RESUMO
To determine the association of QTc interval prolongation with ventricular arrhythmias in patients with chronic heart failure. Descriptive study. This study was conducted at Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, Pakistan from April 2013 to August 2013. Fifty three heart failure patients were monitored for 48 hours using ambulatory holter electrocardiography recorders. Digital ECG data was analyzed for QTc interval along with frequency and severity of arrhythmias. Association of prolonged QTc interval with ventricular arrhythmias and severity of arrhythmias was analyzed. Cardiac arrhythmias were observed in 79.2% patients. QT analysis revealed that 69.8% patients had prolonged QTc interval, 86.4% patients with prolonged QTc had ventricular arrhythmias. Of these 66% patients were found to have severe ventricular arrhythmias. Comparison of mean QTc interval of our study population with a reference value showed significantly higher QTc interval of our study group than the test value. Arrhythmia frequency and severity significantly increases with an increase in QTc interval in heart failure demonstrating association of prolonged QTc interval with high risk of severe ventricular arrhythmias and sudden cardiac death in chronic heart failure
RESUMO
OBJECTIVE: To assess the role of Disodium pamidronate [ 3-amino-1-hydroxypropylidine-1,1-bisphosphonate] in the management of Rheumatoid Arthritis
STUDY DESIGN: A prospective, open, randomized, observational, dose response comparasion [30 mg vs 15 mg of Disodium Pamidronate] study done in the medical department of Cantonment General Hospital Rawalpindi over a three month period
PATIENTS AND METHODS: 16 patients of both genders with rheumatoid arthritis were divided into two groups of 8 each. [Designated A and B.].All patients had established Rhuematoid Arthritis according to 1987 American Rheumatology association revised criteria for the diagnosis of Rheumatoid Arthritis. Each group was randomly allocated to receive a single infusion of Disodium Pamidronate of either 15 [group A] or 30 mg [group B] . A number of parameters of disease activity were recorded [Grip strength [dominant hand; mean of three readings],Ritchie articular index, and early morning stiffness among others]. All patients were admitted and directly observed initially
RESULTS: Group A: Was given 15 mg Pamidronate infusion.Two [2] patients [25 %] showed improvement in clinical parameters and biochemical parameters. 6 patients showed biochemical improvement alone
Group B: Was given 30mg Pamidronate infusion. Five [5] patients [70%] showed rapid clinical and biochemical improvement which was relatively sustained for 1-3 months. All the 8 patients showed biochemical improvement. A transient flu like illness observed in one patient only however he was a responder
CONCLUSIONS: 30mg of single Disodium Pamidronate infusion in an efficacious and rapidly acting management strategy in the therapy of active rheumatoid arthritis. The response is dose related