Myocardial performance index (Tei index)

Myocardial performance index (Tei index)

•        Estimates combined systolic and diastolic function of heart following myocardial infarction, congestive heart failure or cardiomyopathy.
•        Doppler derived time interval index used for both ventricles.
•        Myocardial performance index is calculated as:

    (Isoventricular contraction time + isoventricular relaxation time) / Ejection time

•        Mean normal values for left ventricle: 0.39+/- 0.05 and mean normal values for right ventricle: 0.28+/- 0.04 (Values of <0.40 for LV and <0.30 for RV are considered normal)
•       Higher values correspond to overall cardiac dysfunction.

ECG in infants

ECG in infants

  Prenatal right ventricular dominance causes

1             .     R in lead V1

2             .     Right axis deviation in limb leads

3             .     T wave inversion in V1

 Features of right ventricular dominance regress over time and are replaced by left ventricular    dominance which leads to appearance of small q waves in lateral leads (V5 and V6) in the adolescence.

Invasive fungal infections and treatment (Simplified for residents)

Invasive fungal infections and treatment (Simplified for residents)

Antifungals: AEFA; Azoles, Echinocandins (Capsofungin, Micafungin and Anidulafungin), Flucytocine, Amphotericin B (Including Liposomal preparations)

Fungal infections: CA-CHM; Candida, Aspergillus, Cryptococcus, Histoplasmosis, Mucormycosis

Table		Antifungal agents
Fungal infections		Azoles	Echinocandins	Flucytocine	Amphotericin B
	Candida	+	+	+	+
	Aspergillus	-	+	-	+
	Cryptococcus	Fluconazole	-	+	+
	Histoplasmosis	Itraconazole	-	-	+
	Mucormycosis	Posaconazole	-	-	+

Candida albicans is sensitive to Fluconazole as well newer azoles (Posaconazole, Itraconazole and Voriconazole).

Non albicans candida (Candida glabrata and krusei) is not sensitive to Fluconazole but is effectively controlled by newer azoles such as Posaconazole, Itraconazole and Voriconazole.

Similarly Aspergillus is not sensitive to Fluconazole but newer azoles are effective against it (Posaconazole, Itraconazole and Voriconazole).

Flucytosine is effective against all candida and Cryptococci but not against aspergillus.

Posaconazole and Amphotericin B are effective against all fungi.  

You can also download the pdf file (https://drive.google.com/open?id=0B7fMzOzGc51UYUpvOVJDQVhlSm8) or the text file (https://drive.google.com/file/d/0B7fMzOzGc51ULVZ3dllUS2h4dG8/view?usp=sharing) from these links.

Comments and suggestions are welcomed.