Cardiac assessment among young ischaemic stroke patients in Babylon Province

Abstract: Stroke is the third leading cause of death and the second most frequent cause of morbidity in developed countries. The annual incidence of acute stroke (300/100000) in U.K. Stroke is defined as a focal loss of neurological function of presumed vascular origin, which causes death or last for over 24 hours. Fifty young patients with ischemic stroke are included in this cross-sectional study, collected during the period from 1 January to 30 December 2019 for both sexes. They have been seen as an inpatient for new cases and outpatient clinics in Merjan teaching hospital in Babylon city. A cross-sectional study in which the total number of young ischemic stroke patients were (50) patients divided into two age groups (20-34) years are containing 13(26%) males and 9(18%) females. (35-40) years having 17(34%) males and 11(22%) females, Ischemic stroke patients with early morning events were 8 (16%) hypertensive patients and 3 (6%) non-hypertensive patients compared to 4 (8%) hypertensive patients and 35 (70%) non-hypertensive patients with events occurring at other times, Left-sided hemiplegia found in 31(62%) of patients compared to 19(38%) of patients with right sided hemiplegia. Two or more a risk factors have been found in 28(56%) of patients with is chemical stroke. Most of the embolic stroke associated with seizure, in our study has been found 7(14%) cases, while most of the bleeding stroke preceded with headache in our study has been found 6(12%) cases. Recurrent stroke found in 5 (10%) patients, it has been found that 4 (8%) of them were two to cardiac causes. Elusive diagnosis found in 17(34%) of ischemic stroke patients. The cardiac assessment for any patients it very important firstly in detecting cardiac causes whether congenital (e.g.) patent foramen oval or acquired (e.g.) valvar heart lesion and secondly in management of stroke to prevent recurrence by using anti-thrombotic therapy in Babylon city

Cardiac assessment among young ischaemic stroke patients in Babylon Province

Abstract: Stroke is the third leading cause of death and the second most frequent cause of morbidity in developed countries. The annual incidence of acute stroke (300/100000) in U.K. Stroke is defined as a focal loss of neurological function of presumed vascular origin, which causes death or last for over 24 hours. Fifty young patients with ischemic stroke are included in this cross-sectional study, collected during the period from 1 January to 30 December 2019 for both sexes. They have been seen as an inpatient for new cases and outpatient clinics in Merjan teaching hospital in Babylon city. A cross-sectional study in which the total number of young ischemic stroke patients were (50) patients divided into two age groups (20-34) years are containing 13(26%) males and 9(18%) females. (35-40) years having 17(34%) males and 11(22%) females, Ischemic stroke patients with early morning events were 8 (16%) hypertensive patients and 3 (6%) non-hypertensive patients compared to 4 (8%) hypertensive patients and 35 (70%) non-hypertensive patients with events occurring at other times, Left-sided hemiplegia found in 31(62%) of patients compared to 19(38%) of patients with right sided hemiplegia. Two or more a risk factors have been found in 28(56%) of patients with is chemical stroke. Most of the embolic stroke associated with seizure, in our study has been found 7(14%) cases, while most of the bleeding stroke preceded with headache in our study has been found 6(12%) cases. Recurrent stroke found in 5 (10%) patients, it has been found that 4 (8%) of them were two to cardiac causes. Elusive diagnosis found in 17(34%) of ischemic stroke patients. The cardiac assessment for any patients it very important firstly in detecting cardiac causes whether congenital (e.g.) patent foramen oval or acquired (e.g.) valvar heart lesion and secondly in management of stroke to prevent recurrence by using anti-thrombotic therapy in Babylon city

Single versus second observer vs artificial intelligence to increase the ADENOMA detection rate of colonoscopy-A network analysis

Background and aims: Screening colonoscopy has significantly contributed to the reduction of the incidence of colorectal cancer (CRC) and its associated mortality, with adenoma detection rate (ADR) as the quality marker. To increase the ADR, various solutions have been proposed including the utilization of Artificial Intelligence (AI) and employing second observers during colonoscopies. In the interest of AI improving ADR independently, without a second observer, and the operational similarity between AI and second observer, this network meta-analysis aims at evaluating the effectiveness of AI, second observer, and a single observer in improving ADR.Methods: We searched the Medline, Embase, Cochrane, Web of Science Core Collection, Korean Citation Index, SciELO, Global Index Medicus, and Cochrane. A direct head-to-head comparator analysis and network meta-analysis were performed using the random-effects model. The odds ratio (OR) was calculated with a 95% confidence interval (CI) and p-value \u3c 0.05 was considered statistically significant.Results: We analyzed 26 studies, involving 22,560 subjects. In the direct comparative analysis, AI demonstrated higher ADR (OR: 0.668, 95% CI 0.595-0.749, p \u3c 0.001) than single observer. Dual observer demonstrated a higher ADR (OR: 0.771, 95% CI 0.688-0.865, p \u3c 0.001) than single operator. In network meta-analysis, results were consistent on the network meta-analysis, maintaining consistency. No statistical difference was noted when comparing AI to second observer. (RR 1.1 (0.9-1.2, p = 0.3). Results were consistent when evaluating only RCTs. Net ranking provided higher score to AI followed by second observer followed by single observer.Conclusion: Artificial Intelligence and second-observer colonoscopy showed superior success in Adenoma Detection Rate when compared to single-observer colonoscopy. Although not statistically significant, net ranking model favors the superiority of AI to the second observer

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially