Endoscopic Versus Open Radial Artery Harvesting Used in Coronary Artery Bypass Grafting, Our Experience at Queen Alia Heart Institute Endoscopic versus open radial artery harvesting used in coronary artery

Coronary artery stenosis bypass by using radial artery is good techniques which have longer outcomes. In coronary artery bypass grafting (CABG) the radial artery has several advantages. The radial artery has a thick muscular wall which is more susceptibleto contraction from the competitive flow. As compared to the open harvesting technique endoscopic harvest of the radial artery has long lasting cosmetic results it also reduces the post-operative complications. The purpose of the study is to compare the two harvesting techniques and compare the short term and long term results related to intra-operative and post-operative outcomes Methods: This is retrospective study (In Queen Alia Heart Institute, Amman, Jordan) to compare endoscopic radial artery technique versus open technique by reviewing patients files through a period between June 2013 and June 2018. Total 50 patients of CABG surgery was selected they were divided into two groups. Group A includes endoscopic radial harvest (n= 10) and Group B includes open harvest (n=40). Data was collected on predesigned Performa. Data were entered and analyze through IBM SPSS 22.0 Results: There was insignificant dissimilarity between the pre-operative outcomes between groups. The Post-operative outcomes were almost same in both groups except hand numbness (P-value<0.005). The comparison of intraoperative outcomes like harvest time between both groups indicate that the mean harvest time in group A was shorter than group B (39.20 + 3.73 Vs 51.90 + 2.09, P-value=0.000). The operative time in group A was higher than the group B (306.0 + 11.6 Vs 278 + 4.25 p-value=0.00). The hospital stays in both groups were insignificantly different (p = 0.09) Conclusions: Endoscopic radial artery harvest is best suited technique for CABG surgery as it significantly decreases the harvest time as well as hospital stay. It is also proven that it is safer, less painful and better wound appearance technique with exceptional outcomes based on positive surgical experience.

Diagnostic Efficiacy of Immunochromatography Technique for Detection of Viral Hepatitisinfection in Suspected Serum Specimens

A prospective study was conducted in order to evaluate the diagnostic efficacy of immunochromatography assays for qualitative detection of hepatitis B surface antigen and hepatitis C virus antibodies, using commercially available rapid test devices. Rural population of district Chakwal visiting primary care hospitals for screening of hepatitis B and hepatitis C virus infections was selected as study population. Coagulated blood specimens were collected from a total of 500 individuals; serum was separated and stored at -20 C till analysis. Necessary demographic information with previous exposure and screening history of each individual was also recorded in pre designed performa. The stored serum specimens were analyzed for detection of hepatitis B surface antigen and hepatitis C virus antibodies through immunochromatography technique (ICT) and enzyme linked immunosorbant assay (ELISA) using commercially available ICT rapid test devices and ELISA kits. Out of total 500 specimens analyzed through ICT for HBs Ag detection, 15 exhibited positive outcome for the infection whereas analysis of the same specimens through standard ELIS test revealed 16 true positives. One of the ICT tested specimens was therefore recorded as false negative. The sensitivity of rapid test device for HBs Ag detection was therefore 93.75% with 100% specificity, 100% positive predictive value and 99.8% diagnostic accuracy. Similarly 34 of the 500 ICT tested specimens exhibited positive outcome for hepatitis C virus infection whereas 37 true positives were recorded when same specimens were analyzed through standard ELISA test. The sensitivity of ICT rapid test device for HCV Ab detection was therefore 91.89% with 99.57% specificity, 94.44% positive predictive value, 99.35% negative predictive value and 99% diagnostic accuracy. The findings indicate that the rapid diagnostic immunoassays, in spite of requiring minimum time and equipment, are not comparable with standard ELISA for screening of hepatitis B and hepatitis C virus infections.