Role of Ayurveda based non-invasive intervention in management of ischemic heart disease patient of diabetes

Background: The aim of the study was to determine the effectiveness of IRP therapy in patients of myocardial ischemia attending Madhavbaug clinics in Vidarbha region, Maharashtra.Methods: This was a retrospective study conducted from June 2019 to December 2019, wherein we identified the data of patients suffering from IHD (positive for inducible ischemia from stress test) of either gender or any age, and who had attended the Out-patient departments (OPDs) of Madhavbaug clinics across India. The data of patients who had been administered IRP with minimum 7 sittings over a span of 12 weeks were considered for the study.Results: In the present study, medical records of 50 patients of IHD were analyzed. At the end of IRP therapy there was statistically significant reduction in weight, BMI, SBP, and DBP. VO2 peak was improved at the end of therapy i.e. 26.51±5.93 ml/kg/min as compared to baseline i.e.; 15.62±5.36 ml/kg/min and the difference was highly statistically significant (p<0.001). DTS improved from -2.93±5.88 at baseline to 3.21±6.03 at week 12 of IRP therapy and the difference was highly statistically significant (p<0.0001).Conclusions: Findings of present study suggest that IRP can serve as effective therapeutic option for the management of myocardial ischemia.

Aspergillus Endocarditis of Pulmonary Homograft in a Congenital Heart Disease Patient

Aspergillus endocarditis (AE) is a life-threatening condition with mortality rates approximating 80%. Herein, we describe the case of a 19-year-old patient with congenitally corrected transposition of great arteries, ventricular septal defect, and pulmonary atresia, who underwent seven cardiac surgical procedures in the past. The patient was operated for AE of a previously implanted pulmonary valve homograft associated with septic pulmonary embolism and right heart failure but succumbed to multi-organ failure three months later. To our knowledge, this is one of two reported cases of Aspergillus infection of a pulmonary homograft, indicating the rarity of the disease.

Congenital heart disease in adults

The number of patients with congenital heart disease surviving to adulthood is increasing, with many requiring ongoing medical attention. Although recommendations are that these patients should be cared for in specialist centres, the clinical state of the acutely unwell patient may preclude transfer prior to the instigation of lifesaving treatment. Although the principles of resuscitation in this patient population differ little from those with acquired heart disease, the acutely unwell adult congenital heart disease patient presents a challenge, with potential pitfalls in examination, assessment/monitoring, and intervention. Keys to avoiding errors include: knowledge of the primary pathophysiology, any interventions that have been undertaken, residual lesions present (static or dynamic), and the normal physiological status for that patient-to determine the precise cause for the acute deterioration and to appreciate the effects (detrimental or otherwise) that any supportive and/or therapeutic interventions might have. Expert advice should be sought at the earliest opportunity.