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We report about a patient with congenitally corrected transposition of the great arteries and ebsteinoid malformation of left atrioventricular (AV) valve who presented with incessant orthodromic atrioventricular reciprocating tachycardia due to a left posteroseptal accessory pathway. Radiofrequency catheter ablation using trans-septal approach successfully eliminated the posteroseptal pathway across the morphologic tricuspid valve. This report highlights the importance of delineating the anatomy of the interatrial septum in complex congenital heart diseases for performing safe trans-septal puncture during ablation of accessory pathways.

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Background: Aim of the study was to study relationship between Glycemic control and presence of coronary artery disease on clinical presentation with acute coronary syndrome (ACS). We used blood sugar levels (Fasting and post prandial) and HbA1c as parameter for evaluation of glycemic control, Gensini score was used as a parameter for evaluation of severity of coronary artery disease.Methods: The analysis of 1200 patient’s data were performed to reveal demographic characteristics, correlation of the diabetes control with severity of the ACS. A sub-set of 200 subjects that was collected with a focus to include diabetic and non-diabetic subjects in proportion 1:2 was performed.Results: The Pearson correlation between HbA1c and Gensini score (r=0.0444) was poor the correlation between fasting blood sugar (FBS) and Gensini score (r=0.0586), and between post prandial blood sugar (PPBS) and Gensini score (r=0.0549), between random blood sugar (RBS) and Gensini score (r=0.0331) all indicative of poor correlation. Duration of diabetes and Gensini score revealed r=-0.039. The. Correlation was poor to moderate with one sided ANOVA and consistent on comparing r-sq values between, HbA1c and Gensini Score [rsq=49.62 (p<0.001)], FBS and Gensini score [rsq=32.19 (p<0.001)], PPBS and Gensini score [rsq=25.39 (<0.001)], RBS and Gensini score [rsq=42.49 (p<0.001)] and duration of diabetes and Gensini score [rsq=19.61 (p<0.001)].Conclusions: There was no correlation evident between diabetes and Gensini dcore. The analysis was suggestive of possible strong relationship between diabetes control and IHD severity. There is no correlation between Diabetes and ACS severity. However, better diabetes control is related with better ACS profile.

Background: Pulmonary embolism is a common and potentially life threatening condition. Most patients who succumb to pulmonary embolism do so within the first few hours of the event. The aim of the study was to observe the clinical profile, management and outcome in patients of pulmonary embolism.Methods: A prospective observational study was conducted in the Department of Medicine in a Tertiary care hospital in Western Maharashtra for a period of two years. 55 patients with confirmed diagnosis on CTPA (Computed tomography pulmonary angiography) were included in our study. A detailed history, examination and investigations like D dimer were done in all cases.Results: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%..Conclusions: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%.