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Advances in Gerontology = Uspekhi... 2024The purpose of this review is to demonstrate the importance of using a comprehensive geriatric examination in cardiology, including geriatric aspects of the management... (Review)
Review
The purpose of this review is to demonstrate the importance of using a comprehensive geriatric examination in cardiology, including geriatric aspects of the management of this patient population. Until now, the Russian Federation has completely lacked a geriatric approach to the management of cardiological patients, which provides for consideration of international experience in this survey. The curation of elderly and elderly patients is complicated by the presence of geriatric syndromes and age-associated diseases leading to deterioration of quality of life, repeated hospitalizations, disability and risk of death. The leading geriatric syndrome in geriatric practice is senile asthenia and multiple comorbid polymorbid pathologies of the geriatric patient. A patient admitted to an acute care hospital with a history of cardiovascular comorbid pathology is primarily viewed as a patient at high risk for cardiovascular complications, omitting the risk of adverse outcomes, including loss of independence and impaired functional status. The following literature review demonstrates the importance of defining senile asthenia outside of the geriatrician's office, justifying the need for advanced training for cardiologists in geriatrics.
Topics: Humans; Geriatric Assessment; Aged; Cardiovascular Diseases; Quality of Life; Cardiology; Asthenia; Comorbidity
PubMed: 38944769
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Jul 2024Clustering of hypertension, dyslipidemia, and other metabolic abnormalities is increasing the burden of non-communicable diseases, especially cardiovascular disease. The...
Clustering of hypertension, dyslipidemia, and other metabolic abnormalities is increasing the burden of non-communicable diseases, especially cardiovascular disease. The objective of this study was to explore the pattern of lipid profiles in newly diagnosed hypertensive patients attending Shaheed Mansur Ali Medical College, Dhaka, Bangladesh from August 2020 to December 2020. A total of 59 newly diagnosed hypertensive patients were studied through a cross-sectional approach. Prior to the study, ethical clearance was ensured, and informed written consent was obtained. A pre-structured questionnaire was used for data collection. Collected data were analyzed using SPSS 24.0 version. Slight male preponderance (54.2%) was observed along with an average age of 45 years among studied patients. Raised levels of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) were observed in 91.5%, 98.3%, and 88.1% of patients accordingly. Low level of high-density lipoprotein (HDL) was observed in 47.5% of the patients. Mean TC, TG, LDL, HDL were 286.11±347.37, 311.74±122.76, 163.27±33.67 and 38.29±6.66 mg/dl, respectively. Almost all patients were obese. There is no correlation between the serum lipid profile and blood pressure of the patients. Dyslipidemia was highly prevalent among newly diagnosed hypertensive patients.
Topics: Humans; Male; Hypertension; Bangladesh; Female; Middle Aged; Cross-Sectional Studies; Dyslipidemias; Adult; Lipids; Triglycerides
PubMed: 38944731
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Jul 2024Obesity and hypothyroidism are interlinked. In this prospective study, 142 children and adolescents (mean age 140±34 months, girls 54.2%) either with obesity or...
Obesity and hypothyroidism are interlinked. In this prospective study, 142 children and adolescents (mean age 140±34 months, girls 54.2%) either with obesity or overweight were included from the patients attending at the Endocrine out-patient clinic of Dhaka Shishu (Children) Hospital during a period from March, 2017 to February, 2020 and were assessed for thyroid function. Among them, 85 were obese (Body mass index, BMI >95th percentile), 29 were overweight (BMI between 85th to 95th percentile) and 28 had normal weight (BMI <85th percentile). Girls were more frequent in obese (57.6%) and overweight (51.7%) groups than boys. Mean TSH was not significantly different among the three groups (3.39 vs. 4.01 vs. 4.06mIU/L; p=0.248). Subclinical hypothyroidism was present in 22 cases (15.5%); the frequencies were 3.6% in Group 1, 17.2% in Group 2 and 18.8% in Group 3. Both overweight and obese groups had significantly (p<0.005) higher prevalence of SCH than the normal-weight group. Girls were more frequently affected than boys (72.7% vs. 27.3%, p=0.047). Among the 22 children who had SCH, 2(9.1%) had a mild goiter and higher serum levels of anti-TPO and anti-TG. Serum TSH had no correlations with age, body weight, height, BMI and serum FT₄. The findings indicate that a substantial portion of over weight and obese children and adolescents have SCH and the causes other than thyroid autoimmunity are more prevalent in them.
Topics: Humans; Female; Male; Child; Hypothyroidism; Bangladesh; Adolescent; Prospective Studies; Pediatric Obesity; Body Mass Index; Prevalence; Overweight; Obesity; Thyrotropin
PubMed: 38944727
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Mymensingh Medical Journal : MMJ Jul 2024Pressure sore is an important post-stroke complication that results in increased morbidity, mortality and poor prognosis of the patients. The objective of the present...
Pressure sore is an important post-stroke complication that results in increased morbidity, mortality and poor prognosis of the patients. The objective of the present study was to find out the prevalence and the factors associated with pressure sore among stroke patients. This prospective cross-sectional study includes 50 stroke patients admitted in the Department of Neurology of Dhaka Medical College Hospital, Bangladesh from July to December 2018. Data were collected from the by direct interview of the patients or their relatives or caregiver using a structured case report form. Descriptive statistics were used to represent patients' characteristics and the chi-square test was used to determine the difference between patients' groups. The mean ±SD age of the stroke patients was 59.16±11.53 years and half of them were male. Fifty percent of the patients had been suffering from ischemic stroke and the rest from hemorrhagic stroke. Of all, one-fourth of the patients (24.0%) developed post-stroke pressure sore during the hospital stay and type-specific prevalence was 20.0% in ischemic stroke and 30.0% in hemorrhagic stroke. Common sites of the pressure sore were sacrum (50.0%), buttock (25.0%), heels (17.0%), and greater trochanter (8.0%). Only 8.0% of the patients developed grade IV wounds. Pressure sores of 42.0% of patients healed spontaneously, 25.0% needed conservative management and 25.0% needed a skin graft. This study found that a large portion of stroke patients develop a pressure sore during hospital stay which can deteriorate clinical outcomes and compromise the quality of life of the patients. Adequate preventive measures and proper rehabilitation should be encouraged for better stroke management and to reduce long-term complications.
Topics: Humans; Pressure Ulcer; Male; Cross-Sectional Studies; Female; Middle Aged; Bangladesh; Stroke; Tertiary Care Centers; Aged; Prospective Studies; Prevalence; Risk Factors
PubMed: 38944724
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Jul 2024The presence of bright resonance of more than 1 mm or more cusps of the aortic valve, mitral valve or mitral annulus is termed as cardiac valve calcification. If an... (Observational Study)
Observational Study Comparative Study
The presence of bright resonance of more than 1 mm or more cusps of the aortic valve, mitral valve or mitral annulus is termed as cardiac valve calcification. If an intense echo producing structure located at the junction of the atrioventricular groove and posterior mitral valve leaflet on Echocardiography that is Mitral annular calcification (MAC). This study was conducted to observe the association of MAC with clinical and echocardiographic findings of ischemic heart disease (IHD) and the role of trans-thoracic echocardiography to detect MAC which is a marker IHD. In this prospective, observational, case-control study, total of 100 IHD patients, 50 patients with MAC were assigned as case group and 50 patients without MAC were control group after fulfilling inclusion criteria. All the detailed history, clinical examination and relevant investigation reports of each patient were recorded in pre designed data collection sheet. MAC was detected with transthorasic echocardiography. Analysis was done to observe the association and correlation of MAC with clinical findings of IHD. Mean age of the case control was 55.16±10.73 years and control was 49.80±8.84 years. MAC was noted highest about 56.0% in between age 45 to 60 years. Eighty two percent (82.0%) of cases and 84.0% of controls were male, 18.0% of cases and 16.0% of controls were female. BMI among the MAC group 2.0% were underweight, 72.0% normal, 24.0% over weight and 2.0% were obese and among non MAC controls group 10.0% were underweight, 68.0% normal, 20.0% over weight and 2.0% were obese. Clinically among cases 14(28.0%) had Stable angina, 8(16.0%) had UA, 3(6.0%) had Non STEMI, 2(4.0%) had AMI, 2(4.0%) had Recent myocardial infarction and 21(42.0%) had OMI. Diabetes mellitus was significantly higher in the case groups (p=0.006). Significant p-value was noted in hyper-triyglyceridemia and low HDL in case group than control. Echocardiographic studies showed 52.0% of cases and 32.0% of controls had regional wall motion abnormality (RWMA). Transthorasic echocardiographically detected MAC is an independent predictor of Ischemic heart disease. The low cost, portable and radiation free nature of the ultrasound approach make MAC an attractive parameter in the ongoing search for IHD.
Topics: Humans; Male; Female; Middle Aged; Myocardial Ischemia; Calcinosis; Case-Control Studies; Echocardiography; Mitral Valve; Tertiary Care Centers; Prospective Studies; Heart Valve Diseases; Aged; Adult
PubMed: 38944717
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Jul 2024Coronavirus disease 2019 (Covid-19) disease have been associated with significant mortality amongst doctors globally including Bangladesh. To delineate the...
Coronavirus disease 2019 (Covid-19) disease have been associated with significant mortality amongst doctors globally including Bangladesh. To delineate the clinico-epidemiological characteristics of the physician affected with Covid-19 was the objective of the study. This cross-sectional 'Facebook' based survey was conducted in the period of August 2020 to September 2020. Snowball sampling methods was followed. A total of 151 physicians affected with Covid-19 participated in this survey. Self-reported perceived severity scale (zero meaning not severe at all and ten denoting the most severe) was used. Collected data were analyzed by SPSS 25.0. Among the participants, the majority were male, 98(64.9%). The most prevalent affected age groups were 24-35 years 131(86.8%). Approximately 45.0% worked in COVID dedicated hospital. Entry-level physicians (Medical Officer or Assistant Surgeon) were the most affected 117(94.4%). One-third of the physicians had at least the one co-morbidity. Bronchial asthma, obesity and diabetes were the most frequent. Predominate symptoms of the infection were fever 94(62.3%), cough 94(62.3%) and myalgia 92(60.9%). Half of the participants had sore throat, anosmia, gastro-intestinal symptoms and one-third of the patients developed dyspnea. Perceived severity of the symptoms ranged between 2 and 6. The pattern of drug use to prevent the Covid-19 showed no uniformity. However, intake of Zinc, Vitamin C, Vitamin D, antihistamine and Ivermectin was found in 74.8%, 67.5%, 41.7%, 49.0% and 37.7% respectively. As the current pandemic continues to evolve, physicians must be equipped with appropriate knowledge, skills and must be cautious on the prevention measures against Covid-19.
Topics: Humans; COVID-19; Male; Female; Cross-Sectional Studies; Adult; Bangladesh; Physicians; Middle Aged; SARS-CoV-2; Young Adult; Comorbidity; Severity of Illness Index; Surveys and Questionnaires
PubMed: 38944716
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Jul 2024The cross sectional, analytic and descriptive type study was conducted among 5-10 years aged Bangladeshi children at different areas of Mymensingh District (Fulbaria,...
The cross sectional, analytic and descriptive type study was conducted among 5-10 years aged Bangladeshi children at different areas of Mymensingh District (Fulbaria, Trisal, Haluaghat, Fulpur and Muktagacha), Bangladesh on 109 Bangladeshi children from January 2016 to December 2016. Nonrandom purposive sampling technique was taken for sample collection. Any kind of foot deformity resulting either from physical injury or congenital anomaly was excluded to construct standard data. The present anthropometric study was designed to construct data of 5 to 10 years aged Bangladeshi children regarding great toe length, to measure correlation of stature with great toe length and comparison of great toe length between male and female children. This study has been made out to grow interest among the researchers for future study of different country. Stature of the subject was measured with the stadiometer and great toe length was measured using slide caliper. The children were requested to stand with weight distributed equally on both feet. The legs were perpendicular to the feet. The mean great toe length of both sides of 5, 6, 7, 8, 9 and 10 years aged male were 2.90±0.51 cm, 3.00±0.38 cm, 3.18±0.42 cm, 3.41±0.26 cm, 3.34±0.32cm and 3.57±0.45 cm respectively and those of female were 2.93±0.70 cm, 2.70±0.43 cm, 3.05±0.37 cm, 3.02±0.25 cm, 3.42±0.55 cm and 3.62±0.44 cm respectively. Great toe length showed non-significant positive correlation with stature in 5 years old female, 7 years old male and female, 8 years old male, 9 and 10 years old male and female children. In 5 years old male, 6 years old male and female and 8 years old female children, great toe length showed non-significant negative correlation with stature. Comparison of great toe length between male and female children was done by Unpaired Students 't' test which was statistically non-significant.
Topics: Humans; Male; Female; Child, Preschool; Bangladesh; Cross-Sectional Studies; Toes; Child; Body Height; Anthropometry
PubMed: 38944711
DOI: No ID Found -
BMC Public Health Jun 2024This study aimed to examine prospective associations of different intensity levels and types of physical activity (PA) in early pregnancy with premature rupture of...
OBJECTIVE
This study aimed to examine prospective associations of different intensity levels and types of physical activity (PA) in early pregnancy with premature rupture of membranes (PROM) among Chinese pregnant women.
METHODS
A total of 6284 pregnant women were included from the Tongji-Shuangliu Birth Cohort. Household/caregiving, occupational, sports/exercise and transportation activities during early pregnancy were investigated by the pregnancy physical activity questionnaire (PPAQ), and the diagnosis of PROM was ascertained during the whole pregnancy. Multivariate logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence interval (CI) for the associations between PA and PROM.
RESULTS
Among the 6284 pregnant women, 1246 were identified to have PROM (19.8%). Women undertaking the highest level (3 third tertile) of PA during pregnancy appeared to have a lower risk of PROM [OR = 0.68, 95%CI 0.58-0.80) when compared to those at the lowest tertile of PA. Similarly, women with increased levels of light intensity activity, moderate-vigorous intensive, household/caregiving activity and meeting exercise guidelines during pregnancy were associated with reduced risks of PROM (OR = 0.69, 95% CI 0.59-0.81, OR = 0.70, 95% CI 0.60-0.82, OR = 0.62, 95% CI 0.53-0.73 and OR = 0.82, 95% CI 0.70-0.97, respectively).
CONCLUSIONS
High levels of PA of different intensities and PA of household/caregiving activities and meeting exercise guidelines during the first trimester were associated with a lower incidence of PROM.
TRIAL REGISTRATION
The data of human participants in this study were conducted in accordance with the Helsinki Declaration. This study has been approved by the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China ([2017] No. S225). All participants provided written informed consent prior to enrollment. A statement to confirm that all methods were carried out in accordance with relevant guidelines and regulations.
Topics: Humans; Female; Pregnancy; Exercise; Adult; Fetal Membranes, Premature Rupture; China; Pregnancy Trimester, First; Prospective Studies; Birth Cohort; Young Adult; Surveys and Questionnaires; Risk Factors; Cohort Studies; East Asian People
PubMed: 38944666
DOI: 10.1186/s12889-024-18791-5 -
Enfermeria Intensiva Jun 2024To determine the Intensity of Collaboration between the intensive care professionals of a third level hospital.
OBJECTIVE
To determine the Intensity of Collaboration between the intensive care professionals of a third level hospital.
METHOD
Descriptive cross-sectional study with an analytical approach.
SETTING
6 intensive care units of a third level hospital.
SAMPLE
nurses and doctors. Consecutive type non-probabilistic sampling.
DATA COLLECTION
sociodemographic, economic, motivation and professional satisfaction variables, and the intensity of collaboration using the "Scale of Intensity of Interprofessional Collaboration in Health."
RESULTS
A total of 102 health professionals (91 nurses and 11 doctors) were included. The mean overall Intensity of Collaboration (IoC) was moderate. Men showed higher scores in all factors (p<.05). The IoC global score was higher in the group of professionals with ≤10 years of experience (p=.043) and those who were highly satisfied with the profession (p=.037). Physicians presented higher scores in the global IdC (p=.037) and in the Collaboration mean (p=.020) independently in the multivariate models. A negative linear relationship (rho: -0,202, p=.042) was observed between age and the overall IoC score. Professionals aged ≤30years reported a higher perception of Shared Activities (p=.031). Negative linear relationships were observed between years of experience and total IoC score (rho: -0,202, p=.042) and patients' Perception score (rho: -0.241, p=0.015). The research activity also showed to be a variable related to a greater degree of Collaboration at a global level and in some of the factors (p<.05). The scale of IoC obtained a Cronbach's α of 0,9.
CONCLUSIONS
The intensity of interprofessional collaboration in ICUs is moderate. Professionals with experience of ≤10 years, a higher level of satisfaction and participation in research activities show a greater intensity of collaboration. Doctors perceive collaboration more intensely than nurses. All factors contribute equally to the internal consistency of the questionnaire.
PubMed: 38944574
DOI: 10.1016/j.enfie.2023.10.002 -
Foot and Ankle Surgery : Official... Jun 2024Venous thrombo-embolism (VTE) is a recognised complication of foot and ankle surgery. There are multiple possible anticoagulation treatments available in the UK to...
INTRODUCTION
Venous thrombo-embolism (VTE) is a recognised complication of foot and ankle surgery. There are multiple possible anticoagulation treatments available in the UK to mitigate the risk of developing VTE. Our primary objective was to assess the variability of chemical anticoagulation prescribed in patients undergoing foot and ankle procedures.
METHODS
This was a UK-based national, multicenter, prospective audit spanning a collection duration of 9 months on all foot and ankle procedures, carried out in 68 UK centers between 1st June 2022 and 30th November 2022, with a further 3-month follow up period. All patients who underwent a foot and ankle surgical procedure (including Achilles tendon rupture treatment) were included in this study.
RESULTS
Data on a total of 13,569 patients was submitted. Following data cleansing, 11,363 patients were available for further analysis, with anticoagulation data available for 11,099 patients. There were eleven different chemical anticoagulation treatments recorded across the cohort. A total of 3630 (31.95 %) patients received no chemical anticoagulation. The patients receiving chemical anticoagulation medication could be split into 4 main groups. The most common chemical anticoagulation received was low molecular weight heparin (LMWH) (6303, 84.4 % of patients receiving chemical anticoagulation). Aspirin was given in 4.1 % (308 patients), a Factor Xa inhibitor in 10 % (744 patients) and other anticoagulants (e.g. Warfarin) in 1.5 % (114 patients). The overall VTE rate in this sub analysis of patients receiving chemical anticoagulation, was 1.1 % (83 cases out of 7469). There was no significant difference seen in incidence of VTE between types of anticoagulants, when confounding factors were considered. The duration of post-operative chemical prophylaxis used by participants for most chemical anticoagulants was 6 weeks (64.50 %).
CONCLUSION
There was significant variability of chemical anticoagulants reported in the study, with five different categories of anticoagulants used (including no chemical anticoagulation), and none clearly superior/inferior. The duration of anticoagulation was consistent across types of thromboprophylaxis.
PubMed: 38944567
DOI: 10.1016/j.fas.2024.06.005