RESUMO
Objective: Identify the association between stroke severity and the neurological outcome of an acute stroke using the National Institutes of Health stroke scale (NIHSS). Study design: A descriptive cross-sectional study.Place and duration of study: Northwest hospital Hayatabad Peshawar. Methodology: A cross-sectional descriptive study was done in the general plus stroke unit of the northwest hospital in Peshawar, KPK during Jan 2022 to July 2022.400 admitted patients diagnosed with acute stroke in the past three months were included for NIHSS assessment and were classified as mild, moderate, or severe stroke. After entering all of the data from the collection into SPSS version 16, the information was transferred to an Excel spreadsheet. To further assess the results, the researcher and statistician evaluated all of the cases, radiological findings, and laboratory test data. Results: In this cross-sectional descriptive study, 400 individuals ranging from 30 to 90 years of age were divided into two groups: males and females. The survey was conducted by 49% of men and 51% of women. The stroke severity was assessed to be mild in 22% of cases, moderate in 49%, and severe in 29% of patients. As evaluated by the NIHSS, Patients with acute ischemic stroke were divided into four groups depending on their neurological outcomes: those who improved were 160 (40%), those who remained stable were 124 (31%), and those who deteriorated were 52 (13%), and those who died were 64 (16%). Patients with greater triglyceride levels were 88, while those with lower levels were 312. Acute stroke was also detected in 34% of patients with a covid history, 28% of patients who were covid positive, and 38% of patients who were covid free in this investigation. Conclusion: According to our findings, the NIHSS is a reliable scale for evaluating patients' neurological outcomes and determining the association between acute stroke severity and cognitive functioning (NIHSS).
RESUMO
OBJECTIVE: To determine causative uropathogens and their antibiotic susceptibility pattern among Type-2 diabetics (T2D) with good and suboptimal glycemic control. METHODS: A hospital based cross-sectional study was carried out in Peshawar from April-October, 2019. Four hundred consecutive T2D patients with symptomatic UTI or showing numerous pus cells on routine urinary examination attending outpatient clinic were included. As per the guidelines of the Clinical and Laboratory Standards Institute (CLSI), the urine samples collected were checked for identification of uropathogen by culture. Disc diffusion method was used to determined antimicrobial susceptibility. RESULTS: Of the total (n=400) T2D patients, 205 (51.25%) showed microbial growth. Mean age of patients with UTI was 63.26 ±12.30 years. About two-third (63.9%) of the patients were females. Mean HbA1c was 8.80±2.20%. The frequency of patients with UTI was noticeably greater in the suboptimal glycemic control group 178(86.3%) compared to good control glycemic patients 27(13.7%). Significant mean difference in glycemic levels were observed (HbA1c = 5.86±0.48 and HbA1c = 9.25±2.02, respectively, P < 0.001). E. coli was the predominant pathogen isolated 120(71%), followed by Klebsiella pneumonia Spp (K. pn) 35(17.1%), Pseudomonas auregonosa (P. aeruginosa) 14(6.83%), Enterococcus 12 (5.85%) and Candida Spp were 2(0.98%). Both gram positive and negative-bacteria were highly susceptible to imipenem, meropenem, fosfomycin and nitrofurantoin. CONCLUSION: The frequency of UTI in diabetics was higher in female in comparison to male, and was significantly greater in the suboptimal glycemic control group. E. coli was the most typical isolate followed by K. pn. Imipenem, meropenem, fosfomycin and nitrofurantoin had high susceptibility profile against the isolated pathogens.
