RESUMO
Objective: To find out risk factors of heart failure after ST Elevation Myocardial Infarction [STEMI] and to see the most commonly involved vessels in myocardial infarction responsible for heart failure
Methodology: This cross-sectional study was conducted from June 2013 to November 2013. 225 patients of heart failure [HF] following STEMI who came in the emergency department of the hospital were included. The selected patients were followed till the angiography reporting. Statistical analysis was done in SPSS version 16
Results: Mean age of patients was 51.42 +/-11.78 years. 49.0% patients were hypertensive, 37.3% patients were diabetic, 44.0% were smokers and 18.2% had positive family history. In this study, anterior wall MI was predominant and found in 30.7% patients. 46.7% patients had triple vessel disease [TVD]. There was 33.7% involvement of Left main stem [LMS]
Conclusion: Hypertension and smoking are most common risk factors of heart failure. The patients who present with heart failure are most who have involvement of triple vessel coronary artery disease. Left main stem [LMS] is most commonly involved vessel in these patients
RESUMO
Objective: To determine the effect of Vildagliptin in non-alcoholic, fatty liver disease patients with dyslipidemia
Methods: A randomized placebo controlled trial was conducted at outpatient clinic of Medical Unit-I of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, in which fifty eight patients of NAFLD with dyslipidemia were divided in to two, case and control groups. The case group was given tablet Vildagliptin 50mg twice a day for twelve weeks and control group was given placebo in same way. Body weight, body mass index [BMI], lipid profile, liver enzymes and ultrasound finding of fatty liver were assayed before and after treatment
Results: After 12 weeks treatment of vildagliptin there was significant improvement in following parameters. Body weight and BMI decreased significantly from 88 +/- 11 to79 +/- 12 kg [p0.036] and 30 +/- 4 to 27 +/- 5 kg/m2 [p 0.005] respectively. Notable reduction in the value of TC, TG and LDL-C [TC: 252 +/- 24 to 220 +/- 20mg/dl [p 0.031]; TG: 190 +/- 24 to115 +/- 22 mg/dl [p 0.005]; LDL-C 160 +/- 15 to 145 +/- 13mg/dl [p 0.004]. HDL-C level increased significantly from 29 +/- 5to45 +/- 4 mg/dl [p 0.001].There was remarkable reduction in aminotransferases level [ALT: 78 +/- 17 to 48 +/- 14IU/L [p 0.036]. AST: 63.3 +/- 13 to41 +/- 11IU/L [p 0.002]. There was overall 65.5% improvement in fatty liver grading on ultrasound with vildagliptin while non significant effects were seen in placebo group in all of the above parameters
Conclusion: Vildagliptin exhibited beneficial effects in non-alcoholic fatty liver disease, Nondiabetic patients with dyslipidemia
RESUMO
Objective: To see the role of Vitamin D supplementation on physical status of patients suffering from Congestive Heart Failure [dilated cardiomyopathy]
Methods: In this nonrandomized clinical trial, Forty three Patients with dilated cardiomyopathy who were not showing any significant improvements in physical performance on optimal treatment of heart failure were included. Vitamin D [200,000 IU] supplementation on weekly basis for a period of 12 weeks was added to heart failure treatment. And its effect was seen on 6 minutes' walk distance and Pro-BNP levels. SPSS version 19 was used for data analysis. Dependent sample t-test was used to see the significant effect of vitamin D supplementation on pre-intervention vitamin D levels, 6MWD and Pro-BNP. Taking p-value <0.05 as significant
Results: On clinical assessment most of the patients were in NYHA class II [65%], the percentages of NYHA Class I, III and IV was 19%, 9% and 7% respectively. The baseline mean vitamin D level of the study group was 16.59 +/- 3.54ng/ml and it raised to 31.97 +/- 3.64ng/ml after 12 weeks of supplementation with vitamin D, p value <0.0005. The mean distance travelled by the study group before the intervention was 806 +/- 380ft while it increased to 945 +/- 393ft after the intervention, p value of 0.008. The mean of pro-BNP level of the study group before the intervention was 1024 +/- 635 while it improved to 159 +/- 80 after the intervention with a significant p value <0.0005
Conclusion: Vitamin D supplementation decreases the severity of HF as reflected by reduction in serum pro-BNP levels and significant increase in six minutes' walk distance