Rawalpindi Institute of Cardiology (RIC) is a non-profit tertiary level cardiac hospital located on Rawal Road in Rawalpindi, of the Punjab province of Pakistan. Established in 2012, RIC has nearly 50 departments which provide health facilities to several parts of the country. The hospital was established by Punjab Health Department and inaugurated by former Chief Minister of the Punjab, Shahbaz Sharif. A 272-bed hospital, the current executive director is Professor Dr. Anjum Jalal; the medical superintendent of the hospital is Dr. Muhammad Sohail.
Recent randomized trials showed neutral results for distal medium vessel occlusion (DMVO) thrombectomy, but real-world effectiveness across diverse healthcare settings remains unknown. We evaluated DMVO thrombectomy outcomes in the Middle East and North Africa (MENA) region. The MEMENTO registry retrospectively analyzed consecutive DMVO thrombectomy patients (M2, M3, A2-3, P2-3 segments) across 15 centers (2022–2024). DMVOs were classified as primary, baseline secondary, or iatrogenic secondary. Primary outcome was 90-day functional independence (mRS 0–2). Secondary outcomes included successful recanalization (TICI ≥ 2b), mortality, and symptomatic hemorrhage. Among 164 patients (median age 72, NIHSS 10), subtypes included primary (25
BACKGROUND:Percutaneous atrial septal defect (ASD) closure is an established alternative to surgical repair for patients with secundum ASD, offering minimally invasive treatment with high procedural success rates. Despite its widespread adoption, clinically significant complications such as device embolization and erosion may occur. Our Survey aims at providing a comprehensive, multicenter perspective on the incidence, features, and management strategies for these complications, in order to improve procedural outcomes and patient safety through collaborative data collection. METHODS:This is an international, multicenter survey collecting retrospective data from 30 centers performing transcatheter ASD closures between 2011 and 2021. Participating institutions contributed anonymous aggregate data on patient demographics, procedural details, and clinical outcomes, focusing on the incidence, anatomical and procedural risk factors, and management of device embolization or erosion. RESULTS:A total of 30 institutions participated, providing data on 13.155 procedures of transcatheter closure of ASD, with 40% of them in children. Amplatzer device was used in 58% of cases, with balloon sizing performed routinely in 62% of institutions, mainly with stop flow technique. A total of 17 erosions (0.13%) were reported, of which 10 in children (incidence 0.19%) and 7 in adults (incidence 0.09%). Surgical repair was performed in all these cases, one patient died. Embolizations were reported in 91 cases (incidence 0.7%), with 60% of them in children. Most (80%) occurred within 24 h. Surgical retrieval was carried out in 29% of cases. Irrespective of management, no fatal complications occurred. CONCLUSIONS:Complications such as embolization and erosion after transcatheter ASD closure in children and adults are exceedingly rare but still present in clinical practice and require careful monitoring for prompt recognition and timely intervention, in order to obtain favorable outcomes.
Objective: To assess the association of variant genotypes with ethnicity, developmental milestones and onset of disease course in children with non-syndromic hereditary hearing loss. Study Design: Case-control study. Place and Duration of Study: ENT Department, Combined Military Hospital, Rawalpindi and CREAM Lab-I, Army Medical College, Rawalpindi, Pakistan from Jan to Dec 2022. Methodology: The study enrolled 200 subjects, aged 06 months to 10 years: 100 subjects with non-syndromic hearing loss (NSHL) were placed in Group-A, and 100 healthy individuals in Group-B. Blood samples were collected from each enrolled subject. DNA was extracted followed by polymerase chain reaction, and restriction fragment length polymorphism. Chi-square test was applied to check for association. Results: Analysis of the results indicated ethnicity regions as follows: Punjab 71% (NSHL) and 72% (controls); Khyber Pakhtunkhwa (KP) 19% (NSHL) and 15% (controls); Islamabad (Capital region) 06% (NSHL) and 05% (controls); Sindh 03% each (NSHL & controls) and Baluchistan 01% (NSHL) and 05% (controls). The wild genotype GG was the most common amongst subjects of all regions with highest frequency in Awan caste, both in case and control subjects. Statistically significant (p-value<0.005) difference was observed in NSHL subjects as compared to controls. There was no statistical significance observed between ethnicity and the wild genotype GG, heterozygous genotype GA and mutant genotype AA. Conclusion: In non-syndromic hearing loss (NSHL), the Otoferlin variant A1090E was found to be significantly associated with regional backgrounds among cases. The variant may play a protective role in subjects against NSHL.
Background Type 2 diabetes mellitus is a common metabolic disorder associated with progressive vascular complications. Microvascular dysfunction is an important cause of diabetic nephropathy, retinopathy, and neuropathy. Oxidative stress and prothrombotic activity are considered major contributors to vascular injury among diabetic patients. This study aimed to evaluate the association of prothrombotic and oxidative stress biomarkers with microvascular dysfunction risk in patients with type 2 diabetes mellitus. Methods This hospital-based observational cross-sectional study was conducted at Maryam Medicare Hospital, Vehari, Pakistan, from February 2025 to January 2026. A total of 200 patients with type 2 diabetes mellitus were included using consecutive sampling. Patients were divided into low-risk and high-risk microvascular dysfunction groups based on clinical and biochemical assessment. Prothrombotic biomarkers including fibrinogen, D-dimer, and plasminogen activator inhibitor-1 (PAI-1) were measured along with oxidative stress biomarkers including malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), glutathione (GSH), and catalase activity. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26 (Released 2018; IBM Corp., Armonk, New York, United States). Results Patients with high microvascular dysfunction risk showed significantly increased fibrinogen (421.5 ± 72.4 vs 312.8 ± 48.6 mg/dL), D-dimer (458.7 ± 101.5 vs 228.4 ± 62.1 ng/mL), PAI-1 (34.2 ± 8.7 vs 18.7 ± 5.4 ng/mL), and MDA levels (4.86 ± 0.92 vs 2.41 ± 0.58 nmol/mL) compared with the low-risk group (p < 0.001). Antioxidant biomarkers including TAC, SOD, GSH, and catalase were significantly reduced in high-risk patients (p < 0.001). MDA showed the highest predictive value for microvascular dysfunction risk with an area under the curve (AUC) of 0.871. Conclusion Elevated thrombotic and oxidative stress biomarkers were significantly associated with the presence of microvascular complications in patients with type 2 diabetes mellitus. These findings suggest that these biomarkers may reflect the burden of vascular injury and oxidative stress in patients with established diabetic microvascular complications.
Total Anomalous Pulmonary Venous Return (TAPVR) is a rare congenital defect requiring surgical correction. Outcomes are influenced by associated anomalies and preoperative pulmonary venous obstruction, which increase morbidity, mortality, and postoperative pulmonary hypertension risk. This study reviews our institutional experience with pediatric TAPVR repair, emphasizing postoperative outcomes and prognostic determinants. This single-centre retrospective cohort (2006–2024) at Aga Khan University Hospital included pediatric TAPVR patients (< 18 years). Preoperative, intraoperative, and postoperative data were analyzed. Continuous variables summarized as mean/SD or median/IQR and categorical as frequencies, with appropriate statistical tests applied. Our cohort included 80 patients (65
