2 research outputs found
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Do Troponin Titter and CK-MB Predict Severity and In-Hospital Mortality in Patients with Ischemic Stroke?
Elevation of serum cardiac troponin is a specific marker of the acute coronary syndrome. Serum troponin titer can be elevated in patients with acute ischemic stroke, but its clinical implications remain unclear. Several mechanisms can result in elevated serum troponin levels during the early phase of ischemic strokes, such as primary myocardial injury with secondary cardioembolic cerebral ischemia or primary cerebral ischemia with secondary myocardial damage attributable to activation of the sympathoadrenal system. CK-MB is an enzyme found primarily in the heart muscle but also in the tongue, diaphragm, uterus, prostate, and skeletal muscle. It is considered an important marker for acute myocardial infarction, but it has not been thoroughly studied in stroke. The literature shows insufficient data regarding the association and prediction of morbidity and mortality following acute ischemic stroke and serum cardiac markers. This study aims to measure serum troponin and CK-MB levels in patients with acute stroke and their relation to stroke severity and hospital mortality. An eleven-month cross-sectional study on 100 patients was done in Basrah Teaching Hospital from February to December 2018, involving acute ischemic stroke patients in the neurological and medical wards who presented within 24 hours. Serum troponin and CK-MB titers were measured; a brain CT scan was done to diagnose ischemic stroke. Out of 100 patients, 14 (14%) had a positive troponin titer, 29 (29%) had a positive CK-MB, and ten (10%) had a severe stroke based on their NIHSS score at admission. Those with severe stroke were (60%) and (70%) positive for troponin titers and CK-MB, respectively, with a mortality rate of 40%. The study concludes that serum troponin titer and CK-MB are significantly associated with the severity and mortality of acute ischemic stroke
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The adherence of doctors to brain CT referral criteria: a service evaluation survey from Basrah teaching hospital
Background: CT scans are increasingly utilised in outpatient and emergency departments due to their ability to facilitate swift diagnosis and treatment planning. However, inappropriate use of CT scans, particularly CT scans of the brain, can have negative consequences.
Objectives: This study aims to evaluate the adherence of Basrah Teaching Hospital doctors to the international referral criteria for brain CT scans.
Methods: A retrospective review of medical records was conducted to investigate the utilisation of brain CT scans in the radiology departments of Basra Teaching Hospital for two months and involved 108 referrals. The medical records were thoroughly reviewed to extract relevant information related to the indications of referral, referring doctor, referring place, brain CT results, and assessing the request form completions. The standard referral criteria were extracted from the United Kingdom and European brain CT referral guidelines.
Results: Most of the referrals (75.9%) met the referral criteria, and most of the doctors, regardless of their levels, met the referral criteria; however, the highest rate was among the junior doctors (88.9%), followed by specialists and senior resident doctors. Moreover, most of the units adhered to the referral criteria, but the highest adherence rate was among those referrals from inpatient wards (91.7%). Furthermore, the majority of the doctors and most of the referring wards completed their request forms; however, the highest completion was in specialty and consultant doctors’ groups (77.8%). The results also showed that about half of positive brain CT results are due to neurological causes (46%), followed by head trauma referral (34.6%).
Conclusions: The majority of the doctors at Basrah Teaching Hospital met the international standards for brain CT referrals, and most of the referral wards followed these guidelines