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

How aware are the educators of cardiovascular risk factors?

The aim of this study was to know the frequency of CVD risk factors in teachers of Peshawar. Data for this study was derived from Peshawar Heart study [PHS]. PHS was conducted by Cardiology Department Postgraduate Medical Institute, Lady Reading Hospital, Peshawar to determine various cardiovascular risk factors like diabetes hypertension, hypercholesterolemia, obesity, physical inactivity etc. in various occupational groups of Peshawar. Data of 174 school teachers recruited in Peshawar Heart Study [PHS] was analyzed for the frequency of CVD risk factors. Their mean age was 42.95 +/- 8.29 years. Mean BMI was 26.11 +/- 4.53 Kg/m[2] and 35.05% [n=61] were overweight and 47.07% [n=83] were found to be obese. Mean systolic blood pressure was 131.2 +/- 18.16 mmHg and 33.33% [n=58] had systolic blood of >/= 140 mmHg. Mean diastolic blood pressure was 89.25 +/- 12.13 mmHg and 59.77% [104] had their diastolic pressure >/= 90 mmHg and 5.75% [n=10] were known hypertensive. Mean cholesterol was 168 mg/dl while 20.68% [n=36] had cholesterol of >/=180mg /dl. Out of 174 school teachers 4% [n=7] were known diabetic and 6.32% [n=11] had RBS of >/=140 mg/dl. CAD was found in 3.44% [n=6]. Family history of CAD was positive in 18.96% [n=33]. Fifty eight percent subjects admitted to regular exercise. ECGs were also analyzed and it was found that 2.88% [n=5] were having LVH, 1.75% [n=3] were having right bundle branch block [RBBB] and 2.88% [n=5] have changes of previous myocardial infarction. It was demonstrated in this study that CVD risk factors especially lack of exercise, obesity and hypertension were common in school teachers

Helicobacter pylori stool antigen test [HPSA] for the diagnosis of gastric infection

To determine the accuracy of Helicobacter pylori Stool Antigen test [HpSA], compared with endoscopic histopathology for the diagnosis of gastric HeUcobecter pylori infection. Cross-sectional study. Medical Unit II, Abbasi Shaheed Hospital, Karachi, from March 2003 to March 2004. A total of 50 patients underwent endoscopy for gastric antral mucosal tissue biopsy for histopathology of H.pyiori and advised for HpSA. Patient's information including age, gender, past history, presenting signs and symptoms, results of HpSA and histopathology were recorded. Sensitivity analysis was performed to calculate sensitivity, specificity, and predictive values of HpSA. Among 50 patients, 48% males and 52% females [M: F 1: 1.08], a total of 27 [54%] were true positive while 20 [40%] were true negative. Two patients were false negative and only one was false positive. Sensitivity of HpSA was, therefore, 93.1%, specificity 95% and positive and negative predictive values were 96.42% and 90.9% respectively. Helicobacter pylori stool antigen was an accurate and reliable test for the diagnosis of gastric H. pylori infection