frequency of HBV, HCV and HIV in patients undergoing percutaneous mitral valvuloplasty

Objective: Determine the frequency of Hepatitis B, C and HIV in patients undergoing mitral valvuloplasty with multitrack balloon catheters

Methods: This was a cross sectional study in which 100 consecutive patients of both sexes underwent percutaneous Mitral Valvuloplasty with multi track balloons catheters at the National Institute of Cardiovascular Diseases Karachi from January 2003 to December, 2004. The Viral markers of Hepatitis B Surface Antigen and Antibodies against Hepatitis C and HIV was done in all patients undergoing PTMC prior to procedure

Results: Out of 100 patients undergoing PTMC with multi track balloon catheters, 78 patients were females while 22 of them were males. Screening of these patients showed that 14% of them were Sero positive for HBV while 8% positive for HCV. None of screened patients were HIV positive

Conclusion: 1] The frequency of hepatitis B, C and HIV in patients undergoing PTMC [14% and 8%], as compared to normal population [2.56% for HBsAg] and [5.31% for anti-HCV] respectively. 2] In our country most of patients are non-affording and we have to reuse balloon catheters, so it should be mandatory to screen hepatitis B, C and HIV before undergoing invasive procedures. Balloon used in seropositive patients should be discarded. 3] National guidelines regarding reuse of various hardwire and other preventive measures are mandatory for patient's safety

Treatment Of Dyslipidemia with gemfibrozil: a pilot study in Pakistan

A series of 65 consecutive male patients were referred and evaluated for hyperlipidemia defined as total fasting serum cholesterol> 270 mg% and/or fasting serum Triglycerides> 200 mg%. Of this referred group, a total of 26 patients fulfilling the study criteria were randomized to Drug Group A [16 patients] and Placebo Group B [10 patients]. 8 of the 16 patients in Group A and 8 of the 10 patients in Group B completed the entire 8 weeks protocol Analysis of the data in the subjects completing the protocol showed a 28% reduction in total Cholesterol in Group A vs. a 5% increase in Group B; a 47% reduction in Triglycerides in Group A vs. a 10% increase in Group B; a 25% reduction in LDL-Cholesterol in Group A vs. a 10% increase in Group B; a 13% increase in HDL-Cholesterol in Group A vs. a 7% increase in Group B and finally a 42% increase in HDL-Chol to Total Chol ratio in Group A vs 0% [no] change in Group B In conclusion, Gemfibrozil significantly [p < 0 05] lowered Total Cholesterol, LDL-Cholesterol and Triglycerides and raised HDL-Cholesterol and improved the HDLC,TC Ratio in this Pakistani population The side effects were minor and resulted in 4 of 16 patients [25%] in Group A vs. 2 of 10 [20%] in Group B discontinuing treatment [difference not significant]

Blood glucose level determination in acute myocardial infarction

Hyperglycaemia is often associated with acute myocardial infarction. We observed anecdotally that routine dextrose-water infusion plays some part in raising the blood glucose level during initial treatment in non-diabetic patients with infarction. We tested our observation in a group of 14 patients. In 5 out of 14 patients, IV. line was maintained with heparin lock and in remaining 9, I.V. line was maintained with dextrose-water drip. Blood glucose level was estimated before and after I.V. line maintenance and then daily for 2 days and then on alternate days. It was observed that those patients who were not given dextrose infusion did not show any significant rise in blood glucose level, while 60% of those who were on I.V. dextrose infusion showed some rise in blood glucose level while I.V. line was maintained, and later when I.V. line was discontinued after 24-48 hrs, the blood glucose level fell down to within normal limits. These findings suggest that initial hyperglycaemia in non-diabetic patients may be due to I.V. dextrose infusion

Dilated cardiomyopathy experience in Pakistan

Retrospective analysis of 80 echo confirmed cases was done at NICVD Of these 45 cases thought to be of Idiopathic Dilated Cardiomyopathy on clinical and Echocardiographic grounds were studied in detail Dilated Cardiomyopathy constitutes a greater proportion of patients with cardiac disease than was previously recognized in Pakistan. The clinical, electrocardiographic radiological and echocardiographic profile of idiopathic Dilated Cardiomyopathy as seen m Pakistan is presented and compared with pertinent literature from around the world. The need for a thorough prospective study to clarify and characterize the various aspects of this disease entity remains