Objectives: The objective of our study was to find diagnostic accuracy of APACHE-II score to predict mortality in poly trauma patients within first 24 hours of hospitalization. Study Design: Cross Sectional study. Setting: Department of Emergency Lahore General Hospital. Period: 25 March, 2016 to 25 September, 2016. Material & Methods: A total of 230 patients who fulfilled inclusion criteria were enrolled in the study from emergency department of Lahore General Hospital, informed consent was taken from all patients or their attendants to take their demographic profile (name, age, gender and contact no) and other necessary clinical data. To calculate APACHE-II score, vital signs, blood / serum profile, GCS, age and prolong health problems were measured on patients’ arrival. Patients were classified as per their APACHE-II score. After calculating APACHE-II score patients were managed according to trauma severity and followed up till 24 hours to note the in- hospital mortality. All the data was recorded on a Performa. Statistical analysis was carried out using SPSS 20. Results: Out of 230 patients, 147 (63.91%) were male and 83(36.09%) were female; mean age was 38.53 ± 11.67 years. Out of 230 cases, in hospital mortality occurred in 84(36.5%) while other 146(63.5%) were alive within 24 hours of admission. According to APACHE-II score, 84(36.5%) cases had > 11.5 score and rests of 146(63.5%) had APACHE-II ≤ 11.5. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of APACHE-II was 89.16%, 93.2%, 88.1%, 93.84% and 91.74% respectively. Conclusion: According to the findings of this study, we found APACHE-II highly accurate for indicating in-hospital mortality. Using APACHE-II in future we can devise an efficient treatment plan for poly trauma patients to reduce the probability of hospital mortality.
Aim / Objective: The aim of this study was to evaluate the effect of maximal exercise on the level of cardiac remolding and Atrial Natriuretic Peptide (ANP) in elite athletes as compared to sedentary healthy subjects and correlation of ANP with the adaptation of athlete’s heart and cardiac remodeling (if any) Place and Duration of Study: The present study was carried out at the Department of Physiology, Army Medical College, with collaboration of Armed Forces Institute of Cardiology (AFIC) Rawalpindi from June 2003 to May 2004. Methodology: A total number of 44 subjects were included in this study. These comprised of 22 elite endurance athletes and 22 healthy sedentary volunteers as controls. All subjects were examined clinically to rule out the cardiovascular and pulmonary diseases on the basis of medical history, physical examination, and echocardiography. All the selected subjects were examined on a Toshiba Power Vision 6000 echocardiograph for assessing and measuring their LV end-diastolic internal diameter (LVIDd), Diastolic interventricular septal thickness (IVSTd), diastolic posterior wall thickness (PWTd). The left ventricular mass was (LVM) was calculated by using the Devereux formula. They were subject to go for ergometer cycle exercise before breakfast. The Blood samples were drawn before and after exercise to assess the level of ANP in their samples. Results: It was found that LVIDd, IVSTd, PWTd, LVM were higher in athletes as compared to their age, sex and BMI matched controls. The ANP levels in athlete’s plasma were also high in post and pre exercise sample as compared to controls. Conclusion: Systolic blood pressure, Diastolic Blood Pressure and heart rate are lower in endurance elite athletes than matched sedentary controls. The maximal Exercise increases the level of Atrial Natriuretic Peptide (ANP) in elite athletes significantly as compared to sedentary healthy controls. There was a Positive correlations between ANP and LVIDd, IVSTd, PWTd, and LVM while there was negative correlation between ANP and heart rate, ANP and Blood pressure. However, none of correlation was found to be statistically significant. Keywords: Athlete’s Heart, ANP, Cardiac remodeling in athletes, Echocardiography of heart
Objectives: To determine the role of TRANEXAMIC ACID in prevention of primary postpartum haemorrhage in women. Study Design: Observational Retrospective Cohort Design. Settings: DHQ Hospital, Gujranwala. Period: April 2016 to July 2018. Material & Methods: The data of 110 women who suffered postpartum haemorrhage was retrieved from the hospital records. Exclusion criteria included all the females who were below and equal to 18 years of age. Patients suffering from acute respiratory distress syndrome (ARDS), on long-term anti-inflammatory and steroid therapy were also excluded. Whereas all the women who had experienced postpartum haemorrhage after birth were included. Results: We retrieved data of 110 women who had experienced postpartum haemorrhage after birth. The age of participants was averaged 28.95 + 7.6 years. The group I was named as early treatment group and contained 35 women whereas the group II (late treatment or without TRANEXAMIC ACID) had 75 women. The mean age of women is higher in the group I i.e. 30.2 +6.8 than 27.7+8.4. The TRANEXAMIC ACID was given intravenously with an average dose of 1 gram (0.1-3.0 grams) 1.5 hours after the birth. This was an average time for all cases in group I. The average time was 4.6 hours in group II. Conclusion: We concluded that use of intravenous TRANEXAMIC ACID in postpartum haemorrhage is associated with reduced haemorrhage but a low dose at early treatment may not yield good results.
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