Awareness and frequency of hepatitis B vaccination in high-risk health care workers at a tertiary care hospital

To assess awareness of high risk health care workers about being at risk for contracting hepatitis B and importance of vaccination for them and to determine effectiveness of hepatitis B vaccination amongst them. A cross-sectional study was carried out at Combined Military Hospital, Kharian cantonment from August 2009 to July 2010. Two hundred high-risk health care workers were selected by convenience sampling. Anti-HBs titers were checked to see the effectiveness of vaccination. A questionnaire was administered to record frequency of vaccination, immunity status and their awareness of high risk and protective role of hepatitis B vaccination. Of the 200 participants, 125 [62.5%] were aware of being at high risk for acquiring HBV infection and protective role of vaccine against it. One hundred and six [53%] persons had received vaccination against hepatitis B. Among vaccinated, 87 [43.5%] had protective levels of Anti-HBs titers while 19 [9.5%] had undetectable titers. Nineteen [9.5%] remained unvaccinated despite being aware. A significant proportion of high-risk health care workers lack awareness, vaccination, or immunization against hepatitis B

Frequency of dyslipidaemia in young patients with acute myocardial infarction

To study the frequency of dyslipidaemia in young patients aged between 20-40 years, with Acute Myocardial Infarction in our population. Descriptive study. Coronary Care Unit [CCU] of Armed Forces Institute of Cardiology [AFIC]/ National Institute of Heart Diseases [NIHD], Rawalpindi from December 2008 to May 2009. One hundred patients of acute myocardial infarction [AMI] fulfilling the World Health Organization [WHO] diagnostic criteria of AMI, having ages between 20-40 years, were included in the study after full informed consent using non-probability consecutive sampling. Blood samples for serum lipid profile were taken after 12 hours fasting [within 24 hours of presentation], and analyzed in laboratory of AFIC. Individual patients' results were compiled with respect to age, gender, serum total cholesterol, serum triglycerides, serum low density lipoprotein [LDL] cholesterol, serum very low density lipoprotein [VLDL] cholesterol and serum high density lipoprotein [HDL] cholesterol. The data was entered in SPSS [version 11.0] and analyzed. Of the 100 patients with AMI, 47 were found to have dyslipidaemia. Hypertriglyceridaemia was the most common lipid abnormality as it was found in 32 [68.1%] patients; followed by raised serum VLDL, hypercholesterolemia, raised serum LDL and low serum HDL found in 25 [53.2%], 16 [34.0%], 4 [8.5%] and 2 [4.3%] patients respectively. Out of 47 patients with dyslipidaemia, 28 [59.6%] had more than one lipid abnormality. Frequency of dyslipidaemia in young patients with AMI in our population is high.

Effect of post-myocardial infarction streptokinase [SK] therapy, on myocardial viability - evaluation with thallium- 201 single photon emission computed tomography [TL-201 SPECT]

To evaluate the effect of post-myocardial infarction Streptokinase therapy on myocardial viability, employing Thallium-201 single photon emission computed tomography [TL-201 SPECT]. Retrospective, experimental study. The Nuclear Cardiology Department, Armed forces Institute of Cardiology / National Institute of Heart Diseases, Rawalpindi, from 1[st] April 2009 to 31[st] October 2009. Male patients, who had suffered from acute myocardial infarction [AMI], in an area supplied by the left anterior descending [LAD] artery, had infarct-related electrocardiogram [ECG] changes and received or did not receive Streptokinase therapy, were included. Those with a normal ECG, or history of revascularization, or non-ST elevation MI, or more than on MIs, were excluded. The patients were divided into groups 1 [who received Streptokinase] and 2 [who did not receive Streptokinase]. Each group contained 42 patients and all underwent scintigraphic viability study through intravenous injection of 3.0 mCi [123 MBq] of TL-201, followed by rest-redistribution SPECT imaging on a dual head, dedicated cardiac gamma camera system [Philips Cardio MD [registered sign]]. Emory's cardiac toolbox [registered sign] and AutoQUANT [registered sign] were used for data processing and quantitative estimation of viable myocardium. Empirical scores from 0 to 2 were assigned to each of the scans, in the order of increasing viability, and these were compared across the two groups. Group 1 contained 42 patients [age range = 38 to 80 years, mean = 53.98 +/- 11.26 years], in whom empirical viability scoring was done. Score 0 was seen in 2 patients, score 1 was seen in 15 patients and score 2 was seen in 25 patients from this group. Group 2 also contained 42 patients [age range = 38 to 80 years, mean = 56.71 +/- 9.05 years], in whom viability score of 0 was seen in 3 patients, score 1 was seen in 11 patients and score 2 was seen in 28 patients from this group. Age difference between the two groups was statistically insignificant [p = 0.223]. The myocardial viability results analysed by 3 x 2 contingency table applying chi- square [X[2]] test also showed no significant difference between groups 1 and 2 [p= 0.611]. This study did not find any significant difference in myocardial viability - post- myocardial infarction - in patients who received or did not receive Streptokinase therapy

Risk profile in young patients with acute myocardial infarction

The objective of this study was to determine the frequency of risk factors in young patients with acute myocardial infarction and thus with ischemic heart disease [IHD], aged 20 to 40 years, in our population. A descriptive study. This study was carried out at Combined Military Hospital, Kharian Cantonment Pakistan from January 2007 to December 2008. All patients who fulfilled the inclusion criteria who presented to emergency reception of the hospital with a diagnosis of Acute MI were included. The patients were admitted to coronary care unit [CCU] and were managed for Acute myocardial infarction [MI]. Their detailed history was then taken including symptoms at presentation and their risk factors were assessed with the help of history and laboratory investigations. A total of 137 patients were included during the study period. Mean age was 36 years [SD=3.67]. Majority of patients were males. Smoking was the major risk factor [64.2%] followed by family history of IHD [30.7%]. Most frequent risk factor for Acute myocardial infarction [MI] at young age is smoking followed by family history

Frequency of various cutaneous disorders in chronic hepatits C virus infection

Silent chronic hepatitis C [HCV] infection is endemic in our society. Several different cutaneous manifestations have been studied with it. Understanding these may help in early diagnosis of HCV disease. To determine the types and frequency of various cutaneous disorders in chronic hepatitis C virus infection. This cross sectional study was conducted at the medical department of Combined Military Hospital, Kharian cantonment, Pakistan. Patients of chronic hepatitis C confirmed by serological markers, ELISA, and positive PCR were enrolled from outpatient department. Detailed history taking and relevant systemic examination was carried out. All enrolled patients were specifically examined by a dermatologist to diagnose or rule out the presence of skin disease. Biochemical profile including complete blood count, platelet count, cryoglobulins, and antibodies against nucleus, neutrophil cytoplasm, cardiolipin, and smooth muscle were done. All this information was entered into a specially designed pro forma. All data was analyzed using SPSS Program 10.0. Descriptive statistics were calculated for the study variables. One hundred patients were enrolled during the study period. 47% patients with chronic HCV infection were found to have at least one dermatological disease. Cryoglobulinemia was the commonest finding followed by lichen planus and chronic urticaria. Manifestation with lesser frequency included vitiligo, xerostomia, and purpura. Dermatological diseases are fairly common in patients with chronic HCV infection and can help to identify the silent cases

Frequencies and patterns of arrythmias in anterior and inferior myocardial infarction

The objective of this study was to identify the frequency and clinical patterns of arrhythmias in anterior and inferior myocardial infarction [MI]. A descriptive study. This study was conducted at critical care unit of Combined Military Hospital Kharian cantonment from January 2006 to December 2006. Hundred patients were included in the study that fulfilled the required criteria. They underwent detailed history taking and systemic examination. Patients were monitored through cardiac monitors and serial ECG recordings were taken especially if any rhythm disturbances were observed or if the patient suffered any symptom, till the time of discharge from the hospital. The relevant information was entered into a specially designed pro forma. All the data collected through the pro forma was analyzed through SPSS version 11 in terms of frequency, percentages and proportions. Premature ventricular contractions [PVCs] were the most common rhythm disturbance followed by ventricular tachycardia [VT]. Both were more common in anterior myocardial infarction [MI] than inferior MI. Bradyarrhythmias were more common with inferior MI. PVCs usually manifested with chest pain, VT was accompanied by palpitations and dyspnoea. Atrioventricular [AV] blocks clinically presented as syncope. PVCs are the most common rhythm disturbance after anterior and inferior MI. VT and ventricular fibrillation [VF] are frequent in anterior while bradyarrhythmias are common with inferior MI