ABSTRACT
Background and Objectives: Atrial fibrillation (AF) is a frequently encountered cardiac arrhythmia which may be either symptomatic or asymptomatic. So, this study was conducted to know clinical presentation and to find out possible clinical and etiological profile of patients with AF.Material and Methods: This cross sectional study was conducted at Osh Regional Integrated Clinical Hospital, Osh Territorial City Clinical Hospital, The Kyrgyz Republic in collaboration with Janaki Medical College Teaching Hospital, Janakpurdham, Nepal. Sixty consecutive patients with AF were taken. Presenting complaints, past history, personal history was recorded. A thorough clinical examination was done, electrocardiogram, chest X-Ray posterio-anterior view, echocardiogram, thyroid function test and relevant test were done and analyzed.Results: Forty percent of the patients complained palpitation. Systemic thrombo-embolism was found in 15% of the patients. Other presenting complaints were cough, chest pain, shortness of breath, dizziness, swelling of the legs, tremors. Eighteen percent of patients presented with features of congestive cardiac failure and 30% of the patients gave history of rheumatic heart disease, 16.6% and 11.6% hypertension and ischemic heart disease respectively. Etiology-wise, rheumatic heart disease was the most common (46.6%) followed by hypertension (21.6%), ischemic heart disease (11.6%), dilated cardiomyopathy (6.6%), hyperthyroidism (5%), pneumonia (5%).Conclusion: Rheumatic heart disease, especially mitral stenosis is the most common cause of AF in this study. Systemic hypertension was next common etiology of AF, followed by ischaemic heart disease, dilated cardiomyopathy, thyroid disease. Heart failure, Systemic thromboembolism, decreased exercise tolerance are a major determinants for development of significant morbidity and mortality.
ABSTRACT
Background and Objectives: Envenomation by poisonous snakes is considered as an occupational hazard. Snake bite is a common medical emergency and one of the important causes of mortality and morbidity in tropical region.Material and Methods: The present study was conducted in the emergency department of JMCTH. All the patients admitted to JMCTH from April 2014 to November 2014 with snake bite were followed up from the time of admission to throughout their stay in hospital. The data was obtained from hospital case records, direct interrogation from relatives, friends, person accompanying the patients. The information was collected in a pre-formed Proforma. Data were entered and analyzed using Microsoft Excel.Results: The victims of snake bite predominantly were male. Maximum numbers of snake bite cases were between the age group of 31 to 40 yrs and of low socio-economic status. 67.34 % cases were from rural areas and farmers were the most common victim (69.38 %).Conclusion: Maximum cases occurred during the summer and pre-monsoon months, during daytime and involved the lower limbs. Ptosis was the chief neurotoxic feature followed by dysarthria.