Background The data on infective endocarditis after transcatheter aortic valve implantation (TAVI) is scarce and limited to case reports and case series in the literature. It is the need of the hour to analyze the available data on post-TAVI infective endocarditis from the available literature. The objectives of this systematic review were to evaluate the incidence of infective endocarditis after transcatheter aortic valve implantation, its microbiological profile and clinical outcomes. It will help us to improve the antibiotic prophylaxis strategies and treatment options for infective endocarditis in the context of TAVI. Methods EMBASE, Medline and the CENTRAL trials registry of the Cochrane Collaboration were searched for articles on infective endocarditis in post-TAVI patients till October 2018. Eleven articles were included in the systematic review. The outcomes assessed werethe incidence of infective endocarditis, its microbiological profile andclinical outcomes including major adverse cardiac event (MACE), net adverse clinical event (NACE), surgical intervention and valve-in-valve procedure. Results The incidence of infective endocarditis varied from 0%-14.3% in the included studies, the mean was3.25%. The average duration of follow-up was 474 days (1.3 years). Enterococci were the most common causative organism isolated from 25.9% of cases followed by Staphylococcus aureus (16.1%) and coagulase-negative Staphylococcus species (14.7%). The mean in-hospital mortality and mortality at follow-up was 29.5% and 29.9%, respectively. The cumulative incidence of heart failure, stroke and major bleeding were 37.1%, 5.3% and 11.3%,respectively. Only a single study by Martinez-Selles et al. reported arrhythmias in 20% cases. The septic shock occurred in 10% and 27.7% post-TAVI infective
Background: COVID-19 is an emerging infectious disease and has reached a status of global health emergency. It is widespread in Pakistan causing morbidity and mortality amongst masses. Objectives: Undertaken study aims at investigating knowledge, attitude and practices of the people residing in Lahore, Pakistan whilst the global crisis with sparse data available previously. Methodology: Following lockdown announcement, an immediate online cross sectional study was conducted from the 31st March to 6 April 2020. Data was analyzed by using SPSS IBM version 22. 00. Results: A total of 316 responses were received. Our study has shown that people 95.80% were well familiar with COVID-19, informed via news channels 46.2%. 91.7% believed the virus is contagious, 95.8% reported that the virus is spread by the respiratory droplets, 89.2% believed that all ages are at risk while 62.3% believed it risky for geriatrics only. 60.4% believed in its prevention with 91.7% respondents agreeably quarantined themselves while 6.6% didn’t. 99.7% participants were aware of social/physical distancing and 75.6% found it affecting mental health i.e. cause anxiety, depression etc. 59.2% of respondents were optimistic expecting it to end soon while 32.3% were uncertain. 49.1% said they have diagnostic facility and 89.6% acknowledged efforts of researchers/healthcare providers (doctors, pharmacist, nurses, allied health professionals and paramedical staff) for the society. 94.3% believed that there is need of awareness regarding COVID-19. Conclusion: An ever increasing need of awareness amongst the local population regarding COVID-19 is needed. It will lend hands in preventing spread of COVID-19 with minimal secondary transmission. It is recommended that extensive survey studies are required that can provide supportive data in developing and implementing public health policies regarding COVID-19 pandemic. It would further control and arrest the spread of COVID-19 in country. Bangladesh Journal of Medical Science Vol.19(0) 2020 p. S 69-S 76
BackgroundCoronary artery disease (CAD) is a major killer in today’s world. Pakistan is also affected by this non-communicable disease like other countries. It is a multifactorial disease and is influenced by many gene-gene and gene-environment interactions.MethodsA total of 623 (219 controls, 404 cases) Pakistani subjects were genotyped for four SNPs, rs662 (PON1), rs5918 (ITGB3), rs671 (ALDH2), rs1800795 (IL-6) by PCR-RFLP. Various anthropometric parameters were noted and serum lipid profile was measured using commercially available kits. Statistical analysis was done by SPSS version 22. A Genetic Risk Score (GRS) was calculated from individual SNPs. The association of the SNPs and the GRS with CAD was checked using logistic regression.ResultsThe results showed that the risk allele frequencies of all variants were higher in the cases than the controls, however the difference was not statistically significant association (p > 0.0125). The mean GRS in the controls was 3.99 ± 1.42 and in cases, it was 4.29 ± 1.39, the difference between the groups was significant (p = 0.0109). logistic regression of individual SNPs and GRS with the CAD showed that independent SNPs were not significantly associated with the CAD however, the GRS had a strong association (p = 1.4 × 10− 4). The subjects were divided into three groups based on GRS (Gp 1 with GRS 0–2, Gp 2 with GRS 3–5 and Gp 3 with GRS 6–8). The analysis of the effect of the individual SNPs and GRS groups on different lipid profile parameters revealed no significant association of any of the tested SNPs with any lipid parameter, however, the GRS groups showed marginally significant for TC and highly significant association for TG, LDL-c and HDL-c.ConclusionIn conclusion, use of a GRS can provide better information than individual SNPs. The larger the number of the SNPs included in the analysis, the better would be the risk prediction.
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