The Association of N-terminal Pro-B-Type Natriuretic Peptide with Haemoglobin and Ferritin in Heart Failure Patients

2021 ◽  
Author(s):  
A Sabharwal ◽  
V Nayar ◽  
S Salar

Introduction: The adverse prognosis of heart failure (HF) correlates with both N-terminal pro-B-type natriuretic peptide (NT-proBNP) and ferritin. The contribution of an underlying inflammatory process in the pathogenesis of HF is not only evidenced by increased ferritin (acute phase reactant), but also a reduced haemoglobin (Hb) due to cytokine-mediated bone marrow suppression. However, it remains unknown if there is a linear relationship between NT-pro BNP with ferritin and Hb levels. Objective: To determine an association between very elevated levels of NT-proBNP (>10,000pg/ ml) with Hb and ferritin in patients with HF. Methods: A retrospective, cross-sectional study to evaluate levels of ferritin and Hb among patients with very high NT-proBNP levels (>10,000pg/ml) treated at a district hospital serving a population of 500,000 people. Inclusion criteria: in-patient between October to December 2020, diagnosis of HF, NT-proBNP level >10,000 pg/ml, measured haemoglobin and ferritin level within 7 days of NT-proBNP measurement. Results: Forty-five patients met all of the inclusion criteria. Mean age 81 years ± 12 years. There was a positive correlation between NT- proBNP with ferritin and a negative correlation between NT-proBNP and Hb. With NT-proBNP on the x-axis and Hb on the y-axis, the trend line equated y = -0.0003x + 124.88. With NT-proBNP on the x-axis and ferritin on the y-axis, the trend line equated y = 0.0043x + 311.6. Conclusion: With rising levels of NT-proBNP, Hb levels decrease and ferritin levels increase in a linear manner, simultaneously. Larger studies are required to confirm this observation and to investigate the clinical implications of these findings.

1970 ◽  
Vol 3 (2) ◽  
pp. 126-130
Author(s):  
MM Hoque ◽  
S Shafiullah ◽  
P Sultana ◽  
N Sultana

Background: Accurate diagnosis of heart failure (HF) is essential for its proper management and logical drug therapy to reduce morbidity and mortality. On this perspective researcher are in search of a good biomarker as complementary to the clinical parameters to improve the performance of HF diagnosis. B-type natriuretic peptide (BNP) secreted by cardiac ventricles in HF has emerged as a new promising biomarker in this regard. Objective: To evaluate the performance of plasma BNP as a diagnostic biomarker in HF. Methods: In a cross sectional study 180 clinically suspected HF patients were selected. Their plasma BNP were measured and then subjected to echocardiogram. Patients were categorized as HF and without HF on the basis of echocardiogram and against this information the performance of plasma BNP of study subjects were evaluated as a diagnostic biomarker of HF considering 100 pg/ ml as its cut off point. Results: Sensitivity, specificity, accuracy, PPV, NPV, PLR and NLR of plasma BNP for diagnosis of HF found to be 88 %, 63.8 %, 77.2 %, 75.2 %, 81.0 %, 2.4 and 0.2 respectively. Conclusion: Plasma BNP concentration increases in HF. Based on 100 pg/ml as cut off point, plasma BNP shows good performance in diagnosis of HF Keywords: BNP; Heart failure DOI: http://dx.doi.org/10.3329/cardio.v3i2.9180 Cardiovasc. J. 2011; 3(2): 126-130


2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.


Author(s):  
Mohamed N. Al Arifi ◽  
Abdulrahman Alwhaibi

Objective: Fever alone can lead to rare serious complications in children, such as febrile seizures. The aim of this study is to assess the knowledge, beliefs, and behavior of parents toward fever and its management. Methods: A cross-sectional study using an online questionnaire was applied over a period of 3 months, from January to March 2018, to parents who were living in Saudi Arabia. The inclusion criteria were a parent who is a resident of Saudi Arabia, with at least one child aged 6 years or less, while incomplete questionnaires, having a child aged more than 6 years, or parents who were not living in Saudi Arabia were excluded. Results: A total of 656 parents completed the questionnaire. More than two-thirds of the subjects were female, the majority of whom were aged between 25–33 years old. The best-reported place to measure the temperature of children was the armpit (46%), followed by the ear (28%) and the mouth (10.7%). More than half of the parents considered their children feverish at a temperature of 38 °C. The majority of parents (79.7%) reported that the most serious side effects of fever were seizure, brain damage (39.3%), coma (29.9%), dehydration (29.7%), and death (25%). The most common method used to measure a child’s temperature was an electronic thermometer (62.3%). The most common antipyretic was paracetamol (84.5%). Conclusions: Our study demonstrates the good knowledge of parents in identifying a feverish temperature using the recommended route and tools for measuring body temperature.


2021 ◽  
pp. 088626052199795
Author(s):  
Marwan Akel ◽  
Jana Berro ◽  
Clara Rahme ◽  
Chadia Haddad ◽  
Sahar Obeid ◽  
...  

The objectives of this study were to correlate several factors - including depression, anxiety, stress and self-esteem levels in both men and women - with the occurrence of domestic violence against women (VAW) during quarantine. This cross-sectional study was carried out in April 2020, in the midst of the COVID-19 pandemic when lockdown procedures were implemented; 86 married couples participated in this study amounting to 172 responses in total. A different questionnaire was set for women and men; the couple filled out their respective questionnaire simultaneously, but privately where one did not see the answers of the other. Inclusion criteria included married couples of all ages that are living together during the lockdown of COVID-19. The results of this study showed that a higher total abuse score was found in 39 females (45.3%; CI: 0.34 - 0.56). Being a Muslim female (Beta =24.80) and females having higher anxiety (Beta=0.97) were significantly associated with higher total abuse scores, whereas higher stress score in female (Beta=-0.61) was significantly associated with lower total abuse scores. In conclusion, this study focuses on VAW as a serious problem while demonstrating its further emergence during quarantine. This study also focused on the effects brought on by lockdown policies, including social and economic factors, and their implications in the increase of VAW during this pandemic.


2021 ◽  
Vol 10 ◽  
pp. 204800402110027
Author(s):  
Eshan Ashcroft ◽  
Otar Lazariashvili ◽  
Jonathan Belsey ◽  
Max Berrill ◽  
Pankaj Sharma ◽  
...  

Objectives The right ventricular (RV) function is an important prognostic factor in acute and chronic heart failure (HF). Echocardiography is an essential imaging modality with established parameters for RV function which are useful and easy to perform. However, these fail to reflect global RV volumes due to reliability on one acoustic window. It is therefore attractive to calculate RV volumes and ejection fraction (RVEF/E) using an ellipsoid geometric model which has been validated against MRI in healthy adults but not in the HF patients. Design This is a retrospective analysis of a prospective cross-sectional study enrolling 418 consecutive patients with symptoms of HF according to a predefined study protocol. All patients underwent echocardiographic assessment of RV function using Tricuspid Annular Plane Systolic Excursion (TAPSE) and RV fractional area change (RVFAC) and RVEF/E. Setting Single centre study with multiple locations for acute in-patients including high dependency units. Participants Patients with acute or exacerbation of chronic HF older than 18 y.o. Main outcome measures Ability of RVEF/E to predict patient outcomes compared with two established parameters of RV function over two-year follow-up period. Primary outcome measure was all-cause mortality. Results RVEF/E is equal to TAPSE & RVFAC in predicting outcome (p ≤ 0.01 vs p ≤ 0.01) and provides additional benefit of RV volume estimation based on standard 2D echo measurements. Conclusions In this study we have shown that RVEF/E derived from ellipsoid model is not inferior to well established measures of RV function as a prognostic indicator of outcome in the acute HF.


2020 ◽  
pp. 201010582096214
Author(s):  
Tsegu Hailu Gebru ◽  
Haftea Hagos Mekonen ◽  
Kbrom Gemechu Kiros

Background: Good knowledge of self-care related to heart failure (HF) is key to improve patient outcomes. However, information regarding how much patients know about self-care is lacking in developing countries, particularly in the study setting. Objective: The objectives of this study were to assess HF patients’ knowledge about self-care and to explore predictors among HF patients in Ayder comprehensive specialised referral hospital, Tigray, Ethiopia. Methods: This hospital-based cross-sectional study design was undertaken in Ayder comprehensive specialised referral hospital, Tigray, Ethiopia. A total of 408 HF patients participated, and the study was done between February and April 2018. An interviewer-assisted structured questionnaire was used to collect data. Bivariate logistic regression and multivariable logistic regression were conducted to identify the predictors associated with knowledge about self-care. Results: The mean age of the participants was 45.4 years (standard deviation=19 years). Around 255 (62.5%) of the participants had poor self-care knowledge. Age, New York Heart Association classes, duration of the disease and previous hospitalisation were the factors associated with knowledge about self-care. Conclusion: More than half of all participants had poor knowledge about self-care. Improving existing prevention strategies and strengthening patients’ knowledge are recommended to address this knowledge deficit.


2020 ◽  
Vol 01 (01) ◽  
pp. 009-012
Author(s):  
Laudari S

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.


2021 ◽  
Vol 8 (2) ◽  
pp. 19-23
Author(s):  
Ruqayya Sana ◽  
Farzana Rehman ◽  
Farzana Rehman ◽  
Rashid Javaid

OBJECTIVES: The objective of this study was to compare working length calculated with conventional radiographs and an electronic apex locator (IPEX II) during the root canal treatment of mandibular anterior teeth. METHODOLOGY: A cross-sectional study was done in the Department of Operative Dentistry, Sardar Begum Dental Hospital, Peshawar during February and March 2018. A consecutive sampling technique was used for sampling. Only 30 patients fulfilled the inclusion criteria of our study. Detailed medical and dental history was taken. Only patient fulfilling inclusion criteria were enrolled in the study. Data were analyzed using SPSS version 20. RESULTS: The mean age for patients was 45.33±5.16. 33% out of 30 patients (10) were male and 20 were females. The mean working length calculated from radiographs was 22.25±1.29 (min 20.09-max 24.10). The mean working length calculated by the electronic apex locator (IPEX II) was 22.17±1.28 (min 20.00-max 24.07). The mean difference between working length calculated by radiograph and electronic apex locator was -0.084mm, which means the working length determined by radiographs and by electronic apex locator has no difference in mandibular anterior teeth with single canals. CONCLUSION: Both the methods can be used effectively in endodontics for single-rooted mandibular teeth, but if both are used in combinations can lead to an improvement in the working length accuracy, which may significantly reduce the number of radiographs exposure, and increase the success and comfort for endodontic patients. KEYWORDS: Working Length, Apex Locator, Conventional Radiograph


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