Association between air temperature and self-perceived health status in Southern Germany: Results from KORA FIT study.

BACKGROUND: Short-term exposure to low and high air temperatures can cause serious harmful effects on human health. Existing literature has mostly focused on associations of ambient air temperature with mortality and the need for health care in population-level studies. Studies that have considered self-perceived health status as an outcome when examining the effects of air temperature on health are scarce. In this study, we explored the short-term association of daily mean air temperature with various measures of self-perceived health status. METHODS: This cross-sectional analysis is based on the Cooperative Health Research in the Region of Augsburg (KORA) FIT study conducted in 2018/2019 and included participants from the Augsburg region of Southern Germany. Health-related quality of life (HRQOL) was evaluated by using the 5-level EuroQol Five Dimension (EQ-5D-5L) questionnaire, including the EuroQol visual analog scale (EQ-VAS). Self-rated health (SRH) and comparative self-rated health (CSRH) were each assessed using a single question. Daily mean air temperature data was estimated using a spatiotemporal model and assigned to participants' home addresses at a resolution of 1 × 1 km. Regression models with a Distributed Lag Non-linear Modeling (DLNM) approach were used to investigate the associations between daily mean air temperature and self-perceived health measures. RESULTS: We found no association of heat or cold with the HRQOL, SRH or CSRH. Nevertheless, there was a significant protective association of low air temperature with the EQ-5D-5L dimension "usual activities." CONCLUSION: There was no evidence of daily mean air temperature adversely affecting participants' self-perceived health status.

Sociodemographic determinants of gender disparity in primary percutaneous coronary intervention in Pakistan.

OBJECTIVES: This study aims to contribute to the body of literature on gender disparities after acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS: We identified all adult patients who had AMI between January 2017, and December 2022 and were in follow-up at our institute. We collected data on PPCI, revascularization strategy, sociodemographic characteristics, and in-hospital complications in the years following the procedure. RESULTS: A total of 5,872 patients who underwent PCI for AMI were included in the study, out of which 2,058 (35%) were women and 3,814 (65%) were men. Regarding the timing of PCI, female patients had a significantly longer median door-to-balloon time compared to male patients (136 minutes vs 108 minutes, P-value = 0.006). Female patients had a significantly higher rate of in-hospital mortality compared to male patients (5.5% vs 1.2%, P-value = 0.011). Multivariate logistic regression analysis showed that female gender, older age, and lower household income were independent predictors of longer door-to-balloon time. CONCLUSION: This study highlights gender disparities in PPCI in Pakistan, with female patients facing longer door-to-balloon times and higher in-hospital mortality rates. The findings suggest the need for targeted interventions to improve the access and quality of care for female patients with AMI.

Social Determinants of Clinical Visits After Left Main Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting.

This study aims to investigate the social determinants of clinical visits after LM-PCI versus CABG and their impact on post-treatment care and outcomes. We identified all adult patients who underwent LM-PCI or CABG between January 1, 2015, and December 31, 2022, and were in follow-up at our institute. We collected data on clinical visits, including outpatient visits, emergency department visits, and hospitalizations, in the years following the procedure. The study included 3816 patients, of which 1220 underwent LM-PCI and 2596 underwent CABG. The majority of patients were Punjabi (55.8%), males (71.8%), and had low socioeconomic status (69.2%). The strongest predictors of having a follow-up visit were age (OR (95%CI): 1.41 (0.87-2.35); P value = 0.03), female gender (OR (95%CI): 2.16 (1.58-4.21); P value = 0.07), LM-PCI (OR (95%CI): 2.32 (0.94-3.64); P-value = 0.01), government entitlement (OR (95%CI): 0.67 (0.15-0.84); P value = 0.16), high SYNTAX (OR (95%CI): 1.07 (0.83-2.58); P value = 0.02), 3-vessel disease (OR (95%CI): 1.76 (1.05-2.95); P value <0.01), and peripheral arterial disease (OR (95%CI): 1.52 (0.91-2.45); P value = 0.01). Hospitalizations, outpatient, and emergency visits were more in the LM-PCI cohort as compared to CABG. In conclusion, the social determinants of health, including ethnicity, employment, and socioeconomic status were associated with differences in clinical follow-up visits after LM-PCI and CABG.

Co-occurrence of familial Mediterranean fever with systemic lupus erythematosus in South Asian population.

BACKGROUND AND OBJECTIVE: Familial Mediterranean fever (FMF) and systemic lupus erythematosus (SLE) are autosomal recessive auto-inflammatory diseases, triggered by FMF-associated gene mutations and auto-antigens. The literature on the co-occurrence of these two disorders is limited to case reports and their correlation is considered rare. We investigated the proportion of FMF among SLE patients when compared with a healthy adult cohort in South Asia. METHODS: For this observational study, data from our institutional database were collected for the patients diagnosed with SLE. The control group was randomly selected from the database and were age- matched for SLE. The overall proportion of FMF among patients with and without SLE was considered. Student's t-test, Chi-square, and ANOVA were used for univariate analysis. RESULTS: The study population included 3623 SLE patients and 14,492 controls. In the SLE group, there was a significantly higher proportion of FMF patients compared with the non-SLE group (1.29% vs. 0.79% respectively; p=0.015). SLE was prevalent in Pashtun's (50%) in the middle socioeconomic group while FMF was dominant in Punjabi's and Sindhi's (53%) in the low socioeconomic class. CONCLUSION: This investigation demonstrates that FMF is more prevalent in a South-Asian population cohort of SLE patients.

Tricuspid regurgitation in His bundle pacing: A systematic review.

OBJECTIVE: This systematic review aimed to explore an association of new TR and its quantification in patients undergoing His bundle pacing (HBP). METHODS: A literature review was conducted using Mesh terms (His bundle pacing, tricuspid regurgitation, tricuspid valve incompetence, etc.) in PubMed, EMBASE, Web of science CINAHL, and the Cochrane Library till October 2021. Relevant studies evaluating tricuspid regurgitation in HBP were included and information regarding TR and its related factors (ejection fraction (EF) and New York Heart Association (NYHA) class) were retrieved from the eligible studies. RESULTS: Out of 196 articles, 10 studies met the inclusion criteria, which consisted of 546 patients with HBP. The mean age of the patients ranged between 61.2 ± 12.3 and 75.1 ± 7.9 years with 54.1% males. The overall implant success rate was 79.2%. Only one study reported a 5% incidence of TR, while 9 studies reported no new TR after HBP. Four studies reported overall decrease in TR by 1 grade and 3 studies demonstrated increased TR from baseline. Two studies showed no change from baseline TR. CONCLUSION: HBP causes improvement in TR grade after HBP for cardiac resynchronization therapy (CRT) as well as atrioventricular block (AVB). Further studies in the form of randomized controlled trials are required to further evaluate the effect of HBP on tricuspid valve functioning.

Heat, Heatwaves and Cardiorespiratory Hospital Admissions in Helsinki, Finland.

Background: There is a lack of knowledge concerning the effects of ambient heat exposure on morbidity in Northern Europe. Therefore, this study aimed to evaluate the relationships of daily summertime temperature and heatwaves with cardiorespiratory hospital admissions in the Helsinki metropolitan area, Finland. Methods: Time series models adjusted for potential confounders, such as air pollution, were used to investigate the associations of daily temperature and heatwaves with cause-specific cardiorespiratory hospital admissions during summer months of 2001-2017. Daily number of hospitalizations was obtained from the national hospital discharge register and weather information from the Finnish Meteorological Institute. Results: Increased daily temperature was associated with a decreased risk of total respiratory hospital admissions and asthma. Heatwave days were associated with 20.5% (95% CI: 6.9, 35.9) increased risk of pneumonia admissions and during long or intense heatwaves also with total respiratory admissions in the oldest age group (≥75 years). There were also suggestive positive associations between heatwave days and admissions due to myocardial infarction and cerebrovascular diseases. In contrast, risk of arrhythmia admissions decreased 20.8% (95% CI: 8.0, 31.8) during heatwaves. Conclusions: Heatwaves, rather than single hot days, are a health threat affecting morbidity even in a Northern climate.

Prevalence of and factors associated with under-5 mortality in South Asia.

BACKGROUND: This study investigated the prevalence of and the factors associated with under-5 mortality across five South Asian countries. METHODS: Cross-sectional pooled data from 1999 through 2014 collected from the Demographic and Health Survey (DHS) in five South Asian countries (Bangladesh, India, Maldives, Nepal and Pakistan) were used. Associations of under-5 mortality with sociodemographic characteristics and maternal and child factors were studied using the Cox proportional-hazard method. The estimates were presented as hazard ratios (HR) and their 95% CIs. Kaplan-Meier survival curves were used to describe time-to-event of under-5 survival patterns. RESULTS: Overall, 15-year prevalence of under-5 mortality in South Asian countries was 10%, with Nepal having the highest prevalence (11.1%) and the Maldives the lowest (5%). In a multivariable model in pooled data, older age of mother (HR 0.70, 95% CI 0.68-0.72), being employed (HR 1.09, 95% CI 1.07-1.12), having a higher level of education (HR 0.36, 95%, CI 0.32-0.40) and having a husband with higher level of education (HR 0.74, 95% CI 0.70-0.78) were significantly associated with under-5 mortality. Factors associated with under-5 mortality were mostly common across countries. CONCLUSION: The prevalence of under-5 mortality is still high in South Asia. Most of the studied sociodemographic factors were associated with under-5 mortality and were common across South Asian countries.