ABSTRACT
Objectives: To compare depression and psychological well-being between caregivers of schizophrenic patients and non-caregivers and to study the burden of caregiving as a relative risk for depression and psychological well-being
Methods: This cross sectional comparative study was conducted at International Islamic university Islamabad from January to September 2017. Fifty informal caregivers of schizophrenic patients from 19 to 55 years of age were included in the study. The control group consisted of age and socio-economic status matched healthy volunteers who did not have any psychological or medical patient at home needing care and assistance. For measurement of study variables i.e., burden of caregiving, depression and psychological well-being, instruments used were Zarit Burden Interview [ZBI], The Beck Depression Inventory [BDI] and Warwick-Edinburgh Mental Well-Being Scale [WEMWBS] respectively
Results: Results were analyzed using MANOVA followed by One-Way ANOVA. Findings indicated that informal caregivers of schizophrenia have greater depression and poor psychological well-being in comparison to the non-caregiver controls. Association of caregiving burden with psychological well-being and depression was calculated using Chi Square test and relative risk
Conclusion: Caregiving adversely affects informal caregivers' mental health and wellbeing. Informal caregiving is a burden for the caregivers; health status of family members involved in caregiving should be routinely assessed to enhance their health-related quality of life
ABSTRACT
Objective: To determine the diagnostic accuracy and cut-off values of serum cystatin C as early diagnostic biomarker of diabetic kidney disease. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Pathology, Army Medical College, Rawalpindi in collaboration with Endocrinology Department, Military Hospital [MH], Rawalpindi from November 2015 to November 2016
Methodology: One hundred and nineteen diagnosed patients of type 2 diabetes mellitus were enrolled in the study from the outpatient Endocrinology Department of the MH Rawalpindi. Fifty disease-free controls were also included. Fasting blood samples of the patients and controls were analysed for creatinine by Jaffé's kinetic method and estimated GFR was calculated using MDRD-based equation for GFR. Serum cystatin C was estimated by quantitative turbidimetric method
Results: Serum cystatin C was higher in the diabetic group [mean = 1.022 +/-0.33 mg/dl] as compared to the control group [mean = 0.63 +/-0.14 mg/dl]. ROC curve analysis, keeping less than 60 ml/min/1.73 m2 GFR [CKD-MDRD based] as reference value of the stat variable/gold standard; revealed an area under the curve of 0.914 [95% CI 0.85-0.98] and at optimal sensitivity of 88.2% and specificity of 84.8% the established cut-off of serum cystatin C was 1.26 mg/L
Conclusion: Cystatin C is an accurate biomarker of diabetic kidney disease with good sensitivity and specificity
ABSTRACT
Objective: To determine the effect of gender and physical activity on internet addiction in medical students
Methods: In this cross sectional, analytical study Young's internet addiction test questionnaire was distributed to 350 MBBS students of Army Medical College, Rawalpindi. The study was conducted from January to May 2015. A dichotomous response from students regarding physical activity was obtained which was verified from the sports department of the institution. Based upon total score, internet addiction was categorized as no addiction if the score was less than or equal to 49, moderate addiction when the score was 50 to 79 and severe when the score was 80 to 100
Results: Out of 322 respondents 175 [54.3%] were males and 147 [42.7%] females with a mean age of 19.27 +/- 1.01 years. Total internet addiction score and frequency of internet addiction were similar between males and females [37.71 +/- 11.9 vs 38.63 +/- 14.00, p=0.18 and 25 vs 29, p=0.20]. However, total score and frequency of internet addiction were higher in students lacking physical activity as compared to those with regular physical activity [40.37 +/- 15.05 vs 36.38 +/- 11.76, p=0.01 and 30 vs 24, p=0.01]
Conclusion: Internet addiction is unrelated to gender however it is inversely related to physical activity
ABSTRACT
Objective: To determine the association of depression with socio-demographic factors in patients undergoing hemodialysis
Study Design: Cross sectional comparative study
Place and Duration of Study: Department of Medicine, Military Hospital Rawalpindi, from Jul 2014 to Jun 2015
Material and Methods: Eighty eight patients undergoing hemodialysis were included. Data were collected using the Hamilton Depression Rating Scale. Demographic data, including age, gender, status within the family, education, duration of dialysis and social support was documented. Patients were graded on the basis of Hamilton scoring as: 0-9: normal, 10-13: mild depression, 14-17: moderate depression, above 17: severe depression
Results: There were 61[69.3%] male and 27 [30.7%] female patients with mean age of 48.43 +/- 12.69 years. The mean duration of dialysis was 35 +/- 29.73 days. Sixty seven patients [76.1%] were identified as having depression. Out of these 28 [31.8%] had mild depression while 12 [13.6%] had moderate and 27 [30.7%] had severe depression. Mean depression score was higher in females [17.56 +/- 6.67] than in males [13.13 +/- 5.67] and the difference was significant [p=0.002]. No association of depression with age [p=0.75], duration of dialysis [p=0.07], marital status [p=0.500], status within the family [p=0.47] or education [p=0.59] was revealed, however it was strongly and positively correlated with social support [p<0.005]
Conclusions: A reasonably high percentage of patients undergoing hemodialysis is likely to suffer from depression and by providing social support their depression can be reduced. Female patients are more likely to have depression and need more social support for alleviation of their depression
ABSTRACT
Objective: To find out the effect of computer based animations on learning of Physiology
Study Design: Randomized control trial
Place and Duration of Study: Army Medical College Rawalpindi, from Jan to Sep 2016
Material and Methods: Sixty students of first year MBBS class were selected through simple random sampling and then randomly assigned into two groups of 30 each; group I and II. A pre-test was given to both the groups to assess their basal knowledge about the systems to be taught. In 1st teaching session, experimental group was taught with and control without animations. In 2nd teaching session, control group became experimental and previously experimental group became control. After both the teaching sessions MCQ tests of C2, C3 and C4 level were given to the groups and marks obtained were compared
Results: There were 20 [33.3%] male and 40 [66.7%] female students with mean age of 18.92 +/- 0.56 years. Comparison of pre-test scores confirmed that basal level of knowledge was equal between the two groups [p-value=0.19]. Post-test score comparison showed that experimental group scored significantly higher marks as compared to the controls [p-value=0.001 for post-test I and 0.02 for post-test II]
Conclusion: Level of understanding of student increases if they are shown computer based animations during the physiology lectures. Hence, animations have positive effect on student's academic performance
ABSTRACT
Objective: To assess the personal reflection ability of first year medical students who self-selected different strategies for learning gross anatomy
Study Design: Cross-sectional analytical study
Place and Duration of Study: Army Medical College Rawalpindi from Mar 2016 to Apr 2016. Material and Methods: We described the purpose of the study [to assess students' ability for personal reflection] and called students of first year MBBS to participate in the study. Divided in two groups, Group A who self-selected the models for learning anatomy [response rate] and - of group B who self-selected the cadaveric specimens for learning anatomy. Those who agreed to participate signed an informed consent form and completed the questionnaires. The Groningen Reflection Ability Scale is a fully validated one-dimensional scale to measure personal reflection. It has 23 items rated on a 5-point Likert scale from 1 [strongly disagree] to 5 [strongly agree]. Scores on the Groningen can range from 23 to 115, and persons with greater abilities for personal reflection have higher scores on the scale
Results: Total 60 male students opted for the modalities of anatomy models for learning gross anatomy. Their accumulative reflective score was 4853. While 28 female students opted for the anatomy models for learning gross anatomy with the accumulative score of 2328. Out of 168 students 88 preferred the gross anatomy models for learning. Total 14 male students opted for the modalities of a dissection for learning gross anatomy. Their accumulative reflective score was 1193. While 16 female students opted for the dissection specimens for learning gross anatomy with the accumulative score of!387. Out of 168 students 20 preferred the dissection specimens for learning. Total 19 male students opted for the both modalities of anatomy models and dissection specimens for learning gross anatomy. Their accumulative reflective score was 1580. While 30 female students opted for both the anatomy models and dissection specimen for learning gross anatomy with the accumulative score of 2328. Conclusion: Majority of the students with higher reflective score identified learning strategy preference for gross anatomy models
Subject(s)
Humans , Female , Male , Adolescent , Young Adult , Personality , Learning , Anatomy/education , Cross-Sectional Studies , Surveys and QuestionnairesABSTRACT
Objective: To find out association of speciality and working hours with compassion fatigue
Study Design: Cross sectional comparative study
Place and Duration of Study: Military Hospital and Combined Military Hospital Rawalpindi, Combined Military Hospital Sialkot, from December 2013 to July 2014
Material and Methods: Fifty four doctors from departments of Medicine, Surgery, Anesthesia and Gynaecology participated in the study. Other health care related personnel, not directly related to patient care, were excluded from the study. The data collection tool was a questionnaire "Professional Quality of Life Measure version 5". Data was analysed by SPSS version 22. Chi Square test for goodness of fit was used to determine difference in the frequency distribution of various categories of a single variable whereas Chi square test for independence was used to find association between two categorical variables. The p-value was kept at < 0.05 for significance
Results: Results showed 11 females and 43 males with mean age of 37.69 +/- 9.72 years. Cronbach's alpha was 0.81. Eleven participants [20.4%] showed low compassion fatigue, 37 [68.5%] showed average whereas only 6 participants [11.1%] showed high compassion fatigue scores and the difference was significant [p-value < 0.001]. Working hours were associated with compassion fatigue [p-value = 0.03] but speciality was not [p-value = 0.41]
Conclusion: Chances of suffering from compassion fatigue are significantly higher if working hours are 12 or more, however the disorder is not associated with speciality
ABSTRACT
Objective: To evaluate the perceptions of medical students regarding their training utilizing facilities provided in the skill laboratory of a public sector medical college. Study Design: Cross-sectional study. Place and Duration of Study: Army Medical College, Rawalpindi, from October to December 2014
Methodology: Students of final year MBBS who had underwent skill laboratory training were recruited through convenience purposive sampling. Students not exposed to skill laboratory training were excluded. Data collection tool was a questionnaire having 23 questions with responses on Likert Scale as strongly disagree, disagree, agree and strongly agree coded as 1, 2, 3 and 4, respectively. Data was analysed on SPSS version 22
Results: There were 78 [57%] male and 59 [43%] female students out of 137, with mean age of 22.59 +/- 0.74 years. The response rate was 68.5%. Cronbach's Alpha test was 0.84 showing high reliability. The mean of sum of all the 23 items was 63.85 +/- 8.71, whereas item means was 2.78 +/- 0.38, reflecting a high inclination of students towards skill laboratory training. Frequency of students responding in favour of skill laboratory training was significantly high [p < 0.05]
Conclusion: Medical students perceived skill laboratory training as a favoured learning strategy as compared to practising on real patients for acquisition of various aspects of clinical skills, knowledge and attitude
Subject(s)
Humans , Male , Female , Young Adult , Education, Medical , Cross-Sectional Studies , Education , Perception , Medical Laboratory Science , Surveys and QuestionnairesABSTRACT
A pragmatic and sequential mixed method study was conducted at Army Medical College, from October to December 2014 to determine medical students' perceptions regarding effectiveness of small groups during the CBL [case-based learning] sessions. Tutorial Group Effectiveness Instrument [TGEI] was used after written and informed consent. Free text comments about CBL were invited from the respondents and common ones, and were tabulated. The mean scores were calculated and compared among different subgroups of respondents using appropriate independent sample t-test. Content analysis of qualitative segment was done. A p-value of less than 0.05 was taken as statistically significant. The analysis of qualitative and quantitative variables was integrated in the final interpretation phase to draw conclusion. The average age of the participants was 19.33 +/- 0.657 years. The difference in scores was statistically insignificant for cognitive [p = 0.537], motivational [p = 0.868], and demotivational [p = 0.125] effectiveness between males and females. Insignificant difference was also observed for qualification of the overall group productivity among male and female students [p = 0.162], and exposed and non-exposed groups [p = 0.272]. The perceptions of overwhelming number of participants were in favour of small group discussion as a component of CBL
Subject(s)
Humans , Male , Female , Young Adult , Students, Medical , Education, Medical , Perception , Surveys and QuestionnairesABSTRACT
Objective: To determine the reference range for serum alanine arninotransferase [ALT] levels for young healthy individuals in our population and to find out effects of age and body mass index on alanine arninotransferase
Study Design: Descriptive cross sectional study
Place and Duration of Study: Military Hospital Rawalpindi; from Dec 2009 to April 2010
Material and Methods: Five hundred and fifty three young healthy adults were included in the study. Detailed history was taken. Parameters like Age, height and weight were measured. Relevant investigations were carried out for each subject which included blood complete picture, Chest X-Ray, ECG, Urine routine examination, liver function tests, serum urea, serum creatinine, serum uric acid, plasma glucose [F], Anti HCV antibodies, HBsAg, HIV antibodies and VDRL. Data was analyzed using SPSS version 22
Results: Age of subjects ranged from 19 to 50 years [29 +/- 6] years, BMI 15.59 to 29.8, [21.58 +/- 2]
Serum alanine arninotransferase ranged from 17 to 81 IU/1, [29.9 +/- 8] IU/1. Serum alanine arninotransferase for subjects with body mass index more than 25 Kg/m2 was 29.6 +/- 7 IU/L. There is no significant difference in value of mean ALT overall and in those with BMI of more than 25 [p=0.149]
Conclusion: Mean serum alanine arninotransferase value in young healthy adults included in this study was 29.9 +/- 8 IU/L which is lower than normal reference provided at present which is 40 IU/1. Statistical analysis revelaed that serum ALT is not significantly influenced by age and BMI
ABSTRACT
Objective: To determine the association of ventricular late potentials with left ventricular hypertrophy in patients with systemic arterial hypertension
Study Design: Cohort retrospective study
Place and Duration of Study: Department of Cardiac Electrophysiology, Armed Forces Institute of Cardiology, Rawalpindi from 11[th] Nov, 2014 to 10[th] Nov, 2015
Material and Methods: Sixty four patients with systemic arterial hypertension were divided into two equal groups on the basis of left ventricular hypertrophy. Patients with acute or old myocardial infarction, diabetes mellitus, cerebrovascular accident, heart failure, structural heart disease, bundle branch block and cardiomyopathies were excluded from the study. DMS 300 4L Holter monitors were used to obtain 3 channel signal averaged ECG recording. CardioScan premium luxury software was used for analysis of ventricular late potentials
Results: There were 49 [76.6%] males and 15 females [23.4%] with the mean age of 60 +/- 11.83 years. Ventricular late potentials were revealed in 10 [31.3%] out of 32 patients with left ventricular hypertrophy whereas in patients without hypertrophy only 1 [3.1%] patient showed it. Ventricular late potentials were strongly associated with left ventricular hypertrophy [p-value=0.03] and the relative risk of developing ventricular late potentials was 10 times higher in patients with left ventricular hypertrophy as compared to those without left ventricular hypertrophy
Conclusion: Ventricular late potentials were strongly associated with left ventricular hypertrophy
ABSTRACT
Mitral valve prolapse is generally considered a benign condition, however, a subset of patients remains at high risk of arrhythmogenesis which may lead to sudden cardiac death. To stratify risk of arrhythmogenesis in patients with mitral valve prolapse on the basis of high resolution ECG, Holter monitoring, resting heart rate and mitral leaflet geometry. Cross sectional comparative study. Armed Forces Institute of Cardiology [AFIC]/National Institute of Heart Diseases, Rawalpindi and Army Medical College, Rawalpindi, Pakistan Mitral leaflet displacement and thickness were measured on echocardiography in 37 patients with mitral valve prolapse. Resting heart rate and time domain indices of heart rate variability of each patient were recorded from 24 hours Holter monitoring. High resolution ECG of all the patients was carried out to record ventricular late potentials. Statistical analysis was performed using SPSS and the alpha value was set at <0.05 for significance. The mean values for resting heart rate, leaflet displacement and leaflet thickness were 77.19 +/- 6.29 per minute, 3.64 +/- 0.92 mm and 4.96 +/- 0.79 mm respectively. Ventricular late potentials were present in 8 [21.62%] whereas heart rate variability was reduced in 5 [13.51%] patients. Leaflet thickness was significantly greater in patients with ventricular late potentials as compared to those without [p-value 0.004]. Patients with reduced heart rate variability had significantly higher resting heart rate as compared to those with normal variability [p-value 0.02]. One patient [2.7%] had ventricular late potentials, reduced heart rate variability, resting heat rate of 88 beats per minute and leaflet thickness over 5 mm. Combined effects of high resolution ECG, holter monitoring and leaflet geometry identified the high risk subset, comprising of 2.7% of the study population
Subject(s)
Humans , Male , Female , Arrhythmias, Cardiac , Electrocardiography , Electrocardiography, Ambulatory , Heart Rate , Cross-Sectional StudiesABSTRACT
The objective of this study was to determine the prevalence of hepatitis B and C among the patients who came for dental treatment to Bacha Khan Medical and Dental College, Mardan. Four hundred patients formed the study group. The blood samples of all these patients were taken in the hospital laboratory and were screened for HBsAg and Anti HCV using immunochromatography [ICT] method. The blood was collected by authorized technician and the sera were separated from the coagulated blood by centrifugation at 5000 rpm[revolution per minute] for 10 minutes at 4[degree]C and stored at -20[degree]C for further use. The HBV screening was based on the detection of antibodies against the related virus in the sera using enzyme immunoassays. HCV test is based on detecting viral specific antibodies in serum samples. Of 400 patients examined, 180 [45%] were females and 220[55%] were males. Their ages ranged from 15 to 60 years with a mean age of 33.61 +/- 15.41 years. The highest prevalence was found in lab. technicians and drivers [HCV=18% HBS=12%]. The prevalence of HCV and HBV was nearly equal [HCV=7.75% and HBV = 7.0%]. There was no statistical significant difference in prevalence of HCV and HBV in male and females
ABSTRACT
Prosthodontics treatments are associated with oral complaints like speech, mastication, pain, esthetics etc. Oral complaints vary among removable partial denture and complete denture wearers. The objective of this study was to investigate the common oral complaints and level of satisfaction in removable denture wearers seen to Department of Prosthodontics, Bacha Khan Medical College, Mardan. Data of oral complaints and level of satisfaction from 100 patients; fifty complete dentures and 50 removable partial dentures were recorded on specially designed proforma. Demographics [age and gender], details of dentures [presence and type of dentures; removable partial denture or complete denture], problems with dentures [wearing, eating, communication, aesthetics, psychological], and satisfaction with dentures were recorded. The eating and wearing problems were more significant with complete denture as compared to removable partial denture p<0.005. Speaking were more difficult with removeable as compared to complete dentures p=0.004. No statistically significant difference was found for psychological between both types of wearers CD wearers were less satisfied with quality and shape of teeth than RPD wearers. Females are less satisfied than males
Subject(s)
Humans , Male , Female , Denture, Partial, Removable , Patient Satisfaction , Dental Restoration WearABSTRACT
Objective: The objective of the study was to observe the effect of lipid lowering therapy on homocysteine and TXA[2] concentration in obese hyperlipidemic Sprague Dawley rats
Design: Randomized Control Trial [RCT]
Place and Duration of study: The study was conducted in Department of Physiology and Centre for Research in Experimental and Applied Medicine [CREAM], Army Medical College, Rawalpindi; and National Institute of Health [NIH] Islamabad over a period of 12 months
Methodology: Ninety healthy Sprague Dawley rats divided into three equal groups. Group I [n=30] were healthy controls, group II [n=30] were made obese and group III [n=30] were obese treated [atorvastatin 10 mg/kg/day orally by gavage method for three weeks]. Body weight was recorded thrice weekly, lipid profile was measured by colorimetric method on microlab and homocysteine and TXA2 were measured by Enzyme Linked Immunosorbant Assay
Results: Serum low density lipoproteins and TXA2 decreased after three weeks of atorvastatin administration, elevated HCY concentration in obese hyperlipidemic rats however was not significantly affected
Conclusion: Atorvastatin apart from lowering lipid levels in the body also reduces TXA[2] concentration which is a vasoprotective. Elevated HCY concentration which is deleterious to the endothelium however is not affected
Subject(s)
Animals, Laboratory , Endothelium/drug effects , Homocysteine , Thromboxane A2 , Obesity , Hyperlipidemias , Rats, Sprague-DawleyABSTRACT
To find out the frequency of compassion fatigue in health care providers in military hospitals. Cross sectional comparative study. Armed Forces Post Graduate Medical Institute [AFPGMI] CMH Rawalpindi, MH Rawalpindi and CMH Sialkot from December 2013 to July 2014. Two hundred and fifty four health care professional participated in the study. The participants included doctors, nurses and male nursing assistants. The instrument for collecting data consisted of [Professional Quality of Life Measure version 5] [Pro QOL-5] questionnaire. Data was analyzed by using IBM SPSS version 22. The alpha value was set at <0.05 for significance. There were 128 male and 126 female participants with mean age of 31.72 +/- 8.28 years. Reliability of the questionnaire was determined by Cronbach's alpha which was calculated to be 0.81. Seventy nine participants [31.1%] showed low compassion fatigue, 168 [66.1%] showed average compassion fatigue whereas only 7 participants [2.8%] showed high compassion fatigue scores. The difference in frequency of three compassion fatigue levels was significant [p-value < 0.001]. Compassion fatigue was significantly different amongst doctors, nurses and nursing assistants [p-value < 0.01]. Compassion fatigue is higher in doctors as compared to para medical staff irrespective of gender
Subject(s)
Humans , Male , Female , Empathy , Health Personnel , Cross-Sectional Studies , Hospitals, Military , Surveys and QuestionnairesABSTRACT
To determine association of ventricular late potentials with mitral valve regurgitation in patients with mitral valve prolapse. Descriptive cross sectional study. Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi from May 2006 to February 2007. Thirty Seven Patients with confirmed diagnosis of mitral valve prolapse on 2 dimensional echo echocardiography were selected for the study. Patients having myocardial infarction, ischemic heart disease, hypertension and diabetes mellitus were excluded. Signal Averaged ECG of every patient was recorded using 1200 EPX High Resolution Electrocardiograph and was analyzed for the presence or otherwise of ventricular late potentials. Male to female ratio of study patients was 23:14 with mean age of 26.27 +/- 6.18 years. Twelve patients out of 37 had mitral valve regurgitation. Out of these, 8 [67%] patients had ventricular late potentials on signal averaged ECG. Only 1 [4%] patient without mitral valve regurgitation showed ventricular late potentials. Association between ventricular late potentials and mitral regurgtation was found statistically significant [p = 0.001]. Ventricular late potentials are hghly associated with mitral valve regurgitation in patients with mitral valve prolapse. These can act as noninvasive predictors of ventricular tachyarrhythmias and sudden cardiac death in these patients
Subject(s)
Humans , Male , Female , Heart Ventricles , Mitral Valve Prolapse , Cross-Sectional Studies , ElectrocardiographyABSTRACT
To compare case based learning with conventional teaching from student's perspective. Cross sectional comparative study. Army Medical College, Rawalpindi from May 2012 to November 2012. A closed ended self-administered questionnaire with twelve questions was prepared and distributed to 427 students of 2[nd] to final year MBBS classes. The responses to the questions were dichotomous either in favour of case based learning or conventional teaching. It included both the genders and all the categories of students from 17 to 23 years of age. Duly filled questionnaires were returned by 397 respondents which were included in the study. Univariate analysis of each question was performed by applying Binomial exact test. Reliability was determined through internal consistency by applying Cronbach's alpha test. A total of 294 [74%] male and 103 [26%] female students with mean age of 19.83 +/- 1.41 years participated in the study. Difference in frequency of respondents was significant for all the questions [p-value < 0.05] except question number 1 and 2. Value of Cronbach's alpha was 0.83 showing high reliability. Case based learning is a preferred instructional strategy as compared to conventional teaching from students' perspective
ABSTRACT
To determine the association of QTc interval prolongation with ventricular arrhythmias in patients with chronic heart failure. Descriptive study. This study was conducted at Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, Pakistan from April 2013 to August 2013. Fifty three heart failure patients were monitored for 48 hours using ambulatory holter electrocardiography recorders. Digital ECG data was analyzed for QTc interval along with frequency and severity of arrhythmias. Association of prolonged QTc interval with ventricular arrhythmias and severity of arrhythmias was analyzed. Cardiac arrhythmias were observed in 79.2% patients. QT analysis revealed that 69.8% patients had prolonged QTc interval, 86.4% patients with prolonged QTc had ventricular arrhythmias. Of these 66% patients were found to have severe ventricular arrhythmias. Comparison of mean QTc interval of our study population with a reference value showed significantly higher QTc interval of our study group than the test value. Arrhythmia frequency and severity significantly increases with an increase in QTc interval in heart failure demonstrating association of prolonged QTc interval with high risk of severe ventricular arrhythmias and sudden cardiac death in chronic heart failure
ABSTRACT
To screen out patients with Mitral Valve Prolapse at high risk of ventricular arrhythmogenesis, based upon Heart Rate Variability. Department of Cardiac Electrophysiology Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi from May 2007 to March 2008. This cross sectional study included 37 patients with mitral valve prolapse. Patients with acute or old myocardial infarction, diabetes mellitus, ischemic heart disease and systemic hypertension were excluded. Patients were holtered for 24 hours and time domain analysis of heart rate variability was carried out. Statistical time domain measures of heart rate variability i.e. SDNN, SDANN and RMSSD were calculated. Descriptive statistics were used to calculate frequencies and percentages of categorical variables using SPSS version 22. Mean values of SDNN, SDANN and RMSSD were 141.62 +/- 30.80, 125.16 +/- 25.58 and 28.40 +/- 8.06 milliseconds respectively. Two patients [5.40%] had reduced HRV in all the three indices. In one patient [2.70%] values of SDNN and SDANN were reduced whereas in another one patient [2.70%] the values of SDNN and RMSSD were reduced. In remaining one patient only SDNN was found to be reduced. There is a subset of patients with mitral valve prolapse with reduced heart rate variability which may be at risk of ventricular arrhythmogenesis