A clinical study of arrhythmias associated with acute coronary syndrome: a hospital based study of a high risk and previously undocumented population

Background: ACS represents a global epidemic. Arrhythmia in ACS is common. Careful investigation may lead to further improvement of prognosis. Retrospectively analyzed the year- round data of our center. Study was undertaken to analyze the incidence, frequency and type of arrhythmias in ACS. This is to aid timely intervention and to modify the outcome. Identification of the type of arrhythmia is of therapeutic and prognostic importance.Methods: This cross sectional analytical study was conducted in the Department of Cardiology, Apollo Hospitals Dhaka, from January 2019 to January 2020 with ACS patients. Enrolled consecutively and data analyzed.Results: There were 500 patients enrolled considering inclusion and exclusion criteria. Sample was subdivided into 3 groups on the type of ACS. Group-I with UA, Group-II with NSTE - ACS and Group-III with STE - ACS. Different types of arrhythmia noted. Types of arrhythmia were correlated with type of ACS. 500 patients included. Mean age 55.53±12.70, 71.6% male and 28.4% female. 60.4% hypertensive, 46.2% diabetic, 20.2% positive family history of CAD, 32.2% current smoker, 56.4% dyslipidaemic and 9.6% asthmatic. 31.2% UA, 39.2% NSTE-ACS and 29.6% STE-ACS. Type of arrhythmias noted. 22% sinus tachycardia, 20.2% sinus bradycardia, 9% atrial fibrillation, 5.2% ventricular ectopic, 4.8% supra ventricular ectopic, 2.8% bundle branch block, 2.2% atrio-ventricular block, 1% broad complex tachycardia, 0.4% narrow complex tachycardia, 0.2% sinus node dysfunction and 32.2% without any arrhythmia. Significant incidences of arrhythmia detected - respectively 29.8%, 39.2% and 31%, p<0.001.Conclusions: In conclusion, arrhythmias in ACS are common. More attention should be paid to improve their treatment and prognosis.

To see the work related musculoskeletal disorders among college teachers

Objective: To determine the prevalence of work related musculoskeletal disorders among college teachers of Karachi and Hyderabad

Study Design: Observational / descriptive / Cross sectional study

Place and Duration of Study: This study was conducted at the Department of Physiotherapy and Orthopaedic, Liaquat University Hospital Hyderabad from January 2013 to June 2013

Materials and Methods: We selected college teachers from both gender by convenient sampling. Those selected, were subjected had a work experience of about one year in teaching. Nordic questionnaire was used to determine the work related musculoskeletal disorders. The questionnaires were sent to 400 intermediate teachers and 342 completely filled questionnaires were returned back. Analysis was done through SPSS

Results: The highest prevalence of work related pain was found neck, shoulder, lower back, and knees and pain starts when they perform their work. 50% participants responded that they keep their neck in bending position and shoulders elevated while using black board

Conclusion: The results concluded that neck, shoulder, lower back, and knees are mostly affected regions. The use of ergonomically rules can help to alleviate the problem

Spontaneous Coronary Artery Dissection of LM and LM- LAD artery in Peripartum or Postpartum Women with Acute Myocardial Infarction.

Spontaneous coronary artery dissection (SCAD) is a very rare condition which may result in sudden coronary occlusion, acute myocardial infarction and sudden cardiac death. It usually occurs in young women during pregnancy or postpartum period and in most cases it involves a single coronary artery. The exact etiology is unknown. The prognosis of SCAD is uncertain and optimal treatment is unknown. Early diagnosis and treatment are key for survival, and when identified early, mortality rate is reduced.

Comparison of effects of tramadol and ketorolac in intravenous regional anesthesia

Background: Intravenous regional anesthesia, is easy to administer, reliable method for short procedures, however, adjuncts are needed to improve its efficacy

Objective: To compare the effects of adding tramodol and ketorolac as adjunct to the lignocaine in intravenous regional anesthesia [IVRA], on intra-operative and postoperative pain

Material and Method: A prospective, randomized study was carried out on total of 90 patients who were undergoing upper limb surgery. The patients were divided into three groups as follows: group A received lignocaine 0.5% with tramodol 50 mg, group B was administered lignocaine 0.5% with Ketorolac 30mg, while group C received lignocaine 0.5% only as control. Intra-operatively and post operatively the patient's pain score was evaluated using visual analogue scale [VAS]. All the patients were compared for the time to first analgesic. The groups were also compared for the total number of analgesics required in the first twenty-four hours

Results: A total of 90 patients were included in this study. The mean age of patients in group A [Lignocaine 0.5% 40ml + Tramadol] was 52 +/- 7 years while in group B [Lignocaine 0.5% 40ml + Ketorolac], it was 53 +/- 6 years and in Group C [Lignocaine 0.5% 40ml], 50 +/- 5 years.Tramadol in lignocaine was found to be significantly better [p<0.05] compared to ketorolac in lignocaine and lignocaine alone for intra operative and post operative pain. The patients in tramadol group required significantly less number of analgesics in the first twenty four hours as compared to the other two groups

Conclusion: We conclude that as adjunct tramadol is significantly better as compared to ketorolac and lignocaine alone for intravenous regional anesthesia, with respect to operative, post operative analgesia, time to first analgesic and total analgesics in twenty-four hours

Colorectal carcinoma from Saudi Arabia Analysis of MLH-1, MSH-2 and p53 genes by immunohistochemistry and tissue microarray analysis

To document the incidence and role of p53 and DNA mismatch repair proteins in colorectal carcinomas, and to evaluate the relative frequency of major molecular pathways in colorectal cancers from Saudi Arabia. We collected the formalin fixed, paraffin embedded tissues from 154 colorectal tumors [83 patients from King Faisal Specialist Hospital and Research Centre and 71 from Saudi Aramco Dhahran Health Centre] between January 1989 and December 2003. We analyzed the p53 and mismatch repair gene expression [hMSH-2, hMLH-1] by immunohistochemistry in tissue microarray format. Expression loss of at least one mismatch repair gene was found in 33.8% of cases and significantly associated with the right-sided tumor location [p=0.0047]. The p53 positivity was observed in 57.5% of tumors, and was inversely linked to expression loss of mismatch repair genes [P=0.0102]. The strong confirmation of the previously established associations between tumor phenotype, and mismatch repair gene alteration provided strong evidence for the validity of our experimental approach. Together with the higher incidence of right sided location in Saudi [46.6%] than in Western colon cancers [34.9%], the observed high prevalence of mismatch gene expression loss in Saudi tumors argues for a higher importance of microsatellite instability in this population. If confirmed, it will be interesting to see whether an increased level of familial or sporadic microsatellite instability cases is causing this variation

Molecular mechanisms of curcumin-induced apoptosis in lymphoid malignant cells

Curcumin [diferuloylmethane], a natural compound isolated from the plant Curcuma longa, has been shown to possess potent anti-tumour and anti-oxidative properties. The mechanism by which curcumin initiates apoptosis remains poorly understood. In the present study the effect of curcumin on the activation of apoptotic pathway in human lymphoma cells was investigated. Curcumin induces apoptosis in several primary effusion lymphoma [PEL] cell lines of B cell origin via inhibition of constitutively active AKT/PKB and subsequently loss of mitochondria membrane potential and activation of caspase-3. Pre-treatment of these cells with N-acetyl-cysteine, a scavenger of oxygen radical markedly prevented cell proliferation, apoptosis, de-phosphorylation of AKT loss of mitochondrial membrane potential, activation of caspase and inhibition of XIAP suggesting a role/or reactive oxygen species in this process. Altogether, these findings suggest a novel function for curcumin, acting as a suppressor of AKT activation in B-lymphoma cells by generating oxidative metabolites, leading to inhibition of proliferation via inducing loss of mitochondrial membrane potential and caspase-dependent apoptosis. Therefore, curcumin may have a future therapeutic role in lymphoma and possibly other,malignancies with constitutive activation of AKT

Molecular mechanisms of curcumin-induced apoptosis in lymphoid malignant cells

Curcumin [diferuloylmethane], a natural compound isolated from the plant Curcuma longa, has been shown to possess potent anti-tumour and anti-oxidative properties. The mechanism by which curcumin initiates apoptosis remains poorly understood. In the present study the effect of curcumin on the activation of apoptotic pathway in human lymphoma cells was investigated. Curcumin induces apoptosis in several primary effusion lymphoma [PEL] cell lines of B cell origin via inhibition of constitutively active AKT/PKB and subsequently loss of mitochondria membrane potential and activation of caspase-3. Pre-treatment of these cells with N-acetyl-cysteine, a scavenger of oxygen radical markedly prevented cell proliferation, apoptosis, de-phophorylation of AKI loss of mitochondrial membrane potential, activation of caspase3 and inhibition of XIAP suggesting a role for reactive oxygen species in this process. Altogether, these findings suggest a novel function for curcumin, acting as a suppressor of AKT activation in B-lymphoma cells by generating oxidative metabolites, leading to inhibition of proliferation via inducing loss of mitochondrial membrane potential and caspase-dependent apoptosis. Therefore, curcumin may have a future therapeutic role in lymphoma and possibly other malignancies with constitutive activation of AKT