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Background: Sparse data are available regarding congenital heart disease (CHD) from southern India. This study was designed to document the sociodemographic factors, clinical profile and pattern of CHD at a referral centre. Methods: A cross-sectional observational study was done by direct interview method and review of medical records of 414 participants using internally validated, pre-defined proforma. Results: More than half of the cases (54.6%) referred were within 1 year of age. Wasting was present in 45%. Most of the cases belonged to middle and lower socio-economic status group (79%) and were referred by paediatricians (70%); 48% had travelled more than 500 km to avail cardiac services. Predominant symptoms of referral were respiratory distress (61.8%), feeding difficulties (50%), cyanosis (43.7%) and palpitation (24.9%). Major abnormalities detected were ventricular septal defect (31.2%) and tetralogy of Fallot (21.7%). Conclusions: This study highlights the need of prioritising and planning for the implementation of affordable and accessible cardiac infrastructure to people from rural areas with low socio-economic background. [ABSTRACT FROM AUTHOR]

Background : Open-heart surgery is challenging in preterm neonates and infants, and its feasibility in low-resource settings has not been defined. We describe our institutional experience with open-heart surgeries performed on consecutive preterm infants. Materials, Methods and Results : This was a single-center retrospective cohort from a tertiary hospital in Southern India and included consecutive preterm neonates (<37 weeks) admitted for open-heart surgery. This report is limited to babies who were <3 months at the surgery. The salient features of the 15 preterm included twin gestation: 7 (46.7%); median gestational age at birth: 35 weeks (28-36 weeks); median corrected gestational age at surgery: 37 weeks (33-40 weeks); birth weight: 1.75 kg (1.0-2.6 kg); weight at surgery: 1.8 kg (1.2-2.9 kg); and small for gestational age: 12 (80%). The heart defects included transposition of the great arteries (7), total anomalous pulmonary venous return (3), large ventricular septal defect (VSD) (1), and VSD with coarctation of the aorta (4). Eleven (73%) were mechanically ventilated preoperatively and five had preoperative sepsis. The mean cardiopulmonary bypass time was 169.7 ± 61.5 min, and cross-clamp time was 99.7 ± 43.8 min. There was no inhospital mortality; one baby expired during follow-up at 1 month. Postoperative mechanical ventilation duration was 126.50 h (84.25-231.50 h), and intensive care unit stay was 13.5 days (9-20.8). The total hospital stay was 39 days (11-95 days). Two children (13.3%) had postoperative sepsis. Conclusion : Through collaborative multidisciplinary management, excellent outcomes are feasible in low-resource environments for selected preterm neonates undergoing corrective open-heart operations. [ABSTRACT FROM AUTHOR]

Introduction: Congenital heart diseases (CHD) are among the most common form of birth defects. The fetal cardiac screening by ultrasound can detect a high proportion of cases of CHD. Detection of cardiac anomalies can be challenging and is typically done by fetal cardiac ultrasound performed between 18 and 22 weeks. A transvaginal scan can detect anomalies even at 12-13 weeks. Early and precise detection of CHD can direct appropriate management. Objectives: To detect the incidence of congenital heart diseases at a tertiary care centre and to detect cardiac anomalies early, accurately, and help avail all the benefits of early prenatal diagnosis. Methods: A descriptive cross-sectional study, where 5,000 patients were screened over a period of 10 months who came for routine second trimester (16 to 24 weeks) obstetric evaluation. The fetal heart was evaluated and sequential segmental analysis was done using ultrasonography. Detailed biometric and structural evaluations of all fetuses were undertaken. In high-risk cases (17%), or in cases with positive cardiac findings, the extended fetal echocardiographic examination was performed at 16-20 weeks(850 cases). Follow-up scans were done at 24 weeks and post-natal periods to confirm the diagnosis. Out of 5,000 screened cases, 25 fetuses had CHD. The most common indication for extended fetal echo was maternal (59.2%) followed by fetal (40.2%). In maternal indications, the most common was advanced maternal gestational age (>35 years), followed by bad obstetric history and gestational diabetes. In fetal indications, the most common was abnormal obstetric Doppler findings favouring IUGR. Results: Of 5,000 cases examined by us, at 16 - 24 weeks using Color Doppler, and a high-end ultrasound machine, we could diagnose VSD in 3 cases, ASD in 2 cases, TOF in 2 cases, Transposition of great vessels in 2 cases, Hypoplastic left heart syndrome in 2 cases, Ebstein's anomaly in 1 case and severe fetal hydrops with bradycardia in 1 case. On follow-up scan at 24 weeks, 2 additional VSD cases, 2 additional ASD cases, 2 new cases of TOF, and 1 new case of TGA were diagnosed. However, the number of cases of other pathologies remained the same. On post-natal scan additional cases of VSD, TOF and TGA diagnosed were 2, 1, and 2. Conclusion: An apparently normal appearance at any stage of pregnancy does not exclude a major heart defect, and it seems likely that some defects may be amenable to diagnosis only after birth. Hence follow-up scans with minute observation and technical expertise are need of the hour. Most of the CHDs in our region are missed, primarily because of poor socioeconomic status, lack of availability and awareness of diagnostic echocardiography. Spreading awareness and skill of fetal echocardiography is need of the hour. [ABSTRACT FROM AUTHOR]

Introduction Ignorance about appropriate Infant and Young Child Feeding (IYCF) practices among parents with children of Congenital Heart Defects (CHD) can exacerbate malnutrition in these children leading to significant morbidity and mortality. The use of novel methods for Intensive Nutrition Counselling such as in a WhatsApp social media group can result in significant improvements in the child's nutritional status. Objective of this study is to assess the efficacy of WhatsApp group for Intensive Nutritional Counselling to parents with children of CHD. Methods This was a two-years prospective interventional study, one-group before-after study design, conducted at a tertiary care referral institute in Central India. Here, intervention is in the form of specialised focused nutrition counselling for parents of children with CHD through a WhatsApp social media group. Results The majority of the patients 16 (30.0%) were between the ages of 7 and 12 months, and the most common diagnosis in 25 patients (48.9%) was a Ventricular Septal Defect (VSD). 68.0% of patient-families belonged to the lower socio-economic classes. Before the intervention, 71.1% of children (37 of 52) were found to be underweight, 35.5% of children were stunted and 65.6% of children were wasted. Post intervention, there was 50.0% improvement in weight and 14.0% improvement in height. This intervention particularly helped improve IYCF habits for the age group of 7-12 months. Post-intervention, all parents included the 8 food groups in their children's diet, thus providing them with wholesome nutrition, whereas pre-intervention, parents only provided 2-3 food groups to children on a daily basis. Conclusions This was the first study to explore the use of WhatsApp groups to educate parents of children with CHD about specific nutrition counselling, resulting in an improvement in all 3 child anthropometric indices. [ABSTRACT FROM AUTHOR]

Background: Congenital heart disease (CHD) is a common congenital malformation. Antenatal rubella infection in the mother and genetic defects are important causes to which CHD are attributed. Exact contribution of antenatal rubella infection or genetic causes to CHD is still unknown.Objective: To study the epidemiology, etiology and clinical associations of echocardiographically confirmed congenital heart disease in infants in Western Rajasthan enrolled in the congenital rubella syndrome (CRS) surveillance project. To study the utility of clinical diagnostic criteria in identifying congenital rubella infection.Method: This was a prospective observational study, in which 251 patients with echocardiographically confirmed CHD were enrolled. Detailed clinical evaluation was done in all patients. Rubella serology was done in all patients. Genetic and other testing was done as appropriate.Result: The hospital-based prevalence of CHD in infants was 1% at our center. Fifty-seven percent of the babies had acyanotic septal heart defects of which ventricular septal defect (VSD) was the most common (35%). Anti-rubella immunoglobulin M (IgM) antibodies were positive in 8.5% of the CHD patients. A clinically identifiable genetic cause was present in 3.6% of the cases. In patients who tested positive for anti-rubella IgM antibodies also, VSD was the most common (33%) CHD followed by Tetralogy of Fallot (13.2%).Conclusion: CRS contributes to 8.5% of CHD. CRS is associated with a wide spectrum of CHD. The etiology of a large number of CHD remains elusive. Detailed studies on the cause and mechanism of development of CHD need to be undertaken. [ABSTRACT FROM AUTHOR]

Background: Thyroglossal duct cysts (TGDCs) are the most common congenital cervical anomalies that account for about 2-4% of all midline neck swellings. They may present as a cyst, abscess, or sinus in the anterior neck region. The cysts are managed by the standard or a modified Sistrunk operation with the least chance of recurrence when compared to the removal of the cyst alone. This study aimed to present our experience in the modified Sistrunk operation over thyroglossal duct cyst anomalies with particular emphasis on the clinical diversity in presentation, surgical technique, and management of postoperative complications. Methods: This prospective observational study was carried out on 25 newly diagnosed cases of TGDC, which were confirmed histologically and radiologically over a period of 5 years. Results: All patients underwent a modified Sistrunk operation under general anesthesia and followed up for 2 years. The surgery consisted of complete excision of the cyst with the removal of the central portion of hyoid bone and macroscopically evident duct tissue with intraoperative T-shaped closure of the muscular layer to restore the function of hyoid bone and reduce most postoperative complications, such as recurrence and swallowing difficulties. Conclusion: The results indicate that the modified Sistrunk operation is one of the best surgical procedures for the treatment of TGDC anomalies limited up to hyoid without lingual extension, especially to prevent a recurrence. More attention should be paid to supra and infra hyoid muscular closure to restore the normal function of the hyoid. [ABSTRACT FROM AUTHOR]

Introduction: In developing countries like India, it is common for late presentation of Tetralogy of Fallot (TOF) patients to a hospital as compared to that of developed countries. The objective of this study is to analyze the surgical outcome of TOF patients with age > 15 years. Methods: This is a retrospective descriptive study of the surgical outcomes of 45 adult patients undergoing correction for TOF. Epidemiology, symptomology, and preoperative evaluation were performed. Results: Most of the patients were male (33 [73%]). The median age was 21 years. A total of 42 (93.33%) patients had subaortic ventricular septal defect (VSD), while three (6.6%) patients presented with doubly committed VSD. The most common type of right ventricular outflow tract (RVOT) obstruction was combined infundibular and valvular types, accounting for 34 cases (75.5%). Six patients had infundibular RVOT obstruction, while three patients (6.6%) had predominantly valvular pulmonary stenosis. We performed transright atrial repair in 33 patients. Right atrium-pulmonary artery approach was used in five patients (11.1%). The most common postoperative complication was right bundle branch block, seen in 14 patients, with a mortality rate of 2% in the early postoperative period. We achieved excellent early and midterm survival results and significant improvement in functions and disease-free quality of life. Conclusion: Intracardiac repair in adult TOF can be performed with low mortality, less residual RVOT obstruction, and need for revision of RVOT far less frequent by using the Jhajhria Infundibular Resection Adequacy Assessment technique (JIRAAT) to assess for adequacy of infundibular resectionAdult. Tetralogy of Fallot. Heart Septal Defects, Ventricular. Pulmonary Artery. Postoperative Period. Treatment Outcome. Patients Rights [ABSTRACT FROM AUTHOR]

Introduction: Isolated pulmonary valve stenosis with intact ventricular septum constitutes the third most common congenital heart disease apart from Ventricular Septal Defect (VSD) and Atrial Septal Defect (ASD). Percutaneous balloon pulmonary valvuloplasty is an effective therapeutic alternative procedure of choice in severe valvular PS. Conventionally, the Mansfield balloon is being used worldwide for pulmonary valvuloplasty. Joseph Mitral Valvuloplasty (JOMIVA) balloon offers advantages of longer size, lower cost and its familiarity to use this balloon for mitral valvuloplasty in this institution since long. Aim: To assess the immediate and long-term results of Joseph Mitral Valvuloplasty (JOMIVA)balloon for Pulmonary valvuloplasty in isolated severe Pulmonary Stenosis (PS). Materials and Methods: This was a long term retrospective study conducted at the Cardiology Department of SCB Medical college and Hospital, Cuttack, Odisha, India, where pulmonary valvuloplasty was performed using single JOMIVA balloon in 21 adults and adolescent patients. Clinical and Echocardiography (Echo) Doppler evaluation for restenosis and Pulmonary Regurgitation (PR) were assessed. All the cases were followedup serially in Outpatient Department (OPD) for 12 years in retrospect manner. Results: Data of total 21 participants (15 males and 6 females; mean age was 18.3±6.8 years) were analysed in the study. After pulmonary valvuloplasty, the median transvalvular gradient significantly decreased from 115 mmHg (interquartile range (IQR) 101-128 mmHg) to 46 mmHg (IQR 37-51 mmHg) (p-value<0.0001). Also, the right ventricular systolic pressure reduced significantly from 136 mmHg (IQR 122-148 mmHg) to 67 mmHg (IQR 57-71 mmHg) (p-value<0.0001). Catheterization Laboratory (Cath Lab) complications were transient and selflimiting. Mild to moderate (PR) was noted in all cases i.e., Grade I in 12 cases (57.1%) and Grade II in 9 cases (42.8%) which showed evidence of regression on follow-up. Neither significant restenosis nor significant PR (Grade III /IV) was observed during follow-up period of 12 years. Conclusion: Percutaneous valvuloplasty using JOMIVA Balloon, in case of severe valvular PS in adults, is a cost-effective procedure. It has excellent immediate results, and long-term incremental benefits was observed in this 12-year follow-up study. [ABSTRACT FROM AUTHOR]

Background: The estimated birth prevalence of CHD is 8-12/1000 live births with a significant geographical difference. In India, over 180,000 children are born with CHD every year with state wise variation and contribute to 10% of the present infant mortality. Nearly one thirds of the CHD are critical requiring intervention in the 1st year of life. Most of the CHD are thought to be multifactorial and result from a combination of genetic and non genetic risk factors. Materials and Methods: A total of 200 CHD cases and 200 as control subjects were studied. Risk factors were examined separately. Nkx2.5 gene correlation was studied by using conventional PCR. Main Findings: The prevalence of CHD is reported in this study is 8.48/1000 live births. Total 200 cases of CHDs, VSD-40%, ASD-31%, TOF-11%, PDA-10%, PS-03%, AS-03%, COA-01% and TA-01% are reported. Total 200 cases of CHD patient's mothers medical history was analyzed and noted history of abortions in 65 cases, pregestational diabetes in 60 cases, obesity in 50 cases, family history with CHD in 40 cases, maternal usage of drugs in 15 cases, advanced maternal age in 15 cases and smoking and drinking alcohol in 8 cases. Conclusion: Both Genetic and Non-genetic risk factors are associated to CHDs. Nkx2.5 gene is the master regulator for process of cardio genesis. Nkx2.5 Gene is mostly associated to Atrial Septal Defects, Tetralogy of Fallot and Ventricular Septal Defects. Building a healthy life habits, maternal counseling for periconceptional control of blood glucose, adequate weight maintenance, and avoidance of stress is needed to prevent CHD. [ABSTRACT FROM AUTHOR]

The paper presents a quantitative and qualitative dimensions of congenital heart defect (CHD) research output in India, based on publications data (1335) indexed in Scopus database during 2000-19. CHD research registered 10.0% growth, averaged 7.07 citations per paper, contributed 3.04% share to the global output and constitute 13.48% share of India's research as international collaborative. CHD research is skewed as top 10 countries account for 83.23% of global output. India ranks as the 10th most productive country in the world. The distribution of CHD research by type of research reveal that Tetralogy of Fallout accounted for the highest share (34.31% share), followed by Aortic Stenosis (30.41%), Atrial Septal Defects (28.16%), Ventricular Septal Defects (26.22%), etc. AIIMS - New Delhi, Amrita Institute of Medical Sciences, Coimbatore and PGIMER - Chandigarh lead the country as the most productive organizations (with 222, 73 and 64 papers). Besides, Amrita Institute of Medical Sciences, Coimbatore (33.88 and 4.79), SCTIMST - Trivandrum (30.73 and 4.35) and Institute of Medical Sciences, BHU, Varanasi (17.20 and 2.43) lead the country as the most impactful organizations in terms of citation per paper and relative citation index. B. Airan, A. Saxena and S. Talwar have been the most productive authors (with 63, 63 and 59 papers) and P. Khairy (16.31 and 2.31), B. Vaidyanathan (14.3 and 2.03) and R.K. Kumar (10.53 and 1.49) have been the most impactful authors. Indian Heart Journal, Annals of Pediatric Cardiology (84 papers) and Annals of Cardiac Anaesian (53 papers) topped the list of most productive journals (with 110, 84 and 53 papers). International Journal of Cardiology (18.62), Catheterization and Cardiovascular Interventions (16.64) and Journal of Cardiothoracic and Vascular Anesthesia (11.65) leads in ranking in terms of citation per paper. [ABSTRACT FROM AUTHOR]

A number of guidelines are available for the management of congenital heart diseases (CHD) from infancy to adult life. However, these guidelines are for patients living in high-income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for CHD, as often these patients present late in the course of the disease and may have coexisting morbidities and malnutrition. Guidelines emerged following expert deliberations at the National Consensus Meeting on Management of Congenital Heart Diseases in India, held on August 10 and 11, 2018, at the All India Institute of Medical Sciences. The meeting was supported by Children's HeartLink, a nongovernmental organization based in Minnesota, USA. The aim of the study was to frame evidence-based guidelines for (i) indications and optimal timing of intervention in common CHD; (ii) follow-up protocols for patients who have undergone cardiac surgery/catheter interventions for CHD; and (iii) indications for use of pacemakers in children. Evidence-based recommendations are provided for indications and timing of intervention in common CHD, including left-to-right shunts (atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent ductus arteriosus, and others), obstructive lesions (pulmonary stenosis, aortic stenosis, and coarctation of aorta), and cyanotic CHD (tetralogy of Fallot, transposition of great arteries, univentricular hearts, total anomalous pulmonary venous connection, Ebstein's anomaly, and others). In addition, protocols for follow-up of postsurgical patients are also described, disease wise. Guidelines are also given on indications for implantation of permanent pacemakers in children. [ABSTRACT FROM AUTHOR]

Clostridium sordellii is a gram-positive anaerobic bacteria most commonly isolated from skin and soft tissue infection, penetrating injurious and intravenous drug abusers. The exotoxins produced by the bacteria are associated with toxic shock syndrome. We report here a first case of infective endocarditis due to C. sordellii from a female patient with ventricular septal defect from India. [ABSTRACT FROM AUTHOR]

Gerbode defects are rare Ventricular Septal Defects (VSD) constituting approximately one percent cases of congenital heart diseases. The genetic predispositions towards the Gerbode Defect (GD) have remained an unexplored area of study till date. We investigated the genotype-phenotype correlation in patients with Gerbode VSD. Molecular genetic study on Sanger sequencing and subsequent data analysis showed that the contributing sequence variations in the NKX2-5, GATA4 and TBX5 gene lies in one of the highly conserved regions and this region is responsible for encoding a functional protein. The resulting genotype variation may be responsible for causing the diseased phenotype known as GD. [ABSTRACT FROM AUTHOR]

Introduction: Congenital heart defects (CHDs) are an important cause of mortality and morbidity in children representing a major global health burden. It is thus important to determine their prevalence and spectrum and identify risk factors associated with the development of heart defects. Materials and Methods : A case-control study was carried out in the Department of Pediatrics and Center of Cardiology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, from February 2014 to August 2015. All patients referred with complaints or clinical examination suggestive of CHDs were further evaluated with echocardiography. On Echocardiography, patients having CHDs were included as cases and those having a normal echocardiographic study were included as controls. Healthy controls were also included. 400 cases and 400 controls were thus identified; preterms having patent ductus arteriosus and patent foramen ovale and those with acquired heart defects were excluded. Risk factors among cases and controls were further studied. Results: Acyanotic heart defects were 290 (72.50%) of the total heart defects, whereas the contribution of cyanotic heart defects was 110 (27.50%). Out of all CHDs, ventricular septal defect was the most common lesion with contribution of 152 (38%) cases, whereas among the cyanotic heart defects, Tetralogy of Fallot was the most common lesion (18% of total cases). Out of the total 400 cases, 261 were males (65.25%). On univariate analysis, paternal age (odds ratio, OR, 2.01), bad obstetric history (OR, 2.65), antenatal febrile illness (OR, 4.12), and advanced maternal age (OR, 3.28) were found to increase the risk of CHD whereas intake of multivitamin (OR, 3.02) was found to be protective. The risk factors were further analyzed with multivariate logistic regression analysis and all the above factors were found to be significantly associated. Conclusion: We noted that the profile of CHD in our population was similar to the published literature although many were missed during infancy and detected later in life. Several antenatal factors were found to be associated with the incidence of congenital heart disease emphasizing the need to prioritize antenatal care and counseling to pregnant mothers along with good maternal nutrition and folie acid supplementation. [ABSTRACT FROM AUTHOR]

Objective: To assess the birth prevalence and pattern of congenital heart disease (CHD) using echocardiography in babies born in a community hospital of North India. Methods: A cross-sectional observational study conducted over a period of 3 years. Newborns born over a specific 8-h period of the day were recruited in the study. They underwent routine clinical examination and pulse oximetry, followed by screening echocardiography for diagnosing a CHD. Results: A total of 20,307 newborns were screened, among which 874 had abnormal echocardiograms; 687 had insignificant CHDs, 164 had significant CHDs, and 24 had other abnormal cardiac findings. The birth prevalence of significant CHDs was 8.07 per 1000 live births; 131 newborns had an acyanotic CHD (79.9%) and 33 a cyanotic CHD (20.1%). Ventricular septal defect (VSD) was the most common acyanotic CHD, present in 116 newborns, giving a prevalence of 5.7/1000 live births. Among the cyanotic CHD, transposition of great arteries was most common (prevalence 0.34/1000 live births). Conclusion: The CHD birth prevalence in our study is similar to the reported worldwide birth prevalence. Acyanotic CHD (mostly VSD) is seen in about three-fourths of babies born with CHD. The more sinister cyanotic CHD is present in remaining 25%. [ABSTRACT FROM AUTHOR]

Background: The ratio of peak tricuspid regurgitation velocity (TRV) and right ventricular outflow time-velocity integral (TVI RVOT) has been described as a good correlate of pulmonary vascular resistance (PVR). However, this method has not been well studied in congenital heart disease. Method: Twenty patients with post-tricuspid shunt lesions who were planned to undergo cardiac catheterization were enrolled for the study. The ratio of TRV/TVIRVOT was measured via transthoracic echocardiography and correlated with invasively derived PVR (PVRCATH). PVRCATH was measured by cardiac catheterization. Fick's principle was used to calculate the pulmonary blood flow and oxygen consumption was assumed. Linear regression analysis was done to find the correlation between TRV/TVIRVOT and PVRCATH. Results: There was a significant correlation between the two variables, r = 0.635(P = 0.003). Subgroup analysis revealed that this correlation was better at lower values of PVRCATH (r = 0.817 for PVR < 6 Wood units (WU)) than higher values (r = 0.659 for PVR > 6 WU). TRV/TVIRVOT ratio of greater than 0.145 predicted with 80% sensitivity and specificity a PVR > 6 WU. Conclusions: There is modest correlation between TRV/TVIRVOT ratio and invasively derived PVR in congenital shunt lesions, especially in PVR < 6 WU. TRV/TVIRVOT ratio could be useful in identifying patients with congenital shunts whose PVR is likely to be <6 WU, and hence, do not need cardiac catheterization. (Echocardiography 2012;29:478-483) [ABSTRACT FROM AUTHOR]

Introduction: Pulmonary vascular disease is a risk factor in the surgical management of patients with d-transposition of great arteries (d-TGA) and a ventricular septal defect (VSD). In older infants or children with this physiology, the question of operability often arises. Cardiac catheterization in this condition can be fallacious. It is well known that oxygen reduces pulmonary arterial pressure and pulmonary vascular resistance especially where irreversible pulmonary vascular obstructive disease has still not set in. We tried to implement this effect of oxygen in correlation with echocardiography in patients with TGA-VSD physiology where operability was in question. Methods: Patients with d-TGA and a large post tricuspid shunt in whom operability was considered doubtful were selected for the study. We administered humidified oxygen at the rate of 10 litres/minute by mask for 48 hours in the ward or intensive care unit. After administration of oxygen we reassessed the child echocardiographically looking for signs of lowering of pulmonary vascular resistance which included increased pulmonary venous blood flow to the left atrium (LA) and right to left shunting across the VSD. Observation: We studied 1 patient with d-TGA and aortopulmonary window (APW), 4 patients with TGA / large VSD and 1 patient with Taussig-Bing anomaly. The age of the studied children ranged from 4 months to 3 years with a mean age of 1.1 years. After administering oxygen as described, echocardiogram showed an increase in pulmonary venous blood flow to the LA and right to left shunting across the VSD in 5 patients and increased flow reversal in aorta in presence of the APW. Conclusion: Patients with TGA/VSD physiology with doubtful operability can be subjected to this method of determining operability using echocardiography after administering oxygen. Although not 100% accurate in predicting long term postoperative pulmonary hypertension, this is a simple, noninvasive method that can aid in decision making in such a situation. [ABSTRACT FROM AUTHOR]

This cross-sectional study assessed distribution and pattern of echocardiography confirmed congenital heart disease, among 593 pediatric patients in outpatient departments of a tertiary care hospital in eastern India. Commonest defects were ventricular septal defect (43, 40.7%), atrial septal defect (241, 31.7%), and tetralogy of Fallot (125, 21%). [ABSTRACT FROM AUTHOR]

Acute decompression syndrome (Caisson's disease) is an acute neurological emergency in divers. It is caused due to release of nitrogen gas bubbles that impinge the blood vessels of the spinal cord and brain and result in severe neurodeficit. There are very few case reports in Indian literature. There are multiple factors in the pathogenesis of Acute decompression syndrome (Caisson's disease) such as health problems in divers (respiratory problems or congenital heart diseases like atrial septal defect, patent ductus arteriosus etc), speed of ascent from the depth and habits like smoking that render divers susceptible for such neurological emergency. Usually, immediate diagnosis of such a condition with MRI is not possible in hospitals in the Coastal border. Even though, MRI is performed, it has very low specificity and sensitivity. Facilities like hyperbaric oxygen treatment are virtually non-existent in these hospitals. Therefore, proper education of the divers and appropriate preventive measures in professional or recreational divers is recommended. [ABSTRACT FROM AUTHOR]

A retrospective analysis of case-records data of 53,653 patients (0-18 years) over a two and half year period was conducted to ascertain the spectrum of congenital heart diseases. Two hundred and twenty one patients were found having congenital heart diseases; a prevalence of 4.1/1000. Ventricular septal defect (VSD) was the most frequent lesion seen in 69 (31.2%), followed by patent ductus arteriosus (PDA) in 36 (16.3%) children. Tetralogy of Fallot (TOF) was the most frequent cyanotic heart disease seen in 17 (7.8%) patients. [ABSTRACT FROM AUTHOR]