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Objective: To assess the frequency of mental health problems among healthcare workers related to COVID-19 pandemic among health care workers in a tertiary cardiac care center. Study Design: Descriptive cross sectional study. Place and Duration of Study: This study was conducted at Armed Forces Institute of Cardiology/ National Institute of Heart Diseases (AFIC/NIHD) Rawalpindi (Pakistan) from Apr 2020 to Jun 2020. Methodology: This study was a hospital-based cross-sectional study consisted of 100 healthcare workers including 50 nurses and 50 doctors who volunteered to enroll in our study were included. Approval from the clinical research ethics committee of cardiac care hospital was received before the initiation of this study. Verbal informed consent was provided by all study participants prior to their enrollment. Exclusion criteria comprised of the healthcare workers who refused to participate in it. This study followed the COVID-19 Pandemic Mental Health Questionnaire (CoPaQ) 14. Descriptive statistics were used to describe the percentages and frequencies. Descriptive statistics were used to describe the percentages and frequencies were calculated and analyzed using the Statistical Package for the Social Sciences (SPSS), version 23.0. Results: A total of 100 healthcare workers completed the survey. Mean age of the healthcare workers was 36.5 ± 27.0 years (median=36.00), and 75 (75%) were women and men comprised 25 (25%). Of all participants, 50 (50.0%) were nurses, and 50 (50%) were doctors. A considerable proportion of participants reported symptoms of COVID19, 6 (6.0%), tested positive 14 (14%), currently quarantine 24 (24.0%). While 12 healthcare workers experienced 14 day quarantine time period. 16 healthcare workers reported COVID test positive of their closed one. The fear of infecting others with COVID-19 was found to be 30 (30%). The mental stress that that COVID-19 will personally affect us was found in 28 (28%) of healthcare workers. The fear that consequences of the COVID-19 will be severe health disasters was found in 40 (40%) of the individuals. Conclusion: In this study of physicians and nurses in hospitals with wards for patients with COVID-19, health care workers responding to the spread of COVID-19 reported high rates of symptoms of anxiety, fear, and distress.

Objective: To determine in hospital early complications in diabetics’ vs non diabetics with acute ST elevation myocardial infarction. Study Design: Comparative cross-sectional study. Place and Duration of Study: The study was conducted in emergency departments and adult cardiology wards of Armed Forces Institute of Cardiology/National Institute of Heart Diseases, from Aug to Nov 2019. Methodology: A comparative cross sectional study was conducted on 380 patients (190 patients with diabetes and 190 patients without diabetes) who presented with acute ST-Elevation MI in age group 30 to 70 years to emergency department of Armed Forces Institute of Cardiology/National Institute of Heart Disease during specified period. Patients with rescue PCI and new onset of LBBB were also included. Patients with age group lesser than 30 years or greater than 70 years with STEMI were excluded. Sampled with consecutive non probability technique in patients was assessed with ECG, cardiac enzymes, transthoracic echocardiography, renal Doppler and RFTs. All patients were admitted in wards and were followed up during hospital stay. Patients were evaluated and their record of Primary PCI and thrombolysis was also noted. Data was entered and analyzed with SPSS-23. Results: A total of 380 patients with STEMI were included in this study consisting of 292 (76.8%) male and 88 (23.1%) female from 30 to 70 years. The patients were divided in two groups i.e. diabetic and non-diabetic, 190 patients were included in each group. It was found that frequency of ST-Elevation MI was higher in diabetic group as compared to non-diabetic group. All the patients were analyzed for complications occurred after STElevation MI. LV failure, Brady arrhythmias, atrial fibrillation, post MI angina and cardiogenic shock were the main complications noted. It was found that all these complications are more in diabetic group post MI angina which occurred most frequently in non-diabetic group. Conclusion: In our study we observed that left ventricular failure and arrhythmias were the major complications. Mortality was higher in diabetic patients than non-diabetic patients. In both groups PPCI and SK reduced mortality. Post MI angina were found more frequent in non-diabetic group.

Objective: To compare the hemodynamic effects of Atracurium versus Cisatracurium in Cardiac Patients Undergoing coronary artery bypass graft Surgery. Study Design: Randomized controlled trial. Place and Duration of Study: The study was conducted at Armed Forces Institute of Rawalpindi, a tertiary care hospital, after seeking hospital ethics committee permission, from Apr 2019 to Oct 2019. Methodology: A total of 200 consecutive patients were randomized into two equal groups, group-A and group-C (100 in each group). Group-A patients were induced with 0.5mg/kg of Atracurium, followed by infusion @ 10μg/kg/min whereas group C patients received Cisatracurium @ 0.2mg/kg at induction, followed by infusion @ 2μg/kg/min during the maintainence phase. Systolic blood pressure, diastolic blood pressure, Mean arterial pressure and heart rate were noted at different intervals of both groups. Decrease in systolic blood pressure of >20% from baseline or a value 0.05). Heart rate remained more steady with cisatracurium (p0.05). Conclusion: Cisatracurium found to be more suitable drug in maintaining the stable hemodynamics and preventing fluctuations in pressure in cardiac patients undergoing on-pump bypass surgery.

Objective: To determine in hospital early complications in diabetics' vs non diabetics with acute ST elevation myocardial infarction. Study Design: Comparative cross-sectional study. Place and Duration of Study: The study was conducted in emergency departments and adult cardiology wards of Armed Forces Institute of Cardiology/National Institute of Heart Diseases, from Aug to Nov 2019. Methodology: A comparative cross sectional study was conducted on 380 patients (190 patients with diabetes and 190 patients without diabetes) who presented with acute ST-Elevation MI in age group 30 to 70 years to emergency department of Armed Forces Institute of Cardiology/National Institute of Heart Disease during specified period. Patients with rescue PCI and new onset of LBBB were also included. Patients with age group lesser than 30 years or greater than 70 years with STEMI were excluded. Sampled with consecutive non probability technique in patients was assessed with ECG, cardiac enzymes, transthoracic echocardiography, renal Doppler and RFTs. All patients were admitted in wards and were followed up during hospital stay. Patients were evaluated and their record of Primary PCI and thrombolysis was also noted. Data was entered and analyzed with SPSS-23. Results: A total of 380 patients with STEMI were included in this study consisting of 292 (76.8%) male and 88 (23.1%) female from 30 to 70 years. The patients were divided in two groups i.e. diabetic and non-diabetic, 190 patients were included in each group. It was found that frequency of ST-Elevation MI was higher in diabetic group as compared to non-diabetic group. All the patients were analyzed for complications occurred after STElevation MI. LV failure, Brady arrhythmias, atrial fibrillation, post MI angina and cardiogenic shock were the main complications noted. It was found that all these complications are more in diabetic group post MI angina which occurred most frequently in non-diabetic group. Conclusion: In our study we observed that left ventricular failure and arrhythmias were the major complications. Mortality was higher in diabetic patients than non-diabetic patients. In both groups PPCI and SK reduced mortality. Post MI angina were found more frequent in non-diabetic group. [ABSTRACT FROM AUTHOR]

Objective: To assess the frequency of mental health problems among healthcare workers related to COVID-19 pandemic among health care workers in a tertiary cardiac care center. Study Design: Descriptive cross sectional study. Place and Duration of Study: This study was conducted at Armed Forces Institute of Cardiology/ National Institute of Heart Diseases (AFIC/NIHD) Rawalpindi (Pakistan) from Apr 2020 to Jun 2020. Methodology: This study was a hospital-based cross-sectional study consisted of 100 healthcare workers including 50 nurses and 50 doctors who volunteered to enroll in our study were included. Approval from the clinical research ethics committee of cardiac care hospital was received before the initiation of this study. Verbal informed consent was provided by all study participants prior to their enrollment. Exclusion criteria comprised of the healthcare workers who refused to participate in it. This study followed the COVID-19 Pandemic Mental Health Questionnaire (CoPaQ) 14. Descriptive statistics were used to describe the percentages and frequencies. Descriptive statistics were used to describe the percentages and frequencies were calculated and analyzed using the Statistical Package for the Social Sciences (SPSS), version 23.0. Results: A total of 100 healthcare workers completed the survey. Mean age of the healthcare workers was 36.5 ± 27.0 years (median=36.00), and 75 (75%) were women and men comprised 25 (25%). Of all participants, 50 (50.0%) were nurses, and 50 (50%) were doctors. A considerable proportion of participants reported symptoms of COVID- 19, 6 (6.0%), tested positive 14 (14%), currently quarantine 24 (24.0%). While 12 healthcare workers experienced 14 day quarantine time period. 16 healthcare workers reported COVID test positive of their closed one. The fear of infecting others with COVID-19 was found to be 30 (30%). The mental stress that that COVID-19 will personally affect us was found in 28 (28%) of healthcare workers. The fear that consequences of the COVID-19 will be severe health disasters was found in 40 (40%) of the individuals. Conclusion: In this study of physicians and nurses in hospitals with wards for patients with COVID-19, health care workers responding to the spread of COVID-19 reported high rates of symptoms of anxiety, fear, and distress. [ABSTRACT FROM AUTHOR]

Objective: To compare the hemodynamic effects of Atracurium versus Cisatracurium in Cardiac Patients Undergoing coronary artery bypass graft Surgery. Study Design: Randomized controlled trial. Place and Duration of Study: The study was conducted at Armed Forces Institute of Rawalpindi, a tertiary care hospital, after seeking hospital ethics committee permission, from Apr 2019 to Oct 2019. Methodology: A total of 200 consecutive patients were randomized into two equal groups, group-A and group-C (100 in each group). Group-A patients were induced with 0.5mg/kg of Atracurium, followed by infusion @ 10μg/kg/min whereas group C patients received Cisatracurium @ 0.2mg/kg at induction, followed by infusion @ 2μg/kg/min during the maintainence phase. Systolic blood pressure, diastolic blood pressure, Mean arterial pressure and heart rate were noted at different intervals of both groups. Decrease in systolic blood pressure of >20% from baseline or a value <90 mmHg was considered as hypotension. Results: The mean age of patients was 57.5 ± 6.75 years and 56.52 ± 4.46 years in group A and group C respectively. Systolic and diastolic blood pressure was better maintained with cisatracurium than atracurium. Also Mean arterial pressure remained more stable with cisatracurium (p<0.05), but after opening of sternum and before going on cardiopulmonary bypass, the difference was insignificant in both groups (p>0.05). Heart rate remained more steady with cisatracurium (p<0.05) but had insignificant difference before going on cardiopulmonary bypass (p>0.05). Conclusion: Cisatracurium found to be more suitable drug in maintaining the stable hemodynamics and preventing fluctuations in pressure in cardiac patients undergoing on-pump bypass surgery [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of Coronary artery anomalies using coronary CT angiography. Study Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology and National Institute of Heart Diseases (AFIC/NIHD), from Aug 2014 to Apr 2015. Methodology: After fulfilling ethical criteria, all consecutive patients of either gender who were referred for CCTA were included. CCTA was carried out using a 64-MSCT scanner after IV injection of non-ionic contrast mediums. The scan field was extended from the proximal aorta to the cardiac apex. Retrospective ECG-gated images were obtained. Both coronary arteries were evaluated at different phases of cardiac cycle. Results: Our data shows that mean age as 51.19 ± 12.47 years, 982 (80.89%) male and 232 (19.11%) females, frequency of coronary anomalies were 89 (7.33%). Muscle bridging in mid-course and distal segment of LAD were the most common type. Conclusion: The frequency of Coronary artery anomalies is higher in patients undergoing CTCA for any indication. However, it is required that every patient undergoing CTCA should also be screened for coronary artery anomaly. Some other studies in local population are also required to validate our findings. [ABSTRACT FROM AUTHOR]