The incidence of patent ductus arteriosus (PDA) is about 50-55% in term neonates while it varies in preterm infants, depending upon the gestational age and associated respiratory pathology. Hypotension in preterm infants is common. When it occurs with a PDA, it is often difficult to treat. The minute to minute changes in the hemodynamic status is difficult to monitor clinically, therefore the dilemma is restricting versus liberalizing fluids. We present a case in brief, followed by the discussion on how one should approach such a situation.

Background: One of the leading causes of morbidity and mortality amongst type 2 diabetic (T2DM) patients is Cardiovascular disease (CVD). Patients with T2DM are at a higher risk of developing CVD than non-diabetic patients. Statin therapy has been proven to be effective for the primary prevention of CVD amongst T2DM patients. The objective of this study was to determine the extent of statin therapy use for primary prevention of CVD in T2DM patients at TTH. Methods: A retrospective review of prescription records of T2DM patients who attended the Diabetes Clinic between January 1 2019 to March 31 2019 was conducted. Patient-specific data, evidence of T2DM Diagnosis and prescribed statin therapy were retrieved. Data was collected using a pre-structured tool and analyzed with STATA 15.0. Results: A total of 171 patients were included in this study. Of these, only 49% (84) patients received a statin. Atorvastatin 20mg was prescribed for 76% (64) patients, followed by atorvastatin 10mg for 22% (19) patients. Atorvastatin 40mg and simvastatin 20mg was the least prescribed at 1% (1) patient each. A total of 76% of statin therapies were of moderate-intensity dose, 23% were of low-intensity dose and only 1% was of high-intensity dose. Conclusion: Despite the overwhelming evidence supporting the cardiovascular benefits of statins in T2DM patients, these therapeutic agents are under-prescribed for T2DM patients at TTH with atorvastatin being the most frequently prescribed statin therapy.

The Coronavirus disease 2019 (COVID-19) pandemic has significantly affected the global health care system worldwide. The first COVID 19 case in Bahrain was detected on 24 February for a citizen travelling from Iran. The magnitude of the effect of COVID on the health care systems is unpredictable. However, the COVID national team task force made significant preparations to limit the spread of this virus and flatten the curve of the pandemic locally.

Atrial tachycardia is a sub-type of supraventricular tachycardia (SVT) that can be seen in patients with both structurally normal and abnormal hearts. In contrast to other types of SVTs, an atrial tachycardia does not require an accessory pathway or the atrioventricular node for maintenance. It typically arises from any ectopic site within atrial myocardium and typically the atrial rate ranges between 150-250 beats per minute; in addition P waves may appear either similar or dissimilar to sinus P wave morphology.

The management of surgical aortic valve disease is particularly challenging among young patients and patient’s employed in high risk occupations such as the military. Longer life expectancy predicts an increased probability for prosthetic-valve-related complications. Consequently, there is a recognized need for alternative therapies, and surgical aortic valve repair may offer an attractive option for selected patients. Furthermore, aortic valve repair surgical techniques have evolved, and data from contemporary studies show consistent, successful, and durable outcomes; particularly when performed in high volume centers. The purpose of this review is to discuss the indications for aortic valve repair, review basic operative techniques, and illustrate how pre-procedural echocardiographic imaging is contributing to surgical planning.