Résumé
Objectives: To evaluate the frequency of early remodeling in patients of severe aortic regurgitation after aortic valve replacement and to see the incidence of early remodeling in patients with stroke volume >97 ml versus < 97 ml before aortic valve replacement
Method: This was a prospective comparative study conducted from August 2013 to December 2014 in a tertiary care hospital. Fifty seven [57] patients of isolated chronic aortic regurgitation were included in this study. SPSS v23 was used for data analysis. Independent sample t-test was used for analysis of continuous variables and chi-square test for qualitative variables
Results: Out of fifty seven patients, early remodeling occurred in 34 [59.64%] patients after surgery. The mean pre-operative stroke volume of patient in whom remodeling occurred was 110.3 +/- 9.66 ml while mean pre-operative stroke volume of patients who did not undergo remodeling was 86.65 +/- 7.63 ml. There were 28 [82.4%] patients with stroke volume >97 ml in whom Remodeling occurred where as in patients with stroke volume <97 ml remodeling occurred only in 6 [17.6%] patients [p value 0.004]. There was no inhospital mortality
Conclusion: There is an association between stroke volume and early LV remodeling after Aortic valve replacement. Stroke volume >97 ml is a good predictor of early LV remodeling
Résumé
A cross sectional study of the dietary services for patients in Combined Military Hospital Rawalpindi was conducted to assess the existing system in vogue to see if it is proper or not and what ways and means can be adopted for its improvements. Study parameters were established which included personnel involved in dietary services, diet schedules, entitlement of hospital dietary/hospital stoppages, procurement and transportation of food articles, central storage, delivery of food items to kitchens, state of kitchen, food handling personnel, preparation of food, distribution of food in the ward and existing system of evaluation of dietary services. Food standards were formulated in the light of available literature of WHO, US Health department and Pakistan Army regulations/instructions. The standards were compared with the findings obtained through questionnaire/interviews. It was found that no separate organizational structure of dietary services exists. The in charge of the dietary services was not a qualified dietician. All personnel involved in different stages of dietary services were also found untrained and unqualified. Job descriptions formulated in standing operating procedures of the hospital for the personnel of dietary services were not complete and comprehensive. Cooks for patients were deficient and there was no system of collection of meat, chicken and fish in proper boxes. There was no satisfactory arrangement of washing hands/toilet facility for cooks. The food distribution in the ward was not satisfactory and there was no system of reviewing/evaluation of dietary services
Résumé
The endogenous creatinine clearance was studied in 33 normal subjects and in 80 patients with different renal disorders including chronic renal failure, nephrotic syndrome and renal calculi. Creatinine clearance apparently increased with advancing age in normal subjects and in the patients with renal calculi upto fourth decade after which it followed a gradual decline, but these age related changes in creatinine clearance were not found to be significant statistically. No such age related pattern of variations in creatinine clearance was observed in patients with chronic renal failure and with nephrotic syndrome. In patients with renal calculi, the values of creatinine clearance were apparently higher as compared with the normal subjects for all the age groups. On the other hand in the patients with chronic renal failure, the values of creatinine clearance were considerably lower than those seen in the normal subjects of corresponding age groups. In patients with nephrotic syndrome, the creatinine clearance was found to be significantly low [P < 0.05] as compared with the normal subjects after the age of 20 years