Solitary intratracheal neurofibroma: a rare tracheal tumor

Intratracheal neurofibromas are rare benign tumors with a tendency to transform into malignant form. Intratracheal neurofibroma remain asymptomatic and are incidentally found during routine radiography or may present with wheeze, cough and lower respiratory tract infection. We recently operated a 38 year old gentleman, who presented with progressive shortness of breath and chronic cough for two years. Examination was normal. CT identified a supracarinal, intratracheal mass. Rigid bronchoscopy revealed a hyper vascular mass, attached to membranous trachea. We performed resection anastomosis via right posterolateral thoracotomy. Histopathology revealed neurofibroma. Patient recovered well and was discharged after eight days.

A clinical study of arrhythmias associated with acute coronary syndrome: a hospital based study of a high risk and previously undocumented population

Background: ACS represents a global epidemic. Arrhythmia in ACS is common. Careful investigation may lead to further improvement of prognosis. Retrospectively analyzed the year- round data of our center. Study was undertaken to analyze the incidence, frequency and type of arrhythmias in ACS. This is to aid timely intervention and to modify the outcome. Identification of the type of arrhythmia is of therapeutic and prognostic importance.Methods: This cross sectional analytical study was conducted in the Department of Cardiology, Apollo Hospitals Dhaka, from January 2019 to January 2020 with ACS patients. Enrolled consecutively and data analyzed.Results: There were 500 patients enrolled considering inclusion and exclusion criteria. Sample was subdivided into 3 groups on the type of ACS. Group-I with UA, Group-II with NSTE - ACS and Group-III with STE - ACS. Different types of arrhythmia noted. Types of arrhythmia were correlated with type of ACS. 500 patients included. Mean age 55.53±12.70, 71.6% male and 28.4% female. 60.4% hypertensive, 46.2% diabetic, 20.2% positive family history of CAD, 32.2% current smoker, 56.4% dyslipidaemic and 9.6% asthmatic. 31.2% UA, 39.2% NSTE-ACS and 29.6% STE-ACS. Type of arrhythmias noted. 22% sinus tachycardia, 20.2% sinus bradycardia, 9% atrial fibrillation, 5.2% ventricular ectopic, 4.8% supra ventricular ectopic, 2.8% bundle branch block, 2.2% atrio-ventricular block, 1% broad complex tachycardia, 0.4% narrow complex tachycardia, 0.2% sinus node dysfunction and 32.2% without any arrhythmia. Significant incidences of arrhythmia detected - respectively 29.8%, 39.2% and 31%, p<0.001.Conclusions: In conclusion, arrhythmias in ACS are common. More attention should be paid to improve their treatment and prognosis.

Challenges of valve surgeries in post-renal transplant patients.

Renal transplantation remains a mainstay of therapy for the end‑stage renal disease. Cardiac disease has a high prevalence in this patient population. Cardiovascular disease remains the leading cause of death among kidney transplantation patients. The cardiac disease accounts for 43% of all‑cause mortality among dialysis patients and for ≈38% of all‑cause mortality after transplantation. In this article, we review the factors and outcomes associated with valve surgeries in renal transplant recipients and evaluate the strategy for open heart surgery after renal transplantation performed.

Aortic root to left-atrial fistula after aortic valve replacement: A rare complication and its intraoperative management.

Aorto‑atrial fistula is a rare complication of prosthetic aortic valve replacement (AVR) and most of them have been diagnosed as a late complication. We present a case of this unusual complication after AVR. Intraoperative transoesophageal echocardiography identified and diagnosed this rare and potentially disastrous surgical complication and confirmed adequacy of its surgical repair.

Challenges in cervical screening

Background: Cervical intra-epithelial neoplasia [CIN] is a pre-malignant condition of Cervix easily detectable by a PAP smear. If left untreated CIN progresses to cervical cancer. The objective of our study was to screen patients for CIN using PAP smear cytology and assess usefulness of opportunistic screening. Our aim was also to encourage routine Pap Smear screening of outdoor patients

Methods: The study was conducted at department of Obstetrics and Gynecology Fatima Memorial Hospital Lahore from January 2004 to March 2006. PAP smear samples of 741 patients were analyzed for presence of CIN

Results: Cervical dysplasia was seen in 14 patients and presence of CIN was not confirmed in these cases

Conclusion: PAP smear is a simple and effective screening method for detection of CIN and prevention of cervical cancer. Considering the high incidence of cervical cancer in Pakistan, women should be encouraged to participate in screening and have regular PAP smears