The impact of routine preoperative electrocardiogram in patients age > or = 40 years in Srinagarind Hospital.

A 12 lead electrocardiogram (ECG) has been recommended for adult patients before operations involving general or regional anesthesia. However, there is a growing consensus that it is of little benefit and ECG should be done only in selected subsets of patients with cardiac signs and symptoms or older patients. We prospectively surveyed 1,013 patients before operation, 395 patients were 40 years or more, ECG abnormalities were present in 130/395 (32.9%), significant ECG abnormalities in 31/395 (7.9%) and ECG with management change in 10/395 (2.5%). Old or questionable myocardial infarction were found in 8 (4.0%) and acute ischemia or injury in 4 (2.0%). The frequency of ECG abnormalities increased with age in males but not in females. Abnormal physical examination could predict only 20 per cent of abnormal ECG. The variables which could predict ECG abnormalities were age and irregular pulse. The frequency of ECG abnormalities, significant ECG abnormalities and ECG abnormalities which led to management change in those patients with normal physical examination were 31.7, 6.4 and 2.2 per cent respectively. In conclusion we propose that preoperative ECG may be indicated in both men and women aged > or = 40 years.

Causes of blindness and restoration of sight for the students in the School for the Blind, Khon Kaen.

One hundred and twenty-seven students from the School for the Blind, Khon Kaen, were seen between August 1984 and December 1987. There were 92 males (72.4%) and 35 females (27.6%). The age ranged from 3 to 19 years with the predominant age group being 6-15 years. The majority of the students (95.3%) resided in the Northeast. Only 26 students (20.5%) had positive family histories. Blindness caused by lesions affecting the whole eye was the leading cause of blindness (36.2%). About half of the cases of blindness were preventable and treatable. Most of them (58.3%) were second grade blind. Of all the students seen, 26 students (20.5%) were subjected to treatment for restoration of sight. Only 19 students had complete follow-up post-operative vision. The average visual improvement after treatment was forty-two per cent. The category of blindness was changed to the better side. Blindness was decreased. Visual impairment increased 36.8 per cent after treatment.