exudates and Hypotension

The purpose of this investigation was to determine if a slower speed of spinal anaesthesia injection would reduce the incidence of hypotension.. Randomised controlled trial.. Tertiary level hospital in Malaysia.. 77 patients undergoing elective Caesarean delivery.. Differing speeds of spinal injection.. Systolic blood pressure was assessed every minute for the first 10min and incidence of hypotension (reduction in blood pressure of >30% of baseline) was recorded. The use of vasopressor and occurrence of nausea/vomiting were also recorded.. 36 patients in SLOW group and 41 patients in FAST group were recruited into the study. There was no significant difference in blood pressure drop of >30% (p=0.497) between the two groups. There was no difference in the amount of vasopressor used and incidence of nausea/vomiting in both groups.. In our study population, there was no difference in incidence of hypotension and nausea/vomiting when spinal injection time is prolonged beyond 15s to 60s.. ClinicalTrials.govNCT02275897. Registered on 15 October 2014.

Topics: Adult; Anesthesia, Obstetrical; Anesthesia, Spinal; Asian People; Blood Pressure; Cesarean Section; Female; Humans; Hypotension; Incidence; Injections, Spinal; Malaysia; Postoperative Nausea and Vomiting; Pregnancy; Tertiary Care Centers; Time Factors; Vasoconstrictor Agents

Thrombolytic therapy is a well-established therapy in acute myocardial infarction (AMI), reducing mortality and infarct size. This study is a retrospective analysis of survival and complications after the use of streptokinase at Hospital Universiti Sains Malaysia. Streptokinase was first used here in March 1990. Between then and February 1992, 126 patients were admitted to the Coronary Care Unit. Thirty-two patients who fulfilled our criteria for thrombolytic treatment were given an hour intravenous infusion of 1.5 MU streptokinase, and started on aspirin. A control group of 64 patients selected from before March 1990, and matched for age, sex and site of infarct, was given standard therapy. The survival at 4 weeks post-AMI was 91% in the streptokinase therapy group and 91% in both groups (p > 0.05). The complications encountered were reperfusion arrhythmias (2 patients), hypotension(1), maculopapular rash(1) and gum bleeding(1). None of these complications were statistically increased when compared to the control group and none resulted in the death of a patient. We conclude that streptokinase therapy can be given safely in a rural Malaysian setting. Our survival and complication rates are comparable with other published series.

Topics: Adult; Aged; Arrhythmias, Cardiac; Female; Humans; Hypotension; Infusions, Intravenous; Malaysia; Male; Middle Aged; Myocardial Infarction; Retrospective Studies; Streptokinase; Survival Rate; Thrombolytic Therapy

The negative effect of hypertension has overshadowed possible health problems associated with hypotension. The purposes of this study were to describe the prevalence of hypotension in older adults and to determine the association between hypotension and cognitive function, after adjusting for possible covariates.. The data for the study consisting of 1067 community-dwelling older adults were obtained from a national survey entitled "Identifying Psychosocial and Identifying Economic Risk Factor of Cognitive Impairment among Elderly", conducted in Malaysia. The hypotension was considered as blood pressure <120/75 mm Hg, measuring by standard mercury manometer. Data analysis was performed using the SPSS Version 22.0.. The mean age of the respondents was 68.27 (SD = 5.93). Mean score of cognitive function as measured by MMSE was 22.70 (SD = 4.95). The prevalence of hypotension was 29.3%. The prevalence of cognitive impairment for hypotension group was 25.6%. Results of multiple linear regression analysis revealed that hypotension is negatively associated with cognitive function (Beta = -0.11, p<.01), after adjusting for age, gender, education, marital status, employment status, diabetes, heart disease, stroke and gastritis.. The study showing hypotension is significantly associated with decreased cognitive function in later life, implies more attention to low blood pressure in old age.

Topics: Aged; Aging; Cognitive Dysfunction; Comorbidity; Female; Health Surveys; Humans; Hypotension; Malaysia; Male; Middle Aged; Prevalence

The determination of cerebral perfusion pressure (CPP) is regarded as vital in monitoring patients with severe traumatic brain injury. Besides indicating the status of cerebral blood flow (CBF), it also reveals the status of intracranial pressure (ICP). The abnormal or suboptimal level of CPP is commonly correlated with high values of ICP and therefore with poor patient outcomes. Eighty-two patients were divided into three groups of patients receiving treatment based on CPP and CBF, ICP alone, and conservative methods during two different observation periods. The characteristics of these three groups were compared based on age, sex, time between injury and hospital arrival, Glasgow Coma Scale score, pupillary reaction to light, surgical intervention, and computerized tomography scanning findings according to the Marshall classification system. Only time between injury and arrival (p = 0.001) was statistically significant. There was a statistically significant difference in the proportions of good outcomes between the multimodality group compared with the group of patients that underwent a single intracranial-based monitoring method and the group that received no monitoring (p = 0.003) based on a disability rating scale after a follow up of 12 months. Death was the focus of outcome in this study in which the multimodality approach to monitoring had superior results.

Topics: Accidents, Traffic; Adolescent; Adult; Aged; Blood Pressure; Brain Damage, Chronic; Brain Injuries; Cerebrovascular Circulation; Child; Cohort Studies; Craniotomy; Female; Follow-Up Studies; Glasgow Coma Scale; Humans; Hypotension; Intracranial Pressure; Malaysia; Male; Middle Aged; Monitoring, Physiologic; Oximetry; Reflex, Pupillary; Respiration, Artificial; Severity of Illness Index; Tomography, X-Ray Computed; Transducers; Treatment Outcome

Topics: Anesthesia; Anesthesia, Intravenous; Drug Combinations; Gynecology; Humans; Hypotension; Infusions, Parenteral; Malaysia; Pregnanediones; Pulse; Respiration