ABSTRACT
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
ABSTRACT
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
ABSTRACT
To study the utility of Transradial Coronary Angioplasty in Patients with Chronic stable Angina discharged on same day. This was a single center observational study with prospective data collection of 228 patients underwent transradial coronary angioplasty from January to December 20JO, at Post Graduate Medical Institute, Lady Reading Hospital, Peshawar. Patients of both genders and all ages who had transradial coronary angioplasty for chronic stable angina and were discharged on same day were included in the study, using purposive non-probability sampling technique. Patients with unstable angina and acute coronary syndrome who had to stay for more than one day, were excluded from the study. Patients were followed at one month of hospital discharge in out patients department and clinical outcome data was recorded. A total of 228 patients were included in the study. Male were 64.9% and 35.1% were female with mean age of 56 +/- 9years. All the patients had coronary intervention through right radial artery. Baseline characteristics of the patients were; diabetic 46.4%, hypertensive 45.6%, smokers 32.8%, dyslipidemic were 47.8% and mean values of serum creatinin and Hemoglobin were 1.2 +/- 0.5 and 12.8_2.4, respectively. The frequency of various complications were as follow; mild hem atom a 1.7%, nausea and vomiting 1.3%, pain in hand 10.5%, readmission to hospital for chest pain 7.4%, need for revascularization 3%, hand ischemia 2.5%, minor bleeding 0.8%, and mortality was 1.3%. There was no access site major bleeding or hematoma. The radial artery approach for coronary angiopalsty is found to be very useful with low degree of access site vascular complications and an early patient mobilization
ABSTRACT
To find out the sensitivity and specificity of dobutamine stress echocardiography in comparison to the anaiographic findings. This Cross-Sectional study was conducted at cardiology department, Lady Reading Hospital Peshawar, from January to December 2007. Data was collected by non probability purposive sampling technique. Study patients underwent both dobutamine stress echo and coronary angiography, after taking an informed consent. Dobutamine stress echo was performed according to standard protocol. Total of 50 patients, whose mean age was 51.6 +/- 9.7, were studied. Men were 35 [70%] and women were 15 [30%]. Dobutamine was infused [10 to 40 micrograms/kg/min] in 3 minutes intervals. The inducible ischemia was detected in total 33[66%] patients. Seven patients [14%] had only resting wall motion abnormalities with no change by dobutamine stress. These patients were also taken as positive for ischemia. Coronary angiography showed 43/50 [86%] patients had > 50% stenosis in at least one coronary artery. Compared with coronary angiography, the sensitivity, specificity, positive and negative predictive values and accuracy of dobutamine stress echo for detection of coronary artery disease were 91%, 86%, 97%, 60%and 90% respectively. The sensitivities for SVD, DVD and TVD were 76%, 89% and 100% respectively. Dobutamine stress echo is a sensitive and specific method in non invasive diagnosis of suspected CAD. It is highly sensitive for multivessel disease as compared to single vessel disease
ABSTRACT
To find out frequency of risk factors for cardiovascular disease amongst doctors. This was a cross-sectional study involving doctors [working at Lady Reading Hospital] recruited in Peshawar Heart Study [PHS]. All participants were interviewed in detail including present and past medical history, family history, smoking, drug and dietary history. Pulse, blood pressure, body mass index [BMI] and waist/hip ratio were measured. Random blood sugar and total cholesterol was checked. A supine resting ECG was recorded. Data was analyzed for frequency of cardiovascular risk factors using SPSS Version 16. A total of 208 doctors were interviewed. Mean age was 30.33 +/- 7.0 years. Mean BMI was 24.69 +/- 4.73.Mean waist size was 84.68 +/- 10.571cm. Mean waist/hip ratio was 0.86 +/- 0.068. Mean systolic BP was 121.82 +/- 13.70 mm Hg while mean diastolic BP was 78.89 +/- 09.36 mm Hg. Mean random blood cholesterol was 163.97 +/- 27.93 mg / dl. Mean random blood sugar was 95.79 +/- 24.57 mg /dl. Most [98.55%] of doctors had random blood sugar of less than 180 mg /dl. The big majority of the doctors was not performing any regular exercise [n=157, 75.5%]. Mean duty hours per day were 8.98 +/- 2.073.Active smokers were 39 [18.8%], while 9 [4.3%] were using Naswar. None of the doctors enrolled in study was drinking alcohol. Among modifiable risk factors hypercholesterolemia, diabetes, and hypertension were less frequent amongst doctors while physical inactivity, obesity, unhealthy eating, and smoking were relatively more frequent
ABSTRACT
To determine the frequency of risk factors and complications associated with pregnancy-induced hypertension [PIH] in a hospital based study. Desriptive Study. Study was conducted in obstetric and gynecology department of Khyber teaching hospital Peshawar from March 2006 to March 2007. Sixty eight patients were included in the study. Relevant informations was recorded from patients and treatment chart of the patients on a questionnaire designed in accordance with the objectives of the study. The age range of the patients was from 14 to 48 years with mean age of 27.5 years, and mode of 26 years. The distribution of symptoms was: Increased blood pressure [100%] edema feet [86.76%], nausea, vomiting [32.34%] sudden weight gain [27.94%] visual changes such as blurred or double vision [22.05%] etc. Frequency of risk factors of PIH was: Primigravida [8.72%] previous pre-eclampsia [7.35%] diabetes mellitus [16.17%] obesity [10.29%], chronic hypertension [7.35%], large placenta [4.4%]. While no risk factors recorded in 10.29% patients. Complications of PIH occurred only in 52.94% cases. Frequency of various complications was: haemolysis, elevated liver enzymes and low platelets [HELLP] 80.55%, convulsions 16.66%, pulmonary edema 8.33%, cortical block and intra uterine growth retardation in 2.77% each. Increased blood pressure, edema feet, sudden weight gain, visual changes were main symptoms of PIH in our patients. Primigravida, previous pre-eclampsia, diabetes mellitus, chronic hypertension, obesity and large placenta were found to be as major risk factors of PIH. HELLP, convulsions and pulmonary edema were recorded major complication of PIH