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Prent S.R.,Frontier Lifeline Hospital
Indian Journal of Practical Pediatrics | Year: 2011

The common arrhythmias that a paediatrician is likely to encounter in his clinical practice are the paroxysmal supraventricular tachycardias (PSVT). Of these, AV reciprocating tachycardia (AVRT) is predominantly seen in infancy while AV nodal re-entrant tachycardia (AVNRT) and paroxysmal junctional reciprocating tachycardias (PJRT) occur in the school going age group. The non-paroxysmal supraventricular tachycardias, ventricular arrhythmias and complete heart block are infrequent in children. A clear understanding of the mechanisms that initiate rhythm disturbances namely re-entry, automaticity and block as well as knowledge of the characteristics of myocardial and accessory tissues would enable optimal management of any arrhythmias.

Subramanyan R.,Frontier Lifeline Hospital
Annals of Pediatric Cardiology | Year: 2016

India faces a huge burden of pediatric and adult congenital heart diseases (CHDs). Many acquired valvar, myocardial, and vascular diseases also need treatment in childhood and adolescence. The emergence of pediatric cardiology as an independent specialty has been a relatively recent development. A few centers of excellence in pediatric cardiology have developed. However, the requirement of pediatric cardiac care and pediatric cardiologists is far in excess of what is available. There are no guidelines at present in India for uniform training in pediatric cardiology. Many training programs are nonstructured and do not focus on the regional needs. Both core training and advanced training programs are essential to provide adequate numbers of community-level pediatric cardiologists and academic leaders respectively. This article proposes a detailed plan and curriculum for comprehensive training of future pediatric cardiologists in India. © 2016 Annals of Pediatric Cardiology | Published by Wolters Kluwer - Medknow.

Sasikumar N.,Frontier Lifeline Hospital | Kuladhipati I.,Ayursundra Advanced Cardiac Center
Heart Asia | Year: 2014

Background Complete atrioventricular block complicating acute anterior wall ST elevation myocardial infarction (MI) is classically considered one of the worst prognostic indicators. Methods We present the case of a gentleman who developed complete atrioventricular block during the course of acute anterior wall ST elevation MI, and had spontaneous resolution of the same. Mechanisms of spontaneous resolution of complete atrioventricular block in the setting of acute MI are discussed. Attention is drawn to a subgroup of patients, albeit a minority, who have a better prognosis owing to reversible causes than classically expected and seen. Results Clinical features suggested that this patient had reocclusion of the infarct-related artery after thrombolysis on presentation and spontaneous reperfusion. Conclusion Coronary angiography provides invaluable information for decision making in such clinical scenarios. Complete atrioventricular block due to reversible ischaemia produced by reocclusion of an infarct-related artery should be reversible by percutaneous coronary angioplasty of the infarct-related artery. We suggest that reversible causes be considered before attributing atrioventricular block to irreversible damage, which would require a permanent pacemaker implantation. This would be more significant in most of the developing world, where resources are scarce.

Kumar N.V.,University of Madras | Menon T.,University of Madras | Pathipati P.,Frontier Lifeline Hospital | Cherian K.M.,Frontier Lifeline Hospital
The Journal of heart valve disease | Year: 2013

Infective endocarditis (IE) is a worldwide problem, and at least one-third of cases are culture-negative despite the use of appropriate laboratory techniques. A broad-range polymerase chain reaction (PCR) amplification was performed of the 16S rRNA gene, followed by single-strand sequencing for 26 surgically removed heart valves from patients with culture-negative endocarditis who had undergone valve repair or replacement. Two of the 26 patients were PCR-positive, and sequencing of the amplicon identified the etiological agent. Gram-stained smears of the heart valves were positive in both cases. Three of the remaining 24 cases which were negative by PCR also showed the presence of micro-organisms in Gram-stained smears. The study results emphasize that, in suspected IE cases when there is no growth in culture, a combination of microscopy and 16S rRNA sequencing can be used to identify the pathogen in excised valvular tissue.

Borra S.K.,Frontier Lifeline Hospital | Mahendra J.,Meenakshi Ammal Dental College | Gurumurthy P.,Meenakshi Academy of Higher Education and Research | Jayamathi,Meenakshi Ammal Dental College | And 2 more authors.
Journal of Clinical and Diagnostic Research | Year: 2014

Background: Among various reactive oxygen species, hydroxyl radicals have the strongest chemical activity, which can damage a wide range of essential biomolecules such as lipids, proteins, and DNA.Objective: The objective of this study was to investigate the beneficial effects of curcumin on prevention of oxidative damage of biomolecules by hydroxyl radicals generated in in vitro by a Fenton like reaction.Materials and Methods: We have incubated the serum, plasma and whole blood with H2O2/Cu2 +/ Ascorbic acid system for 4 hours at 37 0C and observed the oxidation of biomolecules like albumin, lipids, proteins and DNA.Results: Curcumin at the concentrations of 50,100 and 200 μmoles, prevented the formation of ischemia modified albumin, MDA, protein carbonyls, oxidized DNA and increased the total antioxidant levels and GSH significantly.Conclusion: These observations suggest the hydroxyl radical scavenging potentials of curcumin and protective actions to prevent the oxidation of biomolecules by hydroxyl radicals. © 2014, Journal of Clinical and Diagnostic Research. All rights reserved.

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