Effect of risk factors like age, gender, hypertension, diabetes, smoking, dyslipidemia on coronary artery disease in Karachiites with angiographical data of local population: Number, site, severity of coronary lesion

The aim of this study was to determine the effect of major risk factors like age, gender, hypertension, diabetes, smoking, dyslipidemia on coronary artery disease in Karachiites and highlighted the angiographic data of local population like number of vessels involvement, site and severity of coronary lesions. This was a cross sectional analytical prospective study which was carried out at Abbasi Shaheed Hospital Karachi from August 2004 - July 2014. We included five hundred [500] consecutive patients [188 female and 312 male] between 26-80 years old, who came for coronary angiography with suspecting ischemic heart disease clinically or otherwise proven by relevant tests like ETT, ECHO, and Thallium stress test. Post PCI and CABG patients were excluded from study. During this study variables like age, gender, hypertension, diabetes, smoking and dyslipidemia were taken into account in relation to coronary artery disease in Karachiites. In addition we also assorted some important findings of coronary angiography like: number of vessels involved, site and severity lesions in our population and compared them with existing literature. Our study revealed that in our local population not only old age and male gender are potential threat for an early coronary artery disease but other variables like hypertension, diabetes, smoking, and dyslipidemia are also playing important role in coronary artery disease. It is also concluded that our population is more prone to multiple vessels involvement with almost involvement of LAD in majority of population

Pharmacological and biological evaluation of extracts from Gratiola officinalis L. [Scrophulariaceae]

The crude extract of Gratiola officinalis and its n-hexane, chloroform, ethyl acetate, n-butanol and aqueous fractions were subjected to biological [Brine Shrimp Bioassay, Insecticidal and Phytotoxicity/Cytotoxic] and neuropharmacological [Head dip, Open field Forced swimming test, Sodium pentothal induced sleep] activities. Results obtained in this study indicated that at high concentration dose [1000microg/ml], all test samples showed 60-95% phytotoxicity. In crude extract, n-butanol and aqueous fractions produced more than 85% phytotoxicity. While low concentration [10microg/ml] dose showed 25-28% phytotoxicity in all test samples. The crude extract was devoid of any effect against the growth of Callosbruchus analis and Tribolium castaneum and caused 10 mortality of Rhyzopertha dominica. n-Hexane, chloroform, ethylacetate, n-butanol and aqueous fractions caused 50, 30, 40, 10 and 20% mortality respectively of C. analis where as chloroform, ethyl-acetate, aqueous and crude extract, n-hexane, ethyl-acetate fractions also caused low mortality [10%] of Tribolium castaneum and Rhyzopertha dominica respectively. In cytotoxic assay at 1000microg/ml concentration, n-butanol fraction produced 36.7% and the crude extract produced 13.3% mortality of brine shrimp, its aqueous fraction was inactive at all concentrations. The results of head dip, open field, mobility time and Pentothal Na induced sleep indicated that crude extract, n-butanol and ethylacetate fractions of G. officinalis had mild sedative effect. However aqueous fraction was found to produce a significant decrease in motor activities and potentiated the duration of sleep

Diagnostic accuracy of Tc-99m-MIBI for breast carcinoma in correlation with mammography and sonography

To evaluate the accuracy of 99mTc-MIBI scintimammography [SMM] in differentiating malignant breast cancer from benign breast mass and in detecting axillary lymph node metastasis in comparison with mammography and ultrasonography. Comparative cross-sectional study. At the Karachi Institute of Radiotherapy and Nuclear Medicine [KIRAN], Karachi, from December 2006 to May 2007. A total of 28 patients [both with breast lumps or/and axillary masses] included were in the study. They underwent clinical examination, mammography and ultrasound imaging followed by planar SMM using a single head detector. All subjects received a 740-1110 MBq bolus injection of [99m]Tc-Sestamibi. 5-10 minutes and 1 hour delayed images were acquired after the injection. SMM scans were considered positive when there was focal area of increased radiotracer uptake. Qualitative [visual] as well as quantitative evaluation of scans was done and compared with ultrasound and mammography, taking histopathology as Gold standard. Sensitivity, specificity, negative and positive predictive values [NPV and PPV respectively] were determined. There were 22 patients presenting with breast lesions [20 palpable, 2 non-palpable] and 6 patients with axillary lump. Scintimammography accurately predicted malignant lesions in the breast [sensitivity 93.3%, specificity. 71.4%, PPV 87.5%, NPV 83.3%, overall accuracy 86.4%] as well as in patients with axillary metastasis [sensitivity 100%, specificity 66%, PPV 75%, NPV 100%, accuracy 83%]. A combination of scintimammography with any other imaging modality provides better results than a single test to detect breast cancer. SMM has good diagnostic accuracy in the detection of breast cancer as well as in axillary metastasis in association with mammography and ultrasound

Estimation of glomerular filtration rate by using tc-99m DTPA plasma I sample method, Gates method, Cockcroft-Gault method and predicted creatinine clearance method: a prospective comparative analysis with plasma 2 - sample clearance method

To compare diagnostic accuracy of predicted clearance method, Gates method. Cockcroft-Gault method and plasma 1-sample clearance method with plasma 2-samples clearance method with Tc-99m DTPA for the estimation of glomerular filtration rate[GFR]. This study included 91 consecutive patients who were referred for evaluation of renal function to the Nuclear Medicine section of Karachi Institute of Radiotherapy and Nuclear Medicine [KIRAN] from September 2004 to September 2005. The GFR was determined simultaneously by 5 methods including Plasma two-Sample Clearance method after Tc-99m DTPA injection [PSC 2]; Plasma one-Sample Clearance method after Tc-99 m DTPA injection [PSC I]; Gamma camera uptake method after Tc-99m DTPA injection [Gates method]; Predicted Creatinine Clearance by Modification of Diet and Renal Diseases [MDRD]: and Cockeroft-Gault's equation for GFR estimation [CG]. PSC 2 was chosen as a reference, Out of the 91 patients, 71 were males and 20 females with age ranging from 16-68 years. The regression equation of the PSC 1, Gates, MDRD and CC method against the NC 2 was Y = 1.884+0.970X [r=0.90, p<0.001, SEE value-10, 23 ml/min/1.73m2]. Y = - 9.944 + l.083X [r=0.82, p<0.001, SEE valuel=11.02 mI/min/1.73m2], Y=25.606+0.640X [r=0.71, <0.002, SEEvaIuc=15.56 ml/min/1.73m2], and Y=14.9811-0.714X [r=0.77, p=0.002, SEE value=14.44 mI/min/1.73m2] respectively. In comparison with the GFR by PSC 2, the PSC I and Gates tended to overestimate by 1% [p=0.359] and 2% [p=0.265] respectively, MDRD and CC tended to underestimate GER by 11% and 14% respectively [p<0.001] PSC I correlate well with PSC 2 and either can be substituted for the other as ideal GFR markers. The Gates method shows good correlation with PSC 2 however it is less precise than PSC I. MDRD and CG methods due to significant underestimation are not considered as ideal GFR marker

randomized clinical trial comparing 50mCi and 100mCi of iodine-[131] for ablation of differentiated thyroid cancers

To compare the efficacy of low [50 mCi] and high dose [100 mCi] Iodine-131 in ablation of differentiated thyroid cancer remnants. Baseline serum thyroglobulin [sTg], thyroglobulin antibody [Tg Ab] and diagnostic whole body iodine scan with 2 mCi of I-131 were performed in each individual. After 6 months serum Tg, Tg Ab [of-thyroxin] and WB iodine scan with 10 mCi of I-131 were done to assess the efficacy of the low and high dose of I-131. Iodine ablative therapy [IAT] was considered successful [complete ablation] if the I-131 whole body scan was negative and sTg level was undetectable. In case of positive scan and/or sTg level detectable the patient was considered as unsuccessfully/partially ablated. In group A, [high dose] successful IAT was seen in 12/20 [60%] patients. Of these 5/7 [71%] had follicular Carcinoma on histopathology and 7/13 [54%] had papillary Ca. In group B, [low dose] successful IAT was seen in 8/20 [40%] patients, out of which 3/10 [30%] had follicular Carcinoma on histopathology and had successful IAT. 5/10 [50%] patients with papillary Carcinoma had successful IAT. As far as histopathology is concerned, in group A, response to high dose I-131 was better in follicular type than papillary type. Whereas in group B, response to low dose I-131 was better in patients with papillary type than follicular. 100 mCi of radioactive Iodine-131 [I-131] is a more effective therapeutic dose than 50 mCi [I-131] in the treatment of differentiated thyroid cancer remnants. Furthermore, follicular Carcinoma respond better to 100 mCi I-131 than 50 mCi while papillary Carcinoma showed an almost equal response to both