Introduction: Reinfarction after incidence of myocardial infarction is a serious complication and is responsible for high mortality. Various factors are responsible for reinfarction including smoking, prior procedures or surgeries, and use of medications such as aspirin, β-blocker, and angiotensin-converting enzyme Iihibitor or angiotensin receptor blockers.Material and Methods: This prospective study was conducted with 243 participants. Participants were divided into two groups: patients who had a reinfarction during hospital and patients who did not.Results: There were 142 (58.4%) men and 101 (41.6%) women in the study. A total of 17 (6.9%) patients had reinfarction. Age (68.4±10.9 vs. 64.4±11.8; 0.001), diabetes (47.05% vs. 22.12%; 0.02), and history of myocardial infarction (29.5% vs. 11.4%; 0.02) were identified as risk factors for reinfarctionConclusion: Our study reports that certain parameters such as age, obesity, diabetes mellitus,, and history of myocardial infarction can be used to assess the risk of reinfarction among these patients.

Introduction: Patients having a cardiovascular disease experience negative states of psychology. An increased incidence of coronary artery disease is attributed to both depression and anxiety.Materials and methods: In this retrospective study, the Hospitalized Anxiety and Depression Scale (HADS) was used to determine anxiety and depression in stable patients of myocardial infarction (MI) at the time of their discharge. All responses were based on the patients’ perceptions two weeks prior to acute MI event. SPSS version 21.0 was used for data entry and analysis.Results: The mean age of the participants in our study was 49.09±5.61 years. About 52.83% (n=28) and 58.49% (n=31) participants suffered from anxiety and depression two weeks prior to their myocardial infarction.Conclusion: Depression and anxiety can be a risk factor for myocardial infarction in susceptible individuals. Attention should be given to mental well-being, and a multi-disciplinary management approach should be taken for these patients including psychiatry and psychology.

Introduction Coronary artery bypass graft (CABG) is the most potent of surgical procedures; in this procedure, the narrowing of the coronary artery due to atherosclerotic plaque is bypassed by forming an alternate route for blood flow to the heart. There are various risk factors associated with the procedure. The aim of this study was to observe if postoperative outcomes are affected by preoperative hematocrit (hct) levels in patients. Methods This longitudinal study was conducted from April 2019 to December 2019. Eighty-two (82) participants who were to undergo CABG surgery were divided into two groups based on their preoperative hct levels. Group 1 had 42 participants with lower levels of hct (less than 35.5% for women and 38.3% for men), whereas group 2 consisted of 40 participants with normal hct levels (greater than 35.5% for women and 38.3% for men). Results The results showed that participants undergoing CABG with lower than normal hct levels had increased blood loss through drainage as compared to participants who had normal hct levels (680.1 ± 301 mL vs. 500.7 ± 412 mL; p-value: 0.02). Group 1 participants also had an increased need for blood and blood product transfusion as compared to group 2 (3.2 ± 1.8 units vs. 1.8 ± 0.9 units; p-value: <0.0001). Furthermore, the participants in group 1 had longer stays in the ICU relative to the other group (5.2 ± 3.1 days vs. 3.4 ± 2.5 days; p-value: 0.003). Conclusion Based on our findings, patients who undergo CABG surgery with lower than normal hct levels are at increased risk of certain complications, including excessive blood loss, need for transfusion, and increased duration of ICU stay. Therefore, preoperative hct levels should be routinely checked in patients undergoing CABG to prevent these complications.

Objectives:To find out the effectiveness of “Illness management and Recovery(IMR)” program as a group intervention for improving daily functioning of clients suffering fromsevere psychiatric illnesses.Setting:The Recovery House, a Psychiatric Rehabilitation Centerin Karachi, Pakistan. Period:Dec 2012 to Sep 2013.Methodology:Fifteen(15) patients wereenrolled in the study. They were randomly divided into two groups, one group with 7 patientsand the second with 8 patients. Informed consent was obtained from the patients and theirfamily. A semi-structured Proforma was used to record the demographic details of patients.Before Starting the IMR program, 15 points rating scale was administered on patients (pre-IMRassessment) and after 9-month program implementation, the scale was again administered(post-IMR assessment) to evaluate the effectiveness of Illness management Program as a groupintervention. After each IMR session patients received sheets to work as homework assignmentsfrom the handouts. Patients received IMR program with, supportive, educational, motivationaland cognitive behavior interventions in group and individual sessions with practitioner. Datacollected was entered into and analyzed by using statistical package for the social science –seventeenth version (SPSS 17).Results:Out of the total 15 patients, 12 (80%) were male and 3(20%) were female. Age range 15 to 67 years with mean age was 37+8.5 years. Education statusof the patients revealed that all patients were educated; 04 (26.7%) had achieved education tothe graduation level; 04 (26.7%) were matriculate; 04 (26.7%) were primary passed; and 03(20%) were educated up to intermediate level. Patients with severe psychiatric illnesses werebipolar disorder 2(13.3%) cases, personality disorder 3(20%) cases, delusional disorder 1(6.7)case, schizophrenia 8(53.3%) cases and schizoaffective 1(6.7%) cases. Total number of WMR(Wellness management and recovery) session attended by each patient ranged from 30 to 62sessions. Results in 15 areas of assessment on the rating scale before the application of illnessmanagement and recovery sessions (Pre-IMR sessions) and after the application of sessions(Post-IMR sessions).Conclusion:Illness management and recovery program is an effective toolto bring about a significant improvement in several domains of life among patients sufferingfrom severe psychiatric illnesses.