Frequency Of Elevated Troponin T In Patients Of Hronic Renal Failure Without Clinically Suspected Acute Myocardial Infarction.

BACKGROUND: Cardiac Troponins are established markers of myocardial injury; however, they may be elevated in chronic renal failure (CRF) patients even in absence of acute myocardial infarction. The objective of the study was to determine the frequency of elevated Troponin T in patients of chronic renal failure without clinically suspected acute myocardial infarction. METHODS: This cross-sectional study was conducted at Medical B Unit of Ayub Teaching Hospital, Abbottabad from 16th December 2013 to 16th June 2014. A sample of 117 patients of chronic renal failure was included in the study without any gender discrimination. The patients were defined as known chronic renal failure when renal failure was reported in their past medical history and by estimation of glomerular filtration rate (GFR). Those patients who had raised Troponin T due to any other reason like acute myocardial ischemia (chest pain, electrocardiographic changes and greater than 20% elevation in Troponin T from baseline), sepsis, heart failure and those who were receiving cardiotoxic chemotherapy were excluded. The subjects were enrolled by non-probability consecutive sampling. Results were analysed by SPSS 16.0. RESULTS: Out of 117 participants, 72 (61.5%) were males and 45 (38.5%) were females. The mean age of the study participants was 52.08±14.21 years. Elevated Troponin T was found in 45 (38.5%) of the patients. There is statistically significant association between the stage of CRF and elevated levels of Troponin T. Statistically significant negative correlation (r=-0.213,p=0.021) was found between the Glomerular Filtration Rate and serum levels of Troponin T. CONCLUSIONS: A high proportion of CRF patients have elevated Troponin T and the rise is significantly associated with the stage of chronic renal failure.

Knowledge of modifiable risk factors of cardiovascular diseases among patients with acute myocardial infarction.

BACKGROUND: Cardiovascular disease is a major cause of mortality and morbidity in Pakistan. Knowledge regarding any disease is an important pre-requisite for implementation of preventive and control measures. This study aimed to evaluate the knowledge of modifiable risk factors of cardiovascular diseases in acute myocardial infarction (MI) patients admitted to Ayub Teaching Hospital, Abbottabad, Pakistan. METHODS: It was a hospital based cross sectional descriptive study carried out in cardiology unit of Ayub Teaching Hospital, on 150 patients with first attack of acute MI. knowledge of four modifiable risk factors; fatty food consumption, smoking, physical activities and obesity, was assessed. RESULTS: Among 150 subjects, 103 (68.7%) were males while 47 (31.3%) were females. Forty three (28.7%) of the patients were having good level of knowledge. Male gender and educational status were associated with good level of knowledge. CONCLUSION: There is a lack of good level of knowledge among patients admitted with acute MI. Implementing aggressive educational strategies is of utmost importance in Pakistani population for preventing the rising prevalence of this disease to combat the burdeni of MI.

In vitro response of tracheal smooth muscle from hyperresponsive guinea pigs to celiprolol.

BACKGROUND: The use of beta-blockers is limited by adverse effects such as bronchospasm in asthmatics. Third generation beta-blockers such as celiprolol may show better respiratory tolerability because they lack beta-blocker induced broncho-constriction. METHOD: Effect of celiprolol on the histamine induced contraction of tracheal muscle strips prepared from ovalbumin-sensitised guinea pigs was studied. Using oxygenated Krebs-Henseleit solution as the nutrient medium, the trachealis muscle activity was measured with isometric force displacement transducer and recorded on 4-channel Oscillograph. RESULT: Celiprolol 10(-4) M shifted the concentration-response curve of histamine downwards and to the right. Mean of amplitude of contraction, percent responses and deviations when compared with the control group were significantly different (p < 0.05). CONCLUSION: Celiprolol antagonised histamine-induced contractions of tracheal muscle of guinea pigs. So it may be considered safe in patients with asthma. However, further clinical evaluation and exploratory work is required.