scholarly journals Effects of Smoking on Pilots of Bangladesh Air Force in Dhaka Area

2016 ◽  
Vol 12 (1) ◽  
pp. 22-27
Author(s):  
Mohammad Ahmed Ahsan ◽  
Umar Rashed Munir ◽  
Mushtaq Ahmad ◽  
Md Shahidullah

Introduction: Smokers have a high morbidity and mortality rate and the causes of excess morbidity and mortality include lung cancer, COPD (Chronic Obstructive Pulmonary Disease) and cor pulmonale. An estimated 100 million people died in the 20th century from tobacco-associated diseases. Smoking also affects the performance and cause physical deterioration of pilots. Objectives: To evaluate the effects of smoking on pilots of Bangladesh Air Force (BAF), Dhaka area. Materials and Methods: This cross sectional study was conducted during the period of January to June 2014 among the available pilots of different age and ranks of 6 flying squadrons of BAF Dhaka area. Data were collected by using a pre-tested semistructured questionnaire distributed among the pilots. Information were also collected from Central Medical Board (CMB), BAF about total number of pilots placed in low medical category and nature of their sickness. Finally chest X-ray and ECG of the pilots were done to find out any respiratory and cardiovascular abnormalities. Data obtained were entered into SPSS version 21.0 for analysis. Results: Total 190 pilots were interviewed and among them, 80(42%) were smokers and 110(58%) were non-smokers. Most of the pilots were within the age group of 26-30 years (30%). Out of 80 smoker, 37(46%) smoked for more than 10 years, rest smoked for 10 years and less. Stress was the most common cause of starting smoking (96.3%). Fifty eight (72.5%) pilots agreed that their stamina and physical efficiency decreased due to smoking, 21 (26.3%) experienced breathlessness at high altitude, 26(32.5%) experienced visual disturbance during night flying. Fifty three (66.3%) pilots complained of occasional episode of palpitation along with increase in pulse rate. Thirty one (39%) experienced occasional headache during high altitude flight, 58(72.5%) had heart burn related to smoking. Thirty eight (47.5%) had occasional bouts of cough with sputum and 40(50%) complained of occasional gum bleeding. These pilots also informed that they reported sick several times for headache, heart burn, cough and URTI (Upper Respiratory Tract Infection) and were unfit for flying duties. During January-June 2014, a total of 10 pilots of BAF Dhaka area were placed in low medical category out of them 6 (60%) pilots had smoking habits and suffered from IHD-4 (Ischemic Heart Disease) and HTN-2 (Hypertension). There was statistically significant association between number of the cigarette smoked, period of smoking and physical deterioration of smoker pilots (P<0.05). Those who smoked more than 10 sticks/day and more than 10 years had moderate to severe physical deterioration. Conclusion: Smoking adversely affects all systems of human body. It impairs altitude tolerance, early induction of hypoxia, impairment of night vision. It affects autonomic systems and thus impairs all compensatory mechanism needed at higher altitudes. Morbidity and mortality related to smoking have linear relation. Pilots must be indoctrinated not to smoke for the sake of their safety flight, own life, their families and the nation. Journal of Armed Forces Medical College Bangladesh Vol.12(1) 2016: 22-27

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Magdi Zordok ◽  
Muhammad Etiwy ◽  
Shruti Hegde ◽  
Michael Maysky

Background: Acute myocardial injury has been reported in approximately 20% of patients with Coronavirus disease 2019 (COVID-19). Little is known about the outcome of this subset of patients. We are testing the hypothesis of higher morbidity and mortality in patients with COVID-19 who have acute myocardial injury. Methods: In this retrospective study, we analyzed data from patients admitted to Steward Healthcare hospitals in Massachusetts between March 22 and April 24, who tested positive for COVID-19 confirmed by serology and found to have elevated troponin levels (>0.01). The sociodemographic information, clinical data, and outcomes of these critically ill patients were retrospectively extracted from the medical records. The primary outcome was in-hospital death. Data were analyzed using JMP statistical analysis software. Results: Two hundred eighty-three COVID-19 positive patients were found to have troponin levels >0.01 on admission. Of these 183 patients (64.6%) were males, 49.1% were Caucasian and 32.1% were African Americans. The mean age of the patients was 70.7 ± 13.8. The prevalence of comorbid conditions was as follows: hypertension, 69.7%; hyperlipidemia, 46.9%; diabetes mellitus, 42.6%; chronic kidney disease, 28.3%; heart failure, 19.3%; atrial fibrillation, 22.1%; coronary artery disease, 17.1%; cerebrovascular accident, 10.2%; obesity, 38%; chronic obstructive pulmonary disease or asthma 20.8%, obstructive sleep apnea, 4.9%. One hundred thirty-seven patients (48.4%) noted to have acute kidney injury on presentation,128 (45.2%) required ICU level of care, 41% required invasive mechanical ventilation for a mean of 10.4 ± 7.9 days, and 38.8% required vasopressors. The average length of stay (LOS) in the medical intensive care unit and the hospital was 11.5 ± 8.3 days and 11.4 ± 9.5 days respectively. The overall in-hospital mortality rate was 45.6%. Conclusion: Patients with COVID-19 and elevated Troponin levels had high morbidity and mortality


2020 ◽  
Vol 99 (5) ◽  
pp. 200-206

Oesophagectomy is being used in treatment of several oesophageal diseases, most commonly in treatment of oesophageal cancer. It is a major surgical procedure that may result in various complications. One of the most severe complications is anastomotic dehiscence between the gastric conduit and the oesophageal remnant. Anastomotic dehiscence after esophagectomy is directly linked to high morbidity and mortality. We propose a therapeutic algorithm of this complication based on published literature and our experience by retrospective evaluationof 164 patients who underwent oesophagectomy for oesophageal cancer. Anastomotic dehiscence was present in 29 cases.


2007 ◽  
Author(s):  
Frank H. Ruggiero ◽  
Joseph A. Werne ◽  
Alex Mahalov ◽  
Basil Nichols ◽  
Donald E. Wroblewski
Keyword(s):  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jonás Carmona-Pírez ◽  
Beatriz Poblador-Plou ◽  
Ignatios Ioakeim-Skoufa ◽  
Francisca González-Rubio ◽  
Luis Andrés Gimeno-Feliú ◽  
...  

AbstractChronic obstructive airway diseases such as chronic obstructive pulmonary disease (COPD), asthma, rhinitis, and obstructive sleep apnea (OSA) are amongst the most common treatable and preventable chronic conditions with high morbidity burden and mortality risk. We aimed to explore the existence of multimorbidity clusters in patients with such diseases and to estimate their prevalence and impact on mortality. We conducted an observational retrospective study in the EpiChron Cohort (Aragon, Spain), selecting all patients with a diagnosis of allergic rhinitis, asthma, COPD, and/or OSA. The study population was stratified by age (i.e., 15–44, 45–64, and ≥ 65 years) and gender. We performed cluster analysis, including all chronic conditions recorded in primary care electronic health records and hospital discharge reports. More than 75% of the patients had multimorbidity (co-existence of two or more chronic conditions). We identified associations of dermatologic diseases with musculoskeletal disorders and anxiety, cardiometabolic diseases with mental health problems, and substance use disorders with neurologic diseases and neoplasms, amongst others. The number and complexity of the multimorbidity clusters increased with age in both genders. The cluster with the highest likelihood of mortality was identified in men aged 45 to 64 years and included associations between substance use disorder, neurologic conditions, and cancer. Large-scale epidemiological studies like ours could be useful when planning healthcare interventions targeting patients with chronic obstructive airway diseases and multimorbidity.


2021 ◽  
pp. 000313482096852
Author(s):  
Sean R. Maloney ◽  
Caroline E. Reinke ◽  
Abdelrahman A. Nimeri ◽  
Sullivan A. Ayuso ◽  
A. Britton Christmas ◽  
...  

Operative management of emergency general surgery (EGS) diagnoses involves a range of procedures which can carry high morbidity and mortality. Little is known about the impact of obesity on patient outcomes. The aim of this study was to examine the association between body mass index (BMI) >30 kg/m2 and mortality for EGS patients. We hypothesized that obese patients would have increased mortality rates. A regional integrated health system EGS registry derived from The American Association for the Surgery of Trauma EGS ICD-9 codes was analyzed from January 2013 to October 2015. Patients were stratified into BMI categories based on WHO classifications. The primary outcome was 30-day mortality. Longer-term mortality with linkage to the Social Security Death Index was also examined. Univariate and multivariable analyses were performed. A total of 60 604 encounters were identified and 7183 (11.9%) underwent operative intervention. Patient characteristics include 53% women, mean age 58.2 ± 18.7 years, 64.2% >BMI 30 kg/m2, 30.2% with chronic obstructive pulmonary disease, 19% with congestive heart failure, and 31.1% with diabetes. The most common procedure was laparoscopic cholecystectomy (36.4%). Overall, 90-day mortality was 10.9%. In multivariable analysis, all classes of obesity were protective against mortality compared to normal BMI. Underweight patients had increased risk of inpatient (OR = 1.9, CI = 1.7-2.3), 30-day (OR = 1.9, CI = 1.7-2.1), 90-day (OR = 1.8, CI 1.6-2.0), 1-year (OR = 1.8, CI = 1.7-2.0), and 3-year mortality (OR = 1.7, CI = 1.6-1.9). When stratified by BMI, underweight EGS patients have the highest odds of death. Paradoxically, obesity appears protective against death, even when controlling for potentially confounding factors. Increased rates of nonoperative management in the obese population may impact these findings.


2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Che-Fang Ho ◽  
Yuan-Yun Tam ◽  
Chia-Chen Wu

Objective. Pneumocephalus is a rare complication that often occurs after traumatic skull base injury, leading to morbidity and mortality. Material and Method. We present the case of a 42-year-old healthy man who injured himself when he stuck a metal stick into his left nasal cavity to relieve prolonged nasal obstruction. Immediate cerebrospinal fluid rhinorrhea and subsequent meningitis and pneumocephalus occurred later. He was presented at our hospital with fever and meningeal signs. Result. Computed tomography scans revealed left rhinosinusitis and air collection in the subarachnoid space. The patient received the conservative treatment of bed rest, intravenous hydration, head elevation, and broad-spectrum intravenous antibiotics. Pneumocephalus and meningitis resolved without any surgery, and he experienced no other sequela or complication. Conclusion. Pneumocephalus is a rare incidence and can lead to high morbidity and mortality. Prompt diagnosis and adequate treatment of pneumocephalus and meningitis proved beneficial for our patient who recovered without any complication or surgery.


2017 ◽  
Vol 52 (2) ◽  
pp. 68-81 ◽  
Author(s):  
Maria Smyrli ◽  
Athanasios Prapas ◽  
George Rigos ◽  
Constantina Kokkari ◽  
Michail Pavlidis ◽  
...  

HPB Surgery ◽  
2000 ◽  
Vol 11 (5) ◽  
pp. 285-297 ◽  
Author(s):  
M. A. J. Moser ◽  
N. M. Kneteman ◽  
G. Y. Minuk

Despite recent advances in hepatic surgery, resection of the cirrhotic liver continues to be fraught with high morbidity and mortality rates. As a result, for many patients requiring resection of HCC the postoperative course is complicated and the probability of cure is diminished by coexisting cirrhosis. In this review, we discuss the characteristics of the cirrhotic liver which make it poorly tolerant of resection and the most common complications that follow such surgery. The main purpose of this paper is to review recent attempts to identify interventions that might be beneficial to cirrhotic patients undergoing resection. These interventions include assessment of liver reserve, advances in surgical technique, and improvement in liver function and regeneration.


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