An-Najah Staff

Objectives Pneumonia is one of the most frequent medical complications of acute ischemic stroke, often apparent early after stroke onset, and it is associated with increased risk of death after stroke attack. We aimed to identify clinically useful factors associated with pneumonia, and to examine the effect of pneumonia on patient's functional outcome at discharge and on in-hospital mortality after the attack.
Objectives Pneumonia is one of the most frequent medical complications of acute ischemic stroke, often apparent early after stroke onset, and it is associated with increased risk of death after stroke attack. We aimed to identify clinically useful factors associated with pneumonia, and to examine the effect of pneumonia on patient's functional outcome at discharge and on in-hospital mortality after the attack.It is an evaluation of post-stroke pneumonia complication among ischemic stroke patients attending a hospital in Malaysia from November 1, 2008 to April 30, 2009. Data included demographic information, risk factors and clinical characteristics. Functional outcome at discharge as measured by the Modified Barther Index (MBI) and in-hospital mortality were assessed. Poor outcome was defined as MBI < 75. SPSS version 15 was used for data analysis.
Results A total of 256 patients were studied, of which 33 (12.9%) experienced pneumonia complication during hospitalization. The key baseline factors associated with the occurrence of post-stroke pneumonia were total anterior circulation infarct (P < 0.001), moderate and severe Glasgow Coma Scale (P < 0.001), atrial fibrillation (P = 0.035) and renal impairment (P < 0.001). Moreover, 24 (60%) of dead cases were suffering from pneumonia during hospitalization (P < 0.001). Additionally, after excluding the dead cases, 8 (9.2%) of patients discharged with poor functional outcome were having pneumonia during their hospital stay (P = 0.002).
Conclusions Pneumonia is independently associated with ischemic stroke poor outcome. Identification of medical history and clinical characteristics on admission can assist clinicians to identify patients at higher risk of developing post-stroke pneumonia thus hastening the initiation of certain interventions to improve patient outcome. 

Purpose: To compare the incidence of radiocontrast-induced nephropathy (RCIN) in patients undergoing coronary angiography pretreated with N-acetylcysteine NAC plus saline hydration or saline hydration alone and to determine the association between various risk factors and RCIN.
Methods: Patients were retrospectively evaluated over a one-year period. RCIN was defined as an acute rise in serum creatinine of at least 0.5 mg/dl or more than 25 % from baseline value. SPSS software, version 13 was used for data analysis.
Results: Overall, 299 patients were studied. Thirteen patients (4.3%) developed RCIN. RCIN was 3.3 % in patients treated with hydration, and 8.3 % in patients treated with NAC plus hydration (p = 0.09). In patients with RCIN, the changes in creatinine and % change in creatinine after 24 h were significantly lower in the NAC plus hydration group (p = 0.039 and p = 0.042, respectively). RCIN was significantly associated with male gender (p = 0.017), history of renal failure (p = 0.006), ischemic heart disease (p =0.003), and diuretic treatment (p = 0.013).
Conclusion: NAC plus saline hydration may not be more effective than saline hydration alone in decreasing RCIN after coronary angiography. Additional efforts to find an ideal preventive treatment are needed.