Boyle, Sir Roger (Michael), (born 27 Jan. 1948), Consultant Cardiologist, York District Hospital, 1983–2011; National Director for Heart Disease, 2000–11, and for Stroke, 2006–11

Introduction: Fetal malnutrition is an important contributor to perinatal mortality and morbidity.This study was aimed to assess the nutritional status of the newborn at birth using ClinicalAssessment of Nutrition (CAN score) and compare it with other conventional anthropometric indices.In addition to studying maternal variables associated with fetal malnutrition. Material andMethods: This prospective study was conducted at Sub-District hospital, Uttarakhand for a 3-monthduration from June 2020 to August 2020. Total 765 term, singleton newborn without majorcongenital malformation or comorbidities were included in the study. Anthropometric indices andCAN score were assessed and compared. Results: The incidence of fetal malnutrition was 17.39%using the CAN score. Fetal malnutrition was detected in 133(17.3%), 65(8.5%), 141(18.4%),91(11.8%), 85(11.1%) of newborn using CAN score, PI, Gestational age, BMI, and MAC/HCrespectively. Out of clinically malnourished babies identified by CAN score, PI, gestational age, BMIand MAC/HC identified 49.23% (32), 76.6% (108), 56.04%(51), 49.41%(42) as fetal malnutrition.BMI has the highest sensitivity and diagnostic accuracy for detecting fetal malnutrition. Maternalvariables associated with FM include early maternal age during conception 81.4% (623),primigravida 33.1% (112), anemia (21%), irregular antenatal checkups (40%) and concurrentillnesses (PIH, urinary tract infection, heart disease, renal disease, vascular disease) (50.9%).Conclusion: CAN score is a simple, handy and cost-effective tool to identify FM. Using BMI with CANscore can serve for screening FM. Among maternal variables, primigravida (33.1), anemia (21.5%),irregular antenatal checkup (40.25%), Concurrent medical illnesses (50.96%) is strongly associatedwith FM. Maternal age is not statistically significant.

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An audit of cholesterol measurement in patients with ischaemic heart disease in a District Hospital

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-83-84 ◽

1997 ◽

Vol 83 (2) ◽

pp. 84-84

Author(s):

M Turner ◽

S Hutchings ◽

A J Marshall

Keyword(s):

Heart Disease ◽

Ischaemic Heart Disease ◽

District Hospital ◽

Cholesterol Measurement

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Does Ageism Affect the Management of Ischaemic Heart Disease?

Journal of Health Services Research & Policy ◽

10.1177/135581960300800109 ◽

2003 ◽

Vol 8 (1) ◽

pp. 40-47 ◽

Cited By ~ 13

Author(s):

Matthew Bond ◽

Ann Bowling ◽

Dorothy McKee ◽

Marian Kennelly ◽

Adrian P Banning ◽

...

Keyword(s):

Heart Disease ◽

Ischaemic Heart Disease ◽

Older Patients ◽

District Hospital ◽

Artery Bypass ◽

Bypass Graft ◽

Percutaneous Transluminal Coronary Angioplasty ◽

Stent Insertion ◽

Retrospective Case ◽

Hospital Patients

Objectives: To analyse access by age to exercise testing, coronary angiography, revascularisation (percutaneous transluminal coronary angioplasty/stent insertion and coronary artery bypass graft surgery) and receipt of thrombolysis, where indicated, for hospital patients with diagnosed cardiovascular disease. Method: Retrospective case note analysis, tracking each case backwards and forwards by 12 months from the patient's date of entry to the study. The setting was a district hospital in the eastern part of outer London. The case notes eligible for inclusion were those of elective and emergency in-patients with an in-patient ICD-10 code of ischaemic heart disease, angina pectoris or acute myocardial infarction and a consecutive 20% sample of new cardiac outpatients with these diagnoses. Results: Analysis of 712 case notes showed that older hospital patients with ischaemic heart disease, and with indications for further investigation, were less likely than younger people to be referred for exercise tolerance tests and cardiac catheterisation and angiography. This was independent of both gender and severity of condition. Older patients did not appear to be discriminated against in relation to receipt of indicated treatments (revascularisation or thrombolysis), although, in the case of revascularisation, older patients were more likely to have been filtered out at the investigation stage (catheterisation and angiography), so selection bias partly explains this finding. Conclusions: The current findings from a single hospital are comparable with the results from a broader study of equity of access by age to cardiological interventions in another district hospital in the same region. Although only two hospitals were analysed, the similarity of findings enhances the generalisability of the results presented here. It appears that age per se causes older cardiac hospital patients to be treated differently.

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