scholarly journals Precipitating factors leading to decompensation of heart failure in patients attending a tertiary care centre of Nepal

2020 ◽  
Vol 17 (1) ◽  
pp. 17-21
Author(s):  
Suman Adhikari ◽  
Ratna Mani Gajurel ◽  
Chandra Mani Poudel ◽  
Hemanta Shrestha ◽  
Sanjeev Thapa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Common Factor ◽  
Tertiary Care ◽  
Decompensated Heart Failure ◽  
Patient Counseling ◽  
Tertiary Care Centre ◽  
Acute Decompensation ◽  
The Government ◽  
Major Factors

Background and Aims: Heart failure is one of the debilitating conditions in patients with various forms of heart disease. It can have impacts on various aspects of the life of a patient. There have been few studies on the etiological aspects and precipitants of heart failure in the Nepalese population. The aim of our study is to find out the major factors that lead to decompensation of heart failure in patients who already have established heart failure. Methods: This study was a single-centre, prospective, observational study conducted in the emergency department of Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC) from 1st June 2019 to 30th November 2019. Hundred and one patients with established heart failure in the past, who presented again with decompensated heart failure were enrolled. Results: The mean age of the patients was 62.81 years (SD=15.92). Factors responsible for acute decompensation of heart failure were identified in 95.0 % of patients included in the study. The most common factor identified was poor compliance with medications and diet and fluid intake (38.6%). Next to it was arrhythmia identified in about 35.6% of cases.Other important factors responsible for decompensation in our study were infection (12.8%), anemia (4.9%) and ischemia (2.9%). Conclusion: Preventable and identifiable factors are responsible for the decompensation of heart failure. Most of these factors can be modified with the use of proper patient counseling/patient education, thereby reducing recurrent hospital admissions and economic burden to the patient and the government as well.

scholarly journals Early and long‐term outcomes of decompensated heart failure patients in a tertiary‐care centre in India

2020 ◽  
Vol 7 (2) ◽  
pp. 467-473
Author(s):  
Sanjay Ganapathi ◽  
Panniyammakal Jeemon ◽  
Rajasekharan Krishnasankar ◽  
Rajamoni Kochumoni ◽  
Purushothaman Vineeth ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tertiary Care ◽  
Decompensated Heart Failure ◽  
Care Centre ◽  
Long Term Outcomes ◽  
Tertiary Care Centre ◽  
Heart Failure Patients

scholarly journals Impact of COVID-19 pandemic on stroke admissions in Qatar

2021 ◽  
Vol 3 (1) ◽  
pp. e000084
Author(s):  
Naveed Akhtar ◽  
Salman Al Jerdi ◽  
Ziyad Mahfoud ◽  
Yahia Imam ◽  
Saadat Kamran ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Small Vessel Disease ◽  
Tertiary Care ◽  
Relative Increase ◽  
Large Vessel ◽  
Tertiary Care Centre ◽  
Transient Ischaemic Attacks ◽  
Stroke Mimics ◽  
Coronary Syndromes ◽  
The Impact

IntroductionThe COVID-19 pandemic has resulted in a dramatic unexplained decline in hospital admissions due to acute coronary syndromes and stroke. Several theories have emerged aiming to explain this decline, mostly revolving around the fear of contracting the disease and thus avoiding hospital visits.AimsIn this study, we aim to examine the impact of the COVID-19 pandemic on stroke admissions to a tertiary care centre in Qatar.MethodsThe Hamad General Hospital stroke database was interrogated for stroke admissions between September 2019 and May 2020. The number of stroke admissions, stroke subtypes and short-term outcomes was compared between the ‘pre-COVID-19’ period (September 2019 to February 2020) and the COVID-19 pandemic period (March to May 2020).ResultsWe observed a significant decline in monthly admissions in March (157), April (128) and May (135) compared with the pre-COVID-19 6-month average (229) (p=0.024). The reduction in admissions was most evident in functional stroke mimics. The average admissions decreased from 87 to 34 per month (p=0.0001). Although there were no significant differences in admissions due to ischaemic stroke (IS), intracranial haemorrhage or transient ischaemic attacks between the two periods, we noted a relative decrease in IS due to small vessel disease and an increase in those due to large vessel atherosclerosis in March to May 2020.ConclusionsThe decline in overall stroke admissions during the COVID-19 pandemic is most likely related to concerns of contracting the infection, evidenced mainly by a decline in admissions of stroke mimics. However, a relative increase in large vessel occlusions raises suspicion of pathophysiological effects of the virus, and requires further investigation.

scholarly journals Invasive Devices and Sensors for Remote Care of Heart Failure Patients

Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 2014
Author(s):  
Sumant P. Radhoe ◽  
Jesse F. Veenis ◽  
Jasper J. Brugts
Keyword(s):  
Heart Failure ◽  
Remote Monitoring ◽  
Hospital Admissions ◽  
Acute Decompensated Heart Failure ◽  
Admission Rate ◽  
Decompensated Heart Failure ◽  
Hospital Admission Rate ◽  
Remote Care ◽  
New Sensors ◽  
Near Future

The large and growing burden of chronic heart failure (CHF) on healthcare systems and economies is mainly caused by a high hospital admission rate for acute decompensated heart failure (HF). Several remote monitoring techniques have been developed for early detection of worsening disease, potentially limiting the number of hospitalizations. Over the last years, the scope has been shifting towards the relatively novel invasive sensors capable of measuring intracardiac filling pressures, because it is believed that hemodynamic congestion precedes clinical congestion. Monitoring intracardiac pressures may therefore enable clinicians to intervene and avert hospitalizations in a pre-symptomatic phase. Several techniques have been discussed in this review, and thus far, remote monitoring of pulmonary artery pressures (PAP) by the CardioMEMS (CardioMicroelectromechanical system) HF System is the only technique with proven safety as well as efficacy with regard to the prevention of HF-related hospital admissions. Efforts are currently aimed to further develop existing techniques and new sensors capable of measuring left atrial pressures (LAP). With the growing body of evidence and need for remote care, it is expected that remote monitoring by invasive sensors will play a larger role in HF care in the near future.

P15 Serum chloride as marker for prognosis for patient with acute decompensated heart failure: a systematic review and meta-analysis on prognosis

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
L K Evangelista ◽  
J D Ramos ◽  
D L Villanueva ◽  
M D Tiongson ◽  
F E Punzalan
Keyword(s):  
Heart Failure ◽  
Cohort Studies ◽  
Quality Assessment ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Cochrane Central Register ◽  
Serum Chloride ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Acute Decompensation

Abstract Background  Several studies have suggested that hypochloremia is associated with adverse outcomes among patients with heart failure. The association appears to be more marked in those with acute decompensation. Research Question: What is the association of hypochloremia with mortality and worsening heart failure among patients in acute decompensation? Objective Determine the association of admission hypochloremia to all-cause mortality, heart failure death and worsening heart failure among patients with acute decompensated heart failure. Criteria for Inclusion of Studies: Studies were included if they satisfied the following criteria 1) observational cohort studies; 2) included patients admitted for acute decompensated heart failure; and 3) reported data on mortality and worsening heart failure in association with admission hypochloremia. Methods A systematic search using MEDLINE, Clinical Key, ScienceDirect, Scopus, and Cochrane Central Register of Controlled Trials databases was done, from June 2018 to January 31, 2019. The characteristics of included studies were collated. Data abstraction and quality assessment, using the Newcastle-Ottawa Quality Assessment Scale, were done independently by two reviewers, and disagreements were settled by a third reviewer. Review Manager (RevMan) 5.3 was utilized to perform Mantel-Haenzel analysis of random effects and compute for relative risk. Results We included three high quality cohort studies involving 3,444 patients admitted for acute decompensated heart failure and having low serum chloride levels on admission. Our study shows that admission hypochloremia is associated with increased risk for all-cause mortality [RR 1.63, (95% CI 1.60 to 2.28, p < 0.00001]. Risks for heart failure death as mentioned in one study and worsening heart failure also in one study are likewise increased with hypochloremia on admission.  Conclusion Admission hypochloremia is associated with higher all-cause mortality among patients admitted for acute decompensated heart failure. The risk for heart failure death and worsening heart failure are also increased. Admission hypochloremia may be a useful prognosticator for heart failure patients.

Revision: review of non-elective hospitalisations of adults with CHD

2017 ◽  
Vol 27 (9) ◽  
pp. 1764-1770 ◽  
Author(s):  
Alexandra Soufi ◽  
Jack M. Colman ◽  
Qunyu Li ◽  
Erwin N. Oechslin ◽  
Adrienne H. Kovacs
Keyword(s):  
Heart Failure ◽  
Length Of Stay ◽  
Quality Care ◽  
Tertiary Care ◽  
Interdisciplinary Approach ◽  
Resource Utilisation ◽  
Tertiary Care Centre ◽  
Single Centre Study ◽  
The Mean ◽  
Service Data

AbstractIntroductionThe adult CHD population is increasing and ageing and remains at high risk for morbidity and mortality. In a retrospective single-centre study, we conducted a comprehensive review of non-elective hospitalisations of adults with CHD and explored factors associated with length of stay.MethodsWe identified adults (⩾18 years) with CHD admitted during a 12-month period and managed by the adult CHD service. Data regarding demographics, cardiac history, hospital admission, resource utilisation, and length of stay were extracted.ResultsThere were 103 admissions of 91 patients (age 37±10 years; 52% female). Of 91 patients, 96% had moderate or complex defects. Of 103 admissions, 45% were through the emergency department. The most common reasons for admission were arrhythmia (37%) and heart failure (28%); 29% of admissions included a stay in the ICU. The mean number of consultations by other services was 2.0. Electrophysiology and anaesthesiology departments were most frequently consulted. After removing outliers, the mean length of stay was 7.9±7.4 days (median=5 days). The length of stay was longer for patients admitted for heart failure (12.2±10.3 days; p=0.001) and admitted directly to the ward (9.6±8.9 days; p=0.009).ConclusionsAmong non-electively hospitalised adults with CHD in a tertiary-care centre, management often entails an interdisciplinary approach, and the length of stay is longest for patients admitted with heart failure. The healthcare system must ensure optimal resources to maintain high-quality care for this expanding patient population.

scholarly journals A profile of heart failure patients in a tertiary care centre in Eastern India

2016 ◽  
Vol 5 (1) ◽  
pp. 216
Author(s):  
Biswajit Majumder ◽  
Yatindra Mohan Bahuguna ◽  
Sharmistha Chatterjee
Keyword(s):  
Heart Failure ◽  
Age Of Onset ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Western Country ◽  
Eastern India ◽  
Tertiary Care Centre ◽  
Heart Failure Patients ◽  
Epidemiological Profile ◽  
Symptoms And Signs

Background: Epidemiological data regarding profile of heart failure in India is lacking. So this study was done to assess the epidemiological profile of heart failure patients in eastern India. Aim of the study was to assess the epidemiological profile of heart failure patients in this part of country.Methods: Total 1000 outdoor and indoor patients presented with symptoms and signs of heart failure according to Framingham criteria were studied.Results: Age of onset of HF is lower than western country. IHD is the commonest cause of HF. Diabetes and hypertensions are important risk factors.Conclusions: Earlier detection and treatment of hypertension and diabetes mellitus might have greater impact in reducing the burden of HF in this part of country.

scholarly journals A Clinico-Etiological Study of Erythroderma in Adults in a Tertiary Care Centre

2021 ◽  
Vol 10 (37) ◽  
pp. 3213-3219
Author(s):  
Jagaragallu Amrutha ◽  
Narasimha Rao Netha Gurram ◽  
Padmaja Pinjala ◽  
Bhumesh Kumar Katakam ◽  
Rajeev Singh Thakur
Keyword(s):  
Clinical Laboratory ◽  
Age Of Onset ◽  
Common Factor ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
Etiological Study

BACKGROUND Erythroderma is a clinical entity that may cause severe systemic manifestations. The difficulty with erythroderma lies in finding the underlying aetiology. It is imperative to demonstrate precise aetiology whenever possible so that distinct therapy may be initiated. At times, despite finding the aetiology, relapses constitute a great menace. The purpose of our study was to assess the clinical profile and aetiology of erythroderma. Besides, the study also illustrated factors leading to relapses; such studies are rare in literature. METHODS This hospital-based, cross-sectional study included 88 patients of erythroderma of either sex and age more than 18 years; their clinical, laboratory, histopathological findings, treatment and outcome were studied. RESULTS The mean age of onset was 47.3 ± 12.35 years with the male to female ratio being 2.38:1. The most common cause of erythroderma was pre-existing dermatoses (67 %) followed by drugs (10.2 %), infections (3.4 %), malignancies (4.54 %), and idiopathic (14.7 %). Psoriasis was the predominant aetiology (45.4 %) among the pre-existing dermatoses with a maximum number of relapses (P = 0.02). Psoriasis was significantly associated with pruritus (P = 0.001), subungual hyperkeratosis (P = 0.0001), palmoplantar keratoderma (P = 0.001). Clinicohistological association was found in 64.6 % of cases. Mortality was seen in 6.8 % of cases. CONCLUSIONS As in previous studies, pre-existing dermatoses were the most common causes in our study; albeit, a special emphasis on factors leading to relapses was given to prevent further episodes. The most common factor of relapse was uncontrolled comorbid disorders (diabetes and hypertension) followed by medication nonadherence. Hence, our study suggests a need for more effective comorbidity management and creating awareness regarding judicial use of drugs which can go far in preventing mortality and morbidity. KEY WORDS Erythroderma, Adults, Aetiology, Relapses, Comorbidities.

scholarly journals Study of knowledge, attitude and practices of contraception in breast-feeding mothers

2019 ◽  
Vol 8 (4) ◽  
pp. 1473
Author(s):  
Aiyleen Shiza Shawl ◽  
Vidya Thobbi
Keyword(s):  
Breast Feeding ◽  
Rural Areas ◽  
Urban Areas ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Lower Class ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Knowledge And Attitude ◽  
The Government

Background: In India, as in many other countries, postpartum family planning is usually initiated after 6 weeks postpartum. Early resumption of sexual activity coupled with early and unpredictable ovulation leads to many unwanted pregnancies in the first year postpartum. Increase in hospital deliveries provides an excellent opportunity to sensitize women and provide effective contraception. Hence the present study was done at our tertiary care centre to assess the knowledge, attitude, practice regarding contraception and to find out the relationship between knowledge and attitude regarding contraception among breast feeding mothers.Methods: A hospital based observational study. The patients admitted at our tertiary care centre in the Department of Obstetrics and Gynecology.Results: Majority of the participants (72%) were in the age group of 21-25 years. 21.2% of the study group was educated up to primary level while 33.2% and 18.4% of the participants studied till SSC and HSC respectively. Majority of participants were from middle class (50%) followed by lower class (36.4%) and upper class (13.6%). 69.6% participants resided in rural areas while 30.4% participants were from urban areas. It was observed that age, education and mode of delivery were the significant factors.Conclusions: As the government gives incentives to couples who opt for permanent sterilization, which is an effective drive, it should also give incentives to couples who follow temporary methods and delay pregnancies. Couples who adopt one child norm or 2 children norm should be encouraged by benefits either in the form of children’s education or health insurance.

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