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Article
CLINICAL CHARACTERISTICS AND OUTCOMES OF ACUTE CORONARY SYNDROMES IN A GROUP OF IRAQI PATIENTS

Author: Moayed B. Hamid مؤيد بشير حامد
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2016 Volume: 14 Issue: 4 Pages: 304-311
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Coronary artery disease (CAD) is one of the most common diseases in the world. Acute coronary syndromes (ACS) represent the acute life-threatening phase of CAD. Epidemiology and management of ACS patients differ a lot between countries and there is a wide gap between guidelines and clinical practice. Objective:To assess contemporary data on clinical characteristics and outcomes of patients with ACS in the Medical City Complex and to evaluate adherence to the guidelines’ recommended treatment.Methods:This is a descriptive study registry, started on January 2014 to June 2014, and involved 348 patients with ACS in the Medical City Complex.Results:The mean age of this study's population was (60.3±11.2 years), ranging between 29 to 90 years old. Most of patients were males (61%). Only 233 (67%) patients have typical angina. Symptom onset-to-admission time was delayed (≥ 12 hours) in 65% of patients. The final diagnosis was: ST elevation myocardial infarction (STEMI) in 126 (36.2%), non ST elevation myocardial infarction (NSTEMI) in 40 (11.4%), and unstable angina (UA) in 182 (52.3%) of patients. Electrocardiography was normal in 29% of patients with UA and 10% of patients with NSTEMI. Anterior territory was the most common location of ischemia (77%). Hypertension (47.9%) was the most significant risk factor followed by diabetes mellitus (41.6%) and smoking (31.8%). Reperfusion therapy for patients with STEMI was applied in 73(57%) patients: 56 (44.4%) by thrombolytic therapy, 24 (19%) by percutaneous coronary intervention (PCI) and 3 (2.3%) by emergency CABG. Overall in-hospital mortality was 7.7% (15%, 7.5% and 2.7% for STEMI, NSTEMI, and UA respectively).Conclusion:There is lack of awareness of ischemic symptoms among our patients. There is high incidence of risk factors that can be modified by primary and secondary measures. There is underutilization of invasive management. We have a high mortality rates in patients with ACS.Keywords:Acute coronary syndromes, registry, in-hospital outcome


Article
Epidemiology of the poisoning in children admitted to emergency unit at Al-Diwaniah teaching hospital of pediatrics

Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2016 Volume: 3 Issue: 1 Pages: 10-16
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

Poisoning in any medical centre is considered as one of the most common medical emergencies in children. Acute poisoning in children constitute about less than three percent of all pediatric emergency admissions. The aim of study; to evaluate acute poisoning in children below 15 year old admitted to emergency unit. Hydrocarbons were the most common poisonous substances leading to hospitalization; we had the highest frequency of admissions in winter. Further, the highest number of poisonous cases was in January and December 79 case and lowest rate 23 case was observed in October; there is an increasing trend in proportion of kerosene poisoning from December to February. The rate of suicidal attempt is very low in our study only 6 cases this result is contrary to other two studies, these are common in adolescent also related to the nature of social environment and learning in each area. In our society accidental kerosene poisoning, which the most common cause of the intoxicated patient admitted to the emergency unit, occur when the patient try to do procedure to prepare kerosene heater stove or for light (lantern). Only very few cases is related to suicidal attack in our study, We recommend to remove all the poisoning agent as soon as possible from the areas easily reach by the child (removal of poisonous plants and removal of fuel sources like kerosene). Poison control centre to triage poisonings, prepare service accurate and timely advice to health personnel and caregiver should be available in each governorate.

Keywords

Poisoning --- Causes --- Hospital outcome --- Aldiwaniah --- Iraq

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