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Quality of Life in Patients with Chronic Heath Failure Followed at the Tertiary Hospitals of Sub-Saharan Africa
Jérôme Boombhi,
Jean-Pierre Kamga,
Liliane Mfeukeu-Kuaté,
Delphine Kingue,
Mazou Ngou Temgoua,
Alain Menanga,
Samuel Kingué
Issue:
Volume 3, Issue 4, December 2019
Pages:
80-85
Received:
14 May 2019
Accepted:
18 June 2019
Published:
25 September 2019
Abstract: Heart Failure (HF) has become one of the most important chronic medical conditions worldwide. It’s associated with high morbidity and mortality. Despite improving in patient’s management, little works have been done to evaluate the quality of life of patients with heart failure in Sub-Saharan Africa. The objective of this work was to assess the quality of life of patients with Chronic Heart Failure (CHF) followed in three reference hospitals of Cameroon. We carried out a cross-sectional study over a period of 04 months, from January to May 2017. The patients were recruited from the cardiology departments of three references Hospitals of Cameroon: Yaoundé Central Hospital (YCH), General Hospital of Yaoundé (GHY) and Yaoundé University Teaching Hospital (YUTH). We included all patients aged 18 years and above followed for CHF and consenting to participate in the study. Patients with other chronic conditions (chronic kidney disease, cancer, schizophrenia) were excluded. The quality of life was assessed using the Minnesota Living with Heart Failure tool (MLwHF). A total of 119 patients were recruited. The mean age was 66 ± 13 years. More than 2/3 (70.6%) of the patients were unemployed. The majority of patients (83.2%) had low monthly income (< 100 000 FCFA). Stage II of heart failure according to New York Heart Association (NYHA) was the most represented (50 %). The median scores for the Minnesota Living with Heart Failure Questionnaire (MLwHFQ) were generally low. The risk factors of poor life quality were: young age (p = 0.039), low educational attainment (p = 0.046), low monthly income (p = 0.024), exposure to tobacco (p = 0.005), low left ventricular ejection fraction (p = 0.003), mental depression (p < 0.001), anxiety (p < 0.001), non-adherence to treatment (p = 0.035). The only factors that remain significant after adjusting for confounders are: mental depression (0, 002) and functional class of NYHA (< 0, 001). In conclusion, Quality of life is slightly affected in patients with chronic heath failure. The few proportion of alter quality of life is explained mostly by psychological and clinical factors. The clinician should pay attention to these factors for the better management of the patients in Sub-Saharan Africa.
Abstract: Heart Failure (HF) has become one of the most important chronic medical conditions worldwide. It’s associated with high morbidity and mortality. Despite improving in patient’s management, little works have been done to evaluate the quality of life of patients with heart failure in Sub-Saharan Africa. The objective of this work was to assess the qua...
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ST Elevation in a Professional Athlete: From the Coronary Care Unit to the Field
Maria Boutsikou,
Elias Sanidas,
Gkiouzelis Giasemis,
George Ziogas,
George Dangas,
Panagiotis Stamatopoulos
Issue:
Volume 3, Issue 4, December 2019
Pages:
86-89
Received:
10 July 2019
Accepted:
17 September 2019
Published:
30 September 2019
Abstract: Interpretation of ECG in athletes can be quite challenging as it requires adequate experience to distinguish physiologic changes related to adaptation to training from pathologic findings. ECG interpretation is an important diagnostic tool for high intensity trained athletes. Herein, we present the case of a young high-competitive athlete who presented with a variant ST elevation on 12lead ECG that was initially considered suspicious of myocardial infarction. Diagnostic workup including clinical examination, echocardiogram, 12-lead surface ECG and laboratory tests (troponin and CK-MB) did not confirm the presence of acute coronary syndrome. The patient was monitored for a few hours and was finally discharged with no restrictions regarding training. ECG in the present case resembles Wellen’s syndrome pattern which represents a pre-infarction stage of CAD with a significant proximal left anterior descending artery (LAD) stenosis that will be followed by ACS of anterior wall if left untreated. However, there were no other findings to support the clinical diagnosis of Wellen’s syndrome in our case and the ECG changes were attributed to a physiological adaptation to training. During exercise several ECG adjustments develop as a result of the decreased sympathetic tone and the increased parasympathetic tone combined with the heterogeneity of ventricle repolarization. The preparticipation screening performed by experienced physicians in the field of sports cardiology is crucial in order to recognize physiologic cardiovascular adaptation to exercise and exclude cardiovascular abnormalities.
Abstract: Interpretation of ECG in athletes can be quite challenging as it requires adequate experience to distinguish physiologic changes related to adaptation to training from pathologic findings. ECG interpretation is an important diagnostic tool for high intensity trained athletes. Herein, we present the case of a young high-competitive athlete who prese...
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Erectile Dysfunction Among Hypertensive Patients in Yaounde, Cameroon
Jerome Boombhi,
Njoya Poumie Aoudou,
Alain Menanga,
Donald Tchapmi,
Ba Hamadou,
Samuel Kingue
Issue:
Volume 3, Issue 4, December 2019
Pages:
90-93
Received:
1 October 2019
Accepted:
28 October 2019
Published:
5 November 2019
Abstract: This study was done to determine the prevalence, associated factors and severity factors of erectile dysfunction, in patients with hypertension in Yaounde. It was a cross sectional descriptive and analytical study that included 170 patients. All the participants were screened for erectile dysfunction using the International Index of Erectile Function 5 (IIEF-5). Results showed that the mean age of our participants was 55 +/- 8 years. The prevalence of erectile dysfunction was 50.6%. Among those affected, the severity was classified as mild (46,5%), moderate (33,7%) and severe (19,8%). After a multivariate analysis, erectile dysfunction remained significantly associated with age (p < 0,001), duration of hypertension of more than 5 years (p=0,001), higher grade of hypertension (p=0,011), diabetes (aOR= 24,56; 95% CI: 3,56 – 83,1; p=0,02), tobacco smoking (aOR= 4,83; 95% CI: 2,70 – 33,2; p=0,016), alcohol intake (aOR= 43,1; 95% CI: 2,53 – 732,7; p=0,009), multiple anti-hypertensive medications (aOR = 3,7; 95% CI: 1,51 – 6,78; p=0,006) and usage of thiazide diuretics (aOR =14,3; 95% CI: 4,32 – 47,3; p < 0,001). The severity of erectile dysfunction was significantly associated with age (p < 0,001), duration of hypertension (p < 0,001), severity of hypertension (p < 0,001), diabetes (p < 0,001), tobacco smoking (p = 0,003), alcohol intake (p = 0,003) and multiple antihypertensive medications (p = 0,001). In conclusion, erectile dysfunction has a high prevalence and severity among Cameroonian hypertensive patients. Age, duration of hypertension, severity of hypertension, diabetes, tobacco smoking, alcohol intake and usage of thiazide diuretics were factors associated with this high prevalence and severity.
Abstract: This study was done to determine the prevalence, associated factors and severity factors of erectile dysfunction, in patients with hypertension in Yaounde. It was a cross sectional descriptive and analytical study that included 170 patients. All the participants were screened for erectile dysfunction using the International Index of Erectile Functi...
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Cardiac Tamponade from Pericardial Mesothelioma Causing Acute Renal Insufficiency in Dog
Sajika Seengam,
Chattida Panprom,
Pat Puncharoen,
Soontaree Petchdee
Issue:
Volume 3, Issue 4, December 2019
Pages:
94-98
Received:
28 October 2019
Accepted:
18 November 2019
Published:
22 November 2019
Abstract: Pericardial mesothelioma is a rare malignancy tumor in dog. Due to an aggressive tumor and low survival rates, mesothelioma is frequently diagnosed at an advanced stage. The objective of this clinical report is to highlight the characteristic of this malignancy tumor to help an early diagnosis and to improve the therapeutic outcomes of this neoplastic tumor. A 10-year-old crossbreed was referred to Kasetsart University Veterinary Teaching Hospital Kamphaengsaen for the evaluation of a history of abdominal distension, lethargy and weekness. During the physical examination, the dog was tachycardia and tachypnea. Ultrasonography imaging of spleen revealed an inhomogeneous appearance and thoracic radiograph showed cardiac enlargement. Electrocardigraphy examination revealed low voltage of QRS complex amplitude. A transthoracic echocardiogram showed a large pericardial effusion with cardiac tamponade and masses were visualized in pericardial sac. Pericardiocentesis was immediately performed to alleviate the cardiac tamponade and cytologic examination was performed to identify the characteristic of pericardial effusion fluid. Clinical symptoms of acute kidney injury were progressed from the second visit including azotemia, hyponatraemia, hyperkalemia and anuria. The dog died about 2 days after admission in the critical care unit. Histopathological examination of the pericardial fluid and pericardial mass confirmed the diagnosis of pericardial mesothelioma. Mesothelioma should be considered in the diagnosis of pericardial effusion in dog. An early stage detection of pericardial mesothelioma may significantly reduction in mortality and allow for more beneficial treatment.
Abstract: Pericardial mesothelioma is a rare malignancy tumor in dog. Due to an aggressive tumor and low survival rates, mesothelioma is frequently diagnosed at an advanced stage. The objective of this clinical report is to highlight the characteristic of this malignancy tumor to help an early diagnosis and to improve the therapeutic outcomes of this neoplas...
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Short Term Follow up for Diabetic Patients Presented with Acute STEMI Undergoing Preventive Versus Culprit Lesion in Primary Percutaneous Coronary Intervention
Mohamed Elsayed Shuman,
Ahmed Abdallah Mostafa,
Ghada Mahmoud Soltan,
Abdalla Mostafa Kamal
Issue:
Volume 3, Issue 4, December 2019
Pages:
99-103
Received:
2 November 2019
Accepted:
23 November 2019
Published:
4 December 2019
Abstract: Objectives: This study aimed to evaluate the short term follow up for diabetic patients presented with acute STEMI underwent preventive percutaneous coronary intervention. Background: preventive PCI appears to be safe as culprit artery PCI with effective reduction of refractory angina and repeated revascularization in selected patients but no benefit on mortality or recurrent MI. Methods: Our study was a prospective, observational study conducted at multicenter hospitals included 120 diabetic patients admitted with acute STEMI and multivessels CAD at National Heart Institute, Menofia university hospital, police academy center and some private hospitals patients from June 2017 to august 2018, group (A) Consisted of 70 diabetic patients with acute STEMI undergone preventive PCI in whom PCI will be done for culprit & non culprit lesions, group (B) Consisted of 50 diabetic patients with acute STEMI undergone PCI for culprit lesion only. Results: The total revascularization group were significantly less suffering from refractory angina 5 (7.1%) vs 15 (30.0%), p= <0.001 and less re-hospitalized for cardiac causes 14 (20.0%) vs 22 (44.0%), p= 0.005, cardiac mortality was 2 patients 0 (0.0%) vs 2 (4%) p= 0.092. Conclusion: The preventive PCI appears to be safe as culprit artery PCI with effective reduction of refractory angina and repeated revascularization but no benefit on mortality or recurrent MI in selected hemodynamically stable STEMI diabetic patients with multivessel disease.
Abstract: Objectives: This study aimed to evaluate the short term follow up for diabetic patients presented with acute STEMI underwent preventive percutaneous coronary intervention. Background: preventive PCI appears to be safe as culprit artery PCI with effective reduction of refractory angina and repeated revascularization in selected patients but no benef...
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Tissue Doppler Imaging Assessment of Left Ventricular Function in Diabetic Patients with Hepatitis C Virus (HCV)
Mohamed Abd El Raheem El Tnoby,
Ahmed Abdallah Mostafa,
Waleed Abdo Ebraheem,
Abdallah Mostafa Kamal
Issue:
Volume 3, Issue 4, December 2019
Pages:
104-113
Received:
25 November 2019
Accepted:
9 December 2019
Published:
24 December 2019
Abstract: Background & Purpose: Hepatitis C virus (HCV) is the motive of many distinctive kinds of heart illnesses globally. Up till now, few cardiologists are aware of (HCV) as an etiology of heart sickness and its treatment. It has been nicely documented that the presence of diabetes mellitus (DM) changed into carefully connected to cardiovascular disorder. The aim of this work was to evaluate the left ventricular function in diabetic patient with hepatitis C (HCV) using tissue Doppler imaging “TDI”. Study design: Comparative study. Setting: Menofia hospitals, Police Academic Hospital and Kafr El-Sheikh hospital from October 2016 to November 2018. Subjects: We included 50 adult HCV patients, allocated into 2 groups with BMI, age and sex matching. Group A: 25 patients below 50 years old who were diabetic (DM), and infected with HCV. Group B: 25 patients below 50 years old with HCV without Dm. Methods: All patients were subjected to Echocardiographic analysis, Doppler tissue imaging, ECG, blood sugar investigations and PCR for HCV. Results: In the studied population, we found that, comparative study between the 2 groups revealed; significant increase in LA mass index, in DM & HCV group (p = 0.035). Non-significant difference as regards all the remaining Echocardiographic variables (p > 0.05). Regarding correlations among DM & HCV cases; Mitral E had a highly significant positive correlation with HCV-PCR (p < 0.01). E/E' ratio and isovolumic relaxation time had a significant positive correlation with HCV-PCR (p < 0.05 respectively). It also shows that; septal mitral E' had a highly significant negative correlation with HCV-PCR (p = 0.004). And also shows that; the remaining Tissue Doppler Echocardiographic parameters, had non-significant correlation with HCV-PCR (p > 0.05). Conclusion: To conclude, our data suggests that, HCV infection had a significant impact on Lt ventricular diastolic function without any other predisposing factors probably due chronic inflammatory reaction and mild fibrosis of the heart muscle, previous studies did not follow strict inclusion and exclusion criteria that confirm the independence role of (HCV) infection to cause diastolic dysfunction. also, the presence of DM in addition to HCV infection add no more adverse effect on cardiovascular outcomes.
Abstract: Background & Purpose: Hepatitis C virus (HCV) is the motive of many distinctive kinds of heart illnesses globally. Up till now, few cardiologists are aware of (HCV) as an etiology of heart sickness and its treatment. It has been nicely documented that the presence of diabetes mellitus (DM) changed into carefully connected to cardiovascular disorder...
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