Pak J Med Sci
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To determine the association of body mass index (BMI) with 30 days and 1-year mortality outcomes of orthopedic elderly patients after hip fracture surgery. ⋯ BMI classification can serve as an important indicator of adverse early outcomes after hip fracture surgery. Over-weight and obese patients have better survival outcomes and have lower 1-year mortality rate.
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To investigate the Barriers and Priorities accorded by hospital and health administrators to neo-natal hearing screening. ⋯ The Barriers to NNHS identified at Hospital and Health care administrator level include lack of awareness, poor health infrastructure, burden on tertiary care and lack of referrals. Inherent barriers to NNHS cover the spectrum of lack of liaison/ linkages between obstetrics and other departments, deliveries at homes especially in rural areas, poor follow-up, scarcity of technical and adequately trained manpower. Intangible barriers to NNHS comprise lack of health care information system, attitudinal barriers, inadequate fiscal resources, and lack of integrated approach at intra departmental levels.
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Case Reports
Transient contrast induced neurotoxicity after coronary angiography: A contrast re-challenge case.
Contrast induced neurotoxicity (CIN) is a rare complication of cardiac catheterization and re-exposure to contrast medium carries the risk of recurrent CIN. We report a case of successful contrast re-challenge in a 60-year-old female patient who developed CIN after her first procedure of coronary angiography (CAG) which resulted in symptoms of disorientation, amnesia and cortical blindness. ⋯ Patient's symptoms resolved completely after 72 hours. Two months later, because of persistent exertional angina, patient was successfully re-challenged with lesser amount of contrast medium with administration of hydrocortisone prior to procedure, and PCI to LAD was completed without recurrence of CIN.
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Approximately one half of patients develop ascites within 10 years of diagnosis of compensated cirrhosis. It is a poor prognostic indicator, with only 50% surviving beyond two years. Mortality worsens significantly to 20% to 50% at one year if the ascites becomes refractory to medical therapy. ⋯ This expert opinion suggests proper assessment of patients with ascites in the presence of underlying cirrhosis. This expert opinion includes appropriate diagnosis and management of uncomplicated ascites, refractory ascites and complicated ascites (including spontaneous bacterial peritonitis (SBP) ascites, hepatorenal syndrome (HRS) and hyponatremia. The purpose behind this expert opinion is to help consultants, postgraduate trainees, medical officers and primary care physicians optimally manage their patients with cirrhosis and ascites in a resource constrained setting as is often encountered in a developing country like Pakistan.
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To determine the effectiveness of macular hole index (MHI) as a predicting factor of visual outcome after full thickness macular hole surgery. ⋯ Macular hole index can be used to predict functional success in macular hole surgery.