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Factors Associated with Congenital Heart Diseases among Children in Uganda: A Case-Control Study at Mulago National Referral Hospital (Uganda Heart Institute)
Grace Kahambu Kapakasi,
Ratib Mawa,
Judith Namuyonga,
Sulaiman Lubega
Issue:
Volume 5, Issue 1, March 2021
Pages:
1-6
Received:
24 September 2020
Accepted:
23 October 2020
Published:
12 January 2021
Abstract: Congenital Heart Diseases (CHD) are among the leading causes of morbidity and mortality associated with congenital malformations among children. Not knowing the risk profile of CHD among children in Uganda impedes development of effective prevention interventions. In this hospital based unmatched case-control study we examined risk factors for all types of CHD among 179 pair of case and control children aged 0-10 years old at Mulago National Referral Hospital. Odds ratios and their corresponding 95% confidence intervals were calculated using multivariate logistic regression. Low birth weight (adjusted OR: 3.15, 95% CI 1.48 - 6.69), high birth order ≥5th birth order (adjusted OR: 3.69 (1.10 – 12.54), maternal febrile illness during pregnancy, maternal and paternal alcohol consumption, and paternal socio-economic status were associated with CHD. Family history of CHD, maternal education level, maternal chronic illness, and paternal education level were not associated with CHD. The results suggest: low birth weight, high birth order, and maternal febrile illness during pregnancy, parental alcohol use and paternal socio-economic status as dominant risk factors for CHD among children. Rigorous implementation of public health policies and strategies targeting prevention of febrile illness during pregnancy, maternal malnutrition, parental alcohol consumption, delivery of high number of children per woman, might be important in reducing the burden of CHD among children in Uganda.
Abstract: Congenital Heart Diseases (CHD) are among the leading causes of morbidity and mortality associated with congenital malformations among children. Not knowing the risk profile of CHD among children in Uganda impedes development of effective prevention interventions. In this hospital based unmatched case-control study we examined risk factors for all ...
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Vasculitis of Vasa Vasorum and Aneurysm Formation in Kawasaki Disease: Predilection for Coronary Arteries Lesions
Zenshiro Onouchi,
Akiko Hamaoka-Okamoto,
Chinatsu Suzuki,
Kenji Hamaoka
Issue:
Volume 5, Issue 1, March 2021
Pages:
7-15
Received:
21 November 2020
Accepted:
25 December 2020
Published:
15 January 2021
Abstract: Backgrounds. The mechanism causing coronary artery lesions in Kawasaki disease (KD) has not yet been fully clarified. Objective. We hypothesized that the main coronary artery (MCA) segment perfused by the vasa vasorum (VV) arose from the atrial and ventricular branches of peripheral coronary arteries in the myocardium (Type 1 VV externa) is more prone to aneurysm formation than that perfused by Type 2 VV originated from the ostium. Methods and Results. We reviewed the coronary angiography and two-dimensional echocardiogram (2DE) data of KD patients in our hospital and measured the distances from the left coronary ostium to the proximal point of the aneurysm in the left MCA (D1) and to the MCA bifurcation (D2). We found that the ratio of the distances (D1/D2) was negatively correlated with the patients’ age of KD onset, indicating that longitudinal extension of the left MCA aneurysms coincided with the development of Type 1 VV externa. We performed a literature review of KD cases with extracardiac aneurysms and found that 15 patients also had giant aneurysms in the MCA. Also, 8 of 9 extracardiac aneurysm cases whose clear 2DE images were available in the reports, the giant MCA aneurysms seemed to have developed at positions immediately adjacent to the ostium. We assume that the giant coronary aneurysms might be a consequence of the coincidence of aneurysms in the MCA segments perfused by Type 1 and 2 VV externas and reflect a severe inflammation where Type 2 VV externa which is less susceptible to blood flow reduction than Type 1 VV externa is affected. Conclusions. Vasculitis in VV externa with the unique structure originating from and distributing most richly across coronary arteries might induce a vicious circle of hypoperfusion of VV externa and reduced coronary blood flow.
Abstract: Backgrounds. The mechanism causing coronary artery lesions in Kawasaki disease (KD) has not yet been fully clarified. Objective. We hypothesized that the main coronary artery (MCA) segment perfused by the vasa vasorum (VV) arose from the atrial and ventricular branches of peripheral coronary arteries in the myocardium (Type 1 VV externa) is more pr...
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Influence of Oxidative Stress Markers on Coronary No-reflow After Primary Percutaneous Coronary Intervention for Patients with Acute Myocardial Infarction
Mahmoud Ragab Darwish,
Walaa Farid,
Ahmed Mokhtar El-Kersh
Issue:
Volume 5, Issue 1, March 2021
Pages:
16-24
Received:
20 December 2020
Accepted:
30 December 2020
Published:
15 January 2021
Abstract: Background: ST-elevation myocardial infarction (STEMI) is one of the leading causes of mortality and morbidity worldwide. However, survival after acute STEMI has considerably improved due to increasing symptom recognition, accurate diagnosis and effective timely reperfusion. This study aimed to investigate the relation between the level of oxidative stress markers and coronary no-reflow after primary percutaneous coronary intervention for patients with acute myocardial infarction. Patients & Methods: This prospective cohort study included 90 patients admitted with acute STEMI at cardiovascular medicine department Naser Institute hospital, during the period from June 2018 till 12 months. Patients were divided into 2 groups according to the post primary PCI thrombolysis in myocardial infarction (TIMI) flow score into: Group I: 45 patients with no-reflow phenomenon. Group II: 45 patients with TIMI flow ≥ 2 after primary PCI. They all underwent primary PCI within 24 hours of presentation. Results: This study showed increased concentrations of Malondialdehide (MDA) in the circulation of patients with no-reflow indicating increased lipid peroxidation which could be attributed to a deficiency of antioxidant defense mechanism. In group I, pt with coronary no-reflow MDA level ranged from 2.8-4.5 nmol/mL with mean 3.9±1.5 nmol/mL, while in group II control group, MDA level ranged from 1.1 – 2.1 nmol/mL with mean 1.55±0.4 nmol/mL, there was statistically significant difference between the two groups (P value<0.004). Conclusions: no-reflow phenomenon after primary PCI can be predicted using the oxidative stress markers.
Abstract: Background: ST-elevation myocardial infarction (STEMI) is one of the leading causes of mortality and morbidity worldwide. However, survival after acute STEMI has considerably improved due to increasing symptom recognition, accurate diagnosis and effective timely reperfusion. This study aimed to investigate the relation between the level of oxidativ...
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Efficacy of Thrombus Aspiration Adjunct to Primary Percutaneous Intervention in ST-elevation Myocardial Infarction Patients with Heavy Thrombus Burden
Shady Hussein Elhusseiny,
Mahmoud Mohamed Abdo,
Shaheer Kamal George,
Sherif Ibraheem Eltantawy
Issue:
Volume 5, Issue 1, March 2021
Pages:
25-32
Received:
7 January 2021
Accepted:
18 January 2021
Published:
28 January 2021
Abstract: The efficacy of thrombus aspiration (TA) for various culprit lesions in ST-segment elevation myocardial infarction has not been sufficiently evaluated, this directed recent randomized clinical trials to question its clinical benefits. We aimed to assess the efficacy of TA based primary percutaneous coronary intervention (PCI) in STEMI subgroup with heavy thrombus burden (TB) and compare it with conventional PCI in different STEMI subgroups. A comparative prospective study conducted on 60 patients (age 22–82 years) with acute STEMI who underwent primary PCI at our hospital from January 2016 to January 2017. Study population were divided into two groups: 1) patients with heavy TB or absence of flow after passage of guidewire underwent TA before stent deployment (test group, 30 patients) and 2) patients underwent conventional PCI (comparative group, 30 patients). Median follow-up duration was 5 days. Statistically significant differences; regarding final angiographic flow assessed by thrombolysis in myocardial infarction (TIMI) flow were found between the two groups in (TIMI) 0 before patients on TIMI flow after (TIMI 3 after 75.9 vs. 58.8%, TIMI 2 after 24.1 vs. 17.6%; P=0.05). In Conclusions; It is preferable to use TA before stenting in patients with STEMI with TIMI 0 flow before intervention.
Abstract: The efficacy of thrombus aspiration (TA) for various culprit lesions in ST-segment elevation myocardial infarction has not been sufficiently evaluated, this directed recent randomized clinical trials to question its clinical benefits. We aimed to assess the efficacy of TA based primary percutaneous coronary intervention (PCI) in STEMI subgroup with...
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An Unusual Cause of Delayed Post-traumatic Acute Aortic Insufficiency: Beef Corning
Afassinou Yaovi Mignazonzon,
Ondze Igor,
Guis Eric,
Weladji Guy,
Michel Carl Thony,
Moukala Thomas,
Larifla Laurent,
Ancedy Yann
Issue:
Volume 5, Issue 1, March 2021
Pages:
33-35
Received:
13 January 2021
Accepted:
3 February 2021
Published:
10 February 2021
Abstract: Aortic insufficiency is a rare disease caused by direct and indirect Chest shocks. The monitoring of patients after chest trauma must be rigorous. We described the case of a 73-year-old male patient who had pulmonary acute edema and was admitted to the emergency department (ED). He had been admitted to the ED one week earlier for a closed chest trauma with brief initial loss of consciousness following a violent shock by beef corning and released after 24 hours of surveillance with a diagnosis of closed chest trauma with a fractured sternum and myocardial contusion. After rapid stabilization of pulmonary acute edema, the examination revealed a diastolic mumur in the aortic focus. Transthoracic and transoesophageal doppler echocardiography had found a massive aortic insufficiency with rupture and perforation of the antero-right sigmoid without vegetation or visualized aortic dissection image and a normal sized left ventricle with good systolic function. The aortography had confirmed massive aortic insufficiency with blood reflux in the left atrium during diastole and normal coronary artery. A thoracic angioscanner was performed formally eliminating an associated aortic impairment and vegetation. There was no biological inflammatory signs and troponin was normalized compared to her elevation at admission one week earlier. The patient was treated two weeks later with an aortic valve replacement. Postoperative evolution was simple, and he came out of the hospital a week earlier and put into functional rehabilitation.
Abstract: Aortic insufficiency is a rare disease caused by direct and indirect Chest shocks. The monitoring of patients after chest trauma must be rigorous. We described the case of a 73-year-old male patient who had pulmonary acute edema and was admitted to the emergency department (ED). He had been admitted to the ED one week earlier for a closed chest tra...
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Multifocal Atherosclerosis: The Clinical Course and Surgical Treatment of Combined Atherosclerotic Lesions of the Carotid and Main Arteries of the Lower Extremities
Kordzakhia George,
Yanushko Vyacheslav,
Klimchuk Ivan
Issue:
Volume 5, Issue 1, March 2021
Pages:
36-40
Received:
6 January 2021
Accepted:
9 February 2021
Published:
23 February 2021
Abstract: Cardiovascular disease (CVD) has been for many years the major cause of deaths in the World. In Europe, despite recent decreases in mortality rates in many countries, CVD is still responsible for about half (46%) of all deaths. Atherosclerosis is a chronic progressive disease which can affect any vascular bed (coronary, cerebrovascular, visceral, peripheral arterial) as a single disease but can also occurs in more than one territory as polyvascular disease. Presence of atherosclerotic disease in one vascular bed frequently indicates an increased risk for its presence in another. The prevalence of polyvascular disease varies from 6% to 71%, depend on the population in whom the study was performed as well as on the study design. Polyvascular disease patients have the worse higher risk profile and worse prognosis than patients with disease in single arterial territory and an improvement in detection and consequent treatment of these patients have been claimed as necessary. The most difficult choice of treatment tactics is the group of patients with peripheral artery disease and concomitant atherosclerotic lesions of other arterial beds. According to a population study conducted in the United States among 3.6 million healthy volunteers based on ultrasound screening, the detection of two or more arterial regions increases with age from 0.04% at 40-50 years, to 3.6% at 80-90 years. At the same time, the results of treatment and prognosis in these patients are much worse than in those with isolated lesions of only one vascular beds.
Abstract: Cardiovascular disease (CVD) has been for many years the major cause of deaths in the World. In Europe, despite recent decreases in mortality rates in many countries, CVD is still responsible for about half (46%) of all deaths. Atherosclerosis is a chronic progressive disease which can affect any vascular bed (coronary, cerebrovascular, visceral, p...
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Glycaemic Status of Patients with Chronic Obstructive Pulmonary Disease on Inhaled Corticosteroid
Mohammad Abul Kalam Azad Khan,
Kabirul Hasan Bin Rakib,
Saiful Islam Patwary,
Abu Saleh Md. Sirajum Munir,
Md.,
Sohel Ahmed,
Mazharul Islam,
Dr. Rabeya Bosri,
Shamim Ahmed,
Md. Abul Kalam Azad,
Md. Abdur Rahim
Issue:
Volume 5, Issue 1, March 2021
Pages:
41-48
Received:
21 November 2020
Accepted:
6 February 2021
Published:
27 February 2021
Abstract: Background: Although the hyperglycaemic effects of systemic glucocorticoid therapy are well known, the effect of inhaled corticosteroids (ICS) on carbohydrate metabolism is still a subject of debate. The systemic bioavailability of ICS is claimed to be minimal and the side effects are negligible. Objectives: The aim of the study was to assess to the effect of inhaled corticosteroid on glycaemic status in patients with COPD. Methods: This Cross-sectional analytical study of COPD patients attending at Internal Medicine department of BSMMU, Dhaka, Bangladesh, between May 2016 to April 2017. After approval of the protocol by IRB and ethical committee, cross-sectional analytical study was done in the department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Total 80 COPD patients were recruited consecutively upon fulfilling the inclusion criteria. Socio-demographic data and disease related data were collected by face to face interview using a semi-structured case record form. The COPD patients were categorized according to global initiative for obstructive lung diseases (GOLD) criteria. The collected data then edited, analyzed and be presented as graphs, tables & charts. Results: There was no statistical difference in the mean age of both group which was 53.85±7.9 and 56±7.6 in control and case respectively. 77.5% of the case and 72.5% of control population are indulging in smoking while only 15% from each group are non-smoker. Large number of cases are service holder and businessman 35% and 20%, which is true for control group also 20% and 47.5%. Most of the cases are from higher socioeconomic background (45%), whereas in control group it is 37.5%. In 20% cases symptoms duration was less than 5 years, where as in control group it was 42.5%. 32% of cases and 7.5% of control group were diagnosed as diabetic when fasting plasma glucose taken into account, while in case of 2- hours plasma glucose the number were 32.5% and 10% respectively and in case of HbA1c the number were 23.5% and 10% respectively. Conclusion: Pre-diabetes and diabetes are highly prevalent among people with COPD which remain undiagnosed & untreated. So, the study findings will help in early intervention of glycaemic control among COPD patients.
Abstract: Background: Although the hyperglycaemic effects of systemic glucocorticoid therapy are well known, the effect of inhaled corticosteroids (ICS) on carbohydrate metabolism is still a subject of debate. The systemic bioavailability of ICS is claimed to be minimal and the side effects are negligible. Objectives: The aim of the study was to assess to th...
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Nutritional and Environmental Contribution as a Determinant of Hypertension Among Adults in Urban-Rural Areas in the Demogratic Republic of Congo
Blaise Makoso Nimi,
Gedeon Longo Longo,
Benjamin Longo Mbenza,
Carine Nkembi Nzuzi,
Roland Vangu Vangu,
Aliocha Nkodila,
Memoria Makoso Nimi,
Elyse Buanga Khuabi,
Michel Lutete Nkelani,
Jean Rene M’buyamba-Kabangu
Issue:
Volume 5, Issue 1, March 2021
Pages:
49-56
Received:
31 January 2021
Accepted:
14 February 2021
Published:
27 February 2021
Abstract: Background and Aim: This study was carried out in the port city of Boma and had the aim of evaluating the impact of nutritional and environmental factors on the prevalence of hypertension. Methods: a cross-sectional survey using a modified WHO STEP wise questionnaire for data collection during face-to face interviews was conducted from March, 1 to April 15, 2018. We did multi-stage cluster sampling. Was an all-inclusive adult over the age of ≥ 18 years having given informed consent. Information on demographic parameters, lifestyles, anthropometric measurements and blood pressure (BP) were obtained. Hypertension was defined as a mean of two BP ≥ 140/90 mmHg or a self-reported history of antihypertensive drug use. Independent factors associated with hypertension were identified using logistic pressure analysis. P<0.05 defined level of statistical significance. Results: The prevalence of hypertension was 35 SES Low (p=0.002), Tabaco (p=0.002), physical Inactivity (p=0.043), Excess consumption of animal fats (p=0.035), and Low frequency consumption fruits and vegetables (p=0.010) have been the nutritional and environmental factors associated with high blood pressure. Conclusion: Nutritional and environmental factors play an important role in increasing the prevalence of hypertension in the city of boma, this requires that the population is in full nutritional transition
Abstract: Background and Aim: This study was carried out in the port city of Boma and had the aim of evaluating the impact of nutritional and environmental factors on the prevalence of hypertension. Methods: a cross-sectional survey using a modified WHO STEP wise questionnaire for data collection during face-to face interviews was conducted from March, 1 to ...
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