European Journal of Cardiovascular Medicine

Research Article Open Access

Incidence and Predictors of Postoperative Nausea and Vomiting Following General Anaesthesia in Adult Patients Undergoing Elective Surgery: A Prospective Observational Study

Dr. Surya Venkata Ramakrishna Nadipalli ,

Dr. Anand Acharya

Pages 26 - 30

Abstract

Background: Postoperative nausea and vomiting (PONV) remains a frequent and distressing complication after general anaesthesia and can delay recovery, increase rescue medication use, and reduce patient satisfaction. Objectives: To determine the incidence of PONV during the first 24 postoperative hours and identify patient- and perioperative predictors among adults undergoing elective surgery under general anaesthesia. Methods: This prospective observational study included 80 adults undergoing elective surgery at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India, from January to June 2017. Demographic characteristics, smoking status, previous PONV or motion sickness, duration of surgery, anaesthetic maintenance, postoperative opioid exposure, and prophylactic antiemetic administration were recorded. Patients were assessed for nausea and vomiting for 24 hours. Univariable analysis and multivariable logistic regression were performed to identify predictors of PONV. Results: PONV occurred in 27 patients, giving an incidence of 33.8%. Nausea occurred in 31.3%, vomiting in 17.5%, and both in 15.0%. Most first episodes occurred within 2 hours after surgery. PONV was more frequent among females, patients with previous PONV or motion sickness, those receiving postoperative opioids, and those with surgery lasting more than 90 minutes. In multivariable analysis, previous PONV or motion sickness, female sex, and postoperative opioid use independently increased PONV risk, whereas prophylactic antiemetic administration was protective. Conclusion: Approximately one-third of adults experienced PONV after elective surgery under general anaesthesia. Female sex, previous PONV or motion sickness, and postoperative opioid exposure were important predictors. Risk-based prophylaxis and opioid-sparing postoperative analgesia should be emphasized to reduce PONV.

Research Article Open Access

Awareness of Lipid Disorders and Their Role in Cardiovascular Disease Prevention: A Cross-Sectional Study among Adults Attending a Tertiary Care Hospital in India

Dr. Sudhakar Arya

Pages 22 - 25

Abstract

Background: Dyslipidemia is one of the most important modifiable risk factors for atherosclerotic cardiovascular disease (CVD), yet public awareness regarding lipid disorders remains poor in India, contributing to delayed diagnosis and inadequate risk-factor control.Objectives: To assess the level of awareness regarding lipid disorders and their role in cardiovascular disease among adults attending the medicine outpatient department of a tertiary care hospital, and to correlate awareness with the actual lipid profile of the study population.Materials and Methods: A hospital-based, cross-sectional, questionnaire-based study was conducted over a period of Six months among 400 adults aged 20-65 years selected by systematic random sampling. A pre-validated, structured questionnaire was used to assess awareness regarding normal lipid levels, risk factors, symptoms and preventive measures for dyslipidemia. Fasting lipid profile was estimated for all participants and dyslipidemia was classified as per National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria. Data were analysed using SPSS version 20.0, and Chi-square test was applied to test association, with p<0.05 considered statistically significant.Results: Overall, only 34.5% of participants had adequate awareness regarding lipid disorders, while 65.5% had poor to moderate awareness. Awareness was significantly higher among participants with higher educational status, urban residence, and a family history of cardiovascular disease (p<0.05). Dyslipidemia, in one or more lipid parameters, was detected in 61.2% of participants, with low HDL-cholesterol (46.5%) being the commonest abnormality, followed by hypertriglyceridemia (34.0%) and raised LDL-cholesterol (28.7%). Participants with poor awareness had a significantly higher prevalence of dyslipidemia compared with those with adequate awareness (68.3% vs. 48.9%, p=0.001).Conclusion: Awareness regarding lipid disorders among the study population was found to be inadequate and was significantly associated with the actual burden of dyslipidemia. Community-based health education programmes focusing on lipid screening, dietary modification and lifestyle changes are urgently required for the primary prevention of cardiovascular disease in India

Research Article Open Access

Comparison of Urinary calcium levels in adult patients with fracture and surgical intervention and without fracture

Pages 17 - 21

Abstract

Background: Fractures, stemming from trauma or medical conditions, pose significant challenges to global healthcare. Despite extensive research on biomechanical aspects, the systemic impact on mineral homeostasis, particularly urinary calcium dynamics, remains understudied in adults undergoing fractures and surgical interventions. Materials and Methods: A prospective observational study conducted at a tertiary medical college in Uttar Pradesh, India, aimed to scrutinize urinary calcium levels in adults with fractures and surgical intervention compared to a fracture-free control group. Participants included adult patients (n=150/group) with fractures requiring surgical intervention and age-matched controls. Serum and urinary calcium levels were assessed, and statistical analyses were performed using appropriate tests. Results: The "Fracture + Surgery" group exhibited lower mean serum calcium levels (9.3 mg/dL) compared to controls (9.7 mg/dL, p<0.001). Urinary calcium levels were significantly elevated in the "Fracture + Surgery" group (175 mg/24h) compared to controls (120 mg/24h, p<0.001). Subgroup analysis based on fracture types revealed nuanced variations in urinary calcium dynamics. Type 2 fractures exhibited the highest mean urinary calcium levels (180 mg/24h, p<0.001). Conclusion: Our study highlights disruptions in calcium metabolism following fractures and surgical interventions, emphasizing the need for comprehensive clinical management. The setting in Uttar Pradesh provides unique insights into diverse patient populations. Future research should explore molecular mechanisms underlying these changes and targeted interventions.

Review Article Open Access

The Most Common Ten Diseases in the Dental Department

Pages 11 - 16

Abstract

In this article the author focuses of the most common ten diseases and anomalies that come across our daily practice in the Dental Department of AHT-SA Hospital. The author depended on the statistics, cases reports and active cases of his daily practice. The most registered anomaly “considered disease” in the Orthodontic Department has been the Malocclusion. It’s found out that 94% of the patient who visited the Orthodontic Clinic of A.H. Hospital have had a sort of “Mal-Occlusion”(1). The other diseases that had been registered had been: the Dental Caries, Periodontitis, Cleft-Lip and Palate, Ectodermal Dysplasia, Dentigerous Cysts, Impacted Third Molars, Mouth breathing “and snoring”, Diabetes and its dental aftermaths and Finally Achondroplasia.

Research Article Open Access

Trends in the management of atrial fibrillation: A neurologist’s perspective

Pages 1 - 10

Abstract

Cardiac embolism, primarily from atrial fibrillation (AF), is implicated in a quarter of all ischemic strokes. In the setting of AF, contraindications to traditional therapies can create a clinical dilemma when choosing an agent for secondary stroke prophylaxis. Newer horizons in the medical and surgical management of AF have helped us choose from a wide variety of available therapies, the best possible management. In this article, we review the current trends in AF management including newer oral anticoagulants as well as surgical devices from a neurologist’s view.

European Journal of Cardiovascular Medicine

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