BackgroundThe objective of the study was to determine the long-term outcomes, including mitral restenosis and regurgitation, after successful percutaneous transvenous mitral commissurotomy (PTMC).MethodsThis cross-sectional prospective study was conducted at the cardiology department of Lady Reading Hospital, Peshawar, Pakistan, from January 2007 to December 2009. A total of 84 patients were followed up for a period of 96 months. Pre and post percutaneous transvenous mitral commissurotomy echocardiography was done on the mitral valve area (MVA) using two-dimensional (2D) and color doppler echocardiography. Patients who had successful PTMC were followed up for MVA loss, mitral regurgitation (MR), and cardiac death. SPSS Software (IBM SPSS Statistics for Windows, Version 22.0, Armonk, NY: IBM Corp.; 2013) was used for data analysis.ResultsOf the 84 patients, 21 were male, and 63 were females. The mean age was 35 ± 11 years. After PTMC, the mean valve two-dimensional area increased from 0.84 ± 0.13 to 1.83 ± 0.49 cm2 (p value <0.001). MR was mild in 49 patients (62.8%), moderate in 27 patients (34.6%), and severe in two patients (2.6%). Good results were achieved in 60 (71.4%). Patients with good results were younger (24 ± 4), and had a relatively lower Wilkin's score, with a mean value of (8.4 ± 2.8). Follow-up events were death in six patients, mitral valve replacement (MVR) in 10 patients, and restenosis in seven patients. The Kaplan-Meier curve was used for the follow-up end points. Patient who required PTMC for mitral restenosis survived for a longer time than those requiring MVR, and those who had cardiac death due to severe pulmonary hypertension or heart failure.ConclusionPatients who had favorable Wilkin’s score and underwent PTMC for severe symptomatic mitral stenosis had better event-free survival in the long term follow-up.
Objective:To determine the frequency of subclinical hypothyroidism in local adult obese population.Methods:The study was conducted at Hayatabad Medical Complex, Peshawar, from March, 2017 to August, 2017. All patients aged between 18 and 60 years with BMI of more than 29kg/m2 were included in the study. Patients on lipid lowering drugs, with renal failure, hepatic failure and already diagnosed cases of thyroid dysfunction were excluded from the study. Thyroid functions were measured for all patients.Results:A total of 127 adults were included in the study in a consecutive manner. Mean age was 34.5 + 7.9 years of which 46.5% were male and 53.5% were female. Mean BMI was 32.05±2.06 kg/m2. The mean serum TSH was 3.13±1.10 mIU/L and mean serum thyroxine level was 1.08±0.25ng/dl. Subclinical hypothyroidism was recorded in 15% of the study population.Conclusion:Subclinical hypothyroidism is highly prevalent in our population with BMI of more than 29kg/m2. Further studies are recommended on relationship between thyroid functions and BMI and its effect on cardiovascular functions.
Objective:To determine the frequency of intraventricular dyssynchrony among patients with left bundle branch block.Methods:The study was conducted at Hayatabad Medical Complex, Peshawar, from January, 2017 to July, 2017. All patients aged 18 years and above with Left Bundle Branch Block (LBBB) on ECG with or without heart failure were included in the study. Patients with valvular heart disease, predominant diastolic heart failure, acute coronary syndromes or coronary revascularization in last three months and atrial fibrillation were excluded. Tissue Doppler Imaging (TDI) parameters were measured from 2-D images in apical 4-chamber and 2-chamber views. Consecutive non-probability sampling technique was used for sample collection.Results:Our study included 159 patients. Mean age was 52 years with SD ± 2.74. Ninety-nine (62%) patients were male and 60 (38%) patients were female. One hundred and three (65%) patients had heart failure while 56 (35%) patients didn’t have heart failure. More over in our study 124 (78%) patients had Intraventricular dyssynchrony while 35(22%) patients didn’t have Intraventricular dyssynchrony.Conclusion:The incidence of Intraventricular dyssynchrony is high among patients with heart failure and left bundle branch block.
Objective: To correlate CALL score and electro physiological abnormalities on EKG and see its effect on mortality and length of stay in patients having moderate to severe covid infection- being admitted in HDU and ICU of the Lady Reading Hospital Peshawar. Methodology: A cross sectional (Descriptive) study was done in HDU and ICU of Lady reading hospital- LRH Peshawar from March 2021 to June 2021.This single centre analysis was conducted after approval from hospital ethical and research committee. All patients meeting the inclusion criteria were included in the study. All patients were subjected to detailed history and examination. Careful scrutiny of past medical records and detailed history were taken under the supervision of a senior physician-who is the fellow of CPSP. Results: Out of 100 patients, 54% were male and 46% were females. The mean age was 60 years. 72% of the population of interest developed rhythm abnormalities. We compared our results for electro cardio graphic abnormalities and clinical outcome using chi-square test and our P value came out 0.00 which is statistically significant (p<0.005). The comparison of CALL score and clinical outcomes in the form of death also came out to be statistically significant, with p value of 0.00 (p<0.05). Conclusion: There is a positive correlation between CALL score and new onset electro cardio graphic abnormalities. They affect the length of stay and influence the clinical outcome.
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