Pub Date : 2023-12-21DOI: 10.51253/pafmj.v73isuppl-3.10968
Imtiaz Ahmed Chaudhry, Nasir Ali, Sidra Afzal, Imran Bashir
Objective: To compare early post-operative outcomes of Single versus Multiple Arterial grafts in Coronary Artery Bypass Grafting (CABG) surgery. Study Design: Analytical Cross-sectional study. Place and Duration of Study: Adult Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases Rawalpindi Pakistan, from Jul 2022 to May 2023. Methodology: One hundred and forty nine patients planned for elective isolated CABG (with two or more grafts) were enrolled in study using consecutive sampling. They were allocated into two groups, group A (Multiple Arterial CABG group) and group B (Conventional CABG group). Data was collected on early post-op outcomes i.e. ICU stay, ventilation time, inotropic duration, chest drainage, rhythm complications including Supraventricular Tachycardia (SVT) and mortality using a structured proforma. Chi-square and t-test were applied to make comparison between both groups. p<0.05 was considered statistically significant. Results: Out of one hundred and forty nine patients, who underwent elective CABG, majority were males 124(83.2%). Mean age of the patients was 59.18±9.28 years. Seventy four (49.7%) patients underwent Multiple Arterial CABG while 75(50.3%) had conventional CABG. Mean ICU stay duration was 56.74±48.30 hours in group A while it was 67.25±73.42 hours in group B; p=0.30. Mean Chest Drainage was 622.05±505.69 ml in group A while it was 846.13±799.67 ml in group B; p=0.04. Mean ventilation time was 10.28 ± 19.88 hours.................. Conclusion: The use of the Radial Artery (RA) in CABG surgery was associated with better early ...............
{"title":"Early Post-operative Outcomes of Single versus Multiple Arterial Grafts in Coronary Artery Bypass Grafting; A Comparative Analysis","authors":"Imtiaz Ahmed Chaudhry, Nasir Ali, Sidra Afzal, Imran Bashir","doi":"10.51253/pafmj.v73isuppl-3.10968","DOIUrl":"https://doi.org/10.51253/pafmj.v73isuppl-3.10968","url":null,"abstract":"Objective: To compare early post-operative outcomes of Single versus Multiple Arterial grafts in Coronary Artery Bypass Grafting (CABG) surgery.\u0000Study Design: Analytical Cross-sectional study.\u0000Place and Duration of Study: Adult Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases Rawalpindi Pakistan, from Jul 2022 to May 2023.\u0000Methodology: One hundred and forty nine patients planned for elective isolated CABG (with two or more grafts) were enrolled in study using consecutive sampling. They were allocated into two groups, group A (Multiple Arterial CABG group) and group B (Conventional CABG group). Data was collected on early post-op outcomes i.e. ICU stay, ventilation time, inotropic duration, chest drainage, rhythm complications including Supraventricular Tachycardia (SVT) and mortality using a structured proforma. Chi-square and t-test were applied to make comparison between both groups. p<0.05 was considered statistically significant.\u0000Results: Out of one hundred and forty nine patients, who underwent elective CABG, majority were males 124(83.2%). Mean age of the patients was 59.18±9.28 years. Seventy four (49.7%) patients underwent Multiple Arterial CABG while 75(50.3%) had conventional CABG. Mean ICU stay duration was 56.74±48.30 hours in group A while it was 67.25±73.42 hours in group B; p=0.30. Mean Chest Drainage was 622.05±505.69 ml in group A while it was 846.13±799.67 ml in group B; p=0.04. Mean ventilation time was 10.28 ± 19.88 hours..................\u0000Conclusion: The use of the Radial Artery (RA) in CABG surgery was associated with better early ...............","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"58 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138950960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.51253/pafmj.v73isuppl-3.10500
Waheed Ashraf, S. Kiani, Muhammad Nadir Khan, Asif Nadeem, Bakht Umar, Ayesha Sana, Javeria Kamran, Muhammad Yaseen
Objective: To find out the association of total ischemic time with no-reflow phenomenon, in terms of Thrombolysis in Myocardial Infarction (TIMI) flow grade, in patients presenting with ST-Elevation Myocardial Infarction and undergoing Primary Percutaneous Coronary Intervention(PPCI). Study Design: Analytical Cross-Sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases Rawalpindi Pakistan, from Nov, 2022 to Jan, 2023. Methodology: This analytical cross-sectional study was conducted on n=184 patients, recruited through consecutive sampling technique to collect data prospectively. Patients were divided into no-reflow and normal flow group. Patients’ total ischemic time was documented and pre & post-procedural TIMI flow was noted. SPSS version-24:00 was used to enter and analyze data. Chi-square, Fisher exact test and t-test were applied and p-value≤0.05 was taken as statistically significant. Results: Out of 184 study participants, 17(9.2%) were females as compared to 167(90.8%) males. The mean age was 60.23±10.28 years. No-reflow phenomenon was observed in 20(10.9%) patients. The mean age was higher in the no-reflow group than that of the normal flow group (62.65±11.61 vs 59.94±10.12 years). Total ischemic time, pre & post-procedural TIMI flow were found to be significantly associated with no-reflow phenomenon (p<0.05). Conclusion: There exists a strong association between total ischemic time and the occurrence of no-reflow phenomenon. Patients with delayed reperfusion present with greater frequency of no-reflow and low TIMI grade and vice versa.
目的以心肌梗死溶栓治疗（TIMI）血流分级为标准，研究接受经皮冠状动脉介入治疗（PPCI）的 ST 段抬高型心肌梗死患者的总缺血时间与无回流现象的关系。研究设计：分析性横断面研究：巴基斯坦拉瓦尔品第武装部队心脏病研究所/国家心脏病研究所，2022 年 11 月至 2023 年 1 月。研究方法这项分析性横断面研究通过连续抽样技术对 184 名患者进行了前瞻性数据收集。患者分为无回流组和正常血流组。记录患者的总缺血时间，并记录手术前后的 TIMI 血流情况。使用 SPSS 24:00 版输入和分析数据。采用卡方检验、费雪精确检验和 t 检验，以 p 值小于 0.05 为差异有统计学意义。结果在 184 名研究参与者中，女性为 17 人（9.2%），男性为 167 人（90.8%）。平均年龄为（60.23±10.28）岁。20名（10.9%）患者出现无回流现象。无复流组的平均年龄高于正常血流组（62.65±11.61 岁 vs 59.94±10.12岁）。总缺血时间、术前和术后 TIMI 血流与无回流现象显著相关（P<0.05）。结论：总缺血时间与无回流现象的发生存在密切联系。再灌注延迟的患者出现无复流的频率更高，TIMI 分级更低，反之亦然。
{"title":"Association of Total Ischemia Time with No-Reflow Phenomenon in Patients Presenting with ST Elevation Myocardial Infarction, Undergoing Primary Percutaneous Coronary Interven","authors":"Waheed Ashraf, S. Kiani, Muhammad Nadir Khan, Asif Nadeem, Bakht Umar, Ayesha Sana, Javeria Kamran, Muhammad Yaseen","doi":"10.51253/pafmj.v73isuppl-3.10500","DOIUrl":"https://doi.org/10.51253/pafmj.v73isuppl-3.10500","url":null,"abstract":"Objective: To find out the association of total ischemic time with no-reflow phenomenon, in terms of Thrombolysis in Myocardial Infarction (TIMI) flow grade, in patients presenting with ST-Elevation Myocardial Infarction and undergoing Primary Percutaneous Coronary Intervention(PPCI). \u0000Study Design: Analytical Cross-Sectional study.\u0000Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases Rawalpindi Pakistan, from Nov, 2022 to Jan, 2023. \u0000Methodology: This analytical cross-sectional study was conducted on n=184 patients, recruited through consecutive sampling technique to collect data prospectively. Patients were divided into no-reflow and normal flow group. Patients’ total ischemic time was documented and pre & post-procedural TIMI flow was noted. SPSS version-24:00 was used to enter and analyze data. Chi-square, Fisher exact test and t-test were applied and p-value≤0.05 was taken as statistically significant. \u0000Results: Out of 184 study participants, 17(9.2%) were females as compared to 167(90.8%) males. The mean age was 60.23±10.28 years. No-reflow phenomenon was observed in 20(10.9%) patients. The mean age was higher in the no-reflow group than that of the normal flow group (62.65±11.61 vs 59.94±10.12 years). Total ischemic time, pre & post-procedural TIMI flow were found to be significantly associated with no-reflow phenomenon (p<0.05). \u0000Conclusion: There exists a strong association between total ischemic time and the occurrence of no-reflow phenomenon. Patients with delayed reperfusion present with greater frequency of no-reflow and low TIMI grade and vice versa.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"18 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138955183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19DOI: 10.51253/pafmj.v73isuppl-3.10647
Zohair Aziz, S. Shahzad, Fahd Ur Rehman, Ismail Ahmed Khan, Asma Zafar Khawaja, H. M. Shafique, Sehrish Mumtaz, Abdul Hameed Siddiqui
Objective: To assess CHADVASC score in predicting in-hospital mortality in patients presenting to the hospital with ST segment Elevation Myocardial Infarction undergoing primary PCI. Study Design: Analytical Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi,Pakistan, from Mar 2023 to Apr 2023. Methodology: A total of 198 patients were enrolled. Their CHADVASC scores were recorded and were divided into Group-A (score of 0-1), B (score 2-3) and C (score 4 and above). Sampling was done by using non-probability consecutive sampling. A brief clinical history including duration of symptoms, comorbid, duration of hospital stay and survivability status were recorded. Chi-square and Independent sample t-test were applied to find the association between In-hospital mortality and CHADVASC score, duration of hospital stay as well as comorbids. p-value <0.05 was taken as significant Results: Among study participants, majority were males 133(67.2%). Mean age of patients was 60.86±9.02 years. In-hospital mortality was noted in 13(6.56%) patients. There was a significant association between CHADVASC score and mortality (p<0.001). It was also noted that mortality increased with prolonged duration of stay in hospital (p=0.03). Another observation noted was that males presented at an earlier age (59.45±9.79 years) than females (63.63±6.54 years).Conclusion: CHADVASC score like the TIMI score and GRACE score can be used to stratify risk in patients presenting with Acute Coronary Syndrome (ACS). It is a fairly easy to use test at bed side and can help clinicians decide further treatment strategies and how .............
研究目的评估CHADVASC评分在预测接受初级PCI治疗的ST段抬高型心肌梗死患者院内死亡率方面的作用：分析性横断面研究：研究地点和时间：巴基斯坦拉瓦尔品第武装部队心脏病研究所/国家心脏病研究所，2023年3月至2023年4月：方法：共招募了 198 名患者。记录他们的 CHADVASC 评分，并将其分为 A 组（0-1 分）、B 组（2-3 分）和 C 组（4 分及以上）。抽样采用非概率连续抽样法。简短的临床病史包括症状持续时间、合并症、住院时间和存活状况。采用卡方检验（Chi-square）和独立样本 t 检验（Independent sample t-test）找出院内死亡率与 CHADVASC 评分、住院时间和合并症之间的关系：研究参与者中，男性占多数，共 133 人（67.2%）。患者平均年龄为（60.86±9.02）岁。13例（6.56%）患者出现院内死亡。CHADVASC 评分与死亡率之间存在明显关联（P<0.001）。研究还发现，住院时间越长，死亡率越高（p=0.03）。另一项观察结果表明，男性的发病年龄（59.45±9.79 岁）比女性（63.63±6.54 岁）要早：结论：CHADVASC 评分与 TIMI 评分和 GRACE 评分一样，可用于对急性冠状动脉综合征（ACS）患者进行风险分层。它是一种相当易于在床边使用的测试，可以帮助临床医生决定进一步的治疗策略以及如何 .............。
{"title":"Association of CHADVASC Score in Predicting In-Hospital Mortality in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI","authors":"Zohair Aziz, S. Shahzad, Fahd Ur Rehman, Ismail Ahmed Khan, Asma Zafar Khawaja, H. M. Shafique, Sehrish Mumtaz, Abdul Hameed Siddiqui","doi":"10.51253/pafmj.v73isuppl-3.10647","DOIUrl":"https://doi.org/10.51253/pafmj.v73isuppl-3.10647","url":null,"abstract":"Objective: To assess CHADVASC score in predicting in-hospital mortality in patients presenting to the hospital with ST segment Elevation Myocardial Infarction undergoing primary PCI.\u0000Study Design: Analytical Cross-sectional study.\u0000Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi,Pakistan, from Mar 2023 to Apr 2023.\u0000Methodology: A total of 198 patients were enrolled. Their CHADVASC scores were recorded and were divided into Group-A (score of 0-1), B (score 2-3) and C (score 4 and above). Sampling was done by using non-probability consecutive sampling. A brief clinical history including duration of symptoms, comorbid, duration of hospital stay and survivability status were recorded. Chi-square and Independent sample t-test were applied to find the association between In-hospital mortality and CHADVASC score, duration of hospital stay as well as comorbids. p-value <0.05 was taken as significant \u0000Results: Among study participants, majority were males 133(67.2%). Mean age of patients was 60.86±9.02 years. In-hospital mortality was noted in 13(6.56%) patients. There was a significant association between CHADVASC score and mortality (p<0.001). It was also noted that mortality increased with prolonged duration of stay in hospital (p=0.03). Another observation noted was that males presented at an earlier age (59.45±9.79 years) than females (63.63±6.54 years).Conclusion: CHADVASC score like the TIMI score and GRACE score can be used to stratify risk in patients presenting with Acute Coronary Syndrome (ACS). It is a fairly easy to use test at bed side and can help clinicians decide further treatment strategies and how .............","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 705","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138960323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19DOI: 10.51253/pafmj.v73isuppl-3.10664
Asma Zafar Khawaja, S. Shahzad, Muhammad Khalil, Zohair Aziz, Mazhar Ahmed, S. Kiani, Javeria Kamran, N. Samore
Objective: To compare the GRACE score and SYNTAX score in predicting Coronary Artery Disease (CAD) severity and the variation of GRACE score with respect to SYNTAX score to assess severity of CAD. Study Design: Analytical, Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Jan 2023 to Jun 2023. Methodology: Data was gathered from n=139 participants by using consecutive sampling technique on a data collection tool.Study variables such as demographics, comorbids, clinical characteristics and SYNTAX and GRACE score were noted to asses their role in determining CAD severity. An experienced cardiologist was assigned to analyze the coronary angiogram findings, performed by using conventional techniques through radial artery, ulnar or femoral artery access. SPSS version-24.00 was used for data management and analysis. Chi square test and Pearson correlation was applied to find the association and correlation respectively. Results: Mean age of study participants was 62.09±9.74 years and males were more in number 114(82.0%). Ninety three (66.9%) patients had NSTEMI. Gender (p=0.011,0.007), was significantly associated with SYNTAX score as well as GRACE score respectively and diabetic status (p=0.003) with GRACE score. There was a strong and positive correlation between GRACE score and SYNTAX score (r=0.64; p<0.001). Both scores showed significant association with CAD severity (p<0.05). Conclusion: There exists a statistically significant and positive correlation between GRACE score and SYNTAX score in non-ACS (NSTEMI and UA) patients who had confirmed diagnosis of CAD on coroangiogram. The greater the GRACE score, the greater was........
{"title":"Comparison of GRACE Score and SYNTAX Score in Predicting Complexity of Coronary Artery Disease in Patients with NST-ACS","authors":"Asma Zafar Khawaja, S. Shahzad, Muhammad Khalil, Zohair Aziz, Mazhar Ahmed, S. Kiani, Javeria Kamran, N. Samore","doi":"10.51253/pafmj.v73isuppl-3.10664","DOIUrl":"https://doi.org/10.51253/pafmj.v73isuppl-3.10664","url":null,"abstract":"Objective: To compare the GRACE score and SYNTAX score in predicting Coronary Artery Disease (CAD) severity and the variation of GRACE score with respect to SYNTAX score to assess severity of CAD.\u0000Study Design: Analytical, Cross-sectional study.\u0000Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Jan 2023 to Jun 2023.\u0000Methodology: Data was gathered from n=139 participants by using consecutive sampling technique on a data collection tool.Study variables such as demographics, comorbids, clinical characteristics and SYNTAX and GRACE score were noted to asses their role in determining CAD severity. An experienced cardiologist was assigned to analyze the coronary angiogram findings, performed by using conventional techniques through radial artery, ulnar or femoral artery access. SPSS version-24.00 was used for data management and analysis. Chi square test and Pearson correlation was applied to find the association and correlation respectively.\u0000Results: Mean age of study participants was 62.09±9.74 years and males were more in number 114(82.0%). Ninety three (66.9%) patients had NSTEMI. Gender (p=0.011,0.007), was significantly associated with SYNTAX score as well as GRACE score respectively and diabetic status (p=0.003) with GRACE score. There was a strong and positive correlation between GRACE score and SYNTAX score (r=0.64; p<0.001). Both scores showed significant association with CAD severity (p<0.05). \u0000Conclusion: There exists a statistically significant and positive correlation between GRACE score and SYNTAX score in non-ACS (NSTEMI and UA) patients who had confirmed diagnosis of CAD on coroangiogram. The greater the GRACE score, the greater was........","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138962443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19DOI: 10.51253/pafmj.v73isuppl-3.10497
Ismail Ahmed, S. Shahzad, Fahd Ur-Rehman, A. Chaudhry, Zohair Aziz, Ali Farahe, Sheharbano Ahmed Khan, Javeria Kamran
Objective: To study the association of Red Cell Distribution Width (RDW) with thrombus burden in patients of ST Elevation Myocardial Infarction (STEMI) undergoing Primary Percutaneous Coronary Intervention (PPCI). Study Design: Analytical Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases Rawalpindi, Pakistan, from Aug 2022 to Dec 2022. Methodology: Using non-probability consecutive sampling, three hundred and sixty-nine (n=369) patients were included in the study. RDW values were obtained from complete blood count sent at presentation in emergency department. Thrombolysis in Myocardial Infarction (TIMI) thrombus grading was used to determine the angiographic thrombus burden. For quantitative variables, means and standard deviations were calculated, while frequencies and percentages were calculated for qualitative variables. Receiver Operating Characteristic (ROC) curve for RDW values for predicting thrombus burden was plotted. Correlation between RDW with thrombus burden was established. Eta, Chi-square and independent samples t-test was used to determine p-value. Results: The study included 369 STEMI patients, out of which 287(77.8%) were males and 82(22.2%) were females. 203(55.0%)patients had high thrombus burden while 166(45.0%) patients had low thrombus burden. Patients in the high RDW groupmore frequently had ventricular arrhythmias, and heart blocks. Mean RDW was 13.57±0.71 in low thrombus burden groupwhile it was 14.67±1.21 in high thrombus burden group. Area under the curve derived from ROC curve for RDW forpredicting high thrombus burden was 0.79(CI=0.74-0.83, p<0.001) Conclusion: The study demonstrates that high RDW is a sensitive and specific predictor of high angiographic thrombus bur..........
{"title":"Association of Red Cell Distribution Width with Thrombus Burden in Patients of ST Elevation Myocardial Infarction Undergoing Primary PCI","authors":"Ismail Ahmed, S. Shahzad, Fahd Ur-Rehman, A. Chaudhry, Zohair Aziz, Ali Farahe, Sheharbano Ahmed Khan, Javeria Kamran","doi":"10.51253/pafmj.v73isuppl-3.10497","DOIUrl":"https://doi.org/10.51253/pafmj.v73isuppl-3.10497","url":null,"abstract":"Objective: To study the association of Red Cell Distribution Width (RDW) with thrombus burden in patients of ST Elevation Myocardial Infarction (STEMI) undergoing Primary Percutaneous Coronary Intervention (PPCI).\u0000Study Design: Analytical Cross-sectional study.\u0000Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases Rawalpindi, Pakistan, from Aug 2022 to Dec 2022.\u0000Methodology: Using non-probability consecutive sampling, three hundred and sixty-nine (n=369) patients were included in the study. RDW values were obtained from complete blood count sent at presentation in emergency department. Thrombolysis in Myocardial Infarction (TIMI) thrombus grading was used to determine the angiographic thrombus burden. For quantitative variables, means and standard deviations were calculated, while frequencies and percentages were calculated for qualitative variables. Receiver Operating Characteristic (ROC) curve for RDW values for predicting thrombus burden was plotted. Correlation between RDW with thrombus burden was established. Eta, Chi-square and independent samples t-test was used to determine p-value.\u0000Results: The study included 369 STEMI patients, out of which 287(77.8%) were males and 82(22.2%) were females. 203(55.0%)patients had high thrombus burden while 166(45.0%) patients had low thrombus burden. Patients in the high RDW groupmore frequently had ventricular arrhythmias, and heart blocks. Mean RDW was 13.57±0.71 in low thrombus burden groupwhile it was 14.67±1.21 in high thrombus burden group. Area under the curve derived from ROC curve for RDW forpredicting high thrombus burden was 0.79(CI=0.74-0.83, p<0.001)\u0000Conclusion: The study demonstrates that high RDW is a sensitive and specific predictor of high angiographic thrombus bur..........","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138963097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.51253/pafmj.v73i5.8979
Awais Ali Khan, None Habib Ullah Khan, None Khurshid Ali Bangash, None Shahzad Ahmed Qasmi, None Syed Adeel Ahmed, None Asif Hashmat, None Babar Shamim
Objective: To study the efficacy of per-operative angiogram and Doppler ultrasound as an adjunct to assess the cerebral vessels during intracranial aneurysm clipping surgery. Study Design: Cross-sectional study Place and Duration of Study: Department of Neurosurgery, Combined Military Hospital, Rawalpindi Pakistan, from Jan 2020 to Dec 2021. Methodology: Forty-eight diagnosed cases of subarachnoid haemorrhage secondary to ruptured aneurysm were included. All the patients who were not coiled-able (broad-based, multi-lobed, complex) were operated on (craniotomy and clipping of aneurysm). Intraoperative angiogram and Doppler ultrasound of cerebral vasculature were done in all cases to see the patency of vessels and the position of clips. Results: Mean age of the patients was 43.97±8.23 years. 24(50.00%) patients had anterior communicating artery aneurysms, 18(37.50%) had middle cerebral artery aneurysms, whereas 6(12.50%) were of an anterior cerebral artery. Craniotomy and clipping of aneurysm were done in all the cases; among them, 15(31.25%) were operated on early (between 48-96 hrs), whereas 33(68.75%) were operated on after 10-14 days. Per-operatively, cerebral angiogram and Doppler ultrasound were used to assess the cerebral vasculature and position of the clip. About of 5(10.00%) required clip readjustment, 4(8.33%) had parent vessel occlusion, 10(20.83%) required vasodilator therapy due to vasospasm, and 4(8.33%) had residual aneurysm neck. All these were rectified during the same procedure. Conclusion: Per-operative angiography and Doppler ultrasound are useful adjuncts in aneurysmal brain surgery to prevent complications like cerebral ischemia, recurrence, residual aneurysm and re-bleed.
{"title":"Use of Per-Operative Angiogram and Doppler Ultrasound as an Adjunct to Assess the Cerebral Vessels Following Aneurysmal Brain Surgery","authors":"Awais Ali Khan, None Habib Ullah Khan, None Khurshid Ali Bangash, None Shahzad Ahmed Qasmi, None Syed Adeel Ahmed, None Asif Hashmat, None Babar Shamim","doi":"10.51253/pafmj.v73i5.8979","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.8979","url":null,"abstract":"Objective: To study the efficacy of per-operative angiogram and Doppler ultrasound as an adjunct to assess the cerebral vessels during intracranial aneurysm clipping surgery. Study Design: Cross-sectional study Place and Duration of Study: Department of Neurosurgery, Combined Military Hospital, Rawalpindi Pakistan, from Jan 2020 to Dec 2021. Methodology: Forty-eight diagnosed cases of subarachnoid haemorrhage secondary to ruptured aneurysm were included. All the patients who were not coiled-able (broad-based, multi-lobed, complex) were operated on (craniotomy and clipping of aneurysm). Intraoperative angiogram and Doppler ultrasound of cerebral vasculature were done in all cases to see the patency of vessels and the position of clips. Results: Mean age of the patients was 43.97±8.23 years. 24(50.00%) patients had anterior communicating artery aneurysms, 18(37.50%) had middle cerebral artery aneurysms, whereas 6(12.50%) were of an anterior cerebral artery. Craniotomy and clipping of aneurysm were done in all the cases; among them, 15(31.25%) were operated on early (between 48-96 hrs), whereas 33(68.75%) were operated on after 10-14 days. Per-operatively, cerebral angiogram and Doppler ultrasound were used to assess the cerebral vasculature and position of the clip. About of 5(10.00%) required clip readjustment, 4(8.33%) had parent vessel occlusion, 10(20.83%) required vasodilator therapy due to vasospasm, and 4(8.33%) had residual aneurysm neck. All these were rectified during the same procedure. Conclusion: Per-operative angiography and Doppler ultrasound are useful adjuncts in aneurysmal brain surgery to prevent complications like cerebral ischemia, recurrence, residual aneurysm and re-bleed.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.51253/pafmj.v73i5.6426
None Farukh Mir Muhammad, None Farhan Akhtar, None Nighat Jamal, None Rabia Ahmed, None Muhammad Asif, None Fatima Wagan
Objectives: To identify the role of immunohistochemistry in correctly identifying metastasis of bone disorders. Study Design: Cross-sectional study Place and Duration of Study: Department of Histopathology Pakistan Naval Ship, Shifa Hospital, Karachi Pakistan, from Jun 2019 to Jun 2020. Methodology: Patients aged 18-75 years, of either gender, already diagnosed case of the primary tumour, and now diagnosed with bone metastasis on biopsy were included. Various imaging techniques were used to locate the site of metastases. The histopathological reports of all the intra-operative specimens of bone metastases were reviewed. Results: The mean age of 60 patients was 59.5±28.8 years and mean weight was 67.4±13.5 kg. The period of presentation from diagnosis of the primary tumour was 34±15.4 months, and the period from onset of symptoms was 8.2±5.8 months. The most common site of the primary tumour was the breast in 18(30%) of patients, followed by the kidney in 14(23.3%) of patients. The most common site of metastasis was the femur in 30(50 %) of patients, followed by the spine in 15 patients. Conclusion: The most common site of primary tumour identified by immunohistochemistry was the breast, followed by the lungs. The femur was the most common site of metastasis, followed by the spine.
{"title":"Role of Immunohistochemistry in Metastatic Bone Diseases","authors":"None Farukh Mir Muhammad, None Farhan Akhtar, None Nighat Jamal, None Rabia Ahmed, None Muhammad Asif, None Fatima Wagan","doi":"10.51253/pafmj.v73i5.6426","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.6426","url":null,"abstract":"Objectives: To identify the role of immunohistochemistry in correctly identifying metastasis of bone disorders. Study Design: Cross-sectional study Place and Duration of Study: Department of Histopathology Pakistan Naval Ship, Shifa Hospital, Karachi Pakistan, from Jun 2019 to Jun 2020. Methodology: Patients aged 18-75 years, of either gender, already diagnosed case of the primary tumour, and now diagnosed with bone metastasis on biopsy were included. Various imaging techniques were used to locate the site of metastases. The histopathological reports of all the intra-operative specimens of bone metastases were reviewed. Results: The mean age of 60 patients was 59.5±28.8 years and mean weight was 67.4±13.5 kg. The period of presentation from diagnosis of the primary tumour was 34±15.4 months, and the period from onset of symptoms was 8.2±5.8 months. The most common site of the primary tumour was the breast in 18(30%) of patients, followed by the kidney in 14(23.3%) of patients. The most common site of metastasis was the femur in 30(50 %) of patients, followed by the spine in 15 patients. Conclusion: The most common site of primary tumour identified by immunohistochemistry was the breast, followed by the lungs. The femur was the most common site of metastasis, followed by the spine.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"260 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136068963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To evaluate the frequency of Cytomegalovirus in Post Hematopoietic Stem Cell Transplant Recipients by molecular method. Study Design: Cross-sectional study. Place and Duration of Study: Virology Department, Armed Forces Institute of Pathology, Rawalpindi Pakistan Jan to Dec2021. Methodology: One hundred and twenty-six hematopoietic stem cell transplant (HSCT) recipients were included in this study and were separated into various age groups. All included patients were CMV IgG positive. Real-time polymerase chain reaction (PCR) was performed on post-HSCT recipients to detect CMV. Results: Out of 126 post-HSCT recipients, CMV was detected in 80(63%) patients and was not found in 46(36%) patients. Among positive patients, 60(75%) were males, and 20(15%) were female. Maximum cases of CMV detection in post-HSCT were found in 23 patients aged 1-10 years. Conclusion: A high frequency of CMV in post-HSCT recipients was observed in this study. CMV cause major complications in immunocompromised patients, such as in transplant recipients. Prevention of CMV infection is a main part of post-transplant monitoring and management.
{"title":"Detection of Cytomegalovirus in Post Hematopoietic Stem Cells Transplant Recipients by Real-Time PCR","authors":"Saifullah Khan Niazi, Nadia Gulzar, Eijaz Ghani, Faraz Ahmed, Noman Shakoor, Hina Hammad","doi":"10.51253/pafmj.v73i5.8812","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.8812","url":null,"abstract":"Objective: To evaluate the frequency of Cytomegalovirus in Post Hematopoietic Stem Cell Transplant Recipients by molecular method. Study Design: Cross-sectional study. Place and Duration of Study: Virology Department, Armed Forces Institute of Pathology, Rawalpindi Pakistan Jan to Dec2021. Methodology: One hundred and twenty-six hematopoietic stem cell transplant (HSCT) recipients were included in this study and were separated into various age groups. All included patients were CMV IgG positive. Real-time polymerase chain reaction (PCR) was performed on post-HSCT recipients to detect CMV. Results: Out of 126 post-HSCT recipients, CMV was detected in 80(63%) patients and was not found in 46(36%) patients. Among positive patients, 60(75%) were males, and 20(15%) were female. Maximum cases of CMV detection in post-HSCT were found in 23 patients aged 1-10 years. Conclusion: A high frequency of CMV in post-HSCT recipients was observed in this study. CMV cause major complications in immunocompromised patients, such as in transplant recipients. Prevention of CMV infection is a main part of post-transplant monitoring and management.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"62 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.51253/pafmj.v73i5.9418
Rabeeta Sheikh, None Irfan Haider, Muhammad Sohaib Nadeem, None Jawad Latif, None Kiran Inam, None Muhammad Fawad UL Qamar
Neuroendocrine breast carcinoma (NEBC) is histologically a rare type of invasive breast cancer. It constitutes only 0.2–0.5% of all invasive breast cancers. In this case series, we are presenting five cases having primary neuroendocrine breast cancers that had been reported at a high-volume cancer centre in Pakistan. In this study, neuroendocrine breast cancer patients at Shaukat Khanum Memorial Cancer Hospital and Research Centre Peshawar were evaluated. We had retrospectively collected information on demographic characteristics of our patients, physical examination, radiological findings, surgical procedures with their outcomes, histopathological and immuno-histochemical characteristics, systemic adjuvant/neoadjuvant therapy and follow-up.
{"title":"Neuroendocrine Breast Carcinoma: a Case Series","authors":"Rabeeta Sheikh, None Irfan Haider, Muhammad Sohaib Nadeem, None Jawad Latif, None Kiran Inam, None Muhammad Fawad UL Qamar","doi":"10.51253/pafmj.v73i5.9418","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.9418","url":null,"abstract":"Neuroendocrine breast carcinoma (NEBC) is histologically a rare type of invasive breast cancer. It constitutes only 0.2–0.5% of all invasive breast cancers. In this case series, we are presenting five cases having primary neuroendocrine breast cancers that had been reported at a high-volume cancer centre in Pakistan. In this study, neuroendocrine breast cancer patients at Shaukat Khanum Memorial Cancer Hospital and Research Centre Peshawar were evaluated. We had retrospectively collected information on demographic characteristics of our patients, physical examination, radiological findings, surgical procedures with their outcomes, histopathological and immuno-histochemical characteristics, systemic adjuvant/neoadjuvant therapy and follow-up.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136106535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To compare the efficacy of Manual Vacuum Aspiration (MVA) with Dilatation and Curettage (DNC) in miscarriages of the first trimester. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Obstetrics and Gynaecology CMH, Peshawar Pakistan, from Feb to Aug 2018. Methodology: A total number of 182 Adult female (20-35 years of age) patients having miscarriage during the first trimester who were either primigravida or with previous history of spontaneous vaginal delivery were included in this study. Patients were assigned randomly into Manual vacuum aspiration (MVA) and Dilatation and Curettage (DNC) groups using the draw randomization technique. Data regarding the efficacy of both procedures and procedural success rate was measured in all patients. Results: A total of 182 Adult female patients, with a mean age of 30.53+5.23 years, having miscarriage in the first trimester, were evaluated. The mean gestational age at the time of abortion was 8.64+1.30 weeks, and the mean parity of study females was 1.96±0.82. The procedure was successfully done in 87(95.6%) patients in the MVA Group versus 84(92.3%) in the D&C Group (p-value 0.35). Conclusion: Manual vacuum aspiration (MVA) is an effective and safe method of abortion with a success rate comparable to that of Dilatation and Curettage (D&C).
{"title":"Efficacy of Manual Vacuum Aspiration versus Dilatation and Curettage in First Trimester Miscarriages","authors":"None Hira Sikander, None Shazia Mahmood Awan, Sanum Kashif","doi":"10.51253/pafmj.v73i5.7201","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.7201","url":null,"abstract":"Objective: To compare the efficacy of Manual Vacuum Aspiration (MVA) with Dilatation and Curettage (DNC) in miscarriages of the first trimester.\u0000Study Design: Quasi-experimental study.\u0000Place and Duration of Study: Department of Obstetrics and Gynaecology CMH, Peshawar Pakistan, from Feb to Aug 2018.\u0000Methodology: A total number of 182 Adult female (20-35 years of age) patients having miscarriage during the first trimester who were either primigravida or with previous history of spontaneous vaginal delivery were included in this study. Patients were assigned randomly into Manual vacuum aspiration (MVA) and Dilatation and Curettage (DNC) groups using the draw randomization technique. Data regarding the efficacy of both procedures and procedural success rate was measured in all patients.\u0000Results: A total of 182 Adult female patients, with a mean age of 30.53+5.23 years, having miscarriage in the first trimester, were evaluated. The mean gestational age at the time of abortion was 8.64+1.30 weeks, and the mean parity of study females was 1.96±0.82. The procedure was successfully done in 87(95.6%) patients in the MVA Group versus 84(92.3%) in the D&C Group (p-value 0.35).\u0000Conclusion: Manual vacuum aspiration (MVA) is an effective and safe method of abortion with a success rate comparable to that of Dilatation and Curettage (D&C).","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136069785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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