Role of magnesium sulphate in ischaemic stroke

To evaluate the role of magnesium sulphate in patients presenting with ischaemic stroke. This experimental type of interventional study was carried out at Mayo Hospital, Lahore. Within 24 hours of onset of clinically diagnosed stroke, which was later confirmed by CT scan, patients were randomized to receive either magnesium sulphate [16mmol IV over 15 minutes and 65mmol over 24 hours] or placebo. Their disability was measured by Barthel score at presentation and outcome measured after three months by death and disability and the results were compared between the two groups. Those patients who had a Barthel score of = 12 at three months were considered independent and those with a score of < 12 were considered disabled. The results were analyzed by SPSS. Fifty patients were recruited in the study. 25 patients were randomized to receive MgSO[4] and 25 received placebo. The Barthel score improved from 5.1 +/- 3.3 at presentation to 13.5 +/- 3.4 after three months in all the patients so the re was improvement whether MgSO[4] was given or not. Patients who were randomized to receive MgSO[4] had a lower Barthel score of 4.2 +/- 2.9 as compared to controls 5.9 +/- 3.5, but after three months they improved more than the controls gaining a score of 15.7 +/- 1.9 versus 11.3 +/- 3.2 [p=0.000]. The mortality rate was not statistically different in the two groups. 88% patients had a Barthel score of > 12 at three months in the MgSO[4] and 30% in the control/placebo group. Combined death and disability was 8% in MgSO[4] group and 60% in the control group. Moreover MgSO[4] was well tolerated. Magnesium sulphate therapy was safe in patients presenting with ischaemic stroke irrespective of the site of infarct. It improves prognosis regarding Barthel score at three months as well as the difference in the Barthel score at presentation and at three months. A greater percentage of magnesium treated patients led independent lives after three months

Complications of streptokinase during infusion in acute myocardial infarction

Myocardial infarction is one of the most common causes of death worldwide. The cornerstone of therapy is thrombolytic therapy. Coronary thrombolysis helps restore coronary patency, preserves left ventricular function and improves survival. The most common thrombolytic agent used is streptokinase. But thrombolytic therapy is at times associated with some complications. This comparative study was aimed to find out the complications occurring during streptokinase infusion in patients presenting with acute myocardial infarction in Mayo Hospital, Lahore. Two hundred patients with definite diagnosis of acute myocardial infraction, who presented to East Medical Ward, Mayo Hospital, Lahore, were included in this study. All patients presenting with AMI were considered for SK therapy. Those who were actually given SK constituted the SK group and those who were not fit for SK, but otherwise SK was indicated, constituted the control group. In SK group 100 patients were given standard t reatment of acute myocardial infarction including streptokinase. In control group 100 patients were given standard treatment of acute myocardial infarction except streptokinase due to non-eligibility. Patients with typical chest pain of at least 30 minutes duration, serial ECG changes and serial cardiac enzyme changes were entered in the study. Comparative / interventional Post SK changes in blood pressure were significant [p= 0.011]. There was post SK hypotension in 48 [24%] and post SK hypertension in 20 [10%] patients. Allergic reaction was present in 4 [2%] only [p=0.044]. Arrhythmias were significantly less prominent in SK group [p=0.000]. Post SK bleeding occurred in 3 [1.5%] only [p=0.082]. 37 patients died [18.5%] in total, out of which 5 [2.55] patients died in SK group and 32 in control group [p=0.000]. CVA occurred in 1 SK group patient only, which was found to be hemorrhagic on CT scan [p= 0.31]. Early administration of SK lowers in-hospital mortality [p= 0.00 0]. Major complications during SK therapy are Hypotension [p= 0.011], Arrhythmias [p= 0.000], Allergic reactions [p= 0.044]

Atrial fibrillation in mitral stenosis and its correlation with age, sex and clinical symptoms

The objective of the study was to calculate the frequency of atrial fibrillation of MS and its correlation with age, sex and clinical symptoms. A prospective descriptive study. Mayo Hospital and Punjab Institute of Cardiology, Lahore. 112 patients of mitral stenosis were investigated with an ECG and an echocardiography to confirm mitral stenosis and to measure anteroposterior left atrial dimensions on M-mode. All patients who were suffering from AF due to causes other than mitral stenosis were excluded. The significance of findings were tested through standard "t"test. Atrial fibrillation is more in female patient and has a linear correlation with age. More common symptoms of shortness of breath followed by palpitation