Objectives: Neuro-critical Intensive Care Units (NICUs) have functioned to deliver intensive medical care services for patients with acute neurology problems. However, physicians and ICU staff do not have any feedback about their patients and their abilities after successful discharge. Various studies have documented short-term survival in ICUs, but the long-term outcome and quality of life (QOL) are less studied.Methods: This is a retrospective cohort study over a period of one year from February 2011 to February 2012 (Shiraz, South of Iran). Patients' charts were used to collect the data. Survival and QOL after one year following NICU admission were assessed for surviving patients by a telephone interview with patients or their family members using Karnofsky Performance Scale (KPS).
Results:Out of 93 patients, 42(45.2%) were male, and 51(54.8%) were female. Malignant ischemic stroke (34%) was the most common cause followed by Guillain Barre Syndrome (21%). Among the living successfully discharged patients, 45% were able to perform normal activity and work without any special assistance. The patients who were unable to work were 28%, but they were able to live at home and care for their most personal needs. The patients who were unable to care for themselves were 3% and required institutional or hospital care. Over one year following discharge, 24% patients were passed away.Discussion: is lower in NICU survivors compared with general population; however, if patients' selection and out of hospital care are done appropriately and continuously, more patients can live independently or even come back to their work. Indeed, it is important to identify patients who benefit more from NICU during decision making for ICU admission. As a result, more efficient rehabilitation could be achieved in the future. However, our conclusions are only related to our ward and do not apply to the total population of critical neurology patients.
Introduction:The aim of this case series study was to determine whether the lower starting doses of prophylactic antimigraine drugs are as effective as the recommended standard regimen when used in combination without increment.
Methods:In this retrospective case series study, we reported old charts of previously visited patients with migraine headache who needed prophylaxis in Shiraz, south of Iran. All medications used in these patients were started as combination of two drugs with the lower doses than mentioned in the literature. Descriptive statistics were used for data analysis.Results: Three patients (7.5%) did not respond to medications and 7 (18.75%) showed a very good response (more than 70% recovery in pain severity). Overall, 29 patients (72%) responded with at least 50% recovery after treatment.
Conclusions:Our results showed lower doses of migraine prophylactic drugs can be effective with the least side effects and the most tolerance for patients. This case series report can be useful in designing further studies; however, no causal inferences should be made from it regarding the efficacy of the investigated treatment.
In this article, a large class of univriate Birnbaum–Saunders distributions based on the scale shape mixture of skew normal distributions is introduced which generates suitable subclasses for modeling asymmetric data in a variety of settings. The moments and maximum likelihood estimation procedures are disscused via an ECM-algorithm. The observed information matrix to approximate the asymptotic covariance matrix of the parameter estimates is then derived in some subclasses. A simulation study is also performed to evaluate the finite sample properties of ML estimators and finally, a real data set is analyzed for illustrative purposes.
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