Journal of Pakistan Medical Association, May 1, 2013
Two autopsy-proved cases are presented of a rare form of congenital heart disease, anatomically c... more Two autopsy-proved cases are presented of a rare form of congenital heart disease, anatomically corrected malposition IS, D, LJ. Anatomically corrected malposition means that despite the abnormal relationship between the great arteries, the aorta arises nonetheless above the anatomically left ventricle and the pulmonary artery originates above the anatomically right ventricle. IS, D, LI briefly indicates the segmental set or combination: situs solitus of viscera and atria (S), ventricular d-loop (D), and l-malposition of the great arteries (L). These are the first cases of anatomically corrected malposition (ACM) in whom the presence of a subaortic muscular conus only has been documented pathologically. This establishes that ACM can occur with a subaortic conus, as well as with a bilateral conus. From the diagnostic standpoint, the distributions or epicardial courses of the coronary arteries are recommended as a helpful approach to ventricular identification. This diagnostic method has widespread angiocardiographic and surgical applications. Symbolic terminology, exemplified by anatomically corrected malposition IS, D, LI is brief and accurate. This approach may conveniently be applied to many other forms of complex congenital heart disease, and it considerably facilitates computer data processing.
C ongenital heart diseases (CHDs) are the most common of all birth defects and one of the leading... more C ongenital heart diseases (CHDs) are the most common of all birth defects and one of the leading causes of mortality in the first year of life. CFC1 gene is a cell signaling protein and it is a co-receptor in nodal signaling pathway and involve in right and left axis determination during gastrulation. This is a case control study, recruited 175 non syndromic patients and 140 controls, healthy unrelated individuals. The study after formal approval includes patients from various pediatric cardiology centers in three years. A detailed family history was taken to elucidate the genetic and environmental factors. Pediatric cardiologist confirmed the diagnosis on the basis of all standard testing like chest X-ray, CBC, ECG, ECHO, heart murmur, cardiac catherization reports etc. DNA extraction and sequencing was done and data was interpreted by multiple sequence alignment software. Statistical data was done by SPSS 17.0. The mean age for controls was 3.14±1.82 years for TOF; 2.97±1.21 and for DTGA patients 1.84±2.26 years. TOF and DTGA were frequent in males. The study demonstrates frequency of this disease with its variation in Pakistani population. Consanguinity affects the rate of CHDs as it is 62% in patients and 25% in controls. Two novel mutations were found in CFC 1 gene. The study reveals frequency and prevalence for TOF and DTGA, their variation and association with other cardiac defects. CFC1 and its mutations may play a key role in cardiac malformation.
Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ, 2005
We determined the risk-factor profile and prevalence of coronary heart disease in Metroville, a l... more We determined the risk-factor profile and prevalence of coronary heart disease in Metroville, a lower middle class urban community in Karachi, and compared them to the Pakistan health survey PNHS 1990-94, and the US health and nutrition survey 1988-94 NHANES111. Subjects < 18 years and pregnant women were excluded as were people with extreme ranges BMI [corrected] heart rate, height and waist. The prevalence of hypertension was 23% in men and women, hypercholesterolaemia was 17% in men and 22% in women (P < 0.001). Hyperglycaemia was present in 5% of men and women and obesity in 33% of men and 47% of women (P < 0.001). Compared to PNHS, the prevalences of obesity, hypertension, hypercholesterolaemia and WHR were higher in our population. Mean values of BMI [corrected] cholesterol, WHR were higher in the US population while mean values were lower for diastolic blood pressure and blood glucose.
Coronary artery dilatation has been observed with coronavirus disease 2019 (COVID-19)-associated ... more Coronary artery dilatation has been observed with coronavirus disease 2019 (COVID-19)-associated multisystem inflammatory syndrome in children (MIS-C), which is more common in those with Kawasakilike disease. MIS-C is a clinical syndrome in children and adolescents; its signs and symptoms, as well as cardiac manifestations, are similar to Kawasaki diseases, such as coronary artery dilation, coronary aneurysms, and ventricular dysfunction. The occurrence of coronary artery dilatation in asymptomatic pediatric patients following COVID-19 infection has not been well documented in the literature. Thus, in this article, we present four cases of coronary artery dilation in children with a past history of COVID-19 infection who had very few or no symptoms and were referred to us for vague chest pain and palpitation. As a result, a high index of suspicion is required, and any patient complaining of chest pain and palpitation with a history of COVID-19 exposure should not be ignored and be given proper coronary artery evaluation. This article also raises the question of whether every child infected with COVID-19 should have an echocardiogram.
Objective: To know the long-term results of percutaneous transmitral commissurotomy (PTMC) and fa... more Objective: To know the long-term results of percutaneous transmitral commissurotomy (PTMC) and fate of pulmonary hypertension in children who have undergone PTMC. Material: During the last 11 years 138 children, aged 10.48 ± 2.24 years (range 3.5 -16) had PTMC. Indications were echocardiographic evidence of moderate to severe mitral stenosis (MS) plus pulmonary hypertension (PH) more than 50 mmHg and/or FC III-IV Result: Pre PTMC, mean pressure gradient (MPG) across the mitral valve (MV) was 18.6 mmHg ± 3.4 which decreased to 7.6 mmHg ± 2.21 .Mitral valve area (MVA) was 0.62 cm2 ± 0.12 which increased to 1.6 cm2 ± 0.3. Systolic Pulmonary artery pressure (SPAP) was 83 mmHg ± 13 decreased to 50 mmHg ± 14.5. Three procedures were unsuccessful. There were 2 deaths, one within half an hour in patient with SPAP of 100 mmHg and left ventricle (LV) dysfunction, had no mitral regurgitation (MR) ,arrhythmias or tamponade after PTMC. Another had thromboembolism of left anterior descending coro...
reconstruction of the upper limb after spinal cord injury. For the C5/6 level tetraplegic with IC... more reconstruction of the upper limb after spinal cord injury. For the C5/6 level tetraplegic with ICHT function at level 0 to 2, we recommend early electromyography of EDC and triceps between 3 and 6 months from injury to establish timing of reconstructive nerve transfers.
The Metroville Health Study aimed to reduce consumption of total cooking fats by 33%, salt by 25%... more The Metroville Health Study aimed to reduce consumption of total cooking fats by 33%, salt by 25% and replace ghee with vegetable oil in a lower middle class urban community in Pakistan. Households (n=403) were randomly assigned to Intervention and Control groups. A baseline screening collected data on CVD risk factors, knowledge and attitudes and household consumption of cooking fats and salt. Intervention households received information about CVD and regular visits by social workers who measured cooking fats and salt and counselled cooks on the goals of intervention. Two years later, 291 households were re-screened. Intervention households reduced consumption of fats and salt compared to differences were total fat, 48% ( p<0.0001); ghee, 37% ( p=0.005); vegetable oil, 33% ( p=0.0001); and salt, 41% ( p=0.011). Household visits by trained social workers were effective in achieving reductions in consumption of cooking fat and salt in a lower class urban community. Asia Pac J Publ...
We determined the risk-factor profile and prevalence of coronary heart disease in Metroville, a l... more We determined the risk-factor profile and prevalence of coronary heart disease in Metroville, a lower middle class urban community in Karachi, and compared them to the Pakistan health survey PNHS 1990-94, and the US health and nutrition survey 1988-94 NHANES111. Subjects < 18 years and pregnant women were excluded as were people with extreme ranges SMI, heart rate, height and waist. The prevalence of hypertension was 23% in men and women, hypercholesterolaemia was 17% in men and 22% in women (P < 0.001). Hyperglycaemia was present in 5% of men and women and obesity in 33% of men and 47% of women (P < 0.001). Compared to PNHS, the prevalences of obesity, hypertension, hypercholesterolaemia and WHR were higher in our population. Mean values of RMI, cholesterol, WHR were higher in the US population while mean values were lower for diastolic blood pressure and blood glucose. RÉSUMÉ Nous avons déterminé le profil des facteurs de risque et la prévalence des coronaropathies à Metroville, communauté urbaine de classe moyenne inférieure à Karachi, et les avons comparést à l'enquête nationale de santé réalisée au Pakistan de 1990 à 1994, enquête et á l' d'examen de la santé et de la nutrition effectuée de 1988-1994 aux États-Unis NHANES III. Les sujets ayant moins de 18 ans et les femmes enceintes ont été exclus ainsi que les fourchettes extrêmes pour l'IMC, la fréquence cardiaque, la taille et le tour de taille. La prévalence de l'hypertension s'élevait à 23 % chez les hommes et les femmes, l'hypercholestérolémie était de 17 % chez les hommes et de 22 % chez les femmes (p < 0,001). Une hyperglycémie était présente chez 5 % des hommes et des femmes et l'obésité chez 33 % des hommes et 47 % des femmes (p < 0,001). Par rapport à l'enquête nationale sur la santé au Pakistan, la prévalence de l'obésité, de l'hypertension, de l'hypercholestérolémie ainsi que le rapport tour de taille/tour de hanches étaient plus élevés dans notre population. Les valeurs moyennes pour l'IMC, le cholestérol et le rapport tour de taille/tour de hanches étaient supérieures dans la population nord-américaine tandis qu'elles étaient inférieures pour la pression artérielle diastolique et la glycémie.
Introduction Ventricular septal defect (VSD) is one of the more common congenital heart defects, ... more Introduction Ventricular septal defect (VSD) is one of the more common congenital heart defects, and aortic regurgitation (AR) is its major complication if it remains unrepaired. We aim to determine the AR incidence in various types of VSD, its immediate and intermediate six to 12-month post-VSD repair outcomes of AR.
Objective: To determine effectiveness and safety of echocardiography guided bed side Balloon Atri... more Objective: To determine effectiveness and safety of echocardiography guided bed side Balloon Atrial Septostomy (BAS) in dextro transposition of great Arteries (dTGA) with intact ventricular septum (IVS) at a public sector tertiary care hospital Karachi, Pakistan. Methods: This case series include 40 patients with echocardiographic findings of dTGA with IVS and restricted PFO (≤ 2mm) who underwent bedside BAS at department of pediatric cardiology NICVD, Karachi, Pakistan. We recorded pre and post BAS diameter of PFO/Atrial Septal Defect (ASD), oxygen saturation (SpO 2 %), and post procedure complications and outcome. Results: Median age was 16 days, Majority of them (n=23, 58%) were severely cyanosed with SpO 2 of 41.4±3.4% and underwent emergency BAS and remaining underwent elective procedure. An increase in SpO 2 % from 46.0±6% to 81.0±3.0% (p=<0.001) and ASD size from 1.4±2.8mm to 5.45±0.4mm was observed (p=<0.001). No complication was observed in most of cases (n=28, 70%). Mean hospital stay was 3.4±1 days. Success rate was 97.5% however, one neonate died due to neonatal sepsis. Conclusion: Our study provides sufficient evidence that bed side balloon atrial septostomy is a safer technique, save a lot of time and resources which were required otherwise in transporting these patients to catheterization laboratory.
Background: Coronary heart disease is the leading cause of death in Saudi Arabia. We designed thi... more Background: Coronary heart disease is the leading cause of death in Saudi Arabia. We designed this study with the objective to determine the prevalence of risk factors of this disease within patients diagnosed with CHD. Aim: our aim is to observe the current prevalence of risk factors of coronary heart disease (CHD), with respect to the lifestyle. We will attempt to identify the possible causes of such habits. Patients and Method: a cross-sectional study among 300 Saudi patients, with known coronary heart disease, was conducted with help of a questionnaire. The study was conducted at the cardiology department of King Abdul Aziz Hospital & Oncology Center in the city of Jeddah. Results: the prevalence of CHD was higher in the male gender by a ratio of 2:1. Also, the prevalence increases with age, the highest being found in age group over 75 years old which is 8 times higher than was observed in age group 35-44 years. 72.5% females and 52.6% males of these atherosclerotic patients was either overweight or obese. The same trend is seen in negative habits of 10 years duration, such as lack of exercise as high as 75.6 % in males and 81.3% in females. Intake of fatty/fast food was found to be 64.85% in both sexes. Intake of sweet/ sugary food was also high, and unfortunately consumption of fruits and vegetables was low. The current smoking trend is 45.9% in men and 21.95% in women. Conclusion: The risk factors assessed in the study were gender, age, obesity, smoking history, physical inactivity, and eating habits. Unfortunately, physical inactivity, bad eating habits, and smoking were found to be very common. The patients must be encouraged to practice healthy lifestyle modifications to reduce morbidity and mortality.
interior walls of the heart, septation of the chambers and their sequence, the valves inside the ... more interior walls of the heart, septation of the chambers and their sequence, the valves inside the heart and/ or the arteries and veins. There are different types of congenital heart defects which can be broadly classified as simple defects and complex defects. It is the most common single group of congenital abnormalities accounting for about 30 percent of the total and has high mortality rate during infancy, depending on the type and severity of lesion. 1-3 It is necessary to mention that the heart ailment is a defect or abnormality, not a disease. 4 Congenital heart defects can be found as either an isolated lesion or in combination with other heart defects. These are also found as a part of/in association with certain
Journal of Ayub Medical College, Abbottabad : JAMC
Percutaneous mitral valvuloplasty (PMV) is still the treatment of choice in selected cases of mit... more Percutaneous mitral valvuloplasty (PMV) is still the treatment of choice in selected cases of mitral stenosis (MS). Multitrack balloon (MTB) catheter is one of the techniques used for PMV with optimal results. We describe a novel refinement of appropriate balloon sizing and wire placement to reduce mitral regurgitation (MR) and Left ventricular (LV) apical perforation, respectively. Ninety four consecutive patients with moderate to severe rheumatic mitral stenosis (MS) were selected for PMV with MTB catheter. Balloon sizing was done by effective balloon dilatation area (EBDA), using standard geometric formula. 0.35" PMV wire was placed in aortic arch /ascending aorta (AA) to avoid LV apical perforation. Mild MR was present in 28(29.8%). Post-procedure MR was present in 50(53.2%). Out of 50 MR cases 44(88%) had mild and 6(12.0%) had moderate MR. No patient had severe MR. With placement of wire in AA and arch of aorta none of the patients developed complication of LV apical perfo...
Journal of Pakistan Medical Association, May 1, 2013
Two autopsy-proved cases are presented of a rare form of congenital heart disease, anatomically c... more Two autopsy-proved cases are presented of a rare form of congenital heart disease, anatomically corrected malposition IS, D, LJ. Anatomically corrected malposition means that despite the abnormal relationship between the great arteries, the aorta arises nonetheless above the anatomically left ventricle and the pulmonary artery originates above the anatomically right ventricle. IS, D, LI briefly indicates the segmental set or combination: situs solitus of viscera and atria (S), ventricular d-loop (D), and l-malposition of the great arteries (L). These are the first cases of anatomically corrected malposition (ACM) in whom the presence of a subaortic muscular conus only has been documented pathologically. This establishes that ACM can occur with a subaortic conus, as well as with a bilateral conus. From the diagnostic standpoint, the distributions or epicardial courses of the coronary arteries are recommended as a helpful approach to ventricular identification. This diagnostic method has widespread angiocardiographic and surgical applications. Symbolic terminology, exemplified by anatomically corrected malposition IS, D, LI is brief and accurate. This approach may conveniently be applied to many other forms of complex congenital heart disease, and it considerably facilitates computer data processing.
C ongenital heart diseases (CHDs) are the most common of all birth defects and one of the leading... more C ongenital heart diseases (CHDs) are the most common of all birth defects and one of the leading causes of mortality in the first year of life. CFC1 gene is a cell signaling protein and it is a co-receptor in nodal signaling pathway and involve in right and left axis determination during gastrulation. This is a case control study, recruited 175 non syndromic patients and 140 controls, healthy unrelated individuals. The study after formal approval includes patients from various pediatric cardiology centers in three years. A detailed family history was taken to elucidate the genetic and environmental factors. Pediatric cardiologist confirmed the diagnosis on the basis of all standard testing like chest X-ray, CBC, ECG, ECHO, heart murmur, cardiac catherization reports etc. DNA extraction and sequencing was done and data was interpreted by multiple sequence alignment software. Statistical data was done by SPSS 17.0. The mean age for controls was 3.14±1.82 years for TOF; 2.97±1.21 and for DTGA patients 1.84±2.26 years. TOF and DTGA were frequent in males. The study demonstrates frequency of this disease with its variation in Pakistani population. Consanguinity affects the rate of CHDs as it is 62% in patients and 25% in controls. Two novel mutations were found in CFC 1 gene. The study reveals frequency and prevalence for TOF and DTGA, their variation and association with other cardiac defects. CFC1 and its mutations may play a key role in cardiac malformation.
Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ, 2005
We determined the risk-factor profile and prevalence of coronary heart disease in Metroville, a l... more We determined the risk-factor profile and prevalence of coronary heart disease in Metroville, a lower middle class urban community in Karachi, and compared them to the Pakistan health survey PNHS 1990-94, and the US health and nutrition survey 1988-94 NHANES111. Subjects < 18 years and pregnant women were excluded as were people with extreme ranges BMI [corrected] heart rate, height and waist. The prevalence of hypertension was 23% in men and women, hypercholesterolaemia was 17% in men and 22% in women (P < 0.001). Hyperglycaemia was present in 5% of men and women and obesity in 33% of men and 47% of women (P < 0.001). Compared to PNHS, the prevalences of obesity, hypertension, hypercholesterolaemia and WHR were higher in our population. Mean values of BMI [corrected] cholesterol, WHR were higher in the US population while mean values were lower for diastolic blood pressure and blood glucose.
Coronary artery dilatation has been observed with coronavirus disease 2019 (COVID-19)-associated ... more Coronary artery dilatation has been observed with coronavirus disease 2019 (COVID-19)-associated multisystem inflammatory syndrome in children (MIS-C), which is more common in those with Kawasakilike disease. MIS-C is a clinical syndrome in children and adolescents; its signs and symptoms, as well as cardiac manifestations, are similar to Kawasaki diseases, such as coronary artery dilation, coronary aneurysms, and ventricular dysfunction. The occurrence of coronary artery dilatation in asymptomatic pediatric patients following COVID-19 infection has not been well documented in the literature. Thus, in this article, we present four cases of coronary artery dilation in children with a past history of COVID-19 infection who had very few or no symptoms and were referred to us for vague chest pain and palpitation. As a result, a high index of suspicion is required, and any patient complaining of chest pain and palpitation with a history of COVID-19 exposure should not be ignored and be given proper coronary artery evaluation. This article also raises the question of whether every child infected with COVID-19 should have an echocardiogram.
Objective: To know the long-term results of percutaneous transmitral commissurotomy (PTMC) and fa... more Objective: To know the long-term results of percutaneous transmitral commissurotomy (PTMC) and fate of pulmonary hypertension in children who have undergone PTMC. Material: During the last 11 years 138 children, aged 10.48 ± 2.24 years (range 3.5 -16) had PTMC. Indications were echocardiographic evidence of moderate to severe mitral stenosis (MS) plus pulmonary hypertension (PH) more than 50 mmHg and/or FC III-IV Result: Pre PTMC, mean pressure gradient (MPG) across the mitral valve (MV) was 18.6 mmHg ± 3.4 which decreased to 7.6 mmHg ± 2.21 .Mitral valve area (MVA) was 0.62 cm2 ± 0.12 which increased to 1.6 cm2 ± 0.3. Systolic Pulmonary artery pressure (SPAP) was 83 mmHg ± 13 decreased to 50 mmHg ± 14.5. Three procedures were unsuccessful. There were 2 deaths, one within half an hour in patient with SPAP of 100 mmHg and left ventricle (LV) dysfunction, had no mitral regurgitation (MR) ,arrhythmias or tamponade after PTMC. Another had thromboembolism of left anterior descending coro...
reconstruction of the upper limb after spinal cord injury. For the C5/6 level tetraplegic with IC... more reconstruction of the upper limb after spinal cord injury. For the C5/6 level tetraplegic with ICHT function at level 0 to 2, we recommend early electromyography of EDC and triceps between 3 and 6 months from injury to establish timing of reconstructive nerve transfers.
The Metroville Health Study aimed to reduce consumption of total cooking fats by 33%, salt by 25%... more The Metroville Health Study aimed to reduce consumption of total cooking fats by 33%, salt by 25% and replace ghee with vegetable oil in a lower middle class urban community in Pakistan. Households (n=403) were randomly assigned to Intervention and Control groups. A baseline screening collected data on CVD risk factors, knowledge and attitudes and household consumption of cooking fats and salt. Intervention households received information about CVD and regular visits by social workers who measured cooking fats and salt and counselled cooks on the goals of intervention. Two years later, 291 households were re-screened. Intervention households reduced consumption of fats and salt compared to differences were total fat, 48% ( p<0.0001); ghee, 37% ( p=0.005); vegetable oil, 33% ( p=0.0001); and salt, 41% ( p=0.011). Household visits by trained social workers were effective in achieving reductions in consumption of cooking fat and salt in a lower class urban community. Asia Pac J Publ...
We determined the risk-factor profile and prevalence of coronary heart disease in Metroville, a l... more We determined the risk-factor profile and prevalence of coronary heart disease in Metroville, a lower middle class urban community in Karachi, and compared them to the Pakistan health survey PNHS 1990-94, and the US health and nutrition survey 1988-94 NHANES111. Subjects < 18 years and pregnant women were excluded as were people with extreme ranges SMI, heart rate, height and waist. The prevalence of hypertension was 23% in men and women, hypercholesterolaemia was 17% in men and 22% in women (P < 0.001). Hyperglycaemia was present in 5% of men and women and obesity in 33% of men and 47% of women (P < 0.001). Compared to PNHS, the prevalences of obesity, hypertension, hypercholesterolaemia and WHR were higher in our population. Mean values of RMI, cholesterol, WHR were higher in the US population while mean values were lower for diastolic blood pressure and blood glucose. RÉSUMÉ Nous avons déterminé le profil des facteurs de risque et la prévalence des coronaropathies à Metroville, communauté urbaine de classe moyenne inférieure à Karachi, et les avons comparést à l'enquête nationale de santé réalisée au Pakistan de 1990 à 1994, enquête et á l' d'examen de la santé et de la nutrition effectuée de 1988-1994 aux États-Unis NHANES III. Les sujets ayant moins de 18 ans et les femmes enceintes ont été exclus ainsi que les fourchettes extrêmes pour l'IMC, la fréquence cardiaque, la taille et le tour de taille. La prévalence de l'hypertension s'élevait à 23 % chez les hommes et les femmes, l'hypercholestérolémie était de 17 % chez les hommes et de 22 % chez les femmes (p < 0,001). Une hyperglycémie était présente chez 5 % des hommes et des femmes et l'obésité chez 33 % des hommes et 47 % des femmes (p < 0,001). Par rapport à l'enquête nationale sur la santé au Pakistan, la prévalence de l'obésité, de l'hypertension, de l'hypercholestérolémie ainsi que le rapport tour de taille/tour de hanches étaient plus élevés dans notre population. Les valeurs moyennes pour l'IMC, le cholestérol et le rapport tour de taille/tour de hanches étaient supérieures dans la population nord-américaine tandis qu'elles étaient inférieures pour la pression artérielle diastolique et la glycémie.
Introduction Ventricular septal defect (VSD) is one of the more common congenital heart defects, ... more Introduction Ventricular septal defect (VSD) is one of the more common congenital heart defects, and aortic regurgitation (AR) is its major complication if it remains unrepaired. We aim to determine the AR incidence in various types of VSD, its immediate and intermediate six to 12-month post-VSD repair outcomes of AR.
Objective: To determine effectiveness and safety of echocardiography guided bed side Balloon Atri... more Objective: To determine effectiveness and safety of echocardiography guided bed side Balloon Atrial Septostomy (BAS) in dextro transposition of great Arteries (dTGA) with intact ventricular septum (IVS) at a public sector tertiary care hospital Karachi, Pakistan. Methods: This case series include 40 patients with echocardiographic findings of dTGA with IVS and restricted PFO (≤ 2mm) who underwent bedside BAS at department of pediatric cardiology NICVD, Karachi, Pakistan. We recorded pre and post BAS diameter of PFO/Atrial Septal Defect (ASD), oxygen saturation (SpO 2 %), and post procedure complications and outcome. Results: Median age was 16 days, Majority of them (n=23, 58%) were severely cyanosed with SpO 2 of 41.4±3.4% and underwent emergency BAS and remaining underwent elective procedure. An increase in SpO 2 % from 46.0±6% to 81.0±3.0% (p=<0.001) and ASD size from 1.4±2.8mm to 5.45±0.4mm was observed (p=<0.001). No complication was observed in most of cases (n=28, 70%). Mean hospital stay was 3.4±1 days. Success rate was 97.5% however, one neonate died due to neonatal sepsis. Conclusion: Our study provides sufficient evidence that bed side balloon atrial septostomy is a safer technique, save a lot of time and resources which were required otherwise in transporting these patients to catheterization laboratory.
Background: Coronary heart disease is the leading cause of death in Saudi Arabia. We designed thi... more Background: Coronary heart disease is the leading cause of death in Saudi Arabia. We designed this study with the objective to determine the prevalence of risk factors of this disease within patients diagnosed with CHD. Aim: our aim is to observe the current prevalence of risk factors of coronary heart disease (CHD), with respect to the lifestyle. We will attempt to identify the possible causes of such habits. Patients and Method: a cross-sectional study among 300 Saudi patients, with known coronary heart disease, was conducted with help of a questionnaire. The study was conducted at the cardiology department of King Abdul Aziz Hospital & Oncology Center in the city of Jeddah. Results: the prevalence of CHD was higher in the male gender by a ratio of 2:1. Also, the prevalence increases with age, the highest being found in age group over 75 years old which is 8 times higher than was observed in age group 35-44 years. 72.5% females and 52.6% males of these atherosclerotic patients was either overweight or obese. The same trend is seen in negative habits of 10 years duration, such as lack of exercise as high as 75.6 % in males and 81.3% in females. Intake of fatty/fast food was found to be 64.85% in both sexes. Intake of sweet/ sugary food was also high, and unfortunately consumption of fruits and vegetables was low. The current smoking trend is 45.9% in men and 21.95% in women. Conclusion: The risk factors assessed in the study were gender, age, obesity, smoking history, physical inactivity, and eating habits. Unfortunately, physical inactivity, bad eating habits, and smoking were found to be very common. The patients must be encouraged to practice healthy lifestyle modifications to reduce morbidity and mortality.
interior walls of the heart, septation of the chambers and their sequence, the valves inside the ... more interior walls of the heart, septation of the chambers and their sequence, the valves inside the heart and/ or the arteries and veins. There are different types of congenital heart defects which can be broadly classified as simple defects and complex defects. It is the most common single group of congenital abnormalities accounting for about 30 percent of the total and has high mortality rate during infancy, depending on the type and severity of lesion. 1-3 It is necessary to mention that the heart ailment is a defect or abnormality, not a disease. 4 Congenital heart defects can be found as either an isolated lesion or in combination with other heart defects. These are also found as a part of/in association with certain
Journal of Ayub Medical College, Abbottabad : JAMC
Percutaneous mitral valvuloplasty (PMV) is still the treatment of choice in selected cases of mit... more Percutaneous mitral valvuloplasty (PMV) is still the treatment of choice in selected cases of mitral stenosis (MS). Multitrack balloon (MTB) catheter is one of the techniques used for PMV with optimal results. We describe a novel refinement of appropriate balloon sizing and wire placement to reduce mitral regurgitation (MR) and Left ventricular (LV) apical perforation, respectively. Ninety four consecutive patients with moderate to severe rheumatic mitral stenosis (MS) were selected for PMV with MTB catheter. Balloon sizing was done by effective balloon dilatation area (EBDA), using standard geometric formula. 0.35" PMV wire was placed in aortic arch /ascending aorta (AA) to avoid LV apical perforation. Mild MR was present in 28(29.8%). Post-procedure MR was present in 50(53.2%). Out of 50 MR cases 44(88%) had mild and 6(12.0%) had moderate MR. No patient had severe MR. With placement of wire in AA and arch of aorta none of the patients developed complication of LV apical perfo...
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