Three-Year Outcomes of Biodegradable Polymer-Coated Ultra-Thin (60 µm) Sirolimus-Eluting Stents in Real-World Clinical Practice

INTRODUCTION@#Although drug-eluting stents (DES) have outclassed the use of bare metal stents, the safety and efficacy of DES at long-term follow-up has still been conflicting because of increased occurrence of late or very late restenosis and stent thrombosis after DES implantation. Hence, the present study was aimed to evaluate the 3-year safety and clinical performance of biodegradable polymer-coated ultra-thin (60 µm) sirolimus-eluting stent (SES) in real-world patients with coronary artery disease (CAD).@*MATERIALS AND METHODS@#This was a physician-initiated, retrospective, single-centre, observational study that included 237 consecutive patients who had previously undergone implantation of only Supraflex SES (Sahajanand Medical Technologies Pvt Ltd, Surat, India) for the treatment of CAD. Follow-up was received after 1 year and 3 years of stent implantation. The primary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI) and target lesion revascularisation (TLR). Stent thrombosis was considered as a safety endpoint.@*RESULTS@#The mean age of patients was 64.1 ± 10.2 years, and 192 (81.0%) patients were male. The average stent length and diameter were 24.4 ± 9.0 mm and 3.1 ± 0.4 mm, respectively. The cumulative MACE rate at 3 years follow-up was 6.5% which included 4 (1.8%) cardiac deaths, 6 (2.8%) MI, and 4 (1.8%) TLR. There were 2 (0.9%) cases of stent thrombosis.@*CONCLUSION@#Treatment of patients with CAD in real-world clinical practice was associated with sustained clinical safety and low rates of restenosis, stent thrombosis and MACE up to 3 years after Supraflex SES implantation.

Spectrum of firearm fatalities in Larkana region

Objective: To determine frequency of firearm fatalities in Larkana region

Study Design: Descriptive study

Place and Duration of Study: The study was conducted at causality and department of forensic medicine and toxicology Chandka Medical College @ SMBBMU Larkana from 1[st] June 2013 to 31[st] May 2015

Materials and Methods: Out of 1870 dead bodies brought for autopsy at causality Chandka Medical College Hospital Larkana and those 357 [19%] cases were selected in whom death occurred due to firearm as mentioned in police inquest report and autopsy record conducted, with the permission of authorities data was collected and analyzed and cause of death was determined by external and internal examination of body

Results: Autopsy record shows that among 357 cases males with 309 [87%] were dominated on females with 48 [13%] with Male/Female ratio of 6:1. The victim ages range from 11 years to 70 years and with location of injuries as 127 [35.57%] on Chest, 92 [25.77%] on Head and Neck, 59 [16.52%] on Abdomen, 38 [10.64%] on Head and Chest, chest and abdomen 31 [8.68%] and 10 [2.82%] on limbs and other parts, with manner of homicide in majority [78.15%] of cases

Conclusion: The majority of victims were young males belonging to rural areas with rifled firearm injuries on Chest, and Head and Neck as a cause of death

Breast cancer; evaluation of risk factors in our local population an institutional based descriptive and prospective study

Evaluation and distribution of established etiological risk factors in patients of breast cancer in our local population. Institution based non-interventional descriptive and prospective study Department of Pathology, Liaquat University of Medical and Health Sciences, Jamshoro from January 2009 to December 2011. One hundred and two cases of breast cancer diagnosed on HE staining were selected for the study. More than 50% were in 4th and 5th Decades of life. 94% were married and 06% were un-married. 65% were in pre-menopausal group and 35% in post-menopause group. 93% had positive history of breast feeding. None of them had ever taken oral contraceptive. Smoking history was present only in 9.80% cases. 27% cases had family history of breast cancer in first degree relative and 13% in 2nd degree relatives. Majority [66.66%] were belongs to lower middle socioeconomic class. Surprisingly in this study marital status, parity, and breast feeding not proved as protective factors against breast cancer

Estrogen and progesterone receptor status and Her-2/Neu over expression in breast carcinoma with relation to age

Carcinoma of the breast is the common malignancy in Pakistani females. The study was conducted to assess estrogen receptor [ER], progesterone receptor [PR] and Her-2/neu over-expression in females with relation to age. Institution based prospective study. This study was carried out at the Histopathology section in the Department of Pathology, LUMHS, Jamshoro from March 2010 to December 2011. Fifty cases of breast carcinoma were selected to evaluate ER, PR and Her-2/neu over-expression by Immunohistochemistry [IHC]. The predominant histologic morphology was Infiltrating duct cell carcinoma. Majority of the cases presented with grade-II [78.7%] with a mean age of 46.5 years. IHC performed on 50 cases revealed ER +ve in 34 [68%] cases with a mean age of 47.5 years and ER -ve in 16 [32%] cases with a mean age of 44.5 years while PR +ve in 30 [60%] cases with mean age of 44.1 years and PR -ve in 20 [40%] cases with a mean age of 50.1 years. Her-2/neu over-expression was found in 15 [30%] cases with a mean age of 41.6 years and Her-2/neu -ve in 35 [70%] cases with a mean age of 48.6 years. ER and PR expression was found at a significant level reflecting a good therapeutic and prognostic value but the frequency of Her-2/neu over-expression was high reflecting a bad prognosis

Pancytopenia: a clinico-haematologic analysis of 100 cases at tertiary care hospital

Pancytopenia is a serious haematological problem, which makes the patient prone to anaemic manifestations, infections and bleeding tandency. Underlying it are many diseases, which are diagnosed by bone marrow aspiration and trephine biopsy. This study was done to describe different etiological causes of pancytopenia in adults population of lower Sindh. Cross sectional study. The study was carried out in the department of pathology and diagnostic and research laboratory, Liaquat University of Medical and Health Sciences [LUMHS] Hyderabad in collaboration with medical units of LUMHS Jamshoro from January 2009 to June 2010. A total of 100 adult patients with Pancytopenia diagnosed on peripheral blood smear examination were admitted in four medical units of LUMHS Jamshoro during study period, were followed by bone marrow examination and trephine biopsy wherever required. Megaloblastic anaemia was diagnosed in 46% cases, followed by aplastic anaemia in 22% and Acute leukaemia in 10% cases and 5% cases each were diagnosed as hyperspleenism and disseminated tuberculosis. Multiple myelomas were diagnosed in 4% cases, Meylodysplastic syndrome in 3% and Non-Hodgkins lymphoma is seen in 3% and Myelo-fibrosis in 2% cases. It is concluded that Megaloblastic anaemia is most common cause of Pancytopenia in our series followed by aplastic anaemia and acute leukaemia

Frequency of hypertension in male and female medical students of public sector university of Jamshoro in hilly region

To evaluate the Frequency of Hypertension in male and female Medical students of Public Sector University of Jamshoro in hilly region. Cross sectional study. This study was conducted at Liaquat University of Medical and Health Sciences Jamshoro from October 2012 to November 2012. A total of 94 Medical students studying in 4[th] year MBBS were randomly selected and were administered questionnaire comprising sections on personal information, gender distribution, age distribution, current status of hypertension, hobbies, family history of hypertension, father's occupation, blood pressure readings by using a standardized calibrated mercury column type sphygmomanometer [Certeza CE model CR 2001] in Medical ward were recorded and careful clinical examination of CVS by Senior and trained Doctors. Among male students 26 of Normal [<130/<85 mmHg], 05 of Prehypertension [130-139/85-89 mmHg], Among females 53 of Normal, 08 of prehypertension and 02 of mild hypertension [140-159/90-99 mmHg] .Some subjects had reduced physical activity with preference of watching TV and reading books. Majority of the students were normotensives. The study concludes that the hypertension is a problem of medical students, detection of common habits that might be correlated with hypertension which needs regular counseling and lifestyle changes, awareness and prevention about hypertension

Frequency of ABO, and Rh [D] blood groups at Hyderabad, Sind and its territory

To see the frequency of ABO, subgroup ABO and Rh[D] blood groups in Patients, and donors, who attended the Liaquat university hospital for any type of surgery, Gynaecology and Obstratical problem, etc, of Hyderabad and its territory. Cross- sectional study. Department of Pathology and Diagnostic and Research Laboratory, LUMHS, Jamshoro/ Hyderabad, from February, 2012 to March, 2012. Donors and patients of both sexes, blood samples were collected under aseptic condition from anti-cubital vein for determination of blood groups. Subjects belonging to Hyderabad and its Territory, were included in this study. ABO blood grouping was determined by tile method using commercially prepared anti sera, anti A, anti B, anti AB [Plasmatic Kent, UK]. Presence of Rh D antigen was determined by anti-D [Biotic Laboratories Ltd UK]. For Rh-negative Du test was done. Our study shows, A positive-22.88%, A negative-02.31%, B positive-33.85%, B negative -03.27%, AB positive-08.27%, AB negative-0.77%, O positive-26.73%, O negative -01.92%. Regarding the management of blood bank and transfusion services in this area. ABO and Rh antigenic structure differs between regions and nations. Knowledge of blood group distribution may also play an important role for clinical studies, reliable geographical information and for forensic studies in the populations. Such studies need to be carried out at all the regional levels of Pakistan

Burden of diabetes mellitus in the families of medical students of lower Sindh

The non communicable diseases are chronic and exist in human body for long period, diabetes is one of those. The origin word of diabetes means siphon or a pipe from which water or any liquid can pass to another container or bottle the word mellitus is Latin and it means sweet, thus diabetes mellitus means sweet urine excreted from the body of person. To ask history of Diabetes in the families of Medical Students. To alculate the burden of diabetes patients present in the family. cross sectional study. This study was carried out at faculty of community medicine and Public Health Sciences Liaquat University of Medical Health Sciences Jamshoro from 1[st] February 2013 to 31[st] May 2013. It is a cross sectional through a pre design and pre tested. Questionnaire having questions about personal bio data like age, sex, rural, urban, merit seats or self financed seats admission history of diabetes in the family and other relevant. The study shows male and female gender of students out of total 154 medical students there were male were 42 [27.27%] and there were 112 [72.72%] female students regarding the type of History of Diabetes in Families of medical students out of total medical students 154, there were 59 [38.31 %] who reported history of diabetes while 95 [61.68%] of no history of diabetes in their families. The Glucometer is a small machine, available in 53 [34.41%] families-and not available 101[65.58%] in the families of the students. The distribution of students according to seat of admission shows out of total 154 students who participated in the study 733 were on merit while 82 were on self finance which means having good income source. The study concludes that there is high burden of diabetes in medical students families in Sindh. Majority is managed on diet, more counseling is required

use of alpha-blockers and hyoscine n-butyl bromide [HBB] for the treatment of nephrolithiasis is most effective treatment for lower uretric stones

Medical expulsion therapy has been shown to be a useful adjunct to observation in the management of ureteral stones. Alpha-1-adrenergic receptor antagonists have been studied in this role. Experimental study. This study was conducted Urology at GMMMC Hospital Sukkur from January 2008 to December 2010. In this study 480 patients were selected, with stones located in the distal tract of the ureter with stone diameters of 5 to 10mm were enrolled in the present study and were randomized into 4 equal groups. Group 1 received hyoscine N-butyl bromide [HBB], Group 2 received alfuzosin, Group 3 received doxazosin and Group 4 received teraozin. The subjects were prescribed diclofenac injection [75 mg] intramuscularly on demand for pain relief and were followed-up after two weeks with x-rays of the kidneys, ureters, bladder and urinary ultrasonography every week. The number of pain episodes, analgesic dosage and the number of days of spontaneous passage of the calculi through the ureter were also recorded. The average stone size for groups 1, 2, 3 and 4 was comparable [6.13, 5.83, 5.59 and 5.48 mm respectively]. Stone expulsion was observed in 11%, 52.9%, 62%, and 46% in groups 1, 2, 3 and 4 respectively. The average time to expulsion was 10.55 +/- 6.21 days in group 1, 738 +/- 5, 55 days in group 2, 785 +/- 5.11 days in group 3 and 7.45 +/- 5.32 days in group 4. Alpha blockers were found to be superior to HBB [p <0.05]. Medical treatment of distal ureteral calculi with alfuzosin, doxazosin and terazosin resulted in a significantly increased stone-expulsion rate and decreased expulsion time when compared with HBB, HBB seems to have a negative effect on stone-expulsion rate

Etiological profile of pancytopenia in children: a hospital based study

To determine the etiological profile of pancytopenia in children admitted in a Paediatric department of a tertiary care hospital. This is a cross-sectional study conducted at Department of Paediatrics Dow University of Health Sciences and Civil Hospital Karachi from January 2009 to December 2009. It included all the patients between 1 -12 years of age, presenting with complaints of pallor, fever and bleeding manifestations and their complete blood picture showed decrease in 2 or 3 blood cells lines i.e hemoglobin less than 10g/dl, absolute neutrophil count less than 1.5X10[3]/L and platelet count less than 150X10[9]/L. Relevant investigations such as complete blood count, peripheral smear, reticulocyte count and bone marrow examination were done to confirm the diagnosis. The data was analyzed through SPSS version 15.0. A total of fifty patients were enrolled. There were 48% males and 52% females. Male to female ratio was 0.9:1. Mean age of patients was 7 + 3.35 years with range from 1 to 12 years. Infectious etiology was found in 50% cases followed by aplastic anemia 22%, malignancies 10% and hypersplenism 8%. Common infections found were malaria 22%, enteric fever 12% and megaloblastic anemia secondary to vitamin B12 deficiency was observed in 4% patients. The most frequent etiology of pancytopenia in children was infections followed by aplastic anemia, malignancy and hypersplenism. Malaria and enteric fever were the two most commonly observed infections causing pancytopenia in children

Nutritional rickets: correlation between clinical, biochemical and radiological profile

To determine the correlation between clinical manifestations, biochemical and radiological profile in children with nutritional rickets. This is a cross-sectional study conducted at paediatric ward of a private sector health facility, Kutyana Memon Hospital Kharadar Karachi. A total of hundred patients aged 2 to 36 months with clinical suspicion of nutritional rickets were included in the study. A detailed history and examination was done and relevant investigations including serum calcium, phosphate, alkaline phosphatase and X-ray wrist joints were done to confirm the diagnosis. Data was analyzed and presented as percentages and frequencies. There were 63% males and 37% females. Majority of children were between 6 to 18 months of age, [49%] followed by 2-6 months [44%] and 18 to 36 months [07%]. Rachitic rosary was the most frequent clinical feature observed in 87% followed by widening of wrist joints in 76% cases. Serum calcium was low in 90% cases and serum alkaline phosphatase was increased in all patients. Serum phosphate was either low or normal in 44% cases each. Radiological findings were suggestive of rickets in 54% cases. Clinical and Biochemical markers are reliable indicators for diagnosis of nutritional rickets, which is more frequent between 2 to 18 months of age