RESUMEN
Objective: our aim of study was to determine early and late outcomes of CABG in patients with poor left ventricular function. The CABG surgery is beneficial in patients who have poor left ventricular function manifested by an ejection fraction 30% or even less. These are the high risk patients but CABG surgery not only promotes their survival but also improve their functional status. They are easy victims of increased operative mortality and diminished long term survival
Methods: in our study we identified 63 patients who underwent CABG surgery despite poor LV function. Data was collected during their follow up visits or telephonic follow up conducted by us. We used pre op. IABP in 2[3.17%] patients. Among these 63 patients 36[57.14%] were documented as healthy and Stable, 9[14.29%] were expired during follow up and in 18[28.57%] follow up was not continued because 4[6.35%] have no contact numbers and 14[22.22%] phones were switched off. The average duration from 2008 to 2015 was taken to be 42.5 months approximately. Each patient necessarily received at least one IMA. : The surgical strategy included approach through median sternotomy. All cases were started as off-pump CABG. Elective conversion to on-pump CABG was done for cases not tolerating off-pump
Results: in this retrospective study we have analyzed the early and late outcomes of CABG in low EF group. Main findings of the study are an acceptable hospital mortality i.e. mortality rate among patients with EF <30% is 1.59% at our tertiary care center However, post-surgery complications prevailed.3 [4.7%] patients encountered deep wound infection and same ratio suffered renal failure. We observed the early outcomes i.e. in hospital mortality evaluated to be 1.58%. These results reflect improving results of surgery in this high risk group
Conclusion: our study demonstrated that all of our patients received at least one arterial graft i.e. internal mammary artery. The minimum standard set by STS is that at least 95% of the patients must receive internal mammary artery. This contributes to the survival benefit of the patients and also improves the quality of life and reduces reoperation rates. In this retrospective study we have analyzed the outcome of CABG in low EF group. Main findings of the study are acceptable hospital mortality. We concluded that acceptable morbidity and mortality rates prevailed among this high risk group at our tertiary care center. We believe that improvements in cardiac anesthesia, surgical technique, extracorporeal perfusion, perioperative care and postoperative management have contributed significantly to better outcomes
RESUMEN
To determine the frequency of different factors which affect the contraceptive prevalence in a tribal society. The study was conducted at 'NAWAN KILLI', district Quetta. Nawan Killi is a pen urban area which is about ten kilometers away from the main city. At this place, mixed community of Baloch, Pashtoons and non-muslims live. The contraceptive prevalence rate was found to be 14.1%. Different misconceptions and socio-economic factors like fear of developing permanent infertility, fear of having side effects, strength of family, social status of mothers, large family for tribal clashes, restriction by the husband and in-laws, not satisfied with the knowledge of LHWs, high socioeconomic status, religious beliefs were found to be adversely affecting the use of contraceptives