scholarly journals Comparison of in-hospital outcome of patients of myocardial infarction with and without streptokinase reperfusion therapy.

2020 ◽  
Vol 27 (09) ◽  
pp. 1971-1975
Author(s):  
Fida Muhammad ◽  
Amir Nazeer ◽  
Sheraz Saleem ◽  
Nighat Fatima ◽  
Shahzad Aslam

Objectives: To compare the in-hospital outcome and complications with and without reperfusion therapy with streptokinase among patients with myocardial infarction was the objective of this study. Study Design: Prospective study. Setting: Cardiology Department, Divisional Headquarter Teaching, Hospital, Sargodha. Period: March 2018 to December 2018. Material & Methods: Three hundred (300) patients with acute STEMI of either gender and above 20 years of age, were divided into two groups (180 patients received SK and 120 patients didn’t receive SK. Demographic features, history and physical examination were noted. In hospital mortality and complications were recorded and compared between groups by chi-square test. Results: There were 76.0% male and 24.0% females with mean age of 55.61±11.35 years. Family history of IHD was present in 28.34% patients and 35.0% patients were smoker. Commonest co-morbidity was hypertension (73.34%), followed by diabetes mellitus (36.67%). In-hospital mortality was 6.6% in SK group and 31.6% in non-SK group (p= <0.001). Overall, in-hospital mortality was 16.67%. LVF was 8.33% and 23.33% (p= <0.001), Mitral regurgitation 1.11% and 2.5% (p=0.848), VT/VF 3.33% and 5.83% (p=0.297), Complete heart block 2.22% and 5.83% (p=0.103), Atrial fibrillation 0.55% and 1.67% (p=0.343), Post MI angina 3.33% and 13.33% (p=0.001), Re-infarction 1.11% and 3.33% (p=0.178), CVA 0.0.55% and 0.0% (p=0.812), Ventral septal defect 0.0% and 3.33% (p=0.029) and Hypotension was 25% and 8.33% (p=0.001)in SK and non SK groups, respectively. Conclusions: Reperfusion therapy with streptokinase among patients with myocardial infarction was found effective in terms of significant low in-hospital mortality rate and low complication rate.

Author(s):  
Joshua Cohen ◽  
John Kao ◽  
Mladen I Vidovich

Background: The incidence of perioperative myocardial infarction (PMI) is 5-35% after high-risk vascular surgeries, and increases mortality. We sought to determine the incidence of PMI after abdominal aortic aneurysm (AAA) and lower extremity revascularization (LE) procedures in current practice and describe the potential benefit of coronary revascularization. Methods: We analyzed the Nationwide Inpatient Sample from 1998 - 2006. Adult records were selected for indicating AAA and LE procedures. This group was queried for acute myocardial infarction and either percutaneous coronary intervention or coronary artery bypass grafting. In-hospital mortality was determined. We compared categorical data using the Chi-square test. Results: The incidence of PMI was 2.4% (6755/269100) overall, in-hospital mortality increased with PMI. Revascularization was associated with decreased mortality. Conclusion: In contemporary US practice, PMI appears to be under-diagnosed in this sample compared to previous prospective studies, and continues to be associated with increased in-hospital mortality. The utilization of coronary revascularization was associated with decreased mortality. Due to the retrospective nature of this study, causation cannot be determined.


2020 ◽  
Vol 52 (4) ◽  
Author(s):  
Muhammad saad Jibran ◽  
Muhammad Irfan

ABSTRACT OBJECTIVE: To compare the door to needle time (DNT), for thrombolysis in acute myocardial infarction, at the new chest pain clinic at emergency room, with the old CCU at the cardiology Department LRH Peshawar. METHODOLOGY: This was a retrospective study conducted at Lady reading Hospital, Peshawar. Two data sets were acquired from hospital records. One for CCU at the cardiology department covered the span from 1st July till 30th sept: 2010. The other for the chest pain clinic emergency department covered the span from 1st April to 15th May, 2017. All the patients having ST elevated acute myocardial infarction eligible for thrombolytic therapy were included in the study. Door to needle time was calculated in both the groups. Comparison of DNT between both groups was made by using student t-test with p-≤0.05 taken as significant. Comparison between other base line qualitative characteristics was made by using chi square test with p-≤0.05 taken as significant. RESULTS: Total of 140 patients were enrolled in CCU group with mean age of 57.96±13.5 years. Out of these 60% were male. While 209 patients were enrolled in ED group with mean age of 58.85±6.9 years. Of these 65.1% were males. Mean DNT in CCU group was 72.42±50.85 minutes while in ED was 31.96±16.6 minutes with p-value 0.0001 with a reduction of 41.30 minutes in the DNT. DNT of <30 minutes and between 30-60 minutes was achieved in 7.1% and 62.8% in CCU group while in rest it was more than 60 minutes. In ED group the DNT achieved was <30 minutes in70.8% and 30-60 minutes in 29.2% of patients while none fell in category of >60 minutes. CONCLUSION: The door to needle time for thrombolytic administration for acute myocardial infarction was significantly less at the chest pain clinic at emergency room than at the CCU at cardiology department.


2020 ◽  
Vol 20 (3) ◽  
pp. 1206-1216
Author(s):  
Stella T Obadeji ◽  
Adetunji Obadeji ◽  
Janet O Bamidele ◽  
Felix T Ajayi

Background: Despite the lack of adequate studies on the safety of drugs in pregnancy, surprisingly, available evidence shows that pregnant women still take large number of drugs. Objectives: The study aim was to determine drug utilization pattern and predictors of number of medications used by pregnant women. Methods: This was a cross-sectional survey of 369 pregnant women attending a secondary health facility. Data were collect- ed using interviewer-administered questionnaire. Descriptive and inferential statistics using the Chi-Square test were carried out with level of significance set at p<0.05. Results: Three hundred and sixty-nine women were interviewed. Their mean age was 27.7 years (SD± 4.78) and the mean number of pregnancies was 2.46 (SD± 1.34). On average, 2.62 medications were taken, with the lowest being 1 and the highest being 12 different medications during the course of pregnancy. Those who were on more than 2 medications were more likely to be older than 30 years, had lower education and with history of associated medical conditions. All participants were on one form of supplements or the other, nearly half had used antimalarials, 12.8%, 5.8% 2.4% were on antibiotics, anti-hypertensive and anti-retroviral medications respectively. All the medications prescribed were from category A, B, C, N, and none from category D and X. Conclusion: Varieties of medications were used during the course of pregnancy among this population, however, most of these drugs were still within safety profile. Keywords: Medications; pregnancy; pattern; predictors; co-morbidity.


2016 ◽  
Vol 33 (S1) ◽  
pp. S164-S164
Author(s):  
Z. Mansuri ◽  
M. Rathod ◽  
P. Bansal ◽  
A. Sutaria ◽  
S. Shambhu

ObjectivesBulimia Nervosa (BN) is an important cause of morbidity and mortality in hospitalized patients. While BN has been extensively studied in the past, the contemporary data for impact of BN on cost of hospitalization are largely lacking.MethodsWe queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample (HCUP-NIS) dataset between 1998-2011 using the ICD-9 codes. Severity of co-morbid conditions was defined by Deyo modification of Charlson co-morbidity index. Primary outcome was in-hospital mortality and secondary outcome was total charges for hospitalization. Using SAS 9.2, chi-square test, t-test and Cochran-Armitage test were used to test significance.Results19,441 patients were analyzed. 94.13% were female and 5.87% male (P < 0.0001). 85.72% were white, 4.55% black and 9.73% of other race (P < 0.0001). Rate of hospitalization decreased from 1136.99/million to 802.47/million from 1998-2011. Overall mortality was 0.20% and mean cost of hospitalization was 15,496.82$. The in-hospital mortality reduced from 0.23% to 0.15% (P < 0.0001) and mean cost of hospitalization increased from 8,194.53$ to 22,547.86$. Total spending on BN related admissions have increased from $73.96 million/year to $139.93 million/year over the last decade.ConclusionsWhile mortality has slightly decreased from 1998 to 2011, the cost has significantly increased from $73.96 million/year to $139.93 million/year, which leads to an estimated $65.97 million/year additional burden to US health care system. In the era of cost conscious care, preventing BN related Hospitalization could save billions of dollars every year. Focused efforts are needed to establish preventive measures for BN related hospitalization.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 2 (5) ◽  
pp. 1808-1811
Author(s):  
Yuni Retnowati

Preeclampsia is hypertension that can affect all organs, occurs after 20 weeks ofgestation, which begins with endothelial dysfunction and decreased organ perfusionoften characterized by proteinuria. Preeclampsia occurs in 5-7% of all pregnanciesand is the leading cause of maternal death in the developing world. The purpose of thisresearch was to identify risk factors associated with the incidence of preeclampsia inpregnant women at the Public health center Karang Rejo Tarakan in 2021. Thisresearch used a case-control study design. The data used secondary data from mothersmedical record with preeclampsia and without preeclampsia in the period 1 July 2020-30 June 2021. The number of samples was 60 cases and controls. Analysis of dataused univariate, bivariat analysis used chi square test. Results: Bivariat analysisshowed that factors associated with preeclampsia were age> 35 years and a history ofhypertension. Conclusion: The most dominant factor related to the incidence ofpreeclampsia in pregnant women is a history of hypertension


2006 ◽  
Vol 13 (03) ◽  
pp. 423-430
Author(s):  
WAJID ALI ◽  
WAJEH UR REHMAN ◽  
NIAZ MAQSOOD

Objectives: To determine the different levels of drug non-compliance inpatients with schizophrenia and to find out its relationship to relapses of the disorder and admission to the hospital.Design: A randomized, retrospective, case- controlled study. Place and Duration of Study: Conducted at GovernmentMental Hospital Peshawar, from April 2001 to December 2002. Patients and Method: 50-Cases were randomly (eachfifth patient) selected from all the admissions with the DSM-IV diagnosis of Schizophrenia, 50- matched controls wererandomly (each fifth patient) selected from the outdoor patients. Both sexes were included. The basicsociodemographic characteristics and the clinical profile of all the patients were collected. The level of drug noncompliancewith previous history of admissions to hospital and total number of relapses. SPSS version 10 was usedfor statistical analysis. The applied method for group comparison was the Chi-square test. Results: The mean age ofstudy group was 33.54 ± 8.15 years as compare to 32.56 ± 9.02 years of control group, most participants were men,and a predominant proportion of participants were married. Majority of the patients were from the lower socio-economicclass. Scores on the drug non- compliance were statistically significant with a p value of (0.027). The differencebetween the two groups, regarding the previous number of relapses was statistically significant with a p value (0.002).The number of previous admission was also statistically significant and the p value was (0.017). 74.1% of the patientswith poor drug compliance relapsed, while 71% of patients with poor compliance needed admission. Conclusion: Animportant measure of out come is compliance with treatment. A substantial proportion of patients with schizophreniacontinues to relapse and are readmitted to the hospital as a result of non-compliance to treatment.


2016 ◽  
Vol 33 (S1) ◽  
pp. S164-S164
Author(s):  
Z. Mansuri ◽  
M. Rathod ◽  
P. Bansal ◽  
U. Mansuri ◽  
S. Shambhu

ObjectivesAnorexia Nervosa (AN) is an important cause of morbidity and mortality in hospitalized patients. While AN has been extensively studied in the past, the contemporary data for impact of AN on cost of hospitalization are largely lacking.MethodsWe queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample (HCUP-NIS) dataset between 1998-2011 using the ICD-9 codes for AN. Severity of co-morbid conditions was defined by Deyo modification of Charlson co-morbidity index. Primary outcome was in-hospital mortality and secondary outcome was total charges for hospitalization. Using SAS 9.2, chi-square test, t-test and Cochran-Armitage test were used to test significance.Results28,150 patients were analyzed. 93.94% were female and 6.06% were male (P < 0.0001). 88.67% were white, 2.93% were black and 8.4% were of other race (P < 0.0001). Rate of hospitalization decreased from 1530/million to 1349.5/million from 1998-2011. Overall mortality was 0.78% and mean cost of hospitalization was 25,829.82$. The in-hospital mortality reduced from 0.95% to 0.44% (P < 0.0001) and mean cost of hospitalization increased from 11,956.55$ to 39,831.51$. Total yearly spending on AN related admissions increased from $145.33 million/year to $420.61 million/year.ConclusionsWhile mortality has slightly decreased from 1998 to 2011, the cost has significantly increased from $145.33 million/year to $420.61 million/year, which leads to an estimated $275.28 million additional burden to the US health care system. In the era of cost conscious care, preventing AN related Hospitalization could save billions of dollars every year. Focused efforts are needed to establish preventive measures for AN related hospitalization.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
Vol 5 (3) ◽  
pp. 875
Author(s):  
Asfri Sri Rahmadeni

<p class="Normal1"><em>Commitment is the attitude or behavior of likes or dislikes shown by someone against the organization at work. Indonesia is recorded as a nurse who has a low organizational commitment (76%) so it harms services. This phenomenon in the hospital can be seen from the indicator of the high turnover rate of nurses which reaches 30.9% which exceeds the standard &lt;5%. Many factors affect organizational commitment. The purpose of this study was to analyze the Personal Factors Associated with Organizational Commitment of Hospital Nurses. This study is a cross-sectional analytic study and purposive sampling technique with a sample of 59 nurses. Chi-Square test results obtained personal factors that have a relationship with organizational commitment Nurse Hospital is age with p = 0,000 and education with p = 0,000, personal factors not related to organizational commitment are gender p = 1,053 and years of service with p = 1,147. Hospitals should conduct research/surveys on Organizational Commitment periodically as an evaluation material in the context of the organization's development and development in the future</em>.</p>


Author(s):  
Y. Widyastuti Y. Widyastuti

  ABSTRACT [In advanced countries the number of permanent contraception option ( kontap ) approximately 10 % of all national family planning methods , while in Indonesia reached approximately 5.7 % . Based on data obtained from medical records Bhayangkara Hospital Palembang in 2010 the number of achievement when seen from the percentage of contraceptive use is only 9.10 % The purpose of this study is known age and parity relationship with the selection of contraceptive methods Surgery Women ( MOW ) in Palembang RS.Bhayangkara obstetrics clinic in 2012 . This study uses the analytic survey with cross sectional approach . The population in this study were women who become new acceptors were recorded in medical records at the hospital . Palembang Bhayangkara Hospitals January 1, 2012 to December 31 in 2012 . The sample in this study is part of a whole number of new acceptors ( either using contraception methods MOW and other family planning methods ) were registered in the hospital . Palembang Police Hospitals of January 1, 2012 to December 31 years of data 2012.Analisa univariate and bivariate statistical Chi - Square test with significance level α = 0.05 . The results showed there were 80 respondents ( 46.3 % ) who became MOW contraceptive acceptors , acceptors who have old age by 45 respondents ( 56.3 % ) and who has a young age by 35 respondents ( 43.8 % ) . acceptors which have high parity were 44 respondents ( 55 % ) who had low parity and a total of 36 respondents ( 45 % ) . From the results of Chi-square test value obtained ρ = 0.00 is smaller than α = 0.05 . There is a significant correlation between age and the selection of MOW Chi square test results obtained ρ value = 0.00 and there was a significant association between parity with the election MOW Chi square test results obtained ρ value = 0 , . From these results , it is expected to power health, especially family planning services at the hospital . Palembang Police Hospitals in order to improve the quality of family planning services in an effective, efficient , and safe are considered particularly suitable for users of contraception OperatingMethodWomen(MOW).                                      ABSTRAK Di negara sudah maju jumlah pilihan kontrasepsi mantap (kontap) sekitar 10% dari semua metode KB nasional, sedangkan di Indonesia baru mencapai sekitar 5,7 %. Berdasarkan data yang diperoleh dari Rekam medik  Rumah Sakit Bhayangkara Palembang tahun 2010 Jumlah pencapain tersebut jika dilihat dari persentasi penggunaan kontrasepsi MOW hanya  9,10% Tujuan penelitian ini adalah diketahuinya hubungan umur dan paritas dengan pemilihan alat kontrasepsi Metode Operasi Wanita (MOW) di poliklinik kebidanan RS.Bhayangkara Palembang Tahun 2012. Penelitian ini menggunakan metode survey analitik dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah wanita yang menjadi akseptor KB Baru yang tercatat di rekam medik  di RS. Bhayangkara Palembang tanggal 1 januari 2012 sampai dengan 31 Desember  tahun 2012. Sampel dalam penelitian ini adalah sebagian dari seluruh jumlah akseptor KB Baru (baik yang menggunakan alat kontrasepsi Metode MOW maupun Metode KB lain) yang teregister di RS. Bhayangkara Palembang dari tanggal 1 januari 2012 sampai dengan 31 Desember  tahun 2012.Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan dari 80 responden terdapat (46,3%) yang menjadi akseptor kontrasepsi MOW, akseptor yang memiliki umur tua sebanyak 45 responden (56,3%) dan yang memiliki  umur muda sebanyak 35 responden (43,8%). akseptor yang memiliki paritas tinggi sebanyak 44 responden  (55%) dan yang memiliki  paritas rendah sebanyak 36 responden (45%). Dari hasil uji Chi square didapatkan ρ value = 0,00 lebih kecil dari α = 0,05. Ada hubungan yang bermakna antara umur dengan pemilihan MOW dari hasil uji Chi square didapatkan ρ value = 0,00 dan ada hubungan yang bermakna antara paritas dengan pemilihan MOW hasil uji Chi square didapatkan ρ value = 0,.Dari hasil penelitian ini, diharapkan kepada tenaga kesehatan khususnya pelayanan KB  di RS. Bhayangkara Palembang  agar dapat meningkatkan kualitas pelayanan KB secara efektif, efisien, dan aman yang dianggap cocok bagi penggunanya khususnya mengenai kontrasepsi Metode Operasi Wanita (MOW).    


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Fu ◽  
C.X Song ◽  
X.D Li ◽  
Y.J Yang

Abstract Background The benefit of statins in secondary prevention of patients stabilized after acute coronary syndrome (ACS) has been well established. However, the benefit of preloading statins, i.e. high-intensity statins prior to reperfusion therapy remains unclear. Most previous studies included all types of ACS patients, and subgroup analysis indicated the benefit of preloading statins was only seen in ST-elevation myocardial infarction (STEMI) patients who underwent percutaneous coronary intervention (PCI). However, the sample size of subgroup population was relatively small and such benefit requires further validation. Objective To investigate the effect of loading dose of statins before primary reperfusion on 30-mortality in patients with STEMI. Methods We enrolled patients in China Acute Myocardial Infarction (CAMI) registry from January 2013 to September 2014. CAMI registry was a prospective multicenter registry of patients with acute acute myocardial infarction in China. Patients were divided into two groups according to statins usage: preloading group and control group. Patients in preloading group received loading does of statins before primary reperfusion and during hospitalization. Patients in control group did not receive statins during hospitalization or at discharge. Primary outcome was in-hospital mortality. Baseline characteristics, angiographic characteristics and outcome were compared between groups. Propensity score (PS) matching was used to mitigate baseline differences between groups and examine the association between preloading statins on in-hospital mortality risk. The following variables were used to establish PS matching score: age, sex, classification of hospitals, clinical presentation (heart failure at presentation, cardiac shock, cardiac arrest, Killip classification), hypertension, diabetes, prior angina, prior myocardial infarction history, prior stroke, initial treatment. Results A total of 1169 patients were enrolled in control group and 6795 in preloading group. A total of 833 patients (334 in control group and 499 in preloading group) died during hospitalization. Compared with control group, preloading group were younger, more likely to be male and present with Killip I classification. The proportion of hypertension and diabetes were higher in preloading group. After PS matching, all the variables used to generate PS score were well balanced. In the PS-matched cohort, 30-day mortality risk was 26.3% (292/1112) in the control group and 11.9% (132/1112) in the preloading group (p&lt;0.0001). Conclusions The current study found preloading statins treatment prior to reperfusion therapy reduced in-hospital mortality risk in a large-scale contemporary cohort of patients with STEMI. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences


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