RESUMO
Introduction: Post-Tonsillectomy Hemorrhage [PTH] remains one of the commonest complications associated with tonsillectomies. Its incidence and risk factors vary widely in literature
Objective: To examine our local experience and assess the incidence of PTH in comparison to that in the literature and to identify factors that contribute in increasing the risk of PTH in our setup. Design: Retrospective study. Setting: Al-Sabah and Zain Hospital, MoH, Kuwait
Methods: A retrospective chart review was conducted on 2,038 patients who underwent tonsillectomy with or without adenoidectomy during a 12-month period [January to December 2010] in Zain and Al Sabah hospitals. Details regarding the patients' age, gender, surgical technique, and level of the operating surgeon were recorded in order to assess any correlation. Intervention: Tonsillectomy. Main Outcome Measure: Incidence of PTH
Results: Out of the 2,038 patients included in this study, a total of 98 patients [4.8%] developed PTH. Thirty-one patients [31.6%] who developed PTH were above the age of 26 years. Out of the 98 patients [4.8%] who developed PTH, 63 patients [64.3%] were male. 'Hot' dissection technique was associated with higher incidence of PTH [71 patients; 72.4%] in comparison to the 'cold' dissection [27 patients; 27.5%]
Conclusion: The incidence of PTH in our institution is 4.8%, which is comparable with that reported in the literature, ranging between 1.5% and 6.68%. Male patients, increasing age and 'Hot' dissection technique were all identified as risk factors for PTH in our setup
RESUMO
The use of certain medications in acute myocardial infarction [AMI] is known to lower morbidity and mortality. We aimed to evaluate, through the use of performance measures, the implementation of specific guidelines-recommended pharmacotherapy in the management of AMI in patients living in the Arabian Peninsula. The Gulf Registry of Acute Coronary Events [Gulf RACE] enrolled ACS patients from 6 countries in the Arabian Peninsula. We examined the use of 7 performance measures that relate to the management of ST-segment elevation myocardial infarction [STEMI] and non-ST-segment elevation myocardial infarction [NSTEMI]. 5833 AMI patients were enrolled in Gulf RACE. In the first 24 hours of hospital arrival, 5713 [98%] patients were administered aspirin. The prescription rate at discharge was 5376 [97%] for aspirin, 4354 [78%] for beta-blockers, 5639 [84%] for statins and 3145 [57%] for clopidogrel. Left ventricular systolic function [LVSF] was evaluated in 3861 [66%] patients. Of those who had ejection fraction < 40% [921 patients], 725 [85%] received angiotensin converting enzyme inhibitor [ACEI] or angiotensin receptor blocker [ARB] at discharge. There was good adherence to guidelines-recommended medications in patients admitted to hospital with a diagnosis of AMI. The implementation of more performance measures need to be evaluated in order to assess the full picture of AMI management in this part of the world