ABSTRACT
Objective: Postoperative atrial fibrillation (POAF) is an arrhythmia most commonly seen after cardiac surgery. Its association with increased mortality, cost and adverse events has made it crucial to identify those at risk and to prevent POAF through preoperative therapy. In order to do that, we have studied the utilization and predictive power of the CHA2DS2-VASc score, and the relationship between other factors such as preoperative medications and patient clinical characteristics. Methods: A retrospective observational study was conducted by reviewing medical charts for patients who underwent coronary arteries bypass grafting (CABG) with or without aortic valve replacement or mitral valve/tricuspid valve repair and aged >18 years. Patients with a preoperative history of atrial fibrillation (AF) or flutter, patients with a pacemaker, patients with prior antiarrhythmic drugs use within the last 6 months, patients who underwent MAZE procedures, or patients with mechanical mitral valve were excluded. Results: At a cut-off score of ≥ 2 the CHA2DS2-VASc showed a 96.8% sensitivity and 23.1% specificity for predicting POAF. It also showed an increased risk at higher scores, a score of at least 3 significantly predicted the occurrence of events (p<0.000). Age, male gender, high BMI were significant predictors of POAF (p<0.001, p<0.05, p<0.001). Patients who received statins preoperatively were at significant lower risk (p<0.001). Conclusion: The CHA2DS2-VASc score is a strong predictor of adverse events postoperatively.
ABSTRACT
Traumatic brain injury following head injury is a major public health problem that can result in significant long-term morbidity and mortality among adults and children worldwide. Emergency brain imaging is necessary for individuals subjected to traumatic brain injury to early detect treatable conditions. Prompt neurosurgical management of treatable conditions can prevent further damage and secondary neurological deficits. This will subsequently improve the outcome and reduce long-term disability. Computed Tomography (CT) of the brain is the investigation of choice for assessment of patients with head injury due to its availability, advantages, and sensitivity for multiple lesions following head trauma. This article will review and discuss the importance of CT imaging in evaluating patients with traumatic brain injury, its advantages, limitations, and prognostic values
ABSTRACT
Background & Objectives: Preoperative hand preparation with a brush-less method is almost a common practice. The aim of this study was to compare the efficacy of brushless preoperative hand preparation using alcohol to antiseptic soap, and non-medicated soap in eliminating germs by standard proper pre-operative hand preparation. Methods: Twenty volunteers tried three different ways of surgical hand preparation with antiseptic soap, alcohol, and non-medicated soap-based preoperative hand preparation. Results: There was no positive bacterial growth sample in the alcohol-based scrubbing group while it was 2% with positive bacterial growth in the antimicrobial soap and 55% with positive bacterial growth in the non-medicated soap group. Conclusion: The alcohol-based pre-operative hand preparation was significantly more efficient than both the antimicrobial soap and the non-medicated soap.