Comparison of Psychological impact of COVID-19 pandemic on Health Care Professionals working in COVID versus Non COVID Health care facilities in

Background: The study aimed to compare the psychological impact of COVID-19 pandemic on health care professionals (HCPs). Methodology: It was a cross sectional study carried out on health care professionals (doctors, nursing staff and paramedical HCPs) in India. Depression, generalized anxiety, panic symptoms, hypochondriacal and obsessional symptoms were assessed through questions based on ICD-10 criteria. A pre tested google questionnaire was prepared and its link was sent through various social media. Results: A total of 626 HCPs (385 doctors, 124 nursing staff, 117 Paramedical HCPs) were included in the study. Depression, generalized anxiety, panic symptoms, hypochondriacal symptoms and obsessional symptoms were found in 13.3%, 21.2% 5.1%, 16.5% and 32.6% of the HCPs respectively. Depression, generalized anxiety and panic symptoms were found to be significantly higher in the HCPs of COVID health care facilities (p0.009; p<0.001; p0.035 respectively). Female HCP was associated with depression [OR 2.34 (1.38-3.96); p-0.002] and panic symptoms [OR 3.43 (1.46-8.07); p-0.005]. Generalized anxiety was more common in HCPs working in COVID health care facilities [1.91 (1.20-3.03); p-0.006]. Conclusion: The study concludes that being a female health care professional, doctors and those working in COVID health care facilities were at a higher risk of having poor psychological health.

Reactive oxygen species-mediated unfolded protein response pathways in preimplantation embryos

Excessive production of reactive oxygen species (ROS) and endoplasmic reticulum (ER) stress-mediated responses are critical to embryonic development in the challenging in vitro environment. ROS production increases during early embryonic development with the increase in protein requirements for cell survival and growth. The ER is a multifunctional cellular organelle responsible for protein folding, modification, and cellular homeostasis. ER stress is activated by a variety of factors including ROS. Such stress leads to activation of the adaptive unfolded protein response (UPR), which restores homeostasis. However, chronic stress can exceed the toleration level of the ER, resulting in cellular apoptosis. In this review, we briefly describe the generation and impact of ROS in preimplantation embryo development, the ROS-mediated activation mechanism of the UPR via the ER, and the subsequent activation of signaling pathways following ER stress in preimplantation embryos.

Systematic review of computer based assessments in medical education

Medical schools, postgraduate training institutes, licensing and certification bodies have developed and implemented many new methods for accurate, reliable, and timely assessments of the competence of medical professionals and practicing physicians. The underlying objective of all these assessments is to not only evaluate the students' learning and educational goals but also to establish the graduating individual's skills and professionalism. Computer based assessment [CBA] has emerged in recent years as a viable alternative to traditional assessment techniques. It has also infiltrated and influenced the medical curriculum where it has been employed for assessment tasks. This study presents how CBA offers pedagogical opportunities and analyzes its usage pattern over the past three decades. We examined 47 CBAs in medical education and analyzed several assessment components, including application area, assessment purpose, assessment type, assessment format, student level, and emphasized the interplay among these components. Our analysis determined that formative assessment is the most frequently used type and 75% of all assessment types employed used the multiple choice questions format

Retrospective analysis mandibular fractures at abbasi shaheed hospital, Karachi

Objectives of this study were to assess the presentation and management of mandibular fractures. This retrospective study was carried out in the Department of Oral and Maxillofacial Surgery, Abbasi Shaheed Hospital Karachi. Sample size was 263. Male: female ratio 15:1. Audit period was from Jan 2010 to Dec 2012. The road traffic accident was leading cause 80%, while fall 7%, assault represented 7%, fire arm injuries 5% and sports injuries were 1%. Site distribution of mandibular fractures 11.78% occurred in the condyle, 19.39% at angle of jaw. In 23.95% or the body, 27.96% parasymphysis, 8.36% Symphysis, 2.28% ramus and in 6.0% dento-alveolar areas were involved. Different treatment modalities were used for the proper reduction and fixation of the fracture. Majority of the patients were treated with open reduction with miniplates fixation. It was concluded that majority of patients belonged to 2nd decade of life with male predominance, parasymphysis and body were the commonest sites of mandibular fractures and road traffic accident was the leading cause of trauma in the studied subjects

Analysis of primary intrathoracic extrapulmonary hydatid cysts a rare clinical entity

To evaluate the anatomic location of cysts, operative characteristics of intrathoracic extrapulmonary hydatid cyst and to determine the outcome of aggressive surgical interventions.Case series. Thoracic Surgery Unit Lady Reading Hospital Peshawar from 1[st] July 2008 to 30[th] June 2011. All patients admitted to Thoracic unit from July 2008 to June 2011 with intra thoracic hydatid cysts were evaluated prospectively as to age, sex, symptoms, diagnostic procedures, anatomic location of cysts, surgical procedures, complications, and outcomes. Chest radiography, computed tomography, and thoracic and abdominal ultrasonography had been performed preoperatively in all of them. Bronchoscopy and spirometry was also performed in all patients for assessment and operability.Echocardiography had been used in 2 patients to determine the contiguity of the cyst to the pericardium. Cystectomy and wide resection were the chief operative procedures. Most of the patients were having cysts in the pulmonary parenchyma only 10 patients had intrathoracic cysts in extrapulmonary locations. This group of patients was included in the study. We excluded patients who had a parenchymal cyst that had perforated to the pleura, myocardial hydatid and patients who had Total of 149 patients were operated for hydatid cystectomy, out of these 139 patients had pulmonary hydatid and 10 patients had intrathoracic extrapulmonary hydatid cysts. These 10 patients constitute our study group; out of these 7 were men and 3 women whose mean age was 39.14 +/- 16.8 years range, [16-69 years]. Eight [80%] of these were symptomatic, most commonly with chest pain, two patients were asymptomatic. There were 2 [20%] mediastinal hydatid, 2 [20%] diaphragmatic, 2 [20%] pericardial, 2 [20%] oblique fissure, and 1 [10%] each in chest wall and pleural hydatid in our study. Albendazole [10 mg/kg] was prescribed to all patients for as long as 3 months postoperatively. No complication, recurrence, or death occurred during the follow up period of 13 +/- 15.4 months [range, 2-36 months].The extrapulmonary location of Hydatid cysts within the thorax is very rare. This rarity may cause difficulties in diagnosis. To avoid recurrence, it is necessary to resect the affected tissues completely and an anthelmintic medical regimen post operatively

Three years audit of maxillofacial trauma at Abbasi Shaheed hospital, Karachi

The purpose of this retrospective study was to analyze the maxillofacial fractures treated during three years period with special attention to the age, causes, fractures pattern, clinical management and treatment modalities. Retrospective study. This study was carried out Oral and Maxillofacial Surgery Department of Abbasi Shaheed Hospital during the period of January 2008 to December 2010 236 Patients data compiled. The data were reviewed and analyzed in terms of age, gender, aetiology, anatomical site and treatment methods. A total of 236 patients were included in this study presenting with maxillofacial trauma out of these 93.6% were males and 6.4% female .Overall male to female ratio was 15:1.The most common age involved was second decade. The most common cause was RTA [82%] followed by fall [7.2%] and then assault [5.5%]. The fracture of the mandible was the most common constituting about [72.5%] of the maxillofacial fractures followed by Zygomaticomaxillary complex [ZMC] fracture [14.4%] and then Maxilla [5.9%]. Regarding treatment more than 50% patients received ORIF [Open reduction Internal fixation] via bone plates while remaining received MMF [Maxillo-mandibular fixation].In ZMC Fracture, Gillies Temporal approach alone is the most common approach accounting 67% of cases while in Le-forte fracture ORIF constitute the most common treatment method. The causes and pattern of maxillofacial fractures reflect trauma patterns within the community and, as such, can provide a guide for the design of programs geared towards prevention and treatment

Multiple arterial variations in the right upper limb of a caucasian male cadaver / Múltiples variaciones arteriales en el miembro superior derecho de un cadáver caucásico masculino

Anatomical variations of the arterial patterns in the upper limb have been describe in many anatomical studies, but the occurrence of four variations in a ipsilateral upper limb is rare. These arterial variations were observed in the right upper limb of a 65 -year old Caucasian male cadaver during routine dissection in the anatomy department, College of Medicine at the King Saud University, Riyadh. These arterial variations include: 1) a large common trunk of the axillary artery giving origin to subscapular artery, profunda brachii artery, common circumflex humoral artery and superior ulnar collateral artery, 2) superficial brachial artery; 3) superficial brachioulnar artery, and 4) the radialis indicis branch from superficial palmar arch. Appreciation of variations in the upper limb vessels is important due to increasing number of procedures both diagnostic and therapeutic as in breast cancer surgery, flap harvesting and arteriogaphy.

En numerosos estudios se han descrito las variaciones anatómicas de los patrones arteriales en el miembro superior, sin embargo, la aparición de cuatro variantes ipsilaterales en un miembro superior es poco frecuente. Estas variaciones arteriales fueron observadas en el miembro superior derecho de un cadáver caucásico masculino de 65 años de edad, durante la disección de rutina en el Departamento de Anatomía de la Facultad de Medicina de la Universidad de King Saud, en Riad. Estas variaciones arteriales incluyen: 1) un gran tronco común de la arteria axilar dando origen a las arterias subescapular, braquial profunda, braquial común y colateral ulnar superior; 2) la arteria braquial superficial; 3) la arteria braquioulnar superficial y 4) la rama radial del índice desde el arco palmar superficial. La observación de variaciones en los vasos del miembro superior es importante debido al número cada vez mayor de procedimientos diagnósticos y terapéuticos, como en la cirugía del cáncer de mama, la recolección de colgajos y arteriografías.

Reliability of landmark identification among orthodontic residents using traditional and indirect digital cephalometry

To determine the inter examiner reliability of landmark identification among Orthodontic Residents using Traditional and Indirect Digital Cephalometry and to determine the intra examiner reliability of landmark identification. A cross-sectional study of six months duration done at Orthodontics Department of KMDC. One conventional Lateral Cephalometric radiograph was randomly selected. Study subjects were 8 residents with mean age was 28.8 years, with a range of 27.5 to 31 years. Cephalometeric tracing was done and landmarks S or Sella, N or Nasion A or Point A, B or Point B, Pog or Pogonion, Gn or Gnathion, Go or Gonion, Me or Menton, Or or Orbitale, Ba or Basion, API or apex of upper incisor, APT or apex of lower incisor were identified using traditional method by an Orthodontic consultant and then tracing was scanned and digitized to obtain the Indirect Digital Cepha image. The same cepha was asked to trace by all 8 study subjects. Kappa statistics was applied to see the agreement between the residents for landmarks identification in conventional and indirect digital cephalograph. Results: The study subjects were 8 orthodontic residents [3 males and 5 females]. Residents had excellent agreement for landmark identification on the conventional and the indirect digital cephalogram. The value of agreement for inter-examiner and intra-examiner reliability was found to be 0.80 [CI: 0.71, 0.89] and 0.83 [CI: 0.79, 0.87] respectively. The reliability of landmark identification was good among residents for both the conventional and the indirect digital cephalometery

Frequency of class-III malocclusion reported in dental OPD, Karachi medical dental college

To determine the frequency of Class-III malocclusion reported Orthodontic department in Karachi Medical Dental College, Pakistan. It was a cross sectional study of orthodontic patients. With convenience sampling a total of 384 patients [267 girls, 117 boys] referred to the Department of Orthodontics, Karachi Medical Dental College, were evaluated in this study. The mean age of the patients was 11.86 +/- 3.16 years. There malocclusion were classified from I, II [Div-1 and Div-2 with sub division right and left], and III, and recorded according to angle classifications. Class-III malocclusion was the least common malocclusion present in the major category of malocclusion and found 8.1% of the samples. Class-III malocclusion requires very early treatment then class-II and Class I malocclusion and has totally reverse treatment philosophy. Having the lower frequency of Class-III malocclusion in the population makes doctor to focus more in later age group and puts less burden on health resources as more patients of Class-II and I can be treated using the same resources. The type of malocclusion, also an important factor that affects a patient's motivation to seek treatment

Histological patterns and clinical presentation of oral squamous cell carcinoma

The objective of our study was to identify the different histological patterns of Oral Squamous cell carcinoma [OSCC] in relevance to demographic variables and to evaluate histological patterns according to various clinical presentations at the joint department of Oral Surgery, Karachi Medical and Dental College and Abbasi Shaheed Hospital Karachi. This descriptive study was conducted from December 2005 to November 2006 at Oral Surgery Department of Karachi Medical and Dental College and Abbasi Shaheed Hospital Karachi. A total of 60 cases presenting with OSCC were included in this study. Their demographic details, habit profile, clinical information of lesion were recorded on a proforma. All the patients underwent biopsy and their histological information was also noted on the same proforma. This study included 60 patients of OSCC. Fifty eight percent of patients were from age group between 41 -60 years. Approximately 63.3% males and 36.7% females were affected and male to female ratio was 1.7: 1. Approximately 48.3% of lesions involved alveolus. Nearly 86.7% of patients were indulged in habits of tobacco chewing. Clinical appearance of lesion showed that 66.7% of lesions were ulcerative type and histologically 48.3% were well-differentiated OSCC. Majority of patients were indulged in habit of tobacco chewing, Ulcerative type was the dominant clinical presentation whereas histologically well-differentiated OSCC was the most common presentation. Infiltration was a consistent finding in all cases

Altered liver morphology and enzymes in streptozotocin induced diabetic rats / Morfología y enzimas del hígado alteradas en ratas con diabetes inducida por estreptozotocina

This study was undertaken to evaluate the relationship and effects of diabetes on liver morphology, architecture and function. The hepatic effects of diabetes were evaluated in vivo using streptozotocin (STZ)-induced diabetic rats as an experimental model. The degree of hepatic dysfunction was measured by using biochemical parameters like serum transaminases (ALT and AST), alkaline phosphatase (ALP)and pseudocholinesterase (PChE) while the histopathological studies were carried out to support the enzymic Parameters. The aim of the study was to investigate the association between diabetic hepatic complications and liver enzyme alterations. This study was performed in the Department of Anatomy; Institute of Pharmaceutical Sciences and Institute of Diabetology and endocrinology of Baqai Medical University, Karachi. Diabetes was induced by a single dose of STZ (45 mg/kg, b.w.) given intraperitoneally in sodium citrate buffer at pH 4.5. Eighty albino rats were divided into five groups: control (A) and STZ treated (B, C, D, and E) which were sacrificed 2, 4, 6 and 8 weeks post treatment respectively. Histopathological examination of liver showed accumulation of lipid droplets, lymphocytic infiltration, increased fibrous content, dilatation and congestion of portal vessels and proliferation of bile ducts. Increased levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), ALP and PChE were observed in the liver. It seems that the diabetic complications in the liver like hepatocyte destruction etc. are likely to be due to alterations in enzyme levels.

Este estudio se realizó para evaluar la relación y los efectos de la diabetes sobre la morfología, arquitectura y la función del hígado. Los efectos hepáticos de la diabetes se evaluaron in vivo utilizando estreptozotocina (STZ) para inducir diabetes en ratas como un modelo experimental. El grado de disfunción hepática se midió mediante el uso de parámetros bioquímicos, como las transaminasas séricas (ALT y AST), fosfatasa alcalina (ALP) y pseudocolinesterasa (PChE), mientras que los estudios histopatológicos se llevaron a cabo para apoyar los parámetros enzimáticos. El objetivo del estudio fue investigar la asociación entre las complicaciones hepáticas diabéticas y la alteración de enzimas hepáticas. Este estudio se realizó en el Departamento de Anatomía, Instituto de Ciencias Farmacéuticas y el Instituto de Diabetología y Endocrinología de la Baqai Medical University, Karachi. La diabetes fue inducida por una dosis única de STZ (45 mg/kg de peso corporal) administrada por vía intraperitoneal en tampón citrato de sodio a pH 4,5. Ochenta ratas albinas se dividieron en cinco grupos: control (A) y tratados con STZ (B, C, D y E), las que se sacrificaron a las 2, 4, 6 y 8 semanas después del tratamiento. El examen histopatológico de hígado mostró acumulación de gotitas de lípidos, infiltración linfocítica, aumento del contenido de fibras, dilatación y congestión de los vasos portales, y la proliferación de conductos biliares. Aumento de los niveles de aspartato aminotransferasa (AST), alanina aminotransferasa (ALT), ALP y PChE fueron observados en el hígado. Parece que las complicaciones de la diabetes en el hígado como la destrucción de los hepatocitos etc., son probablemente debido a alteraciones en los niveles de las enzimas.

Altered kidney morphology and enzymes in streptozotocin induced diabetic rats / Morfología y enzimas renales alteradas en ratas con diabetes inducida por estreptozotocin

We studied the effects of streptozotocin (STZ)-induced diabetes on kidney morphology, anatomy, architecture and on the activities of aminotransferases (AST and ALT), alkaline phosphatase (ALP) and pseudocholinesterase (PChE) in albino rats. The aim of the study was to investigate the association between diabetic kidney complications and kidney enzyme alterations. This study was performed in the Department of Anatomy and Institute of Pharmaceutical Sciences, Baqai Medical University, Karachi and Pathology department of College of Physicians & Surgeons (CPSP) Pakistan in 2007-08. Diabetes was induced by a single dose of STZ (45 mg/kg, b.w.) given intraperitoneally in sodium citrate buffer at pH 4.5. Eighty (80) albino rats were divided into five groups: control (A) and STZ treated (B, C, D, and E) which were sacrificed 2, 4, 6 and 8 weeks post treatment respectively. Histopathology of kidney showed lesions similar to human glomerulosclerosis, glomerular membrane thickening, arteriolar hyalinization and tubular necrosis. Increased levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and pseudocholinesterase (PChE) were observed in the kidney. It seems that the diabetic complications in the kidney are likely to be associated with alterations in enzyme levels.

Se estudiaron los efectos de la diabetes inducida por estreptozotocin (STZ) sobre la morfología, anatomía, arquitectura y sobre las actividades de aminotransferasas (ALT y AST), fosfatasa alcalina (ALP) y pseudocolinesterasa (PChE) en los riñones de ratas albinas. El objetivo del estudio fue investigar la asociación entre las complicaciones renales diabéticas y la alteración de las enzimas renales. Este estudio se realizó en el Departamento de Anatomía y el Instituto de Ciencias Farmacéuticas, Universidad de Medicina Baqai, Karachi y el departamento de Patología de Colegio de Médicos y Cirujanos (CPSP) Pakistán entre el 2007-2008. La diabetes fue inducida por una dosis única de STZ (45 mg / kg de peso corporal) administrada por vía intraperitoneal en tampón de citrato de sodio a pH 4.5. Ochenta (80) ratas albinas fueron divididas en cinco grupos: control (A) y STZ tratados (B, C, D y E), que se sacrificaron a las 2, 4, 6 y 8 semanas después del tratamiento, respectivamente. La histopatología del riñón mostró lesiones similares a la glomeruloesclerosis en humanos, engrosamiento de la membrana glomerular, hialinización arteriolar y necrosis tubular. Aumento de los niveles de aspartato aminotransferasa (AST), alanina aminotransferasa (ALT), fosfatasa alcalina (ALP) y pseudocolinesterasa (PChE) fueron observados en el riñón. Parece que las complicaciones de la diabetes en el riñón están directamente asociadas con alteraciones en los niveles de las enzimas.

Does the existing traditional undergraduate Anatomy curriculum satisfy the senior medical students? A retrospective evaluation / O currículo tradicional de Anatomia é satisfatório para os estudantes do último ano de medicina? Uma avaliação retrospectiva

Objetivo: Apresentar os resultados de um estudo sobre opiniões e conhecimento de residentes de primeiro ano e estudantes de medicina sobre o Currículo de Anatomia e suas sugestões para organizar um curso de bases clínicas em anatomia. Métodos: Residentes de primeiro ano, ao final de seu ano clínico, e estudantes de medicina ao final de seu ano de graduação foram solicitados a avaliar o Currículo de Anatomia que tiveram nos anos pré-clínicos. Resultados: A maioria dos respondentes avaliou o ensino geral de anatomia adequado, mas a grande maioria considerou os cursos de anatomia clínica, anatomia de imagem e anatomia de superfície e viva muito curtos. Os residentes de primeiro ano e estudantes classificaram os cursos de anatomia e temas clínicos integrados como essenciais para seu treinamento clínico e sentiram a necessidade de um curso de anatomia orientado para a clínica, com estudos de casos e participação de docentes de clínica nos anos de ciclo básico. Conclusões: Avaliações retrospectivas ao final do primeiro ano de residência e no último ano de graduação são ?evidências? úteis a serem consideradas na reforma do currículo de anatomia, especialmente para desenvolver um Curso de Bases Clínicas em anatomia. Os resultados de tais estudos devem ser levados em conta ao se discutirem as modificações do currículo de anatomia.

Efeitos do óleo de Nim (Neem) na estrutura e função de ovários de ratas albinas adultas / Effect of Neem oil on the structure and function of the mature female albino rat ovaries

Objetivo: Esse estudo foi realizado para observar o efeito do tratamento com óleo de Nim sobre a fertilidade, a estrutura microscópica do ovário e as alterações associadas ao nível sérico dos hormônios reprodutivos em ratas albinas adultas. Métodos: Os animais foram divididos em grupos – Grupo A1: fêmeas tratadas com baixa dose (0,6 ml de óleo de Nim/animal); Grupo A2: fêmeas tratadas com alta dose (1,2 ml de óleo de Nim/animal); Grupo A3: controles para Grupo A1, receberam dose equivalente de óleo de amendoim; Grupo A4: controles para Grupo A2, receberam dose equivalente de óleo de amendoim. Os animais foram observados por seis semanas. No fim desse período, os animais foram anestesiados, o sangue coletado por punção cardíaca e, depois, sacrificados. Os ovários foram removidos e fixados em solução de formol a 10% para microscopia e em metanol, para cromatografia líquida de alto desempenho. Rresultados: À microscopia, os cortes dos ovários revelaram diminuição do número de folículos maduros. Alterações significativas nos níveis de hormônios reprodutivos e a presença de concentrações maiores dos componentes ativos do óleo de Nim nas gônadas entre as ratas tratadas, também foram demonstradas neste estudo. Cconclusões: Esses achados permitem concluir que o óleo de Nim tem potencial anticonceptivo dose-dependente em ratas albinas.

Health care preferences for children with typhoid fever in two slum communities in Karachi, Pakistan.

This study examined health care preferences and influences in response to initial and persistent symptoms of typhoid fever among children in two slum communities in Karachi, Pakistan. Typhoid fever in this area is endemic and has a high rate of multi-drug resistantce. The study involved a household survey of 502 respondents. Private practitioners, including qualified medical specialists, were the preferred providers for initial symptoms, with government and private hospitals preferred for continuing symptoms. A number of cases continued to select initial health care choices regardless of the severity of symptoms. The findings point to factors of cost, access to care, previous use of a provider and perceived quality of care as key influences regarding health care choices. These findings suggest that cases of typhoid fever in these communities are at risk for not receiving appropriate diagnoses and treatment for children who are at risk for severe cases of multi-drug resistant disease. Suggestions are made for improving the care of children with typhoid in this context.

Pattern of orbital injuries presenting to a teaching hospital in Karachi

The purpose of the Study is to identify the frequency pattern and causes of orbital injuries. The study was conducted at the Department of Oral and Maxillofacial Surgery, Abbasi Shaheed Hospital Karachi over a period of one year from February 2004 to January 2005. A convenience sample of all patients presenting with orbital trauma were included. A 6-item questionnaire with various variables was used to record the parameters. The parameters including age, gender, referral source, cause of injury, site of injury and imaging methods were evaluated. All injuries were assessed and recorded by a single observer. Total study sample was 100 subjects. Male preponderance with male: female ratio of 6:1 approximately, 86%males and 14% females, the mean age of the sample was 29 year. The most common cause of injury was recorded as road traffic accidents 57% followed by assault 19% and fall accounted for 15%. The most common site involved right orbit and the most common site of orbital fracture was inferior orbital rim followed by orbital floor fracture. This study demonstrated that the most common cause of orbital injury was road traffic accidents and inferior orbital rim was involved most frequently

Pattern of coronary arterial distribution and its relation to coronary artery diameter

This study was carried out to determine the pattern of coronary arterial distribution and its relation with coronary artery diameter in adult Pakistani population as demonstrated by selective coronary angiography. Consecutive series of 220 adult subjects who underwent diagnostic coronary angiography at National Institute of Cardiovascular Disease [NICVD] between May 2000 and December 2000 were studied. Patients whose age was more than 18 years, with no apparent disease in the proximal arterial segment, proximal artery and tip of the catheter in the middle of the frame and catheter of a No. 6 French size of same manufacturer used were included in this study. Patients who were given vasodilator before or during the procedure, angiograms showing complete proximal occlusions or ectatic arteries were excluded. Sixty% subjects had right dominance pattern of which 78.1% were male and 21.8% female. By contrast 15% had left coronary dominance, of which 78.7% were male and 21.2% female. Where as, 24% patients had co-dominant [balanced] circulation with 83.3% male and 16.6%, female. In patients with left dominant pattern, the mean diameter of the right coronary artery [RCA] was significantly smaller [p<0.00 I] as compared to dominant right or co-dominant pattern. Where as in patients with right dominant pattern, the mean diameter of the circumflex [CX] artery was significantly smaller [p<0.001] as compared to dominant left. The coronary arterial distribution in Pakistani population is not significantly different from that given in the literature and the diameter of the RCA and the CX artery are significantly affected by dominance pattern