Journal of Ayub Medical College, Abbottabad : JAMC
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J Ayub Med Coll Abbottabad · Apr 2008
Randomized Controlled TrialEarly vascular complications of intraaortic balloon counterpulsation in patients undergoing open heart surgery.
The use of IABP is helpful for haemodynamic stability of patients with low cardiac output and compromised left ventricular function in patients who undergo coronary artery bypass grafting. This procedure is also associated with some vascular complications due to the insertion of IABP. The objective of this research was to study the vascular complications in patients with IABP counterpulsation. We observed the clinical outcome of these patients with special reference to post IABP complications in our research. ⋯ IABP has remarkable beneficial effects in patients with haemodynamic instability due to myocardial ischemia and low cardiac output syndrome. At the same time IABP is related to significant morbidity and mortality related to vascular complications due to its insertion which include limb ischemia, limb loss and even mortality.
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J Ayub Med Coll Abbottabad · Jan 2008
Comparative StudyOff pump coronary artery surgery and intraoperative safety-experience at AFIC/NIHD, Rawalpindi.
Coronary Artery Bypass Grafting (CABG) with cardiopulmonary bypass (CPB) on one hand allows controlled haemodynamics with superior graft quality while on the other hand carries inherent risks of CPB which has renewed interest in Off-pump coronary artery bypass (OPCAB). Haemodynamic instability and intraoperative dysrythmias are major procedural complications of OPCAB, threatening conversion to emergency on-pump surgery. The purpose of this study was to compare intraoperative dysrythmias and inotropic use for haemodynamic stabilization during OPCAB surgery against conventional CABG. ⋯ OPCAB leads to higher frequency of dysrythmias and inotropic use intraoperatively, highlighting lower procedural safety over conventional CABG.
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J Ayub Med Coll Abbottabad · Jan 2008
Frequency of second stage intervention and its outcome in relation with instrumental vaginal delivery versus caesarean section.
To determine the frequency of second stage intervention and the risk of maternal and foetal morbidity and mortality associated with instrumental vaginal deliveries versus caesarean section in our tertiary care set up. ⋯ The frequency of second stage intervention seems high in our set up and is associated with significant maternal and perinatal morbidity. Maternal morbidity was more frequent abdominal delivery while neonatal morbidity and mortality was more frequent with instrumental delivery.
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J Ayub Med Coll Abbottabad · Jan 2008
Severe acute maternal morbidity and intensive care in a public sector university hospital of Pakistan.
The study was planned to review the case series of pregnant women requiring intensive care due to severe acute maternal morbidity in the public sector university hospital, in order to identify failures and priorities in maternal health care provision in Pakistan. ⋯ Maternal morbidity and mortality can be reduced by meticulous adaptation of safe motherhood initiative, provision of separate ICU services for critically ill obstetrical patients and early assessment and aggressive intervention through a team approach involving obstetricians, intensivists and anaesthetists.
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A 33-year-old man was found 20 Cm upper of the floor, compressed by rubbish container in the elevator in an unusually awkward position. The scene investigation corresponded exactly with the localization of the injuries found in the victim. This is a case of death by thorax compression without other fatal factors in which the force causing the chest compression was distinctly determined by the autopsy and scene investigation as accidental traumatic asphyxia.