Purpose: Changes occur in the expression of oestrogen-regulated and proliferation-associated genes in oestrogen receptor (ER)-positive breast tumours during the menstrual cycle. We investigated if Oncotype® DX recurrence score (RS), Prosigna® (ROR) and EndoPredict® (EP/EPclin) prognostic tests, which include some of these genes, vary according to the time in the menstrual cycle when they are measured.
Methods: Pairs of test scores were derived from 30 ER-positive/human epidermal growth factor receptor-2-negative tumours sampled at two different points of the menstrual cycle.
The major changes in hormone levels that occur through the menstrual cycle have been postulated to affect the expression of hormone-regulated and proliferation-associated genes (PAGs) in premenopausal ER+ breast cancer. Whilst previous studies have demonstrated differences in gene expression, here, we investigated if there are within patient changes in the expression of oestrogen- and progesterone-regulated genes (ERGs and PRGs) and PAGs in ER+ breast cancer during the menstrual cycle. Samples from 96 patients in two independent prospective studies of the effect of menstrual cycle on ER+ breast cancer were used.
View Article and Find Full Text PDFBackground & Objectives: Lipoprotein-A has been recognized as a risk factor for ischemic heart diseases. Myocardial infarction (MI) is common complication of ischemic heart disease. Diabetes play an incremental role in the development of coronary artery disease (CAD), however still there are conflicting data regarding the relationship of Lipoprotein-B and MI.
View Article and Find Full Text PDFBackground & Objective: Everolimus-eluting stents, compared with bare metal stents, reduced the risk of restenosis in clinical trials with strict inclusion and exclusion criteria. The objective of this study was to determine the three months clinical outcomes of Everolimus Eluting Stents in patients with stable angina pectoris in Pakistani population.
Methods: It was a descriptive cross-sectional study and the data was collected from Catheterization Laboratory Cardiology Department Lady Readings Hospital Peshawar.
Background & Objective: The risk of restenosis and other adverse cardiovascular events with bare-metal stents have increased with smaller stent diameters and longer stent lengths. However, the exact impact of stent size on the short-term outcomes of drug-eluting stent (DES) implantations has not been much classified in Pakistani population. This study was designed to evaluate the impact of size (length and diameter) of Drug Eluting Stents on Clinical outcomes in patient with stable coronary artery disease at three months of implantation in Pakistani Population.
View Article and Find Full Text PDFIntroduction: Preoperative assessment of pure Ductal Carcinoma Insitu (DCIS) is essential in the surgical planning. The role of Magnetic resonance imaging (MRI) has long been debated. The impact of MRI on the management of High Grade (HG) DCIS was assessed, whether it accurately captures the true size of this entity in comparison to conventional imaging, and, if MRI use would reduce the number of re-excision surgery.
View Article and Find Full Text PDFObjective: To evaluate the breast imaging changes after fat grafting and its impact on cancer follow up.
Methods: This is a retrospective observational study conducted on patients who underwent fat grafting for breast reconstruction. We reviewed mammographic and ultrasound images of patients.
The aim of this prospective study was to assess myocardial viability with nitrate-enhanced Tc-99m sestamibi gated single-photon emission computed tomography in patients with known coronary artery disease. We enrolled 48 consecutive patients (39 men, 9 women) aged 24-82 years, with coronary artery disease and history of myocardial infarction. A Tc-99m sestamibi study was conducted at rest as baseline, followed by a nitrate-enhanced study the next day.
View Article and Find Full Text PDFObjective: To study the effect of thrombolytic therapy in term of success and failure on the type of ST elevation MI, using streptokinase.
Material And Methods: This was a comparative study, conducted at Department of Cardiology, Lady Reading Hospital, Peshawar, from October 2006 to October 2007. Patients with first acute myocardial infarction were divided into group A (successful thrombolysis) and group B (unsuccessful thrombolysis) using ECG criteria.
Background: The term non-ST elevated Acute Coronary Syndrome (ACS) encompasses unstable Angina (USA) and non-ST segment elevated Myocardial Infarction (NSTEMI), both of which may end up in death or a fatal/non-fatal Myocardial Infarction (MI). Unfractionated heparin (UFH) has been shown to reduce death and MI in patients with USA and NSTEMI. Of late, there has been a great interest in the role of low molecular weight heparins (LMWHs) in the two conditions and they have been found to be at least as effective as or even more effective than UFH.
View Article and Find Full Text PDFJ Ayub Med Coll Abbottabad
June 2014
Background: Once considered as disease of the affluent and developed countries, coronary artery disease is emerging as epidemic in the developing world in general and South Asia in particular.
Objective: To observe the trend of presentation of acute coronary syndrome in the local population over the last 16 years.
Material And Methods: Clinical audit from 1995 to 2010 was carried out in which the data was retrieved from the computerised database of the Department of Cardiology, Lady Reading Hospital Peshawar.
Objective: To evaluate left ventricular systolic and diastolic function by Tissue Doppler imaging after acute myocardial infarction.
Methods: It was a hospital based, prospective descriptive study, from 1st July 2010 to 31st Dec. 2010.
J Ayub Med Coll Abbottabad
January 2011
Background: Drug therapy is mostly employed in the management of supraventricular tachycardias (SVTs). However, radiofrequency catheter ablation has been found to be highly effective and safe in the treatment of SVTs. The current study is aimed at sharing our experience of 320 patients who presented with SVTs, and were treated with radiofrequency catheter ablation.
View Article and Find Full Text PDFJ Ayub Med Coll Abbottabad
April 2012
Background: Coronary artery disease (CAD) is no more deemed to be an ailment of the 4th or 5th decade; rather an earlier age incidence is not infrequently encountered in our population. However, there are a few data regarding CAD in young adults, and much about its underlying pathology still remains undetermined. The objective of this study was to delineate the coronary arterial disease pattern in adults under the age of 35 years, but having no known coronary risk factors.
View Article and Find Full Text PDFBackground: Globally, obesity is now recognised as an epidemic. The degree of obesity is proportional to the rate of development of cardiovascular diseases, hence, resulting in a dramatic increase in morbidity and mortality. Apart from obesity, diabetes mellitus is another well recognised risk factor contributing to coronary artery disease.
View Article and Find Full Text PDFJ Ayub Med Coll Abbottabad
July 2011
Background: Coronary artery disease is now frequently encountered in young adult population. However, being a relatively uncommon entity, not many studies are available in this regard. Therefore, the present study was designed to evaluate the clinical characteristics and angiographic features of patients less than 40 years of age with a history of myocardial infarction and compare them to patients older than 40 years.
View Article and Find Full Text PDFJ Ayub Med Coll Abbottabad
July 2011
Background: Globally, obesity is now recognised as an epidemic. The degree of obesity is proportional to the rate of development of cardiovascular diseases, hence, resulting in a dramatic increase in morbidity and mortality. Apart from obesity, hypertension is another well recognised risk factor contributing to coronary artery disease (CAD).
View Article and Find Full Text PDFJ Ayub Med Coll Abbottabad
April 2011
Background: Renal artery stenosis (RAS) is a common finding in patients undergoing coronary angiography. We designed this study to look for the frequency and any predictors of renal artery stenosis in patients with coronary artery disease (CAD).
Methods: A total of 201 consecutive patients with CAD confirmed by coronary angiography underwent an abdominal aortogram in the same sitting to screen for RAS.
Background: Prevention of sudden cardiac death has always been a challenge for electrophysiologists and to date, automatic implantable cardiovertor defibrillator (AICD) is found to be the only remedy. This device delivers an intracardiac shock whenever it senses a fatal ventricular arrhythmia in order to achieve sinus rhythm. If the delivery of these intracardiac shocks becomes frequent, the situation is declared as an electrical storm.
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