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Clinically unrecognized mitral regurgitation is prevalent in lone atrial fibrillation

World Journal of Cardiology 2012年第5期4卷 183-187页

作者： Sanjiv sharma Joel Lardizabal Mark Monterroso Neil Bhambi rohan sharma Rasham Sandhu Sarabjeet Singh Division of Cardiology Bakersfield Heart HospitalBakersfieldCA93308United States

AIM:To investigate the prevalence of clinically unrecognized mitral regurgitation(MR) in lone atrial fibrillation(AF).METHODS:We studied the prevalence and severity of MR by transesophageal echocardiography(TEE) in patients with "lone" AF as compared to a matched cohort of patients in normal sinus rhythm(NSR) undergoing TEE for other indications besides recognized valvular heart ***:A total of 157 subjects(57 in the AF group and 100 in the NSR group) with structurally normal cardiac valves were included in the *** the AF group,moderate MR or more was noted in 66% of thepatients,mild MR in 18%,trace or no MR in 16%.In the control group,moderate MR was noted in 6% of patients,mild MR 31%,trace or no MR in 63 % of *** MR or greater was significantly more prevalent in the AF group compared to the NSR group(66% vs 6%,P < 0.0001).CONCLUSION:Clinically unrecognized moderate MR is prevalent in "lone" AF-either as an etiologic factor leading to "lone" AF or developing after onset of AF.

关键词： Mitral regurgitation Lone atrial fibrillation Normal sinus rhythm

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Ultrasonographic assessment of paediatric ocular emergencies： A tertiary eye hospital based observation

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World Journal of Emergency Medicine 2018年第4期9卷 272-275页

作者： Amar Pujari Deepa R Swamy Rashmi Singh Ritika Mukhija rohan Chawla Pradccp sharma Dr. Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi 110029 India

BACKGROUND: The purpose of this study is to assess the utility of ocular ultrasound B scan in the emergency at the fi rst point of care for detecting posterior segment and orbital pathologies in cases of paediatric ocular ***: A prospective observational study involving 122 paediatric patients presenting to eye emergency over a period of ninety days were assessed with ultrasonography for the posterior segment as well as orbital pathology whenever indicated. The ocular ultrasound was performed gently over closed ***: Posttraumatic globe injuries were the most common indication for posterior segment evaluation, which constituted 80(65.57%) eyes. Among these 52 patients had an anechoic posterior segment and 28 patients had variable findings such as vitreous haemorrhage(8.19%), retinal detachment(6.55%), choroidal detachment(4.91%), posteriorly dislocated clear lens(0.81%) and retained intraocular foreign body(5.73%). Non-traumatic cases constituted around 42(34.42%) eyes, which included corneal ulcer(7.37%), retinoblastoma(6.55%), endophthalmitis(4.91%), extraocular muscle cysticercosis(4.91%), orbital cellulitis(4.09%), periocular haemorrhage(2.45%), proptosis(1.63%), paediatric cataract(1.63%) and cryptophthalmos(0.81%). No adverse events of performing the ultrasound was ***: First point ultrasonography in paediatric ocular emergencies is a cheap, portable and an effective tool in the assertion of signifi cant posterior segment and orbital diseases.

关键词： Paediatric ocular emergencies Ultrasound B scan Posterior segment andorbital pathologies

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Evaluation of fundus autofluorescence patterns in age-related macular degeneration

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International Journal of Ophthalmology(English edition) 2016年第12期9卷 1779-1784页

作者： Pradeep Venkatesh Pradeep Sagar rohan Chawla Varun Gogia Rajpal Vohra Yog Raj sharma Department of Ophthalmology Dr. Rajendra Prasad Centre for Ophthalmic SciencesAll India Institute of Medical Sciences

AIM： To study the various morphological patterns of fundus autofluorescence （FAF） images in patients with age-related macular degeneration （AMD） in Indian ***： Totally 179 eyes of 104 patients with clinical diagnosis of AMD were recruited into the study. Autofluorescence images were captured using confocal scanning laser ophthalmoscope and the patterns of FAF were ***： Of 179 eyes, 27 （15.08%） were early AMD, 58 （32.41%） were intermediate AMD, 94 eyes （52.51%） were late AMD. Of 94 eyes with late AMD, 79 （84.04%） were neovascular AMD and 15 （15.96%） were central geographic atrophy. In eyes with early and intermediate AMD, 9 patterns of FAF were noted. Six patterns （normal, minimal change, focal increased, patchy increased, linear, reticular） were similar to that in the published classification. Two patterns （lacelike and speckled） described in the published classification were not found. Three new patterns （focal hypo-fluorescence, patchy hypo-fluorescence, mixed focal hypo-fluorescence and hyper-fluorescence） were detected. In eyes with neovascular AMD, 6 morphological patterns of FAF were noted. Two patterns （mixed hypo-fluorescence and hyper-fluorescence, central hypo-fluorescence with hyper-fluorescent rim） were similar to that in published classification. Two patterns （normal, near normal or normal background fluorescence in the centre of hypo-fluorescent area） described in the published classification were not found. Four new patterns （minimal change, hypo-fluorescent patch, central hypo-fluorescence with surrounding reticular, bull’s eye） were recognized. In eye with central geographic atrophy 5 morphological patterns were noted and these were similar to that in published ***： Phenotypic differences in the pattern of FAF exist in the study population compared to existing classification systems.

关键词： age-related macular degeneration fundus autofluorescence lipofuscin choroidal neovascularization

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Using a ＋20D lens for non-contact slit lamp biomicroscopy of ocular fundus

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Eye Science 2016年第3期31卷 192-194页

作者： Koushik Tripathy Yog Raj sharma rohan Chawla Tanuj Dada Department of Ophthalmology Centre for Ophthalmic Sciences M1 India Institute of Medical Sciences (MIMS) New Delhi110029 India

Noncontact slit lamp examination of the ocular fundus has been classically done using high power convex lenses like+90D,+78D,and+60D.A real and inverted image of the fundus is formed in between the high power convex l... 详细信息

关键词： Using a lens for non-contact slit lamp biomicroscopy of ocular fundus

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Tranexamic acid for intracerebral haemorrhage within 2 hours of onset: protocol of a phase Ⅱ randomised placebo-controlled double-blind multicentre trial

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Stroke & Vascular Neurology 2022年第2期7卷 158-165页

作者： Nawaf Yassi Henry Zhao Leonid Churilov Bruce C V Campbell Teddy Wu Henry Ma Andrew Cheung Timothy Kleinig Helen Brown Philip Choi Jiann-Shing Jeng Annemarei Ranta Hao-Kuang Wang Geoffrey C Cloud rohan Grimley Darshan Shah Neil Spratt Der-Yang Cho Karim Mahawish Lauren Sanders John Worthington Ben Clissold Atte Meretoja Vignan Yogendrakumar Mai Duy Ton Duc Phuc Dang Nguyen Thai My Phuong Huy-Thang Nguyen Chung Y Hsu Gagan sharma Peter J Mitchell Bernard Yan Mark W Parsons Christopher Levi Geoffrey A Donnan Stephen M Davis Department of Medicine and Neurology Melbourne Brain Centre at The Royal Melbourne HospitalThe University of MelbourneParkvilleVictoriaAustralia Population Health and Immunity Division Walter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia Ambulance Victoria MelbourneVictoriaAustralia Melbourne Medical School The University of MelbourneMelbourneVictoriaAustralia Stroke Division The Florey Institute of Neuroscience and Mental HealthParkvilleVictoriaAustralia Department of Neurology Christchurch HospitalChristchurchNew Zealand Department of Neurology Monash Medical CentreMonash UniversityClaytonVictoriaAustralia Department of Interventional Neuroradiology Liverpool HospitalLiverpoolNew South WalesAustralia Department of Neurology Royal Adelaide HospitalAdelaideSouth AustraliaAustralia Department of Neurology Princess Alexandra HospitalWoolloongabbaQueenslandAustralia Department of Neurology Box Hill HospitalEastern HealthBox HillVictoriaAustralia Stroke Centre and Department of Neurology National Taiwan University HospitalTaipeiTaiwan Department of Medicine Dunedin School of MedicineUniversity of OtagoWellingtonNew Zealand Department of Neurosurgery E-Da HospitalYanchaoKaohsiungTaiwan Department of Neurology Alfred HospitalMelbourneVictoriaAustralia Department of Clinical Neuroscience Monash University Central Clinical SchoolMelbourneVictoriaAustralia Department of Medicine Sunshine Coast University HospitalNambourQueenslandAustralia Department of Neurology Gold Coast University HospitalSouthportQueenslandAustralia Department of Neurology John Hunter HospitalThe University of NewcastleNewcastleNew South WalesAustralia Department of Neurosurgery China Medical University HospitalTaichungTaiwan Department of Internal Medicine Palmerston North HospitalPalmerston NorthNew Zealand Department of Neurology St Vincent's HospitalFitzroyVictoriaAustralia Department of Neurology Royal Prince Alfred HospitalCamperdownNew South WalesAustra

Rationale Haematoma growth is common early after intracerebral haemorrhage(ICH),and is a key determinant of *** acid,a widely available antifibrinolytic agent with an excellent safety profile,may reduce haematoma *** and design Stopping intracerebral haemorrhage with tranexamic acid for hyperacute onset presentation including mobile stroke units(STOP-MSU)is a phase Ⅱ double-blind,randomised,placebo-controlled,multicentre,international investigator-led clinical trial,conducted within the estimand statistical *** In patients with spontaneous ICH,treatment with tranexamic acid within 2 hours of onset will reduce haematoma expansion compared with *** size estimates A sample size of 180 patients(90 in each arm)would be required to detect an absolute difference in the primary outcome of 20%(placebo 39%vs treatment 19%)under a two-tailed significance level of *** adaptive sample size re-estimation based on the outcomes of 144 patients will allow a possible increase to a prespecified maximum of 326 *** Participants will receive 1 g intravenous tranexamic acid over 10 min,followed by 1 g intravenous tranexamic acid over 8 hours;or matching *** efficacy measure The primary efficacy measure is the proportion of patients with haematoma growth by 24±6 hours,defined as either≥33%relative increase or≥6 mL absolute increase in haematoma volume between baseline and follow-up CT *** We describe the rationale and protocol of STOP-MSU,a phase Ⅱ trial of tranexamic acid in patients with ICH within 2 hours from onset,based in participating mobile stroke units and emergency departments.

关键词： placebo centre absolute

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