AIMS Primary percutaneous coronary intervention (PCI) is the preferred treatment for ST-elevation myocardial infarction (STEMI). The distance to primary PCI centres and the inherent time delay in delivering primary PCI, however, limit widespread use of this treatment. This study aimed to evaluate the impact of pre-hospital diagnosis on time from emergency medical services contact to balloon inf...

REPLY We thank Kok, Umans, and Arnold for their statistical calculations. Indeed, a large sample size would be required to prove that there is equivalence in clinical outcome between patients directly admitted compared to transferred patients. To demonstrate that the six-month mortality rate would not exceed more than 1% (6% vs. 7%) would require a sample size of even more than 25,000 patients!...

BACKGROUND An effective emergency referral transport system is the link between the home of the pregnant woman and a health facility providing basic or comprehensive emergency obstetric care. This study attempts to explore the role of emergency transport associated with maternal deaths in Unnao district, Uttar Pradesh (UP). METHODS A descriptive study was carried out to assess the causes of a...

W ithin the United Kingdom, 2 as well as in many other European countries, it is now accepted that neonatal intensive care should no longer be left to local initiatives, but has to be commissioned on a regional basis. Regionalisation of high risk perinatal health care by establishing and commissioning managed clinical networks aims to maintain equality of access whilst maximising the level of e...

Abstract Background Cardiovascular diseases (CVD) are commonly comorbid with mental health disorders, portending poorer cardiac prognosis. Despite the high prevalence of depression and anxiety, guidelines recommending routine screening referral, uptake healthcare in CVD populations remains low. Reasons for underutilisation psychological services this population remain largely unknown. Methods T...