scholarly journals A RANDOMISED CONTROL TRIAL ON CEREBRO VASCULAR ACCIDENT PATIENTS WITH REFERENCE TO AETIOLOGY AND MANAGEMENT: 24 WEEKS, SINGLE-CENTER, PROSPECTIVE OBSERVATIONAL PILOT STUDY

2021 ◽  
pp. 98-103
Author(s):  
LEELA PRASAD K ◽  
SHAIK KAREEMULLA ◽  
ALIYA FIRDOSE K ◽  
YASMEEN S
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Low Income ◽  
Premature Death ◽  
Randomised Control Trial ◽  
Utilization Review ◽  
Medical Sciences ◽  
Middle Income ◽  
Middle Income Countries ◽  
Number Of Patients

Objectives: Stroke is one of the leading causes of death and long-term disability in world. Stroke is an important cause of premature death and disability in low-income and middle-income countries like India, largely driven by demographic changes and enhanced by the increasing prevalence of key modifiable risk factors. The main aim of our study was to assess the clinical profile with special reference to the etiology of the condition, the management, and drug utilization review. Methods: This is a hospital-based prospective observational randomized control trial which was conducted for a period of 6 months at Government General Hospital, Rajiv Gandhi Institute of Medical Sciences, Kadapa. Seventy-five patients were recruited based on study criteria. The data were analyzed and summarized as frequency and percentage by GraphPad Prism software using Microsoft Excel. Results: In a total of 75 patients, it was found that 45 and 30 patients were female. Maximum number of patients (i.e. 36 patients) belonged to 51–60 years age group. We observed that 52 patients were suffering from ischemic stroke, 21 patients were suffering from transient ischemic stroke, and only 2 patients were suffering from ischemic stroke and transient ischemic stroke. Among 75 patients studied, hypertension (62%), diabetes mellitus (28%), smoking (33%), and alcohol (33%) were the risk factors. Conclusion: In this study, ischemic stroke was most prevalent. Hypertension, that is, increase of blood pressure considered as one of the important and major risk factors for stroke occurrence and recurrence. Proper management includes non-pharmacological (physiotherapy) along with pharmacological treatment that included cardiovascular system drugs such as hypolipidemics, cognition enhancers, anticoagulants, and antihypertensive therapy.

scholarly journals Prevalence and risk factors for wheeze, decreased forced expiratory volume in 1 s and bronchoconstriction in young children living in Havana, Cuba: a population-based cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e034192
Author(s):  
Ramón Suárez-Medina ◽  
Silvia Venero-Fernández ◽  
Vilma Alvarez-Valdés ◽  
Nieves Sardiñas-Baez ◽  
Carmona Cristina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Young Children ◽  
Low Income ◽  
Inhaled Corticosteroids ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
First Year ◽  
Middle Income ◽  
Middle Income Countries

ObjectivesAsthma has not been extensively studied in low-income and middle-income countries, where risk factors and access to treatment may differ from more affluent countries. We aimed to identify the prevalence of asthma and local risk factors in Havana, Cuba.SettingFour municipalities in Havana, Cuba.ParticipantsA population-based cohort study design of young children living in Havana, Cuba. Children were recruited from primary care centres at age 12–15 months.Primary and secondary outcome measuresData on wheeze in the past 12 months, asthma treatment and environmental exposures collected regularly until the age of 6 years, when forced expiratory volume in 1 s (FEV1) and reversibility to aerosolised salbutamol were also measured.Results1106 children provided data at the age of 6 years old. The prevalence of wheeze in the previous 12 months was 422 (38%), and 294 (33%) of the study population had bronchodilatation of 12% or more in FEV1after administration of inhaled salbutamol. In the previous 12 months, 182 (16%) of the children had received inhaled corticosteroids, 416 (38%) salbutamol inhalers and 283 (26%) a course of systemic steroids.Wheeze in the first year and a family history of asthma were both positively associated with bronchodilatation to inhaled salbutamol (1.94%; 95% CI 0.81 to 3.08 and 1.85%; CI 0.14 to 3.57, respectively), while paracetamol use in the first year was associated with wheeze at 6 years (OR 1.64, 95% CI 1.14 to 2.35). There were large differences in FEV1, bronchodilatation and risk of wheeze across different geographical areas.ConclusionsAsthma is common in young children living in Havana, and the high prevalence of systemic steroids administrated is likely to reflect the underuse of regular inhaled corticosteroids. If replicated in other comparable low-income and middle-income countries, this represents an important global public health issue.

scholarly journals Quantifying research output on poverty and non-communicable disease behavioural risk factors in low-income and lower middle-income countries: a bibliometric analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e014715 ◽  
Author(s):  
Luke Nelson Allen ◽  
Nicholas Fox ◽  
Alissa Ambrose
Keyword(s):  
Risk Factors ◽  
Impact Factor ◽  
Bibliometric Analysis ◽  
Low Income ◽  
Research Output ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Behavioural Risk Factors ◽  
Number Of Citations

ObjectivesLow-income and lower middle-income countries (LLMICs) bear a disproportionate burden of non-communicable diseases (NCDs). WHO has repeatedly called for more research on poverty and NCDs in these settings, but the current situation remains unquantified. We aimed to assess research output on poverty and NCD risk factors from these countries in relation to upper middle-income and high-income countries.DesignBibliometric analysis of primary research published between 1 January 1990 and 4 May 2017. We searched 13 databases, combining terms for poverty and NCD behavioural risk factors (tobacco, alcohol, diet and physical activity). Independent dual review was used to screen titles, abstracts and full papers. Two-tailed t-testing and multiple linear regression analyses were used to compare differences in means.Outcomes(1) Proportion of lead authors affiliated with institutions based in high and upper middle-income countries vs LLMICs. (2) Mean number of citations for publications from each region. (3) Mean journal impact factor for studies from each region.ResultsNinety-one (67%) of the 136 included studies were led by scientists affiliated with LLMIC-based institutions. These authors represented 17/83 LLMICs (20%), and their studies garnered 4.8 fewer citations per paper than studies led by high-income and upper middle-income-affiliated authors; however, this finding was non-significant (P=0.67). Papers led by authors based in high-income and upper middle-income countries were published in journals with a mean impact factor 3.1 points higher than those from LLMICs (4.9 vs 1.7) adjusting for year of publication and number of citations (P<0.001).ConclusionsMost poverty and NCD risk factor research is led by authors from a small number of LLMICs. These studies are being published in relatively low-impact journals, and the vast majority of LLMICs are not producing any research in this area that is vital to their social and economic development. The paucity of domestic evidence must be addressed to inform global policy.

Abstract 1122‐000011: Risk Factors Associated with Various Subtypes of Ischemic Stroke: A Prospective Study

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Mohammad Shahidullah ◽  
Subash K Dey ◽  
Nahid Sultana
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Ischemic Stroke ◽  
Smoking Habit ◽  
Smoking History ◽  
Large Artery ◽  
Middle Income ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Risks Factors

Introduction : Stroke is the main cause of adult disability and the second most leading cause of death worldwide. The number of deaths due to stroke is 5·54 million worldwide. Stroke is also a major cause of long‐term disability. Globally, 70% of strokes and 87% of both stroke‐related deaths and disability‐adjusted life years occur in low and middle‐income countries. The incidence of stroke varies among various countries. Over the last four decades, the stroke incidence in low and middle‐income countries has become more than doubled. . However, there are limited data and very few studies on various subtypes of ischemic stroke and their risks factors in our country. So, we purposively designed this study. The aim of this study was to investigate the risks factors associated with the various subtypes of ischemic stroke according to TOAST criteria. Methods : This was a prospective observational cross sectional study conducted during June‐2019 to May‐2020. A total of 220 ischemic stroke patients aged above 30 years confirmed by CT Scan/MRI of brain were included in this study. A complete history was taken regarding hypertension, diabetes, dyslipidemia, ischemic heart disease, current smoking history of previous stroke, positive familial history, coronary artery diseases, alcohol consumption and demographic characteristics were noted in the questionnaire. Hypertension was defined as systolic blood pressure (SBP) > 140 mmHg, diastolic blood pressure > 90 mmHg or both on two separate occasions, or the use of anti‐hypertensive medication at any time before the onset of stroke. Diabetes was defined if fasting plasma glucose levels are 126 mg/dl or higher after an overnight fast on more than one occasion or as random blood glucose level 200 mg/dl or higher on more than one occasion. Ischemic stroke was classified according to TOAST criteria. Data were collected with a pre structured questionnaire from the patients’ investigations reports and face to face interview with the researcher (an expert neurologist). Results : Among the 220 stroke patients, Large‐artery atherosclerosis (LAA), Cardio‐embolism (CE), Small‐vessel occlusion (SVO, Stroke of other determined etiology (SODE) and Stroke of undetermined etiology (SUDE) were being observed 84(38.18%), 14(6.36%), 63(28.64%), 12(5.45%) and 47(18.18%). The highest prevalence of subtypes 70(31.82%) was found in the age group (51‐60). The prevalence of subtypes was found 150(68.18%) in male and 70(31.82%) in female. 86(39.09%) prevalence of subtypes was found who were from rural areas whereas 134(60.91%) was observed in urban areas. The significant risk factors associated with the prevalence of various subtypes of ischemic stroke were observed Hypertension, Diabetes Mellitus, Smoking history, Dyslipidemia, Heart disease, H/O Previous Stroke, Positive Familial History, Coronary Artery Disease and Alcohol Consumption (p <0.05). Conclusions : The higher prevalence of Large‐artery atherosclerosis (LAA) was found in this study. It suggests the influence of uncontrolled hypertension, diabetes mellitus, smoking habit and dyslipidemia. So, importance should be given on various subtypes of ischemic stroke and collective preventive measures and strategies are to be taken to control the associated risk factors especially hypertension, diabetes mellitus, smoking habit and dyslipidemia to decrease the stroke mortality rate.

scholarly journals Burden, risk factors and outcomes of hyperemesis gravidarum in low-income and middle-income countries (LMICs): systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025841 ◽  
Author(s):  
Mesfin Tadese Dinberu ◽  
Mohammed Akibu Mohammed ◽  
Tesfalidet Tekelab ◽  
Nigus Bililign Yimer ◽  
Melaku Desta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Low Income ◽  
Fixed Effects ◽  
Hyperemesis Gravidarum ◽  
Meta Analysis ◽  
Primary Data ◽  
Middle Income ◽  
Middle Income Countries ◽  
Patient Consent

IntroductionHyperemesis gravidarum (HG) is a pregnancy condition characterised by excessive nausea and vomiting resulting in dehydration, weight loss and serious adverse pregnancy outcomes including termination of pregnancies. Even though evidence in low-income and middle-income countries (LMICs) is limited, the prevalence of HG in pregnancy ranges from 0.3% to 10.8%. With this systematic review and meta-analysis, we aim to determine the prevalence/burden, risk factors, and maternal and perinatal outcomes of HG in LMICs.MethodsPubMed, CINAHL, EMBASE, EBSCO, Ovid maternity and infant care databases, Cochrane Database of Systematic Reviews, Web of Science and SCOPUS databases will be searched. Reference lists of selected articles will be assessed in order to identify other potential studies of interest. Observational studies and (non) randomised controlled trials conducted from January 2000 to September 2018 in LMIC will be included. A weighted inverse-variance meta-analysis using fixed-effects and random-effects model will be done to generate a pooled estimate. Funnel plot and Egger’s regression statistical test will be applied to check publication bias. Heterogeneity among studies will be checked using Τ2 to determine dispersion. Moreover, meta-regression analysis will be performed to investigate the source of heterogeneity. STATA V.14 will be used to analyse the data.Ethics and disseminationFormal ethical approval and patient consent are not required; as primary data collection will not be employed. The result will be published in a peer-reviewed scientific journal and will be presented at scientific conferences and public press.PROSPERO registration numberCRD42018096284.

scholarly journals Risk‐Attributable Burden of Ischemic Heart Disease in 137 Low‐ and Middle‐Income Countries From 2000 to 2019

2021 ◽  
Author(s):  
Chenran Wang ◽  
Yanghua Sun ◽  
Di Jiang ◽  
Chunping Wang ◽  
Shiwei Liu
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Low Income ◽  
Population Attributable Fraction ◽  
Attributable Fraction ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Background Ischemic heart disease (IHD) imposes the greatest disease burden globally, especially in low‐ and middle‐income countries (LMICs). We aim to examine the population‐attributable fraction and risk‐attributable death and disability‐adjusted life years (DALYs) for IHD in 137 low‐ and middle‐income countries. Methods and Results Using comparative risk assessment framework from the 2019 Global Burden of Disease study, the population‐attributable fraction and IHD burden (death and DALYs) attributable to risk factors in low‐income countries, lower‐middle‐income countries (LMCs), and upper‐middle‐income countries were assessed from 2000 to 2019. In 2019, the population‐attributable fraction (%) of IHD deaths in relation to all modifiable risk factors combined was highest in lower‐middle‐income countries (94.2; 95% uncertainty interval, 91.9–96.2), followed by upper‐middle‐income countries (93.5; 90.4–95.8) and low‐income countries (92.5; 90.0–94.7). There was a >13‐fold difference between Peru and Uzbekistan in age‐standardized rates (per 100 000) of attributable death (44.3 versus 660.4) and DALYs (786.7 versus 10506.1). Dietary risks accounted for the largest proportion of IHD’s behavioral burden in low‐ and middle‐income countries, primarily attributable to diets low in whole grains. High systolic blood pressure and high low‐density lipoprotein cholesterol remained the 2 leading causes of DALYs, with the former topping the list in 116 countries, while the latter led in 21 of the 137 countries. Compared with 2000 to 2010, the increases in risk‐attributable deaths and DALYs among upper‐middle income countries were slower from 2010 to 2019, while the trends in low‐income countries and lower‐middle income countries were opposite. Conclusions IHD’s attributable burden remains high in low‐ and middle‐income countries. Considerable heterogeneity was observed among different income‐classified regions and countries.

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