RESUMEN
Introduction Metabolic syndrome (MetS) is defined as a syndrome of truncal obesity, insulin resistance, hypertension, hypertriglyceridemia, and dyslipidemia. It is well known that MetS increases the risk of cardiovascular disease and adverse events. Each of its components is associated with an increased risk of cardiovascular disease, but data on the association with ischemic stroke are scarce. At the international level, a significant body of research has been conducted on this issue, but the situation is very different in Pakistan. Very little data are present on the subject matter. This study is an endeavor in this direction, generating data, that can be used in early identification and developing treatment services for patients with ischemic stroke having MetS. Aims To determine the frequency of MetS in ischemic stroke patients admitted to a tertiary care hospital in Karachi, Pakistan. Methods This six-month observational and cross-sectional study was conducted at Medical Unit I, Jinnah Postgraduate Medical Centre from July 1, 2019, to December 31, 2019. Patients with a diagnosis of acute ischemic stroke were enrolled. Detailed history, physical examination, and biochemical measurements were noted. The presence of MetS was defined in accordance with the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III)/American Heart Association (AHA) guidelines. Results A total of 224 patients fulfilling the inclusion criteria were inducted into this study. The mean age of presentation was 61.04 ± 14.72 years, and more than two-thirds of the patients were ≥60 years of age. A total of 150 (66.96%) patients with ischemic stroke also had MetS. The male-to-female ratio in this group was 2:1. The most common variables constituting the MetS were truncal obesity, hypertension, and dyslipidemia. The median MetS score was 3. Conclusions MetS is highly prevalent in patients presenting with ischemic stroke irrespective of age or gender. The three most deranged and common components of MetS in these patients are truncal obesity, hypertension, and dyslipidemia.
RESUMEN
Introduction Healthcare services all over Pakistan are facing an ever-growing patient flow. Rapid urbanization and a population boom are mainly responsible for this phenomenon. This is most evident in the emergency department. Not only are the patients in dire need of medical management but they require it within a certain time frame lest it is too late. It is difficult in such situations to deliver satisfactory services. Many studies have analyzed satisfaction levels in doctors, nurses, postgraduates, and patients in the emergency department. But little data is available on the satisfaction levels of attendants that accompany the patients most of the time. Attendants are an integral part of the doctor-patient relationship and their perspective may offer some insight into the shortcomings and issues afflicting the system, especially with regards to emergency medicine. Aim To evaluate the satisfaction levels of attendants of patients treated at the emergency department. Materials and methods This is a cross-sectional study, held from January 1 to June 31, 2018. Patient and attendant confidentiality were ensured. Written consent was taken in all cases. Attendants of patients treated at the emergency department that followed up at four weeks were given a simple questionnaire to fill. There were 10 questions in it, with a simple "Yes" or "No" answer. A "Yes" answer carried one point while a "No" answer had zero points. Satisfaction levels were scored out of 10. Satisfaction levels were grouped as very satisfied (9-10 points), satisfied (7-8 points), partially satisfied/partially dissatisfied (5-6 points), dissatisfied (3-4 points), and very dissatisfied (0-2 points). Results A total of 688 patients followed up at four weeks, with their attendants willing to fill in the questionnaire. Mean satisfaction levels were 7.21 ± 4.59. Almost 60% of the attendants were either very satisfied or satisfied with their experience. Attendants were most satisfied with the cost, lab facilities, availability of medicines, and medical equipment. Time management was the most concerning factor for the attendants. Conclusions Attendants are mostly very satisfied or satisfied with their experience in the emergency department. About one-fifth are either very dissatisfied or dissatisfied.
