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Animal testing and medicine
Rachel Hajar
January-March 2011, 12(1):42-42
DOI:10.4103/1995-705X.81548  PMID:21731811
  42,372 861 16
Pulmonary atresia with ventricular septal defect: Systematic review
Duraisamy Balaguru, Muhammad Dilawar
June-Aug 2007, 8(2):52-61
  32,573 2,145 -
Guidelines to writing a clinical case report

July-September 2017, 18(3):104-105
DOI:10.4103/1995-705X.217857  PMID:29184619
  23,870 3,656 2
Risk factors for coronary artery disease: Historical perspectives
Rachel Hajar
July-September 2017, 18(3):109-114
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_106_17  PMID:29184622
  18,587 2,036 114
Cardiovascular impact of eating disorders in adults: A single center experience and literature review
Muhammad Rizwan Sardar, Andrea Greway, Michael DeAngelis, Erin O’Malley Tysko, Shawn Lehmann, Melinda Wohlstetter, Riti Patel
July-September 2015, 16(3):88-92
DOI:10.4103/1995-705X.164463  PMID:27326349
Eating disorders have multiple medical sequelae, including potentially life-threatening cardiovascular complications. This article describes our cardiology practice experience of treating adults with eating disorders in the outpatient setting and documents baseline cardiac findings in this complex patient population. We describe our findings in patients across the spectrum of eating disorders; past studies have generally focused on anorexia only. This article also includes a review of the current literature on cardiovascular complications associated with disordered eating.
  14,989 136 6
Meandering vessels: A sign of arterial tortuosity on plain chest radiography
Venkatraman Bhat, Ahmed Al Muzrakchi
Mar-May 2008, 9(1):24-26
  14,153 125 -
Pregnancy-related spontaneous coronary artery dissection: Two case reports and a comprehensive review of literature
Azeem S Sheikh, Michael O'Sullivan
April-June 2012, 13(2):53-65
DOI:10.4103/1995-705X.99229  PMID:22919449
Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome, particularly seen in women during pregnancy or in the puerperium. It has a high acute phase mortality. The etiology is uncertain. Hormonal changes during pregnancy, hemodynamic stress and changes in the autoimmune status have been considered as possible etiological factors. A timely diagnosis and institution of appropriate treatment is important for a successful outcome. There is no consensus of opinion for optimal treatment. Conservative management, coronary artery bypass graft surgery, and percutaneous coronary intervention, all have been described in the literature as possible therapeutic options. Spontaneous coronary artery dissection should be considered as a differential in any young woman presenting with chest pain associated with pregnancy. We report two cases of pregnancy-associated spontaneous coronary artery dissection, both successfully managed, along with a comprehensive review of the previously published literature.
  13,954 221 31
The Air of History (Part II) Medicine in the Middle Ages
Rachel Hajar
October-December 2012, 13(4):158-162
DOI:10.4103/1995-705X.105744  PMID:23437419
  13,161 250 4
Protocol-guided phase-1 cardiac rehabilitation in patients with ST-Elevation myocardial infarction in a rural hospital
Abraham Samuel Babu, Manjula Sukumari Noone, Mohammed Haneef, Shijoy M Naryanan
June-Aug 2010, 11(2):52-56
DOI:10.4103/1995-705X.73209  PMID:21187997
Aims: Phase-1 Cardiac Rehabilitation (CR) is an important part in the treatment of patients with ST-Elevation Myocardial Infarction (STEMI). Lack of literature in the rural Indian setting led to the design of this study. Setting and Design: Secondary care rural hospital, non-randomized experimental study. Materials and Methods: Fifteen historical controls and 15 prospectively enrolled patients between January 2007 and December 2007. The prospectively enrolled patients received the phase-1, exercise-based, protocol-guided CR. At discharge, the six-minute walk test (6MWT) distance, Borg's Rating of Perceived Exertion (RPE) after the 6MWT, time to return to baseline parameters after the 6MWT, and complications were assessed. Statistical Analysis used: Independent t-test and the Mann Whitney test. Results: Statistically significant (P < 0.01) differences in ratings of perceived exertion (RPE) and time to return to baseline parameters post the 6MWT were seen in the experimental group ((2 vs. 4 and 5.47 vs. 7.93 minutes, respectively). No significant changes in the 6MWT distance between the groups were noticed (470+151.76 m and 379+170.70 m, respectively). No adverse events during the 6MWT and the phase-1 CR were observed. Conclusion: Protocol-guided, phase-1 CR produces a much faster return of heart rate and blood pressure to baseline following the 6MWT, without producing a great rise in the RPE during the 6MWT, which suggests a training benefit among these patients. The 6MWT can be safely administered in this rural population. However, larger studies will be required to validate these results.
  12,015 936 15
Heart failure in children
N Jayaprasad
July-September 2016, 17(3):92-99
DOI:10.4103/1995-705X.192556  PMID:27867456
Heart failure (HF) in children differs from that in adults in many respects. The causes and clinical presentations may differ considerably among children of different age groups and between children and adults. The time of onset of HF holds the key to the etiological diagnosis. Clinical presentation of HF in younger children can be nonspecific requiring heightened degree of suspicion. The overall outcome with HF is better in children than in adults as HF in children is commonly due to structural heart disease and reversible conditions which are amenable to therapy. The principles of management include treatment of the cause, correction of any precipitating event, and treatment of systemic or pulmonary congestion. Though HF in adults has been the subject of extensive research and generation of evidence-based guidelines, there is a scarcity of evidence base in pediatric HF.
  10,472 1,577 16
Contrast-induced nephropathy
Nazar M. A. Mohammed, Ahmed Mahfouz, Katafan Achkar, Ihsan M Rafie, Rachel Hajar
July-September 2013, 14(3):106-116
DOI:10.4103/1995-705X.125926  PMID:24696755
Contrast-induced nephropathy (CIN) is a serious complication of angiographic procedures resulting from the administration of contrast media (CM). It is the third most common cause of hospital acquired acute renal injury and represents about 12% of the cases. CIN is defined as an elevation of serum creatinine (Scr) of more than 25% or ≥0.5 mg/dl (44 μmol/l) from baseline within 48 h. More sensitive markers of renal injury are desired, therefore, several biomarkers of tubular injury are under evaluation. Multiple risk factors may contribute to the development of CIN; these factors are divided into patient- and procedure-related factors. Treatment of CIN is mainly supportive, consisting mainly of careful fluid and electrolyte management, although dialysis may be required in some cases. The available treatment option makes prevention the corner stone of management. This article will review the recent evidence concerning CIN incidence, diagnosis, and prevention strategies as well as its treatment and prognostic implications.
  10,336 865 84
Epicardial fat and its association with cardiovascular risk: A cross-sectional observational study
Farouk Mookadam, Ramil Goel, Mohsen S Alharthi, Panupong Jiamsripong, Stephen Cha
October-December 2010, 11(3):103-108
DOI:10.4103/1995-705X.76801  PMID:21577377
Background: The association between visceral obesity and cardiovascular risk has been well described. Some studies show a proportional relationship between the presence of visceral obesity and epicardial fat. Measuring the amount of epicardial adipose tissue (EAT) can be a novel parameter that is inexpensive and easy to obtain and may be helpful in cardiovascular risk stratification. However, the relationship between epicardial fat and cardiac function and that between epicardial fat and cardiac risk factors is less well described. Objectives: To evaluate the association between echocardiographic epicardial fat and the morphologic and physiologic changes observed at echocardiography and to evaluate the association between epicardial fat and cardiac risk factors. A cross-sectional study of 97 echocardiographic studies (females, n = 42) was conducted. Two groups were identified: epicardial fat ≥ 5 mm (group I) and <5 mm (group II). Results: Epicardial fat >5 mm was associated with LA enlargement, with lower ejection fraction, increased left ventricular mass, and abnormal diastolic function. On a multivariable regression analysis, all these parameters also correlated individually with EAT thickness independent of age. Hyperglycemia (DM), systolic hypertension, and lipid parameters for metabolic syndrome showed a trend for positive association, but this was not statistically significant. The association was not significant even for higher cutoff limits of EAT thickness. Conclusion: Epicardial fat >5 mm is associated with cardiac abnormalities on echocardiography. This is a sensitive assessment of body fat distribution, is easily available at echocardiography, and is simple to acquire at no added cost. Further studies looking at the appropriate cut-off thickness of EAT and the sites of measurement to be used are needed. Comparison of this simple and inexpensive measure with other measures of obesity, such as waist-hip ratio, body mass index, Dexa scan of visceral fat, and magnetic resonance imaging of visceral, are needed.
  10,783 296 39
Giant left atrium: A review
Ahmed El Maghraby, Rachel Hajar
April-June 2012, 13(2):46-52
DOI:10.4103/1995-705X.99227  PMID:22919448
Giant left atrium is a rare condition, with a reported incidence of 0.3%, and following mainly rheumatic mitral valve disease. Although rheumatic heart disease represents the main cause of giant left atrium, other etiologies have been reported. Giant left atrium has significant hemodynamic effects and requires specific management. In this review, we present two cases, discuss the different definitions, etiologies, clinical presentation and management modalities.
  10,726 351 12
Medical illustration: Art in medical education
Rachel Hajar
April-June 2011, 12(2):83-91
DOI:10.4103/1995-705X.86023  PMID:22121469
  9,900 270 11
Congenital complete absence of pericardium masquerading as pulmonary embolism
Saad Tariq, Sultan Mahmood, Samuel Madeira, Ethan Tarasov
January-March 2013, 14(1):29-32
DOI:10.4103/1995-705X.107118  PMID:23580923
Congenital absence of the pericardium is a rare cardiac condition, which can be either isolated or associated with other cardiac and extracardiac anomalies. There are six different types, depending on the severity of the involvement. Most of the patients with this defect are asymptomatic, especially the ones with complete absence of the pericardium. However, some patients are symptomatic, reporting symptoms that include chest pain, palpitations, dyspnea, and syncope. Diagnosis is established by the characteristic features on chest X-ray, echocardiogram, chest computed tomography (CT), and/or cardiac magnetic resonance imging (MRI). We present here a case of a 23 year-old-male, who presented to our hospital with complaints of pleuritic chest pain and exertional dyspnea, of a two-week duration. He was physically active and his past history was otherwise insignificant. His chest CT with contrast was interpreted as showing evidence of multiple emboli, predominantly in the left lung, and he was started on a heparin and warfarin therapy. A repeat chest CT with contrast three weeks later showed no significant change from the previous CT scan. Both scans showed that the heart was abnormally rotated to the left side of the chest. An echocardiogram raised the suspicion of congenital absence of the pericardium, with a posteriorly displaced heart. In retrospect, motion artifact on the left lung, attributed to cardiac pulsations and the lack of pericardium, resulted in a CT chest appearance, mimicking findings of pulmonary embolism. The misdiagnosis of pulmonary embolism was attributed to the artifact caused by excessive cardiac motion artifact on the chest CT scan. In non-gated CT angiograms, excessive motion causes an artifact that blurs the pulmonary vessels, reminiscent of a 'seagull' or a 'boomerang'. Physicians need to be aware of this phenomenon, as well as the characteristic radiological features of this congenital anomaly, to enable them to make a correct diagnosis.
  9,921 201 4
Abstracts from the 4th Emirates Cardiac Society Congress held on November 7 - 9, 2013

July-September 2013, 14(3):121-153
  9,311 133 -
Transcatheter closure of patent ductus arteriosus using ADO device: Retrospective study of 149 patients
Sadiq M Al-Hamash, Hussein Abdul Wahab, Zayir H Khalid, Isam V Nasser
January-March 2012, 13(1):1-6
DOI:10.4103/1995-705X.96658  PMID:22754633
Background: Patent ductus arteriosus (PDA) is a common form of congenital heart disease and forms about 5-10% of congenital heart diseases. Surgical closure is safe and effective; however, certain patients may experience some morbidity. Recently, transcatheter closure of PDA using the Amplatzer duct occluder has been shown to be safe and efficacious. Objectives: To evaluate whether transcatheter closure with this device offers an alternative to surgical closure of PDA. Patients and Methods: Between July 2006 to July 2008, 149 patients (98 females and 51 males) with PDA underwent cardiac catheterization in an attempt to close their PDA by transcatheter approach using Amplatzer duct occluder device. Results: The patient's age ranged from 4 months to 45 years (median 5 years). Successful PDA closure was achieved in 136 patients (91.2%) with 100% complete closure rate within 24 hours after the procedure. Thirteen patients (8.7%) had unsuccessful attempts, 11 (7.3%) of them had failure of deployment of the device, while embolization of the device occurred in two of the patients (1.3%). Conclusions: Amplatzer duct occluder device is safe and effective for closure of different types and sizes of PDA with low rate of complication.
  9,062 339 13
Coronary perforation and covered stents: An update and review
Mohammed Al-Mukhaini, Prashanth Panduranga, Kadhim Sulaiman, Abdulla Amour Riyami, Mohammed Deeb, Mohamed Barkat Riyami
April-June 2011, 12(2):63-70
DOI:10.4103/1995-705X.86017  PMID:22121463
Coronary perforation is a rare complication of percutaneous coronary intervention. We present two different types of coronary intervention, but both ending with coronary perforation. However, these perforations were tackled successfully by covered stents. This article reviews the incidence, causes, presentation, and management of coronary perforation in the present era of aggressive interventional cardiology. Coronary perforations are classified as type I (extraluminal crater), II (myocardial or pericardial blushing), and III (contrast streaming or cavity spilling). Types I and II coronary perforations are caused by stiff or hydrophilic guidewires. Type I has a benign prognosis, whereas type II coronary perforations have the potential to progress to tamponade. Type III coronary perforations are caused by balloons, stents, or other intracoronary devices and commonly lead to cardiac tamponade necessitating pericardial drainage. However, type III perforations can be managed with covered stents without need for surgical intervention.
  8,882 385 29
Omega-3 in arabian gulf fish: Part 2
HA Hajar Albinali
Dec-Feb 2008, 9(4):165-166
  9,107 97 -
Learning Ancient Greek Medicine from Homer
Rachel Hajar
Sept-Nov 2002, 3(3):8-8
  9,159 0 -
The systolic to diastolic duration ratio in children with normal cardiac function and its relation to heart rate, age and body surface area
Roberto Sarnari, Reema Yousef Kamal, Mark K Friedberg, Norman H Silverman
Mar-May 2009, 10(1):11-16
Background: We have shown the ratio of systole to diastole to be a valuable global index of ventricular dysfunction in pediatric dilated and restrictive cardiomyopathy and also of ventricular function of the single systemic right ventricle in children who have undergone Norwood procedure for hypoplastic left heart. As this index may be a valuable indicator of ventricular performance in other conditions, normal reference values need to be established. The purpose of this study was to establish normal values for the S/D ratio in children and to investigate its relation to heart rate, age and body surface area. Methods: We reviewed 179 echocardiograms of healthy children and young adults (mean: 70.18 months, SD: ± 65.12 months, range 0.02 months to 19 years) and measured the average duration of the holosystolic tricuspid regurgitant jet (systolic interval). The remainder of the cardiac cycle (i.e the period between 2 tricuspid regurgitant jets) was defined as the diastolic interval. We evaluated the relation between the S/D ratio and heart rate, age and body surface area by univariate and multivariate linear regression analysis. Results: Ranges, mean values and standard deviations are reported from age 0.02 months to 19 years (70.18 ± 65.12 months), BSA 0.11 to 2.51m2 (0.85 ± 0.55) and heart rate 50 to 156 bpm (96.72 ± 23.19). The systolic period ranged between 208.5 to 467 msec (314.08 ± 52.57) and the diastolic period between 166.5 to 809 msec (341.34 ± 129.61) yielding a S/D ratio between 0.397 to 1.62 (0.995 ± 0.23). The S/D ratio correlated positively with heart rate (y = 0.0073x+0.2969, r = 0.72). However, in multivariate analysis there was no significant correlation with age and body surface. Heart rate had a greater effect on shortening the diastolic period, in an exponential fashion (y = 130679x -1.3232, r = -0.88) than on systolic period which responded in linear fashion (y = -1.9228x + 500.05, r = -0.85). Conclusions: We provide normal reference values for the S/D ratio across a wide range of heart rates in children, adolescents and young adults.
  8,714 184 -
Stent fracture: How frequently is it recognized?
Mohammed Khalil Mohsen, Awad Alqahtani, Jassim Al suwaidi
April-June 2013, 14(2):72-81
In spite of there being several case reports, coronary stent fracture is not a well-recognized entity and incidence rates are likely to be underestimated. In this article, we review different aspects of stent fracture, including incidence, classification, predictors, outcome, diagnosis, and management.
  8,528 348 -
Chairman's Reflections : Blood-letting
Hajar A Hajar Albinali
June-Aug 2004, 5(2):74-85
  8,813 1 -
Arab Roots of European Medicine
David W Tschanz
June-Aug 2003, 4(2):9-9
  8,812 0 -
The physician's oath: Historical perspectives
Rachel Hajar
October-December 2017, 18(4):154-159
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_131_17  PMID:29326783
  8,401 194 13