No abstract

Moyo Moya Disease (MMD) is a rare, progressively stenotic condition of the intracranial arteries with various cerebrovascular manifestations. Ocular manifestations are seen very rarely and there are only few case reports of ocular perfusion anomalies. Central Retinal Artery Occlusion (CRAO) can be caused by atherosclerosis related thrombosis, carotid embolism, cardiac embolism, thrombophilic disorders, giant cell arteritis, etc. We are reporting a 26 years old patient with CRAO in the right eye, who was found to have the typical features of MMD on cerebral angiography. CRAO with MMD is a rare occurrence.

Background and Objectives: Patients undergoing cardiac catheterization and coronary angiography often experience high levels of anxiety and physiological disturbances. Music therapy and music interventions have been found to be effective in bringing down the anxiety and reducing the physiological disturbances for these patients. However, the efficacy of combination of music and yoga therapies for preprocedural anxiety and physiological disturbances needs to be studied. We aimed in this study to compare the effect of music therapy with the combination of music and yoga therapies to impact the psycho-physiological responses like anxiety, blood pressure, pulse rate and respiratory rate of patients who were posted for coronary angiography Material and Methods: A total of 45 patients who were posted for coronary angiography were included in the study and randomly divided into three groups. Music therapy group(n=16) received music listening intervention in the form listening to pre-recorded, patient-preferred, relaxing raga improvisational music for 15 minutes 1) on the previous day of angiography and 2) 15 minutes before being taken to the catheterization lab on the day of the angiography. The combination of music and the yoga group received both music therapy and yoga therapy in the form of pranava pranayama together for 15 minutes. The control group received only the standard medical treatment. The state of anxiety was measured by a five point single item Likert scale and the physiological measures such as systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR) and respiratory rate (RR) were also recorded for the study Results: Both music therapy alone and the combination of music and yoga therapies resulted in within the group significant reduction in anxiety and respiratory rate and music therapy group recorded additionally significant reduction in SBP, DBP and PR scores during the period of intervention. Conclusion:Our findings indicate that music therapy alone can bring down the anxiety levels and reduce the physiological disturbances of patients posted for angiography. Also, combination of music and yoga therapies can bring down the anxiety levels and improve the deep breathing pattern for these patients posted for angiography. More studies are needed to confirm these findings.

Congenital complete heart block could be absolutely asymptomatic. Increased awareness of suspecting an atrioventricular heart block in patients with slow heart rate and electrocardiograph examination will ensure recognition of this problem. The possibility of sudden cardiac death in these patients should not be forgotten. The goal in the peri-operative anaesthetic management is to preserve the heart rate and maintain haemodynamic stability. Herein, we present a case of congenital complete heart block posted for elective caesarean section for an obstetric indication. We would like to highlight the advantage of bupivacaine–fentanyl combination in maintaining haemodynamic stability and peri-operative heart rate control with temporary pacemaker.