Pulmonary tuberculosis; age related radiological findings

To study the age related radiological finding in pulmonary tuberculosis. Across sectional study. From January 2009 to December 2009 pulmonary department of Bahawal Victoria Hospital Bahawal Pur. The cases diagnosed as pulmonary tuberculosis of either gender above age of 12 years were included in the study. Patients suffering from extra pulmonary tuberculosis, treatment failure, relapse, drug resistant tuberculosis and HIV sero-positive patients were excluded from the study. Patients were divided into groups according to the age. Group 1 consist of patients having age >/= 50years while group 2 consist of patients having <50 years. Data was recorded on the Proforma and was analyzed statistically on SPSS 11. this study consists of 106 patients and divided into two groups. It has been found that apical zone of lung involvement was more common in patients younger than 50 years while involvement of lower zone was more common in patients with age >/= 50years. No significant difference was found regarding the involvement of middle zone, multiple zones and the type of lesions as the p-value was >0.05. The elderly patients with pulmonary tuberculosis have predominant involvement of lower zones. So, lower zone involvement of radiological lesions should be evaluated for pulmonary tuberculosis to start the treatment earlier and to minimize the risk of missing the diagnosis

Different clinical presentations of breast cancer: an overview of 100 patients

To describe different modes of presentation of carcinoma breast in patients presenting at Bahawal Victoria Hospital Bahawalpur. It was a descriptive case series study, conducted in surgical units, Bahawal Victoria Hospital Bahawalpur. The duration of study was from January 2009 to December 2009. 100 female patients of proven carcinoma breast with informed consent were included in this study. All the data was collected on pre designed proforma and results were analyzed using SPSS 10,0 version, The commonest age group developing carcinoma breast was 31-50 years [59%]. Seventy six patients came from rural areas of Bahawalpur and nearby districts. Eighteen patients completed 10 years of schooling while only 5 patients were post-graduate. Twelve patients [12%] were un-married, Total 81% patients presented with lump in the breast. Left breast was involved in 56% of cases and right in 43% cases, One patient had bilateral carcinoma of breast. The duration of illness was ranged from 1 month to 5 years. The commonly observed stage of presentation was Stage III with 46 cases and 16 patients presented in stage IV. Infiltrating ductal carcinoma was the most common histological type 87% cases proved on histology to be infiltrating ductal carcinoma, Breast cancer is very common in the females, when diagnosed at an earlier stage have a more favorable prognosis compared to those at late stage. The females try to hide this problem and present at more advance stage

Coronary artery surgery with or without cardiopulmonary bypass: impact on early outcome

Abstract: during the last 10-15 years, coronary artery surgery without use of cardiopulmonary bypass has gained popularity. Although worldwide incidence of off-pump surgery has remained around 15% , retrospective studies have shown that off-surgery reduces the inflammatory response, mortality and morbidity associated with coronary artery surgery

Objective: to compare early postoperative outcome in patients undergoing coronary artery surgery with or without cardiopulmonary bypass

Methods: a prospective randomized control trial was conducted in Punjab Institute of Cardiology Lahore:-Two hundred consecutive patients. Undergoing coronary artery surgery were randomized in two groups. Group I included 107 patients who underwent coronary artery bypass grafting on CPB and Group II included 93 patients who underwent coronary artery bypass grafting without CPB. Critically ill patients with hemodynamic instability, previous cardiac surgery and patients needing concomitant cardiac procedure were excluded from the study. Incidence of early postoperative [within 30 days] mortality and morbidity [myocardial infarction, bleeding, stroke, arrhythmias, renal and pulmonary complications and infection] were compared among · two groups

Results: in group I, 96 [89.71%] patients were male and 11[10.29%] were female. In group 11, 81[87.09%] patients were male and 12 [12.91%] were female. There was no significant difference in age, preoperative ejection fraction and risk factors for coronary artery disease between two groups. Routine blood tests including Hb, ESR, LFTs, RFTs, Lipid profile, bleeding profile did not show any significant difference among both groups. There was no significant difference in 30 days mortality among two groups, 2.8% in CCABG as compared to 4.3% in OPCAB [p=0.492]. No significant difference in incidence of adverse post-operative cardiac outcomes as Ml [4 [3.7%] in CCABG vs. 7 [7.5%] in OPCABJ, use of intra-aortic balloon pump [2[1.9%] in CCABG vs. 2 [2.2%] in OPCAB] and low cardiac output syndrome [2[1.9%] in CCABG vs. 1 [1.0%] in OPCABJ was found among two groups. No significant difference was observed in amount of bleeding in both groups. The incidence of pulmonary, renal and neurological complications was similar in both groups. Data regarding ICU stay [5.07+3.88 in CCABG vs. 4.23+2.11 in OPCAB] and hospital stay [12.8+8.14 in CCABG vs. 11.55+5.83 in OPCAB] showed insignificant difference

Conclusion: our study has not shown superiority of OPCAB over CCABG with regards to early mortality and morbidity which is consistent with other RCT conducted worldwide. So cautious approach is needed in widespread adoption of OPCAB