scholarly journals Association of hs-CRP Levels and Medications Adherence Status among Heart Failure Patients at a Cardiac Referral Hospital in Tanzania

Author(s):  
Gabriel Maganga ◽  
Pilly Chillo ◽  
Mohamed Janabi ◽  
Appolinary Kamuhabwa

Introduction: Heart Failure (HF) is a global health problem, and despite much progress in new therapies, its prognosis remains poor. This is due to a number of factors including lack of adherence to HF medications. Previous studies have shown high sensitivity C-reactive protein (hsCRP) to change with HF progression, and that plasma hsCRP levels can be used to predict HF progression and assessment of adherence to medications. This association however has not been studied in Sub-Saharan African (SSA) countries, including Tanzania. Aim: To study the association between hsCRP levels and HF medications adherence among HF patients attending the Jakaya Kikwete Cardiac Institute (JKCI) in Dar es Salaam, Tanzania. Materials and Methods: This was a hospital based cross-sectional study, where all eligible adult HF patients were consecutively enrolled as they attended their regular clinics, until the sample size was reached. Patients’ socio-demographic and clinical information was collected through interviews and chart reviews. An 8-item Morisky tool was used to assess patients’ adherence to HF medications. Blood was collected and analysed for hsCRP, Complete Blood Count (CBC) and cholesterol panel. hsCRP was considered elevated when it was >5 mg/L. Data were analysed using Statistical Package for Social Sciences (SPSS) computer software, version 21. All tests were 2-sided, and a p-value of <0.05 was considered to indicate a significant association. Results: In total, 210 HF patients were enrolled. Their mean age was 54±15.9 years and 53.8% were females. In the total population, the mean hsCRP was 7.15±4.94 mg/L, and 122 (58.1%) patients had elevated hsCRP. Poor medications adherence was present in 138 (65.7%) patients. Patients with poor medications adherence were more likely to have elevated hsCRP levels (68.1%) when compared to patients with good adherence (38.9%), p<0.001. In multivariate logistic regression analysis, elevated hsCRP independently predicted poor medications adherence (OR=4.27, 95% CI 2.14-8.51, p<0.001), irrespective of other variables. Conclusion: HF patients with poor medications adherence are 4-times more likely to have elevated hsCRP, irrespective of other clinical and socio-demographic factors in this study cohort. These findings suggest that hsCRP levels can be considered as surrogate to HF medications adherence.

2021 ◽  
Vol 15 (11) ◽  
pp. 3261-3264
Author(s):  
Syed Mohammad Haleem ◽  
Muhammad Hashim Kalwar ◽  
Muhammad Hassan Butt ◽  
Jehangir Hasan ◽  
Javed Khurshed Shaikh ◽  
...  

Background: An increasing number of people around the world suffer from cardiovascular diseases such as atrial fibrillation (AF) and heart failure (HF). Atrial fibrillation (AF) has been linked to poor prognosis in heart failure (HF) patients with mild to moderate LV dysfunction, and it is most prominent in these patients. Despite advancements in care and treatment options like catheter ablation, managing AF is still a therapeutic challenge even with these advances. Aim/Objective: To determine the frequency of atrial fibrillation in heart failure patients. Subjects and Methods: This cross-sectional study was conducted on 246 patients at Adult Cardiology, NICVD, Karachi for Six months after approval from 31-08-2019 till 29-02-2020. Patients' consent was obtained verbally before data were collected prospectively. There were 246 patients with heart failure who had been diagnosed and met the diagnostic criteria. An overview of the event's history was gathered, as well as demographic data. Qualitative variables were presented as frequency and percentages, while quantitative data were given as simple descriptive statistics such as mean and standard deviation. A p-value of 0.05 or lower is considered statistically significant. Results: A total of 246 patients with heart failure were included in this study. The mean age in our study was 56.78±2.81 years. Whereas, mean BNP and ejection fraction in our study was 1144±87.81 pg./ml and 34.65±4.14 %. 136 (55.3%) were male and 110 (44.7%) were female. Out of 246 patients with heart failure, 52 (21.1%) had atrial fibrillation and 194 (78.9%) did not have atrial fibrillation. Conclusion: The results of this research demonstrated that a large percentage of heart failure patients had atrial fibrillation. Thus, it is essential to focus on a comprehensive way of management of heart failure and its comorbidities rather than primarily treating the cardiac symptoms. Keywords: Heart failure and atrial fibrillation.


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Kassahun Gebeyehu Yazew ◽  
Debrework Tesgera Beshah ◽  
Mohammed Hassen Salih ◽  
Tadele Amare Zeleke

Background. Depression is a comorbid disorder in patients with heart failure and it is a major public health problem worldwide. Little is known about the depression among heart failure patients in low-income countries, while, in Ethiopia, none was studied. Objective. This study is to assess the prevalence of depression and associated factors among heart failure patients at cardiac follow-up clinics at Amhara Region Referral Hospitals, Northwest Ethiopia, 2017. Methods. A hospital based cross-sectional study was conducted between March 30, 2017, and May 15, 2017, G.C., by using a systematic random sampling technique to select 422 of 1395 HF patients. Structured interviewer-administered questionnaires and patient card review with a checklist that incorporates the PHQ-9 tool for depression measurement were used. The collected data were checked, coded, and entered into Epi-info version 7 and exported to SPSS version 20. Bivariate logistic regression at p-value <0.2 was exported to multivariate logistic regressions and p-value <0.05 was considered statistically significant. Results. A total of 403 were included with a response rate of 95.5%. Among the participants, 51.1% had depressive symptoms. Factors associated with depressive symptoms were poor self-care behavior 1.60 [AOR (95% CI=1.01, 2.55)], poor social support 1.90 [AOR (95% CI=1.16, 3.12)], being female 2.70 [AOR (95% CI=1.44, 5.07)], current smoking history 4.96 [AOR (95% CI=1.54, 15.98)], and duration of heart failure (>1 year) 1.64 [AOR (95% CI=1.04, 2.59)]. Conclusions. Around half of the patients were depressive. The patients who had poor self-care behavior, were females, had poor social support, had a current history of smoking, and had duration of chronic heart failure >1 year need special attention. Therefore, all referral hospitals need efforts to focus on those problems and target improvements of depressive symptoms.


2021 ◽  
pp. 1-8
Author(s):  
Michael Beraki Mengistu ◽  
◽  
Yonatan Mehari Andemeske ◽  
AriamTsegay Emhatsion ◽  
HabtomTareke Wrieta ◽  
...  

Background: Delirium is a common but often underdiagnosed set of transient symptoms often seen in elderly patients following surgeries under spinal anesthesia. With early recognition and diagnosis based on the established standard criteria delirium can be improved. Early identification of the possible contributingfactors and the magnitude of the burden will help in the management of the fragile elderly patients. The aim of this study is to determine the incidence of postoperative delirium and associated risk factors in elderly patients who have done surgery under spinal anesthesia. Method: This cross sectional study was conducted in the National Referral Hospitals and Sembel PrivateHospital, in Asmara, Eritrea from February to May, 2019. The study participants were elderly patients (age ≥65 years) having no known history of dementia or delirium or no mental disorder, no history of acute cerebrovascular disease. Basic background and clinical characteristics of the patients was collected. To assess the status of cognitive impairment level, the Mini Mental State Examination and Confusion Assessment Method tools were used. Data was collected through an interview method. After the data was entered into SPSS version 22 software, data was analyzed with frequency, percentage, bivariate and multivariate logistic regression analysis method as appropriate. P value <0.05 was considered as statistically significant. Results: The mean age of the participants was 74 ±6.62 and 102 (79.1%) of the participants were males. POD occurred in 14 (10.9%) of the patients. Adjusting all the potential factors, age was identified as arisk factor for developing POD. Conclusion: Age was determined to be a significant risk factor of delirium. Elderly patients require more attention and care and the findings might help to develop preventive strategies to the occurrence of POD


Author(s):  
Yassmin Hassan Mohammed ◽  
Salma Hussein Elhassan ◽  
Mariam Abbas Ibrahim ◽  
May Mohammed Ali ◽  
Nuha Eljaili Abubaker ◽  
...  

Background:  Several prognostic markers are used in clinical stages of Chronic Lymphocytic Leukemia (CLL); including lactate dehydrogenase enzyme (LDH), CD38 and Zeta associated protein kinase (ZAP70). This study aimed to compare LDH with ZAP70 and CD38 as prognostic markers in Sudanese patients with CLL. Materials and Methods: Fifty newly diagnosed patients with CLL were enrolled in this cross-sectional study, the age of patients ranged between 36 - 85 years, with mean of 62 years. Of total patients; there were 34 males (68%) and 16 females (32%). Blood samples were obtained and LDH measurement was done by using Dirui CS-T240 automated analyzer while CD38 and ZAP-70 were measured by flowcytometry. Data were analyzed by statistical package for social science (SPSS) computer software program version 21. Results: The present study revealed a significant association between LDH and Rai staging (p. value= 0.002), when LDH compared with ZA-70 and CD38 as reference prognostic markers; poor correlation between CD38 and LDH was found (R2= 0.086, P value= 0.034) and no correlation between LDH level and ZAP-70 expression (R2= 000, P value= 0.960). In conclusion: According to the outcomes of this study; ZAP-70 and CD38 cannot be substituted by LDH as a prognostic marker.


Author(s):  
NAIF TAWFIQ AL-NWANY

Introduction: Hypertensive is one of the most health problems in the world. People who have hypertension become high risk for other diseases . This study was conducted to identify distribution of hypertensive among patients attended 48 Hospital during 2019. Method : A cross-sectional study was conducted and collected the data of all patients diagnosed with hypertension during the year 2019 as registered by 48 medical compound. The study area has electronic information system which is data collected and filled by physician or specialist in different medical departments and outpatient clinics. The data in excel sheet contain information's about the disease including: name, age, sex and marital status, complications and laboratory tests lipid profile for each patient. Results and conclusion: Hospital registration system indicated the admission of total number of patients with hypertensive was 2225 during that year. Chi square and fisher test analysis showed that the most patients with hypertensive were with age group above 60 year (50%) , married (97.8%) , residence in Sana'a 88.4% . Females under age 60 years (62%), males above age 60 years (56.9%) and hypertension was significant with age with p-value 0.001. Hypertensive heart diseases patients without heart failure (82.7%) most them : (83%) above age 40 years , females (84.7%) and married (82.7%).The most complication of hypertension were heart disease (82%), renal disease (5.9%) , heart failure (5.1%) and stroke (3.2%). In future the researchers need study more about hypertensive risk factors such as life style changes .


2020 ◽  
Author(s):  
Siti Aishah Abas ◽  
Ahmad Taufik Jamil ◽  
Mohd Shahril Ahmad Saman ◽  
Mariam Mohammad ◽  
Sharifah Nor Ahmad

Abstract Background: Viral Hepatitis HIV Co-infection is an important and preventable cause of chronic liver disease, and having them lead to many consequences, especially for those living in wrenched conditions. Thus it is a significant health issue in the communities. This study aimed to determine the prevalence of Viral Hepatitis-HIV Co-Infection and determine the associated variables with this Co-Infection. Methods: A cross-sectional study was done using HIV Case Registry ( Anti Retroviral -(ARV) line listing). We included 1274 patients who were seen under the HIV Clinic services, which were screened for Hepatitis B Virus (HBV) and Hepatitis C Virus ( HCV) upon registered to the clinic. Factors associated with the HBV-HIV and HCV-HIV were determined using bivariate, and multivariate logistic regression analysis using SPSS and odds ratio was used as the measures of association. A P-value of less than 0.05 was considered statistically significant for all the tests. Results: From the 1274 number of HIV patients, the prevalence of HBV-HIV is 5.6% (71 cases), while the prevalence with HCV co-infection was 14.8% (189 cases). As for the frequency of multiple HIV-Coinfection, out of 238 HIV cases with Co-Infection, the majority of 167 cases (70.17%) were HCV-HIV Co-Infected followed by 49 cases (20.5%) were HBV-HIV Co-Infected. In comparison, another 22 cases ( 9.24%) were Co-Infected with HBV-HCV-HIV. In the final model of HBV-HIV Co-Infection, only male gender, CD4 count category less than 199 cells/mm3 and primary care type of facilities were associated with the disease whereas, in the HCV-HIV Coinfection, only male gender, Malay race, Intravenous Drug User (IVDU) modes of transmission, and source of the case from high-risk screening program were associated with the disease. Conclusions: Co-Infection with HCV-HIV is more prevalent from HBV-HIV in our study population. A more targeted intervention of HBV revaccination and more frequent screening of HCV post HCV treatment as reinfection is anticipated in high-risk behaviour patient are some of the intervention programs that can be suggested.


2020 ◽  
Vol 4 (3) ◽  
pp. 60-68
Author(s):  
Katharina Yosephin Lakonawa ◽  
I Gusti Lanang Sidiartha ◽  
I Gusti Ayu Putu Eka Pratiwi

Mortality is still high among children with severe acute malnutrition who require hospitalization. This study investigated the factors independently related to the mortality among hospitalized children with severe acute malnutrition. A cross-sectional study was conducted in a single tertiary referral hospital in Bali, Indonesia from January 2017 to December 2018. A logistic regression test was used to analyze the factors independently related to mortality. Significantly differences were considered if P-value less than 0.05. A total of 138 children with severe acute malnutrition was fulfilled the study criteria, 83 children (60.1%) were male, 79 children (57.2%) were a toddler and 133 children (96.4%) were classified as marasmus. The mortality was found in 60 children (43.4%). On multivariate logistic regression analysis found anemia (aOR 8.6, 95%CI: 2.4 to 30.5, P = 0.001) and metabolic acidosis (aOR 3.4, 95%CI: 1.3 to 9.1, P = 0.01) were statistically significant. It can be concluded that the mortality rate among children with severe acute malnutrition is still high and anemia as well as metabolic acidosis are factors independently related to this mortality.


Author(s):  
Hamed Taheri ◽  
Roya Rafaiee ◽  
Raheleh Rafaiee

Objective: Academic health services play an important role in the prevention and control of diabetes mellitus (DM) in Iran. This study aimed at determining the prevalence of DM-related complications and the associated risk factors among patients with DM in a university-affiliated outpatient diabetes clinic of a referral hospital in Southeast of Iran, Zahedan. Materials and Methods: This cross-sectional study was conducted from January to April 2019 in an academic diabetes clinic. A total of 334 patients with DM, whose characteristics (age, sex, family history of DM, and substance abuse), as well as laboratory and clinical information, were recorded in the baseline forms, were included. The relationship between variables were assessed by Pearson’s correlation coefficient at P-value< 0.05 and using SPSS version 20.0. Results: The mean age of the participants was 54.27 (±11.57) years. In these patients, DM type 2 was estimated at 99.1%, and the mean duration of the disease was 8.98 (±6.93) years. The findings showed that 77.2% of the patients had poor glycemic control. Also, 85.4% of the patients had fasting blood sugar (FBS) level >126 mg/dL. There was a significant relationship between insulin-dependent therapy and drug abuse (P-value <0.001). The prevalence of hyperlipidemia (68.9%), hypertension (50.6%), retinopathy (29.6%), nephropathy (11.7%), and neuropathy (12.3%) was also determined. Conclusion: The majority of the patients (77.2%) in this study had poor glycemic control, and 69.9% of them suffered from microvascular complications, macrovascular complications, or both. Therefore, frequent visits accompanied by patient education could help to better diabetes control


2021 ◽  
Vol 4 (3) ◽  
pp. 419-422
Author(s):  
Liliya Aleksandrovna Osipova ◽  
Lyudmila Mikhailovna Kuzenkova

Background: Mucopolysaccharidoses (MPSs) are a group of lysosomal storage diseases, resulted from glycosaminoglycans’ breakdown failure (GAGs). The study aims to determine the presence of thrombocytopenia, its prevalence, clinical implication, and correlation with the types of MPSs and with the types of glycosaminoglycans storage. Methods: A retrospective cross-sectional study of complete blood count data was conducted among 108 children with a confirmed diagnosis of MPS in the National Medical Research Center for Children's Health, Moscow, Russian Federation. STATISTICA 10 (Stat Soft, Inc. 1984-2011) was used for statistical analysis. A p-value of ≤0.05 was considered significant. Results: The median age of children was 65 [IQR: 41; 102] months, range: 3 – 102 months. The male to female ratio was 3:1. The prevalence of fluctuating or persistent thrombocytopenia in all children with MPS was 19.0%. Thrombocytopenia occurred in patients with MPS I (14.0%), II (19.0%), and III (31.0%). Neither of the patients with MPS IV nor VI demonstrated low platelet count. There was a non-significant predominance (P=0.068) of thrombocytopenia frequency in patients with heparan sulfate storage (22.0%) compared with patients without heparan sulfate burden (0%). Conclusion: Routine checkups of patients with MPSs must include complete blood count with platelet measurement. Cases of thrombocytopenia that requiring treatment, immunomodulatory/ immunosuppressive therapy should be considered. Further research is needed to look for the laboratory confirmation of autoimmune variants of HIT in patients with MPS I, II, III.


Author(s):  
Ningombam Joenna Devi ◽  
Bishwalata Rajkumari ◽  
Longjam Usharani Devi

Background: Elderly in India suffers from both communicable and non-communicable diseases, also functional independence reduces due to physiological changes. This study aims to determine the pattern of morbidity, functional ability in activities of daily living (ADL), instrumental activities of daily living (IADL) and to assess any factors associated with ADL.Methods: A cross-sectional study was conducted from May 2017 to April 2019 among 420 elderly aged 60 years and above residing in rural areas of Wangoi in Manipur. Probability proportional to size (PPS) sampling method was used to select 6 villages out of 28 villages. A pre-tested interview schedule was used as study tool. Data were analysed using SPSS IBM statistics version 21 using mean, SD, proportion, chi-squared (χ²) test, univariate and multivariate logistic regression analysis were performed taking p-value<0.05 as statistically significant.Results: Some form of morbidity was reported by 49.1% of the respondents. The prevalence of dependent according to ADL was 8.1%. According to IADL score, 97.6% female and 46% male have limitation. Elder age group, female gender, living without spouse, illiterate were significantly associated with dependency according to ADL. In adjusted analysis, every unit increased in age, risk of being dependent increases significantly by 10% [AOR=1.10 (1.04-1.16)].Conclusions: Almost half of respondents had some form of morbidity. Only a few (4.5%) were dependent according to ADL. A more comprehensive study covering different communities using various laboratory investigations can be conducted in Manipur.


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