The changing patterns of cardiac diseases in 4 hospital medical schools in 2 Decades.

A retrospective study of 1,293,843 in-patients of the medical schools Siriraj, Chulalongkorn, Ramathibodi and Chiangmai hospitals in the alternate years from 1969 to 1987 (covering almost two decades), according to ICU 8-9, reveals that the proportion to all in-patient admission of 1. all cardiac patient admissions has steadily increased; 2. all cardiac failure admissions has significantly increased, but those due to anaemia and thyroid disturbances are unchanged; 3. all congenital heart disease admissions remained unchanged from 1969 to 1979, but significantly increased thereafter; 4. hypertensive cardiovascular admissions has remained unchanged; 5. rheumatic heart disease admission has decreased; 6. cardiac infection admissions has remained unchanged, but non-infection cardiac inflammation admissions has increased; 7. ischemic heart disease admissions has increased; 8. cardiac beriberi admissions decreased from 1969 to 1979, and unchanged thereafter; 9. cor pulmonale admissions has increased; and 10. cardiomyopathy admissions has increased, particularly after 1977. This information will help in planning for admission and the budgets of hospital medical schools and medical centres. It will also be useful in the planning of preventing specifice heart diseases, such as ischemic heart disease, which is increasing rapidly in the general population.

Medical emergencies at Ramathibodi Hospital, Bangkok, and Maharaj Hospital, Nakorn Ratchasema.

This report is based on a retrospective analysis of 14;914 medical emergency patients at Ramathibodi Hospital and Maharaj Hospital, Nakorn Ratchasema during 1985. It was found that : 1. The commonest medical emergencies were gastrointestinal emergencies (22-31%), followed by emergencies of the respiratory system (15-21%), infections (12-17%), cardiovascular system (7-15%) and the nervous system (10-11%). The prevalence rates of the remaining systems were less than 6%, the majority being less than 2%. 2. The commonest medical emergencies in each system were 2.1 Gastrointestinal system : acute abdomen (44-5%), followed by serve diarrhoea and gastrointestinal haemorrhage. 2.2 Respiratory system : severe asthma (35-64%), followed by pneumonia and breathlessness. 2.3 Cardiovascular system : heart failure (38-54%), followed by angina and myocardial infarction, severe hypertension and cardiac arrhythmias. 2.4 Nervous system : stroke (37-47%) followed by encephalitis and meningitis, status epilepticus and severe headache. 2.5 Endocrine system : glycaemic crises (82-87%) 2.6 Haematological system : severe anaemia (64-83%). The differences in prevalence rates of the medical emergencies at Ramathibodi Hospital (Bangkok), Maharaj Hospital (Nakorn Ratchasima) and John Radcliffe Hospital (England) are discussed.