Assessment of predictors of side branch occlusion after main vessel stenting in coronary bifurcation lesions in patients undergoing percutaneous coronary intervention

Objective: To determine the frequency of side branch [SB] occlusion during percutaneous coronary intervention [PCI] with stenting of bifurcation lesions and to assess the predictors of side branch occlusion in local population. Study Design: Cross-sectional study. Place and Duration of Study: Cardiac Catheterization Lab, Rawalpindi Institute of Cardiology, Rawalpindi, from July 2016 to January 2017

Methodology: A total of 200 patients fulfilling the inclusion criteria were included in the study with non-probability consecutive sampling technique. Variables like diameters and lesion lengths of main vessel and side branch were recorded using quantitative coronary analysis software [QCA]. The SB occlusion was defined as <3 TIMI score following main vessel PCI with stenting. The data was analysed using SPSS version 21.0

Results: Mean age [years] of the study population was 52.27 +/-13.33 including 180 [90.0%] male and 20 [10.0%] female patients. SB occlusion was observed in 15 [7.5%] of cases. Mean SB diameter was significantly larger in cases without SB occlusion than those with SB occlusion [2.06 +/-0.09 vs. 2.17 +/-0.26, p=0.003]. Similarly, SB lesions were significantly shorter in length in those without SB occlusion than those with SB occlusion [3.53 +/-0.51 and 4.66 +/-3.11, p<0.001]. However, mean MV diameter [mm] and mean MV lesions length [mm] in both the groups were statistically not significant

Conclusion: Mean SB diameter and lesion length are useful predictors of SB occlusion during stenting of bifurcation lesions in the local population

Main vessel stenting in coronary bifurcation lesions in patients undergoing percutaneous coronary intervention

Objective: To determine the frequency of side branch [SB] occlusion during percutaneous coronary intervention [PCI] with stenting of bifurcation lesions and to assess the predictors of side branch occlusion in local population

Study Design: Cross-sectional study

Place and Duration of Study: Cardiac Catheterization Lab, Rawalpindi Institute of Cardiology, Rawalpindi, from July 2016 to January 2017

Methodology: A total of 200 patients fulfilling the inclusion criteria were included in the study with non-probability consecutive sampling technique. Variables like diameters and lesion lengths of main vessel and side branch were recorded using quantitative coronary analysis software [QCA]. The SB occlusion was defined as <3 TIMI score following main vessel PCI with stenting. The data was analysed using SPSS version 21.0

Results: Mean age [years] of the study population was 52.27 +/-13.33 including 180 [90.0%] male and 20 [10.0%] female patients. SB occlusion was observed in 15 [7.5%] of cases. Mean SB diameter was significantly larger in cases without SB occlusion than those with SB occlusion [2.06 +/-0.09 vs. 2.17 +/-0.26, p=0.003]. Similarly, SB lesions were significantly shorter in length in those without SB occlusion than those with SB occlusion [3.53 +/-0.51 and 4.66 +/-3.11, p<0.001]. However, mean MV diameter [mm] and mean MV lesions length [mm] in both the groups were statistically not significant

Conclusion: Mean SB diameter and lesion length are useful predictors of SB occlusion during stenting of bifurcation lesions in the local population

Phytochemical analysis and hepatoprotective effect of polyherbal formulation on CCl4 induced hepatotoxicity in mice

The potent phytotherapeutic modalities against the hepatotoxicity have motivated us to explore numerous plants and polyherbal preparations because conventional drug discovery is more expensive and tedious. So, this study was conducted to evaluate the hepatoprotective potential of a polyherbal formulation [PHF], comprising of Solanum nigrum, Silybum marianum, Atrmesia absinthium, Achillea millifolium and Cichorium intybus against carbon tetrachloride [CCl4] induced hepatotoxicity in experimental rats. CCl4 intoxication induced vacuole formation and fast degeneration so selective liver enzymes including alanine aminotransferase [ALT] and aspartate aminotransferase [AST], alkaline phosphatase [ALP] and total bilirubin in rat's plasma, as well as liver histological architecture, were used to evaluate the effect of herbal treatments with different doses [ranging 100-500 mg/kg] for two weeks. Statistical analysis showed that PHF significantly [P<0.05] improved the level of liver enzymes as well as improved the liver architecture comparative to control groups. It could be concluded from current findings that PHF prepared from Solanum nigrum, Silybum marianum, Atrmesia absinthium, Achillea millifiloium and Cichorium intybus have some hepatoprotective activities

Duration of hospital stay in infantile burn: a retrospective study conducted at tertiary care hospital

Objective: The aim of this study was to determine the duration of hospital stay in different types of infantile burn

Methods: This retrospective study was conducted at the plastic surgery, burn unit of Patel hospital during the period of 7 years from January 2007 to December 2013. Children ageing one year or less at the time of admission with any type of burn were included in the study and those above one year were excluded. The patients medical records were obtained from medical record department. SPSS 21 version was used for statistical analysis. Data description is given by percentage. Standard deviation and central tendency [medians and means] were taken as measures of variability. For comparison Chi square test was used. P value less than 0.05 was taken as statistically significant

Results: Total 789 paediatric burn patients were admitted in Patel Hospital during January 2007 to December 2013, in which 106 were infants. Infants having scald burn were 83 [78.3%], fire burn 21 [19.8%] and chemical burn 2 [1.9%]. Male to female ratio was 1.5:1. Out of these 106 infants, 74 [70%] were hospitalized for 1 - 10 days, 18 [16.9%] were hospitalized for 11 - 20 days, 6 [5.6%] and 8 [7.5%] infants were hospitalized for 21 - 30 days and more than 30 days respectively. Most of the infants with different types of burn injuries remained under treatment between 1 - 10 days. Infants with scald, fire and chemical burn were 59 [71.1%], 14 [66.7%], and 1 [50%] respectively and remained under treatment at hospital between 1 - 10 days. It was observed that duration of stay was prolonged for infants with fire burn as compared to those with scald burn, if total body surface area [TBSA] was more than 10%. Infants with both second and third degree of fire burn [66.6%] had length of stay more than 20 days as compared to [27.3%] of scald burn. The length of stay was affected mostly in those infants who had secondary wound infections. Out of 106 infants, 28 [26.4%] had growth of organisms in wound cultures. In 106 infants, 95 [89.6%] were discharged, 2 [1.9%] left against medical advice [LAMA] and 9[8.5%] expired. Among these 6 [66.6%] of them expired due to scald burn and 3 [33.3%] expired due to fire burn. Most of the infants 5 [55.5%] expired within 5 days due to more than 40% of their TBSA involved and having third degree burn

Conclusion: We have seen through this study that infants with less than 10% of their TBSA involved were hospitalized for less than 10 days due to scald, fire or chemical burn. However in fire burn the duration of stay was prolonged as compared to scald burn if TBSA was more than 10% or having both second and third degree burn. The length of stay is also affected for those infants who developed secondary bacterial wound infections. Infants who had more than 40% of their TBSA involved and had third degree burn, survived for less than 5 days

Relationship between clinical and pathologic findings in patients with chronic liver diseases

To explore the relationship between clinical findings of patients with chronic liver diseases and the pathologic grading and staging of liver tissues. Non interventional comparative cross sectional study. Place and Duration of study: The study was conducted in Military Hospital [MH] Rawalpindi for duration of 06 months. The inflammatory activity and fibrosis of consecutive liver biopsies from 100 patients were determined according to the diagnostic criteria of chronic hepatitis. A comparative analysis was carried out for 100 patients with chronic liver diseases by comparing their clinical manifestations with the grading and staging of liver tissues. It was revealed that age, index of clinical symptoms and physical signs were obviously relevant to the pathologic grading and staging of liver tissues [P<0.05]. There is a good correlation between clinical findings and the pathologic grading and staging of liver tissues, which may give aid to the noninvasive diagnosis of liver fibrosis

Facial fractures in children - a study

The objective of the study was to determine the pattern of maxillofacial bone fractures due to trauma in children reporting to the Oral and Maxillofacial Surgery Unit of Khyber College of Dentistry, Peshawar. It was conducted from 2nd April 2007 to 1st October 2007. A self-administered structured Proforma having history and clinical examination related information in addition to some conceptual statements pertaining to maxillofacial trauma was used to collect the data, which were collected from 100 patients. The male to female ratio was 2.5:1 and the highest incidence occurred in the age group of 5-8 years. The mandible was predominantly involved. 86% fractures were at parasymphsis area. For diagnosis Orthopantogram [OPG] was the commonest radiograph used

Ciliopathy with special emphasis on kartageners syndrome

Cilia are hair-like structures extending from the cell membrane, perform diverse biological functions. Primary defects in the structure and function of sensory and motile cilia result in multiple ciliopathies. The most prominent genetic abnormality involving motile cilia is primary ciliary dyskinesia [PCD] or Kartageners syndrome. PCD is a rare, usually autosomal recessive, genetically heterogeneous disorder characterized by sino-pulmonary disease, laterality defects and male infertility. One of the important components of cilia is the Dynein. Ciliary ultrastructural defects are identified in approximately 90% of PCD patients and involve the outer dynein arms, inner dynein arms, or both. Diagnosing PCD is challenging and requires a compatible clinical phenotype together with tests such as ciliary ultrastructural analysis, immunofluorescent staining, ciliary beat assessment, and/or nasal nitric oxide measurements. Increased understanding of the pathogenesis will aid in better diagnosis and treatment of PCD. The aim of the article is to present the basic defect involved in the etiology of this interesting syndrome