andhra Pradesh, India
andhra Pradesh, India

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Nandhagopal R.,SVIMS
Southern Medical Journal | Year: 2010

Tuberous sclerosis (TS) is a well-recognized cause of symptomatic seizures, and rarely coexists with acquired lesions such as neurocysticercosis. We present a 6-year-old boy with tuberous sclerosis and a limited form of epileptic spasms who had, in addition, two coexisting cerebral cysticercal cysts. The association was an incidental finding, but the cerebral tubers could be mistaken for perilesional edema of cysticercal cysts, especially if the clinical features of TS were subtle and not carefully looked for. Our case illustrates the diagnostic and therapeutic implications of recognizing the proximate cause of seizures, such as TS, when the incidental finding of cysticercal cysts might confound the clinical picture in endemic areas. © 2010 by The Southern Medical Association.


Sreenivasa Kumar M.L.,SVIMS | Rajasekhar D.,SVIMS | Vanajakshamma V.,SVIMS | Latheef K.,SVIMS
Journal of the Saudi Heart Association | Year: 2014

Background: Metabolic syndrome is associated with the development of diabetes mellitus and cardiovascular disease. The impact of metabolic syndrome on the progression of atherosclerosis has been well documented. This study was designed to evaluate the impact of metabolic syndrome on global left ventricular function by using left ventricular myocardial performance index (LVMPI). Methods: The diagnosis of metabolic syndrome was made as per the criteria of the International Diabetes Federation. Echocardiography was performed with a Philips IE33 machine using a 1-5. MHz transthoracic probe. LVMPI was calculated by adding isovolumic contraction time with isovolumic relaxation time and dividing it by ejection time. Results: The mean LVMPI value in metabolic syndrome was 0.64 ± 0.09, while that in controls was 0.48 ± 0.06 (p < 0.001). Metabolic syndrome was seen to have more significant influence on LVMPI. Conclusions: Metabolic syndrome is a strong predictor of sub-clinical myocardial dysfunction in subjects free of clinically apparent heart disease. © 2014 King Saud University.


Vamsidhar A.,SVIMS | Rajasekhar D.,SVIMS | Vanajakshamma V.,SVIMS
Indian Heart Journal | Year: 2015

Ruptured sinus of Valsalva aneurysm (SOVA) with multiple communications, ventricular septal defect, and aortic regurgitation are still best treated surgically. We report a case of 30-year-old male with right SOVA, with two communications with right ventricle. Both communications were successfully closed using antegrade and retrograde approaches, respectively. © 2015 Cardiological Society of India.


Chandra V.V.R.,SVIMS | Prasad B.C.,SVIMS | Varaprasad G.,SVIMS
Journal of Neurosurgery: Pediatrics | Year: 2013

The authors report a very rare case of tuberculoma involving the ulnar nerve. The patient, a 7-year-old girl, presented with swelling over the medial aspect of her right forearm just below the elbow joint, with features of ulnar nerve palsy, including paresthesias along the little and ring fingers and claw hand deformity. There was a history of trauma and contact with a contagious case of tuberculosis. There were no other signs of tuberculosis. At surgical exploration the ulnar nerve was found to be thickened, and on opening the sheath there was evidence of caseous material enclosed in a fibrous capsule compressing and displacing the nerve fibers. The lesion, along with the capsule, was subtotally removed using curettage, and a part of the capsule that was densely adherent to the nerve fibers was left in the patient. Histopathological examination of the specimen was consistent with tuberculoma. The patient received adequate antitubercular treatment and showed significant improvement. ©AANS, 2013.


Prasad B.C.,SVIMS | Vemula R.C.,SVIMS | Varaprasad G.,SVIMS
Indian Journal of Surgery | Year: 2013

We report a case of non missile penetrating spinal injury (NMPSI) caused due to an impaled knife in the lumbar region. The patient was neurologically preserved and presented with the knife blade retained in his back. The wound with the knife in situ was explored, the knife removed and a dural laceration was repaired. The wound healed without evidence for cerebrospinal fluid leakage or infection. © 2010 Association of Surgeons of India.


Rajasekhar D.,SVIMS | Vanajakshamma V.,SVIMS | Ranganayakulu K.P.,SVIMS
Acta Cardiologica Sinica | Year: 2016

Iatrogenic aortocardiac fistulae have been described rarely following intracardiac repair. This 28 year-old-male presented to our facility with dyspnea going on 20 days after closure of ventricular septal defect (VSD) and resection of subaortic membrane. A communication was noticed between the aorta and the right ventricle (RV) upon transthoracic echocardiography. Cardiac catheterisation revealed a significant shunt and an aortogram revealed a 6 mm communication between aorta and right ventricle. Percutaneous closure of this defect was attempted under local anaesthesia through right femoral access. An alpha arteriovenous loop was formed despite repeated attempts, hence a retrograde approach for device delivery was considered. An 8mmAmplatzermuscular VSD occluder device was deployed across the defect achieving a complete closure through an 8F delivery sheath. To the best of our knowledge this is the first report of an iatrogenic aorta to RV fistula occurring in a patient following an intracardiac repair which has been successfully treated percutaneously. © 2016, Republic of China Society of Cardiology. All Rights Reserved.


Prasad B.C.,Svims | Chandra V.V.R.,Svims | Varaprasad G.,Svims
Turkish Neurosurgery | Year: 2012

Subdural hematoma (SDH) has been reported in 0.-4% of all intracranial metastatic tumors. Chronic SDH has been reported in intracranial metastases from both solid and haematological malignancies. Here we report recurrent SDH in a patient with chronic myeloid leukaemia(CML) following dural metastases. An elderly male patient a known case of CML was admitted to our casualty with symptoms of headache and altered sensorium and imaging revealed a large right fronto temporo parietal chronic SDH. Thiswas surgically managed and histopathology of the duramater and subdural membrane confirmed infiltration with leukemic cells. The pathogenesis of chronic SDH in malignancies is multifactorial and this case report throws light on leukemic infiltration of duramater as a cause for chronic SDH other than coagulopathy.


PubMed | SVIMS
Type: Journal Article | Journal: Acta Cardiologica Sinica | Year: 2016

Iatrogenic aortocardiac fistulae have been described rarely following intracardiac repair. This 28 year-old-male presented to our facility with dyspnea going on 20 days after closure of ventricular septal defect (VSD) and resection of subaortic membrane. A communication was noticed between the aorta and the right ventricle (RV) upon transthoracic echocardiography. Cardiac catheterisation revealed a significant shunt and an aortogram revealed a 6 mm communication between aorta and right ventricle. Percutaneous closure of this defect was attempted under local anaesthesia through right femoral access. An alpha arteriovenous loop was formed despite repeated attempts, hence a retrograde approach for device delivery was considered. An 8 mm Amplatzer muscular VSD occluder device was deployed across the defect achieving a complete closure through an 8F delivery sheath. To the best of our knowledge this is the first report of an iatrogenic aorta to RV fistula occurring in a patient following an intracardiac repair which has been successfully treated percutaneously.


PubMed | SVIMS
Type: Journal Article | Journal: Indian journal of nephrology | Year: 2014

We present a patient of who ingested large dose of of atenolol and amlodipine and was treated successfully with continuous venovenous hemodiafiltration. Early recognition of indications for renal support and early initiation of the same is the key to successful management.


PubMed | SVIMS
Type: Journal Article | Journal: Journal of cardiovascular and thoracic research | Year: 2015

Percutaneous transvenous mitral commissurotomy (PTMC) is a safe and effective procedure for relief of severe mitral stenosis. PTMC is being done widely and many transseptal procedures requiring large diameter catheters, sheaths are becoming popular. The knowledge of iatrogenic atrial septal defect (iASD) is vital. This study assessed the use of real-time 3D echocardiography (RT3DE) and incidence of iASD in a cohort of patients undergoing transseptal catheterization during PTMC.One hundred ten patients underwent PTMC. The reliability and accuracy of RT3DE for iASD detection was determined, RT3DE was compared with 2D echocardiography (2DE) for iASD occurrence, influencing variables analyzed and followed up for 1 year.RT3DE is more reliable and accurate for the study of iASD than 2DE. Color RT3DE detected iASD in 94 (85.5%), with 2DE iASD was detected in 74 (67.3%) (P < .0001).On follow up 85% had iASD post procedure, 56% at 6 months, 19% at 1 year follow up. The mean iASD diameter was 5.41 3.12 mm and area 6.57 3.81 mm(2). iASD correlated with patient height, Wilkins score, pre-PTMC LA v, and post-PTMC LVEDP.RT3DE imaging is superior in accuracy to traditional 2DE techniques. All the modes of RT3DE are useful in the assessment of iASD. iASD measured by RT3DE correlates with several patient, procedural and echocardiographic variables.

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