Even though not all findings have been equally positive, many retrospective studies seem to have shown an incremental survival improvement by increasing the number of arterial grafts. Multiple arterial (MultArt) grafting is only currently used in a small number of coronary arteries bypass grafting (CABG) surgeries, despite the convincing and comprehensive information in the published literature. The goal of the study is to compare the incidence of in-hospital mortality in patients following CABG with single versus multiple arterial grafts and to evaluate the frequency of single and multiple CABG arterial grafts in patients undergoing CABG for coronary arteries diseases (CAD). Following institutional review board permission, this descriptive case series was carried out at Jinnah Hospital's heart surgery department in Lahore. 250 patients receiving CABG under general anaesthesia were a part of this study. The quantity of arteries grafted was recorded during CABG. It was observed whether there were one or several arterial grafts. A single surgical team carried out every procedure, under general anaesthesia. Patients were moved to post-surgical wards after surgery. Following surgery, patients were monitored there for 7 days. In-hospital mortality is defined as when a patient dies while receiving treatment in the hospital. In this study, inpatient mortality affected 7 (or 5.9%) of patients treated with single grafts and just 1 (or 0.8%) of patients treated with multiple grafts (p=0.022). Patients who received single graft CABG had a considerably greater incidence of in-hospital mortality. The superiority of multiple arterial graft CABG in terms of lower hospital mortality rate was demonstrated by the study's findings.

To treat coronary artery disease, coronary artery bypass graft (CABG) surgery is done worldwide (CAD). Before harvesting the radial artery for cardiac bypass surgery, Allen's test is frequently used to evaluate the hand's ulnar collateral blood supply. Using Doppler Ultrasonography as a gold standard, this study was created to evaluate the diagnostic precision of Allen's test for the ulnar collateral flow of the donor limb before radial arteryharvesting. This cross-sectional study was conducted from January 2015 to September 2017 at the Jinnah Hospital in Lahore's Cardiac Surgery department. The consecutive sampling/non-probability method was employed. A signed consent form was obtained, and specific demographic data (name, age, and gender) was gathered. SPSS version 21 was used to enter and analyze all of the data. The patients in our study had a mean age of 50.91±9.13 years. The ratio of men to women was 1.3:1. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of Allen’s test was 77.05%, 81.36%, 81.03%, 77.42% & 79.17% taking Doppler test as gold standard. Allen's test, which uses Doppler ultrasonography as the gold standard, is a reliable and valid screening test for the ulnar collateral flow of the donor limb before radial artery harvesting, according to the findings of our study.

Preoperative use of aspirin in coronary artery bypass graft surgery (CABG) might rely more on surgeon’s preference rather than on evidence-based approach. Conflicting guidelines and lack of reliable recommendations make ambiguous the preoperative aspirin administration before elective CABG. This study was conducted to compare the outcome with or without aspirin in patients undergoing coronary artery bypass surgery. The aim of the study was to compare the outcome with or without aspirin in patients undergoing coronary artery bypass surgery. This Randomized controlled trial was conducted at the Department of Cardiac Surgery, AFIC/ NIHD, Rawalpindi from 11th Dec 2018 to 10th June 2019. One hundred and fifty patients fulfilling inclusion criteria underwent through CABG were divided into two groups. In group A, 75 patients continued aspirin, while in group B, aspirin was stopped 5 days before surgery. Patient’s demographic features, comorbid conditions, Postoperative bleeding, perioperative MI and need for blood transfusion were noted. The mean age and BMI of patients were 61.41 ± 3.09 and 63.96 ± 7.64 years and 28.98 ± 2.46 and 32.61 ± 1.98 Kg/m2 in group A and B, respectively. Male to female ratios were 3.41:1 and 4.35:1 in group A and B, respectively.  Diabetes and hypertension were seen in 67(89.34%) and 59(78.67%) patients and 69(90.67%) and 70(93.34%) patients in group A and B, respectively. Perioperative MI and blood transfusion were statistically significant among both groups (5.34% vs. 9.34% patients; p=0.0001 and 5.34% vs. 1.34%; p=0.0003). Mean postoperative bleeding was 401.39 ± 121.04 and 389.21 ± 101.13 ml/24 hr. in group A and B, respectively. The continuation of aspirin therapy in patients undergoing elective CABG reduces perioperative MI, increases quantity of postoperative bleeding and need for blood transfusion. There is a significant difference in outcome with or without aspirin in patients undergoing coronary artery bypass surgery.

Human hand is highly evolved in terms of complexity and variations. In this modern medical era, vascular anatomy of the human hand has clinical importance in medical, surgical and radiological sciences. The intention of the current study is to determine the variations which occur as the radial artery branches thus making a contribution to the arterial supply of the index finger and the thumb. The study design was descriptive case series, carried out in the Department of Anatomy in King Edward Medical University from December 2018 to May 2019 on 30 cadaveric limbs. Vivisection of the cadaveric hands was performed following Cunningham’s Manual of practical anatomy. The origin and the course of RA, UA and MA were dissected and identified with further exploration of the blood supply of the index finger and the thumb. All details were entered in a predesigned proforma, and the dissected limbs were photographed. Data was analyzed to find the frequencies of superficial palmar arch as well as the arterial supply of thumb and index finger were also expressed in frequencies. Great variation was observed in the arterial supply to palmar aspect of index finger and thumb. Main contributing artery being radial artery in majority of cases through its common palmar or proper palmar branches arising from SPA or SPBRA. Ulnar artery and median artery were also observed to be supplying these areas in 6.6% and 3.3% cases respectively. The median artery when present was replacing the radial artery on palmar aspect of hand. The dorsum, however, was supplied by the princeps pollicis and the radialis indicis branches of radial artery in all the cases. We concluded that in about 1/3rd (11/30 are incomplete SPA) of our studied sample, arterial supply of the index finger and the thumb is highly dependent on radial artery and should any damage occur to it, vitality of these useful structures will be compromised.

The current study aimed to determine the degree of agreement between ultrasonography and magnetic resonance imaging to detect non-palpable testis among patients with cryptorchidism. This cross-sectional study was conducted at the Department of Radiology, Jinnah Hospital, Lahore, from 15th May 2014 to 14th November 2014. 120 patients under 12 years of age with cryptorchidism were included to detect the presence or absence of testis by magnetic resonance imaging and ultrasonography. 120 patients had a mean age of 5.10 ± 2.5 years ranging from 2 to 11. 90 patients (75%) showed undescended testes by ultrasonography while MRI detected the presence of undescended testes in 98 patients (81.7%). 84 patients were detected for the presence and 16 for the absence of undescended testes by MRI and ultrasound (kappa = 0.512). It is concluded that the agreement between ultrasonography and magnetic resonance imaging (51.2%) is although moderate yet acceptable for detection of non-palpable testis among patients of cryptorchidism.