Objective: To investigate the clinical outcome of dorsal wrist ganglion treated with surgical excision. Methodology: It was a cross-sectional study performed at Kazi Hospital Lahore. Non-probability purposive sampling technique was used to enroll 50 patients of dorsal wrist ganglion who responded through a questionnaire / research proforma. Surgical excision was done under local anesthesia as day case. Results: We collected data of 55 patients. The mean age of the patients having dorsal wrist ganglion cyst was 31. Female patients were in a larger proportion than male patients. Right wrist was affected in n= 29 (58 %) of the individuals. At the end of our follow up only 2(45) patients had residual pain. Hypertrophic scar has been reported to be associated with the lower patient satisfaction (p = 0.001). Luckily in our study only two patients (4%) had this problem. Conclusion: This study concluded that the outcomes of surgical excision of dorsal wrist ganglion is effective technique with high patient satisfaction and cost effectiveness. Keywords: Dorsal wrist ganglion, aspiration, surgical excision, outcome, patient satisfaction.
Objective: To determine the frequency of left ventricular failure after Non-ST elevation myocardial Infarction. Patients and Methods: This was a cross sectional study that was conducted in Cardiology department, Gulab Devi Hospital, Lahore.100 Patients presented in medical O.P.D of either gender with pre diagnosed NSTEMI (as per operational definition), NSTEMI confirmed clinically and by laboratory investigations were selected for study. Thorough history and written consent regarding study was signed by patients as well as the attendants. All the patients of LVF were labeled as per operational definition. Results: Out of 100 patients, 25 were in age group of 30-40 years whereas 75 were in age group of 41-54 years, mean age was calculated 44.06±5.63 years. There were 77% male whereas 23% of the subjects were females. Frequency of left ventricular failure was 37% after Non-ST elevation myocardial infarction. Conclusion: In this new study, we found that 37% of patients went into left ventricular failure after Non ST elevation Myocardial Infarction. The major associations of left ventricular failure were age, gender, BMI, hypertension, diabetes mellitus, smoking and dyslipidemia. Keywords: Non-ST Elevation Myocardial Infarction, Heart Failure
Objective: To find outthe frequency of cardiogenic shock in patients with ACS Study design: Cross sectional study Methodology:A calculated sample of 240 patients presented with acute coronary syndrome confirmed clinically and/or on the basis of ECG and cardiac markers was taken. In addition to collecting basic demographic details patients were inquired about the presence of risk factors (smoking status, diabetesand hypertension).The collected data was entered and analyzed by using SPSS version 16. Quantitative variable were presented in the form of mean, range and standard deviation. Results:Out of 240 patients, 33 patients (13.8%) were having cardiogenic shock and 207 patients (86.2%) were not. In the patients presented with cardiogenic shock, there were 21 (8.8%) with STEMI, 10 (4.2%) with NSTEMI and 2 (0.8%) with unstable angina. In STEMI there were 14 patients (5.8%) with anterior wall MI, 4 patients (1.7%) with inferior wall MI and 3 patients (1.2%) with lateral wall MI. Conclusion:Frequency of cardiogenic shock in patients presented with ACS was 13.8%. It was more commonin patients presented with ST-segment elevation MI as compared to unstable angina and NSTEMI. In STEMI, anterior wall was more involvement was more predominant. Keywords: ACS, Cardiogenic shock, Unstable angina, NSTEMI, STEMI
Objective: To determine the impact of diabetes on adverse outcomes amongst patients presenting for the first time with acute coronary syndrome. Study design: Cohort Study Methodology: A total of 340 patients were enrolled in this study. At presentation patients were divided in two equal age and gender matched groups with 170 patients in Group-A having diabetes and another 170 being non-diabetics in Group-B. Patients were followed up for period of index hospitalization and all adverse outcomes were noted in both groups as per operational definition. Results: Mean age in Group-A with diabetes was 54±12.7 years whereas in non diabetics it was56±13.12 years. In both groups there was male predominance with approximately 60% males and 40% females. In diabetic group, 38% patients had typical chest pain, 62% patients had dyspnea, 20% patients had cardiogenic shock while in non diabetic group, 20% patients had typical chest pain, 40% patients had dyspnea, 10% patients had cardiogenic shock. In diabetic group, 38% patients had heart failure, 10% patients died while in non diabetics 20% had heart failure and 5% patients died. Conclusion: This study concluded that in hospital adverse outcomes after first episode of acute coronary syndrome were more frequent in diabetic patients as compare to non diabetic patients. Keywords: Acute coronary syndrome, Adverse outcomes, First attack
Background Objective: To determine efficacy of modified Valsalva maneuver as compared to standard Valsalva maneuver in treating Supraventricular tachycardia. Methods: This is a Descriptive case series conducted at Department of Cardiology, Azra Naheed Medical College, Lahore. A total of 132 patients with SVT were enrolled in this study. At presentation, patients were randomly divided into 2 groups. 66 of them performed standard Valsalva maneuver and 66 performed modified Valsalva maneuver as their first response. ECG was recorded before and after the Maneuver. Subjects reverted back to sinus rhythm within 1 minute of allocated maneuver were considered successful. Patient’s detailed information about medical and demographic history, including sex, age, blood pressure in mmHg and pulse rate (PR) in beats/min were obtained and entered in a structured questionnaire. Results: In our current study mean age of participants was 40 + 11 years with 33% male and 66% females. Mean duration of SVT in participants was 5 + 4 years. The mean blood pressure was 112+15/72+10 mmHg ranging from 150-90/110-60. The range of Pulse Rate per minute was from 136 to 240 with a mean of 184 + 24. In this study SVT was reverted by Valsalva Maneuver in 89 (67.4%) patients and did not revert by these Maneuvers in 43 (32.6%) patients. Out of 89 reverted, 38 were reverted by performing SVM and 51 were reverted by performing MVM(p-value=0.025). Out of 43 participants unable to achieve primary outcome, 33 (25%) achieved secondary outcome that was reversion of SVT by an intravenous drug. Out of which 23 (17%) were successfully reverted by use of inj. Isopten, 10 (7.5%) were reverted by use of inj. Merol and in 10 (7.5%) cases reversion was unsuccessful. there was no association between age, sex, duration of SVT, presence of Diabetes Mellitus, Hypertension or Ischemic Heart Disease with the effectiveness of Vagal Maneuvers for termination to sinus rhythm. Conclusion: This study concluded that Modified valsalva maneuver is more effective than the standard maneuver in terminating SVT without increasing adverse effects or time spent in the emergency department.
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