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Papillary fibroelastoma of the mitral valve diagnosed and treated in life is extremely rare. There have been eight cases documented so far. We report the first case of a mitral valve papillary fibroelastoma associated with severe rheumatic mitral stenosis and tricuspid regurgitation with stenosis. The tumor arose from the posteromedial papillary muscle of the mitral valve. The mitral valve was replaced after excising the valve with the tumor and the tricuspid valve was repaired. The patient did well and remains asymptomatic.

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An echocardiographic investigation is one of the key modalities of diagnosis in patients suffering from COVID 19, especially if they are elderly, have associated comorbid conditions, and pregnant. Hence, it is becoming extremely essential to look into the correct safety precautions, health-care professionals must take while conducting an echo investigation. At the same time, a focused echo examination aimed at correct imaging view acquisition in the shortest possible time is the need of the hour. The decision matrix formulated for conducting an echocardiographic evaluation is based on the presence or absence of cardiological comorbidity vis-a-vis positive or suspected for COVID- 19. The safety measures and image acquisition have been constructed keeping in mind the current safety precautions by the World Health Organization, the Centers for Disease Control and Prevention, and the Ministry of Health and Family Welfare, India. Cardiovasc. j. 2020; 13(1): 97-101

Radiation-induced Neuropathy-Stoll and Andrews MEDICAL SJURNAL 837high-dose megavoltage x-ray technique. The clinical nature of the damage has been assessed and an attempt made to establish the site of damage.Of the patients receiving 6,300 rads peak dose in 25 to 26 days neurological symptoms were complained of by 73%, and of the group receiving 5,775 rads peak dose by 15%. In the higher-dose group the majority of patients with symptoms had abnormal neurological signs.Pathological data in two cases are given and mention is made of factors other than radiation which may have contributed to the nerve damage noted. It is concluded that high-dose, smallfield megavoltage irradiation following radical surgery leads to delayed damage to the brachial plexus, the incidence being related to the level of dosage. Our past experience with other techniques has been analysed for purposes of comparison.