RESUMO
Background: Atrial fibrillation (AF) is associated with significant mortality and morbidity from stroke and thromboembolism. Despite the availability of effective oral anticoagulation medication, AF patients remain at a high risk of stroke if not treated properly. The purpose of this study was to evaluate antithrombotic therapy practices in patients with AF in the adult cardiac clinic at Hawassa University Comprehensive Specialized Hospital (HUCSH). Methods: It was a retrospective document review study. Total charts of 119 patients who had follow-up at the adult cardiac clinic with a history of documented AF from January 1 to December 30, 2018, were included. Indicators for antithrombotic therapy based on the congestive heart failure, hypertension, age ≥75 (doubled), diabetes, stroke (doubled), vascular disease, age 65 to 74, and sex category (female) (CHA2DS2-VASc) score were recorded. A p value of 0.05 was considered statistically significant. Data analysis was done using SPSS 23 software. Results: In this study, about 55% of patients with AF were receiving the appropriate antithrombotic treatment. The patients were 48 ± 18.2 years old. Of these, 70% were women. The most frequent underlying cardiac etiology was chronic rheumatic valvular heart disease (50%), followed by cardiomyopathy (14%). In nonvalvular AF, the mean CHA2DS2VASc score was 4.0 ± 1.07. In valvular AF compared to nonvalvular AF, the need for appropriate antithrombotic therapy was substantially greater (p 0.0001). Only 8 (13.6%) of the warfarin-using patients had adequate anticoagulation. Conclusion: The study's findings in regard to antithrombotic usage and maintenance of appropriate antithrombotics for stroke prevention in our patients revealed a discrepancy between recommendations and practice. Therefore, we demand that patients with AF who meet the criteria utilize antithrombotics properly to prevent stroke. Warfarin-taking patients' subpar optimum anticoagulation has to be addressed. Lastly, we advocate proper CHA2DS2-VASc score utilization for nonvalvular heart disease. A regular INR follow-up is also advised for patients who have started taking warfarin.
RESUMO
Background: Diabetes is a global health challenge with escalating prevalence rates. Cardiovascular complications represent the leading cause of mortality among individuals with diabetes. Notably, dyslipidemia stands as a prominent risk factor for cardiovascular disease in Type 2 diabetes mellitus (T2DM) patients. Timely detection and management of dyslipidemia in these patients hold the potential to deter its progression and substantially reduce the risk of cardiovascular-related morbidity and mortality. This study was aimed at assessing the burden of dyslipidemia and determinant factors among T2DM patients who were being followed at the Endocrinology clinic of Hawassa University Comprehensive Specialized Hospital (HUCSH). Methodology: An Institutional- based retrospective cross-sectional study was conducted, and samples of 228 patients were selected using a systematic random sampling technique. Data were collected through structured face-to-face interviews using a questionnaire. Bivariate logistic analysis was utilized, and variables with a p-value < 0.25 in this analysis were considered candidates for multivariate logistic analysis. Multivariate logistic regression was employed to identify factors associated with the prevalence of dyslipidemia, with a significance threshold set at p < 0.05. Results: The research revealed an overall prevalence of dyslipidemia among the study participants at 75.9%. The specific manifestations of dyslipidemia were observed as follows: hypertriglyceridemia in 43%, hypercholesterolemia in 25%, elevated low-density lipoprotein in 59.2%, and reduced high-density lipoprotein in 33.3% of the study participants. Factors significantly associated with dyslipidemia included longer diabetes duration, poor physical activity, elevated HbA1C, and obesity. Conclusion: This study underscores a notably high prevalence of dyslipidemia among T2DM patients. The findings highlight the advocate for clinicians to prioritize routine screening, and effective treatment concerning dyslipidemia and its associated risk factors among individuals with T2DM. It is worth mentioning that this study was conducted in a specific hospital setting and limited time, and hence the findings, and generalizability to other healthcare facilities should be taken cautiously.
RESUMO
BACKGROUND: Studies addressing frailty are limited in the global south, including Ethiopia. We estimated the prevalence of frailty and associated factors among older people living with HIV (PLHIV) attending a large Comprehensive Specialized Hospital in southern Ethiopia. METHODS: A systematic sample of 187 PLHIV and 187 HIV-negative controls > 50 years old were recruited between October 1 and November 30, 2021. Data on socio-demographic, behavioural and clinical characteristics were collected using a structured questionnaire. Frailty assessments were completed using the brief frailty instrument (B-FIT-2), which consists of 6 components. Scoring 5-6 points was frail, 2-4 points were pre-frail and below 2 was considered as non-frail. Logistic regression model was used to measure association between variables. RESULTS: Median (IQR) age was 53 (50, 80) for PLWH and 59 (55-66) for controls. Prevalence of frailty was 9.1% for PLHIV Versus 5.9% for controls. A significant proportion of PLHIV was pre-frail; 141 (75.4%) compared to controls 110 (58.8%). Pre-frailty status was associated with HIV diagnosis (adjusted odds ratio (aOR) 4.2; 95% CI 1.8-9.9), low age (aOR 0.3; 95% CI 0.1-0.6), lower educational attainment (aOR 2.2; 95% CI 1.0-4.9), being farmer (aOR 3.2; 95% CI 1.0-10.2) and having high or low body mass index (BMI) (aOR 11.3; 95% CI 4.0-25.8). HIV diagnosis (aOR 9.7; 95% CI 1.6-56.8), age (aOR 0.2; 95% CI 0.1-0.7), lower educational attainment (aOR 5.2; 95% CI 1.5-18.2), single status (aOR 4.2; 95% CI 1.3-13.6), farmer (aOR 19.5; 95% CI 3.5-109.1) and high or low BMI (aOR 47.3; 95% CI 13.8-161.9) predicted frailty. CONCLUSION: A high proportion of frailty and pre-frailty was observed in a cohort of older PLHIV attending care in Southern Ethiopia. Future research should focus on interventions targeting factors associated with frailty.