Medicine and Health Sciences Commons^™

Prediction Of Major Adverse Cardiac Events In The Emergency Department Using An Artificial Neural Network With A Systematic Grid Search, Ahmed Raheem Buksh, Nadeem Ullah Khan, Rida Jawed, Shahan Waheed, Musa Karim

Department of Emergency Medicine

Background: The aim of our research was to design and evaluate an Artificial Neural Network (ANN) model using a systemic grid search for the early prediction of major adverse cardiac events (MACE) among patients presenting to the triage of an emergency department.
Methods: This is a single-center, cross-sectional study using electronic health records from January 2017 to December 2020. The research population consists of adults coming to our emergency department triage at Aga Khan University Hospital. The MACE during hospitalization was the main outcome. To enhance the architecture of an ANN using triage data, we used a systematic grid search …

Accidental Phosphine Gas Poisoning With Fatal Myocardial Dysfunction In Two Families, Saleem Akhtar, Arshalooz Rehman, Surraya Bano, Anwarul Haque

Department of Emergency Medicine

ABSTRACT Aluminum phosphide is commonly used as a rodenticide and insecticide and is one of the most fatal poisons. The active ingredient is Phosphine gas which inhibits cytochrome oxidase and cellular oxygen utilization. The clinical symptoms are due to multiorgan involvement including cardiac toxicity which is the most common cause of mortality. Severity of clinical manifestations depends upon the amount of the gas to which a person is exposed. There is no specific antidote available. High index of suspicion and early aggressive treatment is the key to success. We report 2 cases of aluminum phosphide toxicity in 2 families due …

Hypertensive Crisis, Burden, Management, And Outcome At A Tertiary Care Center In Karachi, Aysha Almas, Ayaz Ghouse, Ahmed Raza Iftikhar, Munawar Khursheed

Department of Emergency Medicine

Objectives:. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi.

Methods: This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included.

Results. Out of 1336 patients, 28.6% (387) had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218). Per oral calcium channel blocker; 35.4% (137) and intravenous nitrate; 22.7% (88) …

Comparison Of Predictive Protocols In Chest Pain Patients In A Tertiary Care Hospital In Karachi, Pakistan, Omer Moin, Uzma Khan, Nadeem Ullah Khan, Munawar Khursheed, Junaid Razzak

Department of Emergency Medicine

Background: The most challenging aspect in evaluation of a patient presenting with chest pain in the Emergency Department (ED) is diagnosis of acute cardiac ischemia (ACI). Various decisions aids have been developed to aid the ED physician in the diagnosis of chest pain. Three different predictive protocols – the Goldman protocol, ACI-TIPI, and the Troponin protocol are used in predicting the occurrence of ACI. None of these decision aids have been tested in the Pakistani population, where risk factors and prevalence of CAD are much different than what is seen in other regions of the world.Aims: The aim of …

Non-Traumatic Aortic Emergencies - Experience From A Tertiary Care Centre In, Nadeem Khan Ullah Khan, Junaid A. Razzak, Hasanat Sharif, Saqib Hamid Qazi

Department of Emergency Medicine

Objective: To review the incidence, clinical presentation and outcome of Non traumatic Aortic emergencies in a tertiary care hospital and its evaluation in the Emergency department (ED).
Methods: We conducted a retrospective review of cases presented to the ED at Aga Khan University Hospital during 15 year period (1988 - 2002) who had final diagnosis of Aortic Dissection or Ruptured Aortic Aneurysm. Patients without confirmatory investigations were excluded. We aimed at looking for the incidence, clinical presentation, evaluation in the ED and final outcome.
Results: Of the 12 cases, 7 had aortic dissection while the remaining 5 had ruptured aortic …