Management Of Penetrating Injury To Thoracic Inlet And Lower Neck With Retained Foreign Body Using Video Assisted Thoracoscopic Surgery.

Penetrating neck and chest injuries are a common form of occupational injuries. We hereby report a unique case in which a metallic rod had penetrated the left chest and neck of a plastic factory worker. The patient was vitally stable when he presented to Emergency Room. Chest X-ray was performed and the patient was rushed to the operating room. VATS (video assisted thoracoscopic surgery) and neck dissection was done for retrieval of the metallic rod. On table, endoscopy was also done to rule out injury to oesophagus. No injury to vital structures was found and the subsequent recovery was uneventful.

Is Grown Up Congenital Heart (GUCH) disease different in a developing country?

In the current era grown up congenital heart disease (GUCH) patients undergoing surgical interventions are increasing. Most of the interventions in the developed countries are either complex or redo-operations in patients who had previously undergone repair, palliation or correction. However, in the developing countries most of the interventions are primary and corrective. This descriptive retrospective study comprised GUCH patients who underwent surgical intervention for congenital heart disease (CHD) at Aga Khan University Hospital, Karachi, from January 2006 to December 2015. A total of 195 patients had been treated surgically with a mean age of 31.0±13.5 years. Majority of the patients underwent surgical interventions for closure of atrial 109(55.3%) and ventricular 51(26.2%) septal defect. The most common complications were prolonged ventilation 16(8.1%). Overall mortality was 4(2.1%). GUCH in our practice is for primary procedure with simple diagnosis that should have been treated before reaching adulthood as is done in the developed countries.

Coronary artery bypass grafting in South Asian patients: Impact of gender.

BACKGROUND: Outcomes following Coronary artery bypass grafting (GABG) vary between genders, with females having a higher postoperative mortality than males. Most of the studies are on Caucasian or mixed population and it is postulated that Asian population and in particular women have higher morbidity and mortality. In this study we have compared outcomes of elective CABG in men and women of South Asian origin in terms of morbidity and mortality. METHODS: From January 2006 to December 2012, 1970 patients underwent isolated elective CABG at the Aga Khan University Hospital, Pakistan were selected. The prospectively collected data was analyzed retrospectively including univariate and multivariate analysis to find the association of morbidity and mortality. RESULTS: Among the study patients 1664 (85%) were male and 306 (15%) female. Hypertension and diabetes were the most common comorbid conditions seen preoperatively in female patients. Atrial fibrillation and sepsis were the most common postop complications seen in females. In hospital mortality was 3.9% in female underwent CABG as against 0.6% in male. Multivariate analysis showed older age, renal failure, dyslipidemia and prolonged cross clamp time as predictors of postoperative morbidity. Multivariate analysis showed female gender, age and renal failure as predictors of in hospital mortality. CONCLUSIONS: Female gender is an independent risk factor for postoperative mortality following CABG however, female gender is not found to be independent risk factor for morbidity. The trend of higher mortality in female patients was comparable to most studies done on Caucasian patients.