Objectives: To find the frequency of CVS diseases in admitted COVID patients and its associations with outcomes. Methodology: A cross-sectional survey was conducted at tertiary care hospitals of Peshawar from April- June 2021. All patients admitted in COVID ward and COVID ICU, consenting to participate were included. Questionnaire along with patients ECG and Echo report, Canadian classification used for angina grading and NYHA classification to classify shortness of breath. Results: The mean age of the sample (n=75) was 60.44 years. Majority were 44(58.66%) males and from ward 82.66%. According to responses using Canadian classification for chest pain were 61 (81.36%) class 2 angina, IN NYHA classification majority (72%) of patients had class 2 SOB. About 14.6% of patients echo showed positive ECHO findings. The average stay of patients were 7.45+-1.3 days .About 22.6% of mortality was noted, majority of expiry were from COVID icu (52.9%) and 69.3% of patients were discharged. About 21.33% of COVID patients had cardiac manifestations, majority were males 87.5%. 43.75% of mortality was seen in patients developing cardiac manifestations. 75% of patients that developed cardiac manifestation had multiple comorbidities, AF was reported in patients age 70 and above. NSTEMI was reported in patients with multiple comorbidities. Most of the Cardiac patients 78.66% did not have cardiac manifestations, only 16.9% of mortality was seen in patients with no cardiac manifestations. Conclusion: Males are more prone to COVID and have more cardiac events. Age above 60 years develop more serious disease and adverse outcomes.
Objective: To correlate CALL score and electro physiological abnormalities on EKG and see its effect on mortality and length of stay in patients having moderate to severe covid infection- being admitted in HDU and ICU of the Lady Reading Hospital Peshawar. Methodology: A cross sectional (Descriptive) study was done in HDU and ICU of Lady reading hospital- LRH Peshawar from March 2021 to June 2021.This single centre analysis was conducted after approval from hospital ethical and research committee. All patients meeting the inclusion criteria were included in the study. All patients were subjected to detailed history and examination. Careful scrutiny of past medical records and detailed history were taken under the supervision of a senior physician-who is the fellow of CPSP. Results: Out of 100 patients, 54% were male and 46% were females. The mean age was 60 years. 72% of the population of interest developed rhythm abnormalities. We compared our results for electro cardio graphic abnormalities and clinical outcome using chi-square test and our P value came out 0.00 which is statistically significant (p<0.005). The comparison of CALL score and clinical outcomes in the form of death also came out to be statistically significant, with p value of 0.00 (p<0.05). Conclusion: There is a positive correlation between CALL score and new onset electro cardio graphic abnormalities. They affect the length of stay and influence the clinical outcome.
Objective: To compare clinical appendicitis with histopathological appendicitis. Study Design: Prospective Cross-sectional study. Setting: Department of Surgery, Lady Reading Hospital, MTI, Peshawar. Period: December 2019 to March 2020. Material & Methods: Out 106 patients with signs and symptoms of acute appendicitis 100 patients were included in the study. 6 patients were excluded because of incomplete data. Patients were examined, ALVARADO score was calculated and routine investigations were done. After open appendectomies all specimens were sent for histopathology. Results: Male to female ratio was 1.7:1, with a mean age of 25 ± 11 year. The most common presenting complain was right iliac fossa pain (98%), followed by nausea/vomiting (86%). The commonest signs elicited were right iliac fossa tenderness (100%), rebound tenderness (100%). Mean ALAVARADO score is 7.39 ± 1.03. Intraoperative findings showed acutely inflamed appendix (90%), perforated appendix (7%) and normal (1%). The histopathology specimens showed acute appendicitis (88%), acute appendicitis with periappendicitis (8%) and normal histology (1%). Conclusion: Our study comparing clinical appendicitis with histological appendicitis with a negative appendectomy rate of only 1% suggests that acute appendicitis remains a clinical diagnosis and that timely accurate clinical diagnosis can prevent many complications associated with delayed/misdiagnosis of acute appendicitis. Laboratory evaluation and imaging especially CT may help in establishing diagnosis in equivocal cases but often leads to delay in diagnosis and also puts extra burden on the health care system.
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