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]

Analgesic effect of ketamine and morphine after tonsillectomy in children

A comparative double blind study of Ketamine and Morphine was conducted on eighty children following tonsillectomy to assess the analgesic, respiratory rate depressant and emesis. Children [6-12 years] were divided into two groups randomly [n=40]. General anesthesia was induced followed by 0.1mg/kg morphine [I/M] and 0.5mg/kg ketamine [I/M] to Group I and Group II respectively before the initiation of surgical procedure. Pain scores [face score and CHEOPS score] were estimated for children at thirty, sixty, one hundred and twenty and two hundred and forty minutes following surgery. Comparison of CHEOPS score estimation reflected that pain scores were statistically significant [P < 0.05] in Group I receiving Morphine as compared to Group II who received Ketamine. The analgesic effect of ketamine and morphine showed statistically insignificant results [P>0.05] in case of face score. Moreover, respiratory rate in Group I had shown statistical association [p<0.05] as compared to the ketamine at 60 and 120 minutes. Furthermore, incidence of vomiting was more in Group I [0.05] as compared to Group II. It can be concluded from the study that ketamine may be used as a suitable substitute to that of morphine in children undergoing tonsillectomy

Knowledge, attitude and practices regarding dengue fever in people of Lahore

Dengue fever has emerged as an important public health problem in recent years and has become endemic throughout major cities in Pakistan. In Lahore, capital of Punjab it has appeared as an epidemic during last few years. Lahore has been worst hit by Dengue and emerged as an epidemic with terrible implications on health and economy of the populations and collapsing the health systems. Study was conducted during the peak of epidemic in 2011. To establish a baseline of knowledge, attitude and practices for dengue prevention. Cross Sectional Study. This study was conducted in Lahore, Capital of Punjab province. Lahore has been divided in to eight administrative zones called 'towns'. Allama Iqbal and Gulberg towns were selected for the study. Study was conducted during the month of September 2011, at the peak of epidemic. The study was focused on densely populated 6 areas and a total of 219 household were randomly selected and interviewed and all information stored in a structured Proforma. Among 219 households, showed that electronic media was the most common source of information within the community, followed by Friends and family. Areas of deficit knowledge were information about vector and its biting time and seasonal prevalence. The identified deficit areas of practices were keeping water storage tanks uncovered and less use of insecticides. Whereas, negative attitude noted was about elimination of larval breeding sources. Overall level of knowledge and practices were low however, study showed positive attitude of community toward Dengue prevention

Maternal mortality in a tertiary care hospital, Lahore: a four year review

This study was carried out to determine the cause and frequency of maternal deaths in Jinnah Hospital, Lahore which is a tertiary care hospital. The study was performed between January 2000 and December 2003 at Gynae unit-I. The case notes of all patients who died during January 2000 to December 2003 period in Jinnah Hospital gynecological unit-I as a result of conditions associated with pregnancy, labor, and puerperium [6 weeks after pregnancy] were reviewed in an effort to identify the most common cause of maternal deaths. Final conclusion regarding the causes of death were drawn after consultation within the department as well as with the concerned department like Medical, Surgical, Anaesthesia and ICU. Total number of deaths recorded during this period was 46. Maternal mortality ratio, measuring the risk of deaths specifically during pregnancy, was calculated to be 289.58/100,000 live births. Direct obstetrical deaths were 43 [93.47%] and there were three indirect deaths. Obstetrical hemorrhage accounted for 14 cases [30.43%]. Septicemia was second most common [11 cases, 23.91%]. Eclampsia accounted for 7 cases [15.21%]. Maternal mortality rate has been improved in 2002 [198.91/100,000] as compared to 333.55/100,000 in 2000 but again there was rise in 2003 [308.64/100,000]

Hyperglycaemic females: an ignored iceberg

This community based study was conducted in a village of Lahore District, Pakistan. All 293 females [age 40 and above] residing in the village were interviewed and capillary venous blood glucose level was measured by Glucometer, randomly and 2 hours after 75 gram of glucose load [after informed consent]. Cut off point was taken at > /= 200mg/dl. Raised blood glucose levels were found among 54 [28%] females that is quite a high prevalence, of these 37 [68%] hyperglycaemic females were not taking regular exercise [p=0.004], 35 [65%] had family income / capita / month /= 140/90] was among 21 [39%], highly significant [p=0.0034]. Association of B.M.1 and hyperglycaemia is non significant. Positive family history of diabetes was observed in 20 [37%] females [p=0.010]. The study concluded that the total burden of hyperglycaemia among females is alarmingly high. There is a dire need to make the female population aware about diabetes, its prevention and control. Mass teaching, specifically regarding self estimation and self care is the need of the day. The objective of this study was to calculate the burden of hyperglycaemia among females and the underlying factors related to hyperglycaemia.

Emergency contraception: knowledge, attitudes and practices of general practitioner

We conducted a telephone survey among general practitioners from different localities of Lahore selected as convenience sample. Information was collected on a pre-designed questionnaire. The main outcome measures were the knowledge regarding preparations, efficacy, safety, side effects and their attitude toward EC. The relationship of knowledge with age, education and years of practice was also assessed. We interviewed 120 GPs [50 males, 70 females]. Among these 65% of the doctors were <40 years of age and 35% > 40 years. Of the responders 38% didn't know anything about emergency contraception, whereas 46% knew only about hormonal method of emergency contraception 15% about the hormonal and IUCD and none of them was aware of Mifepristone. Among these, the knowledge of 30% of the participants about emergency contraception was adequate and that of 70% was inadequate. The difference of accuracy of knowledge was statistically significant [p<0.05]. Only 10% of GPs were in routine practice to talk about EC as a backup support while discussing their patients about contraception. There was no statistically significant difference of knowledge among males and females [p>0.05]. Young GPs [<40 years of age] were more aware of IUCD as EC compared with those more than [>40 years] though the difference was not statistically significant but it might have a clinical significance. GPs with postgraduate education when compared with graduates were more likely to know and talk about EC [P <0.05]. Maximum knowledgeable GPs were those practicing for the last 5 years [30%] as compared to practicing for more than 10 years [6.7%] [p<0 05]. Ethically and morally all GPs were in support of EC and were having favourable attitude towards EC. These findings of our study suggest that the precise knowledge about emergency contraception among doctors [GPs] is inadequate. Prescription practices can improve by generating education and training of health care providers. It should be a routine practice to consider emergency contraception as a part of contraceptive discussion with the couple. The purpose of the present study was to assess the knowledge, attitude and practices of general practitioners toward emergency contraception from different localities of the city of Lahore, which has a population of more than 6 million