Coronary artery bypass grafting: Quality of life of patients in Karachi

In the Third World, cardiac Patients often suffer not only from the nature of their illnesses, but also the insufficiency of the facilities available. Although the effectiveness of coronary artery bypass grafting (CABG) is being evaluated in terms of mortality, complications or recurrence of symptoms, empirical studies assessing the change in Patients\u27 quality of life (QOL) after CABG within the Pakistani cultural context are lacking.Aims: The aims of the present study are to assess and compare the change in health-related quality of life before and 1 month after CABG and to assess the differences in QOL with respect to age, gender and cardiac rehabilitation programme attendance.Method: A prospective single group pre- and post-Study Design was used, whereby Patients completed a questionnaire before and 1 month after surgery. Questions considered the person\u27s physical capacity, psychological wellbeing, social relationships and satisfaction from their health condition.Results:The results indicated a significant improvement in Patients\u27 physical and psychological health, satisfaction with social relationships and overall health status. Younger Patients showed significantly lower scores on the social domain (reflecting greater dissatisfaction with their sex life and personal relationships). Female participants showed significantly lower scores in psychological health post surgery. Lastly, participants of the cardiac rehabilitation programme scored significantly higher in psychological health compared with non-participants.Conclusion: QOL improved from prior to and 1 month after CABG while differing (in specific domains) with respect to age, gender and cardiac rehabilitation programme attendance. The findings can be used to develop interventions to improve health and QOL in specific domains with respect to specific groups

Immunohistochemical Expression of BCL-2 in Malignant Salivary Gland Tumors

Background: Malignant salivary gland tumors (MSGTs) consist of a heterogeneous group of neoplasms with complex clinicopathological features and biological behaviors. The purpose of this study was to determine the expression of Bcl-2 antiapoptotic protein in mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (ADCC), acinic cell carcinoma (ACC) and polymorphous low-grade adenocarcinoma (PLGA) of salivary glands and to find out its association with different grades of these tumors. Material and Methods: This descriptive study included 55 cases of MSGTs. Tissue sections were stained with routine hematoxylin and eosin stain as well as Bcl-2 immunostain. MSGTs were graded as low grade (Low grade MEC, ACC, PLGA, and tubular pattern of ADCC), intermediate grade (cribriform pattern of ADCC, and intermediate grade of MEC) and high grade (high grade of MEC and solid pattern of ADCC) tumors on H&E sections. Bcl-2 expression was scored as ‘negative’ (<5% of neoplastic cells), ‘1’ (5-19% of neoplastic cells), ‘2’ (20-49% of neoplastic cells), and ‘3’ (>50% of neoplastic cells), respectively. Results: MSGTs most commonly involved the parotid gland (52.7%), while ADCC (40%) and MEC (38.2%) were the most common tumors. Expression of Bcl-2 was strongly positive in 56.4% cases of MSGTs which included ADCC (71%), MEC (19.4%) and ACC (9.7%), respectively. A significant association was found between Bcl-2 staining and types of MSGTs i.e., MEC, ADCC, ACC (P = .001) as well as between Bcl-2 staining and grades of MSGTs (P = .013). Conclusions: Bcl-2 protein is expressed in malignant salivary gland tumors. Its expression maybe helpful in grading small biopsies, predicting behavior, and planning targeted therapy of MSGTs.   &nbsp