ABSTRACT
OBJECTIVE: To determine the in-hospital outcome of Native Valve Endocarditis patients and associated complications
STUDY DESIGN, PLACE AND DURATION: Hospital based prospective study, Department of Cardiology, Liaquat University Hospital Hyderabad from July 2005 to December 2007
PATIENTS AND METHODS: 56 consecutive patients, who presented with fever, joint pain, dyspnoea, history of Rheumatic fever, previous history of IE, history of I/V drug abusiveness were studied by history, physical examination, 3 blood samples were taken and sent to the laboratory for culture and sensitivity. All patients were evaluated by Doppler echocardiography on day 1, at 14 day, at one month and on 6th week of treatment. Empiric treatment was started on admission and later adjusted according to culture and sensitivity. Descriptive and inferential statistical analysis was performed using SPSS version 16.0
RESULTS: Males out numbered females with ratio 37[66.1%] / 19[33.9%]. Definite vegetation was found in 40/56 [71.4%]; but definite culture positive cases were 30/56 [53.6%]. Complete improvement was seen in 32[57.1%], 08[14.3%] patients died during the course of treatment in hospital, 10[17.9%] were referred for surgery and 06[10.7%] patients developed recurrent episode of infective endocarditis. 13/56[23.2%] patients developed congestive heart failure, recurrent episodes of fever in 8[14.3%] and valvular regurgitation 6[10.7%] cases
CONCLUSION: Our study showed that native valve infective endocarditis is not un common
Early diagnosis and treatment can help in improving morbidity and mortality, overall outcome and can reduce devastating complications associated with infective endocarditis. Patients who require surgical intervention like large vegetations or abscess should be referred for surgery as early as possible to avoid further complications
ABSTRACT
Objective: to determine the causes of hypoglycemia in diabetics presenting at Liaquat University Hospital Hyderabad/Jamshoro
Study design: descriptive observational study
Place and duration: medical and Cardiology units of Liaquat University of Hospital Hyderabad Jamshoro, from June 2007 to May 2008
Patients and methods: one-hundred and one hypoglycemic cases were analyzed. A detailed enquiry about the presenting symptoms and mode of therapy was made. A thorough physical examination to look for diabetic complications and any concurrent illness was performed. Blood glucose was measured with the help of a Glucometer and response to glucose administration was also noted. Data were computed using SPSS software version 14. P-value up to 0.05 was considered significant
Results: type-2 diabetics presented more commonly with hypoglycemia in adult diabetic population 81/101 [80.1%]. Mean age for type-1 diabetics was 27.7 years and for type-2 diabetics 53.6 years. Male to female ratio was 3.3:1. Type-1 diabetic patients were either brittle diabetic with frequent dosage manipulations or those who had developed chronic complications. Majority of type-2 diabetics 74/81 [91.4%] were more than 40 years of age. Diabetic nephropathy, change in dose of hypoglycemic agents, missed meals, and use of concomitant medications were important associations with hypoglycemia in type 2 diabetic patients. All type-1 diabetics recovered completely after glucose administration. Amongst type 2 diabetics, 5 [6.41%] developed permanent disability and 6 [7.69%] patients died
Conclusion: the adult males having type 2 diabetes suffer more from this complication. Recognition of different causes of hypoglycemia in diabetes patients and prompt treatment of hypoglycemia is important to prevent complications. The reasons of developing hypoglycemia most of the times were on patient's hand
ABSTRACT
Objective: to compare morbidity, in hospital mortality and benefits of Streptokinase [SK] therapy and Non- Streptokinase [non-SK] therapy in acute myocardial infarction patients
Methods: retrospective review of the medical record of 300 patients with all types of acute MI admitted in our CCU between Nov. 2000-April 2001
Resutls: out of 300 patients, 210 [70%] were male and 90 [30%] were female. 150 [50%] were given SK therapy and 150 [50%] did not receive SK therapy because they did not qualify. Mean age was 55 years. The success of SK therapy was judged indirectly through non-invasive measures
Limitations: this data is from a hospital which does not have invasive or PCI facilities; hence it was totally dependent on non-invasive measures. However, this might help in patient management in our society where most hospitals/CCUs do not have invasive facilities
Conclusion: the overall survey shows that not only mortality was improved in SK group but also patients had less complications, early pain relief and shorter hospital stay. However, due to higher earlier event rate in SK group, these patients should preferably be referred to a facility having interventional support