Objective: The purpose of this study was to ascertain the prevalence of silent cardiac ischemia in diabetic patients with type II diabetes. Study Design: Cross-sectional Place and Duration: This study was conducted at Fazaia Medical College, Islamabad from January, 2022 to June, 2022. Methods: Total 115 patients of type-II diabetes mellitus were presented in this study. After taking a thorough medical history, the patient had electrocardiography (ECG) both before and after exercise tolerance testing. This was done in addition to recording their height, blood pressure, weight, and fasting blood sugar levels (ETT). Changes in the electrocardiogram were analysed, and the patient was classified as having silent cardiac ischemia or not depending on the results of the ECG. SPSS 22.0 was used to analyze all data. Results: There were 75 (65.2%) males and 40 (34.8%) females in this study. The mean age was 51.13± 10.29 years and had mean BMI 26.7±8.44 kg/m2. Mean fasting blood sugar was 171±22 mg/dl. Frequency of hypertension was found in 47 (40.9%) cases and 38 (33.04%) patients were smokers. We found that 50 (43.5%) cases had silent cardia ischemia. There was a strong correlation between silent cardiac ischemia and factors such as increasing age, prolonged duration of diabetes mellitus, a smoking history, a history of hypertension, and an increased body mass index (p-value 0.05). Conclusion: We observed that silent cardiac is quite frequent in our population, which necessitates immediate measures to diagnose this issue early for the sake of improved results in the future. Keywords: Type II diabetes mellitus, BMI, Silent cardiac ischemia, Hypertension

Objective: The study was conducted with the aim to estimate the frequency of abnormal lipid distribution in patients with coronary artery disease. Study design: cross sectional, comparative study Place and duration: This study was conducted at Rawal Institute of Health Sciences, Pakistan and Rashid Latif Medical College Lahore in the period from April, 2022 to September, 2022. Methodology: A total of one hundred and thirty two participants of both genders were selected as the study population on obeying the inclusion and exclusion criteria of the study. Participants were distributed in the two comparable groups with 92 CHD patients in case group and 40 healthy people in control group. An informed written consent was signed by all the participants to record patients detailed demographics age, sex and body mass index. Blood sample was taken from each participant to analyze the lipid profile. Frequency of lipid profile (cholesterol, triglycerides, HDL-C, LDL-C and VLDL) were measured using commercially available kits. The entire data was analyzed via SPSS 24.0. Results: Among the total participants, the majority were males (75.8%) while females were (24.2%). Most of the participants were aged > 60 (36.4%), while participants had BMI >25kg/m2 were (56.8%). Majority of the participants were married (64.4%). In the case group, mean TC(>200mg/dl) was 263.91± 23.73, mean TG(>150mg/dl) was 210.71± 42.17, mean HDLc(<40mg/dl) was 47.44±5.91 and mean LDLc(>130mg/dl) was 99.88±20.73 respectively. Case group with CAD showed the majority of males (70.65%) while 29.35% were females. Conclusion: In the given study, it was found that the frequency of abnormal lipid profile (TC, TG, HDL-C and LDL-C) concentrations were considerably higher in the patients with coronary artery disease. Total cholesterol and serum triglyceride were significantly higher than LDL-C and HDL-C. Moreover, males were more likely to had lipid profile abnormalities than females. Keywords: lipid profile, abnormalities, CAD, frequency

Objective: Explore the causes of patients' delayed hospital visits after presenting with acute myocardial infarction to better understand this issue. Study Design: Cross-sectional Place & Duration: Department of Cardiology, Rawal Institute of Health Sciences, Islamabad during the period from February, 2022 to July, 2022. Methods: Seventy patients of both sexes were enrolled in this study, all of whom had been diagnosed with acute myocardial infarction. Ages of patients ranged from 18 to. A patient's age, sex, place of residence, level of education, and socioeconomic position were meticulously noted. It was recorded how often people were running late. Reasons for the late arrival were calculated. Results: There were a total of 70 patients, 48 (70%) of whom were male and 22 (30%) female. Patients between the ages of 41 and 50 made up the largest age group, followed by those between the ages of 51 and 65. It was found that 42 patients (62.9%) arrived more than 2 hours after their symptoms had begun. The use of public transportation was the leading cause of arrival delays (51.4%), followed by large distance (more than 20 km) (38.5%) and the lack of an attendant (38.5%). Conclusion: We found that a significant proportion of patients with acute myocardial infarction had a delayed arrival. The most common causes of late arrival at the hospital were the use of public transportation, travel distance, lack of education, and low socioeconomic level. Keywords: Delayed arrival, Risk factors, Acute myocardial infarction,

Background: Treatment delay is considered to be one of the important predictors of survival in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). We investigated the impact of early successful PPCI for STEMI patients on left ventricular ejection fraction. Methodology: This prospective study was carried out on 50 patients having STEMI undergoing PPCI in NICVD Karachi. Patients were divided into two groups, Group A, early presenter, patients received treatment with PPCI within six hours of the onset of symptoms, and group B, late presenter, patients received treatment after six hours up to twenty-four hours of the onset of symptoms. Results: Group A patients showed promising results, having achieved TIMI grade III flow in 100%, whereas 85% of patients achieved TIMI grade III flow in group B (P = 0.02). There was a statistical difference between the two groups. Using Independent sample T-Test Group A patients showed improved LVEF as compared to Group B (at presentation 45.49±3.99% vs. 35.25±3.85%; P = 0.001 and at 3 months follow up 55.66±0.92% vs. 45.75±1.44%; P = 0.001). Conclusion: Early PPCI treatment of STEMI patients can lead to improved TIMI grade flow and LVEF. Efforts must be made to shorten the delay in reperfusion therapy.