scholarly journals A study on-effect of hematoma and perihematomal edema volume on GCS at the time of admission in patients with spontaneous lobar and basal ganglia hemorrhage

Pulse ◽  
2015 ◽  
Vol 7 (1) ◽  
pp. 22-28
Author(s):  
MA Joarder ◽  
AKMB Karim ◽  
KK Barua ◽  
MA Hossain

Objective: To know effect of hematoma and perihematomal edema volume on Glasgow Coma Scale (GCS) at the time of admission in patients with spontaneous lobar and basal ganglia hemorrhage.Methods: this cross sectional study was conducted in Neurosurgery department, BSMMU to observe effect of hematoma and perihematomal edema volume on GCS at the time of admission in patients with spontaneous lobar and basal ganglia hemorrhage. The duration of study period was from November 2005 to April 2007.Results: a total 48 patients were included in the study and the variables that were analyzed included site of hematoma, volume of hematoma, perihematomal edema and the initial GCS score. Associations between the hematoma and perihematomal edema, site of hemorrhage and perihematomal edema, hematoma volume and GCS at the time of admission, perihematomal edema volume and GCS at the time of admission were evaluated. Level of consciousness (GCS) at the time of admission is the key factor in predicting outcome and neurological deterioration. In our study we found significant association between- hematoma and perihematomal edema volume, hematoma volume and GCS at the time of admission, perihematomal edema volume and GCS at the time of admission. But there was no significant association found between hemorrhage site and perihematomal edema.Conclusion: more the volume of hematoma more was the volume of perihematomal edema. More the volume of hematoma less was the GCS. More the volume of perihematomal edema less was the GCS. But we found no significant association between site of hemorrhage and perihematomal edema volume. GCS is an established predictor of outcome in patients with SICH (spontaneous intracerebral hemorrhage). Accurate prediction of the outcome in ICH patients is important for several reasons: a reliable prognosis must be given to patient and relatives as soon as possible, realistic rehabilitation goals should be set and resources should be allocated in the most efficient way.Pulse Vol.7 January-December 2014 p.22-28

2018 ◽  
Author(s):  
Dave L Dixon ◽  
William L Baker

BACKGROUND The impact and quality of a faculty members publications is a key factor in promotion and tenure decisions and career advancement. Traditional measures, including citation counts and journal impact factor, have notable limitations. Since 2010, alternative metrics have been proposed as another means of assessing the impact and quality of scholarly work. The Altmetric Attention Score is an objective score frequently used to determine the immediate reach of a published work across the web, including news outlets, blogs, social media, and more. Several studies evaluating the correlation between the Altmetric Attention Score and number of citations have found mixed results and may be discipline-specific. OBJECTIVE To determine the correlation between higher Altmetric Attention Scores and citation count for journal articles published in major pharmacy journals. METHODS This cross-sectional study evaluated articles from major pharmacy journals ranked in the top 10% according to the Altmetric Attention Score. Sources of attention that determined the Altmetric Attention Score were obtained, as well each articles open access status, article type, study design, and topic. Correlation between journal characteristics, including the Altmetric Attention Score and number of citations, was assessed using the Spearman’s correlation test. A Kruskal-Wallis 1-way analysis of variance (ANOVA) was used to compare the Altmetric Attention Scores between journals. RESULTS Six major pharmacy journals were identified. A total of 1,376 articles were published in 2017 and 137 of these represented the top 10% with the highest Altmetric Attention Scores. The median Altmetric Attention Score was 19 (IQR 15-28). Twitter and Mendeley were the most common sources of attention. Over half (56.2%) of the articles were original investigations and 49.8% were either cross-sectional, qualitative, or cohort studies. No significant correlation was found between the Altmetric Attention Score and citation count (rs=0.07, P = 0.485). Mendeley was the only attention source that correlated with the number of citations (rs=0.486, P<0.001). The median Altmetric Attention Score varied widely between each journal (P<0.001). CONCLUSIONS The overall median Altmetric Attention score of 19 suggests articles published in major pharmacy journals are near the top 5% of all scientific output. However, we found no correlation between the Altmetric Attention Score and number of citations for articles published in major pharmacy journals in the year 2017.


BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e005947 ◽  
Author(s):  
Cheng-Shyuan Rau ◽  
Hang-Tsung Liu ◽  
Shiun-Yuan Hsu ◽  
Tzu-Yu Cho ◽  
Ching-Hua Hsieh

ObjectivesTo provide an overview of the demographic characteristics of patients with positive blood alcohol concentration (BAC) and to investigate the performance of brain CT scans in these patients.DesignCross-sectional study.SettingTaiwan.Participants2192 patients who had undergone a test for blood alcohol of 13 233 patients registered in the Trauma Registry System between 1 January 2009 and 31 December 2012. A BAC level of 50 mg/dL was defined as the cut-off value. Detailed information was retrieved from the patients with positive BAC (n=793) and was compared with information from those with a negative BAC (n=1399).Main outcome measuresGlasgow Coma Scale (GCS) and Injury Severity Score (ISS) as well as the performance and findings of obtained brain CT scans.ResultsPatients with positive BAC had a higher rate of face injury, but a lower GCS score, a lower rate of head and neck injury, a lower ISS and New Injury Severity Score. Alcohol use was associated with a shorter length of hospital stay (8.6 vs 11.4 days, p=0.000) in patients with an ISS of <16. Of 496 patients with positive BAC who underwent brain CT, 164 (33.1%) showed positive findings on CT scan. In contrast, of 891 patients with negative BAC who underwent brain CT, 389 (43.7%) had positive findings on CT scan. The lower percentage of positive CT scan findings in patients with positive BAC was particularly evident in patients with an ISS <16 (18.0% vs 28.8%, p=0.001).ConclusionsPatients who consumed alcohol tended to have a low GCS score and injuries that were less severe. However, given the significantly low percentage of positive findings, brain CT might be overused in these patients with less severe injuries.


Author(s):  
Prasanthi Govindarajan ◽  
Anisha Chandra ◽  
David Ghilarducci ◽  
Steve Shiboski ◽  
Barbara Grimes ◽  
...  

Background: EMS (Emergency Medical Services) is an important component of the stroke chain of survival. While in hospital stroke time targets have shown to be better when prehospital providers provide advance notification, population-wide studies on thrombolysis rates (IV t-PA) for those who arrive by EMS is sparse. Objective: To examine differences in treatment rates for acute stroke by mode of transport. Methods: This is a cross-sectional study of all patients who were transported to hospitals in two Northern California counties by providers of a single EMS agency during a three year period. Patient demographic data, prehospital provider clinical assessment was obtained from the computerized prehospital transport records and patient location, hospital demographics, physician diagnosis and treatment rates were obtained from statewide administrative patient discharge data. The data sources were linked using probabilistic linkage methodology. Patients ≥18 years of age with validated ICD- 9 code for stroke were included. We excluded inter-facility transports and direct admissions. Results: Of 10,456 patients who had a hospital based discharge diagnosis of stroke, 3787 (36%) were transported by EMS. Mean age at the time of admission was 75 years (+/- 14); 55% (2093) were females, 65% (2471) were whites and 86% (3247) were Hispanics. Most of the patients had Medicare (72%, 2737) and 92% (3471) were transported from home. Majority of the patients were treated at stroke centers [n=3014, (80%)]) and at community hospitals [n=3664, (97%)]. Of 3757 patients with a primary diagnosis of stroke, 4% (150) were treated with IV t-PA. After controlling for covariates, patients transported by EMS had higher odds of treatment with IV t-PA (OR 2.6, 95 CI 1.9-3.3). Treatment at stroke centers (OR 1.5, 95 CI 1-2.2) and academic centers were independently associated with treatment rates (OR 2.4, 95 CI 1.6-3.6). Conclusions: Arrival by EMS to emergency department is associated with higher treatment rates with thrombolytics for acute stroke patients and efforts should be targeted to improve use of EMS for stroke.


Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
José Martín Alanís Naranjo ◽  
Gabriela Olguín Contreras ◽  
Cristo Raymundo Ibarra Jaimes

Introduction: The world is currently suffering from the outbreak of a pandemic caused by the SARS-CoV-2 coronavirus, which causes the disease called COVID-19. This disease was reported for the first time in Wuhan, Hubei Province, China, on December 31, 2019. Hypertension, diabetes and cardiovascular disease are common among patients with COVID-19. In Mexico, information on the association between COVID-19 and hypertension is scarce. Methods: This investigation was a descriptive, observational and cross-sectional study that included patients over 18 years of age who had been hospitalized with laboratory-confirmed COVID-19 between April 6, 2020, and May 6, 2020, and exhibited chest X-ray abnormalities (ground-glass opacity, interstitial alterations and/or multilobar infiltrate). Severity of pneumonia (severe vs. nonsevere) at the time of admission was defined using the community-acquired pneumonia guidelines of the American Thoracic Society (ATS). Results: Information was collected from 89 patients with COVID-19 pneumonia, 34 of whom (38.2%) were hypertensive. When studying risk factors in hypertensive patients and their degree of statistical association with risk of mortality, only the severity of pneumonia stood out. The association between severe pneumonia and mortality was statistically significant (OR: 10.9, CI 1.19-99.6, p value = 0.034). Conclusions: Severity of pneumonia upon admission can be regarded as a marker of adverse clinical outcome in hypertensive COVID-19 patients. Among hypertensive COVID-19 patients, in-hospital mortality was high (68%); such mortality was higher in our study than has been reported in other series worldwide.


2017 ◽  
Vol 14 (3) ◽  
pp. 13-18 ◽  
Author(s):  
Azam Niaz ◽  
Muhammad Hammad Nasir ◽  
Kiran Niraula ◽  
Sumra Majeed ◽  
Joshan Neupane ◽  
...  

Head injury is a leading cause of death in young age group. Extra Dural hematoma, a complication of head injury, is often fatal if not treated in time. The surgical outcome of EDH is dependent upon many variables including preoperative GCS, time between injury and surgery, associated intracranial injuries, anisocoria and hematoma volume. In order to reduce the mortality near to nil, it is essential to determine the magnitude of effect of affecting factors on surgical outcome which will also help us in preoperative counseling and prioritizing the operative candidates. This study was conducted determine the factors affecting surgical outcome of traumatic intracranial extradural Hematoma in Punjab Institute of Neurosciences/ Lahore general hospital, Lahore. It was a Cross sectional study conducted for 3 years from 28th May 2012 to 28th May 2015.The study was conducted on the patients admitted through emergency and diagnosed as Extramural hematoma. These patients underwent surgical evacuation of EDH on emergent basis and outcome was measured by Glasgow Outcome Scale (GOS) after 48 hours of surgery. Using GOS, good surgical outcome was observed in 80.9% (157 out of 194) patients. Preoperative GCS, anisocoria, hematoma volume, associated intracranial injuries and time between injury and surgery were the factors affecting the outcome significantly (p value=0.000) while age and sex of the patient had no significant effect. In Conclusion, good surgical outcome is associated with patients with solitary Extra Dural Hematoma of volume less than 60 ml, preoperative GCS more than 8, absence of anisocoria and undergoing surgical evacuation within 6 hours of injury. Nepal Journal of Neuroscience, Volume 14, Number 3, 2017, Page: 13-18


Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 83 ◽  
Author(s):  
Indira Paz-Graniel ◽  
Nancy Babio ◽  
Ignacio Mendez ◽  
Jordi Salas-Salvadó

Cardiovascular disease (CVD) is one of the main causes of morbidity and mortality around the world. Lifestyle is recognized as a key factor in the development of metabolic disorders and CVD. Recently, eating speed has been of particular interest since some studies have associated it with the development of obesity and other cardiometabolic disorders. We aimed to assess the association between eating speed and various cardiovascular risk factors. We conducted a cross-sectional analysis within the framework of the PREDIMED (Prevención con Dieta Mediterránea) study with 792 participants from the Reus-Tarragona center. Eating speed was self-reported according to participant perception and categorized as slow, medium, or fast. The association between eating speed and cardiovascular risk factors was assessed using Cox regression models with constant time of follow-up for all individuals. Compared to participants in the slow eating speed category, those in the faster eating speed category were 59% more likely to have the hypertriglyceridemia component of the metabolic syndrome (MetS) (Hazard Ratio, (HR) 1.59; 95% Confidence Interval (CI) 1.16–2.17), even after adjustment for potential confounders (HR 1.47; 95% CI 1.08–2.02). No other significant differences were observed. Eating speed was positively associated with the prevalence of the hypertriglyceridemia component of the MetS in a senior population at high cardiovascular risk.


2017 ◽  
Vol 8 (2) ◽  
pp. 56-58
Author(s):  
Garima Biyani ◽  
Swapan Kumar Ray ◽  
Kripasindhu Chatterjee ◽  
Sukanta Sen ◽  
Pradyut Kumar Mandal ◽  
...  

Background: Febrile convulsion (FC) is the most common seizure disorder in childhood. White blood cell (WBC) and C reactive protein (CRP) are commonly measured in FC. Add a paragraph on Aims and Objectives of the study.Aims and Objectives: To compare WBC and CRP in febrile children, aged 6 months to five years, with and without FC, in order to determine whether leukocytosis and elevated CRP can be used as diagnostic tool for febrile seizure.Materials and Methods: In this cross sectional study 214 children (112 with FC), aged 6 months to 5 years, admitted to in the first 48 hours of their febrile disease, either with or without seizure, were evaluated over a 12 months period. Age, sex, temperature; WBC, CRP and hemoglobin were recorded in all children. There was a significant increase of WBC (P<0.001) in children with FC so we can deduct that leukocytosis encountered in children with FC can be due to convulsion in itself.Results: When comparing FC and non-FC children, we encountered a significant increase of WBC (P =0.0005) in children with FC, measured at the time of admission to pediatric medicine ward. There was no significant difference regarding CRP between the two groups. In fact, elevated CRP is a result of underlying pathology.Conclusion: In stable patients, if there’s no reason to suspect a bacterial infection or who don’t have any indication of lumbar puncture, there’s no need to assess WBC as an indicator of underlying infection. Any child with febrile seizure with a high CRP value should be evaluated for infection.Asian Journal of Medical Sciences Vol.8(2) 2017 56-58


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Tayebeh Baniasadi ◽  
Kobra Kahnouji ◽  
Nasrin Davaridolatabadi ◽  
Saeed Hosseini Teshnizi

Abstract Background One of the effective indicators for determining the efficiency and optimal use of hospital resources is the length of stay (LOS). This study aimed to determine the patients’ length of stay and the factors affecting the LOS in the Children’s hospital. Method A cross-sectional study was performed on Children Hospital medical record database including 350 records (April 2015 to Dec 2015). Records were selected by stratified random sampling with proportional allocation. Then the predetermined demographic and hospital variables were extracted through the study of patients’ medical records. All statistical analysis were performed using SPSS software. Results The overall median of the LOS in the studied hospital was 3 days (IQR =3). The results showed that in this hospital the LOS has a significant relationship with the variables of time of admission, the place of residence, type of admission, and the degree of attending physician. Also, with the increasing number of visits, ultrasonography, counseling and laboratory test, LOS was increased. Conclusion Improving processes related to diagnostic procedures, providing adequate staffing for specialized services in all hours of the day, preventing unnecessary and non-emergency admissions in the evening and night, will be effective in optimizing patient LOS.


2020 ◽  
Vol 51 (6) ◽  
pp. 420-425
Author(s):  
Fahad Alkhamis ◽  
Saima Nazish

Objective: The objective of this work was to study the electroencephalographic (EEG) grading of neuronal dysfunction in encephalopathy of various etiologies and assess their association with clinical outcomes. Subjects and Methods: This retrospective cross-sectional study was performed between June and November 2018 at the Neurology Department of King Fahd Hospital of University, Kingdom of Saudi Arabia (KSA) and involved a review and analysis of EEG and medical records pertaining to 222 patients in whom encephalopathy was diagnosed. Results: In patients suffering from encephalopathy, advanced age ( P = .01), low Glasgow Coma Scale (GCS) scores ( P = .00), and certain etiologies, namely hypoxic-ischemic encephalopathy (HIE) ( P = .00), septic encephalopathy ( P = .01), and other illnesses ( P = .00), were significantly associated with unfavorable clinical outcomes, whereas traumatic brain injury (TBI) ( P = .01) and GCS >7 ( P = .00) were associated with favorable outcomes. Among different etiologies, EEG grade I ( P = .02) and grade IV ( P = .04) neuronal dysfunction was significantly associated with TBI while grade III ( P = .05) and grade V ( P = .02) neuronal dysfunction was significantly associated with HIE. Grade I ( P = .03) neuronal dysfunction was mostly observed in septic encephalopathy cases, while patients suffering from other illnesses were also found to have grade I ( P = .04) and grade IV ( P = .05) neuronal dysfunction based on their EEG. Conclusion: EEG is being conducted routinely to determine the course and severity of various forms of encephalopathy. However, the clinical implications of EEG grading for neuronal dysfunction are largely dependent on underlying etiology and other clinical parameters, such as age and GCS score. Further larger prospective cohort studies involving other important prognostic parameters and continuous EEG monitoring are thus needed.


2018 ◽  
Vol 5 (6) ◽  
pp. 2038
Author(s):  
Karthick Jayapal ◽  
Hassan Adnan Mansour

Background: The presentation of minor head trauma warrants immediate and accurate diagnosis for early clinical management among children. Computed Tomography is the gold standard tool for the diagnosis of Traumatic Brain Injury (TBI) among the children. The timing of presentation may have a significant role in predicting the incidence of TBI. This study was done to compare the CT findings among children who presented within and after 24 hours with minor head trauma.Methods: This cross-sectional study was carried out among 992 children between 2-15 years reporting with a history of head injury. All the participants were clinically examined, and relevant history of type of injury and timing of presentation was recorded. CT scan was taken as per PECARN criteria. Data was entered and analysed using SPSS ver 15 software.Results: Majority of the participants belonged to 6-10 years of age (45.2%) and were males (58.5%). About 81.7% of the participants presented within 24 hours. The overall prevalence of TBI among the study participants was 58.6% [55.5-61.6].It was observed that hematoma predominantly presented after 24 hours (74.2%) and majority of the falls presented after 24 hours (92.8%).Patients who presented after 24 hours were at increased risk of presenting as TBI (67.03%) compared to those presenting within 24 hours (56.8%;p<0.05).Conclusions: This study has emphasized the need for including the timing of presentation as a key factor for facilitating early diagnosis and rapid case management of pediatric head trauma.


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