scholarly journals Investigation of Education Requirements of Individuals Using Warfarin and Achievement of Target INR Value

2021 ◽  
Vol 11 (4) ◽  
pp. 4294-4301

Thromboembolic diseases are important causes of morbidity and mortality. Oral anticoagulants for preventing or treating thromboembolic diseases reduce blood clotting and prevent fibrin deposition, thrombus development, and growth. This study aimed to investigate the educational needs and the rate of reaching the target INR level of individuals using warfarin for heart diseases. The population of this cross-sectional study was attempted to reach the entire population by not choosing a sample due to heart diseases between August –September 2019 in the cardiology outpatient clinic of a public hospital operating in Istanbul. However, due to the voluntary basis and incorrect registration of the questionnaires, 157 participants formed the sample. Data were analyzed using the SPSS 25.0 program. 75.1% of the individuals stated that they were informed about the use of warfarin, and 66.8% of those who received the information stated that they received the information from their physician. In addition, 75.7% stated that they took warfarin regularly, 81.7% had regular INR control, 52.1% knew the target INR value, 68.9% knew the complications. It was found to be 47.6. A statistically significant difference was found between individuals who reached the target INR level and those who did not, according to their information acquisition status (p <0.05). The low rate of individuals reaching the target INR level draws attention. For this reason, it is thought that the knowledge level of patients who are starting treatment with warfarin should be increased, and new generation oral anticoagulant drugs can be used as an anticoagulant treatment instead of warfarin in patients whose target INR cannot be achieved despite sufficient training.

2009 ◽  
Vol 13 (Number 2) ◽  
pp. 9-12
Author(s):  
Md. Khalequzzaman ◽  
M A Islam ◽  
Md. O Hoque ◽  
M Ferdous ◽  
A H K Chowdhury ◽  
...  

This cross sectional study was done among 20 patients with aortic stenosis and 20 healthy controls to evaluate the association of cardiac specific troponin 1 (ant) and sonic valvular heart diseases. The study was conducted in °militant, department in National laminae of Cardiovascular Diseases (N1CVD.)A structured queslionilaire and checklist was used to collect data through face to face interview. Color dapple, echocarchiognsphy was done and 5 ml of venous sample was dmwo from each subjects and laboratory estimation of an, was done. The arid in control group and sonic stenosis patients showed significant difference in mean (<0.001). ant level in aortic stenosis patients increases in the absence of heart failure indicating that it can expose the cardiotnyocnes to injury prior to development of oven left ventricular dysftinction. So. serial monitoring of aid may help clinicians to give definitive treatment (reface development af complications.


Author(s):  
Eze U. Chikezie ◽  
Chika O. Duru ◽  
Frances S. Okpokowuruk

Context: Caregivers of children with heart diseases are faced with the long term care of these children and may suffer psychological illnesses as a result. Aims: To determine the prevalence and determinants of depression among caregivers of children with heart diseases attending two Out-patient clinics in South-South Nigeria. Materials and Methods: It was a cross-sectional study involving the use of the revised Center for Epidemiological Studies Depression (CESD-R) questionnaire. Data were entered into an Excel spreadsheet and analyzed using SPSS 22.0. Results: Ages of the participants ranged from 24 to 59 years with a mean age of 37.49 years (SD 6.973) and majority were female (79.9%). The overall mean CESD-R score was 8.61 (SD 16.18), ranging from 0 to 60. There was a significant difference in the CESD-R scores between male and female participants (t=2.362, p=0.02) with females scoring higher than males (10.24± 17.69  and 2.15± 3.13) respectively. Overall, depression was found among 23(17.1%) participants. Depression was significantly associated with the female sex (x2=7.006, p=0.009), a history of a mental health illness in the past (x2=66.496, p=0.029) and the marital status of the participants (x2=19.776, p=0.05). No significant relationship was found between depression and age, religion, tribe and educational status (p>0.05), history of medical illnesses (x2=53.006, p=0.538) or type of heart disease the children/wards of the participants were being managed for (x2=8.274, p=0.902). Conclusion: The rate of depression among caregivers of children being managed for congenital and acquired heart diseases in this study is significant. It is recommended that caregivers of children with congenital and acquired heart diseases are routinely given relevant psychosocial support to prevent the development of depression. Routine screening for depression and appropriate intervention for those who meet the criteria is also recommended.


2020 ◽  
Vol 63 (6) ◽  
pp. 2016-2026
Author(s):  
Tamara R. Almeida ◽  
Clayton H. Rocha ◽  
Camila M. Rabelo ◽  
Raquel F. Gomes ◽  
Ivone F. Neves-Lobo ◽  
...  

Purpose The aims of this study were to characterize hearing symptoms, habits, and sound pressure levels (SPLs) of personal audio system (PAS) used by young adults; estimate the risk of developing hearing loss and assess whether instructions given to users led to behavioral changes; and propose recommendations for PAS users. Method A cross-sectional study was performed in 50 subjects with normal hearing. Procedures included questionnaire and measurement of PAS SPLs (real ear and manikin) through the users' own headphones and devices while they listened to four songs. After 1 year, 30 subjects answered questions about their usage habits. For the statistical analysis, one-way analysis of variance, Tukey's post hoc test, Lin and Spearman coefficients, the chi-square test, and logistic regression were used. Results Most subjects listened to music every day, usually in noisy environments. Sixty percent of the subjects reported hearing symptoms after using a PAS. Substantial variability in the equivalent music listening level (Leq) was noted ( M = 84.7 dBA; min = 65.1 dBA, max = 97.5 dBA). A significant difference was found only in the 4-kHz band when comparing the real-ear and manikin techniques. Based on the Leq, 38% of the individuals exceeded the maximum daily time allowance. Comparison of the subjects according to the maximum allowed daily exposure time revealed a higher number of hearing complaints from people with greater exposure. After 1 year, 43% of the subjects reduced their usage time, and 70% reduced the volume. A volume not exceeding 80% was recommended, and at this volume, the maximum usage time should be 160 min. Conclusions The habit of listening to music at high intensities on a daily basis seems to cause hearing symptoms, even in individuals with normal hearing. The real-ear and manikin techniques produced similar results. Providing instructions on this topic combined with measuring PAS SPLs may be an appropriate strategy for raising the awareness of people who are at risk. Supplemental Material https://doi.org/10.23641/asha.12431435


Author(s):  
Bhagavathami Meenaksh ◽  
Chitraa R. Chandran ◽  
Aravindhan Thathchari Ranganathan ◽  
Kavindapadi Venkateswaran Rama ◽  
Valarmathy Srinivasan

Background: This study aims to determine and compare the levels of trace elements copper, zinc, selenium and chromium in GCF and serum of patients with periodontitis and healthy individuals. Methods: This cross sectional study includes 24 study subjects recruited from the patients reporting to the Department of Periodontics , Tagore Dental College Chennai. All the selected patients were subjected to a clinical examination done by a single examiner. The estimation of trace elements Copper, Zinc, Selenium and Chromium in GCF and serum is performed using Perkin Elmer optima 5300 Inductively Coupled Plasma Emission Spectrometer (ICPOES). Results: GCF and serum copper levels showed no significant difference in both periodontitis and healthy groups . Selenium levels tend to be the same in both groups. Serum zinc levels are more in periodontitis patients than healthy subjects (p less than 0.01). GCF chromium levels are found to be more in patients with periodontitis than healthy. Conclusions : More research is therefore needed to monitor the role of these trace elements C with an increased sample size to ascertain whether they are associated with a reduced risk of periodontitis.


2018 ◽  
Vol 7 ◽  
Author(s):  
Arefeh Shahi

Background: Postpartum depression with a different incidence of 40- 45% in different societies, which it has adverse effects on the health of mothers and their child, given the negative effects of maternal depression and its harmful effects on the baby and the quality of family life. So, this study was performed with the aim to determine postpartum depression and its associated factors in Bandar Abbas city. Materials and Methods: A descriptive cross-sectional study was conducted in 2015 after obtaining consent from mothers by the census. A total of 343 mothers was examined for depression who referred to Bandar Abbas health centers in the 2nd and 4th months after childbirth. The data collection tools included demographic information and Postpartum Depression Edinburgh questionnaires. Finally, the statistical analyses were performed using SPSS (version 22.0) software and data were analyzed using the Independent t-test, Mann Whitney, Chi-square, and Fisher exact tests.Result: Totally, 68 (19.8%) of samples were in the second month and 54 (15.7%) in the fourth month after delivery had postpartum depression. The incidence of depression in the four months was 6.6%. There was a significant difference between depression and income, parental education, father’s use of cigarette and abnormalities of the infant (P <0.001). There was no significant difference between other factors such as gestational age, infant sex, birth weight, unwanted pregnancy, and type of delivery. Conclusion: Regarding the prevalence of this disorder, it seems that postpartum depression screening planning should be considered during child routine care as an essential component, especially for vulnerable groups.


2020 ◽  
Vol 2 (CSI) ◽  
pp. 12-18
Author(s):  
Ali Al-Rubaye ◽  
Dhurgham Abdulwahid ◽  
Aymen Albadran ◽  
Abbas Ejbary ◽  
Laith Alrubaiy

Background: There has been a rapid rise in cases of COVID-19 infection and its mortality rate since the first case reported in February 2020. This led to the rampant dissemination of misinformation and rumors about the disease among the public. Objectives: To investigate the scale of public misinformation about COVID-19 in Basrah, Iraq. Methods: A cross-sectional study based on a 22-item questionnaire to assess public knowledge and understanding of information related to the COVID-19 infection. Results: A total of 483 individuals completed the questionnaire. The most frequent age group was 26–35 years (28.2%); there were 280 (58%) males and 203 (42%) females. Of the participants, 282 (58.4%) were with an education level below the Bachelor’s degree, 342 (70.8%) were married, and 311 (64%) were living in districts in Basra other than the central district. Overall, 50.8% (11.8/ 22 * 100%) of individuals had the correct information regarding COVID-19. There was a significant association between the level of COVID-19 related misinformation and participants’ educational levels and occupation (p <0.05). However, there was no significant difference found across sex, age group, marital state, and area of residence. Conclusions: Misinformation related to COVID-19 is widely spread and has to be addressed in order to control the pandemic. Keywords: COVID-19, misinformation, knowledge, Iraq


2019 ◽  
Vol 19 (8) ◽  
pp. 1198-1206 ◽  
Author(s):  
Yenny ◽  
Sonar S. Panigoro ◽  
Denni J. Purwanto ◽  
Adi Hidayat ◽  
Melva Louisa ◽  
...  

Background: Tamoxifen (TAM) is a frequently used hormonal prodrug for patients with breast cancer that needs to be activated by cytochrome P450 2D6 (CYP2D6) into Zusammen-endoxifen (Z-END). Objective: The purpose of the study was to determine the association between CYP2D6*10 (c.100C>T) genotype and attainment of the plasma steady-state Z-END minimal threshold concentration (MTC) in Indonesian women with breast cancer. Methods: A cross-sectional study was performed in 125 ambulatory patients with breast cancer consuming TAM at 20 mg/day for at least 4 months. The frequency distribution of CYP2D6*10 (c.100C>T) genotypes (C/C: wild type; C/T: heterozygous mutant; T/T: homozygous mutant) was detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), the results of which were subsequently confirmed by sequencing. The genotypes were categorized into plasma Z- END concentrations of <5.9 ng/mL and ≥5.9 ng/mL, which were measured using ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). Results: Percentages of C/C, CT, and T/T genotypes were 22.4%, 29.6%, and 48.8%, respectively. Median (25-75%) Z-END concentrations in C/C, C/T, and T/T genotypes were 9.58 (0.7-6.0), 9.86 (0.7-26.6), and 3.76 (0.9-26.6) ng/mL, respectively. Statistical analysis showed a significant difference in median Z-END concentration between patients with T/T genotype and those with C/C or C/T genotypes (p<0.001). There was a significant association between CYP2D6*10 (c.100C>T) genotypes and attainment of plasma steady-state Z-END MTC (p<0.001). Conclusion: There was a significant association between CYP2D6*10 (c.100C>T) and attainment of plasma steady-state Z-END MTC in Indonesian breast cancer patients receiving TAM at a dose of 20 mg/day.


2021 ◽  
pp. 002076402110255
Author(s):  
Chao-Ying Tu ◽  
Wei-Shih Liu ◽  
Yen-Fu Chen ◽  
Wei-Lieh Huang

Background: Somatic symptom disorder (SSD) is common in medical settings but has been underdiagnosed. Stigma related to psychiatric illness was one of the barriers to making the diagnosis. More and more SSD patients who visited psychiatric clinics with physical complaints identify themselves as having ‘autonomic dysregulation’ in Taiwan. Aims: This study aimed to investigate the characteristics of patients with a subjective diagnosis of ‘autonomic dysregulation’. Method: We assessed the sociodemographic profile, medical/psychiatric diagnoses, subjective psychiatric diagnoses, perceived psychiatric stigma, help-seeking attitude, and healthcare utilization of 122 participants with SSD. Participants who identified themselves as having ‘autonomic dysregulation’ ( n = 84) were compared to those who did not (n=38). Results: Participants with a subjective diagnosis of ‘autonomic dysregulation’ were younger and had a higher education level than those who did not have such a subjective diagnosis. They also had higher scores on the Patient Health Questionnaire-15 (PHQ-15) and Health Anxiety Questionnaire (HAQ), whereas comorbid psychiatric diagnoses were similar in the two groups. Participants with and without a subjective diagnosis of ‘autonomic dysregulation’ did not have a significant difference in perceived psychiatric stigma and help-seeking attitude/behaviors. In a multiple logistic regression model, only age was associated with having a subjective diagnosis of ‘autonomic dysregulation’. Conclusion: Among SSD patients, those who identify themselves as having ‘autonomic dysregulation’ tend to have higher somatic distress and health anxiety than those who do not. ‘Autonomic dysregulation’ is not associated with perceived psychiatric stigma.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Ni ◽  
Hengan Liu ◽  
Ruijie Gong ◽  
Mei Shi ◽  
Shuxian Zhang ◽  
...  

Abstract Background Sexual compulsivity (SC) and its relationship with unprotected intercourse (UI) have long been an intriguing topic, but its existential meaning in the management of public health or, more precisely, sexually transmitted infections (STIs) has rarely been studied to date. This study examines whether SC plays a role in UI among sexually active STI patients. Method A cross-sectional study was conducted in two sexual transmitted disease (STD) clinicals of Shanghai Skin Diseases Hospital in Shanghai. Totally 664 sexually active STI patients were included. Results The ages of the 664 participants ranged from 18 to 76 years, with 58.73% between 26 and 40 years old. 449 (191 male and 258 female) reported had UI during the past 6 months. Although the only statistically significant difference (p < 0.01) was in relation to UI with a casual sexual partner, the difference between male/female and regular/casual sexual partners remained evident. Conclusions SC is evidently a potential predictor of UI with a casual sexual partner in male STI patients, while the use of condoms is more likely to be affected by other factors. In addition to general sexual education, counseling interventions should be provided by health institutions, and specific intervention methods targeting gender and sexual partners should be considered.


Author(s):  
Giorgio Cozzi ◽  
Marta Cognigni ◽  
Riccardo Busatto ◽  
Veronica Grigoletto ◽  
Manuela Giangreco ◽  
...  

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used


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