Acute myocardial infarction; frequency of family history of ischemic heart disease [IHD] and related risk factors in the first degree relatives

To determine the frequency of family history of IHD and related risk factors in the first degree relatives of patients suffered from acute myocardial infarction [AMI]. Descriptive study. PMRC Research Centre, Nishtar Medical College, Multan, Cardiology unit Nishtar Hospital Multan and Chaudhry Pervez Elahi Institute of Cardiology, Multan. One year from July 2011 to June 2012. In this descriptive study 331 patients of AMI of either sex and age >/= 20 years admitted in Cardiology unit of Nishtar Hospital Multan and Chaudhary Pervez Elahi Institute of Cardiology Multan were registered. For data collection non-probability convenient sampling technique was used. Informed consent was taken from each patient. The information were recorded in a pre-designed questionnaire. The data were analyzed through SPSS-11. Mean age of the study cases was 54.99+/-11.25 years [Minimum age was 20 years and maximum was 90 years]. Two hundred sixty four [79.8%] were male and 67 [20.2%] were female patients and male to female ratio was 3.9:1. Out of these 331 patients 111 [33.6 %] were having positive family history of IHD. In these 111 [33.6 %] cases history of diabetes was seen in 45 [40.5 %], 43[38.8 %] had history of hypertension and history of hyper-cholesterolemia was present in 23 [20.7 %] of cases. The family history of IHD in addition to traditional risk factors such as hypertension, hyperlipidemia, diabetes mellitus and smoking is itself an important risk factor for IHD. Relatives of the young patients with IHD should be considered as high risk group and it calls for close surveillance of their first degree relatives and early intervention. All their family members should be advised life style modification, appropriate management of risk factors and regular follow up of even apparently healthy descendents

Painless myocardial infarction; its frequency in patients of acute coronary syndrome

To determine the frequency of painless MI in patients with acute coronary syndrome. Descriptive cross-sectional study. Setting and duration: This study was conducted at cardiology unit Nishtar Hospital Multan and Chaudhry Pervez Elahi Institute of Cardiology Multan. The study duration was 1 year starting from July 2011 to June 2012. This descriptive study included 331 patients of AMI of either sex and age which were admitted at "Cardiology unit Nishtar Hospital Multan and Chaudhry Pervez Elahi Institute of Cardiology Multan" using non-probability convenience sampling technique. Informed verbal consent was taken from each patient for participation. Out of these 331 patients 308 [93.1%] patients reported chest pain as the presenting complaint. Remaining 23[6.9%] presented with clinical feature other than chest pain. Of these 23 patients who presented without chest, minimum age was 30 years while maximum was 90 years with mean age 54.82 +/- 12.28 years. Patients with painless AMI presented with variety of symptoms. Most common symptoms seen in patients of AMI without chest pain were generalized weakness and cold sweats. Out of 23 patients with painless AMI, 15[65.22%] patients were male and 08[34.8%] were female. Diabetes mellitus was present as co-morbid condition in 16[69.56%] while 7[30.44%] patients were non diabetic. Hypertension was present in 8[34.78%] patients with painless AMI. Painless AMI or atypical presentation of AMI is seen in substantial proportion of ischemic heart disease patients. Absence of chest pain in AMI patients may misguide the doctors and diverts his attention towards other diagnosis which can lead to considerable delay in the essential therapies required in the management of AMI. It definitely affects morbidity and mortality of emergency department. Health care professionals particularly those working in emergency set up must keep in mind that absence of chest pain in suspected cases of ischemic heart disease does not necessarily rule out AMI. Features of AMI other than chest pain should also be kept in mind while dealing with a suspected case of ischemic heart disease. Further research work on painless AMI and presentation of AMI other than chest pain is needed

Frequency of various causes of upper gastrointestinal bleed [UGIB] at a tertiary care hospital

To determine the frequency of various causes of upper gastrointestinal bleed [UGIB] at Tertiary Care Hospital. Descriptive cross-sectional study. This study was conducted at the Department of Internal Medicine, Nishtar Hospital Multan from August 2009 to January 2010. A total of 88 patients with upper GI bleed were registered. Prior permission was taken from Institutional Ethical Committee to conduct this study. Informed consent was taken from each patient. Upper GI Endoscopy was done to find out the source and cause of bleeding. For identification of each patient, personal data was collected. All the data collected were entered and analyzed using SPSS-11. Mean age was 41.64 +/- 13.56 years with 49 [55.70%] male and 39 [44.30%] female patients. Majority of the patients 38[43.18%] were between 36-50 years of age. In our series the commonest cause of UGIB was oesophageal varices in 56.82% of cases followed by peptic ulcer disease in 38.63% of patients. Oesophageal varices followed by peptic ulcer disease are the commonest causes of UGIB in our setting

Chronic liver disease [CLD]; frequency in patients presenting with upper gastrointestinal bleeding [UGIB] at Nishtar hospital, Multan

To determine the frequency of chronic liver disease in patients presenting with upper gastrointestinal bleeding [UGIB] at Nishtar Hospital, Multan. Descriptive case series. Six months from August 2009 to January 2010. Department of Internal Medicine, Nishtar Hospital Multan. A total of 88 patients with upper GI bleed were registered. Prior permission was taken from Institutional Ethical Committee to conduct this study. Informed consent was taken from each patient. Upper GI Endoscopy was done to find out the source of bleeding. For identification of each patient, personal data was collected. All the data collected were entered and analyzed using SPSS-10. Mean age was 41.64 +/- 13.56 years with 49 [55.70%] male patients and 39 [44.30%] female patients. Majority of the patients 38[43.18%] were between 36-50 years of age. In our series frequency of chronic liver disease was 56.82%. Chronic liver disease is the most common cause of upper GI bleeding in our setting