Objective: To determine the relative efficacy of intravenous heparin as compared to intra-arterial heparin used during transradial coronary angiography for the prevention of radial artery occlusion. Study Design: Comparative cross-sectional study. Place and Duration of Study: Study was conducted at the Department of Cardiology, AFIC/NIHD Rawalpindi, Pakistan, from Jul 2019 to Dec 2019. Methodology: A total number of 144 patients were considered for the study using the consecutive sampling technique who were undergoing diagnostic coronary angiography. Patients were divided into the intra-arterial group (n=72) who received 50 IU/kg of unfractionated heparin (maximal dose 5,000 U) intra-arterially, and an intravenous group (n=72) received the similar dose through intravenous route. All patients were administered 100 mcg of nitroglycerin to minimize radial artery spasm. Coronary Angiography was performedusing a 6F introducer sheath and diagnostic catheters. Early radial artery occlusion (RAO) at 24 hours after the procedure was detected by performing the plethysmographic (reverse Barbeau’s) and doppler USG evaluation. Chronic RAO was assessed 30 days after the procedure by performing the same tests. Data was collected through a predesigned proforma and analyzed using SPSS 23. A p-value of less than 0.05 was considered as significant. Results: Early RAO was found in 4 (5.6%) of the patients from the intra-arterial groupand 5 (6.9%) of the intravenous group. The difference was found to be statistically insignificant (p-value 0.731). Chronic RAO was observed in 3 (4.4%) of the intra-arterial group as compared to 4 (6%) of the intravenous group. This difference was also statistically insignificant (p-value 0.683) for chronic RAO. Conclusion: Intra-arterial and intravenous heparin administration providedsimilar efficacy to prevent RAO.
Objective: To review all the patients of spinal dysraphism referred to our center over a three year period in order to identify the most typical neuro-radiological appearances on Magnetic Resonance Imaging. Study Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi from Jan 2016 to Dec 2018. Methodology: MR spine reports of 144 patients of spinal dysraphism were retrospectively analyzed. Age, gender, indication for MRI, operative status, and neuro-radiological features (including site and type of lesion) were recorded for these patients. Results: Congenital spinal malformations were more frequent among females87 (60.4%) and between 0-20 years 135 (93.9%) of age. Tethered cord 97 (67.4%) was the most common congenital spinal abnormality followed by spina bifida, diastematomyelia, vertebral segmentation anomalies, myelomeningocele, menigocele. Lip-myelomeningocele, lipoma of filum terminale, and sacral agenesis. Frequently observed associated abnormalities included scoliosis 61 (42.4 %), syrinx 47 (32.6%) and dural ectasia 40 (27.8 %). Conclusion: Congenital spinal malformations are usually complex with variable radiological appearances. Modern high resolution MRI screening is the examination of choice for identification, preoperative evaluation, and long term follow up of such congenital anomalies.
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