Pub Date : 2024-02-22DOI: 10.25259/ijrsms-2021-12-2
Anjali Kale, T. Idhate, Rishivardhan Reddy
Pancytopenia is one of the most common blood disorders observed in routine clinical practice. There are few studies analyzing pancytopenia in Indian scenarios. This cross-sectional study is aimed to identify the cause of pancytopenia and analyze the clinico-hematological characteristics of children with pancytopenia in Western India. So this study was conducted to evaluate clinico-hematological profile of children presenting with pancytopenia and to determine the etiology of pancytopenia in Western India. This two-year descriptive cross-sectional study was conducted in a tertiary care referral hospital. All children with pancytopenia, ranging in age from 1 month to 18 years, were enrolled in the study. A thorough history was taken, as well as general and systemic examination findings, hematological parameters, and bone marrow examination findings were recorded. The age group of enrolled patients ranged from 1 month to 18 years in the 130 cases evaluated (63 males and 67 females), while the mean age was 9.8 years. Fever was the most prevalent symptom (n = 111, 85.40%), followed by generalized weakness and weight loss. Pallor was the most common physical manifestation, followed by knuckle pigmentation, hepatomegaly, and splenomegaly. Study results concluded that the most common cause of pancytopenia was megaloblastic anemia, followed by acute leukemia, aplastic anemia, and infections. Megaloblastic anemia can be distinguished from other causes of pancytopenia based on dietary habits, hematological parameters and serum B12 levels, potentially obviating the necessity for a bone marrow test in most pancytopenia patients. In pancytopenia patients, detailed initial hematological investigations, including bone marrow examination, are beneficial for correct diagnosis. Although megaloblastic anemia is the most prevalent cause, other factors to examine include aplastic anemia, leukemia, Hemophagocytic Lymphohistiocytosis (HLH), hypersplenism, Systemic Lupus Erythematosus (SLE), and viral infections. When a complete history, clinical examination, and baseline hematological parameters are adequately assessed, bone marrow examination can be avoided in most pancytopenia patients.
{"title":"A Cross-Sectional Study of Etiology and Clinico-Hematological Profile of Pancytopenia in Children at Tertiary Care Centre in Western India","authors":"Anjali Kale, T. Idhate, Rishivardhan Reddy","doi":"10.25259/ijrsms-2021-12-2","DOIUrl":"https://doi.org/10.25259/ijrsms-2021-12-2","url":null,"abstract":"\u0000\u0000Pancytopenia is one of the most common blood disorders observed in routine clinical practice. There are few studies analyzing pancytopenia in Indian scenarios. This cross-sectional study is aimed to identify the cause of pancytopenia and analyze the clinico-hematological characteristics of children with pancytopenia in Western India. So this study was conducted to evaluate clinico-hematological profile of children presenting with pancytopenia and to determine the etiology of pancytopenia in Western India.\u0000\u0000\u0000\u0000This two-year descriptive cross-sectional study was conducted in a tertiary care referral hospital. All children with pancytopenia, ranging in age from 1 month to 18 years, were enrolled in the study. A thorough history was taken, as well as general and systemic examination findings, hematological parameters, and bone marrow examination findings were recorded.\u0000\u0000\u0000\u0000The age group of enrolled patients ranged from 1 month to 18 years in the 130 cases evaluated (63 males and 67 females), while the mean age was 9.8 years. Fever was the most prevalent symptom (n = 111, 85.40%), followed by generalized weakness and weight loss. Pallor was the most common physical manifestation, followed by knuckle pigmentation, hepatomegaly, and splenomegaly. Study results concluded that the most common cause of pancytopenia was megaloblastic anemia, followed by acute leukemia, aplastic anemia, and infections. Megaloblastic anemia can be distinguished from other causes of pancytopenia based on dietary habits, hematological parameters and serum B12 levels, potentially obviating the necessity for a bone marrow test in most pancytopenia patients.\u0000\u0000\u0000\u0000In pancytopenia patients, detailed initial hematological investigations, including bone marrow examination, are beneficial for correct diagnosis. Although megaloblastic anemia is the most prevalent cause, other factors to examine include aplastic anemia, leukemia, Hemophagocytic Lymphohistiocytosis (HLH), hypersplenism, Systemic Lupus Erythematosus (SLE), and viral infections. When a complete history, clinical examination, and baseline hematological parameters are adequately assessed, bone marrow examination can be avoided in most pancytopenia patients.\u0000","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The imperative need of post-operative period is effective pain management. Virtual reality (VR) causes psychological distraction from pain stimuli, and thus may cause pain alleviation. The study was undertaken to determine the effectiveness of VR distraction on post-operative pain and experience of VR sessions among the patients. A hospital-based interventional study was conducted for a period of two months with the objectives to estimate changes in post-operative pain intensity after VR session as well as to analyze experience related to VR interventions. It comprised patients of either gender undergoing surgery and with 1–3 days of hospitalization, who were randomized into two groups (age and gender matched). The control group was kept on standard post-operative pain management. The interventional group was subjected to VR exposure in addition to standard care therapy. The Numerical Rating Scale (NRS) scores were obtained twice post-operatively in subsequent days. I-group presence questionnaire (IPQ) responses were obtained after the VR session. Both control and interventional groups had 25 participants each for analysis. In both the groups, majority were given bupivacaine for anesthesia and combination of paracetamol and diclofenac for post-operative analgesia. The NRS scores of both groups obtained post-operatively on standard therapy without VR intervention did not show any significant difference. However, the post-VR-sessions’ NRS scores showed significant reduction as compared to pre-session scores among the participants of the interventional group. The responses obtained via IPQ revealed acceptance for the features of realism, engagement, and presence during VR intervention. Majority confirmed their willingness to undergo VR sessions in future. VR session helped in significant reduction of pain perception as VR simulation diverted considerable attention away from the pain. Majority expressed positive inclination for utilization of VR in comprehensive patient care.
{"title":"Effectiveness of Virtual Reality Environment for Post-Operative Pain Management","authors":"Srinidhi Thippabathuni, Venkata Anil Chandra Dronamraju, Himavathy Kodandarao Gara, Dharma Rao Vanamali","doi":"10.25259/ijrsms_29_2023","DOIUrl":"https://doi.org/10.25259/ijrsms_29_2023","url":null,"abstract":"\u0000\u0000The imperative need of post-operative period is effective pain management. Virtual reality (VR) causes psychological distraction from pain stimuli, and thus may cause pain alleviation. The study was undertaken to determine the effectiveness of VR distraction on post-operative pain and experience of VR sessions among the patients.\u0000\u0000\u0000\u0000A hospital-based interventional study was conducted for a period of two months with the objectives to estimate changes in post-operative pain intensity after VR session as well as to analyze experience related to VR interventions. It comprised patients of either gender undergoing surgery and with 1–3 days of hospitalization, who were randomized into two groups (age and gender matched). The control group was kept on standard post-operative pain management. The interventional group was subjected to VR exposure in addition to standard care therapy. The Numerical Rating Scale (NRS) scores were obtained twice post-operatively in subsequent days. I-group presence questionnaire (IPQ) responses were obtained after the VR session.\u0000\u0000\u0000\u0000Both control and interventional groups had 25 participants each for analysis. In both the groups, majority were given bupivacaine for anesthesia and combination of paracetamol and diclofenac for post-operative analgesia. The NRS scores of both groups obtained post-operatively on standard therapy without VR intervention did not show any significant difference. However, the post-VR-sessions’ NRS scores showed significant reduction as compared to pre-session scores among the participants of the interventional group. The responses obtained via IPQ revealed acceptance for the features of realism, engagement, and presence during VR intervention. Majority confirmed their willingness to undergo VR sessions in future.\u0000\u0000\u0000\u0000VR session helped in significant reduction of pain perception as VR simulation diverted considerable attention away from the pain. Majority expressed positive inclination for utilization of VR in comprehensive patient care.\u0000","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"204 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140445453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cross-sectional data was collected for a period of 1 year to assess the biomarkers of inflammation, and blood viscosity as predictive markers in patients with primary bilateral varicose veins or reticular veins that might progress to varicose veins. A sample of 40 participants, 20 controls and 20 patients aged 18–65 years falling under the reticular veins and symptomatic varicose veins (C1, 2s), primary etiology (Ep), superficial veins (As), reflux pathology (Pr) categories of Clinical, etiologic, anatomic, Pathophysiologic (CEAP) classification with the exception of telangiectatic veins, were included in the study. Blood viscosity was measured using a Capillary Viscometer. Evaluated inflammatory markers were tissue Plasminogen Activator (tPA), Plasminogen Activator Inhibitor-1 (PAI-1), and fibrinogen. Analysis was done using Statistical Package for the Social Sciences (SPSS) software and Chi-square, Fisher’s, Bonferroni, and Analysis of Variance (ANOVA) tests were applied. There was a statistically insignificant relationship between occupation and different study groups. Standing hours and serum fibrinogen levels had a significant difference in different study groups. Serum tPA, Serum PAI-1, and blood viscosity had an insignificant difference between different study groups. It was revealed that the pairwise group comparisons of study group C2 vs. control group C0, study group C1 vs. control group C0 and study group C2 vs. study group C1, and study group C2 vs. control group C0 each were significantly different pairwise. Blood viscosity, tPA and PAI-1 cannot be used as predictive markers in patients with bilateral (B/L) primary varicose veins/reticular veins. Serum fibrinogen levels can be used as predictive markers for the development of B/L primary varicose veins and in our particular study with a predictive range of 189.4–327.9 mg/dL but not for B/L reticular veins. Prolonged standing, irrespective of the occupation of the patient, is associated with the development of B/L reticular veins and B/L varicose veins.
{"title":"A Study of Blood Viscosity and Inflammatory Biomarkers’ Levels in Bilateral Primary Varicose Veins/Reticular Veins as Predictive Markers","authors":"Mukul Urvendra Dahiya, Sanjay Singh, Saurabh Singh, Santosh Kumar Singh, Varsha Kumar","doi":"10.25259/ijrsms_4_2023","DOIUrl":"https://doi.org/10.25259/ijrsms_4_2023","url":null,"abstract":"\u0000\u0000Cross-sectional data was collected for a period of 1 year to assess the biomarkers of inflammation, and blood viscosity as predictive markers in patients with primary bilateral varicose veins or reticular veins that might progress to varicose veins.\u0000\u0000\u0000\u0000A sample of 40 participants, 20 controls and 20 patients aged 18–65 years falling under the reticular veins and symptomatic varicose veins (C1, 2s), primary etiology (Ep), superficial veins (As), reflux pathology (Pr) categories of Clinical, etiologic, anatomic, Pathophysiologic (CEAP) classification with the exception of telangiectatic veins, were included in the study. Blood viscosity was measured using a Capillary Viscometer. Evaluated inflammatory markers were tissue Plasminogen Activator (tPA), Plasminogen Activator Inhibitor-1 (PAI-1), and fibrinogen. Analysis was done using Statistical Package for the Social Sciences (SPSS) software and Chi-square, Fisher’s, Bonferroni, and Analysis of Variance (ANOVA) tests were applied.\u0000\u0000\u0000\u0000There was a statistically insignificant relationship between occupation and different study groups. Standing hours and serum fibrinogen levels had a significant difference in different study groups. Serum tPA, Serum PAI-1, and blood viscosity had an insignificant difference between different study groups. It was revealed that the pairwise group comparisons of study group C2 vs. control group C0, study group C1 vs. control group C0 and study group C2 vs. study group C1, and study group C2 vs. control group C0 each were significantly different pairwise.\u0000\u0000\u0000\u0000Blood viscosity, tPA and PAI-1 cannot be used as predictive markers in patients with bilateral (B/L) primary varicose veins/reticular veins. Serum fibrinogen levels can be used as predictive markers for the development of B/L primary varicose veins and in our particular study with a predictive range of 189.4–327.9 mg/dL but not for B/L reticular veins. Prolonged standing, irrespective of the occupation of the patient, is associated with the development of B/L reticular veins and B/L varicose veins.\u0000","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"149 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vinayak Pai, Pramod Gite, Kavita Joshi, Alhad Mulkalwar, Vikram Kate
Hematological malignancies place a significant financial and medical burden on the affected patients. Well-equipped oncology centers providing healthcare for these patients are also sparse. By studying the epidemiology of those diagnosed with hematological malignancies, it can be correlated with the outcomes and compared with global and national trends. This will allow healthcare decision-makers at all levels to make informed decisions, while allocating resources to combat hematological malignancies. This study is aimed at understanding the pattern of various hematological malignancies presenting at a tertiary care center including their clinical profile, risk factors, etiology and presentation. This was an observational prospective study conducted in King Edward Memorial Hospital, Mumbai, India. Patients aged 12 years and above suffering from hematological malignancies were recruited from the medical wards. The history and systemic examination findings were recorded from patients’ records. The patients were treated as per the discretion of the treating physician and all investigations advised by the treating physician were noted in the respective case record forms. The maximum cases were from the age group 36–50 years, i.e., 32 in number (40%), followed by the age group 51–65 years (25%). A greater number of male patients were encountered than female ones (67.5% vs 32.5%). Most of the patients were unskilled laborers followed by semi-skilled workers. Pesticide exposure was the commonest etiological factor reported in 16 (20%) patients, followed by exposure to silica that was reported in nine patients (11.25%). The common age group to encounter hematological malignancies in patients is 36–50 years, being more prevalent among males. History of exposure to risk factors such as pesticides is commonly seen. Factors such as age and family history do not correlate with the outcome. Females tend to have a better outcome than males.
{"title":"A Study to Assess the Burden of Hematological Malignancies at a Tertiary Care Center","authors":"Vinayak Pai, Pramod Gite, Kavita Joshi, Alhad Mulkalwar, Vikram Kate","doi":"10.25259/ijrsms_13_2023","DOIUrl":"https://doi.org/10.25259/ijrsms_13_2023","url":null,"abstract":"\u0000\u0000Hematological malignancies place a significant financial and medical burden on the affected patients. Well-equipped oncology centers providing healthcare for these patients are also sparse. By studying the epidemiology of those diagnosed with hematological malignancies, it can be correlated with the outcomes and compared with global and national trends. This will allow healthcare decision-makers at all levels to make informed decisions, while allocating resources to combat hematological malignancies. This study is aimed at understanding the pattern of various hematological malignancies presenting at a tertiary care center including their clinical profile, risk factors, etiology and presentation.\u0000\u0000\u0000\u0000This was an observational prospective study conducted in King Edward Memorial Hospital, Mumbai, India. Patients aged 12 years and above suffering from hematological malignancies were recruited from the medical wards. The history and systemic examination findings were recorded from patients’ records. The patients were treated as per the discretion of the treating physician and all investigations advised by the treating physician were noted in the respective case record forms.\u0000\u0000\u0000\u0000The maximum cases were from the age group 36–50 years, i.e., 32 in number (40%), followed by the age group 51–65 years (25%). A greater number of male patients were encountered than female ones (67.5% vs 32.5%). Most of the patients were unskilled laborers followed by semi-skilled workers. Pesticide exposure was the commonest etiological factor reported in 16 (20%) patients, followed by exposure to silica that was reported in nine patients (11.25%).\u0000\u0000\u0000\u0000The common age group to encounter hematological malignancies in patients is 36–50 years, being more prevalent among males. History of exposure to risk factors such as pesticides is commonly seen. Factors such as age and family history do not correlate with the outcome. Females tend to have a better outcome than males.\u0000","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"18 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139782978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vinayak Pai, Pramod Gite, Kavita Joshi, Alhad Mulkalwar, Vikram Kate
Hematological malignancies place a significant financial and medical burden on the affected patients. Well-equipped oncology centers providing healthcare for these patients are also sparse. By studying the epidemiology of those diagnosed with hematological malignancies, it can be correlated with the outcomes and compared with global and national trends. This will allow healthcare decision-makers at all levels to make informed decisions, while allocating resources to combat hematological malignancies. This study is aimed at understanding the pattern of various hematological malignancies presenting at a tertiary care center including their clinical profile, risk factors, etiology and presentation. This was an observational prospective study conducted in King Edward Memorial Hospital, Mumbai, India. Patients aged 12 years and above suffering from hematological malignancies were recruited from the medical wards. The history and systemic examination findings were recorded from patients’ records. The patients were treated as per the discretion of the treating physician and all investigations advised by the treating physician were noted in the respective case record forms. The maximum cases were from the age group 36–50 years, i.e., 32 in number (40%), followed by the age group 51–65 years (25%). A greater number of male patients were encountered than female ones (67.5% vs 32.5%). Most of the patients were unskilled laborers followed by semi-skilled workers. Pesticide exposure was the commonest etiological factor reported in 16 (20%) patients, followed by exposure to silica that was reported in nine patients (11.25%). The common age group to encounter hematological malignancies in patients is 36–50 years, being more prevalent among males. History of exposure to risk factors such as pesticides is commonly seen. Factors such as age and family history do not correlate with the outcome. Females tend to have a better outcome than males.
{"title":"A Study to Assess the Burden of Hematological Malignancies at a Tertiary Care Center","authors":"Vinayak Pai, Pramod Gite, Kavita Joshi, Alhad Mulkalwar, Vikram Kate","doi":"10.25259/ijrsms_13_2023","DOIUrl":"https://doi.org/10.25259/ijrsms_13_2023","url":null,"abstract":"\u0000\u0000Hematological malignancies place a significant financial and medical burden on the affected patients. Well-equipped oncology centers providing healthcare for these patients are also sparse. By studying the epidemiology of those diagnosed with hematological malignancies, it can be correlated with the outcomes and compared with global and national trends. This will allow healthcare decision-makers at all levels to make informed decisions, while allocating resources to combat hematological malignancies. This study is aimed at understanding the pattern of various hematological malignancies presenting at a tertiary care center including their clinical profile, risk factors, etiology and presentation.\u0000\u0000\u0000\u0000This was an observational prospective study conducted in King Edward Memorial Hospital, Mumbai, India. Patients aged 12 years and above suffering from hematological malignancies were recruited from the medical wards. The history and systemic examination findings were recorded from patients’ records. The patients were treated as per the discretion of the treating physician and all investigations advised by the treating physician were noted in the respective case record forms.\u0000\u0000\u0000\u0000The maximum cases were from the age group 36–50 years, i.e., 32 in number (40%), followed by the age group 51–65 years (25%). A greater number of male patients were encountered than female ones (67.5% vs 32.5%). Most of the patients were unskilled laborers followed by semi-skilled workers. Pesticide exposure was the commonest etiological factor reported in 16 (20%) patients, followed by exposure to silica that was reported in nine patients (11.25%).\u0000\u0000\u0000\u0000The common age group to encounter hematological malignancies in patients is 36–50 years, being more prevalent among males. History of exposure to risk factors such as pesticides is commonly seen. Factors such as age and family history do not correlate with the outcome. Females tend to have a better outcome than males.\u0000","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"136 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139842762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adel Khalifa Hamad, Tarique Shahzad Chachar, Ali J Al Hashli, Babur Ikram, Khalifa Abdulrahman Yousif, Manar Al Suwaidi, Habib Al Tareif, Zaid Arekat, Abdulwahab Al Khalifa
Arrhythmias are a common complication following cardiac surgery, and can significantly affect patients’ outcomes. In some cases, post-operative arrhythmias may lead to hemodynamic instability, congestive heart failure, or even sudden cardiac death. Various types of cardiac surgery result in varying rates of post-operative arrhythmias, with more complex procedures causing higher rates. Risk factors for post-operative arrhythmias include advanced age, pre-existing cardiovascular disease, electrolyte imbalances, and the type of cardiac surgery. In this study, we aim to determine the incidence and demographic characteristics of patients who underwent cardiac surgery from November 15, 2020, till November 30, 2021, in a tertiary center in the Kingdom of Bahrain. All adult patients (18 years or older) who were booked for cardiac surgery during the study period were included. Patients with pre-existing documented arrhythmias were excluded from the study. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, and mortality. Descriptive statistics was used to analyze the data, including frequency distributions, means, and standard deviations. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, length of hospital stay, and mortality. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, length of hospital stay, and mortality. A total of 161 patients were enrolled in the study with a mean age of 56.75 ± 1.68 years. Among the total enrolled population, 68.32% were male and 31.68% were female. The majority of patients (61.49%) had undergone urgent surgery. Approximately, half (49.07%) of the patients had coronary artery bypass surgery. Premature ventricular complexes (PVC), atrial fibrillation (AF), junctional rhythm, heart block, and atrial flutter were reported in 30.43%, 29.19%, 11.18%, 9.31%, and 8.07% of patient populations respectively. Pleural effusion (50.31%) and bleeding (19.25%) were common post-surgery complications observed among the patients. The mean oxygen saturation (sO2) of the patients on the day of arrhythmia was 95.67 ± 2.05%. Epinephrine/norepinephrine (71.43%) was the most used inotropic agent used after cardiac surgery. Cardiac surgery is associated with various arrhythmias. The two most common arrhythmias observed in patients after cardiac surgery are premature ventricular contractions and atrial fibrillation.
{"title":"Incidence and Demographic Characteristics of Patients with Post Cardiac Surgery Arrhythmias: A Single Center Retrospective Study","authors":"Adel Khalifa Hamad, Tarique Shahzad Chachar, Ali J Al Hashli, Babur Ikram, Khalifa Abdulrahman Yousif, Manar Al Suwaidi, Habib Al Tareif, Zaid Arekat, Abdulwahab Al Khalifa","doi":"10.25259/ijrsms_30_2023","DOIUrl":"https://doi.org/10.25259/ijrsms_30_2023","url":null,"abstract":"\u0000\u0000Arrhythmias are a common complication following cardiac surgery, and can significantly affect patients’ outcomes. In some cases, post-operative arrhythmias may lead to hemodynamic instability, congestive heart failure, or even sudden cardiac death. Various types of cardiac surgery result in varying rates of post-operative arrhythmias, with more complex procedures causing higher rates. Risk factors for post-operative arrhythmias include advanced age, pre-existing cardiovascular disease, electrolyte imbalances, and the type of cardiac surgery. In this study, we aim to determine the incidence and demographic characteristics of patients who underwent cardiac surgery from November 15, 2020, till November 30, 2021, in a tertiary center in the Kingdom of Bahrain.\u0000\u0000\u0000\u0000All adult patients (18 years or older) who were booked for cardiac surgery during the study period were included. Patients with pre-existing documented arrhythmias were excluded from the study. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, and mortality. Descriptive statistics was used to analyze the data, including frequency distributions, means, and standard deviations. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, length of hospital stay, and mortality. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, length of hospital stay, and mortality.\u0000\u0000\u0000\u0000A total of 161 patients were enrolled in the study with a mean age of 56.75 ± 1.68 years. Among the total enrolled population, 68.32% were male and 31.68% were female. The majority of patients (61.49%) had undergone urgent surgery. Approximately, half (49.07%) of the patients had coronary artery bypass surgery. Premature ventricular complexes (PVC), atrial fibrillation (AF), junctional rhythm, heart block, and atrial flutter were reported in 30.43%, 29.19%, 11.18%, 9.31%, and 8.07% of patient populations respectively. Pleural effusion (50.31%) and bleeding (19.25%) were common post-surgery complications observed among the patients. The mean oxygen saturation (sO2) of the patients on the day of arrhythmia was 95.67 ± 2.05%. Epinephrine/norepinephrine (71.43%) was the most used inotropic agent used after cardiac surgery.\u0000\u0000\u0000\u0000Cardiac surgery is associated with various arrhythmias. The two most common arrhythmias observed in patients after cardiac surgery are premature ventricular contractions and atrial fibrillation.\u0000","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139860171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adel Khalifa Hamad, Tarique Shahzad Chachar, Ali J Al Hashli, Babur Ikram, Khalifa Abdulrahman Yousif, Manar Al Suwaidi, Habib Al Tareif, Zaid Arekat, Abdulwahab Al Khalifa
Arrhythmias are a common complication following cardiac surgery, and can significantly affect patients’ outcomes. In some cases, post-operative arrhythmias may lead to hemodynamic instability, congestive heart failure, or even sudden cardiac death. Various types of cardiac surgery result in varying rates of post-operative arrhythmias, with more complex procedures causing higher rates. Risk factors for post-operative arrhythmias include advanced age, pre-existing cardiovascular disease, electrolyte imbalances, and the type of cardiac surgery. In this study, we aim to determine the incidence and demographic characteristics of patients who underwent cardiac surgery from November 15, 2020, till November 30, 2021, in a tertiary center in the Kingdom of Bahrain. All adult patients (18 years or older) who were booked for cardiac surgery during the study period were included. Patients with pre-existing documented arrhythmias were excluded from the study. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, and mortality. Descriptive statistics was used to analyze the data, including frequency distributions, means, and standard deviations. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, length of hospital stay, and mortality. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, length of hospital stay, and mortality. A total of 161 patients were enrolled in the study with a mean age of 56.75 ± 1.68 years. Among the total enrolled population, 68.32% were male and 31.68% were female. The majority of patients (61.49%) had undergone urgent surgery. Approximately, half (49.07%) of the patients had coronary artery bypass surgery. Premature ventricular complexes (PVC), atrial fibrillation (AF), junctional rhythm, heart block, and atrial flutter were reported in 30.43%, 29.19%, 11.18%, 9.31%, and 8.07% of patient populations respectively. Pleural effusion (50.31%) and bleeding (19.25%) were common post-surgery complications observed among the patients. The mean oxygen saturation (sO2) of the patients on the day of arrhythmia was 95.67 ± 2.05%. Epinephrine/norepinephrine (71.43%) was the most used inotropic agent used after cardiac surgery. Cardiac surgery is associated with various arrhythmias. The two most common arrhythmias observed in patients after cardiac surgery are premature ventricular contractions and atrial fibrillation.
{"title":"Incidence and Demographic Characteristics of Patients with Post Cardiac Surgery Arrhythmias: A Single Center Retrospective Study","authors":"Adel Khalifa Hamad, Tarique Shahzad Chachar, Ali J Al Hashli, Babur Ikram, Khalifa Abdulrahman Yousif, Manar Al Suwaidi, Habib Al Tareif, Zaid Arekat, Abdulwahab Al Khalifa","doi":"10.25259/ijrsms_30_2023","DOIUrl":"https://doi.org/10.25259/ijrsms_30_2023","url":null,"abstract":"\u0000\u0000Arrhythmias are a common complication following cardiac surgery, and can significantly affect patients’ outcomes. In some cases, post-operative arrhythmias may lead to hemodynamic instability, congestive heart failure, or even sudden cardiac death. Various types of cardiac surgery result in varying rates of post-operative arrhythmias, with more complex procedures causing higher rates. Risk factors for post-operative arrhythmias include advanced age, pre-existing cardiovascular disease, electrolyte imbalances, and the type of cardiac surgery. In this study, we aim to determine the incidence and demographic characteristics of patients who underwent cardiac surgery from November 15, 2020, till November 30, 2021, in a tertiary center in the Kingdom of Bahrain.\u0000\u0000\u0000\u0000All adult patients (18 years or older) who were booked for cardiac surgery during the study period were included. Patients with pre-existing documented arrhythmias were excluded from the study. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, and mortality. Descriptive statistics was used to analyze the data, including frequency distributions, means, and standard deviations. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, length of hospital stay, and mortality. Data was collected from patients’ clinical notes including demographic information (age, sex, and nationality), medical history, comorbidities, type of cardiac surgery, laboratory investigations, length of hospital stay, and mortality.\u0000\u0000\u0000\u0000A total of 161 patients were enrolled in the study with a mean age of 56.75 ± 1.68 years. Among the total enrolled population, 68.32% were male and 31.68% were female. The majority of patients (61.49%) had undergone urgent surgery. Approximately, half (49.07%) of the patients had coronary artery bypass surgery. Premature ventricular complexes (PVC), atrial fibrillation (AF), junctional rhythm, heart block, and atrial flutter were reported in 30.43%, 29.19%, 11.18%, 9.31%, and 8.07% of patient populations respectively. Pleural effusion (50.31%) and bleeding (19.25%) were common post-surgery complications observed among the patients. The mean oxygen saturation (sO2) of the patients on the day of arrhythmia was 95.67 ± 2.05%. Epinephrine/norepinephrine (71.43%) was the most used inotropic agent used after cardiac surgery.\u0000\u0000\u0000\u0000Cardiac surgery is associated with various arrhythmias. The two most common arrhythmias observed in patients after cardiac surgery are premature ventricular contractions and atrial fibrillation.\u0000","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"26 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139800289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Varicose veins are defined as dilated, tortuous and elongated veins in the lower limbs. Being one of the most common chronic vascular disorders of the lower limb, the varicose veins affect approximately 10% of the population. If left untreated, the patient may end up with complications like ulceration. The present study is aimed at evaluating the demography, risk factors, clinical features and management of varicose vein patients attending the Department of General Surgery at a tertiary care hospital. This is a prospective observational study conducted at a tertiary care hospital involving patients with lower limb varicose veins. Demographic factors like age, gender, etiology, clinical features, site of incompetence, type of surgical procedure and postoperative complications were studied. Out of 74 patients, majority of them (47.2%) were between 41 and 50 years of age, with a predominance of males (51 cases). Analysis of the history of the patients showed that many were chronic alcoholics (72.9%) and chronic smokers (66.2%). Nearly, 91.8% of them presented with visible dilated veins and pain (60.8%) in the affected limb. The long saphenous vein was greatly involved, and majority of them were managed by saphenofemoral flush ligation + subfascial ligation of perforators (SFFL + SFLP) with minimal postoperative complications. Varicosity of the veins of the lower limb is common in patients with long-standing jobs, chronic alcoholics and smokers. Involvement of the long saphenous vein is observed in majority of the patients. Duplex ultrasound is the most sensitive diagnostic procedure and surgery is the primary modality of the treatment.
{"title":"Clinical Evaluation and Management of Varicose Veins of Lower Limb at a Tertiary Care Hospital in India","authors":"C. Shrikanth, Pradeep Tenginkai, Santosh Nayak K","doi":"10.25259/ijrsms_9_2023","DOIUrl":"https://doi.org/10.25259/ijrsms_9_2023","url":null,"abstract":"\u0000\u0000Varicose veins are defined as dilated, tortuous and elongated veins in the lower limbs. Being one of the most common chronic vascular disorders of the lower limb, the varicose veins affect approximately 10% of the population. If left untreated, the patient may end up with complications like ulceration. The present study is aimed at evaluating the demography, risk factors, clinical features and management of varicose vein patients attending the Department of General Surgery at a tertiary care hospital.\u0000\u0000\u0000\u0000This is a prospective observational study conducted at a tertiary care hospital involving patients with lower limb varicose veins. Demographic factors like age, gender, etiology, clinical features, site of incompetence, type of surgical procedure and postoperative complications were studied.\u0000\u0000\u0000\u0000Out of 74 patients, majority of them (47.2%) were between 41 and 50 years of age, with a predominance of males (51 cases). Analysis of the history of the patients showed that many were chronic alcoholics (72.9%) and chronic smokers (66.2%). Nearly, 91.8% of them presented with visible dilated veins and pain (60.8%) in the affected limb. The long saphenous vein was greatly involved, and majority of them were managed by saphenofemoral flush ligation + subfascial ligation of perforators (SFFL + SFLP) with minimal postoperative complications.\u0000\u0000\u0000\u0000Varicosity of the veins of the lower limb is common in patients with long-standing jobs, chronic alcoholics and smokers. Involvement of the long saphenous vein is observed in majority of the patients. Duplex ultrasound is the most sensitive diagnostic procedure and surgery is the primary modality of the treatment.\u0000","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"25 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139608257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-20DOI: 10.32457/ijmss.v10i3.2168
Jorge Fernando Miño–Bernal, Juan Santiago Serna Trejos, Stefanya Geraldine Bermúdez–Moyano
Introducción: Las quemaduras suponen la cuarta causa de trauma en todo el mundo, usualmente se asocian en gran parte a componente renal, generando un deterioro abrupto de la función renal manifestado en descenso de la tasa de filtrado glomerular como en el balance hídrico del paciente. Objetivo: Presentar una revisión narrativa sobre los aspectos relacionados con el abordaje fisiopatológico, diagnósticos y terapéutico en el paciente quemado con lesión renal aguda. Métodos: Revisión narrativa de artículos relevantes y destacados en el área del manejo del paciente quemado con lesión renal aguda, de diferentes bases de datos como Scopus, Medline, Embase y Google Scholar. Resultados: Los mecanismos fisiopatológicos que conducen al paciente quemado a generar lesión renal aguda han sido ampliamente descritos, asociados principalmente a procesos de rabdomiólisis asociado a condiciones agudas como hipovolemia, entre otras. Conclusiones: Un abordaje optimo en el paciente quemado con compromiso renal agudo, puede mejorar la tasa de sobrevida y rehabilitación de la función renal del paciente, previniendo desenlaces fatales, aumentando la sobrevida de pacientes y las complicaciones asociadas a la misma.
{"title":"Acute kidney injury in the burn patient","authors":"Jorge Fernando Miño–Bernal, Juan Santiago Serna Trejos, Stefanya Geraldine Bermúdez–Moyano","doi":"10.32457/ijmss.v10i3.2168","DOIUrl":"https://doi.org/10.32457/ijmss.v10i3.2168","url":null,"abstract":"Introducción: Las quemaduras suponen la cuarta causa de trauma en todo el mundo, usualmente se asocian en gran parte a componente renal, generando un deterioro abrupto de la función renal manifestado en descenso de la tasa de filtrado glomerular como en el balance hídrico del paciente. Objetivo: Presentar una revisión narrativa sobre los aspectos relacionados con el abordaje fisiopatológico, diagnósticos y terapéutico en el paciente quemado con lesión renal aguda. Métodos: Revisión narrativa de artículos relevantes y destacados en el área del manejo del paciente quemado con lesión renal aguda, de diferentes bases de datos como Scopus, Medline, Embase y Google Scholar. Resultados: Los mecanismos fisiopatológicos que conducen al paciente quemado a generar lesión renal aguda han sido ampliamente descritos, asociados principalmente a procesos de rabdomiólisis asociado a condiciones agudas como hipovolemia, entre otras. Conclusiones: Un abordaje optimo en el paciente quemado con compromiso renal agudo, puede mejorar la tasa de sobrevida y rehabilitación de la función renal del paciente, previniendo desenlaces fatales, aumentando la sobrevida de pacientes y las complicaciones asociadas a la misma.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136313709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-20DOI: 10.32457/ijmss.v10i3.2273
Luis Alberto Corona Martínez, Iris González Morales, María Caridad Fragoso Marchante
The health importance of community-acquired pneumonia is an unquestionable fact given its relationship with hospital and overall mortality. The objective of the investigation was to evaluate the relationship between selected antimicrobials used in the initial treatment (amoxicillin/sulbactam, cefuroxime, ceftriaxone and cefotaxime) and mortality from pneumonia. An observational study was carried out, with a descriptive design and a population of 1,809 patients with pneumonia hospitalized between 2012 and 2019; the necessary information was obtained from the clinical history. Statistical processing was performed using bivariate and multivariate analysis (logistic regression); the ratio of cross products (odds ratio) and its 95% confidence interval were used as a statistician. Among the results, the following stand out: significantly higher lethality values were found in those treated with cefotaxime (33%) than in those who received amoxicillin/sulbactam (24%, OR 1.6[1.0001;2.6]), as well as in those treated with ceftriaxone (30%) compared with those treated with amoxicillin/sulbactam (24%, OR 1.3[1.05;1.8]) and with cefuroxime (24%, OR 1.3[1.04;1.7]). A higher frequency of patients with extensive pneumonia, of patients in a critical state on admission, and of bedridden occurrence during hospitalization were identified in those treated with cefotaxime. In patients with “moderate pneumonia and high probability of unfavorable outcome”, treatment with ceftriaxone or cefotaxime was associated with death; as well as ceftriaxone treatment for all subjects. It is concluded that the initial treatment with amoxicillin/ sulbactam or cefuroxime was more favorable than the use of third generation cephalosporins. Also in the global analysis, the absence of differences in lethality between those treated with amoxicillin/sulbactam and with cefuroxime was recognized.
{"title":"Initial antimicrobial therapy and case fatality in patients with community-acquired pneumonia","authors":"Luis Alberto Corona Martínez, Iris González Morales, María Caridad Fragoso Marchante","doi":"10.32457/ijmss.v10i3.2273","DOIUrl":"https://doi.org/10.32457/ijmss.v10i3.2273","url":null,"abstract":"The health importance of community-acquired pneumonia is an unquestionable fact given its relationship with hospital and overall mortality. The objective of the investigation was to evaluate the relationship between selected antimicrobials used in the initial treatment (amoxicillin/sulbactam, cefuroxime, ceftriaxone and cefotaxime) and mortality from pneumonia. An observational study was carried out, with a descriptive design and a population of 1,809 patients with pneumonia hospitalized between 2012 and 2019; the necessary information was obtained from the clinical history. Statistical processing was performed using bivariate and multivariate analysis (logistic regression); the ratio of cross products (odds ratio) and its 95% confidence interval were used as a statistician. Among the results, the following stand out: significantly higher lethality values were found in those treated with cefotaxime (33%) than in those who received amoxicillin/sulbactam (24%, OR 1.6[1.0001;2.6]), as well as in those treated with ceftriaxone (30%) compared with those treated with amoxicillin/sulbactam (24%, OR 1.3[1.05;1.8]) and with cefuroxime (24%, OR 1.3[1.04;1.7]). A higher frequency of patients with extensive pneumonia, of patients in a critical state on admission, and of bedridden occurrence during hospitalization were identified in those treated with cefotaxime. In patients with “moderate pneumonia and high probability of unfavorable outcome”, treatment with ceftriaxone or cefotaxime was associated with death; as well as ceftriaxone treatment for all subjects. It is concluded that the initial treatment with amoxicillin/ sulbactam or cefuroxime was more favorable than the use of third generation cephalosporins. Also in the global analysis, the absence of differences in lethality between those treated with amoxicillin/sulbactam and with cefuroxime was recognized.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136313712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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