Impact of anemia on outcomes and resource utilization in patients with myocardial infarction: A national database analysis.

BACKGROUND: Although anemia is common in patients with myocardial infarction (MI), management remains controversial. We quantified the association of anemia with in-hospital outcomes and resource utilization in patients admitted with MI using a large national database. METHODS: All hospitalizations with a primary diagnosis code for acute MI in the National Inpatient Sample (NIS) between 2014 and 2018 were identified. Among these hospitalizations, patients with anemia were identified using a secondary diagnosis code. Data on demographic and clinical variables were collected. Outcomes of interest included in-hospital adverse events, length of stay (LOS), and total cost. Multivariable logistic regression and generalized linear models were used to evaluate the relationship between anemia and outcomes. RESULTS: Among 1,113,181 MI hospitalizations, 254,816 (22.8%) included concomitant anemia. Anemic patients were older and more likely to be women. After adjustment for demographics and comorbidities, anemia was associated with higher mortality (7.1 vs. 4.3%; odds ratio 1.09; 95% confidence interval [CI] 1.07-1.12, p < 0.001). Anemia was also associated with a mean of 2.71 days longer LOS (average marginal effects [AME] 2.71; 95% CI 2.68-2.73, p < 0.05), and $ 9703 mean higher total costs (AME $9703, 95% CI $9577-$9829, p < 0.05). Anemic patients who received blood transfusions had higher mortality as compared with those who did not (8.2% vs. 7.0, p < 0.001). CONCLUSION: In MI patients, anemia was associated with higher in-hospital mortality, adverse events, total cost, and length of stay. Transfusion was associated with increased mortality, and its role in MI requires further research.

A Brief Assessment on Recent Developments in Efficient Electrocatalytic Nitrogen Reduction with 2D Non-Metallic Nanomaterials.

In recent years, the synthesis of ammonia (NH3) has been developed by electrocatalytic technology that is a potential way to effectively replace the Haber-Bosch process, which is an industrial synthesis of NH3. Industrial ammonia has caused a series of problems for the population and environment. In the face of sustainable green synthesis methods, the advantages of electrocatalytic nitrogen reduction for synthesis of NH3 in aqueous media have attracted a great amount of attention from researchers. This review summarizes the recent progress on the highly efficient electrocatalysts based on 2D non-metallic nanomaterial and provides a brief overview of the synthesis principle of electrocatalysis and the performance measurement indicators of electrocatalysts. Moreover, the current development of N2 reduction reaction (NRR) electrocatalyst is discussed and prospected.

The incidence and awareness of Rhegmatogenous retinal detachment in Pakistani population.

Retinal detachment (RD) describes the separation of neurosensory retina from the underlying pigment epithelium. There are various methods of treating RD but in many cases, an unusual delay between occurrence of retinal detachment and surgery has been observed. This study was conducted to find the extent of factors involved in delay in surgery. This cross sectional study was carried out at LRBT Eye Hospital, Lahore for 6 months. The non-probability, consecutive sampling technique was used. The demographic information was recorded. The patients were asked for causes of delay in retinal detachment surgery and all factors were measured. Data was analyzed by SPSS version 21. The mean age of patients was 52±9.86 years; the male to female ratio was 1.5:1. About 9.3% patients said that they do not know where to go, 30% patients thought that it was not a severe condition,36.4% patients thought that it would self-heal,17.1% patients didn't go to the doctor due to financial constraints whereas 7.1% patients did not have VR ophthalmologist near their residence. Statistically significant difference was found between the factors and education level of the patients i.e. p-value<0.05. Our study results concluded that people needed to be educated regarding the importance of retinal detachment and surgical procedures and complications associated with it.

CPSP/HSE Postgraduate Overseas Rotational Programme: Residents' Perspective.

OBJECTIVE: To get direct upward feedback from the residents of first batch of CPSP/HSE Postgraduate Scholarship Programme. STUDY DESIGN: Mixed methods qualitative research study. PLACE AND DURATION OF STUDY: CPSP, Regional Office, Lahore, in June 2015. METHODOLOGY: It is a mixed-method study that was conducted in June, 2015. Data was collected through an email survey with 33 medical residents doing their rotation in Ireland; and focus group discussions were carried out with 8 residents, who had successfully completed their rotation. Data were collected through pre-designed questionnaires comprising of open- and close-ended questions. The data were entered into SPSS version 21 and analyzed. RESULTS: The mean age of residents was 29.9 &plusmn;1.1 years, 7 (21.2%) were females and 24 (72.7%) respondents were males. Residents agreed that HSE programme has improved their evidence-based decision making (mean score of 3.3 &plusmn;1.2) and enhanced professionalism (mean score of 3.6 &plusmn;1.1). They disagreed that training has polished their procedural skills (mean score 2.4 &plusmn;1.2). The identified strengths of the programme are: adopting a systematic approach towards patients, evidence-based decision making, better exposure and opportunities, financial stability and development of communication skills. The weaknesses are: less exposure to procedural skills, difficulty in synopsis and dissertation writing and difficulty in adjustment with rotational schedules. CONCLUSION: Residents of CPSP/HSE Programme believed that CPSP/HSE has improved their professionalism, communication skills and increased their future opportunities for career growth. Better communication between CPSP focal person and residents will help sort out many minor but important issues.