scholarly journals A Study on Pattern of Heart Disease and Maternal and Fetal Outcome of Pregnancy in a Tertiary Level Hospital

2016 ◽  
Vol 11 (1) ◽  
pp. 36-41
Author(s):  
Nahreen Akhtar ◽  
Tajmira Sultana ◽  
Syeda Sayeeda ◽  
Tabassum Parveen ◽  
Firoza Begum
Keyword(s):  
Heart Disease ◽  
Mitral Stenosis ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Age Group ◽  
Cross Sectional ◽  
Maternal Fetal Medicine ◽  
Common Cause ◽  
Heart Disease In Pregnancy ◽  
Rheumatic Heart

Background: Cardiac disease is the most common cause of indirect maternal deaths and the most common cause of death overall. It complicates 1% of maternal death.Objective: Management of pregnancy in patients with valvular heart disease continues to pose a challenge to the clinician.the present study was therefore design to find the pattern of Heart Disease and to evaluate the maternal and fetal outcome of pregnancy. Method: This is a cross sectional study done during the period Jan to Dec, 2011in fetomaternal medicine wing of department of Obs & Gynae, BSMMU. All the patients admitted with heart disease in pregnancy during this study period were included in this study. This study prospectively enrolled 54 pregnant women with heart disease.All cases were followed during pregnancy , labour, delivery and in early puerperium.Results: The mean (SD±) age of the patients was 26.08 ± 3.96 ranging from 20 to 35yrs, most ( 26% ) belonged to age group 26 - 30yrs and five (9.26% ) belonged to >30years of age group. Most of the patients 21 (38.89%) were primigravid and 16(29.63%) patients were of second gravida. Out of 54 patients 41(75.93%) women received regular antenatal checkup.Thirty eight(70.37%) patients suffered from rheumatic heart disease. Twenty patients had single valvular involvement, either mitral, tricuspid or pulmonary valve with or without complication. Most of the patients had EF >50% and two patients had EF <49%. Two patients had mild mitral stenosis( >1.5cm2), 5 patients had moderate mitral stenosis (1-1.5cm2) and 6 patients had severe mitral stenosis (<1cm2).Conclusion: Patients with heart disease should be meticulously managed preconceptionally up to the postpartum period by maternal-fetal medicine specialists, obstetricians, cardiologists, and anesthesiologists using a multi-disciplinary approach to their cardiac conditions to have a better outcome of mother and baby.University Heart Journal Vol. 11, No. 1, January 2015; 36-41

scholarly journals Rheumatic Heart Disease in school going children: A cross-sectional epidemiological profile of Jajarkot, Nepal

2019 ◽  
Vol 16 (2) ◽  
pp. 1-4
Author(s):  
Prakash Raj Regmi ◽  
Urmila Shakya ◽  
Ajay Adhikaree ◽  
Jigyasa Regmi Paudyal
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Age Group ◽  
Cross Sectional ◽  
Children And Young Adults ◽  
Group 5 ◽  
Epidemiological Profile ◽  
Rheumatic Heart

Background and Aims: Rheumatic Heart Disease (RHD) is the most common heart disease among children and young adults in Nepal. Identifying the prevalence of RHD is important in planning RHD prevention program. There are few studies on RHD conducted among children of unreached population of Nepal. This study aimed to determine the epidemiological status of RHD among school going children living in rural and underdeveloped community of Jajarkot, Nepal. Methods: This is a cross-sectional study of 6,147 school going children of age group 5 to 16 years from 24 randomly selected schools of Jajarkot in the month of May, 2018. A team of cardiologists from Nepal Heart Foundation examined the children. Diagnosis of RHD was confirmed by echocardiography. Selected socio-demographic data were collected. All positive cases were reviewed by senior cardiologist. Information obtained were analyzed. Frequency and percentage for the categorical data were calculated. Prevalence was reported as cases per thousand school children. Results: The overall prevalence of RHD was 7.32 per 1000 schoolchildren. Borderline RHD was 1.30 per 1000 and definite RHD 6.02 per 1000. On severity scale, mild RHD was 6.18, moderate RHD 0.81 and severe RHD 0.33 per 1000 respectively. Prevalence of RHD varied with age, sex, ethnicity, and severity. RHD was found higher among males, 10-16 years age group and underprivileged children. Conclusion: Jajarkot is found to be a RHD endemic zone in Nepal where prevention efforts should be initiated urgently.

scholarly journals Prevalence of rheumatic heart disease in a major referral cardiology clinic in Ethiopia: A retrospective cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246519
Author(s):  
Melkamu H. Asmare ◽  
Frehiwot Woldehanna ◽  
Samuel Hunegnaw ◽  
Luc Janssens ◽  
Bart Vanrumste
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Urban Areas ◽  
Hypertensive Heart Disease ◽  
Cross Sectional Study ◽  
Interquartile Range ◽  
Age Group ◽  
Cross Sectional ◽  
Working Age ◽  
Rheumatic Heart

Background Rheumatic Heart Disease (RHD) remains one of the major causes of death and disability in developing countries. This preventable, treatable but not curable form of cardiovascular disease is needlessly killing scores of children and youth mainly due to the misunderstanding of the burden of the disease in these countries. We sought to describe the prevalence of RHD at one of the major referral cardiology clinics in Ethiopia. Methods This was a retrospective cross-sectional chart review of all patients referred for a cardiopathy at the Tikur Anbessa Referral Cardiac Clinic from June 2015 to August 2018. We excluded records of patients with a non-cardiac diagnosis and those without a clear diagnosis. A predesigned and tested EXCEL form was used to collect the data. The data was encoded directly from the patient record files. MATLAB’s statistics toolbox (MATLAB2019b) was used for statistical analysis. Results Among the total 7576 records analyzed 59.5% of the patients were women. 83.1% of the data belonged to adult patients with the largest concentration reported in the 18 to 27 age group. 69.7% of the patients were from urban areas. The median age of the study population was 30 (interquartile range = 21–50). 4151 cases were caused by RHD which showed that RHD constituted 54.8% of the cases. The median age for RHD patients was 25 (interquartile range = 19–34). The second most prevalent disease was hypertensive heart disease which constituted 13.6% that was followed by congenital heart disease with 9% prevalence rate. Conclusion The results of this study indicated the extent of the RHD prevalence in Ethiopia’s cardiac hospital was 54.8%. What was more critical was that almost 70% of the RHD patients were mainly the working-age group(19 to 34 years).

Underuse of Injectable Penicillin in Secondary Prophylaxis of Rheumatic Heart Disease in Nepal

2020 ◽  
Vol 01 (01) ◽  
pp. 009-012
Author(s):  
Laudari S
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Cross Sectional Study ◽  
Secondary Prophylaxis ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Rheumatic Heart

Background and Aims: Secondary prophylaxis has remained the mainstay of rheumatic fever and rheumatic heart disease management. Despite the proven ef􀏐icacy and superiority of injectable penicillin in rheumatic heart disease patients, it has been underused in Nepal. Materials and Methods: This is a hospital based cross-sectional study during June 2014 to October 2018 over a period of 52 months at College of Medical Sciences-Bharatpur including 350 patients with clinical and/or echocardiographic evidence of de􀏐inite rheumatic heart disease. Data was collected from both cardiology outpatients and inpatients (admitted in cardioward/coronary care unit). Relevant data and information were entered into the pre-structured proforma and then analyzed by SPSS-16 software. Results: The age of the patients ranged from 6 to 80 years with mean age 36.76±4.6years with female preponderance (F:M=1.26:1). The predominantly involved isolated valve was mitral in 152 patients (44.43%) followed by aortic valve in 70 patients (20.00%) and rest 90 (25.71%) had dual valvular involvement. The common complications encountered were heart failure in 200(57.14%) and arrhythmias in 155(44.29%) patients. Two hundred ten (60.00%) of the patients received penicillin (oral and injectable) and erythromycin. Majority 180/210=85.71%) were prescribed on oral penicillin whereas only 46/210=21.90% received injectable penicillin; the ratio being 3.35:1. Conclusion: RHD is a leading cause of heart failure and death among young population. There is underuse of penicillin with very minimal focus on use of injectable penicillins currently. Hence, Nepal government and other non-governmental organizations should consider implementation of use of penicillin broadly and moreover focus on use and adherence of injectable penicillin. Keywords: Rheumatic Heart Disease, Penicillin, Underuse, Secondary Prophylaxis.

scholarly journals Fetomaternal Outcome in Pregnancy With Cardiac Disease

2012 ◽  
Vol 23 (1) ◽  
pp. 31-35
Author(s):  
Shahanaj Sharmin ◽  
Shahanara Chowdhury ◽  
Didarul Alam ◽  
Mohiuddin Ahmed ◽  
Fahamida Rashid ◽  
...  
Keyword(s):  
Heart Disease ◽  
Birth Weight ◽  
Pregnant Women ◽  
Rheumatic Heart Disease ◽  
Cardiac Disease ◽  
Cross Sectional Study ◽  
Normal Vaginal Delivery ◽  
College Hospital ◽  
Cross Sectional ◽  
Rheumatic Heart

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

scholarly journals Throat colonization and antibiotic susceptibility of group A β-hemolytic streptococci among rheumatic heart disease patients attending a cardiac referral hospital in Tanzania, A descriptive cross-sectional study

2019 ◽  
Author(s):  
Sarah Wangilisasi ◽  
Pilly Chillo ◽  
Delila Kimambo ◽  
Mohammed Janabi ◽  
Appolinary Kamuhabwa
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Antibiotic Susceptibility ◽  
Cross Sectional Study ◽  
Secondary Prophylaxis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Group A ◽  
Rheumatic Heart

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.

scholarly journals A Case of Massive Left Atrial Thrombus

2021 ◽  
Author(s):  
John Ahn ◽  
Colin Burke ◽  
Lindsay Howitt ◽  
Tim Glenie ◽  
Gary Lau
Keyword(s):  
Heart Disease ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Mitral Valve Stenosis ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Left Atrial Appendage Thrombus ◽  
Common Cause ◽  
Rheumatic Heart

Rheumatic heart disease is the most common cause of mitral valve stenosis. Left atrial appendage thrombus is associated with mitral stenosis, but in rare cases the thrombus can extend to the left atrial cavity. We present a case of a severe rheumatic mitral stenosis and associated large left atrial thrombus, with embolic sequelae.

scholarly journals Karakteristik Pasien Penyakit Jantung Rematik yang Dirawat Inap di RSUP Dr. M. Djamil Padang

2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Marhamah Hasnul ◽  
Najirman Najirman ◽  
Yanwirasti Yanwirasti
Keyword(s):  
Heart Disease ◽  
Elementary Education ◽  
Rheumatic Heart Disease ◽  
Heart Valve ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chest X Ray ◽  
Rheumatic Heart

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

scholarly journals Patterns of Rheumatic Heart Disease and Treatment Practices at Tertiary Care Center in Nepal: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Rajesh Nepal ◽  
Madhab Bista ◽  
Sahadeb Prasad Dhungana
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional ◽  
Treatment Practices ◽  
Rheumatic Heart

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.

scholarly journals Evaluation of Demographic Characteristics and Therapeutic Response to ocular Chemical Burn in Patients Referred to Eye Emergency Department of Farshchian Hospital in 2015-2016

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Fateme Eslami ◽  
Nooshin Bazzazi ◽  
Mohamad Ali Seifrabiei ◽  
Maryam Hamidinekoo ◽  
Leila Azizkhani
Keyword(s):  
Occupational Injury ◽  
Cross Sectional Study ◽  
Ocular Injury ◽  
Age Group ◽  
Chemical Burn ◽  
Cross Sectional ◽  
Poor Prognostic Factor ◽  
Common Cause ◽  
Chemical Injury ◽  
Severity Of Injury

Objective:The chemical eye burn is one of the major emergencies in the ophthalmology that will result in irreparable complications in case of inappropriate and timely treatment in severe casesMaterial and Methods:In this cross-sectional study 250 patients with ocular chemical burn who   referred to Farshchian Hospital were enrolled. Demographic characteristic and information regarding the burn were obtained. The Hughes-Roper-Hall classification was used for grading the severity of injury. All patients reevaluated 6 weeks later after injury.Results:Of 250 patients with complete follow up 155 cases ( 62% ) were male and 95 cases ( 38 % ) were female. Chemical injury were more common in the 20-40 years age group ( 108 case = 43/2 % ).The most common cause of chemical injury were occupational injury( 120 case = 48 % ).127 case (50/8 % ) of patients referred during The first hour after injury. The most common material of injury was acid in 102 cases (40/8 % ).Grade I burn was seen in 92 cases ( 36/8 % ) and grade IV in 30 cases ( 12 % ).Grading of the injury was related to the referring time after chemical burn. Severity of injury was more in alkaline burn.In 50 % of grade IV causes the burn had alkaline origin, however only 13/3 % of acid burn had grade IV severity. ( p : 0/001)Conclusion:The incidence of ocular chemical burn was approximately 2/19 % of all patients who referred to emergency ophthalmology service .According to this study ocular injury are more common in the men 20-40 years age group. The most common cause was occupational injury. Delay in referring and alkaline material were poor prognostic factor.

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