Background: Pericardiectomy procedure is commonly indicated for constrictive pericarditis (CP). One of the most important clue to diagnosis of CP is the signs and symptoms of right-sided heart failure that are not completely explained by presence of pulmonary disease or left-ventricular failure. The aim of this study was to assess clinical data presentation and early operative outcomes of pericardiectomy performed for symptomatic chronic constrictive pericarditis who had failed maximal medical therapy. Methodology: A retrospective analysis was carried out of consecutive constrictive pericarditis adult age patients who underwent pericardiectomy procedure from 2002 to 2012. The patients who had intraoperative diagnosis of other then constrictive pericarditis were excluded from further analysis. A total 51 patients were selected for this study. The preoperative assessment, intraoperative findings and postoperative course and outcome such as hospital stay, prolonge ICU stay, post-operative CPV etc. were evaluated. Results: 43 males and 8 females were include in the study among them 41% gave history of previous (TB) and 35% were pediatric patients (teens, as shown less than 19 years). 8 patients had effusive type pericarditis. The preoperative findings revealed dyspnea 54%, Chest Pain 45% and persistent cough 31%. Furthermore, 43% patients had ascites and 41% with pleural effusion. The mean preoperative central venous pressure (CVP) was 20.5 respectively. The post-operative outcome was short hospital stay, the post-operative patients CVP was estimated 13.5 and the mean drop of CVP due to pericardiectomy was estimated 7 respectively. Conclusion: The conclusive findings of our study revealed that among the patients of symptomatic chronic tuberculous CP, the timely pericardiectomy attempt can effectively improve the hemodynamics of the patient. The early pericardiectomy can also reduce the morbidity and mortality rate of these patients.

Background: The most common immunosuppressant, Anti-thymocyte Globulin (ATGs) has been widely used by clinicians for the treatment and prevention of rejection at the time of organ transplant. Transplantation is the best option for the people with renal failure at end stage, requiring replacement of renal therapy. This is a promising treatment option with significant benefits in terms of mortality and morbidity. ATG prevents organ rejection by inhibition of activated T-cells and other immune and nonimmune cells. The aim of the study was to compare different induction regimens with ATG for the survival of smooth kidney transplantation. Methodology: Studies of the last 20 years, focusing on kidney transplantation and the efficacy of antithymocyte use for kidney transplantation were reviewed for the study literature. The keywords used were Kidney Transplantation, Induction agents, ATG, Allograft, Immunosuppressant Agents. Results: Literature suggested that the most important problem with transplantation is the protection of the allograft from activated immunological forces, which begin to react early in the period after transplantation and cause significant damage with serious short-term and long-term consequences. This process is called rejection, which is usually classified as cell-mediated and antibody-mediated rejection. The phenomenon mediated by cells causes concern, as it is the cause of future failures and damage to the allograft. To combat these phenomena with different results, various strategies were adopted. Among these therapies, ATG has recognized the exceptional importance of preventing cellular mediated rejection, allowing allotransplants to function smoothly with the greatest possible long-term benefits. Conclusion: It can be concluded on the basis of previous studies that ATG as an induction agent, is more efficient in reducing the rejection rate in the renal transplantation as compared with other agents.

Background: The pediatric risk of mortality (PRISM) score predicts mortality in the pediatric intensive care unit (PICU). This study aimed to evaluate the application of PRISM score as a predictor of mortality in intensive care units of a tertiary hospital. Methodology: A descriptive cross-sectional study of one year was conducted within the Department of Pediatrics at Ziauddin University and Hospital, located in Karachi, Pakistan. The total number of 263 admitted neonates and children up to the age of 12 years were included. Patients more than 12 years of age admitted in wards and plane for any surgery were excluded from the study; the PRISM score tool was used to collect the data of the neonates and children. Results: The mean PRISM score was high among non-survivors (15.3 ± 7.2) as compared to survivors (12.7 ± 9.2) (p=0.023). The predictability of the PRISM score regarding pediatric mortality was shown by the area under the curve (AUC) i.e., 0.636. Conclusion: The PRISM score found a significant difference between survival and death groups. Therefore the implication of the PRISM score can be needed in PICU to reduce the mortality rate.