Objective: To determine the frequency of right ventricular infarction among patients with acute inferior wall myocardial infarction. Study Design: Descriptive cross sectional study. Place and Duration of Study: Ayub Teaching Hospital, Abbottabad from, Jan 2017 to Sep 2017. Methodology: A total of 163 patients aged 18-75 years and admitted to coronary care unit (CCU) with first attack of acute inferior wall myocardial infarction, were recruited through non probability purposive sampling. Electrocardiogram and Echo were performed of all patients and their findings were noted for the frequency of right ventricular infarction in acute inferior wall myocardial infarction. Results: There were 117 (72%) males and 46 (28%) females. Patients were stratified according to their age in four groups i.e. 13 (8%) patients were less than 40 years of age, 26 (16%) patients were aged between 41 and 50 years, 46 (28%) patients were aged between 51 and 60 years of age and 78 (48%) patients were above 60 years of age. Mean ± SD was 60 ± 1.28. Out of 163 patients, 44 (27%) had right ventricular infarction while 119 (73%) did not have right ventricular infarction. Conclusion: The frequency of right ventricular infraction among patients presenting with acute inferior wall myocardial infarction was 27%.

Objective: To determine in hospital early complications in diabetics’ vs non diabetics with acute ST elevation myocardial infarction. Study Design: Comparative cross-sectional study. Place and Duration of Study: The study was conducted in emergency departments and adult cardiology wards of Armed Forces Institute of Cardiology/National Institute of Heart Diseases, from Aug to Nov 2019. Methodology: A comparative cross sectional study was conducted on 380 patients (190 patients with diabetes and 190 patients without diabetes) who presented with acute ST-Elevation MI in age group 30 to 70 years to emergency department of Armed Forces Institute of Cardiology/National Institute of Heart Disease during specified period. Patients with rescue PCI and new onset of LBBB were also included. Patients with age group lesser than 30 years or greater than 70 years with STEMI were excluded. Sampled with consecutive non probability technique in patients was assessed with ECG, cardiac enzymes, transthoracic echocardiography, renal Doppler and RFTs. All patients were admitted in wards and were followed up during hospital stay. Patients were evaluated and their record of Primary PCI and thrombolysis was also noted. Data was entered and analyzed with SPSS-23. Results: A total of 380 patients with STEMI were included in this study consisting of 292 (76.8%) male and 88 (23.1%) female from 30 to 70 years. The patients were divided in two groups i.e. diabetic and non-diabetic, 190 patients were included in each group. It was found that frequency of ST-Elevation MI was higher in diabetic group as compared to non-diabetic group. All the patients were analyzed for complications occurred after STElevation MI. LV failure, Brady arrhythmias, atrial fibrillation, post MI angina and cardiogenic shock were the main complications noted. It was found that all these complications are more in diabetic group post MI angina which occurred most frequently in non-diabetic group. Conclusion: In our study we observed that left ventricular failure and arrhythmias were the major complications. Mortality was higher in diabetic patients than non-diabetic patients. In both groups PPCI and SK reduced mortality. Post MI angina were found more frequent in non-diabetic group.

Objective: To study the short-term and long-term outcomes of left main angioplasty at AFIC-NIHD. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD) in 2018. Methodology: All cases of left main angioplasty done in 2018 were included in the study. The patients were followed up in clinic or on telephone and mortality (in-hospital, 30 days) outcomes and survival duration were recorded. Kaplan Meier curves were generated to show the survival difference between those who underwent primary or elective LMPCI and survival difference between patients based on extent of coronary artery disease. Results: A total of 73 patients underwent elective or primary left main angioplasty. The extent of coronary artery disease was: single vessel coronary artery disease (26%), double vessel coronary artery disease (37%), and three vessel coronary artery disease (37%). Thirteen patients (17.8%) had primary left main angioplasty, and 60 patients (82.2%) had elective left main angioplasty. Intravascular ultrasound was performed in only 3 patients. The mean duration of follow up was 395 days. A total of 6 (8.2%) patients died. Three patients died in-hospital, another 2 within the first 30 days, and the remaining beyond 30 days. Two of the dead patients had double vessel coronary artery disease, and 4 had three vessel coronary artery disease. The survival difference between the primary vs elective groups was insignificant (Log Rank (Mantel-Cox) (p=0.27). The survival difference between the 3 groups with different extent of coronary artery disease was insignificant (p=0.15). Conclusion: Left main PCI is a safe procedure with acceptable outcomes. Patients with more severe coronary artery disease tend to fare worse.

Objective: To determine the prevalence of brain and neck neoplasms among Interventional Cardiologists. Study Design: Analytical Cross-sectional study. Place and Duration of Study: Department of Cardiology/Interventional Cardiology of two Tertiary Cardiac Care Centers of Rawalpindi and Lahore Pakistan from Mar 2021 to Apr2022. Methodology: By using the non-probability, consecutive sampling technique, fifty Interventional Cardiologists’ (n=50) of both genders between 35-75 years of age, working in the cardiac catheterization labs for more than 10-years are enrolled after their informed consents. The data was collected from the interviews of Interventional cardiologists, from the shared medical records and also from the family members and colleagues. The Interventional cardiologists were enquired about any neurological signs and symptoms particularly in relation to the head and neck malignancy and also asked about undergoing any CT/MRI or PET scan of head and neck region in the past or recent time. Descriptive statistics for data was computed byusing the SPSS version-25. Results: The mean age of the Interventional Cardiologists of tertiary cardiac care center of Rawalpindi was 50.40±7.77years while of Lahore was 49.16±8.89 years. There were 47(94.0%) males and 03(6.0%) females, from both the Institutes. The mean duration of working in cardiac catheterization labs was 17.92±4.57 years. The head and neck neoplasm’s among Interventional Cardiologists was observed in 01(2%) case. Conclusion: The research study concluded that the prevalence of head and neck neoplasms among Interventional Cardiologists is very low (2%). But still it is the need of hour to be more careful about radiation exposure among the Interventional Cardiologists working for long hours in the cardiac catheterization labs, to lessen down the chances of head and neck malignancy.

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