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Paradoxical Embolism with acute arterial ischemia is an uncommon but known entity in medical literature. However, existence of concomitant pulmonary thromboembolism with a patent foramen ovale presenting as limb arterial gangrene has not been reported in literature to the best of our knowledge and search. we present a case of right lower limb arterial gangrene in an elderly female who had concomitant Pulmonary thromboembolism with a patent foramen ovale. The limb gangrene was attributed secondary to paradoxical embolism due to patent foramen ovale. The patient was managed with limb amputation and long term oral anticoagulation...... ReadMore -
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Background: Patients with previous transcatheter aortic valve replacement (TAVR) can present with an acute coronary syndrome that requires coronary angiography and percutaneous coronary intervention (PCI). However, these procedures can be difficult if the patient has a self-expandable TAVR as it covers the coronary arteries. Case Report: An 87-year-old female with aortic valve stenosis and self-expanding TAVR presented with syncope, shortness of breath, and chest pain. Electrocardiography showed sinus bradycardia, left axis deviation, and T-wave inversion in the lateral leads. Troponin levels trended up to 37.8 pg/mL, which was consistent with a non-ST elevation myocardial infarction. A pre-procedural coronary angiography at that time also revealed no significant stenosis. Shared decision-making was performed and..... ReadMore -
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The Covid 19 pandemic is causing a huge survival crisis for mankind. As of october 1, 2021 WHO counted more than 235 million infected cases and 4 million deaths [1]. In Algeria, these figures stand at more than 205,000 confirmed cases and 5875 deaths, since the first cases recorded in February 2020 [2]. Little is known about the epidemiological data of Algerian patients. The objective of the present study was to analyze the clinical, biological and radiological profile of patients with Covid-19 during the first six months of the epidemic in Algiers. Patients And Method Study Design and Participants From April 11 to September 30, 2020, we carried out a descriptive and prospective study at the El Biar Hospital in Algiers, and we enrolled 1008 patients. Only adults with a diagnosis of Covid-19 confirmed by serology test (IgM, IgG) and / or b..... ReadMore -
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53 years old female patient, who presented oppressive precordial pain, radiating to the neck and jaw, for which she went to the emergency room, where an ECG image of complete left bundle branch block was evidenced (Figure 1), with taking ultrasensitive troponin I at > 50,000 pg/ml, presenting data of acute heart failure and acute pulmonary edema, requiring endotracheal intubation, moving urgently to cardiac catheterization without evidence of obstructive coronary lesions, observing in aortography interruption of the aortic arch with collateral vessels connecting to the descending aorta (Figure 2). Later in the ICU, an echocardiogram was performed that reported LVEF of 27%, generalized hypokinesia, severe MI and apical thrombus (Figure 3), diagnosing fulminant myocarditis, for which treatment with methylprednisolone at a dose of 500 mg for..... ReadMore -
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Introduction: Prosthetic valve thrombosis (PVT) is a rare but serious complication of valve replacement, most often encountered with mechanical prostheses. The present study aims to evaluate patients with prosthetic valve thrombosis in terms of the clinical characteristics, risk determinants, treatment, and outcomes in the prospective observational study. Material and Methods: The observational study was conducted in a tertiary care center. All patients suspected of having prosthetic valve dysfunction underwent clinical, echocardiography, and fluoroscopic examination. Data regarding risk determinants, clinical characteristics, and response to treatment were categorized under 3 classes, complete response, partial response, and failed treatment (based upon serial echocardiography and fluoroscopy) were recorded. Result: Out of 29 patients 17..... ReadMore -
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Ortner’s syndrome or Cardiovocal syndrome is hoarseness due to left recurrent laryngeal nerve palsy caused by mechanical affection of nerve from enlarged cardiovascular structures. A middle-aged female presented to us with a long history of hoarseness of voice and exertional dyspnea. The diagnosis of pulmonary artery aneurysm presenting as Ortner’s syndrome was made..... ReadMore -
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Introduction: Risk of conversion to on-pump surgery is one of the concerns about off-pump CABG surgery. Conversion to on-pump surgery carries high morbidity and mortality risk. Our study aimed to investigate the relation between transverse heart and the risk of conversion to on-pump CABG . Materials and Methods: Our study consisted of 3000 patients who underwent isolated off-pump CABG surgery between June 2010 and February 2020. All patients have at least one CABG in the Cx region. We have described vertical and transverse heart according to angle between the left anterior descending artery (LAD) and the left part of the sternal retractor.Results: Our conversion rate was 7.1%. The average intensive care unit (ICU) stay was 1.17±0.10 days in successful off-pump surgery but 3.11±2.11 days in converted surge..... ReadMore -
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PCSK9 is a well validated target for the treatment of hypercholesterolemia. Several pharmaceutical companies focused on the development of injectable monoclonal antibodies. Shifa Biomedical has focused on developing orally bioavailable small molecule PCSK9/LDLR antagonists. PCSK9 antagonists were identified through virtual screening at the PCSK9 surface where the LDLR-EGF-A binds. An SAR study of many analogues were done for their ability to antagonize the PCSK9/LDLR interaction in an in vitro ELISA assay, upregulate the LDLR in a cell-based assay, and increase LDL uptake in a fluorescent Dil-LDL assay. The most potent compound meeting these criteria was P-4, formulated by a nanocrystal/targeted delivery approach for the in vivo studies. Nano formulated P-4 was named P-21. P-4 exhibited a concentration-dependent inhibition of the PCSK9/LD..... ReadMore