QUESTION What is the relationship between vibration of the chest wall and the resulting chest wall force, chest wall circumference,intrapleural pressure, and expiratory flow rate? Is the change in intrapleural pressure during vibration the sum of the intrapleural pressure due to recoil of the lung, chest wall compression, and chest wall oscillation? DESIGN Randomised, within-subject,experimen...

In patients who have myocardial infarction with STsegment elevation, rupture of an atherosclerotic plaque leads to platelet adhesion, activation, and aggregation, with subsequent vessel occlusion due to thrombus formation. In these circumstances, the most effective pharmacologic reperfusion regimen is concurrent fibrinolytic therapy and platelet inhibition. The marked benefit of such a combinat...

Acute ischemic stroke is a major cause of morbidity and mortality in Europe, North America, and Asia. Its treatment has completely changed over the past decade with different interventional approaches, such as intravenous trials, intra-arterial trials, combined intravenous/intra-arterial trials, and newer devices to mechanically remove the clot from intracranial arteries. Intravenous thrombolys...

Fibrinolytic therapy progressed by the evolution of different strategies that helped in enhancing its efficacy and specificity. The use microbial fibrinolytic enzymes is leading to a promising direction for treatment cardiovascular diseases. Subtilisin, member subtilases enzyme abundantly found Bacillus species. isolation subtilisin gene (quaking homolog) from subtilis was attempted present wor...

OBJECTIVE To confirm that either Fibrinolytic therapy or open decortication which of the two is an effective First line treatment of pleural empyema. METHODS This prospective comparative study was conducted in the department of surgery Sheikh Zayed Medical College and Hospital, Rahim Yaar Khan. Seventy eight (78) patients were included in this study. There were two groups of patients; Group I...

BACKGROUND There is conclusive evidence from clinical trials that reduction of mortality by fibrinolytic therapy in acute myocardial infarction is related to the time elapsing between onset of symptoms and commencement of treatment. However, the exact pattern of this relation continues to be debated. This paper discusses whether or not appreciable additional gain can be achieved with very early...

Most cases of acute myocardial infarction are caused by disruption of an atherosclerotic plaque followed by coronary thrombosis (1). In ST-elevation myocardial infarction (STEMI), the thrombus occludes a major epicardial coronary artery. Such an occlusion is an emergency situation, and flow in the occluded vessel should be restored as fast as possible. Various strategies for reperfusion are ava...

Chylothorax is suspected when milky white turbid fluid is obtained from thoracocentesis. Conservative management usually involves intercostal tube drainage, dietary restriction, and total parenteral nutrition. Surgery is indicated when conservative management fails. We describe a young woman with idiopathic chylothorax who failed conservative therapy but refused surgery. We instilled intrapleu...

The scientists William S. Tillett and Sol Sherry were responsible for the introduction of intrapleural fibrinolytics as therapeutic agents, thus supplementing antimicrobial therapy in the treatment of empyema. They were the first to suggest the possibility that the use of these drugs in empyema might obviate the need for radical surgical procedures. This article highlights their original work a...