ABSTRACT
Objective: To know the regression of right ventricular pressure after successful percutaneous transluminalmitral commissurotomy [PTMC] in patients with severe isolated mitral stenosis
Methods: This descriptive study was performed in inpatient and outpatient department of National Institute of Cardiovascular Disease from 1[st] February 2016 to 31[st] August 2016. Echocardiography of all patients with successful PTMC were recorded 24 hours and 06 months following PTMC to see for Regression of right ventricular pressure along with other baseline echocardiographic parameters
Results: A total of 99 patients with severe isolated mitral stenosis who had undergone successful PTMC were studied. Females were 65[65.7%] and males 34[34.3%]. Mean age was 27.44 +/- 6.26 years. TTE performed before and after PTMC showed significant difference in mean mitral valve area [0.89cm +/- 0.089cm[2] vs. 1.68 +/- 0.128 cm[2], p valve <0.001] and mean left atrial diameter [4.66 +/- .82cm vs. 4.46 +/- 0.65cm]. Mean mitral valve gradient pre PTMC was significantly higher [16.38 +/- 2.51 mm of Hg] than that of post PTMC 24 hours [4.75 +/- 1.31 mm of Hg] and Post PTMC 06 months [5.22 +/- 1.21 mm of Hg], p valve <0.001. Mean right ventricular systolic pressure [RVSP] pre PTMC was significantly higher 62.3 +/- 10.91 mm of Hg than that of post PTMC 24 hour's 57.51 +/- 9.67 mm of Hg and post PTMC 06 moths 46.49 +/- 7.8mm of Hg, p value 0.001. Mean LVEF 50.14 +/- 5.82
Conclusion: There was a significant regression of right ventricular pressure following successful PTMC in mid-term [06 months] follow up of severe isolated mitral stenosis patients
ABSTRACT
Background: warfarin was used for decades to prevent stroke in high risk AF patients, recent guidelines and published data is recommending use of NOACs like Rivaroxaban as an alternative to Warfarin, Its use is increasing world over because of its predictable action, less food and drug interaction and no need of monitoring for dose adjustments, considering these facts we planned to conduct a study to see the frequency of use of Rivaroxaban in our local population of AF patients with risk of stroke calculated by CHA2DS2-VASc score
Method: this cross-sectional study was done at National Institute of Cardiovascular disease [NICVD] from May 2017 to September 2017 included 137 non-valvular AF patients with high risk of stroke calculated by applying CHA2DS2-VASc score more than or equal to 2. Clinical details and information about anticoagulant medications prescribed to them was also obtained. SPSS 19 was used for the analysis, descriptive statistics such as mean +/-SD, frequency and percentages were calculated. Z-test, t-test, and chi-square test were used for the assessment and comparison of data. Two sided p-value of 0.05 was considered for statistical significance
Results: total 137 patient were included 50.4% [69] were male, 104 [75.91%] out of 137 were on Anticoagulant therapy, with 86 [62.77%] were on Warfarin and only 18 [13.14%] were taking Rivaroxaban
Conclusion: our study showed very small percentage of non valvular AF patients with risk of stroke were prescribed Rivaroxaban. It's important to update our treating Physicians about this novel agent which is shown to be equally effective and safe in comparison to warfarin, and easy to prescribe without monitoring to reduce stroke risk
ABSTRACT
To determine pre- and postoperative serum S100B concentrations in patients with intracranial tumours that underwent craniotomy and compare the values with healthy controls. An observational, comparative study. Neurosurgical Ward, Jinnah Postgraduate Medical Centre. Karachi, from May 2007 to April 2008. Serum S100B was measured pre- and postoperatively on days 1, 2 and 7 in 18 healthy controls and similar number of patients who underwent craniotomy for intracranial tumours. Mean pre-operative patients and control values were compared using Mann-Whitney [unpaired] or Wilcoxon [paired] tests for comparing between pre- and postoperative values. The p-value was considered significant at < 0.05. Serum S100B concentrations were significantly higher in patients with mean value of 0.19 +/- 0.12 microg/L than in healthy controls [mean 0.03 +/- 0.01, p < 0.0005]. Significantly raised serum S100B concentrations were observed in all postoperative samples when compared with pre-operative samples. S100B concentrations significantly increased on postoperative day 1 [mean = 0.90 +/- 1.07 microg/L, p < 0.0005], decreased on day 2 [mean = 0.84 +/- 0.57 microg/L, p < 0.0005]. The concentrations further declined on day 7 [mean = 0.44 +/- 0.43 pg/L, p = 0.005]. The significantly high postoperative concentrations of S100B in patients appear as a consequence of tissue damage due to surgical procedures. The absence of fall of the S100B concentration in serum from the peak value on postoperative day 1 and day 2 could provide early warning of brain tissue damage leading to neurological deterioration
ABSTRACT
To compare closed and open haemorrhoidectomy by terms of post-operative pain and bleeding. Comparative study. Department of Surgery Peoples University of Medical and Health Sciences, Nawabshah from May 2011 to October 2011. All the patents with established diagnosis of haemorrhoids were divided equally into two groups. The group I was treated with open haemorrhoidectomy while closed haemorrhoidectomy was done in group II. Post-operative pain and bleeding scores were recorded for 3-days in immediate post-operative period and at first and 2[nd] week followups. Pain scores 0-3 [0=none,1=mild, 2=moderate, 3=severe] and bleeding scores 0-2 [0=none, 1=slight, 2=severe] were documented for each patient. Total of 60 patients were recruited. Thirt underwent open and same number had closed haemorrhoidectomy. There were 45 [75%] males and 15 [25%] females. The mean age was 45 year with a male to female ratio of 3:1. Mean pain score for the open haemorrhoidectomy was 1.73 +/- 0.09 [p< 0.0001], while for closed haemorrhoidectomy 0.96 + 0.64 [p< 0.0001]. The mean bleeding score in open group was 1.03 +/- 0.427 [range 0.6 - 1.8] and in closed group 0.52 +/- 0.388 [range 0.2 - 1.6]. Closed haemorhoidectomy was associated with significantly less pain and bleeding than open haemorrhoidecctomy.
ABSTRACT
To find out the incidence of carcinoma of gall bladder in longstanding cases of Cholelithiasis with history of more than 5 years. A prospective observational clinico-pathological study. Departments of surgery, Nawabshah Medical College Nawabshah. From March 2000 to Feb: 2005. Total 180 cases were included in the study among all the 520 cholecystectomies performed during this period, which were symptomatic proven cholelithiasis cases for past 5 years or more. Most patients were from rural area with urban rural ratio 30:70. All the specimens of removed gall bladder were examined histologically. Female to male ratio was 4:1 and age incidence was 5 1-72 years. Out of 180 cases included in the study 12 [6.6%] patients were of carcinoma of gall bladder with female to male ratio 3:1 and peak age incidence was 65 years. The longer duration of disease with gall stones increases the risk of carcinoma in gall bladder. The patient diagnosed cholelithiasis should be counseled for early operation and all the specimens of removed gall bladder should be examined histopathologacally
Subject(s)
Humans , Male , Female , Cholelithiasis , Risk , Incidence , Prospective Studies , Cholecystectomy , CholecystitisABSTRACT
To assess the effectiveness of topical Glyceryl Trinitrate in the treatment of Chronic Anal Fissure. Prospective Observational study from April 2004 to March 2005. Surgical Unit II, Peoples Medical College Hospital, Nawabshah. A total of 46 patients with Chronic Fissure-in-Ano. The data of all the patients who were recruited for the use of 0.2% topical Glyceryl Trinitrate was collected and analyzed for gender, age, symptoms' duration, site, and associated diseases. These patients were followed at regular intervals of four, six, eight and 12 weeks, and six and 12 months to assess the outcome, adverse effects and recurrence. Out of the 46 patients, six did not came back for follow-up, hence they were excluded. Amongst the remaining 40 cases, there were 14 males and 26 females, with ages between 16-64 years. In 26 [65%] patients, the fissure healed completely during eight weeks duration, whereas 10 [25%] patients experienced headache. Recurrence occurred in six [15%] patients; in them lateral internal sphincterotomy was performed. Topical Glyceryl Trinitrate is a good treatment option, as the success rate was 65%, with only 15% recurrence. It is well tolerated and has no chances of faecal and flatus incontinence