scholarly journals Rheumatic Heart Disease among Pregnant Women with Cardiac Diseases in a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Basant Sharma ◽  
Eliza Koirala ◽  
Sudhir Regmi ◽  
Jaya Dhungana ◽  
Bandana Khanal Neupane ◽  
...  

Introduction: Cardiac disease in pregnancy is a major cause of maternal mortality and morbidity in women, particularly in resource limited countries like Nepal. Rheumatic Heart Disease is the commonest cardiac disease complicating pregnancy. There is very limited data and evidence from Nepal regarding rheumatic heart disease complicating the pregnancy. The study aims to find out the prevalence of rheumatic heart disease among cardiac disease patients in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among 41 women with cardiac disease who delivered babies at Chitwan Medical College from 1st January 2018 to 31st December 2019, after taking ethical approval from the Institutional Review Committee. A convenient sampling method was used. Statistical Package for the Social Sciences was used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 41 pregnant women with cardiac disease, 32 (78%) (95% Confidence Interval = 65.32-90.68) had rheumatic heart disease. The mean age of the affected pregnant women was 24.9±4.49 years. Out of 32 patients with rheumatic heart disease, postpartum haemorrhage was the most common maternal complication 5 (15.6%) followed by hypertension 4 (9.7%). Conclusions: Rheumatic Heart Disease was highly common among pregnant women with cardiac disease.

2012 ◽  
Vol 23 (1) ◽  
pp. 31-35
Author(s):  
Shahanaj Sharmin ◽  
Shahanara Chowdhury ◽  
Didarul Alam ◽  
Mohiuddin Ahmed ◽  
Fahamida Rashid ◽  
...  

Aim of our study was to see the maternal and fetal outcomes in women presenting with heart disease during pregnancy and labout. This cross sectional study was carried out in 48 pregnant women with cardiac disease from July 2005 to Dec 2006, in the department of Gynae and Obst at Chittagong Medical College Hospital Chittagong. The Mewan age was 25.40 ±4.46 years. 31(64.6%) patients were from middle class. 27 (56.3%) patients belonged to mulliparous group. 33(68.8%) patients received regular antenatal care, of the 43 (89.7%) patients had rheumatic heart disease and 5(10.5%) had congenital heart disease. Among the rheumatic heart disease, 50% had mitral stenosis. 35(72.9%) patients had in grade-1, 12(25%) had in grade-II, and 1(2.1%) had in grade-III. (64.5%) had normal vaginal delivery, 7(14.5%) had LSCS. 4(8.3%) had heard failure and 1 patient (2.1%) expired due to heart failure, 40(83.3%) were delivered at term, 7(14.6%) had preterm labour and 1(2.1%) had still birth. Regarding birth weight, 17(35.4%) had LBW (Low birth weight), 31(64.6%) had normal birth weight. Rheumatic heart disease is the commonest cardiac lesion among Pregnant women. Fetomaternal morbidity and mortality are strongly correlated with maternal cardiac functional classification. The management of these cases should be multidisciplinary to optimize care of these patients. JCMCTA 2012; 23(1): 31-35


2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Rajesh Nepal ◽  
Madhab Bista ◽  
Sahadeb Prasad Dhungana

Introduction: Rheumatic heart disease is a sequel of rheumatic fever which causes heart valve damage. This study was conducted to look at the pattern of valve lesions and treatment practices in patients with rheumatic heart disease. Methods: A cross-sectional study conducted at the tertiary care center with a diagnosis of rheumatic heart disease from July 2018 to January 2020 by convenient sampling. Ethical clearance was obtained from the Institutional Review Committee (ref no. 55/2018). Data were analyzed by using Statistical package for social sciences version 20. Results: Out of 600 patients, 428 (71.3%) were female. The mean age was 44.24±14.24 years. The isolated mitral valve was affected in 280 (46.6%). Dual involvement of mitral and aortic valve was present in 294 (49%). Only 14 (2.3%) had involvement of isolated aortic valve involvement. Overall, mitral stenosis was the most common abnormality 508 (84.6%) followed by mitral regurgitation 418 (69.6%), aortic regurgitation 320 (53.3%), and aortic stenosis 63 (10.5%). Assessment of the severity of lesions showed that 247 (41.2%) patients had severe mitral stenosis, 119 (19.8%) severe mitral regurgitation, 14 (2.3%) severe aortic stenosis, and 11 (1.8%) severe aortic regurgitation. Majority 493 (82.2%) were treated with medical therapies. Surgical procedures were performed in 51 (8.5%). The use of anticoagulation was in 212 (35.3%) of eligible patients. Conclusions: Mitral valve was affected commonly both in isolation and combination. The majority of patients who were eligible for cardiac interventions were treated medically with suboptimal use of anticoagulation and secondary prophylaxis.


Author(s):  
Sarah Wangilisasi ◽  
Pilly Chillo ◽  
Delila Kimambo ◽  
Mohammed Janabi ◽  
Appolinary Kamuhabwa

Abstract Background: Secondary prophylaxis against repeated attacks of acute rheumatic fever is an important intervention in patients with rheumatic heart disease (RHD) and it aims to prevent throat infection by group A beta-hemolytic streptococcus (GAS), however its implementation faces many challenges. This study aimed to assess throat colonization, antibiotic susceptibility and factors associated with GAS colonization among patients with RHD attending care at Jakaya Kikwete Cardiac Institute in Dar-es-Salaam, Tanzania. Methods: A descriptive cross sectional study of RHD patients attending the Jakaya Kikwete Cardiac Institute was conducted from March to May 2018, where we consecutively enrolled all patients known to have RHD and coming for their regular clinic follow-up. A structured questionnaire was used to obtain patients’ socio-demographic information, factors associated with GAS colonization as well as status of secondary prophylaxis use and adherence. Throat swabs were taken and cultured to determine the presence of GAS, and isolates of GAS were tested for antibiotic susceptibility using Kirby-Bauer disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) version 2015. Antibiotics of interest were chosen according to the Tanzanian Treatment Guidelines. Results: In total 194 patients with RHD were enrolled, their mean age was 28.4 ±16.5 years and 58.2% were females. Only 58 (29.9%) patients were on regular prophylaxis, 39 (20.1%) had stopped taking prophylaxis, while 97 (50.0%) had never been on prophylaxis. Throat cultures were positive for GAS in 25 (12.9%) patients. Patients who stopped prophylaxis were 3.26 times more likely to be colonized by GAS when compared to patients on regular prophylaxis. Majority (96%) of GAS isolates were susceptible to Penicillin, Ceftriaxone and Ciprofloxacin, while the highest resistance (20%) was observed with Vancomycin. No GAS resistance was observed against Penicillin. Conclusion: The prevalence of GAS throat colonization is high among this population and is associated with stopping prophylaxis. The proportion of patients on regular secondary prophylaxis is unacceptably low and interventions should target both patients’ and physicians’ barriers to effective secondary prophylaxis.


2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Marhamah Hasnul ◽  
Najirman Najirman ◽  
Yanwirasti Yanwirasti

Abstrak Penyakit jantung rematik (PJR) adalah penyakit jantung sebagai akibat adanya gejala sisa (sekuele) dari demam rematik (DR) yang ditandai dengan terjadinya cacat katup jantung. Tujuan penelitian ini adalah melihat karakteristik pasien penyakit jantung rematik.yang dirawat. Metode yang digunakan adalah deskriptif observasional dengan desain cross sectional study dan pendekatan retrospektif untuk menilai karakteristik pasien PJR di RSUP Dr. M. Djamil Padang dari Januari 2009 - Desember 2012. Populasi dan sampel sebanyak 54 sampel. Hasil penelitian menunjukkan distribusi pasien terbanyak pada kelompok umur 11-20 tahun (50%), perempuan (57,41%), tingkat pendidikan SD/sederajat dan SLTP/sederajat masing-masing 25,93%, pelajar/mahasiswa (53,70%), dan berasal dari daerah rural (70,37%). Sebagian besar pasien mengeluhkan keluhan utama sesak napas (62,96%). Hasil pemeriksaan elektrokardiografi memperlihatkan LVH sebesar 35,19% dan AF sebesar 27,78%. Berdasarkan pemeriksaan foto toraks umumnya pasien telah mengalami kardiomegali (92,59%). Berdasarkan pemeriksaan ekokardiografi yang paling banyak ditemukan adalah kelainan katup regurgitasi mitral (30,40%), derajat kerusakankatup berat (36,80%), dan fraksi ejeksi normal (72,97%). Pada penelitian ini dapat disimpulkan bahwa terdapat variasi karakteristik dari penderita PJR yang ada di RSUP Dr. M. Djamil Padang. Kata kunci: penyakit jantung rematik, karakteristikAbstract Rheumatic heart disease is a cardiovascular disease caused by delayed sequele of rheumatic fever characterized by heart valve damage. The objective of this study was to observe the characteristics of RHD patients.This study is a descriptive observasional with cross-sectional study design and the retrospective by observing the characteristics of RHD patients in RSUP Dr. M. Djamil Padang from Januari 2009 – December 2012. The population and sample of this study was 54 patients. The result of this study showed that majority of the patients at the age group 11-20 years (50%), female (57.41%), elementary education degree/equal and junior high/equal of each 25.93%, students/university students (53.70%), and come from rural areas (70.37%). Most patients complained experiencedbreathlessness (62.96%). The result of electrocardiography showed LVH is the the highest (35.19%) and AF 27.78%. Based on chest X-ray examination majority of the patients showed a cardiomegaly (92.59%). Based on echocardiography examination, the most heart valve damage is mitral regurgitation (30.40%), the severity is severe (36.80%), and the fraction ejection is in normal limit (72.97%). The conclusion of this research, there are variation in the characteristics of RHD patients in RSUP Dr. M. Djamil Padang.Keywords: rheumatic heart disease, characteristics


2019 ◽  
Vol 5 (3) ◽  
pp. 186-191
Author(s):  
Abrar Wahab ◽  
Md Mahabub Ul Islam ◽  
Mehbuba Mehnoor Laboni ◽  
Anisa Fatema ◽  
Abeda Saleha Renesa ◽  
...  

Rheumatic heart disease (RHD) is a significant public health problem and Non-adherence to treatment is an important and often unrecognized risk factor for cardiovascular mortality. The study aimed to assess self-reported medication adherence by 8-item Morisky Medication Adherence Scale (MMAS-8) among rheumatic heart disease patients and determine the associated factors. A cross-sectional study was carried out by applying a structured interview to Rheumatic heart disease patients aged 18 or higher in a tertiary hospital in Bangladesh. Among Rheumatic heart disease patients, 63.5% showed medium adherence, 36.5% showed low adherence to medication. Walking habit (P= 0.000), exercise habit (P=0.000), smoking habit (P=0.000), and duration of RHD (P=0.005) found significantly associated with medication adherence. Multiple logistic regression analysis also revealed, don't have walking habit more than 10 minutes at a time (AOR=2.416, 95% CI: 1.212-4.816), don't having exercise habit (AOR=2.420, 95% CI: 1.206 – 4.859), don't having habit of smoking (AOR=0.392, 95% CI: 0.183 – 0.841), duration of RHD for less than 15 (AOR=4.190, 95% CI: 0.851 – 20.631) are independent predictors of adherence. Our study demonstrated medium to low medication adherence in the Morisky Medication Adherence Scale among rheumatic heart disease patients. Asian J. Med. Biol. Res. June 2019, 5(3): 186-191


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0258068
Author(s):  
Melkamu H. Asmare ◽  
Frehiwot Woldehanna ◽  
Samuel Hunegnaw ◽  
Luc Janssens ◽  
Bart Vanrumste

2000 ◽  
Vol 6 (2-3) ◽  
pp. 437-446
Author(s):  
A. Bassili ◽  
S. R. Zaher ◽  
A. Zaki ◽  
G. Tognoni

A cross-sectional study was conducted in specialist children’s hospitals in Alexandria, which aimed to evaluate the current regimen of secondary prophylaxis for children suffering from rheumatic heart disease. Two-thirds of the patients had complied with their prophylactic regimen. Prophylactic failure occurred in one-third of the patients, raising doubts about the efficacy of the brands of penicillin prescribed. Recurrence of rheumatic fever was recorded in 37.3% of the patients, with semiurban or rural residence and non-compliance with secondary prophylaxis the significant risk factors. These unsatisfactory findings suggest the need for a more effective strategy of primary and secondary prophylaxis for controlling rheumatic fever in our community


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