Comparison of the Quality of Life after Skeletonized versus Pedicled Grafts in Coronary Artery Bypass Graft Surgery.

It remains a controversial issue whether internal thoracic artery (ITA) should be dissected in skeletonized or pedicled manner during coronary artery bypass graft (CABG) surgery. The main objective of this cohort study was to compare skeletonized versus pedicled grafts on the basis of patients' perceptions of their physical and mental well-being. Isolated nonemergent CABG patients were divided into two groups according to the type of graft used; skeletonized or pedicled. The quality of life (QOL) was measured preoperatively, 6 months postoperatively, and 12 months postoperatively for each patient using the 36-Item Short Form Health Survey tool. The main outcome variables were physical component summary (PCS) score and mental component summary (MCS) score. A total of 140 patients were included in the study with 70 patients in each group. The PCS (p-value = 0.235) and MCS (p-value = 0.239) scores of patients were similar in both the groups before CABG. The PCS and MCS scores were significantly (p-values < 0.0001) improved after CABG at 6 months in both the groups. However, the PCS and MCS scores in the skeletonized group were significantly higher (p-values < 0.0001) than the scores in the pedicled group at 6 and 12 months post-CABG. Both the harvesting techniques improve QOL significantly after CABG. However, skeletonization results in significantly better PCS and MCS scores compared with pedicled harvesting technique.

Assessing acceptability of hypertensive/diabetic patients towards mobile health based behavioral interventions in Pakistan: A pilot study.

INTRODUCTION: Diabetes and hypertension are prevalent chronic diseases among the general population of Pakistan with an exponential progress expected over the upcoming years. Mobile Health services can be an efficient method of helping curtail this rise and improve quality of life of such patients as proven in developed countries. We aim to assess the acceptability of using Mobile Health services among diabetic and hypertensive patients in Pakistan. METHODS: A total of 100 patients were approached in a large tertiary care Government Hospital of Karachi, Pakistan, using a nonprobability convenient sampling technique. Co-authors conducted an interview based sampling of a modified questionnaire to each participant after consent. All data was recorded and analyzed on SPSS 16. RESULTS: A total of 100 patients participated in our study with 66 (66%) males and 34 (34%) females having a mean prevalence age of 54.27. All the 100 participants had easy access to cell phones with 88% participants (88/100) stating that they would be willing to participate in Mobile Health based interventions. A statistically significant number (p=0.014) of them preferred receiving phone calls (85.2%) rather than SMS (14.8%) reminders for these interventions. 85% of the participants even agreed to participate in such intervention on cash incentives. CONCLUSION: The use of phone call reminders or SMS reminders seems like an acceptable and favorable option among hypertensive and diabetic patients. This can greatly improve their self-management and help curtail this rise in the future.

On pump coronary artery bypass graft surgery versus off pump coronary artery bypass graft surgery: a review.

There are two basic ways of performing coronary artery bypass graft surgery (CABG): on pump CABG and off pump CABG. Off pump CABG is relatively a newer procedure to on-pump CABG and does not require the use of the cardiopulmonary bypass machine. On pump CABG is the more traditional method of performing bypass surgery. However its resultant inflammatory effects cause renal dysfunction, gastrointestinal distress and cardiac abnormalities which have forced the surgeons to look for alternatives to the procedure. An extensive literature search revealed that on pump CABG causes better revascularization as compared to off pump CABG while off pump CABG has a much lower post operative morbidity and mortality especially in high risk patients. We suggest that the technique used should depend on the ease of the surgeon doing the operation as both the methods seem almost equally efficient according to the review.