Bioassay-guided isolation of novel and selective urease inhibitors from Diospyros lotus / 中国天然药物

Two new dimeric naphthoquinones, 5',8'-dihydroxy-6,6'-dimethyl-7,3'-binaphthyl-1,4,1',4'-tetraone (1; Di-naphthodiospyrol D) and 5',8'-dihydroxy-5,8-dimethoxy-6,6'-dimethyl-7,3'-binaphthyl-1,4,1',4'-tetraone (2; Di-naphthodiospyrol E), along with known naphthoquinones diospyrin (3) and 8-hydroxy diospyrin (4) were isolated from the chloroform fraction of extract of Diospyros lotus roots. Their structures were elucidated by advanced spectroscopic analyses, including HSQC, HMBC, NOESY, and J-resolved NMR experiments. The fractions and compounds 1-4 were evaluated for urease activity and phosphodiesterase-I, carbonic anhydrase-II and α-chymotrypsin enzyme inhibitory activities. Compounds 1 and 2 and their corresponding fractions showed significant and selective inhibitory effects on urease activities. The IC values of 1 and 2 were 260.4 ± 6.37 and 381.4 ± 4.80 µmol·L, respectively, using thiourea (IC = 21 ± 0.11 µmol·L) as the standard inhibitor. This was the first report demonstrating that the naphthoquinones class showed urease inhibition.

In-hospital complications of acute right ventricular myocardial infarction

To determine the in-hospital complications of acute right ventricular myocardial infarction[RVMI]. This study was conducted at Cardiology Department, Lady Reading Hospital, Peshawar from May to October 2009. A total of 100 patients with acute RVMI were evaluated for in-hospital complications. Male patients were 77 [77%] and females 23 [23%]. Patient's mean age was 59.96+12.3 years with age range 28-82 years. Total in-hospital complication events were 174. In-hospital complications were present in 77% patients. Cardiogenic shock was the commonest complication with frequency of 25.8%followed by acute left ventricular failure [LVF] in 17.8% and atrioventricular blocks [AV Blocks] in 14.3% respectively. Re-infarction occurred in 5.7% [10] patients. Thirty eight patients died in our study [21.8%]. Among RVMI patients, 65% stayed in-hospital for more than 4 days. Frequency of complications is higher and cardiogenic shock is the most common complication in acute RVMI patients

Comparative analysis of type of myocardial infarction in patients with successful or unsuccessful streptokinase thrombolysis following st elevation myocardial infarction

To study the effect of thrombolytic therapy in term of success and failure on the type of ST elevation MI, using streptokinase. This was a comparative study, conducted at Department of Cardiology, Lady Reading Hospital, Peshawar, from October 2006 to October 2007. Patients with first acute myocardial infarction were divided into group A [successful thrombolysis] and group B [unsuccessful thrombolysis] using ECG criteria. Total number of patients were 200. Group A included 136 [68%] patients and group B included 64 [32%] patients. There were total 88 [44%] patients of anterior MI with 47 patients in group A and 41 patients in group B [34.6% vs 64.0%, p<0.001]. There were total 110 [55.0%] patients of inferior MI with 88 patients in group A and 22 patients in group B [64.7% vs 34.4%, p<0.001]. Lateral myocardial infarction was diagnosed in 2 [1%] patients with 1 patient each in group A and group B [0.7% vs 1.6%, p=0.583]. Anterior MI was associated with a higher rate of thromblysis failure while inferior MI and lateral wall MI was associated with a higher rate of successful thrombolysis.

Frequency of coronary heart disease risk factors among nurses

To find out frequency of various risk factors for coronary heart diseases in nurses. This was a cross-sectional study. Nurses working in three shifts at Lady Reading Hospital, Khyber Teaching Hospital, Nursing school of Lady Reading Hospital Peshawar, were included in the study. All participants were interviewed in detail including their family history, past medical history, smoking and dietary history. Pulse, blood pressure, body mass index [BMI] and waist: hip ratio was determined. Their random blood sugar and total cholesterol was checked. Data was analyzed for cardiovascular risk factors using SPSS version 16. A total of 165 nurses were screened and interviewed. Mean age was 40.75 +/- 8.577 years. Mean BMI was 28.80 +/- 4.77. Mean systolic BP was 124.82 +/- 20.91 mm Hg, while mean diastolic BP was 82.45 +/- 13.07 mm Hg. Mean random blood sugar was 128.39 +/- 52.74 mg /dl. Diabetic nurses were 18[10.9%],hypertensive nurses were 31[18.8%], nurses having high cholesterol were 4[2.4%], nurses having documented CAD were2[1.2%], other than above risk factors or conditions were present in 34[20.6%] of the nurses, not having any of the mentioned risk factors or diseases were present in 76[46.1%]. Nurses not having any regular exercise schedule were 104 [63%]. We noticed that among modifiable risk factors hypercholesterolemia, diabetes and hypertension were less frequent in nurses while obesity, physical inactivity and sedentary life style with more duty hours and smoking were more prevalent

Radial artery approach for coronary intervention - early experience

To see the clinical outcome of patients undergoing Transradial Coronary Angioplasty with stable Angina. This was a single center observational study with prospective data collection of 338 patients who underwent transradial coronary angioplasty from September 2009 to August 2011, at Post Graduate Medical Institute, Lady Reading Hospital, Peshawar. Patients of both genders and all ages who had transradial coronary angioplasty for chronic stable angina were included in the study. Patients were clinically examined in out patients department on first month of hospital discharge and clinical outcome data was recorded. A total of 338 patients were included in the study. Male were 58.8% and 41.2% were female with mean age of 52 +/- 7years. All the patients had coronary intervention through right radial artery. Baseline characteristics of the patients were; 48.2% diabetic, 43.2% hypertensive, 30.5% smokers, dyslipidemia was 45.7% and mean values of serum creatinine and Hemoglobin were 1.1 +/- 0.3 and 11.5 +/- 1.5, respectively. The frequency of various complications were as follow; hematoma 1.3%, nausea and vomiting 2.2%, pain in hand 11.2%, readmission to hospital for chest pain 6.5%, need for revascularization 2.2%, hand ischemia 1.8%, minor bleeding 0.9%, no major bleeding and 1.9% mortality. The radial artery approach for coronary intervention is useful with low degree of access site vascular complications and an early mobilization

Efficacy and safety of percutaneous transvenous mitral commisurotomy [ptmc] performed through patent foramen ovale [pfo]

The aim of this study was to assess efficacy and safety of PTMC in patients with severe mitral stenosis [MS] perform through patent foramen ovale. All symptomatic patients with severe MS were included in the study from January 1998 to December 2010, at Cardiology department, Lady Reading Hospital, Peshawar. Transthoracic and trans-esophageal echocardiogram was performed to exclude left atrial appendage/left atrial clot and check the anatomy of interatrial septum. Severely calcified mitral valve and severe mitral regurgitation were excluded. Patent foramen ovale was crossed in majority of cases to reach left atrium. Stenosed mitral valve was dilated with Inoue balloon. Total number of patients was 1818. Females were 74% [p<0.05]. The mean age was 26.51 +/- 7.82 years and mean Body Mass Index [BMI] was 2 19.05 +/- 1.2kg/m[2]. The number of patients who had PTMC through PFO were 2 92.08%. Mean valve area was 0.9 +/- 0.19cm[2] on 2D Echocardiography, which 2 increased to 1.82 +/- 0.17cm[2] [p<0.05], mean mitral valve gradient decreased from 18 +/- 4.04mmHg to 7 +/- 0.25mmHg [p<0.005] and mean right ventricular systolic pressure decreased from 70 +/- 17.4mmHg to 48 +/- 13mmHg [32% drop] [p<0.05] at 24hours after PTMC. Mean time of crossing interatrial septum via PFO was 17 +/- 05minutes. Post PTMC severe MR in PFO group was 3.6% and 2.8% in inter atrial septum group [p=0.21]. Pericardial effusion was noted in 0.11% patients in PFO group and 0.27% in interatrial septum group [p>0.05]. Stroke was present in 1.5% patients. PTMC through patent foramen ovale [PFO] is a safe procedure, with few complications

Frequency of adverse outcomes of acute myocardial infarction in patients with stress hyperglycemia

To determine the frequency of in-hospital adverse outcomes of acute myocardial infarction in patients with stress hyperglycemia. This was a descriptive cross sectional study conducted from August 2010 to January 2011 in Cardiology department, Lady Reading Hospital, Peshawar. Patients of age 25-70 years, of either gender, non-diabetic with acute myocardial infarction with stress hyperglycemia were included. Random blood sugar >/= 144 mg/dl was taken as stress hyperglycemia for patients at presentation of acute myocardial infarction. Patients were monitored for electrical complications such as atrial fibrillation, ventricular tachycardia, ventricular fibrillation and complete heart block and mechanical complications such as cardiac pulmonary edema and cardiogenic shock during hospital stay. The statistical analysis was performed using the statistical package for social sciences [SPSS Ver. 15.0]. A total of 341 patients having acute myocardial infarction with stress hyperglycemia were studied. The mean age was 56.35 +/- 9.748 [95% CI 57.39 - 55.31]. Male were 58.1% [n=198]. The frequency of various major in-hospital electrical adverse outcomes of acute myocardial infarction with stress hyperglycemia were atrial fibrillation [AF] 15.8%, ventricular tachycardia [VT] 11.7%, ventricular fibrillation [VF] 10.9% and complete heart block [CHB] 6.7%, while mechanical adverse outcomes were cardiac pulmonary edema [CPE] 7.9% and cardiogenic shock [CS] 11.7%. Stress hyperglycemia has adverse impact on outcomes of patients presenting with acute myocardial infarction. Among electrical and mechanical complications of acute myocardial infarction in patients with stress hyperglycemia, the two most frequent in-hospital adverse outcomes were atrial fibrillation and cardiogenic shock, respectively

Correlation of functional class of dyspnea with left ventricular diastolic dysfunction

To correlate functional class of dyspnea with left ventricular diastolic dysfunction assessed by echocardiography. This was a single center descriptive study, conducted in Cardiology department Lady Reading Hospital Peshawar from March 2011 to October 2011. All male and female patients of any age with clinical diagnosis of heart failure with sinus rhythm and no to minimal mitral regurgitation were included in the study, using consecutive non-probability sampling technique. Six minute walk test was performed to place the patients in proper NYHA Class of dyspnea. Detailed echocardiographic study was performed to document left ventricular diastolic dysfunction. The data was analyzed on SPSS version 16. Spearman rank correlation coefficient was used to measure the strength of association between pairs of variables. P-value

Echocardiographic findings in hypertrophic obstructive cardiomyopathy [hocm]

To find out various Echocardiographic findings in patients with HOCM. This was a retrospective cross-sectional study performed in Cardiology department Lady Reading Hospital, Peshawar. Data collected from the database computer section of echocardiography department from February 2009 to November 2011.The data was analyzed using SPSS version 14. Total study population was 28. Male were 14 [50%]. Mean age was 52.5_ 15.9 years. Mean left ventricular end diastolic dimension was 3.84cm; inter-ventricular septal thickness 2cm [1.1-3.1] and posterior wall thickness was 1.17cm [0.6-1.6]. Mean Left atrial [LA] diameter was 3.86cm [0.8-5.6]. Mean peak gradient across LVOT was 48.43 mmHg. Mitral regurgitation [MR] was found in 19 [67.9%] patients. MR was mild in 57.1%, moderate in 7.1% and severe in 3.6% of patients. Aortic regurgitation [AR] was found in 13 [46.4%] patients. AR was mild in 35.7%, moderate in 10.7% of patients. Left atrial size was increased in 14 [50%] patients. Mean LA diameter was 4.6cm, 5cm and 5.6cm in patients with mild, moderate, and severe MR respectively. So there was direct relation between severity of MR and LA diameter. The respective mean gradient across LVOT in patients mild, moderate and severe MR was 31mmHg, 43.5mmHg and 140mmHg. So higher the gradient across LVOT, more will be the MR and hence the LA size and the patient will be more symptomatic. HOCM is significantly associated with both MR and AR and there is direct relation between severity of MR with LA diameter and LVOT gradient

Effect of intervention on the control of risk factors in coronary artery disease patients

To assess the effect of optimal medical therapy on the control of risk factors in coronary artery disease [CAD] patients with or with-out intervention. It was a cross sectional comparative study carried out at Lady Reading Hospital, Peshawar January to December 2010. Subjects were divided into two groups based on percutaneous coronary intervention and optimal medical therapy. Study variables were smoking, physical activity, dyslipidemia, diabetes, hypertension and obesity. Informed written consent was taken from all the study participants. Data was recorded on a preformed Questionnaire and analyzed with SPSS version 16. P-value of 0.05 was taken as significant. A total of 315 patients were studied. Baseline characteristic were similar between groups. Smoking was decreased significantly in [PCI group] as compared to [OMT group] [p=0.027]. Physical activity goal >/= 150 min/ week were achieved more in [PCI group] compared to [OMT group][p=0.019]. Goals set for Serum cholesterol, HbA1c%, serum LDL, Systolic blood pressure and Diastolic blood pressure have significantly achieved in [PCI group] as compared to [OMT group] with p- valves of [0.018,0.027,0.023,0.033 and 0.017] respectively. While goals set for Triglycerides, serum HDL and BMI have no significant difference between the two groups with p-valves of [0.223, 0.089 and 0.164 respectively]. Patients who underwent intervention and remained on optimal medical therapy were more adherent to regular exercise and good compliance which lead to better risk factors control for coronary artery disease as compared to patients who remained on optimal medical therapy alone

comparative analysis of in-hospital left ventricular function in patients with successful or unsuccessful streptokinase thrombolysis following acute myocardial infarction

To compare in-hospital left ventricular function in patients with unsuccessful and successful thrombolysis presenting with acute myocardial infarction treated with streptokinase. This comparative study was conducted at department of Cardiology, Lady Reading Hospital Peshawar, from October 2006 to October 2007. Two hundred patients with first acute myocardial infarction were divided into two groups: group A [successful thrombolysis] and group B [unsuccessful thrombolysis], using ECG criteria. To determine Left Ventricular Function, 2-D Echo was used. Group A included 136 [68%] patients and group B included 64 [32%] patients. Impaired left ventricular function was found in 41 [30.1%] patients in group A and 41 [64.1%] patients in group B [p< 0.001]. Left ventricular failure was present in 31 [22.8%] patients of group A and 30 [46.9%] patients of group B [p=0.001]. Cardiogenic shock was diagnosed in 2 [1.5%] patients in group A and 6 [9.4%] patients in group B [p-0.008]. Presence of LVF is strongly associated with unsuccessful thrombolytic therapy in this group of patients

Utility of transradial coronary angioplasty in patients with chronic stable angina discharged on same day

To study the utility of Transradial Coronary Angioplasty in Patients with Chronic stable Angina discharged on same day. This was a single center observational study with prospective data collection of 228 patients underwent transradial coronary angioplasty from January to December 20JO, at Post Graduate Medical Institute, Lady Reading Hospital, Peshawar. Patients of both genders and all ages who had transradial coronary angioplasty for chronic stable angina and were discharged on same day were included in the study, using purposive non-probability sampling technique. Patients with unstable angina and acute coronary syndrome who had to stay for more than one day, were excluded from the study. Patients were followed at one month of hospital discharge in out patients department and clinical outcome data was recorded. A total of 228 patients were included in the study. Male were 64.9% and 35.1% were female with mean age of 56 +/- 9years. All the patients had coronary intervention through right radial artery. Baseline characteristics of the patients were; diabetic 46.4%, hypertensive 45.6%, smokers 32.8%, dyslipidemic were 47.8% and mean values of serum creatinin and Hemoglobin were 1.2 +/- 0.5 and 12.8_2.4, respectively. The frequency of various complications were as follow; mild hem atom a 1.7%, nausea and vomiting 1.3%, pain in hand 10.5%, readmission to hospital for chest pain 7.4%, need for revascularization 3%, hand ischemia 2.5%, minor bleeding 0.8%, and mortality was 1.3%. There was no access site major bleeding or hematoma. The radial artery approach for coronary angiopalsty is found to be very useful with low degree of access site vascular complications and an early patient mobilization

Prevalence of hyperlipidemia in obese and non obese coronary artery disease patients

To determine the prevalence of hyperlipidemia in obese and non-obese patients with diagnosed coronary artery disease. This hospital based descriptive study was conducted in Cardiology Department of Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from 15[th] March 2005 to 30[th] May 2006. A total of 200 patients with diagnosed coronary artery disease were enrolled, 100 were classified as obese and 100 as non-obese. There were 139 males and 61 females in total 200 CAD patients. Serum triglycerides level was 184 +/- 82 in obese patients and 158 +/- 68 in non-obese patients [p = 0.015]. Serum cholesterol level was 208 +/- 61 in obese and 180 +/- 67 in non obese [p = 0.001]. Serum HDL level was significantly more in non obese [48 +/- 36] as compared to obese [37 +/- 8] [p =0.005]. Serum LDL was more [157 +/- 49] in obese as compared to [148 +/- 44] in non obese but with no statistical difference [p =0.156]. Obese CAD patients had significantly had higher levels of triglycerides, total cholesterol with lower HDL levels as compared to non obese CAD patients

Frequency of cardiovascular disease risk factors among doctors

To find out frequency of risk factors for cardiovascular disease amongst doctors. This was a cross-sectional study involving doctors [working at Lady Reading Hospital] recruited in Peshawar Heart Study [PHS]. All participants were interviewed in detail including present and past medical history, family history, smoking, drug and dietary history. Pulse, blood pressure, body mass index [BMI] and waist/hip ratio were measured. Random blood sugar and total cholesterol was checked. A supine resting ECG was recorded. Data was analyzed for frequency of cardiovascular risk factors using SPSS Version 16. A total of 208 doctors were interviewed. Mean age was 30.33 +/- 7.0 years. Mean BMI was 24.69 +/- 4.73.Mean waist size was 84.68 +/- 10.571cm. Mean waist/hip ratio was 0.86 +/- 0.068. Mean systolic BP was 121.82 +/- 13.70 mm Hg while mean diastolic BP was 78.89 +/- 09.36 mm Hg. Mean random blood cholesterol was 163.97 +/- 27.93 mg / dl. Mean random blood sugar was 95.79 +/- 24.57 mg /dl. Most [98.55%] of doctors had random blood sugar of less than 180 mg /dl. The big majority of the doctors was not performing any regular exercise [n=157, 75.5%]. Mean duty hours per day were 8.98 +/- 2.073.Active smokers were 39 [18.8%], while 9 [4.3%] were using Naswar. None of the doctors enrolled in study was drinking alcohol. Among modifiable risk factors hypercholesterolemia, diabetes, and hypertension were less frequent amongst doctors while physical inactivity, obesity, unhealthy eating, and smoking were relatively more frequent

comparative analysis of frequency of in-hospital arrhythmias in patients with successful versus failed thrombolysis following acute myocardial infarction

To compare frequency of in-hospital arrhythmias in patients with successful and failed thrombolysis using streptokinase in patients presenting with acute myocardial infarction [AMI]. This was a comparative study conducted at department of Cardiology, Lady Reading Hospital,Peshawar from October 2006 to October 2007 .Two hundred patients with first AMI were divided into two groups: group A [successful thrombolysis] and group B [failed thrombolysis] using ECG criteria. A total of 200 patients were studied. Group A included 136 [68%] patients while group B included 64 [32%] patients. Among these 24 [12.0%] patients developed arrhythmias. Of these 8 patients were in group A and 16 patients were in group B [5.9% vs. 25.0%, p=0.003].Ventricular tachycardia was the most common arrhythmia. It was documented in 9 [4.5%] patients, with 2 patients in group A and 7 patients in group B [1.5% vs. 10.9%, p=0.003]. The other arrhythmias which included atrial fibrillation, ventricular fibrillation and supraventricular tachycardia were statistically insignificant between the two groups [p=0.174]. In hospital mortality was more common in patients with failed thrombolysis [6 [9.4%] vs. 3 [2.2%] [p=0.023]]. Failed thrombolysis is associated with complex arrhythmias and high in- hospital mortality

Comparison of effect of locally available brands of clopidogrel on platelet aggregation in patients with coronary artery disease

Anticoagulant effect of clopidogrel is of utmost importance in coronary artery disease, especially in prevention of coronary stent thrombosis. Recently, many new local brands of clopidogrel have been launched, with unknown efficacy. This study was conducted with the aim to compare two locally prepared clopidogrel brands, in terms of the effect of a loading dose of 600 mg on inhibition of platelet aggregation in patients with coronary artery disease. This was a double blind randomised study. Sample population consisting of 35 patients, were admitted at Lady Reading Hospital, Peshawar, for the management of coronary artery disease. Baseline platelet aggregation of all these patients was measured. These patients were divided in two groups randomly. Group-A consisting of 18 patients was given brand 'A' clopidogrel 600 mg, while Group-B consisting of 17 patients was give brand 'B' of clopidogrel 600 mg. The platelet aggregation of both groups was then measured at baseline, and at 2, 4, and 6 hours after taking the loading dose of 600 mg. Platelet aggregation time at baseline in Group-A was 2.61 +/- 2.28 sec. and in Group-B it was 2.24 +/- 1.52 sec. [p=0.57]. After 2 hours of clopidogrel administration in Group-A the platelet aggregation time was 1.44 +/- 1.58 sec. and in Group-B it was 1.53 +/- 1.107 sec. [p=0.85]. Platelet aggregation time after 4 hours in Group-A was 0.28 +/- 0.57 sec. and in Group-B 1.06 +/- 1.03 sec. [p=0.009], and after 6 hours it was 0.00 +/- 0.00 sec. in Group-A and in Group-B it was 0.59 +/- 0.71 sec. [p=0.001]. The two brands of clopidogrel had a significant difference in their effect on inhibition of platelet aggregation. Different brands of clopidogrel may not be equally effective

Frequency and predictors of renal artery stenosis in patients with coronary artery disease

Renal artery stenosis [RAS] is a common finding in patients undergoing coronary angiography. We designed this study to look for the frequency and any predictors of renal artery stenosis in patients with coronary artery disease [CAD]. A total of 201 consecutive patients with CAD confirmed by coronary angiography underwent an abdominal aortogram in the same sitting to screen for RAS. Patient demographics and co-morbidities were analysed for any association with RAS. Forty-one of the patients were female [20.4%]; ninety patients were hypertensive [44.8%]; 49 patients [24.4%] were smokers; 19 patients [9.5%] had renal insufficiency; 88 patients [43.8%] had high cholesterol levels; 44 patients [21.9%] were diabetic. Thirty-two patients [15.9%] had single coronary artery disease, 59 patients [29.4%] had two vessel disease, and 110 patients [54.7%] had three vessel disease. Significant renal artery stenosis [>/= 0.50% stenosis] was present in 26 patients [12.9%]. Among the variables studied, only female gender was found to be associated with a higher frequency of renal artery stenosis [24.39% vs 10.0%, p=0.01]. The frequency of renal artery stenosis in patients with coronary artery disease is 12.9%. Female gender is associated with a higher frequency of renal artery stenosis in patients with CAD

Prevalence of asymptomatic left ventricular diastolic dysfunction in normotensive type 2 diabetic patients

To determine the frequency of asymptomatic left ventricular diastolic dysfunction in normotensive type 2 diabetic patients. This descriptive case series study was conducted on 80 normotensive Type 2 diabetic patients at Cardiology Department, PGMI Lady Reading Hospital Peshawar from March 2007 to March 2008. Detailed history and physical examination was performed on every patient. The glycemic status was defined on the basis of HbA1c. Exercise tolerance test was performed on every patient to exclude major ischemia. Echocardiography was performed in left lateral position. Main outcome measure was left ventricular diastolic dysfunction. We enrolled 80 normotensive Type 2 diabetic patients in the study that fulfills the inclusion criteria. Left ventricular diastolic dysfunction was found in 53% [43/80]. There were 20 [47%] males and 23 females [53%] among subjects presenting with diastolic dysfunction. Subjects with diastolic dysfunction the mean age were 55 +/- 15 years. Patients having no left ventricular diastolic dysfunction mean age were 52.5 +/- 7 years. There is a high prevalence of asymptomatic left ventricular diastolic dysfunction in normotensive type 2 diabetic patients

Radiofrequency catheter ablation for supraventricular tachycardias: experience at Peshawar

Drug therapy is mostly employed in the management of supraventricular tachycardias [SVTs]. However, radiofrequency catheter ablation has been found to be highly effective and safe in the treatment of SVTs. The current study is aimed at sharing our experience of 320 patients who presented with SVTs, and were treated with radiofrequency catheter ablation. This descriptive study was carried out in the Cardiac Electrophysiology Laboratory of Lady Reading Hospital, Peshawar from October 2006 to December 2009. Standard 4-wire electrophysiological study was carried out to identify the mechanism of SVT in 320 consecutive patients. Radiofrequency catheter ablation was used to interrupt the tachycardia circuit. Out of a total 320 patients who underwent electrophysiologic study, 168 were found to have atrioventricular nodal re-entry as underlying mechanism; 121 patients were having accessory pathway responsible for re-entry [of these 95 presented with orthodromic reciprocating tachycardia and 26 as antidromic reciprocating tachycardia]; 19 patients were having focal atrial tachycardia, 4 atrial fibrillation and 8 atrial flutter as the underlying cause for SVT. Radiofrequency catheter ablation was used with an overall success of 94% and a complication risk of complete AV block in 0.3% and recurrence rate of 3%. Radiofrequency catheter ablation is safe and highly effective mode of treatment of SVTs