Assessing the efficacy of danshenform compound in patients with stable angina pectoris

To assess the efficacy of danshenform compound in patient with angina pectoris already on optimal dose of anti anginal therapy assessed by exercise tolerance test. Thirty eight patients with stable angina were included in the study. Patients were exercised on treadmill according to Bruce protocol at baseline and one week later. At second week, Danshenform compound 500 mg was prescribed bid for four weeks. At the end of 4 weeks, exercise tolerance test was performed. Duration and number of anginal episodes before and at the end of 4[th] week recorded. Total exercise time, onset of chest pain during exercise, onset of ST segments depression before and after treatment with Danshenform compound was recorded. The number of anginal episodes after 4 weeks treatment with danshenform was reduced significantly from 4.2 +/- 2.4 to 1.4 +/- 1.6/ week [p=0.001]. Time of onset of chest pain improved from 4.63 +/- 2.4 to 5.4 +/- 3.7 minutes [p=0.35] on exercise tolerance test. Duration of exercise increased from 6.52 +/- 1.9 minutes to 8.32 +/- 2.3 [p=0.001]. Time of onset of ST depression increased from 5.8 +/- 1.7 to 7.7 +/- 1.6 minutes [p=0.001] on stress test. Anginal class improved significantly after 4 weeks of treatment with danshenform compound [p=0.001] with no significant effect on resting heart rate [p=0.58] and systolic blood pressure [p=0.07] respectively. Danshenform compound is useful in reducing anginal episodes, increasing exercise duration, improving functional anginal class, delaying the onset of ST depression on exercise tolerance test in patient with ischemic heart disease

Frequency of coronary heart disease risk factors among nurses

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

Frequency of cardiovascular disease risk factors among doctors

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

Complications of conventional sclera buckling occurring during and after treatment of rhegmatogenous retinal detachment

To identify and determine the frequency of the intra-operative and early postoperative compkicaitons of Cinventional Scieral Buckling [CSB] ans the primary surgical intervention in patients with Phegmatogenous Retinal Detachment [RRD]. A quasi-interventional study. Khyber Institute of Ophthalmic Medicl Sciences [KIOMS], Postgraduate Medical Institute [PGMI], Hayatabad Medical Complex [HMC], Peshawar, from April 2005 to June 2006. Fifty consecutive patients who underwent CSB and fulfilled the inclusion criteria, were included in the study. Operative details and any intra-operative complications were noted. The patients underwent another detailed clinical examination and pain assessment on the first postoperative day. All the patients were followed-up minimum for 3 months. Postoperative complications were identified and recorded. The data was analyzed on SPSS 120 for measures of central tendency and dispersion. There were 36 males and 14 female subjects. Mean age was 37.18 +/- 20.145 years. Encirclement [56%] was the most frequently used CSB technique, sixteen [32%] patients had at least one intra-operative complication. Intra-operative complications were iatrogenic sclera break [2%], accidental Sub Retinal Fluid [SRF] drainage [8%], choroidal haemorrhage [2%], subretinal haemorrhage [14%], retinal incarceration [2%], vitreous haemorrhage [6%], raised [4%] or very low [2%], intra-operative IOP and hyphema [2%]. Postoperative complications included systemic complications [24%], choroidal detachment [8%], vitreous haemorrahge [16%], raised IOP [22%], angle closure [2%] and explants exposure [6%]. Mean refractive change in spherical equivalent was -1.478 +/- 0.698 D. final re-attachment rate was [82%] and final BCVA of > 6/60 was achieved in 62% of the subjects in the treated eyes. CSB is a safe and effective option for treating uncomplicated RRD, but it is associated with certain complications. Sub-retinal bleed was the most common intra-operative complication. Raised IOP was most the common early postoperative complication followed by choroidal detachment

Does BMI affect cholesterol, sugar, and blood pressure in general population?

Higher BMI in child hood is also associated with an increase risk for coronary heart disease in adulthood. Impaired glucose tolerance is highly prevalent in children and adolescents with severe obesity. Positive correlations between BMI and glucose, lipids and BP have previously been reported. The objective of this study was to find the correlation of BMI with cholesterol and sugar level in general population. This study was a part of 'Peshawar Heart Study', performed at Cardiology Department, Lady Reading Hospital, Peshawar in 2008-2009. Individuals with different ages, gender, professions, socioeconomic class were randomly selected from general population. Random blood sugar and cholesterol was measured with strip method. Height and weight of each individual was recorded and BMI calculated. All individuals were asked about any current medical illness and whether they were performing any exercise or not. Using SPSS-13, descriptive statistics were used for frequencies. Bivariate correlations were used for measuring correlation between BMI, sugar and cholesterol. Partial correlations were used to factor out the effect of other variables. A total of 2,270 individuals, 1,798 [79.2%] male and 472 [20.8%] female were examined. Mean age was 38.47 +/- 12.66. Mean BMI was 26.38 +/- 4.97. Mean RBS was 113.7 +/- 47.145. Mean cholesterol was 168.47 +/- 28.23. Exercise was performed by 929 [40.90%] individuals. Diabetes was present in 113 [5.0%] and history of high cholesterol in 25 [1.1%] persons. When bivariate correlation analysis were done systolic BP, diastolic BP, RBS and cholesterol had positive correlation with BMI [correlation coefficient of 0.317 [p<0.000], 0.319[p<0.000], 0.125 [p<0.000] and 0.205 [p<0.000] respectively]. These variables also showed a positive correlation among themselves. After factoring out the effects of age, exercise, gender and current medical status on the above correlations, the correlation of RBS and cholesterol with BMI decreased to 0.025 [p=0.232] and 0.135 [p<0.000] respectively and between sugar and cholesterol decreased to 0.018 [p=0.401]. In general population BMI is positively correlated with RBS and cholesterol. With the effect of age, sex, exercise and current medical status, this correlation is reduced

Should we say good bye to exercise ECG testing?

This study was aimed to find out the accuracy of exercise test in patients with suspected coronary artery disease [CAD] presenting to Cardiology department, Lady Reading Hospital, Peshawar. In this retrospective study, records of all those patients with suspected CAD, who presented to Cardiology department, Lady Reading Hospital, Peshawar from July 2000 to July 2003, were analyzed. Only those patients who underwent both exercise tolerance test [ETT] and coronary angiography were included in the study. Exercise test was performed using standard Bruce protocol. Study population comprised of 664 patients, including 559 [84%] men and 105 [16%] women, with mean age of 50+9.7 [range 20-85] years. Coronary angiography showed 601/664 patients had stenosis of >70% in at least one coronary artery. Of these 601 patients 351[58.47%] had abnormal ETT, 105[17.47%] had negative ETT and 145[24.12%] had non-diagnostic ETT. After excluding the non-diagnostic results, the sensitivity was 76.97%. Among the 63/664 individuals with minimal or no coronary stenosis, 18[28.57%] had no ischemic ST changes during ETT, 21[33.33%] had positive ETT and 24[38.09%] had non-diagnostic ETT. Thus the specificity was 46.15%. Positive predictive value of ETT was 95% and negative predictive value was 15%. Overall accuracy of ETT was 55.50%. Exercise ECG testing has an important role in diagnosing suspected coronary artery disease. Patients with positive ETT should further be evaluated by coronary angiography. A negative ETT does not exclude CAD