Background: Excessive perioperative bleeding remains a major complication following open heart surgery, resulting in increased morbidity and mortality of some patients in our institution. A study of the principal causes of excessive nonsurgical haemostatic perioperative bleeding, clinical evaluation, treatment and preventive strategies is justified. Objective/Aim: To characterize the causes of bleeding in patients with hemorrhage that did not require re-exploration and assess the impact on the patient outcomes from different causes of nonsurgical bleeding preoperatively. Materials and Methods: For a period of 31/2 years (March 2013 – February 2016), the National Cardiothoracic Center of Excellence, UNTH, Ituku/Ozalla, Enugu, Nigeria, partnered with different foreign cardiac missions (USA, UK and India) for the performance of open heart surgery. The case files of the patients managed in the envisaged period were retrieved and analyzed using SPSS, version 4.0. The data analyzed were patients’ demographics, the total number of open heart surgery cases, the number that had perioperative nonsurgical bleeding, clinical detection strategies, treatment and preventive modalities as well as the outcome.

The frequency of peripheral arterial disease (PAD) increases with advancing age similar to that of osteoporosis [1], which is the most common bone disease worldwide and a growing public health issue for the aging population. Thus, a better understanding of osteoporosis and related problems are of utmost importance. According to World Health Organization criteria, diagnosis of osteoporosis is based on bone mineral density (BMD) values or presence of osteoporotic fractures [2].

Background: Circulating factors during exercise training are implicated in the adaptive mechanisms of physical conditioning. However, there is lack of information regarding the effect of basketball training on circulating growth and vascular remodeling factors in adolescents. The purpose of this study was to characterize the serum insulin-like growth factor 1 (IGF-1), vascular endothelial growth factor (VEGF), matrix metalloproteinase 3 (MMP-3), albumin (ALB) and aldolase (ALD) responses in healthy adolescent boys over the course of a regular basketball season, and compared them with age- and sex-matched participants not involved systematically in any physical activity. Materials and methods: We evaluated systemic and body composition changes in basketball athletes (n=34; mean age 17.1±0.7 yrs) and controls (n=21; mean age 17.2±0.9 yrs) before training, at peak season (8 wks), and at the end of the season (32 wks). Results: Changes in % body fat and body mass index (BMI) were observed in the training group (TG) over time (P<0.05-0.001), while these parameters remained unchanged in the control group (CG). TG exhibited higher serum ALB and ALD levels compared with CG (P<0.001) while they did not change over time (P>0.05). Circulating IGF-1, VEGF and MMP-3 levels increased in TG over time (P<0.01) and were higher compared to CG (P<0.001), in which there were not any changes.

Rheumatoid arthritis is a chronic systemic inflammatory disease, Rheumatoid arthritis can affect the pericardium, myocardium, and endocardium. RA increases cardiovascular morbidity and mortality by accelerated atherosclerosis. Patients with RA are at a twofold increased risk for myocardial infarction and stroke. Rheumatoid arthritis is often complicated by thrombocytosis. Thrombocytosis usually occurs during the active clinical stages of RA. We report a 40 year old male who presented with sudden onset of back pain, neck pain and gum bleeding he was diagnosed to have Acute Anterior Wall Myocardial Infarction (AWMI) and successfully under went PCI to LAD with uneventful follow up.

Surgical ventricular restoration is a procedure designed to restore or remodel the left ventricle. Surgical ventricular restoration by means of the Dor procedure is a surgical option in patients with coronary artery disease, postinfarction left ventricular aneurysm (LV aneurysm) or ischemic dilated cardiomyopathy with or without ventricular tachycardia. Postinfarction left ventricular remodeling is characterized by LV dilatation and abnormal geometry leading to systolic and diastolic dysfunction. Development of a left ventricular aneurysm is a serious long-term complication of Acute Myocardial Infarction. We report a 69 year old male presented with haemodynamically significant ventricular tachycardia, successfully underwent DOR Procedure with complete recovery.

Objectives: Recently, the model for End-Stage Liver Disease (MELD) was proposed for the prediction of survival in transjugular intrahepatic portosystemic shunt (TIPS) patients. We therefore compared the prognostic accuracy of the MELD model and the Child-Pugh score, in an unselected cohort of TIPS patients followed long-term. Methods: A retrospective chart review and statistical analyses were done on 120 patients consecutively admitted for portal hypertension from 2009 to 2013 in the Jinling hospital (Nanjing, China). Results: The survival rate for all patients was 95.8% at 3 months, 90% at 1 year, and 85.8% at 3 years. Significantly lower survival rates were found in patients with MELD scores of 15 or more in comparison to those with MELD scores of 15 or less (p<0.001).There was no significant difference in survival rate between patients with Child-Pugh classifi cation A and those with Child-Pugh classifi cation B, while the patients with Child-Pugh classification C has a signifi cantly lower survival rate than those with Child-Pugh classification A and B (p<0.001). The discrimination powers of MELD (c statistics: 0.772, 0.680, 0.647 for 3-month, 1-year, and 3-year survival) were not signifi cantly different from the discrimination powers of Child-Pugh score at the same time points (c statistics: 0.795, 0.732, 0.678).