Asadallah Keshmiri, A. Derakhshan, A. Fazlinejad, R. Faridhosseini
Background: Early mortality rate due to acute myocardial infarction (AMI) is approximately 30%, and half of these deaths occur before reaching a hospital. The prevention and early detection play a key role in reducing mortality in AMI. Hepatocyte Growth Factor (HGF), Interleukin 6 (IL-6), and Tumor Necrosis Factor α (TNF-α) are most recent prognostic biomarkers for AMI. The present study was aimed to evaluate the level of these cytokines in AMI. Methods: In this case control study, 39 patients with AMI were compared with 30 healthy subjects. Age, sex and other possible confounding factors were matched. AMI diagnosis was confirmed by typical symptoms, electrocardiogram changes and serum concentration of troponin I and creatine kinase-MB. The levels of TNF-α, IL-6 an HGF at baseline and 3 and 7 days later were measured using ELISA method. Results: Levels of IL-6, TNF-α and HGF increased over time after AMI with ST-segment elevation in study group. The baseline IL-6 levels in AMI group were significantly higher than control group (P<0.05). Conclusions: The results of this study suggest that baseline levels of IL-6 as well as serial changes of serum IL-6, TNF-α and HGF concentrations can be used as potential diagnostic biomarkers in AMI.
{"title":"Measurement of Hepatocyte Growth Factor, Interleukin 6 and Tumor necrosis factor α in Acute Myocardial Infarction","authors":"Asadallah Keshmiri, A. Derakhshan, A. Fazlinejad, R. Faridhosseini","doi":"10.3126/NJH.V16I1.23896","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23896","url":null,"abstract":"Background: Early mortality rate due to acute myocardial infarction (AMI) is approximately 30%, and half of these deaths occur before reaching a hospital. The prevention and early detection play a key role in reducing mortality in AMI. Hepatocyte Growth Factor (HGF), Interleukin 6 (IL-6), and Tumor Necrosis Factor α (TNF-α) are most recent prognostic biomarkers for AMI. The present study was aimed to evaluate the level of these cytokines in AMI. \u0000Methods: In this case control study, 39 patients with AMI were compared with 30 healthy subjects. Age, sex and other possible confounding factors were matched. AMI diagnosis was confirmed by typical symptoms, electrocardiogram changes and serum concentration of troponin I and creatine kinase-MB. The levels of TNF-α, IL-6 an HGF at baseline and 3 and 7 days later were measured using ELISA method. \u0000Results: Levels of IL-6, TNF-α and HGF increased over time after AMI with ST-segment elevation in study group. The baseline IL-6 levels in AMI group were significantly higher than control group (P<0.05). \u0000Conclusions: The results of this study suggest that baseline levels of IL-6 as well as serial changes of serum IL-6, TNF-α and HGF concentrations can be used as potential diagnostic biomarkers in AMI.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44481833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Bhandari, B. Shah, A. Mahaseth, Sanjib K Sharma
Hypertrophic cardiomyopathy is an autosomal dominant disease of cardiac sarcomere with the varied clinical presentation. The common manifestations are heart failure (dyspnea), palpitations, chest pain, stroke and even sudden death. Majority of patients are not recognized because of being asymptomatic. Stroke is one of the complications of hypertrophic cardiomyopathy and usually occurs in the setting of atrial fibrillation, advanced age and congestive cardiac failure. Although infective endocarditis is known, but relatively uncommon, complication of hypertrophic cardiomyopathy, it is not reported from Nepal. We report here a case of 42-year male patient with hypertrophic cardiomyopathy in normal sinus rhythm with infective endocarditis who developed malignant cardioembolic stroke involving left middle cerebral artery territory.
{"title":"Stroke in young secondary to infective endocarditis complicating hypertrophic cardiomyopathy – A case report","authors":"A. Bhandari, B. Shah, A. Mahaseth, Sanjib K Sharma","doi":"10.3126/NJH.V16I1.23904","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23904","url":null,"abstract":"Hypertrophic cardiomyopathy is an autosomal dominant disease of cardiac sarcomere with the varied clinical presentation. The common manifestations are heart failure (dyspnea), palpitations, chest pain, stroke and even sudden death. Majority of patients are not recognized because of being asymptomatic. Stroke is one of the complications of hypertrophic cardiomyopathy and usually occurs in the setting of atrial fibrillation, advanced age and congestive cardiac failure. Although infective endocarditis is known, but relatively uncommon, complication of hypertrophic cardiomyopathy, it is not reported from Nepal. We report here a case of 42-year male patient with hypertrophic cardiomyopathy in normal sinus rhythm with infective endocarditis who developed malignant cardioembolic stroke involving left middle cerebral artery territory. ","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23904","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43058242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Coronary heart disease (CHD) is gradually emerging as a leading cause of morbidity and mortality of many low middle income countries like Nepal. Cardiac rehabilitation awareness program has been proved to be effective for reducing the mortality as well as improving the quality of life among CHD patients. The aim of this study was to explore the awareness on cardiac rehabilitation (CR) in patients with CHD attending a cardiac care centre, Nepal. Method: A descriptive cross sectional study design was used to examine 100 CHD patients attending out-patient departments of Shahid Gangalal National Heart Centre (SGNHC), Kathmandu, Nepal. Purposive sampling technique was used for data collection by face to face interview technique with self developed tool. Data was analyzed with descriptive and inferential statistics. Results: Of all 100 respondents, 55.0% were male and the mean age was 53.23±14.22 years. The median score of awareness was 17 with interquartile range (IQR) 14.0-19.75 and majority (57.0%) of respondents were unaware about CR. The awareness regarding CR was found highest in awareness regarding CHD (75.0%) whereas lowest score was found in time and duration needed for exercise per week (14.0%). The significant influencing variables were age, education status, duration of treatment and participation in CR program for CHD patients. Conclusion: The awareness on CR program in CHD patients in Nepal is not optimal, especially among 54 and above age group, illiterate people, those receiving treatment equal & more than 1 year duration and the CHD patients who didn’t get chance to participate on awareness programs. Hence, it is strongly recommended that health professionals including nurses should organize and promote CR programs including counseling session to improve the awareness level and ultimately enhance quality of life of CHD patients.
{"title":"Awareness regarding cardiac rehabilitation among patients with coronary heart disease attending a cardiac care centre, Kathmandu valley","authors":"R. Shrestha, S. Shrestha","doi":"10.3126/NJH.V16I1.23899","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23899","url":null,"abstract":"Introduction: Coronary heart disease (CHD) is gradually emerging as a leading cause of morbidity and mortality of many low middle income countries like Nepal. Cardiac rehabilitation awareness program has been proved to be effective for reducing the mortality as well as improving the quality of life among CHD patients. The aim of this study was to explore the awareness on cardiac rehabilitation (CR) in patients with CHD attending a cardiac care centre, Nepal. \u0000Method: A descriptive cross sectional study design was used to examine 100 CHD patients attending out-patient departments of Shahid Gangalal National Heart Centre (SGNHC), Kathmandu, Nepal. Purposive sampling technique was used for data collection by face to face interview technique with self developed tool. Data was analyzed with descriptive and inferential statistics. \u0000Results: Of all 100 respondents, 55.0% were male and the mean age was 53.23±14.22 years. The median score of awareness was 17 with interquartile range (IQR) 14.0-19.75 and majority (57.0%) of respondents were unaware about CR. The awareness regarding CR was found highest in awareness regarding CHD (75.0%) whereas lowest score was found in time and duration needed for exercise per week (14.0%). The significant influencing variables were age, education status, duration of treatment and participation in CR program for CHD patients. \u0000Conclusion: The awareness on CR program in CHD patients in Nepal is not optimal, especially among 54 and above age group, illiterate people, those receiving treatment equal & more than 1 year duration and the CHD patients who didn’t get chance to participate on awareness programs. Hence, it is strongly recommended that health professionals including nurses should organize and promote CR programs including counseling session to improve the awareness level and ultimately enhance quality of life of CHD patients. ","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23899","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42912933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Aims: Acute Coronary Syndromes (ACS) represent a significant challenge for healthcare systems worldwide, however there is a vast disparity between developed and developing countries in terms of their management and subsequent patient outcomes. The aim of this reflective report was to explore the services provided for ACS patients in the developing country Nepal and compare them to the highly developed United Kingdom. This was with a view to summarise the priorities for Nepal going forward in addressing this major public health challenge and improving their ACS patient outcomes. Methods: This reflective report was constructed following an elective placement at the Shahid Gangalal National Heart Centre in Kathmandu, Nepal. It involved collecting numerous ACS patient case studies from the United Kingdom (UK) and Nepal and reflecting on their clinical experiences using the Gibbs Reflective Cycle. Reflective Summary: The treatment strategies for ACS are very similar in both countries, however in Nepal it is more difficult to efficiently transport patients into hospital and the population is less aware of the symptoms of ACS, thus contributing to delayed presentations and poorer outcomes. Furthermore, the provision of non-emergency healthcare, collection of patient data and general hospital resources were understandably deficient in comparison to the UK given the difference in financial status. Discussion: In order to address the rising incidence of ACS, Nepal should prioritise investment in the hospital facilities provided for these patients, including suitably equipped emergency transport and cardiac catheterisation laboratories. In addition, they should work towards an electronic patient database and more established non-emergency healthcare services. Perhaps most importantly is the need for improved health promotion about the risk factors for ACS and the signs of a heart attack.
{"title":"How do the cardiology services for patients presenting with acute coronary syndromes compare between developing and developed countries?","authors":"D. Mears","doi":"10.3126/NJH.V16I1.23887","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23887","url":null,"abstract":"Background and Aims: Acute Coronary Syndromes (ACS) represent a significant challenge for healthcare systems worldwide, however there is a vast disparity between developed and developing countries in terms of their management and subsequent patient outcomes. The aim of this reflective report was to explore the services provided for ACS patients in the developing country Nepal and compare them to the highly developed United Kingdom. This was with a view to summarise the priorities for Nepal going forward in addressing this major public health challenge and improving their ACS patient outcomes. \u0000Methods: This reflective report was constructed following an elective placement at the Shahid Gangalal National Heart Centre in Kathmandu, Nepal. It involved collecting numerous ACS patient case studies from the United Kingdom (UK) and Nepal and reflecting on their clinical experiences using the Gibbs Reflective Cycle. \u0000Reflective Summary: The treatment strategies for ACS are very similar in both countries, however in Nepal it is more difficult to efficiently transport patients into hospital and the population is less aware of the symptoms of ACS, thus contributing to delayed presentations and poorer outcomes. Furthermore, the provision of non-emergency healthcare, collection of patient data and general hospital resources were understandably deficient in comparison to the UK given the difference in financial status. \u0000Discussion: In order to address the rising incidence of ACS, Nepal should prioritise investment in the hospital facilities provided for these patients, including suitably equipped emergency transport and cardiac catheterisation laboratories. In addition, they should work towards an electronic patient database and more established non-emergency healthcare services. Perhaps most importantly is the need for improved health promotion about the risk factors for ACS and the signs of a heart attack. ","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23887","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42042704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Dhungana, R. Karmacharya, P. Pyakurel, A. Shrestha, A. Vaidya
Introduction: Nepal lacks a comprehensive, integrated health information system (HIS) to address the growing burden of cardiovascular diseases (CVDs). Method: We performed a literature search and reviewed papers, government reports, and websites related to HIS. We included existing situations of HIS, major gaps, strength weakness opportunity threat (SWOT) analysis and role of different stakeholders to address CVD burden in Nepal. Results: Health data from different health facility level are filled in district health information software (DHIS-2). DHIS-2 has been implemented in 10 districts in full-fledged manner and partial phase in 22 districts. Data are collected by means of paper-based registers, tally sheets, and monthly data collation forms. The collated data are sent monthly to the district level and entered into the computer using DHIS-2 software and submitted to the national health departments. Major gaps in health management information system (HMIS) are lack of separate heading of CVDs and lack of implementation of the existing data collection system. The strengths of the HIS are robust and decentralized health care delivery system in a good number of medical institutions. Weakness is lack of public and private partnership, concrete policy on health information and dissemination. Opportunities are the existence of policies and regulations mandating health facilities to report indicators, the involvement of private institutions and the expansion of existing DHIS-2 system. Conclusion: Nepal currently lacks reliable and accurate data on timely manner to address the growing burden of CVDs. There is a need to strengthen the existing DHIS with a commitment from expertise and leadership.
{"title":"Health information system as an integral component of cardiovascular surveillance system in Nepal","authors":"S. Dhungana, R. Karmacharya, P. Pyakurel, A. Shrestha, A. Vaidya","doi":"10.3126/NJH.V16I1.23890","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23890","url":null,"abstract":"Introduction: Nepal lacks a comprehensive, integrated health information system (HIS) to address the growing burden of cardiovascular diseases (CVDs). \u0000Method: We performed a literature search and reviewed papers, government reports, and websites related to HIS. We included existing situations of HIS, major gaps, strength weakness opportunity threat (SWOT) analysis and role of different stakeholders to address CVD burden in Nepal. \u0000Results: Health data from different health facility level are filled in district health information software (DHIS-2). DHIS-2 has been implemented in 10 districts in full-fledged manner and partial phase in 22 districts. Data are collected by means of paper-based registers, tally sheets, and monthly data collation forms. The collated data are sent monthly to the district level and entered into the computer using DHIS-2 software and submitted to the national health departments. \u0000Major gaps in health management information system (HMIS) are lack of separate heading of CVDs and lack of implementation of the existing data collection system. The strengths of the HIS are robust and decentralized health care delivery system in a good number of medical institutions. Weakness is lack of public and private partnership, concrete policy on health information and dissemination. Opportunities are the existence of policies and regulations mandating health facilities to report indicators, the involvement of private institutions and the expansion of existing DHIS-2 system. \u0000Conclusion: Nepal currently lacks reliable and accurate data on timely manner to address the growing burden of CVDs. There is a need to strengthen the existing DHIS with a commitment from expertise and leadership.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46708535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Pyakurel, D. Yadav, Jeevan Thapa, N. Thakur, Pramita Sharma, N. Koirala, S. Yadav, Akanksha Chaurasia, Sumit Sharma, June Thapa, S. Thapa, A. B. Shah, Pratigya Panta, Rajina Shrestha, Arpana Dangi, B. Acharya, U. Pyakurel, N. Jha
Background: Hypertension is one of the major risk factors for the rising burden of cardiovascular diseases (CVDs) in developing region. It has also been recognized as one of the major public health problems in the developing countries since the early seventies and the rate is increasing not only in urban areas but in rural areas with low socio-economic condition. Methods: A cross sectional study was conducted in Jogidaha Village Development Comittee(VDC) and Triyuga Municipality of Udaypur district of South-Eastern Nepal. A total of 430 participants of age 18-59 years were selected. Semi-structured questionnaire (WHO NCD STEPS instrument) was used to collect information on demographic variables and associated risk factors with use of show cards. Clinical and anthropometric measurement were done. Primary outcome was prevalence of hypertension. Bivariate and multivariate analysis were performed to show strength of association among various risk factors with hypertension. Results: The prevalence of hypertension was found to be 25.1%. Prevalence of overweight and obesity was found to be 49.8%. Hypertension was significantly associated with age (AOR=1.09, CI=1.05-1.10) and gender (male >female; AOR= 2.12,CI =1.22-3.68). Similarly, increased waist-hip ratio(7.12; CI 2.87-17.67),alcohol consumption(OR=2.82,CI=1.77-4.52), and use of tobacco products (OR =1.8,CI=1.02-3.20) showed significant association with hypertension. Conclusion: There is high prevalence of hypertension in rural districts of South-Eastern Nepal. A community-based preventive approach with early detection and treatment and life-style modification is needed to reduce the burden of disease and make sustainable changes.
背景:高血压是发展中地区心血管疾病(cvd)负担上升的主要危险因素之一。自70年代初以来，它也被认为是发展中国家的主要公共卫生问题之一，而且不仅在城市地区，而且在社会经济条件较差的农村地区，发病率也在上升。方法:在尼泊尔东南部乌代普尔地区约吉达哈村发展委员会(VDC)和特里尤加市进行了一项横断面研究。共有430名年龄在18-59岁之间的参与者被选中。使用半结构化问卷(世卫组织非传染性疾病STEPS工具)收集有关使用展示卡的人口统计变量和相关风险因素的信息。进行了临床和人体测量。主要结局是高血压的患病率。进行双变量和多变量分析，以显示各种危险因素与高血压的相关性。结果:高血压患病率为25.1%。超重和肥胖的患病率为49.8%。高血压与年龄(AOR=1.09, CI=1.05-1.10)和性别(男性>女性;Aor = 2.12, ci =1.22-3.68)。同样，腰臀比增加(7.12;CI 2.87-17.67)、饮酒(OR=2.82,CI=1.77-4.52)和使用烟草制品(OR= 1.8,CI=1.02-3.20)与高血压有显著关联。结论:尼泊尔东南部农村地区高血压患病率较高。需要采取以社区为基础的预防办法，及早发现和治疗并改变生活方式，以减轻疾病负担并作出可持续的改变。
{"title":"Prevalence and associated risk factor of hypertension among individuals of age 18-59 years in South-eastern Nepal: A cross-sectional study","authors":"P. Pyakurel, D. Yadav, Jeevan Thapa, N. Thakur, Pramita Sharma, N. Koirala, S. Yadav, Akanksha Chaurasia, Sumit Sharma, June Thapa, S. Thapa, A. B. Shah, Pratigya Panta, Rajina Shrestha, Arpana Dangi, B. Acharya, U. Pyakurel, N. Jha","doi":"10.3126/NJH.V16I1.23894","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23894","url":null,"abstract":"Background: Hypertension is one of the major risk factors for the rising burden of cardiovascular diseases (CVDs) in developing region. It has also been recognized as one of the major public health problems in the developing countries since the early seventies and the rate is increasing not only in urban areas but in rural areas with low socio-economic condition. \u0000Methods: A cross sectional study was conducted in Jogidaha Village Development Comittee(VDC) and Triyuga Municipality of Udaypur district of South-Eastern Nepal. A total of 430 participants of age 18-59 years were selected. Semi-structured questionnaire (WHO NCD STEPS instrument) was used to collect information on demographic variables and associated risk factors with use of show cards. Clinical and anthropometric measurement were done. Primary outcome was prevalence of hypertension. Bivariate and multivariate analysis were performed to show strength of association among various risk factors with hypertension. \u0000Results: The prevalence of hypertension was found to be 25.1%. Prevalence of overweight and obesity was found to be 49.8%. Hypertension was significantly associated with age (AOR=1.09, CI=1.05-1.10) and gender (male >female; AOR= 2.12,CI =1.22-3.68). Similarly, increased waist-hip ratio(7.12; CI 2.87-17.67),alcohol consumption(OR=2.82,CI=1.77-4.52), and use of tobacco products (OR =1.8,CI=1.02-3.20) showed significant association with hypertension. \u0000Conclusion: There is high prevalence of hypertension in rural districts of South-Eastern Nepal. A community-based preventive approach with early detection and treatment and life-style modification is needed to reduce the burden of disease and make sustainable changes. ","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41815569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Aims: The incidence of cardiovascular diseases (CVDs) is rapidly increasing at an alarming rate worldwide. This study aimed to identify the knowledge and practices of coronary artery diseases.Method: A cross sectional study and a purposive sampling method was used to select the cities and five different cities of Nepal were selected for this study. Literate people, one who can fill the questionnaire, voluntarily participated for this study during the free cardiac health camp organized by Shahid Gangalal National Heart Center. Total 356 participants participated in this study.Results: This study reveals that one fourth (22.5%) of the participants had excellent knowledge and 32.6% were with poor knowledge regarding the prevention of CAD (coronary artery disease), whereas one fifth had no risk factors of CAD and half of them had 2-3 risk factors. Maximum six risk factors were present only on 0.6%, regarding the practices, 31.7% of them monitored blood pressure at least once, (92.1%) haven’t had the blood sugar test yet whereas only 7.9% had lab test to monitor the blood sugar and blood cholesterol was done by 3.9%.Conclusion: This study concludes with the poor knowledge and practices on CAD. Awareness programs can help people to be aware of risk factors of CAD.
{"title":"Knowledge and practices on prevention of coronary artery diseases in nepalese community: A cross-sectional from five different cities in Nepal","authors":"Sunita Bhattarai, P. Neupane","doi":"10.3126/NJH.V15I2.21474","DOIUrl":"https://doi.org/10.3126/NJH.V15I2.21474","url":null,"abstract":"Background and Aims: The incidence of cardiovascular diseases (CVDs) is rapidly increasing at an alarming rate worldwide. This study aimed to identify the knowledge and practices of coronary artery diseases.Method: A cross sectional study and a purposive sampling method was used to select the cities and five different cities of Nepal were selected for this study. Literate people, one who can fill the questionnaire, voluntarily participated for this study during the free cardiac health camp organized by Shahid Gangalal National Heart Center. Total 356 participants participated in this study.Results: This study reveals that one fourth (22.5%) of the participants had excellent knowledge and 32.6% were with poor knowledge regarding the prevention of CAD (coronary artery disease), whereas one fifth had no risk factors of CAD and half of them had 2-3 risk factors. Maximum six risk factors were present only on 0.6%, regarding the practices, 31.7% of them monitored blood pressure at least once, (92.1%) haven’t had the blood sugar test yet whereas only 7.9% had lab test to monitor the blood sugar and blood cholesterol was done by 3.9%.Conclusion: This study concludes with the poor knowledge and practices on CAD. Awareness programs can help people to be aware of risk factors of CAD.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V15I2.21474","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41831259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heart disease in a child requires complex set of expertise as physiology and challenges presented in pediatric cardiology are much different from adult cardiology. In preclinical era of renaissance, children and adults were examined by the same physician. At the outset of 20th century, the need for a special center for children with heart disease was identified as several authors began to add specific sections devoted to congenital heart disease in books of anatomy and pediatrics. A major milestone was reached when Helen Taussig, in charge of cardiac clinic in Harriet Lane Hospital, Baltimore, USA, established pediatric cardiology center for the first time. Pediatric cardiology gained further prominence in 1938 when Robert Gross successfully ligated the patent ductus arteriosus in a seven year old girl. The first successful creation of systemic to pulmonary shunt by Blalock and Taussig in 1944 boldly introduced surgical interventions. The field of pediatric cardiology has been making remarkable developments, with dramatic improvements in diagnostic tools, and with cardiac surgeons constantly pushing the envelope, culminating in being first subspecialty board of pediatrics in USA in 1961. These developments have changed the outlook of cardiac diseases in children and instilled hope for cure in previously untreatable disorders. Interestingly, advances made in pediatric cardiology have provided
{"title":"Pioneers and champions for the little hearts: A history of pediatric cardiology in Nepal","authors":"Poonam Sharma","doi":"10.3126/NJH.V15I2.21468","DOIUrl":"https://doi.org/10.3126/NJH.V15I2.21468","url":null,"abstract":"Heart disease in a child requires complex set of expertise as physiology and challenges presented in pediatric cardiology are much different from adult cardiology. In preclinical era of renaissance, children and adults were examined by the same physician. At the outset of 20th century, the need for a special center for children with heart disease was identified as several authors began to add specific sections devoted to congenital heart disease in books of anatomy and pediatrics. A major milestone was reached when Helen Taussig, in charge of cardiac clinic in Harriet Lane Hospital, Baltimore, USA, established pediatric cardiology center for the first time. Pediatric cardiology gained further prominence in 1938 when Robert Gross successfully ligated the patent ductus arteriosus in a seven year old girl. The first successful creation of systemic to pulmonary shunt by Blalock and Taussig in 1944 boldly introduced surgical interventions. The field of pediatric cardiology has been making remarkable developments, with dramatic improvements in diagnostic tools, and with cardiac surgeons constantly pushing the envelope, culminating in being first subspecialty board of pediatrics in USA in 1961. These developments have changed the outlook of cardiac diseases in children and instilled hope for cure in previously untreatable disorders. Interestingly, advances made in pediatric cardiology have provided","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V15I2.21468","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45931376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Sawadogo, Yacouba Tamboura, M. Doumbia, I. Diarra
Cardiac myxomas may have different clinical presentations that may expose the patient to sudden death due to obstruction of the left ventricle inflow. The authors report a case of 34 years old male who was diagnosed with left atrial myxoma that presented as mitral valve obstruction with severe pulmonary hypertension. He underwent emergent sternotomy under cardiopulmonary bypass and the myxoma was successfully removed. The postoperative course was uneventful.
{"title":"Giant obstructive myxoma presenting as mitral valve obstruction with severe pulmonary hypertension.","authors":"A. Sawadogo, Yacouba Tamboura, M. Doumbia, I. Diarra","doi":"10.3126/NJH.V15I2.21478","DOIUrl":"https://doi.org/10.3126/NJH.V15I2.21478","url":null,"abstract":"Cardiac myxomas may have different clinical presentations that may expose the patient to sudden death due to obstruction of the left ventricle inflow. The authors report a case of 34 years old male who was diagnosed with left atrial myxoma that presented as mitral valve obstruction with severe pulmonary hypertension. He underwent emergent sternotomy under cardiopulmonary bypass and the myxoma was successfully removed. The postoperative course was uneventful.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V15I2.21478","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45604118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Aims: Nepal is a developing country with increasing rates of cardiovascular disease (CVD), and the recent 2015 earthquakes imposed critical social and epidemiological effects to the population. This study aims to assess the prevalence of CVD risk factors, social health behaviours and atrial fibrillation (AF) in a native population from a remote Nepalese village that was the epicentre of the May 2015 earthquake.Methods: Observational, cross-sectional study, addressing the population of dislodged inhabitants of Sindhupalchok. Data was collected during an opportunistic clinical screening in the midst of a humanitarian medical mission and consisted of demographic, anthropometric and medical data.Results: A total of 270 patients were assessed (41% in a temporary settlement with continuous organisational support and 59% in the remote village with less back-up). Among adults, 89% had low fruit consumption, 49% were overweight or had augmented waist circumference, 42% had smoking habits, 57% consumed alcohol regularly, 22% had high blood pressure measurements and 5% had abnormal glycaemic levels. An 11% prevalence of AF was found among the elderly.Conclusions: The studied population has a high prevalence of CVD risk factors, poor health behaviours and a significant prevalence of AF among the elderly representatives. International partnering and humanitarian work might be important tools to assess the population’s needs and implement corrective measures.
{"title":"Prevalence of cardiovascular disease risk factors, health behaviours and atrial fibrillation in a Nepalese post-seismic population: a cross-sectional screening during a humanitarian medical mission","authors":"T. Adrega, J. Ribeiro, Luís Santos, J. Santos","doi":"10.3126/NJH.V15I2.21470","DOIUrl":"https://doi.org/10.3126/NJH.V15I2.21470","url":null,"abstract":"Background and Aims: Nepal is a developing country with increasing rates of cardiovascular disease (CVD), and the recent 2015 earthquakes imposed critical social and epidemiological effects to the population. This study aims to assess the prevalence of CVD risk factors, social health behaviours and atrial fibrillation (AF) in a native population from a remote Nepalese village that was the epicentre of the May 2015 earthquake.Methods: Observational, cross-sectional study, addressing the population of dislodged inhabitants of Sindhupalchok. Data was collected during an opportunistic clinical screening in the midst of a humanitarian medical mission and consisted of demographic, anthropometric and medical data.Results: A total of 270 patients were assessed (41% in a temporary settlement with continuous organisational support and 59% in the remote village with less back-up). Among adults, 89% had low fruit consumption, 49% were overweight or had augmented waist circumference, 42% had smoking habits, 57% consumed alcohol regularly, 22% had high blood pressure measurements and 5% had abnormal glycaemic levels. An 11% prevalence of AF was found among the elderly.Conclusions: The studied population has a high prevalence of CVD risk factors, poor health behaviours and a significant prevalence of AF among the elderly representatives. International partnering and humanitarian work might be important tools to assess the population’s needs and implement corrective measures.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V15I2.21470","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69323077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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