Search

Background: Stroke presents as the second most prominent factor contributing to global mortality. Immediate brain imaging can be valuable for assessing functional recovery potential. This study investigated the association between Alberta Stroke Program Early CT Score (ASPECTS) and functional outcomes in patients with left and right-hemisphere strokes. Methods: A prospective cohort study was conducted in July-Dec2 022, at a tertiary care hospital in Karachi including patients of either gender presenting within 2 days of stroke while excluding posterior circulation strokes, TIA & unwilling patients using a non-probability consecutive sampling technique. A total of 152 patients with acute ischemic stroke involving anterior circulation were analyzed and patients were categorized into two groups: the left hemisphere group (n=76) and the right hemisphere group (n=76) accordingly. ASPECTS scores were calculated from brain CT scans, while functional outcomes were measured using the modified Rankin Scale (mRS) at the three-month mark. Descriptive analysis and chi-square test were applied using SPSS vr25. Results: Patients (n=152) had a mean age of 61.75 ± 13 years, with males comprising 67% of the cohort. ASPECTS scores were notably higher in left hemisphere strokes (median 9, IQR 2) than right hemisphere strokes (median 8, IQR 3) (p=0.036). Higher ASPECTS scores (≥7) correlated with improved outcomes (mRS ≤2) in both hemispheres. There was no statistically significant difference in both groups’ functional outcomes (p=0.182). Conclusion: ASPECTS predicts functional outcomes in acute ischemic strokes equally well regardless of the affected hemisphere.

Background: Non-invasive ventilation (NIV) is the first-line management for acute exacerbation of COPD (AECOPD), but some patients don't improve and need invasive ventilation, leading to high mortality. We conducted a study to determine risk factors associated with NIV outcomes in these patients. Identifying predictive parameters of NIV failure could help timely intervention and prevent mortality. Methods: A Quasi Single Arm study was conducted at a tertiary care Hospital, in Karachi, from July to December 2022. We studied 170 COPD patients admitted to Medicine Department and Medical ICU with acute respiratory failure, among those 170 patients 80 were male and 90 were female, aged above 40 and below 80 years. Results: Among 170 AECOPD patients studied, 38% experienced NIV failure, while 61% had NIV success. In the NIV failure group, 38.46% of patients died in hospital. Most factors like quadrant infiltrate, weak cough reflex, low consciousness level, more requirements of oxygen, low pH, more respiratory rate, and positive blood cultures (p-value