Objective: To determine the prevalence of brain and neck neoplasms among Interventional Cardiologists. Study Design: Analytical Cross-sectional study. Place and Duration of Study: Department of Cardiology/Interventional Cardiology of two Tertiary Cardiac Care Centers of Rawalpindi and Lahore Pakistan from Mar 2021 to Apr2022. Methodology: By using the non-probability, consecutive sampling technique, fifty Interventional Cardiologists’ (n=50) of both genders between 35-75 years of age, working in the cardiac catheterization labs for more than 10-years are enrolled after their informed consents. The data was collected from the interviews of Interventional cardiologists, from the shared medical records and also from the family members and colleagues. The Interventional cardiologists were enquired about any neurological signs and symptoms particularly in relation to the head and neck malignancy and also asked about undergoing any CT/MRI or PET scan of head and neck region in the past or recent time. Descriptive statistics for data was computed byusing the SPSS version-25. Results: The mean age of the Interventional Cardiologists of tertiary cardiac care center of Rawalpindi was 50.40±7.77years while of Lahore was 49.16±8.89 years. There were 47(94.0%) males and 03(6.0%) females, from both the Institutes. The mean duration of working in cardiac catheterization labs was 17.92±4.57 years. The head and neck neoplasm’s among Interventional Cardiologists was observed in 01(2%) case. Conclusion: The research study concluded that the prevalence of head and neck neoplasms among Interventional Cardiologists is very low (2%). But still it is the need of hour to be more careful about radiation exposure among the Interventional Cardiologists working for long hours in the cardiac catheterization labs, to lessen down the chances of head and neck malignancy.
Objective: To determine in hospital early complications in diabetics’ vs non diabetics with acute ST elevation myocardial infarction. Study Design: Comparative cross-sectional study. Place and Duration of Study: The study was conducted in emergency departments and adult cardiology wards of Armed Forces Institute of Cardiology/National Institute of Heart Diseases, from Aug to Nov 2019. Methodology: A comparative cross sectional study was conducted on 380 patients (190 patients with diabetes and 190 patients without diabetes) who presented with acute ST-Elevation MI in age group 30 to 70 years to emergency department of Armed Forces Institute of Cardiology/National Institute of Heart Disease during specified period. Patients with rescue PCI and new onset of LBBB were also included. Patients with age group lesser than 30 years or greater than 70 years with STEMI were excluded. Sampled with consecutive non probability technique in patients was assessed with ECG, cardiac enzymes, transthoracic echocardiography, renal Doppler and RFTs. All patients were admitted in wards and were followed up during hospital stay. Patients were evaluated and their record of Primary PCI and thrombolysis was also noted. Data was entered and analyzed with SPSS-23. Results: A total of 380 patients with STEMI were included in this study consisting of 292 (76.8%) male and 88 (23.1%) female from 30 to 70 years. The patients were divided in two groups i.e. diabetic and non-diabetic, 190 patients were included in each group. It was found that frequency of ST-Elevation MI was higher in diabetic group as compared to non-diabetic group. All the patients were analyzed for complications occurred after STElevation MI. LV failure, Brady arrhythmias, atrial fibrillation, post MI angina and cardiogenic shock were the main complications noted. It was found that all these complications are more in diabetic group post MI angina which occurred most frequently in non-diabetic group. Conclusion: In our study we observed that left ventricular failure and arrhythmias were the major complications. Mortality was higher in diabetic patients than non-diabetic patients. In both groups PPCI and SK reduced mortality. Post MI angina were found more frequent in non-diabetic group.
Objective: To study the frequency of In-Stent Restenosis and its treatment in patients undergoing Percutaneous Coronary Intervention for coronary artery disease. Study Design: Descriptive cross sectional study. Place and Duration of Study: Department of Cardiology, Armed Forces Institute of Cardiology & National Institute of Heart disease (AFIC/NIHD) Rawalpindi, from Jul 2017 to Jul 2019. Methodology: All the patients who underwent Percutaneous Coronary Intervention for Coronary Artery Disease at our institute were considered for this study. A consecutive sampling method was used and inclusion/exclusion criteria was applied. Following data was obtained; 1) Demographic information and clinical risk factors like history of hypertension, hyperlipidemia, diabetes mellitus, smoking, coronary artery disease characteristics(number of diseased arteries, bifurcation lesions, calcification, chronic total occlusions-CTO and tortuosity) 3), Stent factors (under expansion, fracture, longitudinal miss, stent gap). Data recording, storage, assessment and analysis was done by using SPSS software version 21. Results: Among 1332 cases, 50 had In-Stent Restenosis with overall prevalence of 3.75%. Mean age of the patients with In-Stent Restenosis was 58.76 (± 9.97), with 45 (90%) male and 5 (10%) female. Diabetes Mellitus was the commonest risk factor (22.9%) followed by Hypertension (18%). Sixty four percent of the patients (n=32) had Single Vessel Coronary Artery Disease, 14 (28%) had Double Vessel Coronary Artery Disease and 4 (8%) had Tripple Vessel Coronary Artery Disease. Left Anterior Descending was the commonest coronary artery that developed In-Stent Restenosis, followed by Right Coronary Artery and Left Circumflex respectively. Previously deployed stents which developed In-Stent Restenosis showed longitudinal geographical miss in 16%, stent under expansion in 6% and stent gap in 4%. There was statistically significant association (p-value=0.02) between stent length and frequency of In-Stent Restenosis and it was commonest in stents longer than 30 mm. Eighty six percent(n=43) of In-Stent Restenosis cases in our study group was treated with Drug Eluting Stent followed by Drug Eluting Balloon in 32% and Plain Old Balloon Angioplasty in 22%. Conclusion: History of diabetes mellitus and greater stent length were major risk factors in developing In-Stent Restenosis in our study. DES was the commonest treatment modality used.Keywords: , , .
Objective: To determine the frequency of cardiac arrhythmias in hypertensive patients. Study Design: Analytical Cross -sectional study. Place & Duration of Study: Tertiary Cardiac Center, Lahore Pakistan from Jan 2021 to Dec2021. Methodology: Two hundred patients (males and females), age between 20-80 years, suffering from hypertensive disease (Blood Pressure ≥ 140/90mmHg), one year before were assessed in the study. After that ECG was done according to International standards. Then patients undergone 24 hour Holter monitoring test. Presence of cardiac arrhythmia was confirmed by the interpretation of 12 lead ECG and 24 hour Holter report. All the data was noted. Patients with cardiac arrhythmias were treated in consultation from the Electrophysiology (EP) department of the hospital. By using the SPSS version 26, the statistical data was tabulated, analyzed and interpreted. Results: The mean age was calculated to be 58.64±7.74 years. In this study the males were 148(74%) while 52(26%) were females. The mean duration of hypertension was found to be 5.09±1.56 years. Cardiac arrhythmias were noted in 22(11%) cases. Out of 22 cases of cardiac arrhythmias, 02(1%) patients had premature atrial contractions, 02(1%) had atrial flutter, 04(2%) had premature ventricular contractions and 14(7%) had atrial fibrillation. Cardiac arrhythmias were significantly higher in patients above 40 years of age (p<0.05). There was no difference in both genders as well as duration of hypertension has unremarkable effect on cardiac arrhythmias (p>0.05). Conclusion: The research study concluded that in hypertensive patients, the cardiac arrhythmias frequency is low but its value is not unremarkable.
Objectives: To determine the role of CHADS-VASc Score in predicting No Reflow phenomenon in STEMI patients undergoing primary PCI. Study Design: Analytical cross-sectional study. Place and Duration of Study: This study was carried out at a Tertiary Cardiac Care Center from Feb to May 2022. Methodology: A total of (n = 320) patients who underwent PPCI at Armed Forces Institute of Cardiology from 4th February to 3rd May 2022 were enrolled in this study. Patients were divided into 2 groups, Comparision group with no NRP and NRP group. Descriptive statistics was run to present the categorical data in frequencies and percentages and continuous data in Mean±SD. Chi square test was applied to compare both groups regarding categorical and continuous variables. CHADS-VASc score was also compared in both groups. Results: Out of (n=320) patients, 80(25%) patients developed NRP. Age, Diabetes, LV EF, history of stroke or TIA, peripheral arterial disease, TIMI thrombus grade, total stented length and CHADS-VASc score were found to be significantly associated with NRP. Binary logistic regression analysis revealed diabetes, LV EF, TIMI thrombus grade, total stented length and CHADSVaSc score to be independent predictors of NRP.ROC analysis revealed a cutoff CHADS-VaSc score of 3 to be a good predictor of NRP (sensitivity 65% and specificity 82%). Conclusion: CHADS-VASc score can be an important pre PCI tool to predict NRP during primary PCI.
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