When drotaverine [No-Spa] injected in to the perivascular tissues of internal mammary artery [IMA] relives the peri-operative vascular spasm and increases the blood flow in IMA when used as a pedicle graft in CABG

To compare two groups of patients submitted to different modes of delivery of Drotaverine and its effect on internal mammary artery spasm during Coronary artery by pass grafting at The National Institute of Cardiovascular Diseases, Karachi. Experimental study. This study was carried out at the National Institute of Cardiovascular Diseases Karachi from 1[st] Jan 2013 to 31[st] December 2013. Data was analyzed from one hundred patients who underwent CABG at our institute. They were divided into two groups: Group 1 consisted of 50 patients in which Drotaverine [No-Spa] was sprayed topically over the IMA: Group 2 also consisted of 50 patients in which Drotaverine [No-Spa] was injected with blunt needle in the peri vascular tissue of IMA. After Drotaverine application, the mean blood flow were significantly low in Group I was 117.2 +/- 4.87ml/min as compared to Group II which was 136.2 +/- 7.11 ml/min [p<0.01]. Result of our study suggests; Drotaverine injected perivascularly better relieves spasm of internal mammary artery and increases the blood flow

Mediastinal synovial sarcoma

The mediastinum is an uncommon site of synovial sarcoma which is a rare soft tissue malignancy. An 18 year old boy was admitted for right sided chest pain since one year. Based on the CT scan chest findings, tru-cut biopsy of the mass was performed and histopathology initially reported as neurofibroma. The tumor was excised via posterolateral thoracotomy and excisional biopsy established the diagnosis of primary synovial sarcoma arising from the mediastinum. Patient was started on adjuvant chemotherapy at the oncologist tumor board's recommendation and he received 6 cycles of adriamycin and ifosfamide. At last follow up he is free of tumor recurrence