Comparison of percutaneous cystolitholepexy with vesicolithotomy in peadiatric age group for safety and efficacy.

Objectives: Urolithiasis is the common disease of tropical and subtropical areas and in children, the urinary bladder is the most common site for stone formation in the lower urinary tract. Which account for 5% of urinary calculi .Most common cause of vesical stone is dietary deficiencies, treatment options are continuously refine from vesicolithotomy to scar less procedures, aim of this refinement to reduce the morbidity and complication. The purpose of study to evaluate post-operative outcome in terms of safety and accuracy of percutaneous cystolitholapaxy (PCVL) with open vesicolithotomy in children having Vesical stones. Study Design: Retrospective Comparative study. Setting: Department of Urology Sheikh Zayed Hospital Rahim Yar Khan. Period: January 2018 to December 2018. Material & Methods: Data collected of 15 patient who underwent for open vesicolithotomy (group-I) and 15 children underwent for PCCL (group II) the patients' age ranged from 1 year to 10 years. The stone size ranged from 1cm to 3cm in both groups, the procedure was performed under anesthesia with intubation. Dilation of the tract was made with help of alken metallic dilators. We use the adult nephroscope with 24Fr sheath, the same which used for PCNL. Pneumatic fragmentation was required for stones larger than 1.5 cm. Results: Procedures completed with complete stone clearance. The average hospital stay was 2.1 days in group I and 1.0 in group II. Analgesia requirement were 29.3 vs 12.3mg. in group I, six patients (40%) had fever while in group II only one patient(6.7%) has fever. 5 patients observed with hematuria in group I while In group II it was observed in 2 patients. Conclusions: PCCL is a minimal invasive procedure with less morbidity in term of postoperative pain, urinary leakage, fever and hospital stay, and it is a cost effective option for small vesical stones.

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Evaluation of idiopathic scoliosis by anterior and posterior arthrodesis

Coluna/Columna ◽

10.1590/s1808-185120151402145201 ◽

2015 ◽

Vol 14 (2) ◽

pp. 88-92 ◽

Cited By ~ 1

Author(s):

Jean Carlo Frigotto Queruz ◽

Allan Kato ◽

Carlos Abreu de Aguiar ◽

Luiz Muller Avila ◽

Luis Eduardo Munhoz da Rocha

Keyword(s):

Idiopathic Scoliosis ◽

Hospital Stay ◽

Posterior Approach ◽

Thoracolumbar Spine ◽

Average Hospital ◽

Icu Stay ◽

Group I ◽

Number Of Patients ◽

Significant Difference ◽

Group Ii

<sec><title>OBJECTIVE:</title> To evaluate comparatively surgical treatment of adolescent idiopathic scoliosis type 5CN by anterior and posterior approach.</sec><sec><title>METHODS:</title> The study consists of a comparative retrospective study of two groups of patients with the thoracolumbar spine arthrodesis technique by anterior and posterior approach. Twenty and two patients were sequentially selected, 11 operated by anterior approach - called Group I - and 11 by posterior approach - Group II. Anamnesis and physical examination were performed, as well as length of hospital stay and ICU stay, degree of correction, comorbidities and pre and postoperative radiographic images data were gathered.</sec><sec><title>RESULTS:</title> The mean age was 13.7 years in Group I and 14 years in Group II. The average hospital stay was 5.81 days for Group I and 5 for Group II. The average ICU stay was 2.81 and 2 days, respectively. Considering the operated levels, Group I presented an average of 4.81 vertebrae (4-6 levels), and Group II presented an average of 6.36 vertebrae (5-11 levels). Complications did not show statistically significant difference.</sec><sec><title>CONCLUSION:</title> Despite the limited number of patients in groups, it was demonstrated that the posterior approach reduces the number of days of hospitalization and ICU stay. However, it was found increased levels included in the arthrodesis.</sec>

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Ep.Th.654Home Based Pre-Rehabilitation in Hepatic & Pancreatic Oncological Surgery- A Way Forward for Improved Patient Outcome

British Journal of Surgery ◽

10.1093/bjs/znab309.070 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Nauman Ahmed ◽

Rami Obeidallah ◽

Daren Subar

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Cost Effective ◽

P Value ◽

Oncological Surgery ◽

Operative Outcomes ◽

Home Based ◽

Group I ◽

Operative Complications ◽

Group Ii

Abstract Aims To ascertain the impact of ‘’Cost effective home-based pre-rehabilitation’’ on post-operative outcomes in patients undergoing major hepatic and pancreatic oncological surgery. Methods In this non-randomized comparative study (2019-2021), we included 36 patients having pancreatic or hepatic malignancy. In group I, patients were signed up for home-based pre-rehabilitation program and dietary modification. Group II; included patients who did not have rehabilitation. The two groups were compared for post-operative outcomes (post-operative complications, length of ITU and hospital stay) Results Mean age was 69.05±9.68 years in group I and 67.50±8.75 years in group II (p-value 0.61). Open approach was used in 02 (11.0%) patients in group I and in 09 (50%) patients in group II (p-value 0.01). More patients in group II needed admission in intensive care unit (ICU); 18 (100%) versus 11 (61.1%) in group II (p-value 0.0003). The group I had shorter length of hospital stay as compared to Group II (p-value 0.0001). There was no significant difference in post-operative complications between the groups. Conclusion Home based pre-rehabilitation, has shown beneficial outcomes in terms of less requirement for ITU admission post operatively, shorter length of hospital stay and cost effective method of pre rehabilitation.

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Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0144 ◽

2019 ◽

Vol 101 (1) ◽

pp. 21-29 ◽

Cited By ~ 4

Author(s):

M Arnous ◽

H Elgendy ◽

W Thabet ◽

SH Emile ◽

SA Elbaz ◽

...

Keyword(s):

Clinical Trial ◽

Hospital Stay ◽

Recurrence Rate ◽

Primary Closure ◽

Randomised Clinical Trial ◽

Limberg Flap ◽

Complication Rates ◽

Cosmetic Results ◽

Group I ◽

Group Ii

BackgroundAlthough several surgical techniques for treatment of sacrococcygeal pilonidal sinus (SPND) have been described, there is no consensus on the optimal surgical procedure. In this study we compared excision with primary closure and Limberg flap in the treatment of SPND.MethodsThis was a prospective randomised clinical trial in patients with SPND who were randomly allocated to one of two groups: group I (excision and primary closure) and group II (Limberg flap technique). The primary outcome of the trial was recurrence of SPND whereas postoperative complications, return to work and cosmetic results were the secondary outcomes.ResultsSixty patients were included, with a mean age of 24.1 years and mean body mass index (BMI) of 26.8 kg/m2. Group 1 had significantly shorter operation time than group II. Both groups had similar hospital stay and comparable complication rates (43.3% vs 30%; P = 0.4). Group I had significantly higher recurrence rate (20% vs 0; P < 0.02) and significantly better cosmetic satisfaction score than group II. Being hairy (P = 0.04), positive family history (P = 0.03), diabetes mellitus (P = 0.005) and history of previous surgery for SPND (P = 0.01) were the significant predictors for recurrence.ConclusionsThe Limberg flap is an effective technique for the treatment of SPND with very low recurrence rate and comparable complication rate and hospital stay to excision and primary closure. Excision and primary closure offered the advantages of quicker healing time, earlier resumption of daily activities, better cosmetic results, which may render it more suitable for patients with low risk for recurrence.

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Short term versus conventional Catheterisation after Genital Prolapse Surgery

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v26i2.13782 ◽

2013 ◽

Vol 26 (2) ◽

pp. 68-71 ◽

Cited By ~ 3

Author(s):

Khurshida Tahmin ◽

Shamsun Nahar Begum

Keyword(s):

Hospital Stay ◽

Urine Volume ◽

Genital Prolapse ◽

Prolapse Surgery ◽

Controlled Clinical Trial ◽

Group I ◽

Short Period ◽

Group Ii ◽

Catheter Urine ◽

Randomised Controlled

This Randomised controlled clinical trial was undertaken to determine the suitable time of catheter removal after urogenital prolapse surgery in order to reduce the catheter related UTI and its long term sequel. Method: Total 80 patients undergoing vaginal hysterectomy with pelvic floor repair were enrolled and randomised into two equal groups by lottery method. Trans-urethral catheter was removed on 2nd & 5th post operative day in group I (n=40) and in group II (n=40) respectively. Post voidal residual urine volume before operation and after removal of catheter was measured in all patients by ultrasound scanning. Re-catheterisation was done for three more days if residual volume > 200ml after removal of catheter. Urine samples were taken before removal of catheter and send for routine microscopic examination and culture & sensitivity test to detect UTI.Results: Removal of catheter on 2nd post-operative day lead to significant reduction of rate of UTI. The rate of UTI following removal of catheter was 7.5% versus 42.5% in group I and in group II (p<0.001). But need for recatheterisation was significantly higher in group I (15%) than in group II (2.5%). The mean duration of catheterisation was 47.63 (±0.628) and 119.35 (±0.864) hours in group I and group II respectively. Majority of the patients in group I did not require prolongation of catheterisation. Mean duration of hospital stay after operation was 5 days in group I and 7.95 days in group II (p<0.001). Conclusion: Short period catheterisation is associated with lower rate of UTI and shorter hospital stay. Disadvantages of prolonged catheterisation outweigh the advantages. Therefore removal of the catheter on the 2nd post-operative day after genital prolapse surgery is preferable than 5 days catheterization DOI: http://dx.doi.org/10.3329/bjog.v26i2.13782 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 68-71

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APPENDICULAR MASS

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.02.2341 ◽

2010 ◽

Vol 17 (02) ◽

pp. 180-184

Author(s):

SARDAR ALI ◽

HAFIZ MUHAMMED RAFIQUE

Keyword(s):

Conservative Treatment ◽

Acute Appendicitis ◽

Cost Effective ◽

Female Ratio ◽

Surgical Exploration ◽

Group I ◽

Variable Extent ◽

Group Ii ◽

Adhesive Intestinal Obstruction ◽

Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 to November 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying studentChi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

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Results of observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2019-23(2)-16 ◽

2019 ◽

Vol 23 (2) ◽

pp. 267-276

Author(s):

K. A. Khyzhniak ◽

Y. V. Volkova ◽

K. Y. Sharlai ◽

M. V. Khartanovych

Keyword(s):

Cardiopulmonary Bypass ◽

Hospital Stay ◽

Postoperative Period ◽

Surgical Intervention ◽

Infusion Therapy ◽

The Third ◽

Group I ◽

Aortic Pathology ◽

Number Of Patients ◽

Group Ii

The aim of the work was to analyze the results of the observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass. 118 patients with surgical aortic pathology (SAP) were examined. Patients were divided into 2 groups. Group I included 46 patients who were additionally prescribed a solution of meglumin sodium succinate (reamberin), group II included 46 patients who were additionally assigned a solution of D-fructose-1,6-diphosphate sodium hydrate salt (esophosphine). The control group (K) consisted of 26 patients who had surgical pathology of the aorta, all the criteria coincided with patients of groups I and II, but did not have additional substances as part of intensive care (IT) in order to prevent postoperative cognitive dysfunction (PСD). Analyzed the patient's condition on a scale of postoperative mortality prediction EuroSCORE II, the depth of anesthesia with a BIS monitor, the qualitative composition of the leukocyte formula, nasal and rectal temperature, blood gas composition, electrolyte level, glucose, lactate, coagulogram indices, hemolysis and phosphates; levels of autoantibodies to brain antigens (MBP, calcium binding protein S-100, NSE and GBA) were determined in the serum by ELISA a day before the operation and on the first, third, seventh and fourteenth day after surgery. The morphometric and functional properties of erythrocytes were investigated the day before the operation (starting level), 12:00 after the operation, and on the third day of hospital stay. The initial assessment of the cognitive abilities of the patients was made the day before the operation, on the third, seventh and fourteenth day of hospital stay. Used to determine the magnitude of the coefficient of linear Pearson correlation. In the analysis, no significant differences were found between the preliminary data on the phosphorus content in the patients' blood, however, the recovery dynamics of its numbers differed in the K, I and II patients. So, in group K and in group I, after 12:00 after surgery, the level of phosphatemia was 0.86 ± 0.21 mmol/l and 0.85 ± 0.18 mmol / l, on the 3rd day of hospital stay — 0,94 ± 0.08 mmol/l and 0.97 ± 0.04 mmol/l, on the 7th day — 1.04 ± 0.16 mmol/l and 1.07 ± 0.21 mmol/l and on The 14th day — 1.08 ± 0.12 mmol/l and 1.1 ± 0.14 mmol/l. It can be noted that the dynamics of blood phosphatemia in patients of groups K and I was identical, its figures almost coincided in terms of the level of phosphorus in the blood and the corresponding number of patients in the variation rows of patients in both groups. It may be noted that there is an unconditional positive effect on the course of the perioperative period of the option of infusion therapy in the IT complex in patients of group II.

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Evaluation of the effectiveness of vacuum-assisted closure in the treatment of Fournier gangrene

10.31083/jomh.2021.089 ◽

2021 ◽

pp. 1

Keyword(s):

Hospital Stay ◽

Wound Closure ◽

Length Of Hospital Stay ◽

Vacuum Assisted Closure ◽

Analgesic Requirement ◽

Vac Therapy ◽

Fournier Gangrene ◽

Group I ◽

Group Ii ◽

Closure Method

Background and objective: To evaluate the effectiveness of vacuum-assisted closure (VAC) in the treatment of Fournier gangrene (FG). Material and methods: Forty-eight male patients treated for Fournier gangrene were included in the study. The patients were divided into two groups (Group I: conventional dressing, Group II: VAC therapy). Characteristics of the patients, laboratory parameters, number of debridement procedures, daily number of dressings, visual analogue scale (VAS) during dressing, analgesic requirement, colostomy requirement, time from the first debridement to wound closure, wound closure method, length of hospital stay, and mortality rates were compared. Results: Group I comprised 33 patients and Group II comprised 15 patients. The number of dressings, VAS score and daily analgesic requirement were statistically significantly lower in Group II (p < 0.05) than in Group I. The number of debridement procedures, colostomy requirement, orchiectomy rate, time from first debridement to wound closure, length of hospital stay, wound closure method and mortality rate were similar between these two groups (p > 0.05). Conclusion: The clinical results of conventional dressing and VAC therapy were similar for treating FG. VAC therapy is an effective postoperative wound care method that offers less requirement for dressing changes, less pain, less analgesic requirement and more patient satisfaction compared to conventional dressing.

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Socket preservation by beta-tri-calcium phosphate with collagen compared to platelet-rich fibrin: A clinico-radiographic study

European Journal of Dentistry ◽

10.4103/1305-7456.178298 ◽

2016 ◽

Vol 10 (02) ◽

pp. 264-276 ◽

Cited By ~ 17

Author(s):

Swati Das ◽

Rajesh Jhingran ◽

Vivek Kumar Bains ◽

Rohit Madan ◽

Ruchi Srivastava ◽

...

Keyword(s):

Calcium Phosphate ◽

Cost Effective ◽

Cortical Plate ◽

Socket Preservation ◽

Platelet Rich Fibrin ◽

Tissue Replacement ◽

Group I ◽

The Mean ◽

Group Ii ◽

Insight Into

ABSTRACT Objectives: This study was primarily designed to determine the clinico-radiographic efficacy of platelet-rich fibrin (PRF) and beta-tri-calcium phosphate with collagen (β-TCP-Cl) in preserving extraction sockets. Materials and Methods: For Group I (PRF), residual sockets (n = 15) were filled with autologous PRF obtained from patients’ blood; and for Group II (β-TCP-Cl), residual sockets (n = 15) were filled with β-TCP-Cl. For the sockets randomly selected for Group II (β-TCP-Cl), the reshaped Resorbable Tissue Replacement cone was inserted into the socket. Results: Clinically, there was a significantly greater decrease in relative socket depth, but apposition in midcrestal height in Group II (β-TCP-Cl) as compared to Group I (PRF), whereas more decrease in buccolingual width of Group I (PRF) than Group II (β-TCP-Cl) after 6 months. Radiographically, the mean difference in socket height, residual ridge, and width (coronal, middle, and apical third of socket) after 6 months was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). The mean density (in Hounsfield Units) at coronal, middle, and apical third of socket was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). There were statistically significant apposition and resorption for Group I (PRF) whereas nonsignificant resorption and significant apposition for Group II (β-TCP-Cl) in buccal and lingual/palatal cortical plate, respectively, at 6 months on computerized tomography scan. Conclusion: The use of either autologous PRF or β-TCP-Cl was effective in socket preservation. Results obtained from PRF were almost similar to β-TCP-Cl; therefore being autologous, nonimmune, cost-effective, easily procurable regenerative biomaterial, PRF proves to be an insight into the future biofuel for regeneration.

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Comparative Efficacy of Nebulized 3% Hypertonic Saline versus 0.9% Normal Saline in Children with Acute Bronchiolitis

Bangladesh Journal of Child Health ◽

10.3329/bjch.v42i3.39264 ◽

2018 ◽

Vol 42 (3) ◽

pp. 130-137 ◽

Cited By ~ 1

Author(s):

Khandaker Tarequl Islam ◽

Abid Hossan Mollah ◽

Abdul Matin ◽

Mahmuda Begum

Keyword(s):

Hospital Stay ◽

Hypertonic Saline ◽

Normal Saline ◽

Severity Score ◽

Oxygen Therapy ◽

Length Of Hospital Stay ◽

Clinical Severity ◽

Acute Bronchiolitis ◽

Group I ◽

Group Ii

Background: Acute bronchiolitis is leading cause of hospitalization in infants below 2 years of age. Bronchiolitis being a viral disease, there is no effective treatment. 3% nebulized hypertonic saline and 0.9% nebulized normal saline are often used, although there is disagreement over their efficacy. The aim of this study was to evaluate the efficacy of 3% hypertonic saline in children with acute bronchiolitis in reducing clinical severity and length of hospital stay. Methodology: A randomized control trial carried out in the Department of Pediatrics, Dhaka Medical College Hospital from January 2013 to December 2013.Ninty children from 1 month to 2 years of age hospitalized with clinical bronchiolitis were randomized to receive 3% nebulized hypertonic saline(Group-I) or 0.9% nebulized normal saline (Group-II). Nebulization was done 8 hourly until discharge. Outcome variable were clinical severity score, duration of oxygen therapy and length of hospital stay. Results: Baseline clinical severity score and O2 saturation were in group-I 9.0±1.0 and 94.9±1.7 and in group- II 9.3±1.8 and 94.6±2.6 respectively (p>0.05). At 72 hours, the mean severity score for the group-I was 1.64±0.99 and that for the group-II was 3.0 ± 1.48 (95% CI -2.17 to - 0.53, p=0.002). The cases of group-I required a shorter duration of oxygen therapy compared to those of group-II (15.0±6.0 hours vs 26.4±5.37 hours, 95% CI -20.35 to -2.44, p<0.05). Forty two (93.3%) of the group-I children recovered by the end of72 hours and discharged whereas 26 (57.8%) of the group-II children recovered during the same period (p<0.05). Length of hospital stay was shorter in group-I compared to group-II (58.1±22.0 hours vs 74.7±27.2 hours, 95% CI -26.89 to- 6.17, p=0.002). None of the cases encountered any side-effects. Conclusion: Nebulization with 3% hypertonic saline significantly reduced clinical severity, length of hospital stay and duration of oxygen therapy in case of acute bronchiolitis in comparison to 0.9% normal saline and was safe. Bangladesh J Child Health 2018; VOL 42 (3) :130-137

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On-shelf Streptokinse EnsuRes More Favorable In-hospital Outcome after Acute STEMI (OSTRIC trial) - A Single Centre Randomized Controlled Trial

Bangladesh Heart Journal ◽

10.3329/bhj.v33i2.39309 ◽

2018 ◽

Vol 33 (2) ◽

pp. 126-133

Author(s):

Afzalur Rahman ◽

Mohammad Arifur Rahman ◽

Farhana Ahmed ◽

Rezvey Sultana ◽

Nabil Amin Khan

Keyword(s):

Cardiogenic Shock ◽

Hospital Stay ◽

Controlled Trial ◽

Primary Pci ◽

Injection Time ◽

Cardiac Events ◽

Mortality And Morbidity ◽

Acute Stemi ◽

Group I ◽

Group Ii

Introduction: The burden of CAD is increasing at a greater rate in South Asia than in any other region globally. Among them acute ST elevation myocardial infarction (STEMI) is one of the leading causes of death and disability. Major aspect of treatment of acute STEMI is reperfusion of the infarct related artery. Delay in reperfusion is associated with higher mortality and morbidity rates. While primary percutaneous coronary intervention (PCI) is the preferred mode of reperfusion, only few patients can get this form of reperfusion within recommended timelines. On the other hand, thrombolysis is easily available, economical and evaluated in several clinical studies. Thrombolysis is an important reperfusion strategy, especially when primary PCI cannot be offered to STEMI patients, with a time dependent fashion. Methods: This randomized controlled trial was conducted in the department of Cardiology of National Institute of Cardiovascular Diseases since January 2016 to June 2018. Objective of the study was to find out the outcomes of acute STEMI patients after getting on-shelve or purchased Streptokinase (STK). Initially there was no free supply of STK in our hospital as it is an expensive drug, later on fund was arranged and STK was made available at free of cost by the hospital authority. Total 300 patients fulfilling inclusion and exclusion criteria were included in the study. Group I: 150 patients received on-shelf STK when it was made free by the authority and Group II: 150 patients received purchased STK when it was not available at free of cost. Study populations were analyzed for LVF, Cardiogenic shock, MACE (re-infarction, stroke and death) and duration of hospital stay. Results: The mean age of the study population in group I and II were 53.88 ± 14.51 vs. 57.18 ± 15.28 years (p= 0.46). Mean door to injection time in group I and II were 25.51 ± 7.9 vs. 70.36 ± 16.6 minutes (p=<0.001). ST segment resolution was significantly higher in on-shelf STK group then purchased group which were 109 (72.7%) vs. 92 (61.3%), p=0.03. Considering the in-hospital outcome we found that in group I and group II LVF (killip III/IV) was 10 (6.7%) vs. 23 (15.3%) , Cardiogenic shock was 11 (7.3%) vs. 24(16%) , re-infarction was 9(6%) vs. 13 (8.7%) , Stroke was 6 (4%) vs. 8 (5.3%) and death was 12 (8%) vs. 23(15.3%). Among them LVF (killip III/IV), Cardiogenic shock and Death were significantly higher in group II (p=0.02, 0.01 and 0.04 respectively). Major adverse cardiac events (MACE) included re-infarction, Stroke and death, were significantly higher in group II [27 (18%) vs. 44(29.3), p= 0.02]. Mean hospital stay was significantly higher in group II (6.05 ± 1.81) then group I (5.33±1.26), (p=<0.001). Multivariate logistic regression analysis showed hypertension (p=.025) and door to injection time (p=.002) were statistically significant predictors for in-hospital major advance cardiac events (re-infarction, stroke and death) after streptokinase therapy. Conclusion: Despite the strength of evidence based medicine pertaining to the benefits of primary PCI in STEMI, treatment options in Bangladesh are often dictated by resources, logistics, availability and affordability. In our country, not many hospitals offer primary PCI services round the clock. So thrombolysis by streptokinase it the potential reperfusion strategy in our context. In our study it has been found that onshelf Streptokinase significantly reduce door to injection time which ultimately reduce cardiovascular mortality and mortality and also significantly reduce hospital stay. Hospitals intended to treat acute STEMI patients should have on-shelve Streptokinase to reduce door to injection time which affect the inhospital outcome by reducing significant cardiovascular mortality and morbidity. Bangladesh Heart Journal 2018; 33(2) : 126-133

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