: Heart failure (HF) is a chronic illness with high prevalence and mortality, leading to economic burden of health due to prolonged hospital stay and re-admissions. Failure to comprehend the importance of identifying mental illnesses could lead to explanations that why the morbidity and mortality of heart failure patients endure to be very high. Objective: To determine the frequency of anxiety and depression in heart failure patients. Methods: It is a descriptive cross sectional study including 323 CHF patients admitted to the Faisalabad Institute of Cardiology hospital, 250 were males and 73 were females, mean age was 54.1 ± 9.2 years having 70 years as maximum and 25 years as minimum.  Data was collected with the help of HADS questionnaire. Patients were interviewed for assessment of anxiety and depression. Data was analyzed using SPSS version 24. Mean and standard deviation was calculated for quantitative data and for qualitative data frequency and percentages was calculated. To measure the association of anxiety and depression with age categories and gender, chi square test was used. P values less than and equal to 0.05 were taken as significant. Results: The results showed that 43% subjects had <11 score indicating no anxiety, 57% had >11 score indicating anxiety. 45% subjects had<11 score indicating no depression, 55% had >11 score indicating depression. Conclusions: The study concluded that frequency of depression and anxiety is high in congestive heart failure patients. Strategies are required to assess and diagnose these mental illnesses to establish early treatment which may foster multidisciplinary health care team approach and interventions that address the psychological burden.

Objective: To observe the effect of modified ultrafiltration on hemodynamics of pediatric patients. Study Design: A descriptive cross-sectional study. Place and Duration of Study: Pediatric Cardiac Surgery department, AFIC/NIHD Rawalpindi, from Jun 2019 to Dec 2019. Methodology: A total of 60 pediatric patients were included undergoing open-heart surgery with cardiopulmonary bypass, having age ≤6 years and weights ≤15kg. To assess hemodynamics parameters observed were pre modified ultrafiltration and post modified ultrafiltration measurements of haemoglobin level, systolic pressure, diastolic pressure, central venous pressure and the number of transfusions given after off-bypass. The data was entered and analyzed in SPSS-23. Results: The pre-operative mean Hb level of the 60 sampled patients was 12.08 ± 2.89 g/dl. The findings taken pre modified ultrafiltration and post modified ultrafiltration of haemoglobin level was (9.91 ± 0.91 g/dl and 13.09 ± 1.38 g/dl, p<0.05) after an average filtration of 370.83 ± 66.56 ml of the filtrate. The mean of systolic pressure was (61.3 ± 2.01 mmHg and 70.68 ± 1.76 mmHg, p<0.05), diastolic pressure was (49.95 ± 1.35 and 59.7 ± 6.85, p<0.005), Central Venous Pressure was (10.07 ± 1.18 and 9.9 ± 1.09, p>0.005) compared pre modified ultrafiltration and post modified ultrafiltration respectively. Conclusion: The study concluded that modified ultrafiltration has a significant impact on haemoglobin levels after bypass, decreases the allogenic transfusions and also improve the hemodynamics of the patient.

Despite advancing medical technology, Heart Failure (HF) is still a prevalent disease with high mortality and high health expenditure. To improve patient outcome and prognosis, it is important to identify the association of risk factors which leads to the co-morbid depression and anxiety in heart failure patients. Objectives: To determine the association of depression and/or anxiety with age, gender and ejection fraction in heart failure patients. Methods: It is an analytical cross sectional study including 323 CHF patients who visited the to the Faisalabad Institute of Cardiology hospital Out-Patient Department, 250 were males and 73 were females, mean age was 54.1 ± 9.2 years having 70 years as maximum and 25 years as minimum.  Data collection was done using Hospital Anxiety and Depression Scale (HADS) questionnaire to assess depression and anxiety. Data was analyzed using SPSS version 24. For quantitative data, mean and standard deviation was calculated and for qualitative data frequency and percentages was calculated. To measure the association of anxiety and depression with age categories, ejection fraction and gender, chi square test was used. P values less than and equal to 0.05 were taken as significant. Results: No association of depression and anxiety with gender and Left Ventricular Ejection Fraction (LVEF) was observed. However, depression and anxiety were found to be significantly associated with age Conclusions: The study concluded that age is a strong risk factor of depression and anxiety in congestive heart failure patients. Multidisciplinary health care team approach and interventions are required to cater chronic heart failure (CHF) patients to address the psychological burden.

Objective: To examine the types of procedures and analyze the frequency of anesthesia-related complications during pediatric cardiac catheterization. Study Design: A prospective observational study. Place and Duration of Study: Pediatric Cardiac Catheterization Lab at AFIC/NIHD Rawalpindi, from July 2019 to Nov 2019. Methodology: Total 180 consecutive patients undergoing cardiac catheterization fulfilling inclusion criteria were studied. Demographic variables, diseases, type of procedure, variables and anesthesia-related complications were noted. All the data was analyzed using SPSS-23. Results: The study included180 patients where 96 (53.3%) were male and 84 (46.7%) were female. Most of the patients in our study were between ages 1 to 3 years (85). 99 (55.0%) patients had diagnostic cardiac catheterizetion (CC), while 81 (45%) patients underwent interventional procedures. The overall complication rate noted as 18.9%, including arrhythmia in 11.1% followed by hypotension 4.4%, laryngospasm 3.9% and inotropic support requirement 3.3%, Mortality was 0.6%. Most of the patients presenting to the pediatric cardiac catheterization lab were for PDA device closure (16.6%). Age of child was found to be significant risk factor for cardiac catheterizetion associated complications with a p-value of 0.022. Conclusion: Congenital and structural heart disease catheterization procedures are progressively increasing, especially due to the medical advances and complex interventional therapeutic procedures. A thorough preanesthesia assessment should be carried out to optimize before cardiac catheterization.