Association between angiographic severity of coronary artery disease and high sensitivity C-reactive protein

Objectives: To determine correlation between blood levels of high sensitivity c-reactive protein [Hs CRP] and severity of coronary artery disease [CAD] on coronary angiography measured through Gensini scoring system

Study type, settings and duration: The descriptive case study was conducted at Rawalpindi institute of cardiology. The duration of study was six month

Patients and Methods: Adult patients of both genders between age 25 to 60 years visiting to outpatient department of the institute and registered for coronary angiogram were included. From each of the enrolled patient about 5cc venos blood sample was collected and Hs-CRP was performed. Severity was measured through Gensini score after coronary angiography. Angiographic Gensini scores were correlated with Hs-CRP using Pearson's correlation [2-tailed]. Value of < 0.05 was considered statistically significant

Results: Total 87 patients fulfilling the inclusion criteria were enrolled among them 81.6% [n=71] were males and 18.4% [n=16] were females. The correlation coefficient was found to be 0.043, implying that there is negligible relationship between Hs-CRP and Gensini scores at p= 0.696

Conclusion: There is no significant correlation between Hs-CRP and severity of CAD measured through Gensini scores on coronary angiography

Frequency of risk factors in male patients with acute coronary syndrome

To determine the frequency of risk factors in male patients presenting with acute coronary syndrome. Observational study. Armed Forces Institute of Cardiology and National Institution of Heart Diseases, Rawalpindi, from October 2007 to September 2008. Male patients with acute coronary syndrome were included in this study. Patients having angioplasty [PCI], coronary artery bypass surgery, chronic liver and kidney diseases were excluded. Presence of diabetes, smoking, hypertension, dyslipidemia, physical activity, stress, a family history of coronary artery disease [CAD] and medication was hypertension, dyslipidemia, physical activity, stress, a family history of coronary artery disease [CAD] and medication was documented. Blood pressure, ECG, cardiac enzymes, fasting blood glucose, lipid profile and echocardiography were done within 24 hours of admission. Body mass index and waist circumference were measured. Data was analysed using SPSS-15. a total of 135 male patients of ACS were studied having mean age of 54.26 +/- 11.60 years. Maximum number of patients aged between 51 to 60 years, [n= 41, 31.9%]. STEMI [ST-elevation myocardial infarction] was diagnosed in 96 [71.1%] patients, non-STEMI in 12 [8.9%] while 27 [20%] patients were having unstable angina. Smoking was documented in 60 [44%] patients, hypertension in 50 [37%], diabetes in 34 [25.2%] and a family history of premature CAD obese [BMI >/= 30]. Waist circumference > 90 cm was found in 86 [63.6%] subjects. Sixty four [47.4%] patients were active frequent combinations, observed in 24 [17.9%] subjects. Dyslipidemia, smoking, hypertension and diabetes were most frequent risk factors. Public awareness to control risk factors can reduce the prevalence of CAD

Rhino-sino-orbito-cerebral mucormycosis, a case report and literature review

Mucormycosis is rare, life threatening infection, especially in diabetic with ketoacidosis. The infection is caused by a group of sapiophytic fungi of class phycomicetes rhizoniucor, rhizopus and mucor are more common fungi. The diagnosis is based on high clinical suspicion, CT / MRI imaging and histopathological confirmation. We present a 50 years, diabetic female, with history of mainly left sided facial pain, swelling is recent decreased left eye movement as well. I ugh suspicion of Mucormycosis on CT which confirmed on histopathology later on. Patient responded well clinically with amphotericine B posaconazole and endoscopic debridement. Patient was discharged 10 days later with followed up MRI and antifungal treatment for 6 month

Fibrodysplasia ossificans progressiva: a rare and severely disabling disease-case report and review of literature

Fibrodysplasia ossaficans progressive is an extremely rare and severely disabling, autosomal dominant condition that effects 1 in 2 million people. We report a 3 years old female child referred to radiology department from pediatric orthopedic clinic with complaints of multiple painful swellings over the back and inability to sleep due to discomfort. Radiological investigations that include - X-Rays and C.T Scan were done that revealed heterotopic ossifications in muscles, facia and in ligaments. X-Rays revealed bilateral hallus valgus deformity with microdactyly that is characteristic of fibrodysplasia ossificans progressive

Role of carotid doppler in coronary artery disease

To find out the Intima media thickness [IMT] of carotid artery disease in coronary artery disease and to identify hemodynamically significant stenosis [i.e.>70%] in patients undergoing coronary artery bypass surgery. A descriptive study. The study was conduct at AFIC and MH Rawalpindi from 2003 to 2004. One hundred patients of triple, double and single vessel coronary artery disease were studied. There were 85 male and 15 female patients, ranging from 35 to 77 years. The patients were studied by Toshiba Ultrasound Machine equipped with high frequency linear transducers. In 10 patients having more that 70% ICA stenosis, conventional angiography was done. Intima-media thickness of common carotid artery was increased in 92 patients with mean value of 1.1 mm. Plaques were seen in 92 patients with commonest location at carotid bifurcation with extension into the origin of ICA. 15 patients has >70%, 10 patients > 50% stenosis and 67 patients in the range of 1-50% stenosis. 6 patients showed normal intima-media thickness with no evidence of plaque. In two patients ultrasound could not locate bifurcation of CCA. Doppler ultrasound showed 98% sensitivity in diagnosis of > 70% stenosis. Doppler ultrasound is a non-invasive imaging modality of choice in evaluation of extra-cranial carotid artery disease

Hypercholesterolemia and IHD two years experience at combined military hospital Multan

Hypercholesterolemia is a health risk, and a strong relationship between this and atherosclerosis has been established through epidemiological, experimental, and clinical trial data. We indented to reestablish this association in one of our local population. We followed 540 consecutive patients during two years period who were admitted to the medical units of combined military hospital Multan with ischemic heart disease [IHD]. Mean age of the patients was 48.39 +/- 0.61 years, mean cholesterol 214.61 +/- 1.69 mg/dl, mean high-density lipids [HDL] 50.13 +/- 1.05 mg/dl, mean low-density lipid [LDL] 154.53 +/- 2.27 mg/dl and mean triglycerides [TG] 172.81 +/- 3.63 mg/dl. Risk factors were recorded in 450 patients out of which hypertension was recorded in 120 [22.22%] patients, diabetes in 100 [18.51%] patients, family history of HID in 80[14.81%] patients while there were 150 smokers. There were 383[70.09%] male patients in whom the mean cholesterol was 213.32 +/- 2.26 mg/dl, mean LDL 151.39 +/- 2.79 mg/dl, mean HDL 49.16 +/- 1.00 mg/dl and mean triglycerides was 170.64 +/- 4.18 mg/dl. There were 157[29.10%] female patients in whom mean cholesterol was 222.94 +/- 5.07 mg/dl, mean LDL159.73 +/- 4.48 mg/dl, mean HDL 53.05 +/- 2.95 mg/dl and mean TG 178.81 +/- 8.33 mg/dl. 51[9.44%] patients [mean age 50.10 +/- 1.91] presented with acute myocardial infarction out which 43 were males and 8 females. Mean cholesterol in this group of patient was 221.36 +/- 3.70 mg/dl, mean LDL 155.17 +/- 3.28 mg/dl, mean HDL 52.09 +/- 1.22 mg/dl, mean TG 170.41 +/- 6.74 mg/dl. 22 [4.1%] patients [Mean age was 33.05 +/- 1.35] presented with unstable angina of which 13 were males and 9 females. In this group, mean cholesterol was 231.14 mg/dl, mean LDL 162.70 mg/dl, and mean HDL 42.86 mg/dl. It can be concluded from this study that hypercholesterolemia is associated with IHD and levels of cholesterol, low-density lipoproteins and triglycerides were higher than the desirable levels in our local population. Though the levels of the cardio protective HDL were also higher in our study group which was contrary to the common observation