Background Myocardial revascularization surgery has shown better long term survival expectancy compared to medical therapy in patient with impaired left ventricular function.
Objective To evaluate the change in ejection fraction after 90 days in patients who underwent coronary artery bypass surgery and had preoperative left ventricular ejection fraction of less than and equal to 45% in a single cardiac center of Nepal over the period of 2 years.
Method Out of 82 eligible patients during 2 years, 3 patients expired in immediate postoperatively and 24 patients had loss of 90 days’ follow up. So, they were excluded from the study. Total 55 patients were taken for the study for whom statistical analysis was done to compare preoperative ejection fraction with post-operative 90 days’ ejection fraction.
Result Single vessel disease was present in 2(3.6%) patients, double vessel disease in 7(12.7%) patients and triple vessel disease in 46(83.6%) of the patients. In 2(3.6%) patients 2 grafts, in 18(32.7%) patients 3 grafts, in 33(60%) patients 4 grafts and in 2(3.6%) patients 5 grafts were placed for revascularization. The mean left ventricular EF in preoperative patients was 37.12±5.69% which improved to 45.80±10.00% in postoperative follow up at 90 days which was statistically significant (p=0.000).
Conclusion Surgical revascularization of myocardium in preoperatively impaired left ventricular function patients helps improve left ventricular ejection fraction postoperatively. So we suggest surgical revascularization in patient with low ejection fraction for improvement of myocardial function. Hence improve survival rate in these patients.
Background and Aims: The spectrum of congenital heart diseases (CHD) presenting for surgery to any cardiac center varies depending upon the geographical location of the center. This study is aimed to reveal the spectrum of CHD operated at a tertiary level cardiac center of Nepal.
Methods: This is a retrospective study conducted at the Department of Cardiovascular Surgery at Shahid Gangalal National Heart Center (SGNHC), Kathmandu, over a period of five years, from April 14, 2015 to April 13, 2020. All patients with a confirmed diagnosis of congenital heart disease who had undergone palliative or definitive cardiac surgery were included.
Results: Out of the total 2698 patients, there were 1374 (50.93%) females. The total number of acyanotic congenital heart disease was 1919 (71.13%), and that of cyanotic was 779 (28.87%). Male to female ratio among acyanotic and cyanotic were 0.85:1 and 1.31:1 respectively. Among all CHDs, atrial septal defect (ASD) (38.13%) followed by ventricular septal defect (VSD) (21.68%) and atrioventricular septal defect (AVSD) (5.04%) respectively were the commonest acyanotic heart lesions. Considering only the pediatric population (age 0-18 years), the commonest was VSD (27.06%) followed by ASD (22.3%) respectively. The commonest cyanotic was tetralogy of Fallot (TOF) (14.15%) followed by double outlet right ventricle (DORV) (4.44%) and total anomalous pulmonary venous connection (TAPVC) (2.89%) respectively.
Conclusion: Female population was slightly more in number amid acyanotic lesion whereas male population was dominant in cyanotic lesion. The commonest acyanotic CHD was ASD and, TOF was the commonest cyanotic lesion.
This Time series forecasting (TSF) assists in making better strategic decisions under uncertain circumstances so that financial crisis can be avoided, wise investments can be made, under/over contracting of utility can be avoided, staffs can be scheduled appropriately, service providers can provide better service, mankind can get prepared for natural disasters and many more.However, the accuracy in forecasting plays a vital role and achieving such is a challenging task owing to the vagueness and nonlinearity associated with most of the real world time series. Therefore, improving the forecasting accuracy has become a keen area of interest among the forecasters from different domains of science and engineering. In this work a survey on time series forecasting approaches on various applications has been performed. Keywords: Time series forecasting, Regularization, Regression
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