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Articles 1 - 13 of 13
Full-Text Articles in Medicine and Health Sciences
Which Outcomes Are Most Important To Measure In Patients With Covid-19 And How And When Should These Be Measured? Development Of An International Standard Set Of Outcomes Measures For Clinical Use In Patients With Covid-19: A Report Of The International Consortium For Health Outcomes Measurement (Ichom) Covid-19 Working Group, William H. Seligman, Luz Fialho, Nick Sillett, Christina Nielsen, Farhala Mari Baloch, Philip Collis, Ingel K M. Demedts, Marcelo P. Fleck, Maiara A. Floriani, Nasreen Muhammad
Which Outcomes Are Most Important To Measure In Patients With Covid-19 And How And When Should These Be Measured? Development Of An International Standard Set Of Outcomes Measures For Clinical Use In Patients With Covid-19: A Report Of The International Consortium For Health Outcomes Measurement (Ichom) Covid-19 Working Group, William H. Seligman, Luz Fialho, Nick Sillett, Christina Nielsen, Farhala Mari Baloch, Philip Collis, Ingel K M. Demedts, Marcelo P. Fleck, Maiara A. Floriani, Nasreen Muhammad
Section of Cardiology
Objectives: The COVID-19 pandemic has resulted in widespread morbidity and mortality with the consequences expected to be felt for many years. Significant variation exists in the care even of similar patients with COVID-19, including treatment practices within and between institutions. Outcome measures vary among clinical trials on the same therapies. Understanding which therapies are of most value is not possible unless consensus can be reached on which outcomes are most important to measure. Furthermore, consensus on the most important outcomes may enable patients to monitor and track their care, and may help providers to improve the care they offer through …
Clinical Outcomes Of Physiologically-Guided Revascularisation, Nasir Rahman, Ghufran Adnan, Awais Farhad, Jamshed Ali, Ihsan Ullah
Clinical Outcomes Of Physiologically-Guided Revascularisation, Nasir Rahman, Ghufran Adnan, Awais Farhad, Jamshed Ali, Ihsan Ullah
Section of Cardiology
Objective: To assess the clinical outcomes of revascularisation based on fractional flow reserve (FFR) and/or instantaneous wave-free ratio (iFR).
Study design: Descriptive study.
Place and duration of study: Department of Medicine, The Aga Khan University Hospital, Karachi from January 2012 to January 2020.
Methodology: A cohort of patients having moderate to severe coronary stenosis, undergoing coronary revascularisation based on invasive physiological assessment (FFR or iFR) were assessed. The participants were divided into the revascularisation-deferred group and the revascularization-performed group, based on the physiological results. Cox-proportional hazard model building was done, using a stepwise approach by assessing all plausible interactions and …
Features On Cardiac Magnetic Resonance Imaging And Accuracy Of Echocardiographic Findings For Diagnosing Constrictive Pericarditis, Salik Ur Rehman Iqbal, Fateh Ali Tipoo Sultan
Features On Cardiac Magnetic Resonance Imaging And Accuracy Of Echocardiographic Findings For Diagnosing Constrictive Pericarditis, Salik Ur Rehman Iqbal, Fateh Ali Tipoo Sultan
Section of Cardiology
Constrictive pericarditis is a rare disease with a difficult diagnosis. Cardiac magnetic resonance (CMR) imaging data of Aga Khan University Hospital from January 2011 to March 2020 was retrospectively reviewed and patients with the diagnosis of constrictive pericarditis were included. A total of 22 patients were included with the mean age of 46±16 years and majority 17(77%) were male. The most common findings on transthoracic echo were significant respiratory variation in mitral and tricuspid inflow velocities in 20(91%), and septal annular e'>9 in 10 (86%). The most common finding on CMR was respiratory septal shift in 22(100%), followed by …
Covid-19 Bbibp-Corv Vaccine And Transient Heart Block - A Phenomenon By Chance Or A Possible Correlation - A Case Report, Pirbhat Shams, Jamshed Ali, Sheema Saadia, Aamir Hameed Khan, Fateh Ali Tipoo Sultan, Javed Tai
Covid-19 Bbibp-Corv Vaccine And Transient Heart Block - A Phenomenon By Chance Or A Possible Correlation - A Case Report, Pirbhat Shams, Jamshed Ali, Sheema Saadia, Aamir Hameed Khan, Fateh Ali Tipoo Sultan, Javed Tai
Section of Cardiology
Importance: Bradyarrhythmia during COVID19 illness carries prognostic significance. Electrophysiological side effects of COVID19 vaccine remain largely unknown. It is imperative to report nature of cardiovascular side effects of the vaccine.
Case presentation: An 80 years-old-man presented with complains of dizziness, trepidation and shortness of breath following his first shot of COVID-19 BBIBP-CorV (Sino-pharm). ECG on arrival showed 2:1 atrioventricular block with an underlying old left bundle branch block. The AV block changed into Mobitz type-I over the course of next 2 days and into a sinus 1:1 conduction on fourth day of presentation. However, our patient underwent permanent pacemaker implantation …
Cardiovascular Fellow-In-Training Feedback On Virtual And Simulator-Based Learning Experience During Covid-19 Pandemic In A Low To Middle Income Country - A Cross-Sectional Study, Pirbhat Shams, Intisar Ahmed, Hunaina Shahab, Zehra Kadani, Aisal Khan, Marvi Shams, Yawer Saeed, Syedah Saira Bokhari, Aamir Hameed Khan
Cardiovascular Fellow-In-Training Feedback On Virtual And Simulator-Based Learning Experience During Covid-19 Pandemic In A Low To Middle Income Country - A Cross-Sectional Study, Pirbhat Shams, Intisar Ahmed, Hunaina Shahab, Zehra Kadani, Aisal Khan, Marvi Shams, Yawer Saeed, Syedah Saira Bokhari, Aamir Hameed Khan
Section of Cardiology
Background: COVID-19 pandemic has introduced us to a greater need of virtual learning platforms and has resulted in less clinical exposure for fellows-in-training. Virtual and simulator-based learning is not widely available in LMIC. It is imperative to analyze feedback of CV fellow-in-training regarding this mode of learning before large scale implementation.
Methodology: This was an observational study conducted between July-August 2020. A multicentered survey was conducted. Survey questionnaire was disseminated to FIT (fellow-in-training) via Google Forms. The questionnaire contained a total of 24 questions about virtual and simulator-based learning during the pandemic.
Results: A total of 68 FIT responded to …
Comparing Sensitivity And Specificity Of Pacemaker Id Application And Cardiac Rhythm Management Device-Finder Application In Identifying Cardiac Implantable Electronic Device Manufacturer Using Chest Radiograph - An Observational Study, Pirbhat Shams, Muhammad Mehdi, Jamshed Ali, Intisar Ahmed, Sheema Saadia, Sameen Iqbal, Aamir Hameed Khan, Yawer Saeed
Comparing Sensitivity And Specificity Of Pacemaker Id Application And Cardiac Rhythm Management Device-Finder Application In Identifying Cardiac Implantable Electronic Device Manufacturer Using Chest Radiograph - An Observational Study, Pirbhat Shams, Muhammad Mehdi, Jamshed Ali, Intisar Ahmed, Sheema Saadia, Sameen Iqbal, Aamir Hameed Khan, Yawer Saeed
Section of Cardiology
Background: Smartphone-based applications to identify cardiac implantable electronic devices (CIED) are extremely useful in circumstances, where urgent device interrogation is needed, and a device identification card is not available. Few studies have provided insights regarding the utility of these applications. We have studied two widely available applications i.e., Pacemaker ID app (PMIDa) or Cardiac Rhythm Management Device-Finder (CRMD-f) to identify device manufacturers in CIEDs.
Methods: 547 patients who underwent CIED implantation from the year 2016-2020 in our institute were enrolled. There were 438 Medtronic and 109 St. Jude's devices. All chest radiographs were de-identified and resized into 225*225 pixels focusing …
Prognostic Significance Of Ischaemic Electrocardiographic Changes During Stress Testing In Patients With Normal Nuclear Myocardial Perfusion Imaging, Ghufran Adnan, Fateh Ali Tipoo Sultan, Umaira Alauddin, Maria Ali Khan
Prognostic Significance Of Ischaemic Electrocardiographic Changes During Stress Testing In Patients With Normal Nuclear Myocardial Perfusion Imaging, Ghufran Adnan, Fateh Ali Tipoo Sultan, Umaira Alauddin, Maria Ali Khan
Section of Cardiology
Objective: To evaluate cardiovascular outcomes in patients with normal nuclear myocardial perfusion imaging, but ischaemic electrocardiogram changes during pharmacological or exercise stress tests.
Methods: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of patients who underwent either pharmacological or exercise stress myocardial perfusion scan and had a normal scan with ischaemic electrocardiogram changes between January 2013 and December 2014. All cardiac events, including angina, myocardial infarction, heart failure, coronary revascularisation and cardiac death, as well as non-cardiac deaths were noted. Data was analysed using STATA 14.2.
Results: Of the 2770 patients whose data …
Brain Abscess Caused By Lactococcus Lactis In A Young Male, Intisar Ahmed, Kashif Aziz, Hameed Tareen, Muhammad Arslan Ahmed
Brain Abscess Caused By Lactococcus Lactis In A Young Male, Intisar Ahmed, Kashif Aziz, Hameed Tareen, Muhammad Arslan Ahmed
Section of Cardiology
Lactococcus lactis cremoris is one of the gram positive cocci, not known to be pathogenic in humans. We report a case of brain abscess due to lactococcus lactis in an adolescent. An 18-year male with congenitally corrected transposition of great arteries and dextrocardia was admitted with fever, headache and right-sided numbness. Magnetic resonance imaging revealed a well circumscribed irregular heterogeneous abnormal signal intensity lesion in left temporo-parietal lobe having central area of diffusion restriction and peripheral wall enhancement on post-contrast images. He underwent mini-craniotomy for abscess drainage. Pus culture revealed growth of lactococcus lactis. He was treated with ceftriaxone and …
Periprocedural And In-Hospital Outcomes Among Percutaneous Coronary Intervention In Saphenous Vein Graft: A Retrospective Observational Study At A Tertiary Care Hospital In South Asian Country, Abdul Baqi, Sheema Saadia
Periprocedural And In-Hospital Outcomes Among Percutaneous Coronary Intervention In Saphenous Vein Graft: A Retrospective Observational Study At A Tertiary Care Hospital In South Asian Country, Abdul Baqi, Sheema Saadia
Section of Cardiology
Background: Saphenous vein graft (SVG) may occlude either early or several months to years after coronary artery bypass graft (CABG) surgery. Doing re-do CABG surgery is associated with higher complication and mortality rate as compared to percutaneous coronary intervention (PCI) in SVG. However, PCI of SVG is associated with more periprocedural and in-hospital complications as compared to PCI of native coronary arteries. Due to the scarcity of local data in this regard, this study was designed to estimate the periprocedural and in-hospital outcomes among PCI in SVG.
Objectives: We aim to study the periprocedural and in-hospital outcomes among patients who …
Patterns Of Left Ventricular Hypertrophy And Late Gadolinium Enhancement On Cardiac Mri In Patients With Hypertrophic Cardiomyopathy And Their Prognostic Significance - An Experience From A South Asian Country, Fateh Ali Tipoo Sultan, Sheema Saadia
Patterns Of Left Ventricular Hypertrophy And Late Gadolinium Enhancement On Cardiac Mri In Patients With Hypertrophic Cardiomyopathy And Their Prognostic Significance - An Experience From A South Asian Country, Fateh Ali Tipoo Sultan, Sheema Saadia
Section of Cardiology
Objectives: Cardiac magnetic resonance (CMR) imaging is very pertinent in the diagnosis and risk stratification of patients with hypertrophic cardiomyopathy (HCM). We aimed to assess the patterns of left ventricular (LV) hypertrophy, late gadolinium enhancement (LGE), and their prognostic significance in HCM patients in Pakistani population, as no such data are available from Pakistan.
Material and methods: This was a retrospective, single center study. All patients who had confirmed diagnosis of HCM on CMR at Aga Khan University Hospital during the period of 2011-2019 were identified and included in the study.
Results: A total of 74 patients were included with …
Structural And Functional Properties Of Subsidiary Atrial Pacemakers In A Goat Model Of Sinus Node Disease, Luca Soattin, Zoltan Borbas, Jane Caldwell, Brian Prendergast, Akbar Vohra, Yawer Saeed, Andreas Hoschtitzky, Joseph Yanni, Andrew Atkinson, Sunil Jit Logantha
Structural And Functional Properties Of Subsidiary Atrial Pacemakers In A Goat Model Of Sinus Node Disease, Luca Soattin, Zoltan Borbas, Jane Caldwell, Brian Prendergast, Akbar Vohra, Yawer Saeed, Andreas Hoschtitzky, Joseph Yanni, Andrew Atkinson, Sunil Jit Logantha
Section of Cardiology
Background: The sinoatrial/sinus node (SAN) is the primary pacemaker of the heart. In humans, SAN is surrounded by the paranodal area (PNA). Although the PNA function remains debated, it is thought to act as a subsidiary atrial pacemaker (SAP) tissue and become the dominant pacemaker in the setting of sinus node disease (SND). Large animal models of SND allow characterization of SAP, which might be a target for novel treatment strategies for SAN diseases.
Methods: A goat model of SND was developed (n = 10) by epicardially ablating the SAN and validated by mapping of emergent SAP locations through …
Office Blood Pressure Measurement: A Comprehensive Review, Saulat Siddique, Aamir Hameed Khan, Hunaina Shahab, Yu-Qing Zhang, Jam Chin Tay, Peera Buranakitjaroen, Yuda Turana, Narsingh Verma, Chen-Huan Chen, Hao-Min Cheng
Office Blood Pressure Measurement: A Comprehensive Review, Saulat Siddique, Aamir Hameed Khan, Hunaina Shahab, Yu-Qing Zhang, Jam Chin Tay, Peera Buranakitjaroen, Yuda Turana, Narsingh Verma, Chen-Huan Chen, Hao-Min Cheng
Section of Cardiology
The conventional auscultatory methods for measuring blood pressure have been used to screen, diagnose, and manage hypertension since long. However, these have been found to be prone to errors especially the white coat phenomena which cause falsely high blood pressure readings. The Mercury sphygmomanometer and the Aneroid variety are no longer recommended by WHO for varying reasons. The Oscillometric devices are now recommended with preference for the Automated Office Blood Pressure measurement device which was found to have readings nearest to the Awake Ambulatory Blood Pressure readings. The downside for this device is the cost barrier. The alternative is to …
Covid-19 Presenting With Spontaneous Pneumothorax, Intisar Ahmed, Hunaina Shahab, Muhammad Arslan Ahmed, Muhammad Sohaib
Covid-19 Presenting With Spontaneous Pneumothorax, Intisar Ahmed, Hunaina Shahab, Muhammad Arslan Ahmed, Muhammad Sohaib
Section of Cardiology
The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease mainly affects respiratory system. Its common clinical findings include fever, cough and shortness of breath. Characteristic radiological features of the disease include peripherally distributed, bilateral ground-glass opacities, predominantly involving the lower lung zones. In this report, we present a case of COVID-19 disease presenting with spontaneous pneumothorax. A 26-year male patient was admitted to the Emergency Department with fever, dry cough, shortness of breath and right-sided chest pain. Radiographic imaging of the patient revealed pneumothorax on the right and peripherally distributed non-homogenous opacification. …