FC 068QUALITY OF LIFE OVER TIME IN OLDER MEN AND WOMEN WITH ADVANCED CKD - RESULTS FROM THE EQUAL STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Nicholas Chesnaye ◽  
Yvette Meuleman ◽  
Esther De Rooij ◽  
Friedo W Dekker ◽  
Marie Evans ◽  
...  

Abstract Background and Aims Differences between the sexes are apparent in the epidemiology of CKD. Cross-sectional studies show that women consistently report a poorer health-related quality of life (QoL) than men, however, longitudinal studies are lacking. Here we investigate the sex-specific evolution of QoL over time in advanced CKD. As a secondary aim, we explore the sex-specific determinants of QoL. Method EQUAL is an observational prospective cohort study in stages 4 and 5 CKD patients ≥65 years not on dialysis with an incident estimated glomerular filtration rate (eGFR) < 20 ml/min/1.73m². Data on QoL (measured using the RAND-36), clinical and demographic patient characteristics were collected between April 2012 and September 2020. QoL trajectories were modelled by sex using linear mixed models, and joint models were applied to deal with informative censoring. We followed patients until death or dialysis initiation. Results We included 5151 QoL measurements in 1416 patients over a total of 1986 person years of follow-up. Overall, the physical component summary (PCS) declined with 2.0 (95% CI 1.4-2.6) points and the mental component summary (MCS) by 2.4 (95% CI 1.8-3.0) points per year. Although women had overall lower QoL scores, figure 1 demonstrates that PCS and MCS declined more than twice as fast in men (PCS: 2.4 per year, 95% CI 1.7 – 3.1, MCS: 2.9 per year, 95% CI 2.2 – 3.6) compared with women (PCS: 1.1 per year, 95% CI -0.2 – 2.0, MCS: 1.5 per year, 95% CI 0.5 – 2.4). We identified a non-linear interaction effect between sex and eGFR levels on QoL, demonstrating a stronger negative effect of decreased eGFR on both PCS (p=0.02) and MCS (p=0.04) in men compared with women. Subsequent adjustment for renal decline attenuated the difference in rate of QoL decline between men and women (difference after adjustment; PCS: 1.1, 95% CI -0.1 – 2.2, MCS: 1.2, 95% 0.0 – 2.3). In univariable analyses, higher serum haemoglobin was more beneficial to QoL in men compared to women (p-value for interaction; PCS: p=0.03, MCS: p=0.01). Higher serum phosphate had a strong harmful effect on both PCS and MCS in men, but not in women (PCS & MCS: p<0.001). The presence of pre-existing diabetes had a negative effect on PCS and MCS in men, but to a lesser extent in women (PCS: p=0.02, MCS: p=0.01). Conclusion Despite the higher overall QoL reported by men, both their physical and mental QoL declined approximately twice as fast compared with women. The faster decline in men was mediated in part by their lower levels of renal function, which had a stronger impact on their QoL as compared with women. Furthermore, in exploratory analyses we identified that high levels of phosphate, low levels of haemoglobin, and pre-existing diabetes were more detrimental to QoL in men than in women.

2019 ◽  
Vol 14 (2) ◽  
pp. 243
Author(s):  
Dina Fahmawati

Cigarette smoke contains nicotine which disturbs health. Nicotine is capable of reducing the taste of food, so  there is appetite suppressant. The ability of nicotine in increasing blood liposuction process can affect the increase in blood cholesterol level. The research aims to study the difference between food intake and blood cholesterol level between smokers and non-smokers. This study was a comparative observational analytic study using cross-sectional design. The data of particular  subjects and smoking habit were  obtained from the questionnaire. The food intake was obtained by interview using 2x24 hours food recall form while the blood cholesterol level was obtained by blood sampling which was then analyzed using laboratory test. The subjects were 13 smokers and 13 non-smokers, taken by simple random sampling. The data were analyzed by Independent t-Test. The results have suggested that the difference in the average  food intake and  blood cholesterol level between smokers and non-smokers were not significant. The substantial average difference was found in the level of cholesterol intake, so  the statistical test has showed a significant difference, p-value = 0.005 < α(0.05). Smoking has a harmful effect for health so  people must decrease its consumption or stay abstinent from it. The longer human get exposed to cigarette, the more susceptible they get the illness from it.


2018 ◽  
Vol 1 (2) ◽  
pp. 114
Author(s):  
Wahdaniah Wahdaniah ◽  
Sri Tumpuk

Abstract: Routine blood examination is the earliest blood test or screening test to determine the diagnosis of an abnormality. Blood easily froze if it is outside the body and can be prevented by the addition of anticoagulants, one of which Ethylene Diamine Tetra Acetate (EDTA). Currently available vacuum tubes containing EDTA anticoagulants in the form of K2EDTA and K3EDTA. K3EDTA is usually a salt that has better stability than other EDTA salts because it shows a pH approaching a blood pH of about 6.4. The purpose of this research is to know the difference of erythrocyte index results include MCH, MCV and MCHC using K3EDTA anticoagulant with K2EDTA. This research is a cross sectional design. This study used venous blood samples mixed with K2EDTA anticoagulant and venous blood mixed with K3EDTA anticoagulants, each of 30 samples. Data were collected and analyzed using paired different test. Based on data analysis that has been done on MCH examination, p value <0,05 then there is a significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value. Then on the examination of MCV and MCHC obtained p value <0.05 then there is no significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value.Abstrak: Pemeriksaan darah rutin merupakan pemeriksaan darah yang paling awal atau screening test untuk mengetahui diagnosis suatu kelainan. Darah mudah membeku jika berada diluar tubuh dan bisa dicegah dengan penambahan antikoagulan, salah satunya Ethylene Diamine Tetra Acetate (EDTA). Dewasa ini telah tersedia tabung vakum yang sudah berisi antikoagulan EDTA dalam bentuk  K2EDTA dan  K3EDTA. K3EDTA  biasanya berupa garam yang mempunyai stabilitas yang lebih baik dari garam EDTA yang lain karena menunjukkan pH yang mendekati pH darah yaitu sekitar 6,4. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan hasil indeks eritrosit meliputi MCH, MCV dan MCHC menggunakan antikoagulan K3EDTA dengan K2EDTA. Penelitian ini merupakan penelitian dengan desain cross sectional. Penelitian ini menggunakan sampel darah vena yang dicampur dengan antikoagulan K2EDTA dan darah vena yang dicampur dengan antikoagulan K3EDTA, masing-masing sebanyak 30 sampel. Data dikumpulkan dan dianalisis menggunakan uji beda berpasangan. Berdasarkan analisis data yang telah dilakukan pada pemeriksaan MCH didapatkan nilai p < 0,05 maka ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit. Kemudian pada pemeriksaan MCV dan MCHC didapatkan nilai p < 0,05 maka tidak ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit.


e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Marianne C. Jacobus ◽  
Max F.J Mantik ◽  
Adrian . Umboh

Abstract: Haemoglobin is the main component of red blood cells that serves as a transporter of oxygen and carbon dioxide in the blood. The normal range of haemoglobin values can be used to determine the degree of anemia according to age and gender. Geographical condition such as altitude influences the haemoglobin value. This study aimed to obtain the difference of haemoglobin levels between teenagers with good nutrition status who live at the highland and those at the seaside. This was an observational analytical study with a cross sectional design. Samples were students with good nutrition status of SMPN 3 Tomohon (living at the highland) and those of SMP Kristen Nazaret Tuminting (living at the seaside). There were 60 students who met the inclusion criteria as follows: adolescent, good nutrition status, healthy, aged 13-15 years, lived at the highland or at the seaside ≥ 6 month, and willing to be performed blood examinations, and had been approved by their parents. The Mann-Whitney test for the difference between haemoglobin levels of the two groups showed a p value < 0,001. Conclusion: There was a very significant difference between haemoglobin levels of good nutrition teenagers who lived at the highland and at the seaside. Keywords: haemoglobin levels, good nutrition, teenagers, highland, seaside  Abstrak: Hemoglobin merupakan komponen utama sel darah merah dan berfungsi sebagai transporter oksigen dan karbon dioksida dalam darah. Batas normal nilai hemoglobin dapat digunakan untuk menetapkan derajat anemia, dengan distribusi usia dan jenis kelamin spesifik didasarkan pada sampel referensi sehat. Kondisi geografis, seperti ketinggian tempat dari permukaan laut menjadi faktor pertimbangan dalam distribusi nilai normal hemoglobin. Penelitian ini bertujuan untuk mendapatkan perbedaan kadar hemoglobin antara remaja gizi baik yang tinggal di pegunungan dengan yang tinggal di tepi pantai. Jenis penelitian ini analitik-observasional dengan desain potong lintang. Sampel penelitian yaitu remaja gizi baik yang tinggal di pegunungan yaitu siswa SMPN 3 Tomohon dan yang di tepi pantai yaitu siswa SMP Kristen Nazaret Tuminting. Subjek penelitian berjumlah 60 remaja yang memenuhi kriteria inklusi yaitu gizi baik, sehat, berumur 13-15 tahun, berdomisili di pegunungan atau tepi pantai ≥6 bulan, bersedia dilakukan pemeriksaan darah, dan telah disetujui oleh orang tua. Data yang diperoleh dianalisis menggunakan uji Mann-Whitney dengan bantuan program SPSS. Hasil uji Mann-Whitney mengenai perbedaan kadar hemoglobin antara kedua kelompok menunjukkan nila p <0,001. Simpulan: Terdapat perbedaan yang sangat bermakna kadar hemoglobin remaja gizi baik yang tinggal di pegunungan dengan di tepi pantai.Kata kunci: kadar hemoglobin, remaja gizi baik, pegunungan, tepi pantai


2020 ◽  
Vol 19 (2) ◽  
pp. 1-5
Author(s):  
Aso Sabir Saeed ◽  
◽  
Osama MohammadAmin Shukr

Background: Several studies have demonstrated an association between obesity and migraine. It’s still unclear whether migraine is the cause or it's the result of obesity. Objective: We investigated the prevalence of migraine among obese and non-obese individuals and analyzed the relationship between migraine prevalence and obesity. Patients and Methods: This is cross-sectional observational study was carried out at the neurology outpatients’ department of the Rizgary Teaching Hospital in Erbil, Iraq, from July 1st , 2018 to September 30, 2019. We interviewed and examined 300 persons, both obese (n=154) and non-obese (n=146), and of both gender. All of them were adults (>18 years old). Each person's weight, height, body mass index (BMI), and waist circumference were measured.The diagnosis of migraine was made according to the International Headache Society’s criteria. Obesity was present if the individual’s BMI is ≥30 and/or waist-to-hip ratio is >0.9 in females and >1.0 in males. Results: Out of the 300 persons, 14 males (8.5%) got migraines while migraine was found in 37 females (27.4%), irrespective of their weight. Out of the 300 persons, the prevalence of migraine among obese individuals was 21.4% (n=33) and while in non-obese individuals was 12.3% (n=18). There was a statistically significant difference between the groups (p-value=0.045). The overall prevalence of migraine was 16.9% of the persons interviewed. Conclusion: The results showed that migraine is more prevalent among obese persons than non-obese persons and the difference was statistically significant. Keywords: Migraine, obesity, BMI, headache


2020 ◽  
Vol 7 (6) ◽  
pp. 997
Author(s):  
Dharmendra Jhavar ◽  
Neha Kirti ◽  
Sumit Kumar Vishwakarma ◽  
Umesh Kumar Chandra ◽  
Vinod Verma

Background: Since a long time ago, the experts have realized that determination of cut-off point for diagnosing diabetes will be revised over time with the lower blood glucose level as the more sensitive diagnosis for detecting the occurring complication and biochemical changes.Methods: This cross sectional study was carried out in the department of medicine, M.G.M. Medical College and M.Y. Hospital Indore from July, 2016 to August, 2017 in 200 individuals and patients having euglycemic status attending General Medicine OPD.Results: In the low and high normal group 2 (2.0%) and 8 (8.0%) were having abnormal total cholesterol (TC) level respectively. The mean total cholesterol in the low normal group was 117.16±26.94mg/dl and it was 154.74±28.38mg/dl in the high normal group. The difference was found to be statistically significant (p value 0.000). In the low and high normal group, 4 (4.0%) and 17 (17.0%) were having abnormal triglyceride (TG) levels respectively. The mean TG levels in the low and high normal group were 96.93±22.64mg/dl and 110.55±32.37mg/dl respectively. The difference was found to be statistically significant (p value 0.001). In the low and high normal group, 6 (6.0%) and 14 (14.0%) patient was having abnormal uric acid levels respectively. The mean uric acid levels in the low and high normal group was 4.88±1.10mg/dl and 5.31±1.31mg/dl respectively. The difference was found to be statistically significant (p value 0.013).Conclusions: Higher levels of Cholesterol and Triglycerides were found more commonly in high normal euglycemic group compared to low normal euglycemic group. Mean cholesterol and mean triglyceride levels were higher in high normal euglycemic group.


2022 ◽  
Vol 12 (1) ◽  
pp. 175-187
Author(s):  
Sumani Abdul-Manan ◽  
Alhassan Iddrisu Abdullai ◽  
Buhari Gunu Yussif

Background: A proven strategy for saving lives from vaccine-preventable diseases is the timely vaccination of the people. In Ghana, there is considerable hesitation about the Covid-19 vaccines due to anxieties and uncertainties about their safety. With varying perceptions and believes being developed about Covid-19 vaccines, there is a likely negative effect on vaccine acceptance or otherwise. This study aims to ascertain the levels of acceptance of potential Covid-19 vaccine among Ghanaian adults, to identify predictors of vaccine acceptance or hesitance. Methodology: A web based cross-sectional survey conducted among Ghanaians above 18 years, conducted between the month of February and March, 2021. Data were collected by administering online google forms (Questionnaire). The questionnaire was shared through social media platforms. A snowball sampling technique was used where researchers shared google forms to close friends and family. Analyses were conducted at p-value <0.05 using descriptive statistics, cross-tabula­tions and logistic regression. Results: A total of 350 responses were achieved by end of data collection. Out of these, only 348 were considered for analysis based on the inclusion and exclusion criteria. Majority of the respondents (65.2%) were male, a third (30%) of them live in rural areas and about 57.5% were married. Factors such as age, educational level, prior vaccine acceptance history, personal vulnerability and self-feeling of health were significantly associated with covid-19 vaccine acceptance. Conclusion: The results depict low acceptance rate for potential covid-19 vaccine among Ghanaians. Government and MoH should engage the media on its role in combating misinformation with regards the Covid-19 vaccine. Key words: coronavirus disease 2019 (Covid-19), vaccine, hesitance, acceptance.


Author(s):  
Asma Abdelaal Abdalla ◽  
Siham Ahmed Balla ◽  
Amna Abdalla Babiker ◽  
Safaa Abdelhameed Medani ◽  
Rania Abdalla Osman Khalfa ◽  
...  

Aims: To measure the waist circumference of Sudanese adults in Khartoum Locality and its relationship to blood pressure and lifestyle  during celebration of international day of hypertension in May 2016 . Study Design: It was a descriptive cross-sectional study. Place of the Celebration: Khartoum Locality at Alsahaa Alkhadraa (The Green Park). Methodology: A total of 364 adult participants, 196 men and 168 women were interviewed using structured questionnaire. Blood pressure (BP) was measured considering hypertension as ≥ 140 mmHg and ≥ 90 mmHg for systole and diastole BP respectively. Waist circumference was measured using an anthropometric measuring tape at cut-off point of 94 cm and 80 cm for men and women respectively. Data was managed by SPSS version 20 and Chi-square test at 95% CL was used to test the association between waist circumference, blood pressure and life style characteristics. Results: Age distribution of the study population showed 48.2% females and 45.4% males in the middle age group (38-57 years). Two thirds of the study population were hypertensive, 62.8% of males and 64.3% of females. The mean waist circumference of men was 97.82 cm + 16.7, mean Systolic BP was 127 + 22 and mean Diastolic BP was 85 + 15. The mean waist circumference of women was 99.31 + 16.2, mean Systolic was 128 + 24 and mean Diastolic BP was 84 +17. Abnormal waist circumference was found in 61.2% of males and 86.9% of females. Fifty nine (30.1%) of the males and 86 (51.2%) of the females with abnormal waist circumference were hypertensive. The association between abnormal waist circumference and high blood pressure was significant among both sexes, P value = 0.001. Physical exercise and fat and salt foods were not significantly associated waist circumference in both men and women. Conclusion: Two thirds of women and men in the celebrating areas were hypertensive.  Half of women and one third of men were significantly hypertensive and having abnormal waist circumference. Doing physical exercise, avoiding fat and salt foods was insignificantly associated with normal waist circumference. Large survey with representative sample is needed to estimate the real Sudanese waist circumference.  


e-GIGI ◽  
2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Lidia A. Kewo ◽  
Damajanty H.C. Pangemanan ◽  
Aurelia Supit

Abstract: To date, there are lots of documentations about the adverse effects of smoking on the oral cavity. Albeit, smoking is still considered as a casual thing in our community. Chemicals contained in the cigarette smoke can irritate the gums and soft tissues of the mouth, thus inhibiting wound healing after tooth extraction. This study was aimed to determine the difference in post-extraction dental wound healing between smokers and non-smokers. This was a comparative analytical study with a cross sectional design. Samples were obtained by using total sampling method. Subjects consisted of 16 smokers and 16 non-smokers that fulfilled the study eligibility criteria. Their oral cavities were examined to check the signs of inflammation (calor, dolor, rubor, tumor, and functio laesa). The results showed that there was a difference in post-extraction wound healing in inflammatory phase between smokers and non-smokers. As many as 9.4% of smoker patients and 34.4% of non-smoker patients recovered at 7 days post extraction. The Mann Whitney U test showed a p-value of 0.005. In conclusion, there was a significant difference in post-extraction wound healing between smokers and non-smokers.Keywords: smokers, non-smokers tooth extraction, wound healing Abstrak: Kebiasaan merokok bukan merupakan hal asing di masyarakat walaupun banyak dokumentasi mengenai akibat buruk dari merokok terhadap rongga mulut. Bahan kimia yang terdapat dalam asap rokok dapat mengiritasi gusi dan jaringan lunak mulut sehingga menghambat penyembuhan luka pasca ekstraksi gigi. Penelitian ini bertujuan untuk mengetahui perbedaan penyembuhan luka pasca ekstraksi gigi antara pasien perokok dengan bukan perokok. Jenis penelitian ialah analitik komparatif dengan desain potong lintang. Pengambilan sampel menggunakan total sampling yang memenuhi kriteria penelitian. Terdapat sebanyak 16 orang perokok dan 16 orang bukan perokok sebagai subyek penelitian. Pemeriksaan rongga mulut dilakukan untuk melihat tanda-tanda inflamasi (kalor, dolor, rubor, tumor, dan fungsio laesa). Hasil penelitian menunjukkan terdapat perbedaan penyembuhan luka 7 hari pasca ekstraksi gigi pada fase inflamasi antara pasien perokok dengan yang bukan perokok; sebanyak 9,4% pasien perokok dan 34,4% pasien bukan perokok yang sudah sembuh. Hasil uji Mann Whitney U mendapatkan nilai p=0,005. Simpulan penelitian ini ialah terdapat perbedaan bermakna dalam penyembuhan luka pasca ekstraksi gigi antara pasien perokok dengan yang bukan perokokKata kunci: perokok, bukan perokok, ekstraksi gigi, penyembuhan luka


2019 ◽  
Vol 1 (1) ◽  
pp. 21
Author(s):  
Arif Nugrahanto ◽  
Soupani Andri Nasution

Several studies related to the effect of audits on taxpayer compliance provide different conclusions. Bergman and Nevarez (2006) find the fact that tax audits negatively affect compliance. In contrast, Gemmel and Ratto (2012) concluded that the audit had a negative effect on the group of taxpayers who obeyed, and at the same time had a positive effect on the group of taxpayers who did not comply. Given the different conclusions, the researcher is interested in testing in the Indonesian context by using the SIDJP data from the Directorate General of Tax for the period 2009-2013.The difference-in-differences approach model implemented in this study adopts Norman Gemmell and Marissa Ratto (2012). The dependent variable is income tax while the independent variable is the dummy variable for group, time and type of audits. Regression results show that the interaction coefficient between the dummy group variable and the time dummy variable which is the difference-in-differences coefficient, has a p-value that is statistically insignificant to reject null hypothesis. It tells that there is no difference in the level of compliance between the audited (corporate) taxpayer and non-audited (corporate) taxpayers. No impact on the level of compliance of taxpayers may come from several reasons, including the small coverage of the tax audits, the existence of the bomb crater effect, and the results of the type of updating audit risk.


Author(s):  
Purvi Patel

Measurement of lumbar range of motion (LROM) is a routine method in the examination of patients with low back pain. There is no standard technique which may be used to accurately describe the range of motion in the different plane. So in present study, an attempt has been made to compare goniometric measurement with tape measurement for its sensitivity, specificity and accuracy for measuring spine mobility in normal adults. In this cross sectional study, 137 healthy adults between the ages of 18-26 years of age were included consecutively and assessed using Tape method and goniometry for trunk mobility in all planes (sagittal, frontal and transverse). The association of goniometry with tape method was assessed using chi square test. The study showed that the difference between goniometry and tape method was statistically significant (p value <0.05) for all movements except flexion (p value 0.215). Also the sensitivity, specificity and accuracy of goniometry is not as good as tape method except for flexion compared to tape method. So, from this study we can conclude that Goniometry was not as good as tape method for all movements except forward flexion where both can be equally used.


Sign in / Sign up

Export Citation Format

Share Document