attending government and private medical, dental, and engineering colleges in Patna were approached during the course of this study. Students were briefed about the study and questionnaire. BDI-II (Beck's Depression Inventory-II) was administered to the students and they were instructed to fill it. Beck's scores were recorded and a descriptive analysis performed. Results: 2798 students out of 3,100 responded positively to the survey by completely filling out the form. The overall response rate was 90.25%. The overall prevalence of depressive symptoms was found to be 47.78%. Of the three streams, students belonging to the engineering stream (40.28%) showed a maximum prevalence of depressive symptoms followed by dental (38.50%) and medical students (34.74%). Conclusion: Our study showed an alarming prevalence of depression among professional course seeking students. This multi-dimensional disorder continues to affect student's performance and professionalism, thus, extending its negative impact to the community at large. This may carry out later in their lives, thus leaving a long-term negative impact. Considering the high rate of depressive symptoms, establishing a unit or facility to identify or diagnose it at an early stage and providing psychological support to students is recommended.

Introduction: Tonsillitis is widespread among children and has serious poststreptococcal complications, and both the patients and the otolaryngology surgeon have to face the question on what is the role and benefit of using long-acting penicillin and whether it is an alternative method of treatment to surgery? This study was carried out to evaluate the effectiveness of tonsillectomy compared with long-acting penicillin in the treatment of recurrent tonsillitis, comparing their effects on the levels of the antistreptolysin O titer (ASOT) and erythrocyte sedimentation rate (ESR). Methods: This study was carried out as a prospective study. A total of 100 Children were chosen for this study. Subjects fulfilling the inclusion criteria like , Age of 5–15 years , Children suffering from recurrent tonsillitis with signs of chronic tonsillitis: inequality in the size of the tonsils, enlarged cervical lymph nodes, and pus in the tonsillar crypts 6 , Severe attacks of tonsillitis: seven times in 1 year or five times in each of 2 years, or three times in each of 3 years & An ASOT of greater than 400 IU/ml and an ESR of greater than 30 ml/1 at 1/2 h 10,11.were selected by simple random sampling method. Results : The frequencies of occurrence of fever, cough, obstructive sleep apnea, unequal tonsil size, and pus in the tonsillar crypts were 80% , 51 % , 4% , 52% , and 48 %, respectively. Effect of tonsillectomy versus the effect of long-acting penicillin on ASOT, we found that the levels after 3 months were lower in patients who were treated by tonsillectomy than in those who were treated with long-acting penicillin; the difference between both the groups was found to be statistically significant. Conclusion: This study presents important insight into the alternate treatment regimens of Recurrent Tonsillitis in rural children. This study demonstrates that the first line of treatment of recurrent chronic tonsillitis is tonsillectomy, as it is both clinically effective and cost-effective for children and that the second line of treatment is long-acting penicillin with long-term follow-up, and in patients, have contraindications for surgery such as bleeding diathesis.

Patients with the chronic obstructive pulmonary disease have ongoing systemic inflammation, which can be assessed by measuring serum C- reactive protein. Objective: To explore whether CRP could be used as an independent predictor of disease outcome in COPD. Methods: A cross-sectional study was conducted among 50 COPD patients attending Respiratory Medicine outpatient services in the Regional Institute of Medical Sciences (RIMS), Imphal from January 2015 to September 2016. Patients aged 18-67 were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. Computerized Spirometer Helios 401 was the instrument used to measure lung volumes and capacities. BeneSpheraTM CRP Latex Slide test kit was used to estimate serum c-reactive protein. Results and observation: The present study was conducted on fifty COPD patients in which serum CRP level showed positive correlation with COPD (p=0.002) but serum CRP level with spirometric parameters showed significant negative correlation;FEV1 (r=-0.451, p=0.001), FEV1/FVC (r=-0.617, p

Background: Transfusion therapy in patients with thalassemia major needs to address the common questions such as what should be the optimal hemoglobin (Hb) level for effective transfusion and how do transfusion requirements affect the success of iron chelation therapy. Objective: The objective of the study was to evaluate iron overload and adequacy of packed red blood cells (PRBCs) transfusion in children with thalassemia major along with the correlation of serum ferritin level with transfusional iron load and pre?transfusion Hb level. Materials and Methods: This single?center retroprospective observational study was carried out in thalassemia day care center of tertiary care hospital for 1 year over 32 transfusion?dependent ??thalassemic patients up to 18 years of age. Data including pre?transfusion hemoglobin level, number and volume of PRBC transfused, and serum ferritin level for 1 year were analyzed, and annual transfusion iron load was calculated. Correlation of serum ferritin level with transfusional iron load and pre?transfusion Hb level was determined using Pearson coefficient (r) and p-value. Results: The mean pre?transfusion hemoglobin level was 6.4±0.23 g%. The average number and volume of PRBCs transfused in a year were 12.5±3.02 and 112 ml/kg, respectively, with the average annual transfusional iron load of 121.3 mg/kg ±28.9 or 0.3 mg/kg/day. A significant positive (r=0.4184, p=0.017) correlation was observed between serum ferritin level and transfusional iron load with the mean serum ferritin level of 1744±604.6 ng/ml. Negative correlation was observed between serum ferritin and pre?transfusion Hb level (r=?0.2624 and p=0.1537). Conclusion: All patients were undertransfused and this undertransfusion further leads to more accumulation of iron in the body through increased absorption of dietary iron as a result of anemia and ineffective erythropoiesis.

Introduction: Diabetes mellitus (DM) is an important public health problem, where patients do not present with any pulmonary complaints because of large vascular and ventilatory reserve. As obesity is regarded as one of the risk factors leading to diabetes, the present study will try to determine the effect of body mass index (BMI) on pulmonary system. Aim: The present study is aimed to find out the effect of BMI on pulmonary function tests (PFTs) among diabetic patients. Materials and Methods: The study was undertaken in the departments of Physiology and Medicine to determine the effect of BMI on PFTs. Thirty (30) known diabetic patients were recruited from medicine OPD on the basis of guidelines according to American Diabetes Association (ADA) and they were divided into two groups based on their BMI. PFTs were performed using computerized spirometer. Data were entered and analyzed using independent student’s t-test. Results: Patients with higher BMI have reduced values of Forced Vital Capacity (FVC), Forced Expiratory Volume in 1st sec (FEV1), FEV1/FVC, Forced Expiratory Flow in between 25%-75% (FEF25-75%) compared to those with lower BMI, whereas with higher BMI, Peak Expiratory Flow Rate (PEFR) was increased. The differences in FEV1, PEFR and FEF25%-75% values among the two groups were found to be significant (p-values are 0.003, 0.05 and 0.026 respectively). Conclusion: Increased BMI can have detrimental effects on pulmonary functions among diabetics. So, early awareness about body weight and prevention strategy would be important steps towards making a diabetes free nation. Keywords: Body Mass Index (BMI), Diabetes Mellitus, Pulmonary Function Tests (PFTs).

Aim: This study aimed to evaluate concurrent laparoscopic totally extraperitoneal (TEP) inguinal hernia repair and transurethral resection of the prostate (TURP) with determination of outcomes. Materials and Methods: This retrospective study was conducted at our hospital, from June 2011 to June 2020. Over 9 years, 17 patients with co-existing uncomplicated unilateral or bilateral inguinal hernia (primary/recurrent) and significant benign prostatic hypertrophy were operated in the same sitting. The following outcomes were compared: duration of the surgery, conversion to open hernia surgery, intraoperative and post-operative complications, duration of hospital stay, recurrence, time taken to resume normal activity and cost of the treatment. Results: This study included 17 patients with a mean age of 65 years (range of 50–87 years). The average time taken for the surgery was 115 min with no conversion to open hernia repair. The mean post-operative stay was 3.7 days. There were four patients (23.5%) with seromas identified at day 10, only two remained at 6 weeks and none at 12 weeks. None had significant bleeding intraoperatively or postoperatively. There was no superficial or deep wound infection (including mesh infection). There was no recurrence of inguinal hernia. Two patients (11.7%) developed post-TURP urethral stricture and underwent cystoscopic stricturoplasty, 3 and 2.5 months after the initial procedure. The time taken to resume normal activity was 7 (±1) days. The hospital cost is reduced by 25% as compared to the sum of costs when both the operations are done separately. Conclusion: Concurrent TEP inguinal hernia repair and TURP is a practical, safe and cost-effective procedure.

Introduction: Dental anxiety negatively affects patients’ oral and overall health. This study explored attitudes and clinical practices of licensed Bihar general dentists who treat patients with dental anxiety. Methods: An anonymous self-administered mail survey was sent to 250 general dentists licensed and practicing in Bihar. Responses to 21 pre-coded questions were analysed. Frequencies were examined; cross-tabs, Chi-Square, and Fischer’s Exact Test were calculated for statements according to dentists’ gender. Alpha was set at p = 0.05. Results: Nearly all respondents treated anxious patients; males were more likely to find it challenging than females. Dentists were most familiar with distraction, although half found Tell-show-do to be an effective tool. Female dentists were more likely than males to be familiar with anxiolytics and find them effective. Conclusion: Overall, Bihar general dentists are most familiar with using distraction and Tell-show-do during appointments for anxious patients. Gender differences exist in attitudes towards anxiolytic use for patients with dental anxiety. Practice Implications: By identifying techniques that are comfortable for patient and practitioner, oral health disparities associated with dental anxiety may be reduced.

Sinus of Valsalva Aneurysms are extremely rare cardiac anomalies.The sinus of Valsalva aneurysm (SVA) is a small dilatation caused by a separation between the aortic media and annulus fibrosus. Its may be either acquired or congenital. The right coronary sinus is most frequently affected. The most common complication being rupture.We present the case of a 12-year old girl with ruptured non-coronary sinus of valsalva aneurysm associated with ventricular septal defect , mitral regurgitation grade II and severe pulmonary hypertension. Echocardiography is sufficient to diagnose SVA, its complications, repercussions, and surgical options. SVA, even if asymptomatic, has potential risks of expansion,rupture, cardiac failure, endocarditis, embolism and sudden death. This justifies surgical correction, with a low mortality rate in both the short- and long-term. KYAMC Journal Vol. 10, No.-4, January 2020, Page 211-213

Patients with moderate to severe dry eyes are often screened at the Dry Eye Clinic to rule out connective tissue diseases. Rheumatoid factor (RF) is one of the screening tools to rule out rheumatoid arthritis (RA). Patients who turn out positive for the RF are often subjected to anti-CCP antibody evaluation for confirmation of disease. This article tries to highlight 3 cases of negative and anti-CCP antibody positive cases which presented to the ophthalmic clinic, unaware of their systemic status. Though RF is the cheapest modality to screen for RA, it is not always a reliable marker. One should order anti-CCP antibody for patients where suspicion is high, despite RF being normal.

Reverse sural flap (RSF) is commonly used for soft tissue reconstruction of distal leg and heel defects. The classic method of flap transfer is the single-staged cutaneous islanded reverse sural flap (SS-RSF). This method is associated with variable flap complications notably the venous congestion. The other form of flap transfer is the two-stage reverse sural flap (TS-RSF), in which the pedicle of the flap is exteriorized in the first stage. Flap division and re-inset are done in the second stage. The aim of this paper is to review the flap outcomes and complications among the SS-RSF and TS-RSF reconstruction of soft tissue defects in the distal leg and heel. This is a retrospective chart review of RSF being operated in a tertiary care hospital. The duration of study was 1.5 years. Twelve RSFs (6 SS-RSF, 6 TS-RSF) were done for soft tissue defects in the distal leg and heel. Wounds of various etiologies (traumatic, chronic, non-healing ulcers) were reviewed. Trauma was the most common etiology with 8 out of 12 (66.7%) patients. Large wounds, donor site damage and patients with peripheral vascular disease were excluded from the study. Five out of six (83.3%) of TS-RSF healed uneventfully. However, 3 out of 6 (50%) of SS-RSF had partial flap necrosis. All complicated flaps healed well subsequently. No donor site complication was found in any of our patients. Pedicle exteriorization in TS-RSF eliminates the element of venous congestion and eventually flaps necrosis. Less technical expertise and minimal morbidity are additional advantages of TS-RSF. Level IV, therapeutic study.

Introduction: Many studies have been done for screening of congenital heart disease (CHD) in the neonatal period utilizing pulse oximetry as a screening tool along with routine clinical assessment, but none of them from our province. Objective: The objective of the study was to find out the diagnostic accuracy of pulse oximeter at three different sites as a screening tool to diagnose CHD among neonates. Methods: A diagnostic study was conducted in neonatal intensive care unit of a tertiary care hospital of Odisha from October 2016 to September 2018 after approval from the Institutional Ethics Committee. Three hundred and seventy-four neonates (both inborn and outborn) with gestational age >34 weeks were included in the study. Oxygen saturation (SpO2) in the right hand (RH), right foot (RF), and left foot (LF) was estimated by pulse oximeter among all participants after 10 min of postnatal life. All the study subjects were evaluated by two-dimensional (2D) echocardiography for the detection of CHDs. All the diagnostic accuracy tests (sensitivity [Sn], specificity [Sp], positive predictive value, negative predictive value, and diagnostic odds ratio) were calculated taking 2D echocardiography as the gold standard with software, and for all statistical purpose, p

Total anomalous pulmonary venous connection (TAPVC) is a rare congenital heart disease in which there is developmental absence of connection of all four pulmonary veins with the left atrium. To report a rare case and share our experience in surgery and post-operative management for supracardiac TAPVC. Patient with supracardiac TAPVC with atrial septal defect (ASD) secundum variety with rudimentary patent ductus arteriosus (PDA) underwent rechanneling of pulmonary veins to left atrium (LA) with gluteryldehye treated autologous pericardial patch closure of ASD with ligation of ascending vertical vein and ligation of rudimentary PDA.Post operatively there were no events of pulmonary hypertensive crisis, low cardiac output syndrome, right heart failure or conduction defect were observed and echocardiogram showed adequate pulmonary venous drainage with no residual shunt across the interatrial septum. Marked development in surgical results of TAPVC has been observed in recent years with declining mortality rate from 65% in early sixties to 5% in current surgical scenerio. KYAMC Journal Vol. 10, No.-2, July 2019, Page 118-121

Introduction: Beta-thalassemia major is the most common chronic hemolytic anemia. It is a well-comprehended fact that the toxic effects of iron overload particularly the cardiomyopathy are the major complication that roots from beta-thalassemia major children. Therefore, timely diagnosis is crucial to optimize the long-term gain. Objective: The objective of the study is to find the cutoff level of serum ferritin for early diagnosis of cardiac iron overload. Materials and Methods: This study was an observational analytical cross-sectional diagnostic study which was conducted from November 2016 to October 2018. With due approval of Institutional Ethics Committee and after taking proper informed consent from the parents and/or legal heir, 105 thalassemic children were enrolled in the study by simple consecutive sampling after satisfying the pre-defined inclusion and exclusion criteria. In this study, two-dimensional Doppler echocardiography was used to detect cardiac iron overload. Serum ferritin levels were estimated, and cutoff values were calculated for each of the echocardiographic parameters of cardiac iron overload, i.e. ejection fraction (EF), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD) by receiver operating characteristic curve analysis. Sensitivity (Sn), specificity (Sp), positive predictive value, and negative predictive value were calculated with considering p

Introduction: The renal involvement has been reported in Plasmodium falciparum, Plasmodium malariae, and recently in Plasmodium vivax infection. Although malaria is highly endemic in the rural locality of Odisha and a significant proportion of severe malaria causes acute renal complication, there is no definite study on the survival of malarial acute kidney injury (AKI) in children of the setup of the current study. Objective: The objective of the study was to find out the survival of malarial AKI in children. Methods: A prospective analytical study was conducted from October 2016 to September 2018 in the postgraduate department of pediatrics, of a tertiary care hospital in Odisha, after approval from the Institutional Ethics Committee. Children with smear-positive and/or quantitative buffy coat (QBC) positive malaria were included in the study. All the relevant data (age, gender, duration of hospital stays, stages of AKI, signs, and symptoms of AKI, serum urea and creatinine, electrolytes, and routine hemogram) were collected, validated and results were analyzed in terms of one-way ANOVA and Kaplan–Meier survival analysis. Results: Out of 202 malarial cases, 50.4% (102) cases were found to be suffering from malarial AKI. Out of 102 malarial AKI children, 68% were affected due to falciparum infection, 12% due to vivax, and rest 20% due to mixed infection. The median duration of survival in days between three stages of AKI was significant as evidenced by Tarone-Ware Chi-square=48.365 (df=2), p=0.000. Conclusion: Mortality was 6% and all of these deaths belong to Stage 3 AKI; furthermore, the morbidities are more in Stage 3 as compared to other stages.

BACKGROUND: Many different flaps had been described to cover exposed bone in fingertip amputations and injuries. The variants of VY advancement flap, by far the simplest, had proven to render good functional and aesthetic outcome. We aimed to revisit and compare the various VY advancement flaps in fingertip reconstruction. METHODS: PubMed [MEDLINE] database was searched for VY advancement flap in fingertip reconstruction. Demographic and outcome data were extracted from relevant studies and comparative analysis was made. Patients with fingertip amputations undergoing reconstruction by either Kutler of Atasoy flaps in our institute, were assessed for sensory recovery, cold intolerance, joint’s range of motion, and aesthetic outcomes and results were analysed. RESULTS: Among the 744 articles, 32 citations went full text review and were included, while data of 13 articles were tabulated. Weighted mean of 2PD in Kutler and Atasoy estimated to be 6 and 7.5 mm respectively. Hook nail deformity was in 29% and 35%, pain was present in 71% and 30% patients, in Kutler and Atasoy flaps respectively. Forty fingertips with Allen type II/III were reconstructed. Sensory outcomes of Atasoy flap and Kutler flaps were better than the previous study results. Four patients had cold intolerance. All patients achieved satisfactory aesthetic outcome. CONCLUSION: Over time, VY advancement flap have been successfully used for reconstruction of Allen type II-IV fingertip amputations, as suggested by the good sensory, functional and aesthetic outcomes.

Endogenous Cushing’s syndrome (CS) is rare in infancy. Bilateral micronodular adrenocortical disease (BMAD), either primary pigmented nodular adrenocortical disease or the non-pigmented isolated micronodular adrenocortical disease is an important aetiology of CS in this age group, which requires bilateral adrenalectomy for cure. BMAD may be isolated, or a component of Carney complex. Isolated sporadic BMAD without other systemic manifestations poses a diagnostic challenge. Paradoxical cortisol response to dexamethasone suggests, while adrenal histopathology and mutational analysis of the culprit genes confirm BMAD. BMAD was suspected in 6-year-old infant with midnormal adrenocorticotrophic hormone, inconclusive adrenal and pituitary imaging and paradoxical increase in cortisol following high dose of dexamethasone. Exome sequencing revealed heterozygous c.354+1G>C (5′ splice site) variant in the myosin heavy chain gene (MYH8), located in chromosome 17. This particular variant has not been reported in the literature. In view of suspected phenotype and its absence in the population databases, the variant was classified as pathogenic.

Diabetes is one of the common diseases of modern times and one of the most common systemic disorder that is connected to periodontal disease. Periodontal diseases are bacterially induced chronic inflammatory diseases affecting the tissues surrounding and supporting the teeth. The lesion begins as gingivitis, an inflammation of the gingival tissues only, and may progress to periodontitis, where destruction of connective tissue attachment and alveolar bone can eventually lead to tooth loss. Hence based on above reported findings the present study was planned for study of prevalence of tooth Loss in Patients Suffering from Diabetes from Bihar Region. The present study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar. Total 100 cases were enrolled in the present study. In the enrolled patients 50 cases were Diabetic and 50 were non-diabetic cases. The data generated from the present study concludes that periodontal disease increases in diabetes group than in control group. Thus, a diabetic patient should always see that he/she maintains his/her oral hygiene by following proper tooth brushing habits. Diabetics should take care to see that they get their teeth restored as early as possible, if decayed. They should follow the instructions given by the physician or the dietician for the intake of non-cariogenic diet. The prevention of periodontal breakdown in diabetic patients is mostly based on the education of the individual. Thus, patients should be informed about the importance of oral health for diabetics, and they should be taught that the main symptom of periodontal disease is gingival bleeding. Keywords: Tooth Loss, Diabetes, periodontal disease, bihar, etc

Patients with asthma have an ongoing inflammation, which can be assessed by measuring serum C- reactive protein. Objective: To explore whether CRP could be used as a predictor of disease outcome in asthma. Methods: A Cross-sectional study was conducted among 50 asthma patients attending Respiratory Medicine outpatient services in Regional Institute of Medical Sciences (RIMS), Imphal from January 2015 to September 2016. Patients aged 18-67 were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. Computerized Spirometer Helios 401 was the instrument used to measure lung volumes and capacities. BeneSpheraTM CRP Latex Slide test kit was used to estimate serum C-reactive protein. Results and Observation: The present study was conducted on fifty asthma patients in which serum CRP level showed association with severity of asthma ( p=0.001) but serum CRP level with spirometric parameters showed significant negative correlation; FVC (r=-0.711, p

OSMF (Oral Submucous Fibrosis) is a widely recognized precancerous condition which is also looked upon as a potentially malignant disorder of and is characterized by a reduction in mouth opening, having palpable circumoral fibrous bands either on one side or bilaterally along with the sensation of “burning mouth”. The condition is defined as “an insidious, chronic disease affecting any part of the oral cavity and sometimes the pharynx. Although occasionally preceded by and/or associated with vesicle formation, it is always associated with juxta-epithelial inflammatory reaction followed by fibroelastic change of the lamina propria, with epithelial atrophy leading to stiffness of the oral mucosa causing trismus and inability to eat”. The increased consumption of commercially prepared arecanut preparations (Gutkha, Pan masala) specially in the younger generation has led to such high incidence of this diseasein certain areas of India. Based on above reported findings the present study was planned for Study of Cases of Oral Submucous Fibrosis (OSMF) from Bihar Region. All the patients were informed consents. The aim and the objective of the present study were conveyed to them. Approval of the institutional ethical committee was taken prior to conduct of this study. Total 30 cases of the patients suffering from oral submucous fibrosis were enrolled in the present study. In conclusion, the result of present study provides information on the prevalence of oral mucosal lesion in our population. It is important that preventive efforts be carried out by the concerned authorities and public health professionals in establishing tobacco cessation clinics and tobacco education in such masses (especially the young generation) along with a long standing and a close knit motivation program that enables our future generations to come to avoid the menace of tobacco and its subsequent health effects. Keywords: Oral Submucous Fibrosis, OSMF, Oral Cancer, Bihar region, etc.

A 78-year-old male presented with a large ulceroproliferative growth on the left gluteal area. Histopathology suggestive of squamous cell carcinoma. The tumor arising from underlying hidradenitis suppurativa. In this patient, unlike typical furuncles, the lesions lack characteristic central rupture and drainage. There was no signs of metastasis. Tumor removed by wide excision and reconstruction done with VY advancement flap.

Lipoma is a common benign mesenchymal tumour. However, angiomyxolipoma (AML) is one of its rarer variants. It was first described by Mai et al in 1996 in the lipomatous lesions having mature adipocytes in a myxoid background with rich vascular network. We present the case of a 21 year-old man with recurrent forehead swelling diagnosed as AML on microscopy. It is important to document this rare variant to add to the limited literature and to aid in differentiating it from its malignant counterpart. Moreover, as our case presented with recurrence within a short period of time, a precise diagnosis and documentation of recurrence is essential as it is reportedly the first case with recurrence among the 21 cases of AMLs previously published.

Introduction: Oral cancer is one among the alarming diseases related to oral cavity. Its prevalence and incidence have increased in many folds, in the past decade. This has led the investigators to find the preliminary stages and related early evaluating methods to restrain it. Few clinical lesions such as leukoplakia, erythroplakia, oral submucous fibrosis and lichen planus reflected malignant changes. These premalignant disorders provided scope to assess the underlying cellular and molecular events, which shall be helpful in early detection, aggressiveness and prognosis of the patient. Materials and Methods: Forty formalin fixed, paraffin embedded blocks were utilized and evenly subdivided into Group I – control tissue, Group II – mild epithelial dysplasia, Group III – moderate epithelial dysplasia and Group IV – severe epithelial dysplasia. The study group was categorized based on the WHO classification of dysplasia 2005. Routine staining was performed to reconfirm the diagnosis of all the samples. Simultaneously, immunohistochemical staining was done with cluster differentiation-44 (CD44) antibody. Positive cells were counted on 10 representative fields with a minimum of 100 cells per field using ×20. Statistical Analysis: Comparison of four groups with respective to number of positive cells was done using Kruskal–Wallis ANOVA test. Pair-wise comparison of three grades of oral epithelial dysplasia and the controls was done using Mann–Whitney U test. Results: The mean of Group I is 745.50, Group II is 665.20, Group III is 530.10 and Group IV is 322.90. A statistically significant P = 0.00001 was ascertained on comparison of the mean between the groups. Conclusion: CD44, a cell membrane marker could help in cell adhesion and cell-cell interactions. Loss of CD44 expression enhances the binding of the growth factors with their principle receptors that enhances the cellular proliferation. It can be used as a prognostic marker for identifying the rate of malignant transformation in these disorders.

Digital, Background: Two glucagon-like peptide-1 (GLP-1) receptor agonists reduced renal outcomes in people with type 2 diabetes at risk for cardiovascular disease. We assessed the long-term effect of the GLP-1 receptor agonist dulaglutide on renal outcomes in an exploratory analysis of the REWIND trial of the effect of dulaglutide on cardiovascular disease. Methods: REWIND was a multicentre, randomised, double-blind, placebo-controlled trial at 371 sites in 24 countries. Men and women aged at least 50 years with type 2 diabetes who had either a previous cardiovascular event or cardiovascular risk factors were randomly assigned (1:1) to either weekly subcutaneous injection of dulaglutide (1·5 mg) or placebo and followed up at least every 6 months for outcomes. Urinary albumin-to-creatinine ratios (UACRs) and estimated glomerular filtration rates (eGFRs) were estimated from urine and serum values measured in local laboratories every 12 months. The primary outcome (first occurrence of the composite endpoint of non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular causes), secondary outcomes (including a composite microvascular outcome), and safety outcomes of this trial have been reported elsewhere. In this exploratory analysis, we investigate the renal component of the composite microvascular outcome, defined as the first occurrence of new macroalbuminuria (UACR >33·9 mg/mmol), a sustained decline in eGFR of 30% or more from baseline, or chronic renal replacement therapy. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01394952. Findings: Between Aug 18, 2011, and Aug 14, 2013, 9901 participants were enrolled and randomly assigned to receive dulaglutide (n=4949) or placebo (n=4952). At baseline, 791 (7·9%) had macroalbuminuria and mean eGFR was 76·9 mL/min per 1·73 m2 (SD 22·7). During a median follow-up of 5·4 years (IQR 5·1-5·9) comprising 51 820 person-years, the renal outcome developed in 848 (17·1%) participants at an incidence rate of 3·5 per 100 person-years in the dulaglutide group and in 970 (19·6%) participants at an incidence rate of 4·1 per 100 person-years in the placebo group (hazard ratio [HR] 0·85, 95% CI 0·77-0·93; p=0·0004). The clearest effect was for new macroalbuminuria (HR 0·77, 95% CI 0·68-0·87; p, Ciencias Médicas y de la Salud

Digital, Background Three different glucagon-like peptide-1 (GLP-1) receptor agonists reduce cardiovascular outcomes in people with type 2 diabetes at high cardiovascular risk with high glycated haemoglobin A1c (HbA1c) concentrations. We assessed the effect of the GLP-1 receptor agonist dulaglutide on major adverse cardiovascular events when added to the existing antihyperglycaemic regimens of individuals with type 2 diabetes with and without previous cardiovascular disease and a wide range of glycaemic control. Methods This multicentre, randomised, double-blind, placebo-controlled trial was done at 371 sites in 24 countries. Men and women aged at least 50 years with type 2 diabetes who had either a previous cardiovascular event or cardiovascular risk factors were randomly assigned (1:1) to either weekly subcutaneous injection of dulaglutide (1·5 mg) or placebo. Randomisation was done by a computer-generated random code with stratification by site. All investigators and participants were masked to treatment assignment. Participants were followed up at least every 6 months for incident cardiovascular and other serious clinical outcomes. The primary outcome was the first occurrence of the composite endpoint of non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular causes (including unknown causes), which was assessed in the intention-to-treat population. This study is registered with ClinicalTrials.gov, number NCT01394952. Findings Between Aug 18, 2011, and Aug 14, 2013, 9901 participants (mean age 66·2 years [SD 6·5], median HbA1c 7·2% [IQR 6·6–8·1], 4589 [46·3%] women) were enrolled and randomly assigned to receive dulaglutide (n=4949) or placebo (n=4952). During a median follow-up of 5·4 years (IQR 5·1–5·9), the primary composite outcome occurred in 594 (12·0%) participants at an incidence rate of 2·4 per 100 person-years in the dulaglutide group and in 663 (13·4%) participants at an incidence rate of 2·7 per 100 person-years in the placebo group (hazard ratio [HR] 0·88, 95% CI 0·79–0·99; p=0·026). All-cause mortality did not differ between groups (536 [10·8%] in the dulaglutide group vs 592 [12·0%] in the placebo group; HR 0·90, 95% CI 0·80–1·01; p=0·067). 2347 (47·4%) participants assigned to dulaglutide reported a gastrointestinal adverse event during follow-up compared with 1687 (34·1%) participants assigned to placebo (p, Ciencias Médicas y de la Salud

Rehabilitation of congenital lower limb deficiencies remains a challenge. A four-year-old boy presented with bilateral lower limb deficiency since birth and inability to stand. Orthoprosthesis with modified bucket type socket accommodating the right rudimentary limb, connected by a tubular shank and a modified foot piece on right side was prescribed. The left side of socket was incomplete inferiorly for the limb to pass through. An additional left Ankle Foot Orthosis (AFO) was also prescribed. The child achieved independent standing as well as started taking steps with a rollator.

Garcinia mangostana L. (Fruit) has been commonly used as folklore drug in the treatment of various types of diseases. The present experiment was designed to evaluate the potential effect of α-mangostin mediated pharmacological modulation of hepatic carbohydrate metabolism in streptozotocin (STZ) induced diabetic rats. Oral glucose tolerance test (OGTT) was performed in normoglycemic rats. Single intraperitoneal injection of STZ (60 mg/kg, body weight) was used for induction the diabetes in Swiss albino (Wistar strain) rats. The rats were divided into different groups. Blood glucose level, body weight, insulin, glycated hemoglobin and hemoglobin levels were recorded at regular intervals. Biochemical parameters, liver enzymes, lipid profile, antioxidant parameters and inflammatory cytokine mediators were also scrutinized. Histopathology study of kidney, pancreas and liver were performed. The result of OGTT study depicted the better utilization of glucose in experimental rats. STZ induced diabetic rats treated with α-mangostin (25, 50 and 100 mg/kg, p.o.) and glibenclamide depicted the decline in the level of blood glucose; enhanced body weight and showed the better utilization of glucose by different organs. STZ induced diabetic rats treated with α-mangostin illustrated the increased level of plasma insulin, hemoglobin, hexokinase, HDL, total protein, SOD, CAT, GSH and declined level of glycated hemoglobin, fructose-1-6-biphosphatase, glucose-6-Phosphatase, TC, TG, LDL, VLDL, CRE, BUN, SGOT, SGPT, ALP and LPO at effective dose dependent manners. Histological study showed the inflamed blood vessels in diabetic kidney, which was less in α-mangostin treated rats; diabetic pancreatic showed the complete damage of β cells, islets, aciini and producing necrosis, but all damage was less obvious in α-mangostin treating group rats; diabetic liver showed the damage of hepatocytes as well as central vein but was less in treated groups. Considering the above results, α-mangostin shows potential to develop a medicine for diabetes, hyperlipidemia, renal and hepatic protection as combinational or mono-therapy.

Background: Worldwide, breast cancer is the most common cancer among women and is a leading cause of cancer death. In the present study, we investigated the NQO1 C609T genotypic and allelic distribution in north Indian breast cancer patients. Materials and Methods: The genotypic distribution of the NQ01 C609T polymorphism was assessed in 100 invasive ductal carcinoma (IDC) breast cancer patients and 100 healthy controls using allele specific PCR (AS-PCR). Results: A lower frequency of the CC genotype was found in breast cancer patients (24%) than in the controls. On the other hand, TT genotype frequency was also found to be higher in female healthy controls (32%) than the female breast cancer patients (20%). The frequencies of all three genotypes CC, CT, TT in patients were 24%, 56% and 20% and in healthy controls 50%, 22% and 32% respectively. We did not find any significant correlation between the NQO1 C609T polymorphism and age group, grading, menopausal status and distant metastasis. A less significant association was found between the NQ01 C609T polymorphism and the stage of breast cancer (X2=5.931, P=0.05). Conclusions: The present study shows a strong association between NQO1 C609T polymorphism with the breast cancer risk in the north Indian breast cancer patients so that possible use as a risk factor should be further explored.

Background The safety and efficacy of everolimus eluting bioabsorbable vascular scaffold (BVS) in the management of “ST” segment elevation myocardial infarction (STEMI) are yet to be established. Aims To evaluate immediate and short term safety and efficacy of the everolimus-eluting ABSORB BVS compared with non BVS drug eluting stent (DES) in patients with STEMI. Methods From December 2013 to December 2014, 220 patients with STEMI were included in this study. Among them, 35 patients treated with BVS were compared with a control group composed of 180 patients who underwent non BVS DES implantation in the same time period. The incidence of major adverse cardiac events (MACE: stent thrombosis: death, non-fatal myocardial infarction, or target vessel/lesion revascularization) before discharge and up to six months was evaluated. Results 1 vessel disease was more frequent whereas, 2 and 3 vessel disease was less frequent in BVS group. Procedural characteristics were also similar between groups, except for the use of post dilation (p = 0.04). Procedural success, in-hospital, and up to six-month MACE rates were similar between both groups. Definite or probable stent thrombosis did not occur (according to the ARC criteria) in BVS patients, though two patients during the index admission and another two patients in the first month after DES implantation had stent thrombosis. Conclusion The use of the ABSORB BVS for STEMI is feasible and associated with good procedural safety, and angiographic success rate.