International Journal of Integrated Medical Research

Clinical Presentations and Outcome of Cardiovascular Disorders Seen in The Emergency Department of a Private Cardiac Center in Port Harcourt, South-South Nigeria

2024-03-22T07:03:52+00:00

Background: Cardiovascular emergencies are sudden and require immediate action, posing a significant public health challenge, especially in low-income settings. To effectively control cardiovascular disease (CVD) and reduce deaths from cardiovascular emergencies, data-driven decision-making is necessary. Hence, this study aims to describe the pattern of clinical presentations and outcomes of cardiovascular disorders seen in a private cardiac center in Port Harcourt.

Method: This retrospective cross-sectional study examines the Clinical Presentations and Outcome of Cardiovascular disorders at the emergency department of Goodheart Medical Consultants Hospital, South-South Nigeria, spanning three years (2019-2021). Emergency case records were retrieved, extracting pertinent data on patient socio-demographics, diagnoses, and treatment outcomes.

Results: A total of 1644 patients were admitted, averaging 54.75±18.53 years old, with ages ranging from 3 to 92 years. Among them, 607 (36.9%) were admitted for cardiovascular emergencies. Notably, cardiovascular diseases were more prevalent among females, constituting 314 (51.7%) compared to males, 293 (48.3%). The largest proportion of patients (41.2%) fell within the 61-80 age group. Heart failure accounted for the most common cardiovascular disease (41.9%), while heart block was the least frequent (0.5%). Of the admitted patients with cardiovascular diseases, 95.7% were discharged home, 2.6% died, and 1.6% were referred elsewhere.

Conclusions: The most common CVD was heart failure (41.9%), and was most prevalent between the ages of 41 and 80 thus, indicating that the risk of CVD increases with age. Heart failure also accounted for most occurrences of mortality, discharge and referral. Early detection and prompt management of CVD emergencies should be practiced.

Clinical Correlates of Patients Who Had Pacemaker Implantation in Port Harcourt, Southern Nigeria

2024-04-10T02:28:48+00:00

Background: Permanent pacemaker implantation is a relatively safe procedure that significantly improves morbidity and mortality among patients with symptomatic bradycardia. There is limited information on the clinical correlates of pacemaker patients in the south-south Nigeria, especially in a private tertiary cardiac clinic. This study is aimed at describing the clinical correlates as seen in patients who had pacemaker implantation in a private hospital in Port Harcourt, Southern Nigeria.

Materials and Methods: This was a retrospective study of patients who had pacemaker implantation in the University of Port Harcourt Teaching hospital from 2012 to 2013 and GoodHeart Medical Consultants Hospital in Port Harcourt, Southern Nigeria from 2014 to 2023.

Results: The mean age (±SD) of total population at the time of implantation was 66.8 (±10.6) years. Men were more than the women (51.8% vs. 48.2%). Single-chamber unit was mostly implanted, single-chambers were in 25 (60.98%) while Dual chamber units were implanted in 16 (39.02%) of patients. Complete heart block (CHB) was the most common (60.98%) indication for permanent pacemaker insertion followed by second degree atrioventricular block (29.27%) and other indications (9.76%). The most common presenting symptoms were dizziness (in 56.1% of patients), blackout (24.4%), and dyspnea (19.5%). The complications observed were Lead dislodgment/malfunction, pocket infection in 3 patients each, and device expulsion in 2 patients.

Conclusion: Pacemaker implantation in Port Harcourt south-south, Nigeria started in September 2012. There was great apathy and inertia on the side of patients and their relations as well as poor infrastructures, hence, the few numbers of patients at the onset. The major reason for pacemaker implantation were complete heart block (CHB) and second degree Atrioventicular block (2^nd degree AVB). Pacemaker implantation is a highly effective procedure in treatment of symptomatic bradycardia. It is a lifesaving procedure as it improves quality of life and is associated with relatively low complications and has now achieved a wider acceptance among the populace.

Tuberculosis Relapse; Retrospective Algerian Study

2024-04-21T22:33:43+00:00

Introduction: Tuberculosis relapse is defined by the reappearance of active tuberculosis one year or more after the first episode of tuberculosis is treated and declared cured.

The objective is to establish the epidemiological, clinical, radiological, and evolving profile of patients with tuberculosis relapse.

Methods: This is a retrospective study covering cases of tuberculosis relapses, collected in the pulmonology department of the Sidi Bel Abbes University Hospital for 11 years (2008–2019).

Results: Our series is made up of 17 men and 4 women. The average age was 43 years old. Active smoking was found in 66%, alcoholism in 28%, diabetes in 38%, and a low socioeconomic level in 83%. The average time between the first episode and relapse is 2 ± 1 years. A direct examination of the sputum confirmed the diagnosis of tuberculosis. Radiologically, tuberculosis manifested itself as extensive excavated lung lesions in 45% of cases. The evolution was favorable in the majority of cases; however, there was resistance to anti-tuberculosis drugs in one case and one death following bilateral pneumothorax.

Conclusion: Tuberculous relapses are the prerogative of young smokers with poor social conditions. The seriousness lies above all in the risk of the emergence of resistance to anti-tuberculosis drugs.

A One Year Cross Sectional Study on Surgical Site Infections (Ssi), Associated Risk Factors and Antimicrobial Sensitivity Patterns in A Government Tertiary Care Teaching Hospital, Egmore Chennai

2024-03-24T09:15:41+00:00

Background: Surgical Site Infections (SSI) is one of the most commonly reported nosocomial infection which has an adverse impact on the hospital as well as on the patient.

Objectives:

To study the prevalence of Surgical Site Infections.
To identify the risk factors associated with the development of SSIs.
To identify the etiological pathogens and their antimicrobial susceptibility

Methodology: We conducted a one-year cross sectional study on SSI in IOG. 152 post lscs cases who developed SSI were included in the study. Factors like age, duration of surgery, co-morbidities, type of skin suture, pathogen and their antimicrobial sensitivity associated with SSI and their outcomes were studied. Swabs were collected from the infected surgical wounds and processed by the conventional microbiological methods. Antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method and interpretation done by CLSI guidelines 2020.

Results: Among the 6650 cases of LSCS done in our hospital in the year 2021, 152 cases developed surgical site infection. Of which 67% of the population comprise of the age group 18-30 yrs, anemia, diabetes, hypetension were the predominant risk factors associated with SSI. About 37% of the cases needed wound resuturing remaining 63% of the cases were medically managed. The common pathogen encountered with SSI were E. coli, Klebsiella and MRSA. Around 82% of the organism were sensitive to Amikacin and 48% of them were sensitive to Gentamycin, about 43% of the pathogen were resistant to Ampicillin.

Conclusions: The overall prevalence of SSI in our hospital was 2.28% in the year 2021. Early diagnosis and prompt treatment of risk factors like anemia, diabetes and hypertension may prevent SSI and improve outcomes in infected cases. Decrease in the duration of surgery, decreases the incidence of SSI. Empirical use of antibiotics based on the common organism encountered and their sensitivity patters improves the outcome of SSI. Peroidic surveillance of SSI and measures to prevent it to be done on regular basis.

Portal Venous Stenting for Portal Vein Anastomotic Stenosis After Liver Transplantation: A Case Report

2024-04-23T02:42:32+00:00

Liver transplantation (LT) is currently one of the most crucial methods for treating end-stage liver disease. The survival rate after transplantation has exceeded 70-80%. Vascular complications after LT are a significant cause of postoperative failure. Therefore, early diagnosis and proactive treatment of vascular complications after LT can lead to a more comprehensive recovery for the patient. This case involves a 55-year-old female patient with liver cirrhosis. Three days after the right lobe of the liver was transplanted, she was found to have elevated blood pressure, increased ascites, and deteriorating liver function. Doppler ultrasound revealed insufficient blood supply to the portal vein (PV), while computed tomography (CT) diagnosed stenosis at the PV anastomosis, resulting in partial thrombosis in the hepatic artery and hepatic vein. The self-expanding stent (Bard® E-LUMINEXX™) was deployed using angiography to widen the vascular anastomotic stenosis. The portal venogram after the stent placement revealed that the stent was well positioned and open, leading to improved PV flow and a significant reduction in PV pressure. Reduce pulse pressure and improve arterial blood flow.