RESUMEN
BACKGROUND: The elevated WBC count has been accepted as part of healing response following myocardial infarction as well as a predictor of adverse cardiovascular events. The study was designed to find out correlation between WBC count and coronary risk factors, cardiac biomarkers, C-reactive protein (CRP), incidence of adverse cardiac events and mortality in patients of ACS in Pakistan. METHODS: One hundred and thirty-three patients of ACS were stratified according to WBC categories, WBC1 (< 7000/mm3), WBC2 (7100-10,000/mm3) and WBC3 (> 10,000/mm3). The WBCs were counted on admission by Sysmex cell counter, CRP by immunoturbidimetric method, and CK-MB and Trop-I by enzyme immunoassay. Adverse cardiac events and mortality were recorded for 12 months of follow up period. RESULTS: Long-term mortality in patients with ACS was 6.4% in WBC1, 18.2% in WBC2 and 40.9% in WBC3 categories, while short term mortality was 2.6%, 3.0% and 18.2% in WBC1, WBC2, and WBC3 categories respectively. Relative to patients in lower 2 WBC categories, patients in the highest category were 7 times more likely to die during 30 days (HR 7.83, p = 0.017) and more than 9 times during the total follow up period (HR 9.42, p < 0.001). Cox regression analysis showed WBC3 a strong independent predictor of mortality (HR 6.36, p = 0.016). WBC count showed a positive correlation with coronary risk factors, cardiac biomarkers and CRP. CONCLUSION: WBC count is a strong independent predictor of mortality in patients with ACS and has positive correlation with coronary risk factors, cardiac biomarkers and CRP.
Asunto(s)
Síndrome Coronario Agudo/sangre , Recuento de Leucocitos , Síndrome Coronario Agudo/mortalidad , Biomarcadores/sangre , Proteína C-Reactiva/metabolismo , Distribución de Chi-Cuadrado , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Modelos de Riesgos Proporcionales , Factores de RiesgoRESUMEN
BACKGROUND: Inflammation plays a key role in the initiation and progression of atherosclerosis, the most common cause of acute coronary syndrome. C-reactive protein (CRP) that enhances plaque inflammation is synthesized six hours after myocardial infarction. METHODS: High sensitivity C-reactive protein was measured by Immunoturbiditory method in 50 healthy controls and 100 patients of acute coronary syndrome on conservative or interventional management. RESULTS: Serum C-reactive protein levels [mg/L +/- SEM] at the time of admission were significantly raised in patients of acute coronary syndrome (11.90 +/- 2.30) as compared to controls (2.30 +/- 0.18) and further increased progressively during 24 hours of follow up period. C-reactive protein levels also increased significantly in patients who underwent interventional management (115.90 +/- 7.73) as compared to those who were on conservative management (22.28 +/- 5.54). CONCLUSION: Serum C-reactive protein levels were found to be significantly raised in patients with acute coronary syndrome as compared to controls. In addition, patients undergoing interventional management had higher C-reactive protein levels, post intervention, as compared to those on conservative management.
Asunto(s)
Síndrome Coronario Agudo/tratamiento farmacológico , Proteína C-Reactiva , Inflamación/sangre , Síndrome Coronario Agudo/sangre , Síndrome Coronario Agudo/terapia , Angina Inestable , Estudios de Casos y Controles , Forma MB de la Creatina-Quinasa , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/sangre , Pronóstico , Factores de Tiempo , Troponina IRESUMEN
Obesity and overweight have become a problem of public health magnitude associated with substantial economic burden not only in the developed countries but also in the developing countries. The number of overweight children and adolescents has doubled in the last two decades in the United States and worldwide, including developing countries. No study on childhood obesity and overweight is available in Pakistan. Obesity in children impacts on their health in both short and long-term and obesity and its preventive strategies are poorly understood. Increasing number of these children and adolescents all over the world demand not only a substantial political will but also an investment for primary and secondary preventive measures and novel approaches in the treatment modalities.
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Obesidad , Niño , Humanos , Obesidad/complicaciones , Obesidad/epidemiología , Obesidad/prevención & control , Pakistán/epidemiología , Salud PúblicaRESUMEN
BACKGROUND: Misconceptions in Physiology are common and are carried into later years of medical education, perhaps leading to difficulty in understanding Pathology and Medicine later on. To find the prevalence of misconceptions in Respiratory Physiology, one question was asked to 1st, 2nd, 3rd and 4th year MBBS students while they were still studying basic sciences and the response was analyzed accordingly. METHODS: The question was asked "What happens to the tidal volume during exercise?" to 153 MBBS medical students during their first to fourth year medical education and they were asked to pick the right answer from three choices. RESULTS: The correct answer was picked by 35% of students from all four classes. Furthermore, class wise distribution of the data revealed that correct answer was given maximally by first year students (45%) and fourth year students (43%). But, only 27% and 8% of second and third year students answered the question correctly. CONCLUSION: This data shows the extent of prevalence of misconceptions in Respiratory Physiology among medical students during their years of medical education at one medical institute in Pakistan.
Asunto(s)
Formación de Concepto , Estudiantes de Medicina/psicología , Volumen de Ventilación Pulmonar , Evaluación Educacional , Ejercicio Físico/fisiología , Humanos , PakistánRESUMEN
We report a case of 2 months old female (born to a cocaine abuser mother) having respiratory dysfunction attributed to pneumonia. Autopsy, following a sudden, unexpected death, revealed a double aortic arch which was compressing the trachea and the esophagus. Health care professionals should conduct a detailed cardiac assessment on all cocaine-exposed infants at the time of birth and during infancy. Double aortic arch should be considered as a possible complication of intrauterine cocaine exposure and may present as sudden death.