Context:Dry eye is a very common as well as under-diagnosed ocular disorder. It is not only troublesome in terms of its symptoms but also imposes a great financial burden.Aims:To determine the prevalence of dry eye in ophthalmology out-patients at a Tertiary Care Hospital and its association with various clinico-epidemiological factors.Settings and Design:A hospital-based study at a Tertiary Care Center was conducted including 400 out-patients of age 40 years and above.Materials and Methods:Patients were consecutively selected and underwent a routine ophthalmological examination along with tear film break-up time (TBUT) as a screening tool for detecting the presence of dry eye.Statistical Analysis:We performed a descriptive, univariate and multivariable logistic regression analysis to calculate odds ratios and 95% confidence interval.Results:The mean age of the study population was 58.6 years. The overall prevalence of dry eye was found to be 54.3%. An association was found between dry eye prevalence and outdoor workers, participants working indoor using air conditioners, housewives, diabetics, patients who have undergone previous ocular surgery and those with meibomian gland dysfunction.Conclusions:Dry eye is a very common condition with a high prevalence among the elderly. We recommend the screening of all out-patients by TBUT, which is a simple test to perform and examination of lids for meibomian gland disease, which if present can be treated. Further studies are needed to establish uniform diagnostic criteria for dry eye, which will help to get more concrete prevalence data, as well as its etiological factors.
Objective: To evaluate the role of an open access heart failure service based at a teaching hospital for the diagnosis and treatment optimisation of patients with heart failure in the community and to identify measures that may further enhance the effectiveness of such a service. Subjects: 963 patients with suspected heart failure seen over an eight year period referred by their general practitioners to the cardiology department at a district general hospital. Main outcome measures: Presence or absence of left ventricular systolic dysfunction (LVSD) (left ventricular ejection fraction , 50% on echocardiography), and determination of the risk factors and predictors of LVSD.Results: The majority of the patients were women (60% v 40%) and elderly (mean age 68.8 years). On echocardiography, only 30.8% were found to have LVSD. Patients were more likely to have LVSD if they were men (42.3% v 23.1%, p , 0.001, relative risk (RR) 1.8), were . 60 years of age (33.5% v 20.
The first goal of the study is to provide a descriptive overview of the utilization of left ventricular assist device (LVAD) for the treatment of congestive heart failure (CHF) and determine the rates of LVAD use stratified by patients' demographic and hospitals' characteristics in the United States. Next, is to measure the hospitalization outcomes of length of stay (LOS) and cost in inpatients managed with LVAD. MethodsWe conducted a cross-sectional study using the nationwide inpatient sample and included 184,115 patients (age ≥65 years) with a primary discharge diagnosis of hypertensive and non-hypertensive CHF and was further classified by inpatients who were managed with LVAD. We compared the distributions of demographic and hospital characteristics in CHF inpatients with versus without LVAD by performing Pearson's chi-square test for categorical variables, and independent sample t-test for continuous variables.
The primary goal of our study is to evaluate the mortality rate in inpatient recipients of multivessel percutaneous coronary intervention (MVPCI) and to evaluate the demographic risk factors and medical complications that increase the risk of in-hospital mortality. MethodsWe conducted a cross-sectional study using the Nationwide Inpatient Sample (NIS, 2016) and included 127,145 inpatients who received MVPCI as a primary procedure in United States' hospitals. We used a multivariable logistic regression model adjusted for demographic confounders to measure the odds ratio (OR) of association of medical complications and in-hospital mortality risk in MVPCI recipients. ResultsThe in-hospital mortality rate was 2% in MVPCI recipients and was seen majorly in older-age adults (>64 years, 74%) and males (61%). Even though the prevalence of mortality among females was comparatively low, yet in the regression model, they were at a higher risk for in-hospital mortality than males (OR 1.2; 95% CI 1.13-1.37). While comparing ethnicities, in-hospital mortality was prevalent in whites (79%) followed by blacks (9%) and Hispanics (7.5%). Patients who developed cardiogenic shock were at higher odds of inhospital mortality (OR 9.2; 95% CI 8.27-10.24) followed by respiratory failure (OR 5.9; 95% CI 5.39-6.64) and ventricular fibrillation (OR 3.5;. ConclusionAccelerated use of MVPCI made it important to study in-hospital mortality risk factors allowing us to devise strategies to improve the utilization and improve the quality of life of these at-risk patients. Despite its effectiveness and comparatively lower mortality profile, aggressive usage of MVPCI is restricted due to the periprocedural complications and morbidity profile of the patients.
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