In selected patients of mitral stenosis with LA thrombus (type Ia, Ib, and IIa), BMV can be performed safely with the modified over the wire technique. Systemic thromboembolism, technical failures and other complications are very rare when performed by experienced operators.

Aim This retrospective study compares admissions and outcomes due to acute decompensated heart failure (ADHF) during the COVID-19 pandemic from 25 March to 25 July 2020 with the historical patient control who were admitted during the same period in 2019. Methods and results Data of the participating hospitals was collected and analysed from the ICC NHFR (Indian College of Cardiology National Heart Failure Registry) for 2019 and 2020. Total number of ADHF admissions, demographics, aetiology, co-morbid conditions and in-hospital mortality was compared and analysed. A significant decrease in the number of hospital admissions due to ADHF from 2019 to 2020 (1056 vs. 526 respectively) was noted. Incidence of admissions with <40% ejection fraction (EF) reduced in 2020 (72.4% and 80.2% in2020 and 2019)and >40% (EF) increased (27.6% and 19.8% in 2019 and 2020 respectively, p = 0.0005). Ischemic heart disease (IHD) was the most common aetiology (78.59% in 2019 and 80.98% in 2020, p = 0.268). The in-hospital mortality was numerically higher in 2020 (10%) than in 2019 (8%), but not statistically significant (p = 0.161). Conclusion This study from the registry shows that the incidence of ADHF admissions during COVID-19 lockdown significantly reduced compared to the previous year. Demographic patterns remained similar but patients presenting with de -novo HF increased; IHD was the most common cause. The in-hospital mortality was numerically higher during the lockdown. The impact of lockdown perhaps led to fewer hospitalisations and this is to be factored in future strategies to address health care delivery during such crises.

Aim & Objective: To compare the accuracy of modified Alvarado score and ultrasonography in the diagnosis of acute appendicitis to reduce the morbity and mortality from appendicitis and also reduce the negative appendicectomy rates Methodology: This study was undertaken in 100 patients with a provisional diagnosis of acute appendicitis getting operated in Prathima Institute of Medical Sciences, Karimnagar from November 2016 to October 2018. Modified Alvarado score and USG findings were applied in the preliminary diagnosis, which was confirmed by intra operative and histopathological findings. Results: Fifty five patients were females and forty five were males. There was no statistical significance in the male to female ratio. The highest incidence (37%) was found in the age group of 21-30 and the lowest (4% each) was seen in the age group of 51-60 & 61 & above respectively. Ninety nine patients presented with anorexia and tender RIF. Ninety eight patients had migratory RIF pain. Nausea & vomiting, rebound tenderness, and leucocytosis were seen in 58, 53 and 39 patients respectively. Only 27 patients had elevated temperature. Forty three patients had a score of >7 out of which 42 had appendicitis and 1 was normal on histopathological examination which contributed to 97.7% and 2.3% of the patients respectively. Sensitivity, specificity and accuracy of MAS was 44.6%, 83.3%, 47% respectively. Sixty one patients were found to have appendicitis by USG out of which 60 had appendicitis and 1 was normal on histopathological examination, with a sensitivity of 63.8% and a specificity of 83.3% & accuracy 65%. Ninety four patients were diagnosed to have appendicitis by histopathological examination and 6 were reported to be normal. Accuracy of ultrasound to diagnose acute appendicitis was 65% and MAS was 47%.

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