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Objective: To compare cardiac troponin-I levels in post-operative period of on-pump (ONCAB) versus off-pump coronary artery bypass surgery. Study Design: Prospective Observational Study. Place and Duration of Study: Armed Forces Institute of Cardiology, from Jan 2019 to Dec 2019. Methodology: This prospective observational study was done at Armed Forces Institute of Cardiology from 1st January 2019 to 31st December 2019. Eighty six (43 in each on-pump and off-pump) patients admitted for elective coronary artery bypass grafting, aged 30-80 years were included in the study. Baseline data and cardiac troponin- I levels preoperatively as well as at 6, 12, 18 and 24 hours after the surgery in both groups were recorded and analyzed. Results: Out of 100 patients, mean age of the patients was 57.59 ± 10.24 years and 85% were males. All the base line characteristics, comorbid conditions and intra-operative findings were identical in both groups. There was marked rise in CK-MB levels postoperatively in overall participants. There was significant rise in Troponin I levels postoperatively in overall participants. Compared to OPCAB, postoperative Troponin I at 6hours and 12- hours was significantly higher in ONCAB. Conclusion: Compared to OPCAB, postoperative Troponin I at 6 hours and 12-hours was significantly high in ONCAB. However, there was no gross discrepancy in postoperative Troponin I levels between OPCAB and ONCAB at 18- & 24-hours after surgery. [ABSTRACT FROM AUTHOR]

Objective: To compare the early morbidity & mortality of total sub-valvular apparatus preservation technique vs partial preservation technique and no preservation technique in mitral valve replacement. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Cardiac Surgery, Armed Forces Institute of Cardiology Rawalpindi, from Jan 2017 to Dec 2018. Methodology: One hundred fifty seven patients who underwent Mitral valve replacement were included in study. These patients were divided into three groups; group "A" comprised of those patients with total subvalvular apparatus preservation (n1=46), group "B" comprised of those patients with partial sub-valvular apparatus preservation (n2=70), group "C" comprised of those patients with no sub-valvular apparatus preservation (n3=41). Results: There were no statistical difference in the pre-operative data of the patients. No statistical difference noted in cross clamp & bypass time (p>0.05). The early morbidity in terms of ICU stay, Ventilation time, Inotropic supports, post-operative bleeding, Blood transfusion, postoperative rhythm abnormality & Re-exploration were statically significant (p<0.05). The mortality rate of patients with total sub-valvular apparatus preservation was 2.17% which is significantly less than those with partial preservation (2.85%) & no preservation (9.75%). Conclusions: Mitral valve replacement with total subvalvular apparatus preservation had low postoperative morbidity & mortality in comparison with partial and no preservation techniques. [ABSTRACT FROM AUTHOR]

Women consist almost half of the total population in Pakistan and majority of them are living in remote rural areas facing heavy burden of poverty. They are the most vulnerable and deprived segment of the society. For meaningful and sustainable economic development women participation in economic activities is equally important as men. Availability of economic opportunities for women are limited in rural area as a result their participation in integrated economic development is also limited. To make them active participant of development there is need of proper initiatives. The First Microfinance Bank (FMB) is part of the Aga Khan Development Network (AKDN) which has been running a successful microfinance and integrated rural development program in the remote and isolated Northern areas of Pakistan since 1982. The major objective of the bank is to increase the outreach of financial services to those sections of the society that are often neglected by the traditional banking sector. Empowerment of women is the top priority of the bank and the governing principle of the bank is to reduce the vulnerability of poor women and increase their standing in society. We analyze the impact of VGFS by the First Microfinance Bank on poverty reduction and women empowerment in rural area of district Gilgit. A field survey questionnaire was designed to assess the impact of Microfinance on the women empowerment in Gilgit. A total of 200 female respondents were selected through multi-stage, disproportionate, stratified sampling technique, wherein 100 respondents of treatment group are selected on random basis and the rest 100 respondents of control group were selected using score matching technique. Using Mean Difference model of impact evaluation, the study results show that microfinance services of (FMFB) has significantly contributed towards women's empowerment by influencing women's decision-making power and enhancing their overall socio-economic status. Results also show that VGFS by FMFB help in reducing poverty. [ABSTRACT FROM AUTHOR]