Daycare cardiothoracic surgery

OBJECTIVE: The implications of Day Care Cardio Thoracic procedures in a developing country like Pakistan. DESIGN: Observational and prospective study. It was conducted at the Cardiac Surgery Unit, Civil Hospital Karachi, from July 1999 to December 2000. 35 patients with different methods of surgery were selected and the procedures performed on them were anterior mediastinotomy, permanent pace maker insertions, cervical sympathectomy, patent ductus arteriosus ligation, and eloiser's flaps. Out of 35 patients, only 3 were detained for over 24 hours solely for logistic reasons. All of them had been told to report back after 10 days and none of them had any wound infection or chest complication. Based on our experience, we found our protocol safe and effective in a selected group of patients. We recommend that quite a number of procedures can be done safely with economic advantages and better utilization of hospital resources without sacrifying the quality of health services

Seasonal variation in the onset and occurrence of acute myocardial infarction

The object of the study was to analyse the seasonal variation in the onset and occurance of first myocardial infarction in Karachi. It is a retrospective study done in Civil Hospital Karachi where patients diagnosed as acute myocardial infarction of 1st onset whether referred from casualty, OPD, general practices or coming directly to Civil Hospital Karachi. Patients were diagnosed as acute myocardial infarction on the basis of 12 lead standard E.C.G. findings, cardiac enzymes alongwith the history and clinical features of AMI. We found more cases of acute MI in some particular months of a year. About 75 mean numbers of patients came to the Civil Hospital Karachi each year from 1985 to 1990 out of whom more number of patients came in early winter and late winter. 95% confidence interval is from 66 to 84