The Effect of Preoperative Hematocrit Levels on Early Outcomes After Coronary Artery Bypass Graft.

Introduction Coronary artery bypass graft (CABG) is the most potent of surgical procedures; in this procedure, the narrowing of the coronary artery due to atherosclerotic plaque is bypassed by forming an alternate route for blood flow to the heart. There are various risk factors associated with the procedure. The aim of this study was to observe if postoperative outcomes are affected by preoperative hematocrit (hct) levels in patients. Methods  This longitudinal study was conducted from April 2019 to December 2019. Eighty-two (82) participants who were to undergo CABG surgery were divided into two groups based on their preoperative hct levels. Group 1 had 42 participants with lower levels of hct (less than 35.5% for women and 38.3% for men), whereas group 2 consisted of 40 participants with normal hct levels (greater than 35.5% for women and 38.3% for men). Results The results showed that participants undergoing CABG with lower than normal hct levels had increased blood loss through drainage as compared to participants who had normal hct levels (680.1 ± 301 mL vs. 500.7 ± 412 mL; p-value: 0.02). Group 1 participants also had an increased need for blood and blood product transfusion as compared to group 2 (3.2 ± 1.8 units vs. 1.8 ± 0.9 units; p-value: <0.0001). Furthermore, the participants in group 1 had longer stays in the ICU relative to the other group (5.2 ± 3.1 days vs. 3.4 ± 2.5 days; p-value: 0.003). Conclusion Based on our findings, patients who undergo CABG surgery with lower than normal hct levels are at increased risk of certain complications, including excessive blood loss, need for transfusion, and increased duration of ICU stay. Therefore, preoperative hct levels should be routinely checked in patients undergoing CABG to prevent these complications.

Frequency of Cardiovascular Manifestation in Patients With Hyperthyroidism.

Introduction Cardiovascular manifestations are very common in hyperthyroidism. Various cardiovascular symptoms such as palpitations, exercise intolerance, dyspnea, angina, edema, and congestive heart failure are commonly reported in hyperthyroidism. In this study, we determine the frequency of cardiovascular signs, symptoms, and various conduction disorders associated with hyperthyroidism. Methodology This cross-sectional, observational study was conducted in the cardiology department of a tertiary care hospital in Pakistan in close association with the internal medicine department from August 2019 to December 2019. A total of 100 hyperthyroid patients confirmed based on thyroid stimulating hormone (TSH, also known as thyrotropin), free T4 (FT4; thyroxine), and free T3 (FT3; triiodothyronine) were enrolled in the study. Results The most common cardiovascular symptom in this study was palpitations identified in 72% of the participants, followed by breathlessness in 41% of the participants. The most common cardiovascular sign was a pulse rate of more than 100 beats per minute found in 72% of the participants. The most common abnormality in electrocardiogram (ECG) was sinus tachycardia in 39% of the participants, followed by atrial fibrillation in 22% of the participants. In echocardiography, 5% of the participants had systolic dysfunction. Conclusion In this study, cardiovascular signs, symptoms, ECG, and echo changes were very frequent in hyperthyroidism. Management of hyperthyroidism should include routine ECG and echo testing, and cardiologists should be involved in thorough cardiovascular examination.

Comparison of the Prevalence of Erectile Dysfunction Between Hypertensive and Normotensive Participants: A Case-Control Study.

Introduction Hypertension is a very common risk factor for erectile dysfunction (ED). In recent time, changes in lifestyle has led to an increase in the prevalence of hypertension, which has increased the risk of ED. The purpose of this study is to assess the prevalence of ED in hypertensive patients and compare various domains of sexual activity between hypertensive and normotensive participants. Methods This case-control study was conducted in an outpatient department of a tertiary health care hospital in Pakistan from March 2019 to September 2019. Two hundred and twelve clinically diagnosed hypertensive patients were enrolled and were identified as case group. Control group consisted of 212 people, without any history of hypertension. Sexual function was assessed with the International Index of Erectile Function (IIEF). Results The prevalence of erectile dysfunction in hypertensive group was 61.79%, compared to 20.28% in normotensive group. Erectile weakness (OR = 4.32, CI 2.64-7.05), impaired morning erection (OR = 5.02, CI 2.98-8.47), complete erectile failure (OR = 2.32, CI 1.14-4.75), impaired spontaneous erection (OR = 5.45, CI 3.28-9.03), ejaculatory disturbances (OR = 5.20, CI 2.96-9.12) and reduced sexual interest (OR = 5.12, CI 3.04-8.64) were found to be significantly higher in patients with hypertension compared to normotensive participants. Conclusion This study has found ED to be prevalent in hypertensive patients. Identifying and acknowledging hypertension as a risk factor may help identify patients with ED and reinforce the clinician's importance of asking sexual history of hypertensive patients.