Objective: To look for the presence or absence of seasonal variation of pulmonary embolism (PE). To analyze the effect of age, sex and the presence or absence of deep vein thrombosis(DVT) and its risk factors on the occurrence of PE. To analyze the ECG changes and the presence or absence of sinus tachycardia in patients with acute PE. Method: One hundred three patients with PE were studied retrospectively, during the years 2002-2007 at the intensive and respiratory care unit and general medical units in Ibn-Sena Teaching Hospital. Results: One hundred three patients with PE were studied. The age of the patients correlates significantly with the presence of PE being highest between 21-50 year of age, with p-value of <0.001. There were no seasonal variations in the distribution of PE with P-value of 0.06. Females significantly outnumbered male patients with P-value of 0.002. There was no statistically significant association between the clinically evident DVT or its absence and the diagnosis of PE with p-value 0.278. The association between the presence of PE and positive doppler ultrasound for DVT were significant with p-value of 0.023. There was a significant association between the presence of PE and sinus tachycardia with p-value of <0.001, and negative correlation with the classical ECG changes. Conclusion: There was no seasonal variation in the distribution of PE. There was significant association between the presence of PE and positive doppler ultrasound for DVT. Sinus tachycardias were commonly present with acute PE. We need to have more sophisticated facilities for proper diagnosis of PE.
Objectives: Systemic inflammatory response syndrome is one of the most important causes of intensive care unit (ICU) morbidity and mortality worldwide. The aim of this study is to explore the spectrum of diseases responsible for SIRS admission in Mosul, and to identify the mortality rate and the factors associated with poor outcome. Methods: Fifty patients with sepsis or non-infective SIRS were studied during the period from June 1 st to November 30 th 2009. Patients were collected from the medical ICU and the general medical wards in Ibn-Sina Teaching Hospital in Mosul,. Acute physiology and chronic health evaluation II (APACHE II) score was utilized to assess the severity of illness on admission. The patients included in the study received the standard medical care according to their condition, and were followed to delineate the cause of their illness, the percentage of microbiological confirmation, the duration of hospital stay, the mortality rate and the factors that influence their outcome. Results: Sepsis represented 86% of cases of SIRS, of which 82% of them were caused by community acquired infections. Pneumonia was responsible for 48.8% of sepsis cases, followed by acute pyelonephritis and intra-abdominal infection. Sepsis was microbiologically confirmed in 44.2% of patients, and blood culture was positive in 18.6% of patients. Impaired consciousness, anaemia, hyperglycaemia and high blood urea were associated with excess mortality rate; while positive blood culture and hypoalbuminaemia correlated with high APACHE II score. The overall mortality rate was 44%. Patients with severe sepsis had a mortality rate of 55.2%. Conclusion: SIRS is an important cause of hospital admission in Mosul, with associated high mortality rate. ICU admission should be seriously considered for patients with certain risk factors that predict poor outcome.
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