comparative analysis of in-hospital left ventricular function in patients with successful or unsuccessful streptokinase thrombolysis following acute myocardial infarction

To compare in-hospital left ventricular function in patients with unsuccessful and successful thrombolysis presenting with acute myocardial infarction treated with streptokinase. This comparative study was conducted at department of Cardiology, Lady Reading Hospital Peshawar, from October 2006 to October 2007. Two hundred patients with first acute myocardial infarction were divided into two groups: group A [successful thrombolysis] and group B [unsuccessful thrombolysis], using ECG criteria. To determine Left Ventricular Function, 2-D Echo was used. Group A included 136 [68%] patients and group B included 64 [32%] patients. Impaired left ventricular function was found in 41 [30.1%] patients in group A and 41 [64.1%] patients in group B [p< 0.001]. Left ventricular failure was present in 31 [22.8%] patients of group A and 30 [46.9%] patients of group B [p=0.001]. Cardiogenic shock was diagnosed in 2 [1.5%] patients in group A and 6 [9.4%] patients in group B [p-0.008]. Presence of LVF is strongly associated with unsuccessful thrombolytic therapy in this group of patients

Assessing the efficacy of danshenform compound in patients with stable angina pectoris

To assess the efficacy of danshenform compound in patient with angina pectoris already on optimal dose of anti anginal therapy assessed by exercise tolerance test. Thirty eight patients with stable angina were included in the study. Patients were exercised on treadmill according to Bruce protocol at baseline and one week later. At second week, Danshenform compound 500 mg was prescribed bid for four weeks. At the end of 4 weeks, exercise tolerance test was performed. Duration and number of anginal episodes before and at the end of 4[th] week recorded. Total exercise time, onset of chest pain during exercise, onset of ST segments depression before and after treatment with Danshenform compound was recorded. The number of anginal episodes after 4 weeks treatment with danshenform was reduced significantly from 4.2 +/- 2.4 to 1.4 +/- 1.6/ week [p=0.001]. Time of onset of chest pain improved from 4.63 +/- 2.4 to 5.4 +/- 3.7 minutes [p=0.35] on exercise tolerance test. Duration of exercise increased from 6.52 +/- 1.9 minutes to 8.32 +/- 2.3 [p=0.001]. Time of onset of ST depression increased from 5.8 +/- 1.7 to 7.7 +/- 1.6 minutes [p=0.001] on stress test. Anginal class improved significantly after 4 weeks of treatment with danshenform compound [p=0.001] with no significant effect on resting heart rate [p=0.58] and systolic blood pressure [p=0.07] respectively. Danshenform compound is useful in reducing anginal episodes, increasing exercise duration, improving functional anginal class, delaying the onset of ST depression on exercise tolerance test in patient with ischemic heart disease

Frequency of coronary heart disease risk factors among nurses

To find out frequency of various risk factors for coronary heart diseases in nurses. This was a cross-sectional study. Nurses working in three shifts at Lady Reading Hospital, Khyber Teaching Hospital, Nursing school of Lady Reading Hospital Peshawar, were included in the study. All participants were interviewed in detail including their family history, past medical history, smoking and dietary history. Pulse, blood pressure, body mass index [BMI] and waist: hip ratio was determined. Their random blood sugar and total cholesterol was checked. Data was analyzed for cardiovascular risk factors using SPSS version 16. A total of 165 nurses were screened and interviewed. Mean age was 40.75 +/- 8.577 years. Mean BMI was 28.80 +/- 4.77. Mean systolic BP was 124.82 +/- 20.91 mm Hg, while mean diastolic BP was 82.45 +/- 13.07 mm Hg. Mean random blood sugar was 128.39 +/- 52.74 mg /dl. Diabetic nurses were 18[10.9%],hypertensive nurses were 31[18.8%], nurses having high cholesterol were 4[2.4%], nurses having documented CAD were2[1.2%], other than above risk factors or conditions were present in 34[20.6%] of the nurses, not having any of the mentioned risk factors or diseases were present in 76[46.1%]. Nurses not having any regular exercise schedule were 104 [63%]. We noticed that among modifiable risk factors hypercholesterolemia, diabetes and hypertension were less frequent in nurses while obesity, physical inactivity and sedentary life style with more duty hours and smoking were more prevalent

Prevalence of hyperlipidemia in obese and non obese coronary artery disease patients

To determine the prevalence of hyperlipidemia in obese and non-obese patients with diagnosed coronary artery disease. This hospital based descriptive study was conducted in Cardiology Department of Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from 15[th] March 2005 to 30[th] May 2006. A total of 200 patients with diagnosed coronary artery disease were enrolled, 100 were classified as obese and 100 as non-obese. There were 139 males and 61 females in total 200 CAD patients. Serum triglycerides level was 184 +/- 82 in obese patients and 158 +/- 68 in non-obese patients [p = 0.015]. Serum cholesterol level was 208 +/- 61 in obese and 180 +/- 67 in non obese [p = 0.001]. Serum HDL level was significantly more in non obese [48 +/- 36] as compared to obese [37 +/- 8] [p =0.005]. Serum LDL was more [157 +/- 49] in obese as compared to [148 +/- 44] in non obese but with no statistical difference [p =0.156]. Obese CAD patients had significantly had higher levels of triglycerides, total cholesterol with lower HDL levels as compared to non obese CAD patients

comparative analysis of frequency of in-hospital arrhythmias in patients with successful versus failed thrombolysis following acute myocardial infarction

To compare frequency of in-hospital arrhythmias in patients with successful and failed thrombolysis using streptokinase in patients presenting with acute myocardial infarction [AMI]. This was a comparative study conducted at department of Cardiology, Lady Reading Hospital,Peshawar from October 2006 to October 2007 .Two hundred patients with first AMI were divided into two groups: group A [successful thrombolysis] and group B [failed thrombolysis] using ECG criteria. A total of 200 patients were studied. Group A included 136 [68%] patients while group B included 64 [32%] patients. Among these 24 [12.0%] patients developed arrhythmias. Of these 8 patients were in group A and 16 patients were in group B [5.9% vs. 25.0%, p=0.003].Ventricular tachycardia was the most common arrhythmia. It was documented in 9 [4.5%] patients, with 2 patients in group A and 7 patients in group B [1.5% vs. 10.9%, p=0.003]. The other arrhythmias which included atrial fibrillation, ventricular fibrillation and supraventricular tachycardia were statistically insignificant between the two groups [p=0.174]. In hospital mortality was more common in patients with failed thrombolysis [6 [9.4%] vs. 3 [2.2%] [p=0.023]]. Failed thrombolysis is associated with complex arrhythmias and high in- hospital mortality

Frequency of cardiovascular risk factors among prisoners

To find out frequency of various risk factors for cardiovascular diseases in prisoners. This was an cross-sectional study involving prisoners recruited in Peshawar Heart Study [PHs]. All participants were interviewed in detail including family history, past medical history, smoking history and drug history. All participants pulse, blood pressure, body mass index [BMI] and waist hip ratio was determined. Their random blood sugar and total cholesterol was checked. ECG was carried out. Data was analyzed for cardiovascular risk factors. Total of 166 prisoners were screened and interviewed. Mean age was 62 years. Mean BMI was 26.52 +/- 4.59. Mean systolic BP was 136.8 +/- 22.91 mm Hg and mean diastolic BP was 87.77 +/- 11.93 mm Hg. Mean random blood cholesterol was 178.91 +/- 29.12mg/dl. Mean random blood sugar was 135 +/- 4.93 mg /dl. Out of 166 prisoners, 20 [2%] had random blood sugar more than 180 mg /dl. Active smokers were 36 [21.7%]. Most prisoners were not exercising 119 [71.7%]. We found that risk factors for cardiovascular diseases like lack of exercise, smoking, obesity and hypertension are quite frequent in this group

Does BMI affect cholesterol, sugar, and blood pressure in general population?

Higher BMI in child hood is also associated with an increase risk for coronary heart disease in adulthood. Impaired glucose tolerance is highly prevalent in children and adolescents with severe obesity. Positive correlations between BMI and glucose, lipids and BP have previously been reported. The objective of this study was to find the correlation of BMI with cholesterol and sugar level in general population. This study was a part of 'Peshawar Heart Study', performed at Cardiology Department, Lady Reading Hospital, Peshawar in 2008-2009. Individuals with different ages, gender, professions, socioeconomic class were randomly selected from general population. Random blood sugar and cholesterol was measured with strip method. Height and weight of each individual was recorded and BMI calculated. All individuals were asked about any current medical illness and whether they were performing any exercise or not. Using SPSS-13, descriptive statistics were used for frequencies. Bivariate correlations were used for measuring correlation between BMI, sugar and cholesterol. Partial correlations were used to factor out the effect of other variables. A total of 2,270 individuals, 1,798 [79.2%] male and 472 [20.8%] female were examined. Mean age was 38.47 +/- 12.66. Mean BMI was 26.38 +/- 4.97. Mean RBS was 113.7 +/- 47.145. Mean cholesterol was 168.47 +/- 28.23. Exercise was performed by 929 [40.90%] individuals. Diabetes was present in 113 [5.0%] and history of high cholesterol in 25 [1.1%] persons. When bivariate correlation analysis were done systolic BP, diastolic BP, RBS and cholesterol had positive correlation with BMI [correlation coefficient of 0.317 [p<0.000], 0.319[p<0.000], 0.125 [p<0.000] and 0.205 [p<0.000] respectively]. These variables also showed a positive correlation among themselves. After factoring out the effects of age, exercise, gender and current medical status on the above correlations, the correlation of RBS and cholesterol with BMI decreased to 0.025 [p=0.232] and 0.135 [p<0.000] respectively and between sugar and cholesterol decreased to 0.018 [p=0.401]. In general population BMI is positively correlated with RBS and cholesterol. With the effect of age, sex, exercise and current medical status, this correlation is reduced

Prevalence of risk factors for cardiovascular diseases among journalists in Peshawar - the Peshawar heart study

To assess the prevalence of risk factors for cardiovascular diseases in journalists working in Peshawar. This was a descriptive study involving journalists working in Peshawar recruited in Peshawar Heart Study [PHS]. All participants were interviewed in detail including family history, past medical history, smoking history and medications history. Dietary habits were explored. All participants' pulse, blood pressure, BMI and waist hip ratio was determined. Their random blood sugar and total cholesterol was checked. Twelve lead ECG was recorded. Data was analyzed for cardiovascular disease risk factors. Total of 150 Journalists were interviewed at press club Peshawar. Mean age was 32 +/- 7.7 years. Current smokers were 36% [n=54]. Naswar was consumed by 6% [n=10]. Family history of cardiovascular disease was present in 30% [n=46]. Only 26% [n=40] took regular exercise. Mean Body Mass Index was 25.68 +/- 4.78. Mean W/H ratio was 0.91 +/- 0.03. Mean systolic blood pressure was 115. 31 +/- 14.63 mmHg while 20% [n=31] had systolic of > 140 mmHg. Mean diastolic blood pressure was 75.30 +/- 9.92 mmHg. Mean cholesterol was 158 .53 +/- 20.31 mg%. Mean random blood sugar was 98. 28 +/- 32.12 mg% with five journalists having more than 180mg%.Risks factors for cardiovascular disease like obesity, smoking, sedentary life style, hypercholesterolemia and hypertension were found prevalent among the journalists working in district Peshawar

Pre and post percutaneous transvenous mitral commissorotomy assessment of ventricular functions in severe rheumatic mitral stenosis by tissue doppler imaging echocardiography

To evaluate the left and right ventricular functions in patients with rheumatic mitral stenosis by Doppler tissue imaging echocardiography technique before and 24 hours after percutaneous transvenous mitral commissurotomy. A total of 60 patients included in the study. Pre and Post Percutaneous Transvenous Mitral Commissurotomy of Left and Right Ventricular functions were assessed by calculating velocities at Mitral and Tricuspid Valve Annulus by using Tissue Doppler Imaging Echocardiography at Echo Wing of Cardiology unit LRH. The peak systolic velocities improved from 0.07 +/- 0.01 Pre to 0.085 +/- 0.01 Post Percutaneous Transvenous Mitral Commissurotomy with statistical significance [p-value=0.001] at Mitral valve annulus. Similarly early diastole and late diastolic velocities also showed statistically significant improvements at mitral annulus. Pre Percutaneous Transvenous Mitral Commissurotomy early diastolic velocity of 0.075 +/- 0.02 improved to 0.1 +/- 0.02 Post Percutaneous Transvenous Mitral Commissurotomy with a highly significant P-value of 0.001. For late diastole, p-value was also significant [Pre=0.11 +/- 0.02, Post=0.15 +/- 0.03, p-value=0.01]. An analysis of various velocities was also made at individual sites of mitral valve annulus i.e., septal, lateral, inferior and anterior sites. At all these sites, Post Percutaneous Transvenous Mitral Commissurotomy velocities were statistically significant with p-value less than 0.05. Tricuspid annular velocities did not show statistically significant improvements after 24 hours of Percutaneous Transvenous Mitral Commissurotomy. Systolic and diastolic velocities significantly improved after Percutaneous Transvenous Mitral Commissurotomy at mitral annulus, but this change was not observed at tricuspid annulus. It showed that Tissue Doppler Imaging Echocardiography aided in assessment of immediate improvement in left ventricular function after Percutaneous Transvenous Mitral Commissurotomy in patients suffering from severe mitral stenosis and in sinus rhythm