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ObjectivesThe aim of this study was to assess the prognosis in patients with left main coronary artery stenosis one year after percutaneous coronary intervention (PCI).MethodsOur study included 40 patients who underwent PCI for left main coronary artery stenosis without the use of intravascular ultrasound (IVUS). Patients were followed for a year, and the prognostic effect of PCI on a composite end-point of revascularization, new myocardial infarction, cardiac death, and on all-cause mortality was assessed in multivariable Cox analysis.ResultsThe multivariable analysis showed a good prognosis in patients receiving PCI with a total event rate of 7.5%. The independent predictors for major adverse cardiac events (MACE) were diabetes (p = 0.02). Other prognostic factors included in the model were gender, age, smoking, body mass index (BMI), hypertension, the complexity of the vessel, and ejection fraction.ConclusionPCI for left main coronary artery stenosis without the use of IVUS has a good prognosis after one year of clinical follow-up.

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One of the common indications for fibreoptic bronchoscopy in clinical practiceis patients presenting with radiological hilar and parahilar mass lesions. The study was aimed at better understandingof disease pattern on fibreoptic bronchoscopy in such patients. Objectives: To determine frequency of variousdiseases confirmed on fibreoptic bronchoscopies conducted for hilar and parahilar radiological opacities. Determine thefrequency of complications during fibreoptic bronchoscopy. Design: Descriptive study. Place and Duration of Study:This study was conducted at Military Hospital Rawalpindi from June 2002 to Dec 2002, which is a tertiary carehospital for armed forces. Materials & Methods: Sixty patients undergoing fibreoptic bronchoscopy for hilar andparahilar opacities were included in the study. Endobronchial biopsies, bronchial washing and brushing were performedfor histopathological and cytological analysis. Results: The most frequent finding on Bronchoscopy was anendobronchial mass lesion in 41 (68.3%) cases followed by inflammatory changes in 5(8.4%) and external compressionin 7(12%) cases. No endobronchial mass was seen in 7(12%) patients. Diagnostic yield was highest in patients in whoma mass lesion was seen on bronchoscopy, yielding a diagnosis in 97.5% of cases. Bronchogenic carcinoma was themost common diagnosis( 87.8%) in such cases with squamous cell carcinoma as the most frequent subtype 24 (58.5%).The diagnostic yield was low when either inflammatory changes, external compression or normal bronchial findings wereobserved on bronchoscopy. Overall Histopathological and cytological examination of the biopsies showed bronchogeniccarcinoma in 40(65%) cases, squamous cell in 28(70%) cases, small cell in 10 (25%) cases and adenocarcinoma in2(5%) cases, squamous metaplasia in 3(5%), non-specific inflammation in 7(10%), chronic non-caseatinggranulomatous inflammation in 2(3.3%) and caseating granuloma (tuberculosis) in 1(1.7%) case. No large cell orundifferentiated carcinoma was seen in this study. No histological diagnosis could be made in 8(14%) cases. Majorbleed occurred in one (1.6%) case who had a highly vascular tumor bleeding on biopsy. Minor bleed was seen in 3(5%)cases and marked fall in O2 saturation was noted in 2(3.3%) patients. No complications were observed in 54(90%)patients. Conclusion: Fibreoptic bronchoscopy is a high yield diagnostic procedure in hilar and parahilar lung shadowsand is completely safe and is highly recommended in all such cases as most will have malignant tumors requiringhistological diagnosis. Tuberculosis is an uncommon diagnosis in such patients. Complications of the procedure arefew and mostly minor .

Introduction: Serum potassium levels have been shown in some animal studies to be associated with the process of atherosclerosis. We decided to assess the correlation of serum potassium level in ischemic heart disease patients with disease severity and its relationship with prognosis in terms of major acute cardiac events (MACE). Material and methods: This was a cross-sectional cohort study carried out at cardiology department of Rehman Medical Institute, from July 2016 to 31 st Aug. 2018 a period of 26 months. 622 patients were included in the study. Clinical and angiographic characteristics were assessed based on the serum potassium level. Correlation of serum potassium level with Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) and Gensini scores was also evaluated. Follow up for MACE was carried out after one year. Results: Mean serum potassium level was 3.93 ± 0.95 (mEq/l) in coronary artery disease patients. Serum potassium level showed negative correlation with SYNTAX score (r =-0.60, p < 0.05) and Gensini score (r =-0.64, p < 0.05). There was also a significant difference between low and high potassium level in relation to the multi-vessel disease on coronary angiography (p < 0.05). Low potassium level was a good predictor of adverse outcomes as shown by Kaplan-Meier analysis. Multivariate Cox regression analysis showed that serum potassium level and diabetes were independent predictors of MACE (p < 0.05). Conclusion: Low serum potassium level is correlated with more severe coronary atherosclerosis. Low potassium levels are associated with significantly poor outcomes.