ABSTRACT
Objective: To compare heroin users with their age and gender matched relatives as regards non-invasive investigations like chest x-ray, electrocardiography [ECG] and 2D-echocardiography
Study Design: Case control study
Place and Duration of Study: Armed Forces Institute of Cardiology-National Institute of Heart Diseases, Rawalpindi, from Feb 2010 to Jul 2010
Material and Methods: Sixty one heroin users [cases] and their 100 non-substance abuser age and gender matched relatives [controls] were included through non-probability consecutive sampling. Chest x-ray [CXR], 12-lead electrocardiography [ECG] and two-dimensional echocardiography [2D-ECHO] were done of each one and the result was interpreted by respected consultants. The data were analyzed on SPSS version 15. Descriptive statistics of mean and standard deviation [SD] were described for quantitative variables while frequency and percentages for qualitative variables. Independent samples t-test compared quantitative variables while for qualitative variables chi-square test was used. Ninety five percent confidence intervals were calculated for all variables
Results: Statistically significant differences were noted between cases and controls as regards chest X-ray. A total of 10% cases had findings consistent with tuberculosis [TB] as compared to 3% controls [p=0.045]. There was however no cardiac abnormality in any study subject. Significant 12-lead ECG findings other than normal were noticed in 12 [19.7%] heroin users as compared to 10 [10%] controls [p=0.083]. In 12 lead ECG, the predominant finding was t wave inversion in leads AVF and III. According to 2D-echocardiography [2D-echo] reports, 15 [24.6%] heroin users [cases] and 17 [17%] controls had abnormal findings [p=0.242]. We report no vegetations on any cardiac valve
Conclusion: On radiological and cardiac parameters, heroin users are a different population as compared to the non-heroin users. The knowledge about variations on non-invasive investigations not only helps the healthcare workers to optimize treatment regarding rehabilitation but also facilitate diagnosis and treatment
ABSTRACT
Objective: The study was conducted to highlight the sickness absenteeism pattern among the doctors and nurses of Combined Military Hospital, Lahore in the year 2014
Study Design: Cross sectional descriptive study
Place and Duration of Study: Combined Military Hospital [CMH] Lahore, 1 year from Jan 2014 to Dec 2014
Patients and Methods: Sick-in-Quarter [SIQ] reports of doctors and nurses were collected from the SIQ register of Combined Military Hospital, Lahore for the duration of 1 year. This data was categorized based on gender, rank, causes and duration of illness. Frequencies of Sickness absenteeism of the health care providers based on these categories were noted and analyzed through SPSS 20
Results: A total of 670 SIQ's were issued to health care professionals at CMH Lahore in 2014. Of these, 164 [24.5%] were issued to males and 506 [75.5%] were issued to females. Out of these 316 [47.2%] were doctors and 354 [52.8%] were nurses [p<0.001]. Maximum absenteeism was caused by respiratory diseases 176 [26.28%]. Monday showed the highest predominance of sick reports with 166 [24.8%]. Most SIQ's were issued in April 90 [13.4%] while a low number of SIQs were issued in February 20 [3%]
Conclusion: Sickness absenteeism was highly prevalent, and was higher among nurses than doctors. Respiratory diseases were the leading cause of sickness absenteeism among the doctors and nurses. Measures are needed to sustain the health of doctors and nurses to improve the overall patient care
ABSTRACT
To assess the overall outcome and success of Fontan surgery at our institute. AFIC-NIHD Rawalpindi. 01 September 2005 to 31 March 2010. For this retrospective study, institute's cardiac surgery database was used. Patients of single ventricle physiology, who had normal Left Ventricular End-diastolic Pressure and pulmonary artery pressures, were included. Data was analyzed using SPSS version 16. A total of 34 Fontan procedures were done. The mean age at operation was 4.83 +/- 1.37 years. There were 22 [64.7%] males and 12 [35.3%] females. Twenty five [73.5%] had a staged Fontan [successful previous Bidirectional Glenn's shunt, BDG]. Nine [26.5%] were primary Fontan procedures [no successful previous Bidirectional Glenn's shunt, BDG]. Thirty two [94.8%] were Extra Cardiac Conduit Fontan [ECCF] and 2[5.8%] were Intra Cardiac Fontan. Mean Bypass time was 132.65 +/- 48.44 minutes. Aorta was cross clamped in intracardiac Fontan and its mean time was 43.31 +/- 5.85minutes. Fenestration was employed in 14 [41.2%] patients. Mean pre-operative oxygen saturations were 77.41 +/- 10.27%, which significantly increased to 93.94 +/- 3.96% post-operatively [p<0.001]. In-hospital mortality was 2 [5.8%]. Fontan surgery has acceptable morbidity and mortality in our set up