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Application Of Euroscore To Predict Risk Of Mortality After Coronary Artery Bypass Grafting In Pakistani Population

by Ali Naeem (2014-VA-780) | Dr. Muhammad Hassan Mushtaq | Dr. Ammar Hameed Khan | Dr. Mamoona Chaudhry | Dr. Muhammad Nasir.

Material type: book Book; Literary form: not fiction Publisher: 2016Dissertation note: Coronary artery bypass surgery has become the standard of care for advanced coronary artery disease. It is one of the most audited and closely monitored operations in the history of surgery. Morbidity and mortality associated with this operation is also very closely monitored by surgeons, hospitals, professional bodies and governments at large. Based on the preoperative clinical information available about patients preparing to undergo coronary artery bypass surgery various predictive models for assessment of mortality risk have been developed over the last two decades in various regions across the world. Euro SCORE is one such predictive model which can accurately predict the risk of mortality for large groups of patients for the population in which it was developed. A large number of Pakistanis and nationals from South East Asian countries reside in different European countries and form part of the population on which this score has been developed and validated. We intend to find out the predictive accuracy of this model in our patients living in Pakistan. Euro SCORE accurately predicts operative mortality in patients from Pakistani population. This study will be conducted at the Department of Cardiac Surgery Shalamar Hospital Lahore. One hundred consecutive patients admitted to hospital for coronary artery bypass surgery will be enrolled in study. A total of 18 variables as included in EuroSCORE (Appendix 1) will be collected and entered into database. The expected mortality risk will be calculated by the EuroSCORE Calculator software (http://www.euroscore.org/). Actual or observed mortality and morbidity will also be recorded. Statistical analysis will be performed using SPSS version16. Continuous numerical data will be presented as mean ± Standard deviation, the Student t test will be used to compare means of normally distributed data. The qualitative data will be analyzed using chi square test. The relationship of the observed and the expected rates of mortality will be assessed using ROC curves for the accuracy of prediction of the Euro-SCORE. This study will indicate how accurately Euro SCORE can predict the risk of mortality after coronary artery bypass grafting in our population and more over it may indicate other patient related variables that can contribute to operative mortality other than Euro SCORE. Availability: Items available for loan: UVAS Library [Call number: 2713-T] (1).

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Descriptive Epidemiology And Risk Factors Of Antenatal Depression Among Women Visiting Tertiary Care Hospital In Lahore

by Gulshan Umbreen (2015-VA-415) | Prof. Dr. Mansur Ud Din Ahmad | Dr. Mamoona Chaudhry | Dr. Muhammad Nasir.

Material type: book Book; Literary form: not fiction Publisher: 2017Dissertation note: Mental health is an important but neglected component of reproductive health. Mental health problems among women of reproductive age group (15–45 yrs.) contributes to 7% of Global Burden of Diseases of women of all ages. During pregnancy prevalence of depression ranges from 4% to 20%. Women with perinatal depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany perinatal depression may produce or create difficulties to perform daily care activities for themselves and for their babies. Several risk factors predispose to depression during pregnancy are poor antenatal care, economic deprivation, previous history of psychiatric disorders, previous events during pregnancy like previous abortions, and modes of previous delivery like past instrumental or operative delivery age, marital status, gravidity, whether pregnancy was planned. Antenatal depression was the strongest indicator of postnatal depression. A hospital based cross sectional survey for duration of 4 months (December 2016 to March 2017) was performed in Lady Aitchison hospital Lahore. Pregnant women who visited to the obstetrics and gynecology departments for routine prenatal or perinatal care. Woman belongs to lower middle class was included and women with physical disabilities such as deafness and dumbness as well as those with a history of or ongoing mental illness/retardation was excluded in this study. Sampling was done by using convenience sampling technique and sample size was 300. Information regarding risk factors of antenatal depression was collected by using structured questionnaire and a screening tool, Edinburgh postnatal Depression Scale to assess depression after taking written consent. Data was obtained by face to face interview. Data was analyzed by using SPSS software with 95% confidence 85 interval. Descriptive analysis was conducted in terms of who, when and where. Frequency distribution and graphs were be made. Chi- Square test was applied to see the association of risk factors. Depression and various risk factors have been identified among pregnant woman. Association found among various risk factors like age, education of woman and husband, occupation of husband, Husband income, Family type, number of persons living in home, number of children’s, number of daughters, trimester of pregnancy, mode of delivery, pregnancy status, fear from childbirth, Bitter experience/Complication in current /previous Pregnancy and Family Support. Through assessment provide an opportunity in need of intervention to safeguard the well-being of mother and baby and reduce the impact of antenatal depression on the mother, her baby, and her family. Availability: Items available for loan: UVAS Library [Call number: 2903-T] (1).

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