Effect of Use of Ambulance as Emergency Medical Service in Patients of ST-Elevation Myocardial Infarction

Objective: To study the frequency of ambulance utilization by the St-elevation Myocardial Infarction patients toreach hospital, perception of ambulance users about the facilities available in the ambulance, and evaluate theclinical outcomes of STEMI between ambulance users and non-users.Study Design: Cross-section survey-based study.Place and Duration of Study: The study was carried out in the Department of Cardiology at Chaudry Pervaizth th Elahi Institute of Cardiology (CPEIC) Multan from 14 April 2020 to 14 September 2020.Materials and Methods: Patients with the diagnosis of STEMI were included in the study and were classifiedinto two groups' ambulance and non-ambulance users, to reach the facility. Patients' demographics, initialpresenting symptoms, availability of ambulance, and time to reach the hospital were recorded. Moreover, theywere followed for complication during their stay and base line laboratory indicators. Ambulance users werealso evaluated for their perception about availability of medical services in the ambulance. The data collectedfrom both of the groups were compared through student's t-test and chi-square test. Statistical value less than0.05 was considered as significant.Results: Out of 300 patients, 32.6% were ambulance users while 67.4% were non-ambulance user. Nosignificant difference was found in age, gender, underlying comorbidity, and initial presenting symptomsbetween two groups. Majority of ambulance users (74%) arrived in less than 45minutes. Differentcomplications were recorded but no significant difference was found between two groups. Majority ofambulance users 31.5% were neutral about the level of satisfaction for ambulance facilities.Conclusion: Frequency of ambulance utilization by STEMI patients is not only low in Pakistan, but ambulancesystem is also not successful in producing significant change in clinical outcomes. Therefore an awarenesscampaign along with ambulance improvement campaigns should be launched to bring a meaningful change.

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The evolution of neuropsychiatric symptoms during treatment for hyperthyroidism

Romanian Journal of Medical Practice ◽

10.37897/rjmp.2021.2.27 ◽

2021 ◽

Vol 16 (2) ◽

pp. 273-278

Author(s):

Oana-Maria NICOLA (MARIOARA) ◽

◽

Alice Elena GHENEA ◽

Cristina-Nicoleta VLĂDOIANU ◽

Valentin CARLIG ◽

...

Keyword(s):

Neuropsychiatric Symptoms ◽

Antithyroid Drug ◽

T Test ◽

Chi Square ◽

Antithyroid Drug Therapy ◽

Significant Difference ◽

Hamd Score ◽

Chi Square Test ◽

Student’S T ◽

Student’S T Test

Introduction. The link between the action of thyroid hormones and neurological, cognitive and affective function is well known. The aim of the study is to evaluate the changes of hormone’s value and symptoms at hyperthyroid patients after 6 months and 1 year of treatment. Materials and methods. In our study, we enrolled 80 patients with hyperthyroidism (new cases) and we asked them to fill out a questionnaire three times: first time was when they were into a thyrotoxic state (before the antithyroid drug therapy – ATD) and after that during ATD treatment (when they were into an euthyroid state after 6-12 months of treatment, average 7 months). Results. There is no statistically significant difference between the ages of the study and control groups (p Student’s t -test = 0.207 > 0.005), nor between the distributions according to gender (p Chi square test = 0.827) or area of residence (p Chi square test = 0.820). For HAMD score, there is highly significant differences (p < 0.001) before treatment, a statistically significant difference after 6 months (p Student’s t-test = 0.015 < 0.05), and no statistically significant difference after 1 year. Conclusion. Depression and anxiety were improved following thyroid function normalization in hyperthyroidism.

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Rheumatologist perspective of the Brazilian consensus for detection of auto antibodies in HEp-2 CELLS

Advances in Rheumatology ◽

10.1186/s42358-021-00190-8 ◽

2021 ◽

Vol 61 (1) ◽

Author(s):

Isadora Carvalho Medeiros Francescantonio ◽

Leandro Augusto Rodrigues dos Santos ◽

Paulo Luiz Carvalho Francescantonio ◽

Luiz Eduardo Coelho Andrade ◽

Wilson de Melo Cruvinel

Keyword(s):

Clinical Practice ◽

Immunofluorescence Assay ◽

Chi Square ◽

Dichotomous Data ◽

Level Of Satisfaction ◽

Significant Difference ◽

Chi Square Test ◽

Geographic Regions ◽

Relevant Pattern ◽

Structured Questionnaire

Abstract Objective To evaluate the perception of rheumatologists regarding the recommendations of the Brazilian Consensus for detection of Autoantibodies (BCA) on HEp-2 Cells by Indirect Immunofluorescence assay (IFA) and how BCA recommendations help in clinical practice. Methodology A structured questionnaire regarding the BCA recommendations for detection and interpretations of autoantibodies in HEp-2 cells was applied to randomly selected rheumatologists. The results were tabulated using the Microsoft® Excel program, expressed as a simple percentage and the dichotomous data were analyzed using the Chi-square test and the Epi Info® program. Results Four hundred fuorteen rheumatologists participated in the study: 70% of them considered their knowledge of the HEp-2 IFA test satisfactory or excellent, and 43% said they knew the BCA recommendations in general, without distinguishing the edition of the BCA to which they refer. The Revista Brasileira de Rheumatologia/Advances in Rheumatology was the means of dissemination most consulted by specialists (50%). According to the rheumatologists’ opinion, the most relevant pattern was the homogeneous nuclear (78%) and 65% stated they were satisfied with the BCA recommendations at a level of satisfaction greater than or equal to 80%. There was no significant difference in the perception of rheumatologists from the several Brazilian geographic regions. Conclusion Brazilian rheumatologists are aware of the BCA guidelines and most are satisfied with the content published, considering that the BCA recommendations assist positively in the clinical practice. Most rheumatologists recognize the patterns associated with rheumatic autoimmune diseases and have used BCA recommendations to interpret the results of the HEp-2 IFA test.

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DIFFERENTIAL CELL COUNT AS DIAGNOSTIC AND PROGNOSTIC MARKER OF ACUTE MYOCARDIAL INFARCTION

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v24i2.1320 ◽

2018 ◽

Vol 24 (2) ◽

pp. 175

Author(s):

Sri Anita ◽

Liong Boy Kurniawan ◽

Darwati Muhadi

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cell Count ◽

Inflammatory Marker ◽

St Elevation Myocardial Infarction ◽

Chi Square ◽

Cross Sectional ◽

Differential Cell Count ◽

Differential Cell ◽

St Elevation

Myocardial infarction is a necrosis of myocardial cells due to lack of blood and oxygen supply caused by obstruction of coronary arteries, mostly due to atherosclerosis processes. Increased inflammatory marker level is associated with poor cardiovascular prognosis. This study was aimed to know whether leukocytes count, differential cell count and the Ratio of Neutrophils-Lymphocytes (RNL) could distinguish between types of Acute Myocardial Infarction (AMI) and to evaluate its correlation with mortality. This was a cross-sectional retrospective study using medical records patients which were diagnosed as AMI by clinicians in Cardiac Centre of the Dr. Wahidin Sudirohusodo Hospital during the period of April 1st, 2015 - May 31st, 2016. Statistical analysis used the Mann-Whitney and Chi-Square test, p<0.05 was considered as significant. The total subjects were 435 patients divided into 289 ST- Elevation Myocardial Infarction (STEMI) and 146 Non-ST-Elevation Myocardial Infarction (NSTEMI). There were significant differences in that mean of leukocytes, neutrophils, lymphocytes, monocytes, eosinophils counts and RNL between STEMI and NSTEMI (p <0.05). Significant differences were also found in leukocyte, neutrophils, lymphocytes, eosinophils, basophils and RNL mean between those who died and survived (p <0.05) and a significant correlation between increased leukocytes, neutrophils, basophils counts with mortality (p <0.05). In conclusion, the number of leukocytes and leukocyte count can be used as diagnostic markers of AMI between STEMI and NSTEMI, as well as prognostic markers among patients who died and survived. Routine blood sampling cohort studies in patients with AMI can avoid the bias of the results obtained.

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Effect of ondansetron on spinal induced hypotension in caesarean deliveries

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v8i4.32384 ◽

2020 ◽

Vol 8 (4) ◽

pp. 193-199

Author(s):

Pujan Balla ◽

Anil Shrestha ◽

Ninadini Shrestha ◽

Navindra Bista ◽

Moda Nath Marhatta

Keyword(s):

Spinal Anesthesia ◽

Elective Caesarean Section ◽

P Value ◽

Chi Square ◽

Induced Hypotension ◽

Intergroup Comparison ◽

Chi Square Test ◽

The Mean ◽

Student’S T ◽

Student’S T Test

Background: Spinal anesthesia is the preferred technique of anesthesia employed for caesarean sections. However, it is very often complicated by hypotension. Different drugs and techniques have been used to prevent the hypotension induced by spinal anesthesia. In this study, the effect of ondansetron on the prevention of hypotension after spinal anesthesia was evaluated. Objectives: To determine the effect of prophylactic ondansetron on prevention of spinal induced hypotension in elective caesarean section. Methodology: Eighty-six parturients planned for elective caesarean deliveries were randomized into two groups of 43 each. Group O received Ondansetron 4 mg (4 ml) and Group S received Normal Saline (4 ml) intravenously 10 minutes prior to spinal anesthesia. Blood pressure, heart rate, phenylephrine requirements, occurrence of nausea and vomiting and APGAR scores of neonates were compared between the groups. Hemodynamic data was analyzed using Student’s t-test for intergroup comparison and ANOVA was used for intragroup comparison. Categorical data was analyzed using Pearson Chi-Square test. For all determinants, p-value <0.05 was considered significant. Results: Occurrence of hypotension in Group O (20.9 %) was significantly lower than in Group S (72.1%) (p < 0.05). The mean arterial pressure was significantly higher in Group O at 2, 6, 8, 12 and 14 minutes (p < 0.05). The use of phenylephrine (37.21 mcg vs. 146.51 mcg, p < 0.05) and occurrence of nausea (11.6%, vs. 41.9% p < 0.002) was significantly lower in ondansetron group. Conclusion: Ondansetron is effective in preventing spinal induced hypotension in elective caesarean sections.

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Fishery regulamentation or ethnoknowledge? The dilemma of the management of the mapará fisheries on the lower Tocantins river in northern Brazil

Research Society and Development ◽

10.33448/rsd-v10i11.18963 ◽

2021 ◽

Vol 10 (11) ◽

pp. e131101118963

Author(s):

Esther Mirian Cardoso ◽

Paulo Allison Costa da Mata ◽

Matheus dos Santos Souza ◽

Maria Clara Pinheiro de Souza ◽

Victoria Isaac

Keyword(s):

Socioeconomic Development ◽

Economic Importance ◽

Chi Square ◽

Great Economic Importance ◽

Chi Square Test ◽

Northern Brazil ◽

The Mean ◽

Tocantins River ◽

Student’S T ◽

Student’S T Test

The fishery of mapará (Hypophthalmus marginatus) is of great economic importance in the Amazon region. Despite this, it is observed that the current norms of management disagree with the ethnoknowledge of fishermen of the Tocantins river. Therefore, there are many seizures and fines in the Tocantins Low region. This work appeared as a demand of the fishermen of the region and had as purpose to test the pertinence of the fishing legislation on the capture of the species and to provide subsidies for the adaptation of the norms to the local reality. For this, a mapará fishery was taken on the Pindobal Grande river, in the municipality of Igarapé-Miri, in the state of Pará. A sample of the captured individuals was collected, and identification, sexing and biometry were done. Fishing was described, and the sex ratio tested with the Chi-Square test and the mean length differences between the sexes with the Student's t-test. The results were compared with current legislation and literature data. The captured mapará individuals were mostly above 30 cm, as determined by legislation. It is concluded that, despite using a network that is prohibited, the capture of the species in the region acts selectively, due to the ethno-cognition and the fisherman's action ("taleiro"). Therefore, it is necessary that the legislation be revised, seeking the reconciliation between the conservation of ecosystems, the traditional knowledge and the socioeconomic development of the region.

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Sports potential modeling of young basketball players: a preliminary analysis

Brazilian Journal of Kinanthropometry and Human Performance ◽

10.1590/1980-0037.2019v21e59832 ◽

2019 ◽

Vol 21 ◽

Author(s):

Dilson Borges Ribeiro Junior ◽

Jeferson Macedo Vianna ◽

André de Assis Lauria ◽

Emerson Filipino Coelho ◽

Francisco Zacaron Werneck

Keyword(s):

Adult Height ◽

High Potential ◽

Basketball Players ◽

Chi Square ◽

Chi Square Test ◽

Student’S T ◽

The Relationship ◽

Student’S T Test ◽

Adult Stature

Abstract The aims of this study were: 1) to evaluate the sports potential of young basketball players; 2) to identify variables that discriminate sports potential assessed by coaches; 3) to verifythe relationship between classification of the multidimensional profile of athletes and classification of the sports potential by coaches. Sixty-two young basketball players aged 15.6±1.1 years from U-15 (n = 24) and U-17 (n = 38) categories participated in the study. A test battery was applied to evaluate sports potential indicators: 1) anthropometric; 2) physicomotor; 3) psychological;4) skills;5) socio-environmental;6) maturational and 7) sports potential.Clusteranalysis was performed in three groups: high, medium and low potential. Student’s t-test was used for the comparison between athletes evaluated by the coach as excellent and the others and the Chi-Square test to verify the relationship between sports potential classifications. It was observed that in the high-potential group, athletes were chronologically older, with higher % predicted adult height (PMS), competitive and determined sports orientation, higher body size, lower skinfold summation, and greater physicomotor performance. In comparison with other athletes, high-potential basketball players presented higher stature, wider wingspan,longer limb length, greater predicted adult stature and higher Z score of the % PMS. It could be concluded that the multidimensional approach was useful for the evaluation of the sports potential of young basketball players, requiring the use of multidimensional variables, in addition to coaches’ opinion regarding the potential of their athletes.

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Abstract 346: Platelet Reactivity to Aspirin and Clopidogrel in Patients with Acute ST Elevation Myocardial Infarction and its Correlation with High Sensitivity C- Reactive Protein

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.33.suppl_1.a346 ◽

2013 ◽

Vol 33 (suppl_1) ◽

Author(s):

Archana Rajdev ◽

Oana Penciu ◽

Jacqueline Bradley ◽

Cristina Mihu ◽

Alan Siqueros ◽

...

Keyword(s):

Myocardial Infarction ◽

Platelet Reactivity ◽

High Sensitivity ◽

St Elevation Myocardial Infarction ◽

Diabetic Patients ◽

C Reactive Protein ◽

Reactive Protein ◽

Significant Difference ◽

St Elevation ◽

Hs Crp

INTRODUCTION Implantation of bare metal or drug eluting stents supported by dual antiplatelet therapy (DAPT) is standard treatment for the management of patients with ST elevation myocardial infarction (STEMI). Individual response to aspirin and clopidogrel is heterogeneous, and decreased response is associated with thrombotic events following stenting. We postulated that systemic inflammation at the time of STEMI would diminish responsiveness to DAPT. The aim of this study is to evaluate the correlation between elevated high-sensitivity C-reactive protein (hs-CRP) as a marker of inflammation and decreased platelet sensitivity to DAPT in STEMI. METHODS We recruited patients with STEMI undergoing percutaneous coronary intervention (PCI) who received oral clopidogrel 600 mg loading dose followed by 75 mg daily maintenance dose and aspirin 325 mg daily. Platelet reactivity and hs-CRP were measured within 72 hours of PCI and at 6 weeks. For patients receiving eptifibatide, blood samples were taken 48 hours after discontinuation. Platelet reactivity was assessed using the VerifyNow platelet function analyzer. A cut-off value of 208 platelet reaction units (PRU) was used to define high on-clopidogrel platelet reactivity (HCPR) and a value of 454 aspirin reaction units (ARU) was used to define high on-aspirin platelet reactivity (HAPR). RESULTS In 20 patients aged 31 to 85, in hospital and 6 weeks after STEMI, hs-CRP was 6.7 (SD 4.0) and 2.6 (SD 3.2) respectively, p< 0.01. Changes in ARU from 408.3 (SD 54.3) to 425.2 (SD 68.2) and PRU from 157.8 (SD 74.7) to 164.2 (SD 75) were not statistically significant. 2 patients had HAPR in hospital; 1 became sensitive at follow up. 2 patients developed HAPR and HCPR. We saw a trend towards higher PRU in diabetic patients and those prescribed statins. CONCLUSIONS Although we found a significant difference in hs-CRP levels between the first and second time point, no significant difference was found in on-aspirin and on-clopidogrel platelet reactivity between the time points.Thus, in this small series, the acute inflammatory state associated with STEMI did not appear to influence the on-DAPT reactivity at the dosages used. Trends among those with diabetics and prescribed statins will be discussed

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Impact of collateralisation to a concomitant chronic total occlusion in patients with ST-elevation myocardial infarction: a subanalysis of the EXPLORE randomised controlled trial

Open Heart ◽

10.1136/openhrt-2018-000810 ◽

2018 ◽

Vol 5 (2) ◽

pp. e000810 ◽

Cited By ~ 2

Author(s):

Ivo M van Dongen ◽

Joëlle Elias ◽

K Gert van Houwelingen ◽

Pierfrancesco Agostoni ◽

Bimmer E P M Claessen ◽

...

Keyword(s):

Myocardial Infarction ◽

Clinical Decision Making ◽

Controlled Trial ◽

Left Ventricular ◽

St Elevation Myocardial Infarction ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Significant Difference ◽

St Elevation ◽

The Impact

ObjectiveThe impact on cardiac function of collaterals towards a concomitant chronic total coronary occlusion (CTO) in patients with ST-elevation myocardial infarction (STEMI) has not been investigated yet. Therefore, we have evaluated the impact of well-developed collaterals compared with poorly developed collaterals to a concomitant CTO in STEMI.Methods and resultsIn the EXPLORE trial, patients with STEMI and a concomitant CTO were randomised to either CTO percutaneous coronary intervention (PCI) or no-CTO PCI. Collateral grades were scored angiographically using the Rentrop grade classification. Left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume (LVEDV) at 4 months were measured using cardiac magnetic resonance imaging. Well-developed collaterals (Rentrop grades 2–3) to the CTO were present in 162 (54%) patients; these patients had a significantly higher LVEF at 4 months (46.2±11.4% vs 42.1±12.7%, p=0.004) as well as a trend for a lower LVEDV (208.2±55.7 mL vs 222.6±68.5 mL, p=0.054) when compared with patients with poorly developed collaterals to the CTO. There was no significant difference in the total amount of scar in the two groups. Event rates were statistically comparable between patients with well-developed collaterals and poorly developed collaterals to the CTO at long-term follow-up.ConclusionsIn patients with STEMI and a concomitant CTO, the presence of well-developed collaterals to a concomitant CTO is associated with a better LVEF at 4 months. However, this effect on LVEF did not translate into improvement in clinical outcome. Therefore, the presence of well-developed collaterals is important, but should not solely guide in the clinical decision-making process regarding any additional revascularisation of a concomitant CTO in patients with STEMI.Clinical trial registrationNTR1108.

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Level of Satisfaction in the Use of the Wraparound Hawley and Thermoplastic Maxillary Retainers

The Angle Orthodontist ◽

10.2319/031319-197.1 ◽

2019 ◽

Vol 90 (1) ◽

pp. 63-68 ◽

Cited By ~ 1

Author(s):

Adenilson Silva Chagas ◽

Karina Maria Salvatore Freitas ◽

Rodrigo Hermont Cançado ◽

Fabricio Pinelli Valarelli ◽

Luiz Filiphe Gonçalves Canuto ◽

...

Keyword(s):

The Other ◽

Chi Square ◽

Level Of Satisfaction ◽

Intergroup Comparison ◽

Significant Difference ◽

Chi Square Test ◽

Orthodontic Patients ◽

Better Than

ABSTRACT Objective To compare the level of satisfaction in the use of wraparound Hawley and thermoplastic maxillary retainers. Materials and Methods The study sample included 70 orthodontic patients (24 males and 46 females), who were in the retention stage (mean age = 20.80 years). All patients wore the two types of maxillary retainer for 1 month each, along with a 3×3 fixed mandibular retainer. After the use of each retainer, the patients responded to a questionnaire evaluating the level of satisfaction with their use of the maxillary retainer. Intergroup comparison was performed by independent t tests. Chi-square test was used to evaluate preference for the type of retainer by gender. Results The thermoplastic retainer was better for swallowing and the wraparound Hawley appliance was better for hygiene and durability. The other factors evaluated (adaptation, speech, comfort, esthetics, satisfaction, and fitting) did not show significant differences between the retainers. There was also no significant difference in preference for the appliances. Conclusions Regarding the overall satisfaction and the preference, there was no difference between the wraparound Hawley and thermoplastic retainers. The wraparound Hawley appliance was better in hygiene and resistance than the thermoplastic retainer; and the thermoplastic appliance was better than the wraparound Hawley for swallowing fluids and saliva.

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Comparison Of Full-Mouth Scaling and Quadrant-Wise Scaling in the Treatment of Adult Chronic Periodontitis

Brazilian Dental Journal ◽

10.1590/0103-6440201801715 ◽

2018 ◽

Vol 29 (3) ◽

pp. 296-300 ◽

Cited By ~ 2

Author(s):

Caio Vinicius G. Roman-Torres ◽

Matthew S. Bryington ◽

Sergio T. Kussaba ◽

Angelica Castro Pimentel ◽

Ryo Jimbo ◽

...

Keyword(s):

Chronic Periodontitis ◽

Surgical Techniques ◽

Culture Method ◽

Biochemical Tests ◽

Chi Square ◽

Microbial Detection ◽

Significant Difference ◽

Microbiological Parameters ◽

Chi Square Test ◽

Student’S T

Abstract In the search for the ideal treatment of periodontal disease various non-surgical techniques should be considered. The objective of this study was to evaluate the efficacy of full-mouth scaling (FMS) by clinical and microbiological parameters. 670 individuals were evaluated with 230 subjects meeting the selection criteria and were divided into two groups; 115 subjects treated with FMS and 115 treated with weekly sessions of scaling and root planning (SRP). The patient population had a mean age of 51.67 years, with moderate chronic periodontitis. Subjects were evaluated prior to treatment (T1) and 90 days after execution of therapy (T2), with regards to: probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and microbial detection for the presence of Porphyromonas gingivalis (P.g.) and Prevotella intermedia (P.i.) by culture method and confirmed by biochemical tests. Subjects treated in the FMS group also rinsed with 0.12% chlorhexidine mouthwash for seven days following treatment. The results were analyzed using statistical Student’s t-test and chi-square test. No statistically significant differences were observed for PD and CAL between T1 and T2 in both groups. For GI and PI significant difference was observed between the groups. For the evaluated microbial parameters was observed reduction of P.g. and P.i., but only for P.g. with a significant reduction in both groups. The full mouth scaling technique with the methodology used in this study provided improved clinical conditions and reduction of P.g. in subjects with moderate periodontitis, optimizing the time spent in the therapeutic execution.

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