effect of multiple risk factors on the severity of coronary artery blockage among the patients who had undergone angiography in the cardiology unit of JHL

Coronary artery disease [CAD] is the leading cause of mortality in the elderly. Traditional cardiovascular risk factors [CVRFs] such as advancing age, diabetes mellitus, hypertension, dyslipidemia, smoking, obesity, and family history of CAD are well recognized for their association with clinical events and acute coronary syndromes; however, the correlation between CVRFs and atherosclerotic burden, assessed angiographically, is not as well established, with the studies reporting variable and inconsistent results. To study the effect of multiple risk factors on the severity of coronary artery blockage among the patients who had undergone angiography. A Descriptive Cross Sectional Study. This study was carried out at Cardiac unit Jinnah Hospital Lahore from May 2010 to July 2010. The study included 120 patients undergoing angiography and were assessed for severity of risk factors. Cross tabulation was performed with dependent variable, severity of coronary artery disease and independent variables like familial tendency, smoking, Diabetes, hypertension, obesity and high cholesterol level. Chi square test was applied to see statistical significance. severity of coronary artery disease was assessed by number of coronary vessels involved. Vessels with more than 50% blockage on angiography were labeled as blockade. Among them 42% of the subjects had one vessel involved and 78% of the subjects had more than one vessel involved. Mean age of subject were 53.0 yrs with SD + 11.7. 76.7% were male and 23.3% were female. 49.2% had familial history of Coronary artery disease 66.7% were smokers. 38.3% of subjects had diabetes mellitus. 68.3% of the subjects had hypertension. 37.5% of the subjects were overweight. 17.5% of the subjects had cholesterol level > 250 mg/dl 75.8% of the subjects had a proximal blockade, 20.0% had a distal blockage and 4.2% had both proximal and distal blockage. Smoking, duration of smoking, number of cigarettes smoked per day and obesity are positively associated with severity of coronary artery disease and are statistically significant [P<.05]. While high cholesterol level, diabetes and Hypertension had a non-significant relationship in our study. There is a significant association between the severity of risk factors and the severity of coronary artery disease. The association of Smoking, duration of smoking, number of cigarettes smoked per day and obesity with severity of coronary artery disease is statistically significant [P<.05]

Malnutrition assessment of chronic obstructive pulmonary disease patients

To assess the prevalence and severity of malnutrition among COPD patients along with the effect of dietary intervention on the disease outcome. This was an interventional, Quasi- experimental study. The study was conducted at Department of Medicine and Department of Chest Diseases, Jinnah Hospital, Lahore. Total duration was one year from April 2009 to March 2010. Sample Size: 100 patients with COPD were investigated. Purposive Non-probability sampling. Majority of the patients were in the age range 50 - 70 years with more males than females. 97% patients had a positive tobacco smoking history. 57 - 78% of the patients included in the study were found to be malnourished, out of which 65 - 68% were moderately malnourished and 10% were severely malnourished according to SGA rating and BMI. There was a strong correlation between COPD staging and malnourishment. 54% patients with stage III COPD were malnourished while 90% patients with stage IV were found to be malnourished. Malnutrition is invariably observed in COPD patients and is more frequent and more severe in patients with advanced stage disease. Patients with COPD might benefit from a dietary intervention both in terms of pulmonary functions and nutritional state, which might have beneficial effects on prognosis

Comparison of pulmonary function tests in smokers and non-smokers

To compare the lung function tests in healthy non-smoker with age and sex matched smokers who are asymptomatic of respiratory impairment. This cross sectional analytic study was carried out from June 2009 to November 2009 in Department of Medicine and Pulmonology, Jinnah Hospital, Lahore. A total of 200 subjects were included in the study. All individuals were selected from healthy general public visiting Jinnah hospital Lahore as attendants of the patients.FVC, FEV1 and FEV1/FVC were measured and recorded in Performa. Data was entered and analyzed in SPSS 10. Mean age was 36.77+6.58 years. It was 34.11+7.38 in smokers and 33.43+5.39 in non-smokers group. Mean FEV1 was 2.55+0.79 in smokers and 3.52+0.55 in non-smokers. Mean FVC was 3.94+0.69 in smokers and 4.35+0.69 in non-smokes. Smoking causes significant reduction in lung functions in asymptomatic smokers which can be prevented by quitting smoking

Effect of oxidative stress created by free radicals on human serum proteins in patients with diabetes mellitus and myocardial infarction

Oxidative Modification of Blood Serum Proteins due to free radical stress has been studies in 65 patients Diabetes Mellitus [DM] and Myocardial Infarction [MI]. It has been shown that both DM and MI patients have increased level of Oxidatively Modified Human Serum Proteins [OMHSP] as compared to healthy persons. Diabetic patients had a significantly higher level and slower dynamic of OMHSP that non-diabetic patients did during 14 days after the onset of Acute MI. The data suggest that oxidative modification of proteins may be a possible factor contributing to the poorer outcome of MI in diabetic patients. The study was conducted in Cardiology and Medical units of Allama Iqbal Medical College /Jinnah Hospital Lahore during 2001-2002

In-hospital outcome of acute myocardial infarction in correlation with 'thrombolysis in myocardial infarction' risk score

Effective risk stratification is integral to management of acute coronary syndromes [ACS]. The Thrombolysis in Myocardial Infarction [TIMI] risk score for ST-segment elevation myocardial infarction [STEMI] is a simple integer score based on 8 high-risk parameters that can be used at the bedside for risk stratification of patients at presentation with STEMI. To evaluate the prognostic significance of TIMI risk score in a local population group of acute STEMI. The study included 160 cases of STEMI eligible for thrombolysis. TIMI risk score was calculated for each case at the time of presentation and were then followed during their hospital stay for the occurrence of electrical and mechanical complications as well as mortality. The patients were divided into three risk groups, namely 'lowrisk', 'moderate-risk' and 'high-risk' based on their TIMI scores [0-4 low-risk, 5-8 moderate-risk, 9-14 high risk]. The frequencies of complications and deaths were compared among the three risk groups. Post MI arrhythmias were noted in 2.2%, 16% and 50%; cardiogenic shock in 6.7%, 16% and 60%; pulmonary edema in 6.7%, 20% and 80%; mechanical complications of MI in 0%, 8% and 30%; death in 4.4%, 8%, and 60% of patients belonging to low-risk, moderate-risk and high-risk groups respectively. Frequency of complications and death correlated well with TIMI risk score [p=0.001]. TIMI risk score correlates well with the frequency of electrical or mechanical complications and death after STEMI

Relationship of hyperlipidemia and hypoproteinemia with severity of nephrotic syndrome

Back Ground: there is a large body of literature implicating hyperlipidemia as a major risk factor in the pathogenesis of cardiolvascular disease [CVD] in the general population and it is well known that patients with chronic kidney disease [CKD] exhibit significant alterations in lipoprotein metabolism. Present cross sectional study was designed to find out the relation of hyperlipidemia and hypoproteinemia with severity of nephritic syndrome

Material and Methods: twenty four adults with severe nephritic syndrome [group 1] and twenty adults patients with less severe nephrotic syndrome [group II] between 30 to 65 years of age were included in the study. Twenty healthy subjects with age and sex matched were enrolled as control subjects in the study. Lipid profile including total cholesterol, free cholesterol, cholesterol ester, triacylglycerol, phospholipids, serum proteins, albumin and urinary protein [albumin] were estimated by using standard techniques

Results: a significant increased level of total cholesterol, free cholesterol, cholesterol ester, triacylglycerol, phospholipids was observed in less severe nephrotic syndrome. On the other hand a highly significant increased level of all the components of lipids was observed in severe nephrotic syndrome. A highly significant decreased level of serum proteins and serum albumin with proteinuria was observed in both groups of patients as compared to normal subjects

Conclusion: in both less severe and severe nephrotic syndrome, a complex metabolic process occurs which may cause marked changes in protein and lipid profile which further deteriorates the condition by enhancing the rate of progressive glomerular injury, perhaps by promoting an intraglomerular equivalent of atherosclerosis. This constitutes an additional rationale for reducing lipid levels in nephritic patients