Do preoperative pulmonary function indices predict morbidity after coronary artery bypass surgery.

Context: The reported prevalence of chronic obstructive pulmonary disease (COPD) varies among different groups of cardiac surgical patients. Moreover, the prognostic value of preoperative COPD in outcome prediction is controversial. Aims: The present study assessed the morbidity in the different levels of COPD severity and the role of pulmonary function indices in predicting morbidity in patients undergoing coronary artery bypass graft (CABG). Settings and Design: Patients who were candidates for isolated CABG with cardiopulmonary bypass who were recruited for Tehran Heart Center-Coronary Outcome Measurement Study. Methods: Based on spirometry findings, diagnosis of COPD was considered based on Global Initiative for Chronic Obstructive Lung Disease category as forced expiratory volume in 1 s [FEV1]/forced vital capacity <0.7 (absolute value, not the percentage of the predicted). Society of Thoracic Surgeons (STS) definition was used for determining COPD severity and the patients were divided into three groups: Control group (FEV1 >75% predicted), mild (FEV1 60–75% predicted), moderate (FEV1 50–59% predicted), severe (FEV1<50% predicted). The preoperative pulmonary function indices were assessed as predictors, and postoperative morbidity was considered the surgical outcome. Results: This study included 566 consecutive patients. Patients with and without COPD were similar regarding baseline characteristics and clinical data. Hypertension, recent myocardial infarction, and low ejection fraction were higher in patients with different degrees of COPD than the control group while male gender was more frequent in control patients than the others. Restrictive lung disease and current cigarette smoking did not have any significant impact on postoperative complications. We found a borderline P = 0.057 with respect to respiratory failure among different patients of COPD severity so that 14.1% patients in control group, 23.5% in mild, 23.4% in moderate, and 21.9% in severe COPD categories developed respiratory failure after CABG surgery. Conclusion: Among post-CABG complications, patients with different levels of COPD based on STS definition, more frequently developed respiratory failure. This finding may imply the prognostic value of preoperative pulmonary function test for determining COPD severity and postoperative morbidities.

Post-operative Morbidities Associated with Oral Cavity Carcinoma: A Retrospective Review.

Oral carcinomas have been one of the main causes of mortality and morbidity. Tobacco chewing and cigarette smoking being the most common etiological factors management of these oral cavity cancers must take into account many factors; T1 lesions can be effectively removed using surgical removal, laser destruction or radiation therapy, while hallmark for intermediate stage oral cavity cancers is combined surgical resection with reconstruction and post-operative adjuvant radiation therapy. Treatment of these carcinomas adversely affects oral competence, ability to speech and deglutition, patient specific factors such as strong support system and patient independence must be considered, thus in this article we would review the morbidities-related post-operatively to the oral carcinomas.

Morbidity Profile of Pre-School Children in an Urban Slum Area.

Background : Pre-school morbidity is an important index of the health status of a community. The high degree of morbidity amongst this age group in India is a common occurrence. Objectives : To study burden of illness and etiology of morbidity in pre-school children (0-5 year). Material & Methods : Cross sectional study for 4 months in an urban slum area of Visakhapatnam. Clinical examination of the children in age-group 0-5 years along with interviews of their parents were done in a house-to-house survey. Results: Morbidity was found in 146 out of the total 353 children. The male-female ratio of morbid children was 1.5: 1. Communicable diseases were found in 82% while non-communicable diseases like PEM and anaemia was a finding in about 18%. Conclusions : Communicable diseases were commoner cause of morbidity in the pre-school children. The conditions associated with morbidity were younger age, poor socioeconomic conditions, low birth weight & increasing birth-order.

Causes of Neonatal Admissions and Deaths at a Rural Hospital in Kwazulu-Natal; South Africa

One of the Millennium Development Goals (MDG-4) is to reduce child mortality by up to two-thirds by 2015. In most developing countries; a higher proportion of neonatal deaths are observed. We quantify the causes of neonatal morbidity and mortality at a rural hospital. A retrospective review of consecutive neonatal admissions to Empangeni Hospital; between January and December 2005; was conducted. Of 1;573 admissions; male babies made up 57.8 of admissions and 63 of the deaths. The most common causes of admission were birth asphyxia (38.2); prematurity (23.5); and infection (21). The average length of stay was 9.2 days (SD 12 days). The overall mortality rate was 13.8 but higher (23.4) among the referred babies. Admission and death rates of low birthweight babies ( 2;500g) were 53 and 84; respectively. Two-thirds (67.7) of those babies who died were born preterm. Over half (56.6) of the deaths took place within the first three days of life. Logistic regression showed that extremely low birthweight (OR