Papers by Usman Javed Iqbal
Pakistan Journal of Medical and Health Sciences
Objective: The objective of this study was to compare the in hospital outcome of coronary artery ... more Objective: The objective of this study was to compare the in hospital outcome of coronary artery bypass grafting in male versus female. Methodology: The cross sectional comparative study was conducted in a tertiary care setting. Using non probability sampling a calculated sample of 100 patients (50 males and 50 females) undergoing CABG were enrolled. After getting their informed consent, preoperative, intraoperative and postoperative variables were entered in the predesigned performa and the patients were observed for the difference in mortality and morbidity in both groups during hospital stay. Results: In this study 50 male and 50 females were enrolled with mean age of 54.21±8.03 years. Pulmonary complications were the most common (14%) following postoperative wound infection (12%), atrial fibrillation (10%), low cardiac output syndrome (5%), renal failure (4%), neurologic complications (4%), postoperative MI (4%) and stroke (1%). No complication other than postoperative wound inf...
Pakistan Journal of Medical and Health Sciences, 2022
Objective: The objective of this study is to determine the frequency of asymptomatic left ventric... more Objective: The objective of this study is to determine the frequency of asymptomatic left ventricular systolic dysfunction in high risk patients. Study Design: Cross sectional survey Setting: The study was conducted in the Department of Cardiology, Gulab Devi Hospital, Lahore. Methodology: 150 patients aged more than 50, who do not have signs and symptoms of heart failure like dyspnea on exertion, orthopnea and PND and having any 2 or more of these risk factors, Diabetes mellitus,Hypertension, IHD and Obesity were selected for this study. Each patient was asked about age, sex, diabetes mellitus, hypertension and symptoms of heart failure. Height and weight was checked and BMI was calculated in every patient. 6 minute walk test was done in every patient to rule out dyspnea on exertion. Echocardiography was performed in OPD of cardiology department. Left ventricular (LV) ejection fraction (EF) less than 50% was taken as LV systolic dysfunction. Results: The mean age of the patients wa...
Pakistan Journal of Medical and Health Sciences, 2021
Objective: To determine the impact of diabetes on adverse outcomes amongst patients presenting fo... more Objective: To determine the impact of diabetes on adverse outcomes amongst patients presenting for the first time with acute coronary syndrome. Study design: Cohort Study Methodology: A total of 340 patients were enrolled in this study. At presentation patients were divided in two equal age and gender matched groups with 170 patients in Group-A having diabetes and another 170 being non-diabetics in Group-B. Patients were followed up for period of index hospitalization and all adverse outcomes were noted in both groups as per operational definition. Results: Mean age in Group-A with diabetes was 54±12.7 years whereas in non diabetics it was56±13.12 years. In both groups there was male predominance with approximately 60% males and 40% females. In diabetic group, 38% patients had typical chest pain, 62% patients had dyspnea, 20% patients had cardiogenic shock while in non diabetic group, 20% patients had typical chest pain, 40% patients had dyspnea, 10% patients had cardiogenic shock. ...
Pakistan Heart Journal, 2015
First described in Japan, Takotsubo cardiomyopathy (TTC) is increasinglybecoming recognized world... more First described in Japan, Takotsubo cardiomyopathy (TTC) is increasinglybecoming recognized worldwide as a cause of sudden and reversible diminishedleft ventricular function characterized by left apical ballooning and hyperkinesis ofthe basal segments, often with symptoms mimicking acute coronary syndrome.Associated with physical or emotional stress, its exact pathogenesis has notbeen established, though evidence supports a neurohumoral etiology. Seizureshave been reported as triggers of Takotsubo cardiomyopathy. It is unknown ifseizure associated TTC differs from TTC associated with other triggers. In thisreport, we present a rare case of Takotsubo cardiomyopathy in a young femalewho presented with chest pain having a history of transient attacks of seizures.
Pakistan Journal of Medical and Health Sciences, 2021
Aim: To find the frequency of recently poor glycemic control as assessed by HbA1c in diabetic pat... more Aim: To find the frequency of recently poor glycemic control as assessed by HbA1c in diabetic patients with acute coronary syndrome Study design & Setting: Observational study. Methods: The study included 60 diabetic patients presented with acute coronary syndrome. Diagnosis of acute coronary syndrome was based on patient’s symptoms, ECG changes and cardiac enzyme results. HBA1c level report was collected for all patients from their hospital record. SPSS 21 version was used to analyze the collected data. The qualitative data was presented in the form of graphs while the quantitative data was presented by simple descriptive statistics in the form of mean, range and standard deviation. Results: Out of sixty patients enrolled in this study 2(45%) were females and 33(55%) were males. 28(46.67%) patients presented with ST-elevation MI (STEMI) whereas 25(41.66%) patients presented with non ST-elevation MI. 7(11.66%) had unstable angina. Out of sixty patients 21(35%) patients were having p...
Journal of Fatima Jinnah Medical University, 2016
Background: Hospital waste management is an important issue when taken in relevance of overall en... more Background: Hospital waste management is an important issue when taken in relevance of overall environmental and public health. In Pakistan, not much attention has yet been focused to assessment of waste management in public or private sector hospitals. Hence we aimed to focus on this problem. Objective: Evaluation of existing waste management situation in public and private health sectors Methodology: This was a cross sectional study conducted in eight public and private hospitals of Lahore. A pre-defined comprehensive questionnaire was made on basis of literature regarding hospitals waste management. The data was entered and analyzed using SPSS 18.0. Detailed descriptive results in form of percentages and ratios were presented. Results: Out of total eight hospitals 6 (75%) hospitals had written hospital waste management plan and 6 (75%) had waste management team. Seven (87.5%) were aware of hospital waste associated risks, 6 (75%) had devised training program. Post exposure procedure after injury was available to 37.5% of the hospitals only, routine surveillance for staff was present in 62.5% hospitals, reporting system on accidents of HMW was present in only 25% (2 of 8). HW weighing was available in 50% (4 of 8) hospitals. Segregation was available in all 8 (100%) hospitals. Hospital waste was disposed of (whether treated or not treated) in pits in 12.5% (1 0f 8) hospital, in municipal dumping sites in 50% hospitals and burned in 3 hospitals (37.5%). Conclusion: Provision of training, reporting of accident injuries, post exposure procedure for injured staff, improvement in collection, transport, storage and safe disposal of waste are deficient areas and need to be improved in all hospitals.
Pakistan Heart Journal, 2020
Objective: To assess the knowledge and practices of contraception in females presented with cardi... more Objective: To assess the knowledge and practices of contraception in females presented with cardiac disease.Methodology: This cross sectional study was conducted at obstetrics and gynaecology department, Gulab Devi Hospital, Lahore. A total of 246 consecutive female subjects referred to gynaecology and obstetrics ward by cardiology department were enrolled. Informed consent was taken and confidentiality was ensured. The cardiac disease of the respondent was noted and a detailed obstetric history, number of previous pregnancies, date of last child born and last menstrual period (LMP) was taken. Knowledge and practices of contraception was gathered through a structured questionnaire. Data were entered and analyzed by SPSS version 20.0. Categorical data were presented in the form of frequencies and percentages & presented through graphs while mean+SD was computed for quantitative data.Results: The mean age of the study participants was 28±6.7 years. Majority of the study participants (...
ORIGINAL PROF-2556 ABSTRACT… Background: Intermittent antegrade warm blood cardioplegia is routin... more ORIGINAL PROF-2556 ABSTRACT… Background: Intermittent antegrade warm blood cardioplegia is routinely used as a mean of myocardial protection since its introduction. There is a considerable debate on the longest time off cardioplegia interval during aortic cross clamping. Objective: To see the frequency and extent of myocardial damage in patients undergoing CABG receiving intermittent antegrade warm blood Cardioplegia at LTOC (longest time off cardioplegia) 11-15 minutes (Group I) and 16-20 minutes (Group II). Patients and Methods: A randomized prospective study involving 94 patients was arranged to see the safe periods of intermittency. There were two groups of patients having LTOC of 11-15 minutes (Group I) and 16-20 minutes (Group II). 20 minutes was the upper limit. The duration of study was from 1-09-2013 to 10-02-2014. Data was analyzed using SPSS Version 16. Independent sample t-test and chi-square were applied to see the significance. Results: Mean age was 54.1±9.36 years. There were more males as compared to females. More than 50% of the patients had Hypertension and Diabetes. There was no urgent surgery. Triple vessel disease (TVD) was present in 48.9% patients and 40.4% had Double vessel disease (DVD). Average blood flow during CPB was 2.4±0.14 (L/ min.m-2). Average body temperatures were 31.7±2.3 0 C. Cardioplegia temperature was 36-37 0 C. According to Left Ventricular Function Classification, 43.6% of the patients were of LV grade II and 10.6% of LV grade III. There was no significant increase in the levels of CK-MB in two groups. 77.8% patient in Group I and 66.7% in Group II gained spontaneous rhythm (p-value 0.16). IABP was inserted in 5.4% patients in group I and 5.6% in group II (p-value 0.97). There was no failure to wean off from bypass and no peri-operative mortality. The levels of inotropes viz dopamine and epinephrine on weaning were also almost the same. Perioperative MI occurred only in 7 patients (ruled out by biochemical evidence). Conclusions: A reasonable margin of safety exists with intermittent antegrade warm blood cardioplegia in these two groups. So the LTOC (longest time off cardioplegia) up to 20 minutes is unlikely to lead to adverse clinical outcomes and is clinically acceptable.
Aim & Objective: To see the spectrum of chest X-ray abnormalities in sputum positive T.B patients... more Aim & Objective: To see the spectrum of chest X-ray abnormalities in sputum positive T.B patients. Methodology: In this descriptive cross sectional study a total of 120 patients aged 16-80 years of either sex, with sputum positive smear were taken from the Pulmonary Tuberculosis department of Gulab Devi Chest Hospital, whose chest X-rays were interpreted to see the suspicion of PTB and related spectrum of abnormalities on chest X-rays. Results: Mean age of our patients was 40.7±16.8 years with male to female ratio of 1:1.4. Bilateral lung was involved in 62 (51.7%) patients and 58 (48.3%) patients have unilateral involvement of lung in chest X-rays. 68 (56.67%) patients had Infiltrative shadows. Cavitatory lesions were present in 49 (40.83%) cases and only 3 (2.5%) patients had non-cavitatory lesions on chest X-rays. Opacity or consolidation was seen in 41 (34.1%) cases while abnormalities in terms of pleural effusion or pneumothorax was seen in only 18 (15%) cases in CXR. Conclusio...
Objective: The aim of the study is to see the effect of aortic cross clamp time on renal function... more Objective: The aim of the study is to see the effect of aortic cross clamp time on renal function post operatively. Material and Methods: In a prospective study 90 patients were selected for CABG first time with normal renal function. A questionnaire was made to see the effect of aortic cross clamp time on post operative renal function. Demographic factors, pre operative, intra operative and post operative variables were evaluated. The patient were divided into two groups according to aortic cross clamp time, patient with aortic cross clamp time 50 minutes and patients with aortic cross clamp time > 50 minutes ultimately they were evaluated to see the occurrence of acute kidney injury (AKI). Results: AKI was observed in 6 patients with aortic cross clamp time = 50 minutes and 36 patients with aortic cross clamp time > 50 minutes. The aortic cross clamp time was highly associated with blood urea post operatively at day 1 (p value 0.002), day 2 (p-value 0.000) and day 3 (p-value...
Aim: To find out the factors associated with placenta previa and their contribution in causing pl... more Aim: To find out the factors associated with placenta previa and their contribution in causing placenta previa. Methods: A matched case control study was conducted in obstetrics & gynecology department of Jinnah Hospital, Lahore and completed in Gulab Devi Hospital, Lahore. The patients who presented in the hospital with vaginal bleeding and diagnosed as having placenta previa through ultrasound were included in this study. With respect to these cases (patients of placenta previa) 60 females that were not having placenta previa were selected as a control. In addition to collecting the basic demographic details questions were asked about the medical history, gynecological history and obstetrics history in order to confirm the presence or absence of related risk factor. All information was recorded on a predefined questionnaire. For the analysis of data, SPSS version 16.00 was used. Mean of both case and control groups were compared on the basis of different variables. Chi square test...
The Professional Medical Journal, 2015
Objectives: The objective of this study was to find the prevalence of cardiacdisease among pregna... more Objectives: The objective of this study was to find the prevalence of cardiacdisease among pregnant females and its impact on feto-maternal outcome. Study Design:Descriptive case series. Setting: Cardiology department Gulab Devi Chest Hospital LahoreDuration: April 2013 to April 2014. Patients & Methods: All pregnant females with cardiacdisease at any gestation with booked or un-booked statutes were included in this study. Patientswere admitted for thorough evaluation and investigations. Labor was monitored intensively. Dataregarding maternal outcomes were noted down on pre-formed questionnaire. Intra partum andpostpartum details were also noted down along with fetal outcome. The results were analyzedusing SPSS version 16.0.. Results: The total number of females presented with cardiac diseasewas 2650, out of which only 35 women were reported as pregnant. The duration of pregnancyat the time of presentation was as follows: 05 (14.2%) females presented in first trimester, 20(57.1%) in...
The Professional Medical Journal, 2015
Background: Development of heart failure is always secondary to presenceof risk factors like diab... more Background: Development of heart failure is always secondary to presenceof risk factors like diabetes mellitus, hypertension, age, smoking and underlying coronaryartery disease. Objective: The objective of this study was to find the frequency of risk factorsand coronary artery involvement in patients of heart failure after myocardial infarction. StudyDesign: A non-randomized cross sectional study. Setting: Gulab Devi Chest Hospital. Period:Six months. Methods: 100 patients was done. Using non probability (purposive) samplingtechnique; all patients with ages between 20 to 80 years, irrespective of gender, diagnosedwith heart failure (with ejection fraction ≤ 40%) secondary to STEMI were included in thestudy. Patients that were not having heart failure secondary to STEMI and those that hadn’ttheir coronary angiography done were excluded from the study. The data were analyzed usingSPSS Version 20. Descriptive statistics was used to see analyze the data. Results: Mean ageof patients was...
The Professional Medical Journal, 2015
Background: Thrombolysis In Myocardial Infarction (TIMI) risk score predictsadverse clinical outc... more Background: Thrombolysis In Myocardial Infarction (TIMI) risk score predictsadverse clinical outcomes in patients with non–ST-elevation acute coronary syndromes(NSTEACS). Whether this score correlates with the coronary anatomy is unknown. Objective:To determine the frequency of low, moderate and high TIMI risk score in patients of NSTEACSand to compare the frequency of two vessel coronary artery disease on angiography withlow, moderate and high TIMI risk scores in patients of NSTE-ACS. Study design: This was across sectional study. Setting: Department of Cardiology, Gulab Devi Chest Hospital, Lahore.Duration: Six months. Patients and Methods: Total 170 patients were included in the study.Patients’ selection was done with the help of a pre-defined inclusion and exclusion criteria. TIMIrisk score was calculated for each patient and patients were categorized into low, moderate andhigh risk groups (as per operational definition). Patients were further evaluated with coronaryangiograms t...
Pakistan Journal of Medical and Health Sciences, 2022
Objective: To find outthe frequency of cardiogenic shock in patients with ACS Study design: Cross... more Objective: To find outthe frequency of cardiogenic shock in patients with ACS Study design: Cross sectional study Methodology:A calculated sample of 240 patients presented with acute coronary syndrome confirmed clinically and/or on the basis of ECG and cardiac markers was taken. In addition to collecting basic demographic details patients were inquired about the presence of risk factors (smoking status, diabetesand hypertension).The collected data was entered and analyzed by using SPSS version 16. Quantitative variable were presented in the form of mean, range and standard deviation. Results:Out of 240 patients, 33 patients (13.8%) were having cardiogenic shock and 207 patients (86.2%) were not. In the patients presented with cardiogenic shock, there were 21 (8.8%) with STEMI, 10 (4.2%) with NSTEMI and 2 (0.8%) with unstable angina. In STEMI there were 14 patients (5.8%) with anterior wall MI, 4 patients (1.7%) with inferior wall MI and 3 patients (1.2%) with lateral wall MI. Conclu...
The Professional Medical Journal
Background: Intermittent antegrade warm blood cardioplegia is routinely usedas a mean of myocardi... more Background: Intermittent antegrade warm blood cardioplegia is routinely usedas a mean of myocardial protection since its introduction. There is a considerable debate onthe longest time off cardioplegia interval during aortic cross clamping. Objective: To see thefrequency and extent of myocardial damage in patients undergoing CABG receiving intermittentantegrade warm blood Cardioplegia at LTOC (longest time off cardioplegia) 11-15 minutes(Group I) and 16-20 minutes (Group II). Patients and Methods: A randomized prospectivestudy involving 94 patients was arranged to see the safe periods of intermittency. There weretwo groups of patients having LTOC of 11-15 minutes (Group I) and 16-20 minutes (GroupII). 20 minutes was the upper limit. The duration of study was from 1-09-2013 to 10-02-2014.Data was analyzed using SPSS Version 16. Independent sample t-test and chi-square wereapplied to see the significance. Results: Mean age was 54.1±9.36 years. There were moremales as compared to femal...
… Background: Thrombolysis In Myocardial Infarction (TIMI) risk score predicts adverse clinical o... more … Background: Thrombolysis In Myocardial Infarction (TIMI) risk score predicts adverse clinical outcomes in patients with non–ST-elevation acute coronary syndromes (NSTEACS). Whether this score correlates with the coronary anatomy is unknown. Objective: To determine the frequency of low, moderate and high TIMI risk score in patients of NSTE-ACS and to compare the frequency of two vessel coronary artery disease on angiography with low, moderate and high TIMI risk scores in patients of NSTE-ACS. Study design: This was a cross sectional study. Setting: Department of Cardiology, Gulab Devi Chest Hospital, Lahore. Duration: Six months. Patients and Methods: Total 170 patients were included in the study. Patients' selection was done with the help of a pre-defined inclusion and exclusion criteria. TIMI risk score was calculated for each patient and patients were categorized into low, moderate and high risk groups (as per operational definition). Patients were further evaluated with coronary angiograms to assess the double vessel CAD. All angiographies were performed by a single physician. Data analysis was done on SPSS version 17. Results: Mean age of our patients was 54.81±10.55 years. Gender distribution shows that there were 106(62%) male and 64(38%) female patients. TIMI score risk classification showed that among 50(29.4%) patients TIMI risk score was low, among 107(62.9%) patients it was moderate and in 13(7.6%) patients it was high. There were 105(62%) patients who had two vessel coronary artery disease. Among 105 patients who had two vessel coronary artery disease, 25(23.8%) had low TIMI score, 69(65.7%) had moderate and 11(10.5%) of the patients had high TIMI score. Conclusion: In patients with non-ST-elevation acute coronary syndrome undergoing cardiac catheterization, the TIMI risk score is significantly associated with two vessel coronary artery disease. So it should be recommended that a routine invasive strategy be carried in patients with moderate or higher TIMI risk score.
Background: Acute myocardial infarction (M.I) is potentially critical and the most common cardia... more Background: Acute myocardial infarction (M.I) is potentially critical and the most common cardiac
emergency presenting to a hospital. Having significant mortality and morbidity cardiovascular risk
factors are on the rise in Pakistan. In view of the associated lower survival ischemic heart diseases thus
represent an important public health problem.
Aim and Objective: The objective of the study was to determine the frequency of various conventional
risk factors in the patients presenting with myocardial infarction, so as to guide our planning for primary
and
secondary
prevention
of
this
disease
in
our
community.
Methodology: A total of 100 consecutive patients from 20 – 80 years of age presenting with MI were
included in the study. Their detailed history was taken including symptoms at presentation and their
risk factors were assessed with the help of history and laboratory investigations. Following common
risk factors were studied namely, gender, smoking, hypertension, diabetes, hyperlipidemia, family history
and
obesity.
Results: Frequency wise risk factors were lined up as male sex (74%), smoking (70%), hypertension
(62%), diabetes mellitus (60%), hyperlipidemia (44%), family history (40%) and obesity (14%). Out of
these risk factors, 48% patients were presented with at least one major risk factor, 23% with two major
risk factors and 29% were presented with three or more major risk factors.
Conclusion: Smoking, hypertension, diabetes and hyperlipidemia were the major modifiable risk factors
in our patients, which require a better control. The awareness of risk factors amongst the general
public is low. Thus there is an urgent need to create more and more awareness about the preventive aspects
and
healthier
life
style
in
our
community.
Key Words: Ischemic heart diseases, Risk factors, Morbidity, Coronary artery disease.
ABSTRACT… Objectives: The objective of this study was to find the prevalence of cardiac
disease a... more ABSTRACT… Objectives: The objective of this study was to find the prevalence of cardiac
disease among pregnant females and its impact on feto-maternal outcome. Study Design:
Descriptive case series. Setting: Cardiology department Gulab Devi Chest Hospital Lahore
Duration: April 2013 to April 2014. Patients & Methods: All pregnant females with cardiac
disease at any gestation with booked or un-booked statutes were included in this study. Patients
were admitted for thorough evaluation and investigations. Labor was monitored intensively. Data
regarding maternal outcomes were noted down on pre-formed questionnaire. Intra partum and
postpartum details were also noted down along with fetal outcome. The results were analyzed
using SPSS version 16.0.. Results: The total number of females presented with cardiac disease
was 2650, out of which only 35 women were reported as pregnant. The duration of pregnancy
at the time of presentation was as follows: 05 (14.2%) females presented in first trimester, 20
(57.1%) in second trimester, 08 (22.8%) in third trimester and 02 (5.7%) patients presented in
postpartum period. There were 08 (22.8%) patients who had preterm labor. In terms of fetal
outcome 04 babies had birth weight of less than 1.5 kg, 12 had 1.5-2.0 kg, 15 were in range
of 2-2.5 kg and 04 were more than 2.5 kg. 27 (77.1%) were term and 08 (22.8%) were preterm
babies. Cleft lip and atrial septal defect were the only two identified congenital anomalies.
Conclusion: The overall prevalence of cardiac diseases during pregnancy was found to be 1.3% in this study. Most common affected age group was of 20-25 years. Most common cardiac
disease found in our patient was mitral stenosis. 02 pregnancies ended in intrauterine fetal
death. 08 babies were born preterm. Cleft lip and atrial septal defect were the only two identified
congenital anomalies in newborn delivered by our pregnant patients. Every effort should made
to create awareness regarding pre-pregnancy counseling, so that associated fetal and maternal
morbidity can be reduced.
Key words: Valvular heart disease, maternal health, Child Health.
ABSTRACT
Objective: Hospitals and other healthcare
establishments have a duty of care for the
env... more ABSTRACT
Objective: Hospitals and other healthcare
establishments have a duty of care for the
environment and for public health.
Negligence regarding biomedical waste
management can cause serious
environmental and public health issues. The
objective of this study was the evaluation of
existing waste management situation in
public hospitals and private health sectors.
Methodology: A cross sectional study was
conducted in nine hospitals. The
methodology consisted of performing
interviews with the authorities and
personnel involved in the management
regarding administrative aspects, handling
& treatment strategies for hospital waste.
Results: In this cross sectional study we
observed that out of 09 hospitals 06
hospitals had a proper written HWM plan,
06 had training programs but only 44.4% of
them had received the training. 07 out 09
(78%) were aware of hospital waste
associated risks. HW weighing was done in
only 04 hospitals. Proper segregation was
available in all (100%) hospitals. With
respect to storage of the waste 04 hospitals
had temporary, 03 had central and 01 had
both temporary and central storage areas.
On-site transport was carried out on carts,
trolleys and two wheels bin containers while
off-site transportation was carried out on
dedicated vehicles and on municipality
vehicles. On-site treatment facility was
available as per follows: Open fire 22%,
Incineration 11% and chemical disinfection
was 00. Hospital waste was disposed off in
pits in 01 0f 09 hospitals, in municipal
dumping sites in 04 hospitals and burned in
03 hospitals. None of the hospital had waste
water treatment plant.
Conclusion: Handling, segregation,
disinfection, storage, transportation and
final disposal are vital steps for safe and
scientific management of biomedical waste
in any establishment. To minimize the risk
to public health, we found that waste
segregation, as well as infectious waste
treatment prior to disposal, has to be
conducted properly by the hospital
management.
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Papers by Usman Javed Iqbal
emergency presenting to a hospital. Having significant mortality and morbidity cardiovascular risk
factors are on the rise in Pakistan. In view of the associated lower survival ischemic heart diseases thus
represent an important public health problem.
Aim and Objective: The objective of the study was to determine the frequency of various conventional
risk factors in the patients presenting with myocardial infarction, so as to guide our planning for primary
and
secondary
prevention
of
this
disease
in
our
community.
Methodology: A total of 100 consecutive patients from 20 – 80 years of age presenting with MI were
included in the study. Their detailed history was taken including symptoms at presentation and their
risk factors were assessed with the help of history and laboratory investigations. Following common
risk factors were studied namely, gender, smoking, hypertension, diabetes, hyperlipidemia, family history
and
obesity.
Results: Frequency wise risk factors were lined up as male sex (74%), smoking (70%), hypertension
(62%), diabetes mellitus (60%), hyperlipidemia (44%), family history (40%) and obesity (14%). Out of
these risk factors, 48% patients were presented with at least one major risk factor, 23% with two major
risk factors and 29% were presented with three or more major risk factors.
Conclusion: Smoking, hypertension, diabetes and hyperlipidemia were the major modifiable risk factors
in our patients, which require a better control. The awareness of risk factors amongst the general
public is low. Thus there is an urgent need to create more and more awareness about the preventive aspects
and
healthier
life
style
in
our
community.
Key Words: Ischemic heart diseases, Risk factors, Morbidity, Coronary artery disease.
disease among pregnant females and its impact on feto-maternal outcome. Study Design:
Descriptive case series. Setting: Cardiology department Gulab Devi Chest Hospital Lahore
Duration: April 2013 to April 2014. Patients & Methods: All pregnant females with cardiac
disease at any gestation with booked or un-booked statutes were included in this study. Patients
were admitted for thorough evaluation and investigations. Labor was monitored intensively. Data
regarding maternal outcomes were noted down on pre-formed questionnaire. Intra partum and
postpartum details were also noted down along with fetal outcome. The results were analyzed
using SPSS version 16.0.. Results: The total number of females presented with cardiac disease
was 2650, out of which only 35 women were reported as pregnant. The duration of pregnancy
at the time of presentation was as follows: 05 (14.2%) females presented in first trimester, 20
(57.1%) in second trimester, 08 (22.8%) in third trimester and 02 (5.7%) patients presented in
postpartum period. There were 08 (22.8%) patients who had preterm labor. In terms of fetal
outcome 04 babies had birth weight of less than 1.5 kg, 12 had 1.5-2.0 kg, 15 were in range
of 2-2.5 kg and 04 were more than 2.5 kg. 27 (77.1%) were term and 08 (22.8%) were preterm
babies. Cleft lip and atrial septal defect were the only two identified congenital anomalies.
Conclusion: The overall prevalence of cardiac diseases during pregnancy was found to be 1.3% in this study. Most common affected age group was of 20-25 years. Most common cardiac
disease found in our patient was mitral stenosis. 02 pregnancies ended in intrauterine fetal
death. 08 babies were born preterm. Cleft lip and atrial septal defect were the only two identified
congenital anomalies in newborn delivered by our pregnant patients. Every effort should made
to create awareness regarding pre-pregnancy counseling, so that associated fetal and maternal
morbidity can be reduced.
Key words: Valvular heart disease, maternal health, Child Health.
Objective: Hospitals and other healthcare
establishments have a duty of care for the
environment and for public health.
Negligence regarding biomedical waste
management can cause serious
environmental and public health issues. The
objective of this study was the evaluation of
existing waste management situation in
public hospitals and private health sectors.
Methodology: A cross sectional study was
conducted in nine hospitals. The
methodology consisted of performing
interviews with the authorities and
personnel involved in the management
regarding administrative aspects, handling
& treatment strategies for hospital waste.
Results: In this cross sectional study we
observed that out of 09 hospitals 06
hospitals had a proper written HWM plan,
06 had training programs but only 44.4% of
them had received the training. 07 out 09
(78%) were aware of hospital waste
associated risks. HW weighing was done in
only 04 hospitals. Proper segregation was
available in all (100%) hospitals. With
respect to storage of the waste 04 hospitals
had temporary, 03 had central and 01 had
both temporary and central storage areas.
On-site transport was carried out on carts,
trolleys and two wheels bin containers while
off-site transportation was carried out on
dedicated vehicles and on municipality
vehicles. On-site treatment facility was
available as per follows: Open fire 22%,
Incineration 11% and chemical disinfection
was 00. Hospital waste was disposed off in
pits in 01 0f 09 hospitals, in municipal
dumping sites in 04 hospitals and burned in
03 hospitals. None of the hospital had waste
water treatment plant.
Conclusion: Handling, segregation,
disinfection, storage, transportation and
final disposal are vital steps for safe and
scientific management of biomedical waste
in any establishment. To minimize the risk
to public health, we found that waste
segregation, as well as infectious waste
treatment prior to disposal, has to be
conducted properly by the hospital
management.
emergency presenting to a hospital. Having significant mortality and morbidity cardiovascular risk
factors are on the rise in Pakistan. In view of the associated lower survival ischemic heart diseases thus
represent an important public health problem.
Aim and Objective: The objective of the study was to determine the frequency of various conventional
risk factors in the patients presenting with myocardial infarction, so as to guide our planning for primary
and
secondary
prevention
of
this
disease
in
our
community.
Methodology: A total of 100 consecutive patients from 20 – 80 years of age presenting with MI were
included in the study. Their detailed history was taken including symptoms at presentation and their
risk factors were assessed with the help of history and laboratory investigations. Following common
risk factors were studied namely, gender, smoking, hypertension, diabetes, hyperlipidemia, family history
and
obesity.
Results: Frequency wise risk factors were lined up as male sex (74%), smoking (70%), hypertension
(62%), diabetes mellitus (60%), hyperlipidemia (44%), family history (40%) and obesity (14%). Out of
these risk factors, 48% patients were presented with at least one major risk factor, 23% with two major
risk factors and 29% were presented with three or more major risk factors.
Conclusion: Smoking, hypertension, diabetes and hyperlipidemia were the major modifiable risk factors
in our patients, which require a better control. The awareness of risk factors amongst the general
public is low. Thus there is an urgent need to create more and more awareness about the preventive aspects
and
healthier
life
style
in
our
community.
Key Words: Ischemic heart diseases, Risk factors, Morbidity, Coronary artery disease.
disease among pregnant females and its impact on feto-maternal outcome. Study Design:
Descriptive case series. Setting: Cardiology department Gulab Devi Chest Hospital Lahore
Duration: April 2013 to April 2014. Patients & Methods: All pregnant females with cardiac
disease at any gestation with booked or un-booked statutes were included in this study. Patients
were admitted for thorough evaluation and investigations. Labor was monitored intensively. Data
regarding maternal outcomes were noted down on pre-formed questionnaire. Intra partum and
postpartum details were also noted down along with fetal outcome. The results were analyzed
using SPSS version 16.0.. Results: The total number of females presented with cardiac disease
was 2650, out of which only 35 women were reported as pregnant. The duration of pregnancy
at the time of presentation was as follows: 05 (14.2%) females presented in first trimester, 20
(57.1%) in second trimester, 08 (22.8%) in third trimester and 02 (5.7%) patients presented in
postpartum period. There were 08 (22.8%) patients who had preterm labor. In terms of fetal
outcome 04 babies had birth weight of less than 1.5 kg, 12 had 1.5-2.0 kg, 15 were in range
of 2-2.5 kg and 04 were more than 2.5 kg. 27 (77.1%) were term and 08 (22.8%) were preterm
babies. Cleft lip and atrial septal defect were the only two identified congenital anomalies.
Conclusion: The overall prevalence of cardiac diseases during pregnancy was found to be 1.3% in this study. Most common affected age group was of 20-25 years. Most common cardiac
disease found in our patient was mitral stenosis. 02 pregnancies ended in intrauterine fetal
death. 08 babies were born preterm. Cleft lip and atrial septal defect were the only two identified
congenital anomalies in newborn delivered by our pregnant patients. Every effort should made
to create awareness regarding pre-pregnancy counseling, so that associated fetal and maternal
morbidity can be reduced.
Key words: Valvular heart disease, maternal health, Child Health.
Objective: Hospitals and other healthcare
establishments have a duty of care for the
environment and for public health.
Negligence regarding biomedical waste
management can cause serious
environmental and public health issues. The
objective of this study was the evaluation of
existing waste management situation in
public hospitals and private health sectors.
Methodology: A cross sectional study was
conducted in nine hospitals. The
methodology consisted of performing
interviews with the authorities and
personnel involved in the management
regarding administrative aspects, handling
& treatment strategies for hospital waste.
Results: In this cross sectional study we
observed that out of 09 hospitals 06
hospitals had a proper written HWM plan,
06 had training programs but only 44.4% of
them had received the training. 07 out 09
(78%) were aware of hospital waste
associated risks. HW weighing was done in
only 04 hospitals. Proper segregation was
available in all (100%) hospitals. With
respect to storage of the waste 04 hospitals
had temporary, 03 had central and 01 had
both temporary and central storage areas.
On-site transport was carried out on carts,
trolleys and two wheels bin containers while
off-site transportation was carried out on
dedicated vehicles and on municipality
vehicles. On-site treatment facility was
available as per follows: Open fire 22%,
Incineration 11% and chemical disinfection
was 00. Hospital waste was disposed off in
pits in 01 0f 09 hospitals, in municipal
dumping sites in 04 hospitals and burned in
03 hospitals. None of the hospital had waste
water treatment plant.
Conclusion: Handling, segregation,
disinfection, storage, transportation and
final disposal are vital steps for safe and
scientific management of biomedical waste
in any establishment. To minimize the risk
to public health, we found that waste
segregation, as well as infectious waste
treatment prior to disposal, has to be
conducted properly by the hospital
management.