scholarly journals Clinical analysis of cardiac failure in post-myocardial infarction patients

2018 ◽  
Vol 5 (3) ◽  
pp. 587
Author(s):  
R. Jaya Prakash Reddy ◽  
P. Vijaya Narasimha Reddy

Background: Cardiac failure is one of the common complications of Acute Myocardial Infarction. As CAD is the leading cause of death and post MI Cardiac failure also causing increase in rate of Mortality. It directs us to assess the complications of MI and to evaluate the precautionary & preventive steps of cardiac failure.Methods: The present study comprises of 50 cardiac failure patients with history of MI in the past and who presented with myocardial infarction with cardiac failure were included in this study. We excluded the patients who presented with Cardiac failure without Prior history of MI. This hospital based cross sectional study was conducted at Rajiv Gandhi Institute of Medical Sciences (RIMS), Ongole, Prakasam District, Andhra Pradesh. The study was carried out for a period of 1 year with informed consent.Results: In present study majority number of patients (33) show hypokinesia and 10 are found to have dyskinesia and only 4 are akinesia. In this study More than 50% patients are with history of anterior wall involvement. 36(72%) patients have elevated JVP, 34(68%) have cardiomegaly, 38 patients presented with PND. 29(58%) patients are DM and 35(70%) are HTN and only 6(12%) patients are neither DM, nor HTN.Conclusions: Cardiac failure is a common complication after MI. Most common presentations are breathlessness, chest pain, PND, JVP etc. Anterior wall MI on ECG either isolated or associated with other walls is the leading cause of post MI cardiac failure.

Author(s):  
P. Vijaya Narasimha Reddy ◽  
R. Jaya Prakash Reddy

Background: Cardiac failure is a clinical syndrome that may result from any structural or functional cardiac disorders that impairs the pumping ability of the heart. Post infarction cardiac failure is one of the common complications of Acute Myocardial Infarction which is influenced by factors like extent of MI, Life style, associated co-morbid conditions.Methods: The present study comprises of 50 cardiac failure patients with history of MI in the past and who presented with myocardial infarction with cardiac failure were included in this study. This study was conducted at Rajivgandhi Institute of Medical Sciences, Kadapa, YSR District, Andhra Pradesh. The study was carried out for a period of 2 years. Informed consent was taken from each and every patient included in the study.Results: In our study 42 (84%) are males and 8 (16%) are females. Out of 50 patients 37 (74%) are smokers and 32 (64%) are alcoholics. In our study maximum number of patients i.e. 60% of the patients are sedentary in nature. Among 42 male patients 28 are having WHR >0.9 and 8 female patients WHR >0.8 is quite significant.Conclusions: Post MI cardiac failure is more common in males and sedentary lifestyles. Smoking, alcohol consumption and associated co morbid conditions have linear relationship with incidence of post infarction Cardiac failure. Abdominal obesity has positive effect on incidence of post MI cardiac failure.


2021 ◽  
Vol 14 (10) ◽  
pp. e245963
Author(s):  
Jayanty Venkata Balasubramaniyan ◽  
Judah Nijas Arul ◽  
Jebaraj Rathinasamy ◽  
Thangavel Periyasamy

Myxomas arising from the left ventricle (LV) are extremely rare and can be easily mistaken for a thrombus. We report a case of a 35-year-old man who presented with an acute cerebrovascular accident, having had a prior history of an anterior wall myocardial infarction 2 years back with an echocardiographic evaluation showing mild LV systolic dysfunction. His present prothrombotic workup revealed hyperhomocystinaemia and elevated levels of factor VIII. Present echocardiography revealed a mass arising from a scarred LV wall. Considering the possibility of a thrombus, he was initially started on parenteral anticoagulation. Unfortunately, consequent echocardiogram evaluation showed no reduction in size of the LV mass hence surgical removal was done. Histopathological evaluation unveiled the mass to be a myxoma.


Author(s):  
Bushra . ◽  
Ambreen Ghori ◽  
Azra Ahmed ◽  
Najma Dalwani ◽  
Mushtaque Ali Shah ◽  
...  

Background: Pregnancy is a very crucial time in a woman’s life. In this period of time, not only multiple physiological alterations effect the usual health status but also makes women more vulnerable to contract infection and face negative sequalae. Hepatitis C, a blood borne viral infection serve the similar fate when encountered by pregnant ladies. This study is based on exploring the prevalence of the Hepatitis C virus seropositivity among pregnant population. Moreover, we also evaluated the major risk factors leading to the infection in these mothers. Besides this, infected mothers were studied for their pregnancy outcomes.Methods: In this study 114 pregnant females were observed for this cross-sectional study. It was conducted in Gynecology Unit- 1, Liaquat University Hospital Hyderabad, for the period of January 2017 to July 2017. Chi square test was applied for statistical analysis on SPSS version 16. The criteria for enrollment in the study was set to be a pregnant lady belonging to age group 20-35 years; having singleton pregnancy; was a booked case at the hospital with compliant to antenatal follow ups; admitted to the labor room for delivery. All the non-pregnant ladies, whom had co morbid conditions such as hypertension or diabetes or had infected with hepatitis B or D were excluded from the study. Furthermore, pregnant ladies with multiple gestion or those who were either diagnosed of hepatitis C prior to conceive or had a previous history of hepatitis C were also excluded.Results: Present study revealed that out of 114, 10(8.8%) pregnant ladies were found seropositive for Hepatitis C virus. Prior history for transfusion of blood was the Foremost risk factor discovered, with 60.5% women reported this. History of surgery was the 2nd commonest factor and 43.9% had this in their medical records. On the other hand, only 8.8% women gave the history for previous evacuation. While observing pregnancy outcomes, we found 48.2% neonates had low birth weight, 41.2% were born preterm and 21.1% had low APGAR score.Conclusions: In a nutshell hepatitis c is prevalent in the pregnant population of this region and showing its effects in the form of compromised pregnancies. History of blood transfusion and previous surgery were found to be chief risk factors in the study.


Cephalalgia ◽  
2018 ◽  
Vol 38 (12) ◽  
pp. 1841-1848 ◽  
Author(s):  
Nathan P Young ◽  
Muhamad Y Elrashidi ◽  
Paul M McKie ◽  
Jon O Ebbert

Background Neuroimaging for headache commonly exceeds published guideline recommendations and may be overutilized. Methods We conducted a retrospective cross-sectional study of all outpatient community patients at Mayo Clinic Rochester who underwent a neuroimaging study for a headache indication in 2015. We assessed the neuroimaging utilization pattern, clinical application of red flags, and concordance with neuroimaging guidelines. Results We identified 190 outpatients who underwent 304 neuroimaging studies for headache. The median age was 46.5 years (range 18–91 years), 65% were female, and most reported no prior history of headache (n = 97, 51%). A minority of patients had prior brain imaging studies (n = 44, 23%) and neurological consultations for headache (n = 29, 15%). Few studies were ordered after consultation with a neurologist (n = 14, 7%). Seventy-seven percent of patients were documented to have a “red flag” justifying the imaging study. Abnormal neuroimaging findings were found in 3.1% of patients with warning flags (5/161); carotid dissection (n = 3) and reversible cerebral vasoconstrictive syndrome (n = 2). An estimated 35% of patients were imaged against guidelines. Conclusions The prevalence of serious causes of headache in a community practice was low despite the presence of a documented red flag symptom. Inadequate understanding or application of red flags may be contributing to recommendations to image patients against current guidelines. Interventions to reduce unnecessary neuroimaging of patients with headache need to be designed and implemented.


2020 ◽  
Vol 24 (2) ◽  
pp. 149-155
Author(s):  
Hamzullah Khan ◽  
Mohammad Zahid Khan ◽  
Mian Mohammad Naveed

Objective: To determine the frequency of COVID-19 and characteristics of patients presenting to the COVID-19 clinic at Qazi Hussain Ahmed Medical Complex (QHAMC) Nowshera. Methodology: This cross-sectional study was conducted from 21st Feb 2019 to April 8, 2020, in QHAMC Nowshera. Relevant information was collected on a pre-designed Performa prepared following the objectives of the study. Results: Out of 220 patients, 165(75%) were males, and 55(25%) females. 96(43.6%) of the patients were in the age range 18-30 years followed by 52(23.6%) in age range 31-45years and 17(7.7%) with age>60 years etc. Out of total the nasopharyngeal swabs of 26(11.6%) strong suspects were sent for PCR testing. 208(94.5%) were sent home while 12(5.5%) were advised quarantine. Forty-seven (21.4%) had a travel history to an epidemic area in the last 14 days. 51(23.2%) had a positive history of contact. Eighty-five (38.6%) had a fever and sore throat followed by 27(12.3%) with (fever & cough), 24(10.9%) with (cough and shortness of breath/dyspnea) and 14(6.4%) with a simple flue, etc. Out of 26 cases, 6(2.7%) were COVID-19 Positive, 12(5.5%) were negative and results of 8(3.6%) were still awaited. The PCR repeated the test for confirmed cases showed;  4(1.8%) negative, one died and one was refractory positive.  A positive correlation (p=0.03, r=0.4) of an increase in age with the severity of the disease/outcome was recorded. Conclusion: The frequency of infectivity with COVID-19 was 2.6%. A higher number of patients with mild symptoms attend the COVID clinic. The rate of infection and mortality was higher in age> 60 years.


2019 ◽  
Vol 02 (01) ◽  
pp. 16-20
Author(s):  
M. B. Bharathi ◽  
Thanzeem Unisa ◽  
Swathi Chandresh ◽  
Venkatesh C. R. ◽  
Harsha S.

Abstract Introduction Bell's palsy (BP) is the common cause of facial palsy. This study aims to report and analyze the age, sex distribution, symptomatology, site of lesion, and prognosis in 101 patients with (BP). Materials and Methods This is a cross-sectional study conducted at tertiary referral center, JSS Hospital, Mysuru. All patients consenting to participate in this study, of all ages, of either sex, both outpatients and inpatients with a diagnosis of BP during this study period were included. Results Of the 101 patients analyzed, maximum cases (25.7%) were in third decade of age; 55.4% were males, and both right and left sides of the face were equally involved. Maximum number of patients (50.5%) had a history of postaural pain at presentation Topodiagnostic tests showed majority of BP cases involving geniculate or suprageniculate regions (67.3%) in our study. 20.8% had lesion above the nerve to stapedius, and 11.9% had lesion below the nerve to stapedius. Electrodiagnostic test—electroneuromyography (ENMG)—was abnormal in 57 (67.1%) individuals at day 4. 50.4% of patients had a House-Brackmann (HB) facial nerve grade IV at presentation. 90% of the BP group in our study recovered normal to near-normal facial nerve function by the end of 28 days’ time. Conclusion Each case of BP should be evaluated with thorough clinical examination, topodiagnostic tests, and electrodiagnostic tests. Appropriate management will help in almost full recovery of disease.


2012 ◽  
Vol 45 (01) ◽  
pp. 094-096 ◽  
Author(s):  
Rafi Parnia ◽  
Ladan Ghorbani ◽  
Nariman Sepehrvand ◽  
Sanaz Hatami ◽  
Shahrzad Bazargan-Hejazi

ABSTRACT Background and Aim: The umbilicus plays an important role in the aesthetic appearance of the abdomen. So, its restoration during reconstructive surgeries, such as an abdominoplasty, is a challenge. The aim of this study was to evaluate quantitative indices based on constant skeletal points in the anterior wall of abdomen in order to provide an appropriate site of a neo-umbilicus during an abdominoplasty. Materials and Methods: In this descriptive, cross-sectional study, we enrolled 65 young adult girls (20-25 years old) who were nulliparous, nulligravid, and without any history of surgery. Weight, height, distance from xiphoid to umbilicus (Xu), distance from the pubic symphysis to xiphosternum (Xp), and anterior superior iliac spine (interASIS) distance of the subjects were measured. Data were analysed by SPSS ver. 16 using descriptive statistics and multiple regression tests in order to present a formula (equation). Results: Mean age was 22.74 ± 1.51 years, mean weight 54.98 ± 6.51 kg, mean height 160.91 ± 4.11 cm and body mass index (BMI) was calculated to be 21.25 ± 2.61 kg/m 2 . Mean Xp distance was 32.26 ± 2.23 cm and mean Xu distance was 17.11 ± 1.64 cm. Xu/Xp ratio (ratio of umbilicoxiphoid distance to puboxiphoid distance) was 53.06 ± 3.9%. Data were analysed using multiple regression test and likelihood ratio. The formula used in determining the appropriate site of neo-umbilicus during abdominoplasty was suggested: Xu=−0.98 + 0.91Xp − 0.07H. Conclusion: By applying these quantitative methods, the natural site of neo-umbilicus could be determined. This may reduce practice errors and increase patient satisfaction. In addition, these findings provide plausible evidence to defend against possible legal complaints.


2017 ◽  
Vol 19 (1) ◽  
pp. 29-36 ◽  
Author(s):  
Marzieh Honarbakhsh ◽  
Mehdi Jahangiri ◽  
Haleh Ghaem

Background: Using appropriate respiratory protection equipment (RPE) is very important to protect healthcare workers (HCWs) against respiratory hazards. The aim of this study was to identify the level of knowledge, perceptions and practices of HCWs on using RPE. Methods: This cross-sectional study was conducted with 284 employees of educational hospitals affiliated to Shiraz University of Medical Sciences. The study’s instrument was a self-made questionnaire that comprised four components: demographic inquiries and questions designed to assess the knowledge, perceptions and practice of HCWs regarding RPE. Collected data were analysed using SPSS software version 21. Results: Average scores of knowledge, perceptions and practice of HCWs on using RPE were 66.50% ± 11.93%, 80.32% ± 10.05% and 70.12% ± 20.51%, respectively. A significant association was observed between knowledge and age, job experience, history of using respirator, marital status and risk of respiratory hazards in the workplace and perceptions with age and education and practice with education. Conclusion: Studied HCWs had positive perceptions and moderate level of knowledge and practice about the use of RPE. Full implementation of respiratory protection program in the hospitals would be helpful to improve the knowledge, perceptions and practices of HCWs regarding RPE.


Author(s):  
Ali Reza Yusefi ◽  
Parnian Nikmanesh ◽  
Zahra Kavosi ◽  
Ahmad Sadeghi

Background: Medication errors are one of the major causes of injury to patients while receiving medical care. This study aimed  to investigate the effective causes of medication errors in nurses in educational hospitals affiliated with Shiraz University of Medical Sciences. Methods: This descriptive-analytical and cross-sectional study was conducted in 2020 on 340 nurses from 10 educational  hospitals affiliated to Shiraz University of Medical Sciences. The data collection tool was a questionnaire. Data were analyzed using t-test, ANOVA and Pearson correlation coefficient were analyzed using SPSS23 software . Results: According to the results, human factors have been the most important factor in the occurrence of medication errors. The most important causes of medication errors with respect to human, managerial and environmental factors include fatigue due to overwork (3.13 ± 1.16), method of supervision (3.06 ± 0.98) ,and heavy workload (3.00 ± 1.19), respectively. There was a statistically significant relationship between human factors and  age (p = 0.024), gender (p = 0.013), employment relationship (p = 0.016), and marital status (p = 0.027), and between management factors and employment relationship (p = 0.034) and the number of patients under observation (p = 0.011). Conclusion: Considering the most important causes of medication errors, including fatigue due to overload, supervision methods, and heavy workload, using strategies to reduce fatigue due to workload, such as balancing nurses' work shifts and also holding workshops on supervision methods is recommended in order to improve the level of managerial competencies of nurses.


2021 ◽  
Vol 7 (6) ◽  
pp. e639
Author(s):  
Chul-Hoo Kang ◽  
Young Mee Kim ◽  
Yang-Ji Kim ◽  
Su-Jeong Hong ◽  
Do Yoon Kim ◽  
...  

ObjectiveThis study aimed to determine the frequency of pathogenic NOTCH3 variants among Koreans.MethodsIn this cross-sectional study, we queried for pathogenic NOTCH3 variants in 2 Korean public genome databases: the Korean Reference Genome Database (KRGDB) and the Korean Genome Project (Korea1K). In addition, we screened the 3 most common pathogenic NOTCH3 variants (p.Arg75Pro, p.Arg544Cys, and p.Arg578Cys) for 1,000 individuals on Jeju Island, where the largest number of patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) have been reported in Korea.ResultsThe pathogenic NOTCH3 variant (p.Arg544Cys) was found in 0.12% of sequences in the KRGDB, and 3 pathogenic variants (p.Arg75Pro, p.Arg182Cys, and p.Arg544Cys) were present in 0.44% of the Korea1K database. Of the 1,000 individuals on Jeju Island, we found 2 cysteine-altering NOTCH3 variants (p.Arg544Cys variant in 9 and p.Arg578Cys in 1 individual) in 1.00% of the participants (95% confidence interval: 0.48%–1.83%). The presence of cysteine-altering NOTCH3 variants was significantly associated with a history of stroke (p < 0.001).DiscussionPathogenic NOTCH3 variants are frequently found in the general Korean population. Such a high prevalence of pathogenic variants could threaten the brain health of tens of thousands to hundreds of thousands of older adults in Korea.


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