Effect of risk factors like age, gender, hypertension, diabetes, smoking, dyslipidemia on coronary artery disease in Karachiites with angiographical data of local population: Number, site, severity of coronary lesion

The aim of this study was to determine the effect of major risk factors like age, gender, hypertension, diabetes, smoking, dyslipidemia on coronary artery disease in Karachiites and highlighted the angiographic data of local population like number of vessels involvement, site and severity of coronary lesions. This was a cross sectional analytical prospective study which was carried out at Abbasi Shaheed Hospital Karachi from August 2004 - July 2014. We included five hundred [500] consecutive patients [188 female and 312 male] between 26-80 years old, who came for coronary angiography with suspecting ischemic heart disease clinically or otherwise proven by relevant tests like ETT, ECHO, and Thallium stress test. Post PCI and CABG patients were excluded from study. During this study variables like age, gender, hypertension, diabetes, smoking and dyslipidemia were taken into account in relation to coronary artery disease in Karachiites. In addition we also assorted some important findings of coronary angiography like: number of vessels involved, site and severity lesions in our population and compared them with existing literature. Our study revealed that in our local population not only old age and male gender are potential threat for an early coronary artery disease but other variables like hypertension, diabetes, smoking, and dyslipidemia are also playing important role in coronary artery disease. It is also concluded that our population is more prone to multiple vessels involvement with almost involvement of LAD in majority of population

Needle stick injuries among health care workers of public sector tertiary care hospitals of Karachi

To estimate the frequency of needle stick injuries [NSI] among health care workers [nurses, student nurses and paramedical staff] in public hospitals of Karachi. Cross sectional, observational. This study was conducted in three public tertiary care hospitals of Karachi, from November 2007 to January 2008. Data was collected by structured interview-based questionnaires in Urdu and English language. Questionnaire was designed to obtain information regarding demography, work experience, hepatitis vaccination status, and occurrence of needle stick injuries with associated factors. Needle stick injury that occurred in the previous month was the defined outcome. Data was entered in Epi Data and analyzed in SPSS version 15. A total of 417 health care workers participated in the study. Mean age of the participants was 24 +/- 11 years. Estimated proportion of participants with history of at least one time NSI was found in 66%. Around 13% [n=54] had one or more NSI in the previous one month at work and half of them were affected by non-sterile needle. None of them sought medical care. Almost 90% of them were not wearing gloves or taking any other protective measures at the time of injury. There can be serious consequences of needle stick injuries in public hospitals as large proportion of injuries involve non-sterile used needles and health care workers do not take appropriate measures of protection

Incidence of complications after cardiac surgery, single unit experience

The objective of this study was to determine the incidence of complications after cardiac surgery in a single unit. This was an observational study. This study was conducted in the department of Cardiac surgery of Civil Hospital Karachi, Dow University of Health Sciences Karachi, over the period of 1 year. This being a prospective, observational study, therefore all patients undergoing cardiac surgery were included in this study, only exclusions being those patients who had redo or reopen procedures. Any complications that took place were noted in the proforma. This study was based on proforma that included patients profile, pre operative investigations, operative data, included date of surgery, type of surgery [whether coronary, valvular or others]. Both intra and post operative complications, like cardio vascular complications, respiratory complications, neurological complications, renal implications, infective complications and miscellaneous complications were noted and entered in the proforma. Over the period of one year, 312 patients have their cardiac surgeries in the department of cardiac surgery, Civil Hospital, Karachi. Over all rate of complications were 118 [37.8%], cardiovascular complications were in 65 patients, neurological in 8 patients, respiratory in 27 patients, renal in 5, infective in 10, and miscellaneous complications in 3 patients. There were two [.6%] mortalities in our study group. This study concludes that cardiac surgery is not free of complications. Therefore it must be done with care and with all the possible supportive measures. The incidence of complications in our unit is about the same as in other renowned centers of the world, but central nervous system complications were less as compared to others, probably related with younger age group of patients in our study

Blood transfusion is associated with increase resource utilization and bacterial infection

To observe the association of blood transfusion and clinical outcome in cardiac surgery patients. Forty patients underwent cardiac surgery during a period of two months in a single institution. Coronary artery bypass surgery [CABG] was performed in 21 [52.5%] patients, Mitral valve replacement [MVR] in 15 [37.5%] patients, aortic valve replacement [AVR] in 2 [5%] patients and Atrial septal defect [ASD] was closed in 2 [5%] patients. The mean age of the patients were 41.7 +/- 18 years, 80% were male. Twenty five [62.5%] patients required blood transfusion. Transfusion group showed chest wound infection [7.5%], pulmonary oedema [12.5%] and shortness of breath [10%]. Total leukocyte count and platelets count were significantly lower in transfusion group. We conclude that blood transfusion is associated with increased rate of infection and pulmonary oedema, with high cost and resource utilization. Blood transfusion should be used with appropriate caution