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JLUMHS-Journal of the Liaquat University of Medical Health Sciences. 2016; 15 (4): 164-167
in English | IMEMR | ID: emr-190136


Background: Coronary artery disease [CAD] has a predilection for older age. However, both in developed and developing countries, an epidemiological shifts for CAD is observed and now it is more frequently seen in young adult population, but there is paucity of data regarding emerging clinical picture. Therefore, the present study was designed to determine the percentage of patients at 45 years of age and below afflicted with myocardial infarction. The study was also aimed to determine the sex distribution, associated risk factors and clinical features in young patients

Methods: This descriptive study conducted through convenient sampling technique at Coronary Care Unit of Liaquat University Hospital, Hyderabad and on all patients admitted with acute myocardial infarction during the period of one year to determine the frequency of acute myocardial infarction among younger patients aged

Results: The overall prevalence of acute myocardial infarction among young adults was 46.80%. The mean age of study subjects was 37.63 +/-6.26 years; male outnumbered [80.7%, n= 71] female [19.3%, n=17]. Most of the patients belongs to age group between 41 - 45 years [40.9%, n= 36] and the most common underlying condition that may linked to myocardial infarction was cigarette smoking [65.9%, n= 58]. Out of total 88 patients the mortality rate was [12.5%, n= 11] and ventricular arrhythmias were the most common [6.8%, n=6] complication

Conclusion: The acute myocardial infarction is not uncommon in younger aged male smokers

International Journal of Women Empowerment. 2015; 1 (December): 33-35
in English | IMEMR | ID: emr-186218


The research investigates the domestic violence against women in Tangwani District Kandhkot Kashmore Sindh Pakistan. Data were collected from 150 women by using qualitative and quantitative methods were used. The qualitative methods involved initial focus group meetings that were followed by the survey questionnaire. The survey questionnaire was more of an in depth interview because of the sensitive nature of the issues and therefore included open ended questions with certain inferences on the types of violence recorded on a quantitative sheet. Data were analyzed by using E-View 7. It was revealed that most of the surveyed women were quiet depressed and their male counterparts not working but they are solely depending on women work in SMEs. It was further revealed that the rural women is less confident and their husbands were always given them hard time once they are exposing themselves to outside the boundaries of the house. The biggest challenges which they were facing they were doing all business in house, lack of marketing facilities, Karo Kari criminal activities and they were deprived from the basic rights. The number of women who died of stove burns in the first six months of 2011-2014 was 300 compared to 1300 murders that took place at the same time

JLUMHS-Journal of the Liaquat University of Medical Health Sciences. 2015; 14 (1): 12-15
in English | IMEMR | ID: emr-192249


OBJECTIVE: The objective of the study is to determine the efficacy of different home prophylactic plaque control methods in patients undergoing orthodontic treatment

MATERIAL AND METHODS: A cross sectional study was conducted at the Department of Orthodontics, Liaquat University of Medical and Health Sciences, Jamshoro and private orthodontic clinics in Hyderabad

The patients fulfilling the inclusion criteria were asked to chew the plaque disclosing tablet [EviplacPastilhas], swish it for 30 seconds, then asked to spit out and asked to wash once with drinking water, plaque score was calculated by using Turesky Modification of Quigley Hein plaque index. Selected patients were given a self-administered questionnaire regarding mechanical means of plaque control

RESULTS: In this study 42% were male and 58% females. The mean age was 19.1 + 2.47 years

The mean plaque score was 4.29+ 1.58 in this study. 62.9% patients were using regular tooth brush and 34.3% were using orthodontic tooth brush. 18.8%, 6.9%, and 3.7% patients were using inter-dental brush, tooth picks and dental floss respectively

The analysis of variance [ANOVA] test revealed no significant differences in different type of brush

CONCLUSION: It is concluded that majority of orthodontic patients were cleaning their teeth either with orthodontic brush or regular tooth brush and very few patients were using interdental aids to control plaque. Both regular and orthodontic brushes were effective in controlling plaque with is statistically insignificant difference

Pakistan Oral and Dental Journal. 2014; 34 (2): 339-343
in English | IMEMR | ID: emr-159518


The objective of this study was to assess the frequency of needle stick injury [NSI] among dental health care providers including dental technicians. A cross sectional survey was conducted among dental health care providers running independent dental clinics at Hyderabad and Karachi during the month of April 2013 and a total of 166 qualified dentists and 88 dental technicians were interviewed. Ninety [54.2%] out of 166 qualified dentists and 45 [51.1%] out of 88 dental technicians had been the victims of NSI at least once in preceding 12 months. 104 [62.6%] dentists knew about universal guidelines for prevention of needle stick injury, whereas only 7 [8%] technicians knew about safety guidelines. Only 67 [40.4%] dentists out of 166 and 7 [8.0%] technicians out of 88 reported about the needle stick injury to health authorities [or seniors]. Common reasons for non-reporting among qualified dentists were: 55 [33.1%] believed that there was no benefit to report, 45 [27.1%] did not know where to report and 32 [19.3%] assumed that needle was new. In the category of technicians, 52[59.1%] did not want to report. 03[3.4%] believed needles were used for first time and 5 [5.7%] believed nothing will happen. The risk of blood borne viral infections due to needle stick injury among dental health care providers, especially dental technicians is very high. Based on local studies and international guidelines, national guidelines for Pakistan should be developed by experts to minimize the chances of needle stick injury

Isra Medical Journal. 2014; 6 (3): 146-150
in English | IMEMR | ID: emr-183500


Objective: To observe the protective effect of Curcuma Longa in Nitro-Methane Sulfonamide induced hepatotoxicity

Study design: Experimental Case Control Study

Place and duration: Departments of Physiology and Postgraduate Research Lab of ISRA University Hyderabad, from 1st June 2012 to 31st December 2012

Methodology: 40 male albino Wistar rats were equally divided into four groups of 10 each. Group A used as the control group and was fed the normal rat chow for 09 days. Group B was fed with Nitro-Methane sulfonamide for 09 days followed by Curcuma Longa for next 09 days. Group C was given Curcuma Longa for 09 days followed by Nitro-Methanesulfonamide for next 09 days. Group D was given Nitro-Methane sulfonamide in combination with Curcuma Longa for 09 days. After 24 hours of feeding, blood samples from groups A and D were taken from dorsal vein in the tail of rats for biochemical analysis of serum levels of ALT, AST, ALP and a-GT at days 01 and 09 and for groups B and C blood samples were collected at day 01, day 09 and day 18

Results: The analysis showed that prevention from the Nitro-Methane sulfonamide induced hepatotoxicity by the Curcuma Longa administration was observed after 18 days with a p value < 0.012, and Pearson's correlation for regression at - 0.06 and -0.07

Conclusion: The results have clearly proven that Curcuma Longa in powdered form as used in the daily diet in our part of world acts as a homeostatic booster against a huge variety of stressors especially "over the counter" drug induced hepatic stresses

JLUMHS-Journal of the Liaquat University of Medical Health Sciences. 2014; 13 (2): 61-66
in English | IMEMR | ID: emr-192209


OBJECTIVES: To assess the efficacy and efficiency of forehead flap in reconstruction of maxillofacial region defects

STUDY DESIGN: Descriptive study

PLACE AND DURATION: Department of Oral and Maxillofacial Surgery King Edward Medical University/Mayo hospital Lahore, from November 2009 to June2012

METHODOLOGY: This study was carried out on 30 [Thirty] consecutive patients, of either sex, who required soft tissue reconstruction of maxillofacial region including oral cavity defects due to trauma, infection or after tumor ablative surgery. Follow up was done for four months and on every follow up visit, patients were questioned about the degree of satisfaction, with mouth opening and donor site aesthetics. Cosmetic deformity judged subjectively

RESULTS: The axial pattern fascio-cutaneous flap, for the reconstruction of maxillofacial region with oral cavity defect, performed in 30 patients. Success rate of the flap was 100%, with only partial necrosis of the flap in 1 case. Subjective assessment of the donor site however showed suboptimal results with 30% [n-9] patients moderately satisfied and 20% patients [n-6] were unsatisfied

CONCLUSION: Forehead flap is a reliable technique for reconstruction of maxillofacial region defects

Isra Medical Journal. 2013; 5 (3): 189-192
in English | IMEMR | ID: emr-189021


Objectives: To find out the simple, economical and diagnostic test for detecting Acute Myocardial Infraction [AMI] at distant areas

Study Design: Cross sectional study


Methodology: 03 ml of blood sample was collected from 140 patients presenting to the Emergency /Coronary Care Units of hospitals viz Isra University Hyderabad, Red Crescent Hyderabad and Civil Hospital Hyderabad. The slides were prepared and white blood cells were counted microscopically at Post Graduate laboratory of Isra University Hyderabad

Results: In present study Neutrophil/Lymphocyte [N/L] ratio was observed and compared in both subjects [cardiac and non-cardiac]

The N/L ratio was found to be normal in non-cardiac patients but was significantly raised in patients with myocardial infarction

Especially in Acute Myocardial Infarction with ST segment elevation [AMI-STE] in comparison to Acute Myocardial Infarction with non STsegment elevation [AMI-NSTE] was also observed [p< 0.001]

Conclusion: The N/L ratio was significantly raised in patients with AMI suggesting an additional diagnostic parameter for AMI at primary health care units

Isra Medical Journal. 2013; 5 (3): 198-199
in English | IMEMR | ID: emr-189024


Objectives: To observe and assess the efficacy of Aloe Vera extract on skin wound healing

Study Design: Analytic and experimental

Place And Duration: Departments of Physiology, Pathology and Postgraduate Research Lab of ISRA University Hyderabad, from June 2011 to December 2011

Methodology: 20 millimeter long cuts were made over the back of 18 rabbits. The rabbits were divided into three groups A,B and C, each comprising 06 numbers, and treated daily for 11 days with Xylo Aid, mixture of Xylo Aid and Alo Vera extract and Aloe Vera extract, and marked blue, black and green respectively. Taking the operation day as zero, 3 rabbits were sacrificed after 24 hours and then alternatively till the llth post-operative day. The entire wound area along with 4-5 mm of the surrounding skin was excised and fixated in 10% formaldehyde, after processing sections were made stained with Hand E and observed under microscope, the fibroblasts were counted to see the quality of wound healing, keeping group A as control the results were tabulated

Results: Visual observation showed that by llth day post wounding the recovery was 75% approximately with Aloe Vera extract application, 50% and 30% was observed with mixture application and Xylo Aid respectively

Conclusion: Aloe Vera application for 11 days on rabbit skin wound showed better healing process in comparison to mixture and Xylo Aid

Medical Forum Monthly. 2012; 23 (2): 18-23
in English | IMEMR | ID: emr-124972


To determine seroprevalence of Toxoplasmosis in women with repeated abortions in our local population. Prospective Cross-sectional study. This study was conducted in the Department of Microbiology Basic Medical Sciences Institute [BMSI] Jinnah Postgraduate Medical Centre [JPMC] Karachi from April 2006 to May 2008. Sera from 130 pregnant and post-aborted women with history of repeated abortions [group A] and 50 pregnant women with no history of abortion [group B - as controls] were analyzed for Toxoplasma IgM antibodies by ELISA technique to see the prevalence of toxoplasmosis. 24% of women of group A and 14% of women of group B were seropositive for toxoplasma IgM antibodies. Most of the cases with toxoplasmosis have had their abortions in the first trimester. Gradual increase in Toxoplasma antibody positivity with increasing gravida was observed. Women with negative serological status are at risk of acquiring a primary infection during pregnancy, hence education regarding preventive measures should be provided to them and every pregnant woman may be advised for Toxoplasma IgM antibodies investigation

Humans , Female , Abortion, Habitual/parasitology , Toxoplasma/immunology , Pregnancy Complications, Parasitic , Enzyme-Linked Immunosorbent Assay , Seroepidemiologic Studies , Immunoglobulin M , Cross-Sectional Studies
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2011; 21 (1): 23-25
in English | IMEMR | ID: emr-112813


To determine the frequency of HDV among hepatitis B surface antigen [HBsAg]-positive liver disorders. An observational cross-sectional study. Medical Unit I, Chandka Medical College Hospital, Larkana, from July 2003 to June 2008. Adult patients with HBs liver related disorders were evaluated for the presence of delta antibodies using commercially available ELISA kits. Descriptive statistcs were used for describing data. Proportions of anti D antibodies between gender and age were compared using chi-square test with significance at p < 0.05. Of the 774 cases, 438 were males [60.4%] and 336 were females [39.6%]. The mean age was 36.5 +/- 14.39 for males and 34.03 +/- 13.16 years for females ranging from 15 to 60 years. Anti-HDV was positive in 183 patients [23.6%].The frequency of HDV was not significantly different between the gender groups [p=0.718]. HDV infection was markedly higher in chronic than acute liver disorders. The HBV/HDV co-infection is frequent in the studied area. Therefore, practitioners and health care managers should be made aware of the risk of dual infection with HBV and HDV

Humans , Male , Female , Hepatitis Delta Virus , Hepatitis B Surface Antigens/metabolism , Liver Diseases/immunology , Seroepidemiologic Studies , Cross-Sectional Studies
Pakistan Journal of Otolaryngology-Head and Neck Surgery. 2010; 26 (2): 37-39
in English | IMEMR | ID: emr-131061


[1] To see the morphological patterns of non-neoplastic and neoplastic lesions of salivary glands. [2] To see the frequency of adenoid cystic carcinoma in salivary gland and extra salivary sites. Retrospective and prospective study. This study was conducted at pathology department, Basic Medical Sciences Institute, JPMC Karachi during 2005 to 2008 i.e. over 4 years. Data collection of all the cases of salivary gland lesions including the cases of adenoid cystic carcinoma at extra salivary sites over a 4-years period gland [2005-2008]. Heamotoxylin and eoxin [H and E] stained sections were studied in all cases. Special stains performed in selected cases included PAS, Reticulin and Trichrome. Total of 43 cases were retrieved and evaluated. Out of 43 cases only 2 cases [4.6%] were non-neoplastic i.e acute and chronic sialadenitis. Among the neoplastic lesions, most common benign tumour was pleomorphic adenoma counting 32 cases [74.4%] and one case [2.3%] of monomorphic adenoma. In the malignant tumours there were 3 cases [74.4%] and one case [2.3%] of monomorphic adenoma. In the malignant tumours there were 3 cases [6.9%] of adenoid cystic carcinoma, 3 cases [6.9%] of muco-epidermoid carcinoma and 1 case [2.3%] each of squamous cell carcinoma and acinic cell carcinoma. Total cases of adenoid cystic carcinoma were 6 [14.6%]. 3 of them originated from the salivary glands and 3 were seen at extra salivary sites including one case each in lacrimal gland, vagina and nasal cavity. Benign tumours comprise 76.7% of all salivary gland lesions. Adenoid cystic carcinoma was the most common malignant tumour, also found at extra salivary sites; therefore it should not be overlooked at extra salivary sites

Medical Forum Monthly. 2009; 20 (11): 54-59
in English | IMEMR | ID: emr-111235


To determine the vasodilator activity of 17 beta-estradiol as being genomic or non-genomic. The experimental protocol was divided into three groups, In group I aorta of rat was subjected to serial dilutions of norepinephrine and a standard concentration was selected, which produced optimal vasoconstriction. In group II, tissue was challenged with serial dilutions of 17 beta-estradiol in the presence of vascconstriction induced by the standard concentration of norepinephrine. Meanwhile in group III tissue was challenged with serial dilutions of 17 beta-estradiol in presence of standard concentration of norepinephrine after pretreatment with dactinomycin, which was used to inhibit protein synthesis so that genomic mode of action could be blocked. In our study 17 beta-estradiol, after pretreatment with dactinomycin, produced vasodilator activity in the same pattern as obtained without administration of protein synthesis inhibitor in the tissue preconstricted with norepinephrine [P<0.001]. The observations demonstrate the vasodilator activity of the 17 beta-stradiol to be its non-genomic action

Animals, Laboratory , Vasodilation/drug effects , Genomics , Rats , Norepinephrine , Dactinomycin , Postmenopause
Isra Medical Journal. 2009; 1 (3): 72-78
in English | IMEMR | ID: emr-125393


The use of ashes as a natural medicine for wound healing was evaluated in surgically induced wounds in the rabbit skin wound model. Ashes were prepared from dried buffalo dung, wood, and charcoal and their contents were analyzed with atomic absorption spectrophotometry. Each type of ashes was used as an experimental application on surgically induced skin wounds in the rabbit; an antibacterial ointment was used as a control. The healing results were evaluated over approximately 13 days. Consistent healing was observed in all the experimental wound sites, which was comparatively more rapid than the control wound site. The healing was deemed complete on eleventh day only with charcoal ash whereas for dung-cake ash and wood ash, the completion time was approximately 13 days. Ashes have unique properties to influence and enhance safe and sepsis-free wound healing in the rabbit skin wound model

Animals , Rabbits , Fibroblasts , Treatment Outcome , Charcoal , Acacia
JLUMHS-Journal of the Liaquat University of Medical Health. 2009; 8 (3): 201-204
in English | IMEMR | ID: emr-195958


Objectives: to compare the lipid profile in glycemic uncontrolled type 1 diabetes mellitus [DM] with type 2 glycemic uncontrolled diabetes mellitus [DM] and with matched controls

Study design: comparative study

Place and duration: diabetic Clinic Ward-7, Jinnah Postgraduate Medical Centre, Karachi- Pakistan, from March 2007 to June 2007

Methodology: total 120 adult subjects of either sex were included with set criteria in study and were distributed into three groups of 40 subjects. Group 1 glycemic uncontrolled diabetes type 1 using insulin regularly, Group 2 glycemic uncontrolled diabetes type 2 using oral hypoglycemic drugs regularly, and Group 3 non-diabetic controls. Lipid, lipoproteins, fasting serum sugar and HbA1c were analyzed and compared between both groups of diabetes as well as control group

Result: fasting serum glucose, HbA1c, total cholesterol, triglycerides, and LDL cholesterol were significantly increased whereas HDL cholesterol levels were found to be significantly decreased in both groups of diabetes than in control group. There was no significant difference between type 1 diabetics [group 1] and type 2 diabetics [group 2] in any parameter except that HDL cholesterol levels were increased significantly in type 2 glycemic uncontrolled diabetics, compared to type 1 glycemic uncontrolled diabetics

Conclusion: patients with glycemic uncontrolled diabetics type 2 have greater disturbance in lipid and lipoprotein metabolism as compare to type 1 glycemic uncontrolled type 1 as well as to controls

JLUMHS-Journal of the Liaquat University of Medical Health. 2009; 8 (3): 205-209
in English | IMEMR | ID: emr-195959


Objective: to document the outcomes of open mesh repair in the management of various Hernias

Study design: a descriptive case-series study

Sampling technique: non-probability purposive

Place and duration of study: department of Surgery, Unit-I Chandka Medical College Hospital, Larkana, from July 2003 to June 2008

Patients and methods: two hundred and eighty patients of hernia operated by sublay mesh repair were analyzed for postoperative outcomes as pain, surgical site infection, hematoma/seroma, sinus formation and recurrence. Data were collected by filling specially designed proforma for each patient. Follow up visits were scheduled at three weeks, six weeks, three months and six months postoperatively

Results: polypropylene sublay mesh repair was performed in 280 patients of hernia comprising of 174 males and 106 females with male to female ratio of 1.6:1. Age ranged from 20 to 78 years, mean 51 years. Inguinoscrotal hernia was the commonest type [52.5%], followed by periumbilical hernia [26.25%] and incisional hernia [13%]. Postoperatively 254 [91%] patients had uneventful recovery, 15 [5.3%] had surgical site infection, while 11 [3.9%] patients developed seroma. Neither recurrence nor chronic discharging sinus was noted

Conclusion: open mesh repair for hernia is a safe and effective technique, associated with low morbidity. Technique has proved to be simple and easy to perform, with minimal postoperative pain and early mobilization

JAMC-Journal of Ayub Medical College-Abbotabad-Pakistan. 2009; 21 (4): 87-89
in English | IMEMR | ID: emr-104386


Pulmonary aspiration of gastric contents leading to acid aspiration syndrome [AAS] is a well recognized risk factor during general anaesthesia [GA] for Caesarean section [CS]. The cross sectional observational study was conducted during July 2008 to October 2008 at Department of Anaesthesiology and Intensive Care, Liaquat University of Medical and Health Sciences Jamshoro, Sindh, Pakistan. The objective was to assess anaesthetic practice patterns and measures to prevent aspiration of acid gastric contents in full term pregnant women undergoing anaesthesia for Caesarean section. A structured questionnaire regarding practice of anaesthesia for Caesarean section was distributed among anaesthetists working and practicing at Hyderabad. Results from the completed questionnaires were transferred to a Microsoft Excel spreadsheet and the responses represented as percentages. General anaesthesia was preferred by 75.4% anaesthetists for caesarean section, 83.6% anaesthetists used rapid sequence induction with cricoid pressure during general anaesthesia, 29.5% respondents restricted clear fluids for 2-3 hours. Antacids were used by 90% of the anaesthetists, while about 50% anaesthetists performed extubation when patients were fully awake. Recommended practice patterns and measures to prevent aspiration of acid gastric contents during anaesthesia for caesarean section are not observed by most of the anaesthetists working at Hyderabad

JAMC-Journal of Ayub Medical College-Abbotabad-Pakistan. 2008; 20 (4): 37-40
in English | IMEMR | ID: emr-101888


Nosocomial infection is defined as an infection which develops 48 hours after hospital admission or within 48 hours after being discharged. The objectives were to assess the frequency of nosocomial infection in patients admitted to intensive care unit [ICU] and to determine the etiological factors in such patients. It was an Observational Study and conducted in Intensive Care Unit, Liaquat University Hospital Hyderabad Sindh Pakistan from January 2008 to November 2008. All patients above 16 years of age admitted in the ICU for more than 48 hours and developed clinical evidence of infection that did not originate from patients' original diagnosis at the time of admission, were included in the study. Data was entered in a proforma and analyzed using SPSS version 10.0. During the study period, 97 out of 333 patients acquired nosocomial infection. The frequency of nosocomial infection was 29.13%. Respiratory tract infection was seen in 29 [30.1%], urinary tract infection in 38 [39.1%] and blood stream infection in 23 [23.7%] patients. Other infections we identified were skin, soft tissue, wound and gastrointestinal tract infections. Patients admitted in intensive care unit are at more risk of acquiring nosocomial infection from different sources. It is suggested that proper nursing care, sterilization and disinfection of instruments and equipment and careful handling of invasive procedures are the best tool to control these life threatening infections

Humans , Male , Female , Cross Infection/etiology , Intensive Care Units , Hospitals, University
JAMC-Journal of Ayub Medical College-Abbotabad-Pakistan. 2008; 20 (2): 96-98
in English | IMEMR | ID: emr-87420


The objective of this study was to determine the mortality rate in patients presenting with Necrotizing Fasciitis. This prospective study was conducted at ward 26, JPMC Karachi over a period of two years from March 2001 to Feb 2003. All patients above the age of 12 years diagnosed to be having Necrotizing Fasciitis and admitted through the Accident and emergency department were included in this study. After resuscitation, the patients underwent the emergency exploration and aggressive surgical debridement. Post-operatively, the patients were managed in isolated section of the ward. The patients requiring grafting were referred to plastic surgery unit. The patients were followed up in outpatients department for about two years. Over all, 25 male and 5 female patients fulfilled the inclusion criteria and were included in this study. The common clinical manifestations include redness, swelling, discharging abscess, pain, fever, skin necrosis and foul smelling discharge etc. The most common predisposing factor was Diabetes mellitus whereas the most commonly involved site was perineum. All patients underwent aggressive and extensive surgical debridements. The common additional procedures included Skin grafting, Secondary suturing, Cystostomy and Orchidectomy. Bacteroides and E. coli were the main micro-organisms isolated in this study. Bacteroides was the most common microorganism isolated among the eight patients who died. Necrotizing Fasciitis is a potentially life threatening emergency condition and carries the mortality rate of about 26.6%. The major contributing factors to increase the mortality missed initially diagnosed, old age, diabetes mellitus truncal involvement and late presentation. Anorectal involvement of disease carry worse prognosis. Hyperbaric oxygen therapy and proper use of unprocessed honey reduced the mortality rate

Humans , Male , Female , Prospective Studies , Fasciitis, Necrotizing/microbiology , Fasciitis, Necrotizing/therapy , Fasciitis, Necrotizing/pathology , Bacteroides/pathogenicity , Diabetes Complications , APACHE , Escherichia coli
JAMC-Journal of Ayub Medical College-Abbotabad-Pakistan. 2008; 20 (3): 10-13
in English | IMEMR | ID: emr-87437


To compare the frequency and severity of post dural puncture headache in obstetric patients using 25G Quincke, 27G Quincke and 27G Whitacre spinal needles. Comparative, randomized, double-blind, interventional study. Liaquat University Hospital Hyderabad from October 2005 to December 2006. 480 ASA I-II full term pregnant women, 18 to 45 years of age, scheduled for elective Caesarean section, under spinal anaesthesia, were randomized into three groups: Group I [25G Quincke spinal needle: n=168], Group II [27G Quincke spinal needle: n=160] and Group III [27G Whitacre spinal needle: n=152]. Spinal anaesthesia was performed with 1.5-2.0 ml 0.75% hyperbaric bupivacaine using 25G Quincke spinal needle [Group I], 27G Quincke spinal needle [Group II] and 27G Whitacre spinal needle [Group III] at L3-4 inter-vertebral space. Each patient was assessed daily for four consecutive days following Caesarean section. Frequency and severity and of postdural puncture headache [PDPH] were recorded. Data were analyzed using SPSS-11. Frequency of PDPH following the use of 25G Quincke [Group I], 27G Quincke [Group II] and 27G Whitacre [Group III] spinal needles was 8.3% [14/168], 3.8% [6/160] and 2.0% [3/152] respectively. In Group I, PDPH was mild in 5 patients, moderate in 7 patients and severe in 2 patients. In Group II, it was mild in 2, moderate in 3 and severe in 1 patient. In group III, it was mild in 2 and moderate in 1 patient. Severe PDPH did not occur in Group III. Most of the patients with PDPH developed it on first and second postoperative day. When using a 27G Whitacre spinal needle, the frequency and severity of PDPH was significantly lower than when a 25G Quincke or 27G Quincke needle was used

Humans , Female , Anesthesia, Spinal/instrumentation , Cesarean Section , Post-Dural Puncture Headache/prevention & control , Needles , Double-Blind Method , Postoperative Complications , Pregnancy
Pakistan Heart Journal. 2007; 40 (1-2): 19-23
in English | IMEMR | ID: emr-197992


Background: left main coronary artery [LMCA] disease is a potentially lethal disease that can be effectively treated if it is recognized early. The aim of our study was to define the demography of patients with left main disease among those undergoing angiography at our center

Methods: the profile of 180 patients, who were found to have left main disease out of a total of 1111 consecutive patients undergoing coronary angiography, was studied retrospectively. Obstructive left main disease was defined as >/= 50% diameter stenosis on angiogram. All patients having atheromatous involvement of left main coronary artery from plaques to total occlusion were included

Results: the overall incidence of left main disease was 16.2%, however, if only obtrusive lesion lesions were considered it was 4.5%. Mean age was 58.9 years. 41.6% [75] were smokers and 50% were hypertensive Diabetes is prevalent in the majority of this patient, being 67.2%, but the incidence of obstructive disease is not increased. Obstructive left main disease is seen in 34.7% among male smokers against 21.6% in nonsmokers

Conclusion: left main disease appears to be related to increasing age. Diabetes is the commonest prevalent risk factor in this patient population. Among male smokers obstructive left main disease prevalence is higher than nonsmokers