Knowledge of modifiable risk factors of cardiovascular diseases among patients with acute myocardial infarction.

BACKGROUND: Cardiovascular disease is a major cause of mortality and morbidity in Pakistan. Knowledge regarding any disease is an important pre-requisite for implementation of preventive and control measures. This study aimed to evaluate the knowledge of modifiable risk factors of cardiovascular diseases in acute myocardial infarction (MI) patients admitted to Ayub Teaching Hospital, Abbottabad, Pakistan. METHODS: It was a hospital based cross sectional descriptive study carried out in cardiology unit of Ayub Teaching Hospital, on 150 patients with first attack of acute MI. knowledge of four modifiable risk factors; fatty food consumption, smoking, physical activities and obesity, was assessed. RESULTS: Among 150 subjects, 103 (68.7%) were males while 47 (31.3%) were females. Forty three (28.7%) of the patients were having good level of knowledge. Male gender and educational status were associated with good level of knowledge. CONCLUSION: There is a lack of good level of knowledge among patients admitted with acute MI. Implementing aggressive educational strategies is of utmost importance in Pakistani population for preventing the rising prevalence of this disease to combat the burdeni of MI.

Effect of a family planning program on documented emotional support and reproductive goals counseling after previable pregnancy loss.

OBJECTIVES: To evaluate the effect of the Ryan Program for family planning training on patient counseling surrounding previable pregnancy loss. METHODS: We conducted a retrospective cohort study of patients with first- and second-trimester miscarriages, therapeutic abortions, ectopic and molar pregnancies, from years before and after establishing a Ryan Program. We compared documentation of coping and future reproductive goals by patient factors, using chi square testing and logistic regression. RESULTS: We included 285 pregnancies: 138 pre-Ryan, 147 post-Ryan. Documentation of coping and future goals was greater post-Ryan than pre-Ryan (57.8% vs. 26.8% for coping, 72.8% vs. 50.7% for goals; both p < 0.001). Coping was less likely to be documented for adolescents (aOR 0.02), patients of Asian race (aOR 0.08), those diagnosed in the emergency department (aOR 0.22), and those with ectopic or molar pregnancy (aOR 0.14) (all p < 0.005). Coping documentation increased with second-trimester loss (aOR 6.19) and outpatient follow-up (aOR 3.41) (all p < 0.005). CONCLUSIONS: Establishment of a Ryan Program was associated with greater attention to patient coping and goals after previable pregnancy loss. Patients experiencing medically-dangerous pregnancy losses receive less attention to their coping. PRACTICE IMPLICATIONS: Comprehensive family planning training and outpatient access may improve patient-centeredness of care for previable pregnancy loss.