Objective: This study sought to evaluate the correlation of left ventricular ejection fraction (LVEF) with Signal – Average Electrocardiogram (SAECG) in patient with acute myocardial infarction. Background: Post MI risk stratification is still a debatable issue. Appropriate investigation to ascertain the patient at risk of sudden cardiac death is sometimes difficult. Abnormalities in the SAECG have been determined to be independent predictors of risk of developing ventricular arrhythmias in patients convalescing from myocardial infarction. Correlation of LVEF with SAECG will identify the small group of patient at risk of fatal arrhythmia. Method: This observational study was carried out in the cardiology center, Combined Military Hospital, Dhaka cantonment during the period of January 2010 to January 2011. Patient with first acute myocardial infarction within 7 days of sustaining acute myocardial infarction were included in the study. All three parameters of SAECG (Total QRS duration, Low Amplitude Signal (LAS) under 40μvolt, Root - mean -square (RMS) voltage of last 40 msec) were recorded, and basing on the results, patients were grouped into normal or abnormal SAECG. Result: A total of 106 patients of acute MI were studied. Mean age of the patients were 54(SD±10.5) years (range 34 to 90 years). Only 13(12%) patients were female with male to female ratio of 7.15:1. 32% patients were thrombolysed & abnormal SAECG was more in patients who were thrombolysed (p value<0.05) but logistic regression analysis showed no significant association. Smoking had significant association with abnormal SAECG by univariate analysis (p value<0.05) but logistic regression analysis showed no significant association with smoking and sex (p value >0.05). 46% patients had inferior/inferoposterior myocardial infarction. Abnormal SAECG was more among patients with inferior MI (p <0.05). Mean LVEF was 45.81% (SD±9.68). Correlation of LV function was assessed by both Pearson’s correlation and Ç2 test but no significant association was seen. Logistic regression analysis showed the similar result. Conclusion: In our study, no correlation was found between abnormal signal-averaged ECG and left ventricular ejection fraction following acute myocardial infarction. Further large, multi center study with more selective variables is required to find out any association of SAECG and LV ejection fraction. University Heart Journal Vol. 17, No. 1, Jan 2021; 3-9
Introduction: Dog bites in humans are a major public health problem. Globally, millions of people are bitten by dogs but most of the fatal cases occur in children. Dog bites in human are a serious public health problem and have been well documented worldwide. As rabies is not a notifiable disease in Bangladesh and most deaths occur in rural areas where surveillance is poor. Objectives: To determine the pattern of dog bite injuries and associated health problems among children. Methods: The study was an observational retrospective study carried out at the Dept. of General Surgery, Chuadanga Sadar Hospital, Chuadanga, Bangladesh. The study reviewed the clinical data of patients managed for dog bite related injuries and rabies over a four and half year period between January 2016 and June 2020. A proforma was designed to extract relevant clinical data from the case records. Information extracted included the age, sex of the victims, site of the bite, time of presentation in the hospital, pre-hospital treatment, hospital treatment including post-exposure prophylaxis and complication. Results: In all, 200 cases of dog bite injuries were managed constituting 0.89% of the total consultations; 5 (2.5%) had rabies. Most of the victims were aged 6-12 years (55.0%) and majority (67.0%) was boys. Eighty two percent of the victims presented within 24hrs of the injury. 92 (46.0%) had WHO grade 3 dog bite injury at presentation and the lower limb was the commonest (56.0%) bite site. Use of herbal preparation was the most common pre-hospital treatment 60%. Although 95.0% received anti-rabies vaccine, only 55.5% of them completed the vaccination schedule. The case fatality rate for dog bite was 5.0%. The 5 that died all presented late, had no post exposure prophylaxis and died within 24 hours of admission. Conclusion: There is need for public enlightenment on dangers associated with dog bites and also for the government to ensure vaccination for cost of post exposure prophylaxis treatment for children free of cost
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