Skeletonization of Left Internal Mammary Artery in Coronary Artery Bypass Grafting.

Objective: To compare mean per-operative flow capacity between skeletonized and pedicled left internal mammary artery (LIMA) in patients undergoing coronary artery bypass grafting (CABG) surgery.

Study Design: Randomized control trial.

Place And Duration Of Study: Department of Cardiac Surgery, Armed Forces Institute of Cardiology and National Institute of Heart Diseases (AFIC-NIHD), Rawalpindi, Pakistan from February to August, 2013.

Topical application of tranexamic acid reduces postoperative bleeding in open-heart surgery: myth or fact?

Objective: To determine the efficacy of topical application of Tranexamic acid in controlling postoperative bleeding in open-heart surgery.

Study Design: Double blind randomized control trial.

Place And Duration Of Study: Departments of Cardiac Surgery and Intensive Care of Armed Forces Institute of Cardiology and National Institute of Heart Diseases (AFIC-NIHD), Rawalpindi, Pakistan, from May to October 2011.

Aortic aneurysm: a rare cause of Ortner's syndrome.

A young man presented with hoarseness of voice and was found to have left vocal cord paralysis and a large opacity on chest X-ray in the left upper zone. CT angiography showed a giant aneurysm of the aortic arch involving the left subclavian artery. Using a dual perfusion system, with the femoral bypass circuit taking care of the spinal protection and the aortic bypass circuit providing the cerebral protection, the aneurysm was excised and a 16 mm Dacron graft was anastomosed to the aortic arch and the left subclavian artery was anastomosed to the interposition graft.

School children training for basic life support.

Objective: To determine the background knowledge of high school children on basic life support by calculating the points scored in a MCQ-based test; to evaluate results of teaching basic life support skills to them; and assessing their power of retention by re-testing them on skills and MCQ test after the workshop.

Study Design: Quasi-experimental study.

Place And Duration Of Study: Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, Pakistan, from 1st September to 31st December 2008.

Digoxin as a rescue drug in intra aortic balloon pump and inotrope dependent patients.

Background: In absence of cardiac transplant program in our country, when patients with poor left ventricular (LV) functions undergo coronary revascularisation surgery, they are on one or more inotropic supports with intra aortic balloon pump (IABP) at the time of weaning off from cardiopulmonary bypass (CPB). Post-operatively, due to the poor LV function, many of these patients become dependent on inotropic supports and IABP and eventually have a poor outcome. We used digoxin in these patients as a rescue drug, where more than one attempts to wean them off IABP and inotropic support had failed.

Maternal satisfaction after spinal anaesthesia for caesarean deliveries.

Objective: To determine the level of satisfaction in terms of intra-operative pain and postoperative nausea, vomiting and backache among patients receiving spinal anaesthesia for caesarean section.

Study Design: Cross-sectional survey.

Place And Duration Of Study: Department of Anaesthesia and Intensive Care at the Combined Military Hospital, Bahawalpur, from August 2005 to June 2007.

Aneurysm of the right subclavian artery presenting as hoarseness of voice.

Intrathoracic segment of the subclavian artery is a rare location for a peripheral arterial aneurysm. A young man presented with hoarseness of voice, diminished pulses in right upper limb and superior mediastinal widening on X-ray chest. Computed tomography (CT) scan revealed an aneurysm of right subclavian artery with thrombus in its wall.

Intensive care management after inadvertent intravascular injection of liquid paraffin.

Medication errors in the hospitals are not uncommon even in the developed countries. A 30 years old lady was admitted with 32 weeks pregnancy with gastroenteritis followed by intrauterine death. In the high dependency unit of obstetric department, accidentally 50 milliliters of liquid paraffin was administered intravenously.

Anaphylaxis during anesthesia - role of skin prick testing in diagnosing multiple sensitivities.

The true incidence of anaphylactic reactions and their associated morbidity and mortality remain poorly defined. This is due to uncertainties in reporting accuracy and exhaustivity. A 23 years old male developed severe anaphylaxis under general anesthesia with cardiovascular collapse, bronchospasm and angio-edema.

Predicting difficult intubation--a comparison between Mallampati classification and Wilson risk-sum.

Objective: To compare the Mallampati classification and Wilson risk-sum and adopt a predictive rule in our setup that has better results.

Design: An analytical study.

Place And Duration Of Study: The main Operation Theatre of Combined Military Hospital, Rawalpindi from 1st September to 31st December 2000.