scholarly journals The characteristics of patients with possible familial hypercholesterolemia—screening a large payer/provider healthcare delivery system

QJM ◽  
2019 ◽  
Vol 113 (6) ◽  
pp. 411-417 ◽  
Author(s):  
A Elis ◽  
M Leventer-Roberts ◽  
A Bachrach ◽  
N Lieberman ◽  
R Durst ◽  
...  
Keyword(s):  
General Population ◽  
Health Services ◽  
Familial Hypercholesterolemia ◽  
Chronic Kidney Disease Stage ◽  
Healthcare Delivery ◽  
Disease Stage ◽  
Study Cohort ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
History Of

Abstract Background Familial hypercholesterolemia (FH) is an under-diagnosed condition. Aim We applied standard laboratory criteria across a large longitudinal electronic medical record database to describe cross-sectional population with possible FH. Methods A cross-sectional study of Clalit Health Services members. Subjects who met the General Population MED-PED laboratory criteria, excluding: age <10 years, documentation of thyroid, liver, biliary or autoimmune diseases, a history of chronic kidney disease stage 3 or greater, the presence of urine protein >300 mg/l, HDL-C>80 mg/dl, active malignancy or pregnancy at the time of testing were considered possible FH. Demographic and clinical characteristics are described at time of diagnosis and at a single index date following diagnosis to estimate the burden on the healthcare system. The patient population is also compared to the general population. Results The study cohort included 12 494 subjects with out of over 4.5 million members of Clalit Health Services. The estimated prevalence of FH in Israel was found to be 1:285. These patients are notably positive for, and have a family history of, cardiovascular disease and risk factors. For most of them the LDL-C levels are not controlled, and only a quarter of them are medically treated. Conclusions By using the modified MED-PED criteria in a large electronic database, patients with possible FH can be identified enabling early intervention and treatment.

scholarly journals The Relationship between Diabetes Mellitus History with Chronic Kidney Diseases in Inner Disease Room RSUD dr. M. Yunus Bengkulu

2020 ◽  
Vol 24 (3) ◽  
pp. 1-10
Author(s):  
Devi Listiana ◽  
Awal Isgiyanto ◽  
Icha Alvionita
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Health Workers ◽  
Kidney Diseases ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
History Of

This study aimed to study the association of history of diabetes mellitus with chronic kidney disease in Inner Disease Room RSUD dr. M. Yunus Bengkulu. This research used cross sectional design. The population in this study patients with kidney failure who were treated in the Inner Disease Room RSUD dr. M. Yunus Bengkulu, amounting to 142 patients. Sampling technique total sampling that was all patient of chronic kidney disease which was treated in Inner Disease Room RSUD dr. M. Yunus Bengkulu  which amounted to 142 patients sampled. The data collection in this study used secondary data by looking at documentary records in the Inner Disease Room of dr. M. Yunus Bengkulu. Data analysis technique was done by using univariate and bivariate analysis with Chi-Square  (χ2 ) statistic test through SPSS program.The results of the study were: from 142 patients, there were 74 patients (52.1%) with chronic kidney disease stage 5, 80 patients (56.3%) had a history of diabetes mellitus, there was a significant relationship between history of diabetes mellitus with chronic kidney disease in Inner Disease Room RSUD dr. M. Yunus Bengkulu with moderate relationship category, and patients with a history of diabetes mellitus have a risk 6 times compared of chronic kidney disease stage 5 with patients who have no history of diabetes mellitus. It was expected that health workers, especially nurses in order to provide more complete nursing care, especially in patients with chronic kidney disease.

scholarly journals Analysof Reticulocyte Hemoglobin Equivalent Levels in Patients with Chronic Kidney Disease Stage IV and V

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Agri Febria Sari ◽  
Rikarni Rikarni ◽  
Deswita Sari
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Status ◽  
Chronic Kidney Disease Stage ◽  
Stage Iv ◽  
Disease Stage ◽  
Cross Sectional ◽  
Iron Storage ◽  
Laboratory Installation ◽  
Ckd Stage

Reticulocyte hemoglobin equivalent (RET-He) represents hemoglobin content in reticulocyte. Reticulocyte hemoglobin equivalent test can be used to asses iron status of chronic kidney disease (CKD). Iron deficiency happens in 40% CKD and could lead to anemia manifestation. Level of RET-He gives real-time assesment of iron availability for hemoglobin production and the level will getting lower when iron storage for erythropoiesis decreasing. Reticulocyte hemoglobin equivalent is more stabil than feritin and transferin saturation in assessing iron status. Aim of this study is to determine RET-He level in patients with CKD stage IV and V. This study is  a cross sectional descripstive study. Subjects were 96 CKD stage IV and V patients that met inclusion and exclusion criterias. Subjects conducted blood tests at Central Laboratory Installation Dr. M. Djamil Hospital Padang from July to September 2020. Examination of RET-He level was analyzed by Sysmex XN-1000 flowcytometry fluorescense method. Data was presented in frequency distribution table. The RET-He level below cutoff (<29,2 pg) indicates the need for iron suplementation therapy for CKD stage IV and V patients. Samples with RET-He level below cutoff were 48 (50%) and 48 (50%) were above cutoff.

scholarly journals Exploring general practitioners’ perceptions about the primary care gatekeeper role in Indonesia

2020 ◽  
Author(s):  
Joko Mulyanto ◽  
Yudhi Wibowo ◽  
Dionne S. Kringos
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Work Experience ◽  
Healthcare Delivery ◽  
Care Facility ◽  
Personal Factors ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
And Performance

Abstract Background In the current healthcare delivery system funded by National Health Insurance (NHI) in Indonesia, the gatekeeper role of primary care services is critical to ensuring equal healthcare access for the population. To be effective, gatekeeping relies on the performance of general practitioners (GPs). However, the perceptions held by Indonesian GPs about their gatekeeper role are not yet well documented. This study describes the self-perceived knowledge, attitudes and performance of Indonesian GPs with respect to the gatekeeper role and explores associated factors. Methods We conducted a cross-sectional study of all primary care facilities (N = 75) contracted by the regional NHI office in the Banyumas district. The 73 participating GPs completed a written questionnaire that assessed their knowledge, attitudes and performance in relation to the gatekeeper role. Personal and facility characteristics were analysed in a generalised linear model as possible associating factors.Results GPs scored relatively high in the domains of knowledge and performance but scored lower in their attitudes towards the gatekeeper role of primary care. In the full-adjusted model, no factors were significantly associated with the knowledge score. Work experience as GPs, private or civil service employment status and rural or urban location of the primary care facility were linked to attitude scores. Full- or part-time employment and type of facility were factors associated with the performance score. Conclusion GPs in Indonesia are knowledgeable and report that they adequately perform their function as gatekeepers in primary care. However, their attitudes towards the gatekeeper function are less positive. Attitudes and performance with respect to the primary care gatekeeper role are likely influenced more by contextual factors such as location and type of facility than by personal factors. Efforts to address contextual issues could include improvements in practice standards for privately practising physicians and public information campaigns about gatekeeping regulations. Such efforts will be crucial to improving the gatekeeper role of primary care in Indonesia and assuring efficient access to high-quality care for all.

scholarly journals Cardiovascular Risk Factors in Patients with Acute MI in a Secondary Hospital in Bangladesh

2020 ◽  
Vol 12 (2) ◽  
pp. 96-101
Author(s):  
Mohammad Ullah ◽  
Suman Kumar Saha ◽  
Md Toufiqur Rahman ◽  
Md Abdul Karim ◽  
Rashid Ahmed
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Family History ◽  
Cardiovascular Diseases ◽  
General Population ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Secondary Hospital

Background: Incidence of noncommunicable disease, specially cardiovascular diseases, is increasing in Bangladesh. Prevalence of risk factors in ischaemic heart disease (IHD) has been studied in different tertiary hospitals and institutes. This study was done in a secondary hospital with a patient population mainly of low socioeconomic condition and was compared with other patient groups of the country and Indian subcontinent. Methods: this cross sectional study was conducted in Manikganj Sadar Hospital from July 2019 to December 2019. All the patients admitted with the diagnosis of myocardial infarction (MI) were included. Cardiovascular risk factors, like smoking, diabetes mellitus (DM), hypertension (HTN), family history of premature cardiovascular diseases, dyslipidaemia and obesity, were evaluated among the patients. Results: This cross-sectional study showed most of the patients were in the age group of 50-59 years. 66% of the male patients and 2% of the female patients were smoker. 66% of the patients were hypertensive, 44% patients were diabetic, 28.5% patients were overweight, 60.4% patients had total cholesterol > 200mg/dl, 73.6% patients had LDL>130 mg/dl, 110 76.3% patients had HDL < 40 mg/ dl, 72.2% had triglyceride >150 mg/dl and 39% patients had family history of premature cardiovascular disease. Ninety (62.5%) patients had anterior MI, 50 (34.7%) patients had inferior MI and 4 (2.7%) patients had NSTEMI. 65 patients had no major risk factor and 57 % had three or more risk factors. Conclusion: The study population was more aged in comparison to other studies conducted in different parts of Bangladesh. Prevalence of smoking habit was lower but the prevalence of HTN, DM and dyslipidaemia were higher than the general population and other cohorts of MI patients. The prevalence of major risk factors was much higher than the general population of Bangladesh. Cardiovasc. j. 2020; 12(2): 96-101

scholarly journals Hypertension, Chronic Kidney Disease, and Renal Pathology in a Child with Hermansky-Pudlak Syndrome

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Roberto Gordillo ◽  
Marcela Del Rio ◽  
David B. Thomas ◽  
Joseph T. Flynn ◽  
Robert P. Woroniecki
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Stage Ii ◽  
Renal Pathology ◽  
Disease Stage ◽  
Not Otherwise Specified ◽  
Ckd Stage ◽  
History Of ◽  
Hermansky Pudlak Syndrome

We report a child with Hermansky-Pudlak Syndrome (HPS) and chronic kidney disease (stage II) with histological diagnosis of focal segmental glomerulosclerosis (FSGS). A 15-year-old male of Puerto Rico ancestry with history of HPS, hypertension (HTN), asthma, obesity, and chronic kidney disease (CKD) stage II presented with new-onset proteinuria without edema. His blood pressure had been controlled, serum creatinine had been 0.9–1.4 mg/dL, and first morning urine protein/creatinine ratio (UPC) ranged from 0.2 to 0.38. Due to persistent nonorthostatic proteinuria with CKD, renal biopsy was performed and FSGS (not otherwise specified) with chronic diffuse tubulopathy (tubular cytoplasmic droplets) and acute tubular injury was reported. Ceroid-like material is known to infiltrate tissues (i.e., lungs, colon, and kidney) in HPS, but the reason for the renal insufficiency is unknown. Nonspecific kidney disease and in one adult case IgA nephropathy with ANCA-positive glomerulonephritis have previously been reported in patients with Hermansky-Pudlak syndrome. To our knowledge, we report the first pediatric renal pathology case of HPS associated with CKD. This paper discusses presentation and management of renal disease in HPS.

scholarly journals Evaluation of Drug Use Patterns of Out Patient Attendees in a Tertiary Care Teaching Hospital in Dermatology and Venereology Department as a Tool to Promote Rational Prescribing

2014 ◽  
Vol 4 (1) ◽  
pp. 4-9
Author(s):  
Nushrat Noor ◽  
Md Jamal Uddin ◽  
Mohammad Afsan ◽  
Hafiza Akhter ◽  
Farhana Kabir
Keyword(s):  
Tertiary Care ◽  
Inappropriate Prescribing ◽  
Healthcare Delivery ◽  
Essential Medicine ◽  
Cross Sectional Study ◽  
World Health ◽  
Carbon Paper ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Prescribing Indicators

Background: Drug utilization studies are pre requisite for the formulation of drug policies. They offer useful methods for teaching and training in drug therapy and also identify the problems that arise from drug usage in healthcare delivery system and highlight the current approaches to the rational use of medicines. Objectives: The main objective of the prescription audit or evaluation was to measures for improving the prescription practices and to generate information on the core prescribing indicators proposed by the World Health Organization (WHO). Methods: This was a descriptive type of cross sectional study. The study was conducted in the Out Patient Department (OPD) of Dermatology & Venereology in a tertiary care private hospital, Dhaka, Bangladesh in between January and March’2012. A total of 300 prescriptions were obtained with the help of a pre-inserted carbon paper in a special format using WHO core prescribing indicators. Results: The average number of drugs per encounter was 3.8 and no single drug was prescribed by generic name. Use of antibiotic (56% of encounters) was frequent, but injection use (2.67% of encounters) was within the recommendation of WHO. The use of fixed drug combinations (FDCs) was 15.28% of prescribed drugs. Only 22.08% drugs were prescribed from national essential medicine list. Conclusion: The findings from the current study showed a trend towards inappropriate prescribing. DOI: http://dx.doi.org/10.3329/updcj.v4i1.21158 Update Dent. Coll. j: 2014; 4 (1): 04-09

scholarly journals Morbidity profile and prescription audits using WHO core prescribing indicator in government hospitals of Province 1, Nepal

2021 ◽  
Vol 3 (2) ◽  
pp. 15-22
Author(s):  
Shambhu Shah ◽  
Prasanna Dahal ◽  
Anil Kumar Sah ◽  
Surya B. Parajuli ◽  
Naveen Shrestha
Keyword(s):  
Metabolic Diseases ◽  
Healthcare Delivery ◽  
Circulatory System ◽  
Essential Medicine ◽  
Cross Sectional Study ◽  
World Health ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Essential Medicine List ◽  
Tertiary Hospitals

Background: Periodic assessment of morbidity and drug use at various levels of healthcare delivery system is important to recognize common prevalent morbidities and rationalize the use of medicines. The study was conducted to determine the common morbidities and audit prescription using WHO prescribing indicator in government operated tertiary hospitals of eastern Nepal. Methods: A cross-sectional study was carried out in government tertiary hospitals of Province 1, Nepal, from March 2019 to August 2019. For analysis, descriptive statistics were used.  Prescribing characteristics were evaluated using recommended guidelines of the World Health Organization (WHO) prescribing indicators. Results: Six hundred prescriptions were analyzed. The most prevalent morbidity was endocrine, nutrition & metabolic diseases (21.5%) followed by diseases of the respiratory system (19.8%), circulatory system (17.6%), and digestive system (12.8%). The most frequently encountered individual disease entity were hypertension (18.7%), diabetes (15.5%), acid peptic disorders (14%). A total of 2072 drugs were prescribed with an average of 3.45 (± 1.39) drugs per consultation. About 30.2% of prescriptions encountered contain at least one antibiotics, whereas injectable were prescribed in 1.8%. Only 3.9% of total medicines were prescribed in generic name and 31.7% of drug prescribed were from essential medicine list. Conclusion: Among the prescriptions evaluated, diseases of the endocrine, respiratory, cardiovascular, and gastrointestinal systems were the most common morbidities. Polypharmacy was prevalent to some extent whereas prescribing in generic and essential medicine list was poor relative to standard WHO recommendations. However, the overall prescribing of antibiotics and injection were found to be satisfactory.

scholarly journals Mental health outcomes and associations during the coronavirus disease 2019 pandemic: A cross-sectional survey of the US general population

2020 ◽  
Author(s):  
Bella Nichole Kantor ◽  
Jonathan Kantor
Keyword(s):  
Mental Health ◽  
General Population ◽  
Multivariable Analysis ◽  
Anxiety And Depression ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Us ◽  
History Of ◽  
Male Sex ◽  
Baseline Demographic

AbstractPandemic coronavirus disease 2019 (COVID-19) may lead to significant mental health stresses, potentially with modifiable risk factors. To determine the presence of and magnitude of associations between baseline associations and anxiety and depression in the US general population, we performed an internet-based cross-sectional survey of an age-, sex-, and race-stratified representative sample from the US general population. Degrees of anxiety, depression, and loneliness were assessed using the 7-item Generalized Anxiety Disorder scale (GAD-7), the 9-item Patient Health Questionnaire (PHQ-9), and the 8-item UCLA Loneliness Scale, respectively. Unadjusted and multivariable logistic regression analyses were performed to determine associations with baseline demographic characteristics. A total of 1,005 finished surveys were returned of the 1,020 started, yielding a completion rate of 98.5% in the survey panel. The mean (SD) age of respondents was 45 (16), and 494 (48.8%) were male. Baseline demographic data were similar between those that were (n=663, 66.2%) and were not (n=339, 33.8%) under a shelter in place/ stay at home order, with the exception of sex and geographic location. Overall, 264 subjects (26.8%) met criteria for an anxiety disorder based on a GAD-7 cutoff of 10; a cutoff of 7 yielded 416 subjects (41.4%) meeting clinical criteria for anxiety. On multivariable analysis, male sex (OR 0.65, 95% CI [0.49, 0.87]) and living in a larger home (OR 0.46, 95% CI [0.24, 0.88]) were associated with a decreased odds of meeting anxiety criteria. Rural location (OR 1.39, 95% CI [1.03, 1.89]), loneliness (OR 4.92, 95% CI [3.18, 7.62]), and history of hospitalization (OR 2.04, 95% CI [1.38, 3.03]), were associated with increased odds of meeting anxiety criteria. 232 subjects (23.6%) met criteria for clinical depression. On multivariable analysis, male sex (OR 0.71, 95% CI [0.53, 0.95]), increased time outdoors (OR 0.51, 95% CI [0.29, 0.92]), and living in a larger home (OR 0.35, 95% CI [0.18, 0.69]), were associated with decreased odds of meeting depression criteria. Having lost a job (OR 1.64, 95% CI [1.05, 2.54]), loneliness (OR 10.42, 95% CI [6.26, 17.36]), and history of hospitalization (OR 2.42, 95% CI [1.62, 3.62]), were associated with an increased odds of meeting depression criteria. Income, media consumption, and religiosity were not associated with mental health outcomes. Anxiety and depression are common in the US general population in the context of the COVID-19 pandemic, and are associated with potentially modifiable factors.

scholarly journals Distribution of Pruritus and Its Association With Serum Parathormone Level in Chronic Kidney Disease (Stage-5) Patients On Maintenance Hemodialysis

2020 ◽  
Vol 28 (1) ◽  
pp. 54-59
Author(s):  
Rafiqul Hasan ◽  
Md Nizamuddin Chowdhury ◽  
Md Nazrul Islam ◽  
Parvez Iftekher Ahmed ◽  
ASM Tanim Anwar ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Normal Serum ◽  
Disease Stage ◽  
Maintenance Hemodialysis ◽  
Cross Sectional ◽  
Maintenance Haemodialysis

Background: Pruritus is a common manifestation in patients on hemodialysis. The aim of this study is to determine the distribution of pruritus and evaluate the association between pruritus and serum parathormone levels in chronic kidney disease patients on maintenance haemodialysis. Methods:This analytic, descriptive, cross-sectional study was performed over 191 patients of maintenance haemodialysis in 2014. Information related to the patients including age, gender, residence, pruritus was extracted from questionnaires. Serum levels of intact parathormone were measured & data were analyzed. Results: 68% of the patients had pruritus. The Mean ± SD of serum parathormone was 53.25±7.96 pg/ml in patients with pruritus and 81.91±9.34 pg/ml in patients without pruritus. Our study showed that most patients with pruritus had normal serum parathormone levels and no significant association was found between pruritus and serum parathormone levels. Conclusion: serum parathormone level may not play a role in uraemic pruritus in these patients. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 54-59

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