Low major adverse cardiac event rates following bioresorbable vascular scaffold implantation: Impact of implantation technique on treatment outcomes

Background and objective Studies conducted across the world have reported that the rates of major adverse cardiac events (MACE) following the use of bioresorbable vascular scaffolds (BVS) are comparable to that noted with traditional drug eluting stents (DES). However, there is limited data on the immediate and medium-term clinical outcomes following the use of the Absorb BVS (Abbott Vascular, Santa Clara, SA) in the Indian context. This study was conducted to determine real-world evidence on the immediate and medium-term clinical outcomes in all patients undergoing percutaneous coronary intervention (PCI) with the Absorb BVS. Methods Data of all patients who were treated with Absorb BVS at our center were evaluated. Between December 2012 and October 2016, 142 patients underwent PCI with BVS. The MACE rates during hospitalization, at 30 days, 3 months, 6 months after PCI, and every 6 months thereafter were the primary endpoints evaluated with median follow up of 13 months. Results Mean age of the study participants was 53.7 ± 11.8 years. Intravascular ultrasound imaging was performed in 15.34% of patients. Predilatation and postdilatation were performed in 81.8% and 84.6% of scaffolds, respectively. There were no episodes of MACE during hospitalization. However, 1 BVS-related MACE was observed at the 1-month (0.7%) as well as at the ≥12 month (0.8%) follow up visits. At the 6- and 12-month follow up visits, 2 (1.5%) and 3 (2.5%) non-BVS-related MACEs, respectively, were recorded. Conclusion The use of Absorb BVS in this real-world experience was associated with very good immediate and medium-term clinical outcomes.

Hepatitis C Liver dysfunction and relationship with hemostatic disorders

Objectives: HCV liver disease is associated with abnormal liver functions and often results in various haematological disorders. This study was conducted on 100 HCV positive patients in Mayo Hospital, Lahore

Material and Method: The objective of this study was to establish a relationship between severity of liver disease and subsequent haemostatic disorders. The severity of liver disease was assessed by ALT, AST, Albumin, AST/ALT ratio and APRI Score and Hemostatic disorder was evaluated by Platelet Count, PT, APTT and D-Dimers which showed a significant positive correlation between the severity of liver disease and the increasing hemostatic derangements

Results: The results of the study showed that mean age was 41.29 +/- 11.15 years with minimum and maximum ages being 21 and 66 respectively. There were 63% male and 37% female pts and male to female ratio was 1.70: 1. In this study the mean PLT count was 202.870 x109/L +/- 66.779 x109/Lwith minimum count being 35.000 x 109/L. The PLT count was lower than normal in 21% of the pts. The distribution of D. Dimers was < 0.5 in 42%, 0.5 1 in 55% and it was > 1 in 3% of the pts. The mean PT and APTT were 16 seconds +/- 1.81 seconds and 37 seconds +/- 4.28 seconds respectively. The PT was prolonged in 48% and APTTin 5% of the patients

Conclusion: The severity of liver disease was assessed by ALT, AST, Albumin, AST/ALT Ratio and APRI Score while the Hemostatic abnormality was checked by Platelet count, PT, APTT and D-Dimers. The results of liver function tests and the coagulation profile along with the levels of AST/ALT Ratio and APRI Score in this study have proved that as the liver disease advances, the hemostatic derangement also increases

Myths in dentistry - perception or truth? A cross sectional survey

Objective: To determine the knowledge, attitude and practices of people of Karachi regarding myths in dentistry

Study Design: Observational / Descriptive / Cross sectional study

Place and Duration of Study: This study was conducted at the OPD of Karachi Medical and Dental college and citizens of Karachi January 2015 - June 2015

Materials and Methods: The sample size was 150. Patients were recruited through convenience sampling

Data regarding myths in dentistry was recorded on a predesigned proforma. Data was analyzed using SPSS 17.00

Results: Results of the study shown that people with elderly age i.e. 39-50 years and with illiterate and primary level of education are most commonly involved in myths regarding dentistry. Females are the most common respondents involved in dental myths

Conclusion: It has been concluded from the study that dental myths are common facet of our community. There is a need to carry out community awareness programmes in order to teach and guide the community for these misconceptions

Effectiveness of sterilization and disinfection of extracted human teeth for institutional use: a case control study conducted at a tertiary care hospital

Objectives: To determine the most effective method of sterilization and disinfection of extracted human teeth foruse in dentalcolleges

Study Design: Case Control study

Place and Duration of Study: This study was conducted at OMFS and Microbiology Department, KMDC, Karachi from June 2013 to December 2013

Materials and Methods: Freshly extracted human teeth [n=50] were obtained and sent for bacteriological processing. Teeth were dividing into 5 groups; samples were taken pre and post treatment. A platinum wire loop was flamed in red heat and cooled; sample was inoculatedinC for 48 hours. Colony count was noted to observe the quantity of microorganism, which determines the efficacy of the sterilizing method

Results: The results of the study revealed that the autoclave, hot air oven had shown no growth.While5% sodium hypochlorite, hydrogen peroxide and normal saline had shown positive growth of microorganisms

Conclusion: Autoclave and Hot air oven are effective methods of sterilization of extracted human being teeth for use in dental college in preclinical settings

Current pattern of antibiotic resistance of clinical isolates among conjunctival swabs

To identify the etiological agent in bacterial conjunctivitis and to determine the antibiogram of bacterial isolates. This observational study was conducted at Dr. Essa's Laboratory over a period of 12 months ending in March 2012. Two hundred samples taken from conjunctiva of patients with conjunctivitis were cultured on routine medium and the antibiograms of bacterial isolates were determined by Kirby- Bauer disc diffusion method. The analysis of the culture showed that 41% were cultured positive with gram positive bacteria Staphylococcus aureus 52.5% and Staphylococcus epidermidis 30.1% and Micrococci 8.3%. However, 9.1% were gram negatives with Klebsiella pneumoniae 5.14% and Pseudomonas aeruginosa 2.6% and 1.36% were others [Acinetobacter, Haemophilus, E.coli and Moraxella] keeping in view the increasing use of contact lens and unclean fingers. The overall antibiograms of bacterial isolates indicate aminoglycosides [gentamicin, tobramicin] and the newer quinolones as apparent drug of choice for empirical therapy, followed by chloramphenicol, since drug fussy gram-negatives such as Pseudomonas, Acinetobacter and E.coli were among the conjunctival isolates. Resistance profile of gram positive isolates shows cefixime 91.4%, doxycycline 57.9%, cotrimoxazole 29.3%, ampicillin 22.9%, ciprofloxacin 13.4%, cephradine 8.3%, cefuroxime 7.1%, fosfomycin 4.7%, ceftriaxone 3.6%, co-amoxiclav 3.6%, cefotaxime 3.5%, vancomycin 2.6%. Resistance to all conventionally used antibiotics is increasing, therefore identification of etiological agent and antibiogram is important to treat conjunctivitis and to avoid complications

Prevalence of methicillin resistant staphylococcus epidermidis in biomaterial related infections

To determine the prevalence spectrum of methicillin resistant Staphylococcus epidermidis in biomaterial infections. Experimental and observational study. This study was conducted in the department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi, during the period of January 2010 to Dec. 2010. A total of 300 subjects of all ages and sex were included. Swab from cannulae tips, catheters tips, old cannulae infected wounds, injection abscess were collected from Jinnah Postgraduate Medical Centre, National Institute of Child Health and Civil Hospital, Karachi and processed according to standard laboratory methods. A total 103 methicillin resistant Staphylococcus epidermidis, causing biomaterial related infection, isolated from 300 patients were analyzed. Bacterial pathogens were commonly isolated from patients of all ages who developed biomaterial related infections. Patients suffering from infections related with biomaterial should be monitored for MRSE at regular intervals

Significance of serological monitoring for hepatitis b viral infection in hemodialysis patients

To find out the prevalence of Hepatitis B by serologicai monitoring in chronic hemodialysis patients. The study was carried out in the department of Microbiology BMSI, JPMC Karachi, from January 2010 till February 2011. Two hundred blood samples were coiiected from the patients on chronic maintenance hemodialysis from the different hospitals/ dialysis centres in Karachi, that had at least twenty cycles of hemodialysis in tertiary care hospitals of Karachi. Biood was collected from each patient and the test was performed according to the standard protocol. Out of 200 patients, 51 [25.5%] patients were already vaccinated for HBV while in 149 [74.5%] patients there was no history of HBV vaccination. Among these 149 patients, 32 [21.47%] showed seropositivity for HBV infections in our study. The risk for acquiring these infections is significantly as-sociated with increasing duration of dialysis. Mean age of 56.7_SD 0.68 years with male predominance. There are only 25.5% patients who were vaccinated against HBV infection among 200 patients. The study revealed that HBV prevalence was commonly found among dialysis patients and only quarter of them were vaccinated. The vaccination should be mandatory in dialysis centers to prevent and control hepatitis B in hemodialysis units

Epidemiology and outcome of burns at Khyber teaching hospital Peshawar

To determine the epidemiology, describe the clinical presentation, outcome and the factors responsible for fatal outcome of burn patients. A total of 240 patients admitted in Surgical D unit, Khyber Teaching Hospital, Peshawar from March 2004 to Feb 2005 with burn injuries were included. Patient characteristics including age, sex, type of burn, total body surface areas [TBSA] burned, any first aid received, treatment given in hospital and outcome were recorded. 52.2% of the 240 patients were females. 31.66% patients were below 10 years of age, while 21.25% and 27.08% were in the second and third decades. Majority had less than 20% TBSA burns [47.5%] and only 4.1% had more than 50% TBSA burns. Flame burns were the commonest [45%] followed by scalds 31.6% and electrical 10.83%. Scalds were common in children. 130 patients improved with daily washes, dressing and debridements, systemic and local antibiotics. Skingrafts needed in 30 patients, 36 were referred to plastic surgery unit and 16 with more than 40% TBSA burns were referred to specialized burn centres. Mortality was 19 with sepsis as the leading cause, multiple organ failure, and shock were other causes of mortality. Burns injury is a major public health concern and is associated with significantly high morbidity and mortality. Flame, scald and electrical burns are commonly a result of domestic and occupation accidents and are preventable. The effectiveness of initial resuscitation, infection control and adequate surgical treatment improves short and long term outcomes