Laura Špejeraitė has completed her MD from Vilnius University, Faculty of Medicine. She also completed her six months long Internship in various departments and has done her Residency in Family Medicine. Now, she is working as a Senior Doctor Resident at Vilnius University Hospital Santariskiu Clinics.
Diseases of circulatory system are the principle cause of death within European countries. As Lithuania takes top positions of this unfavorable statistics for several years, we purposed to investigate public awareness of stroke warning signs and response to stroke onset. Adults aged 25-65 years were surveyed at “Vilniaus Centro Poliklinika” primary health care center during their regular doctor appointments in 2015. Knowledge about stroke symptoms, action to take and time gap for effective treatment after stroke onset was determined via close-ended questions, offering multiple right and wrong answers. Additional demographic and personal medical history was collected. Data from (n=408) respondents were studied. The main age was 44.09±11.9 and (53.2%) were women. Respondents recognized on average 4.29 stroke symptoms of 6 possible (SD±1.12). Frequent adult knew 4 or 5 signs, but only (14%) recognized all correct stroke signs. The most prevalent stroke symptom was “confusion, trouble speaking” (76.72%) accompanied by “sudden acute head pain” (76.47%). Barely (5.63%) participants listed the correct “three-hour time period for effective stroke treatment” and all six stroke signs. Almost all respondent would “call ambulance” at particular condition. Knowledge of stroke symptoms was significantly higher among men than women (p=0.006). No difference found by age, education, self-reported risk factors and smoking history. Adequate response to stroke onset is principal component in time sensitive outcomes but it is not efficient among Lithuanian urban adults. There is a great necessity for stroke managing programs such as mass media or role of primary care providers to be strengthened.
Imran Tahir completed his MBBS from National University of Science and Technology at the age of 23 years. Currently training in medicine in West Midlands United Kingdom.
Background: Every four minutes someone is admitted to hospital suffering from a heart attack or a chest pain event in the UK, totaling over 150,000 hospitalizations a year. Chest pain is one of the most common presentations in the emergency department and quite a few of them get admitted as low risk ACS patients. With the developments in technology, we have increasingly sensitive troponin assays available. Previous-generation troponin assays have been used as diagnostic and prognostic markers in acute coronary syndrome patients and for risk stratification to guide triage decisions and aid in treatment selection. New, high-sensitivity troponin assays represent an important advance with added sensitivity for cardiac myocyte necrosis. High-sensitivity troponin assays detect concentrations of the same proteins that conventional sensitivity assays are aimed at detecting, just in much lower concentrations.\r\n\r\nObjective: Can high sensitivity troponin avoid unnecessary admission and save money.\r\n\r\nMethod: We did the retrospective data analysis for 100 patients presenting in the emergency department of University Hospital Birmingham in the month of March 2016. All adult patients admitted with the diagnosis of ACS were included in the study.\r\n\r\nResults: We included 100 patients admitted with the diagnosis of ACS under the medical team in the month of March 2016. 86% patients had a serial troponin done during the admission. Rest of the 14% had a single troponin done. Only 8% patients had a raise in the serial troponin, rests of them were discharged home. The average length of stay was 33 hours. \r\n\r\nDiscussion: Based on the results of this data analysis, it has been highlighted that considering the use of high sensitivity troponins at 0 and 2 hours coupled with appropriate risk stratification of patients presenting with chest pain in the Emergency department, can possibly help in safely discharging a major percentage of patients and avoiding unnecessary admissions to the hospital. At the same time making it possible to achieve the above objectives within the NHS policy of 4 hours breech time for the Emergency department\r\n\r\nConclusion: We have 5-10 patients every day presenting to the emergency department with chest pain. About 50% of them get admitted with the diagnosis of ACS. 86% of our patients could have been potentially discharged home by using high sensitivity troponin at 0 and 2 hours and hence could have avoided 86% admissions. This in turn could have saved quite some money. With the growing pressure in the emergency departments due to ever increasing number of patients all these high sensitivity tests could potentially make some difference.\r\n