Objective: Our research was designed to evaluate the association of uncontrolled hypertension with coronary artery disease and analyze the role of intervention in preventing CAD mortality ratio. Methodology: This case controlled single-center study was conducted in department of Medicine, Peoples University of Medical and Health Sciences Nawabshah Pakistan from January 2020 to September 2021. In this study, BP screening was done among the adult population aged 50 years or over. All the recruited patients of coronary artery disease were divided into two main groups for a clinical trial; case (identified cases of uncontrolled hypertension) and the control group (without history of cardiovascular disorders and used medication for hypertension). For evaluating physician intervention, both groups were divided into two main groups for treatments; the standard Bp control (having <140 mm Hg SBP level) and the intensive blood pressure control (whose SPB <120 mm Hg). we used BP-lowering medication which adjusted the systolic blood pressure around 135–139 mm Hg in the standard group and less than 120 in intensive group. Results: Overall the female prevalence was comparatively high (63.2%) than males (37%). No significant differences were found in the baseline characteristics of participants. In 42% of cases, we found coronary artery calcification. Univariate logistic analysis of our study demonstrates the association of CAD with age, smoking, and BMI. We also found a positive association of CAD with higher CRP, and uncontrolled hypertension. Conclusion: Our study observed a significant association between uncontrolled hypertension and coronary artery disease. The results of our study concluded that interventions in terms of BP control might be affected due to pre-existing cardiovascular diseases. However, intensive BP treatment would help to reduce the mortality ratio of CAD patients.
Background: Non-ST segment elevation myocardial infarction (NSTEMI) is a clinical condition characterized by typical symptoms of myocardial ischemia along with electrocardiographic changes and a positive value of troponin. After presentation in the emergency department, these patients have their troponin I value and electrocardiography done. Echocardiography (echo) should also be performed on these patients. This study was conducted to determine the prognostic significance of ECG, echo, and troponin.Methods: This observational study was conducted at a tertiary care cardiac hospital on 221 diagnosed patients of NSTEMI. Electrocardiography was performed to see any particular resting ECG findings and the peak values of cardiospecific troponin were analyzed for associations with major adverse events after a sixmonth period of follow-up. On echo, the left ventricular ejection fraction was divided into two categories: left ventricular ejection fraction (LVEF) <40% and LVEF >40%.Results: The most frequent finding on presenting ECG was ST depression in anterior leads (V1-V6) in 27.6%. Median troponin I at presentation was 3.2 ng/dl and the median ejection fraction was 45%. The overall allcause mortality rate at six months was observed to be 8.6%; re-infarction in 5%, re-hospitalization in 16.3%, and heart failure in 25.3% were observed. However, mortality was higher for patients with baseline ECG findings of A-fib, generalized ST-depression, poor R-wave progression, Wellens sign, and T-wave inversion in inferior; the mortality rate was also relatively higher among patients with poor LVEF (<30%).Conclusion: ECG and echo were prognostically significant and with the combined incidence of adverse events. However, troponin lacks prognostic significance at six months.
Aim: The purpose of this study was to predict the patient’s death due to sudden cardiac arrest with left ventricular dysfunction by analyzing the value of BNP Study design: Prospective longitudinal study Place and duration: This study was conducted at Karachi institute of heart diseases Karachi, Pakistan from Feb 2020 to Feb 2021 Methodology: This cross sectional study was conducted from Feb 2020 to Feb 2021 on 70 patients who were pin pointed with acute STEMI complicated by left ventricular systolic failure and hospitalized in our hospital. A total of 70 patients who were recognized with STEMI, 48 of whom got primary PCI, and 17 of whom received thrombolytic treatment. Results: The average age of the patients was 57.6 years and the range being from 35 to 80 years. Male patients constituted 73.3 percent of the study. It was discovered a mean of NYHA of 2.5, an average Killip classification of 2.8 and an average TIMI score of 8.1. A 90-day follow-up showed that 48 patients survived out of which 7 were reported to have a life-threatening arrhythmia and 12 had sickle cell disease. When ROC curve was shown, Pro-BNP indicated Sc.D. and unanticipated cardiac death was forecasted which also stipulated an AUC of 0.76, while the AUC was 69.6 percent of the ROC curve of the same neuropeptide in evaluating accuracy in prediction of VT, by. A Kaplan-Meier analysis reveals that an increase in pro-BNP over 3.2ng/ml has a significant predictive influence on SCD [OR 0.748 (CI 95 percent: 0.07-0.932), p-value .039] Conclusion: BNP levels in individuals with ischemic cardiomyopathy after an acute MI are a significant, independent predictor of sudden death. Keywords: BNP levels, ischemic cardiomyopathy, sudden death, myocardial infarction
Background: COVID-19 has a significant impact on lives worldwide. Owing to the adverse effect of this pandemic, there has been a major shift from in-person learning activities to virtual learning. Different methods of virtual learning or e-learning, such as online classes and webinars, have emerged rapidly. Objective: The aim of this study is to identify the perceptions of healthcare professionals regarding e-learning during the COVID-19 pandemic. Method: An online survey was conducted using Microsoft Forms sent via a text link to mobile phones and emails to healthcare professionals. The questionnaire had multiple-choice questions and five-point scaling to determine perceptions about virtual learning. Data in the form of responses were collected, analyzed, and summarized as mean ± standard deviation and percentage. Results: Responses were received from a total of 410 participants, out of which 240 (58.54%) were females, and 170 (41.46%) were males. Among all participants, 294 (71.71%) were doctors. A vast majority of participants (90%) attended online webinar/e-conferences since the pandemic. The mobile phone was the most commonly used device for e-learning. More than half of the participants opined that in-person meetings are more effective than virtual meetings. In terms of medical learning, 40.48% of participants believed that virtual conferences are more convenient compared to conventional in-person attendance. According to 42.2% of participants, lack of personal interaction in virtual meetings affected their ability to acquire knowledge and experience. Conclusion: Our survey demonstrated the acceptance of virtual learning by healthcare professionals as a new learning method. The majority of participants seem willing to adapt to this new medium.
Aim: This purpose of this study was to compare the effects of clopidogrel and ticagrelor in cases of antiplatelet therapy for treating acute coronary syndromes Study design: retrospective longitudinal comparative study Place and duration: This Study was conducted at Sandeman Provincial Hospital Quetta, Pakistan over a period of two years, from February 2019 to July 2021 Methodology: A study population of 1002 patients was taken, each diagnosed with acute coronary syndrome. The inclusion criteria for these patients included that they had been previously treated with antiplatelet therapy and had been subject to invasive therapy and management. The multiplate analyzer was used to measure the platelet count for each patient. Patient history was taken and the response of each patient to the medication was recorded throughout the interval of one year. The outcome after one year on the medication was also noted and analyzed. Results: Ticagrelor was given to patients who were young and possessed a lesser chance of having diabetes. These patients also presented with an elevated ST segment or had previously suffered from a myocardial infarction, the p value was recorded to be greater than 0.05. It was noted that patients who were treated with ticagrelor had a lower risk score of bleeding. Patients who were treated with ticagrelor also showed a lower risk score for the global registry of acute coronary events (grace) where the results showed that patients treated with ticagrelor had a score of 121 ± 27 versus 127± 31.5 and the p value was equated as 0.002. There were greatly reduced results for the high platelet reactivity in patients treated with ticagrelor. When patients treated with clopidogrel were compared with patients treated with ticagrelor the high platelet reactivity results showed that it was 37.5% versus 16.7% respectively with the p-value of less than 0.0001. Conclusion: The results from the study concluded that in case of patients who were categorized as lower risk, ticagrelor was prescribed more frequently, but it was not prescribed as frequently in the case of higher risk patients. Ticagrelor was also discontinued in case of side effects such as bleeding, trouble breathing or bradyarrythmia. However, these side effects were not common. Discontinuation rates were higher after most cases of coronary artery bypass graft surgery. These higher discontinuation rates were noted in patients who were treated without the use of revascularization. There is a need for more research to be done on this and educating surgeons on the benefits and pitfalls of the medication and its effects is also needed. Keywords: Ticagrelor, clopidogrel, acute coronary syndromes. comparison
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.