Project description:BACKGROUND:Cardiovascular disease (CVD) is the primary cause of death worldwide, accounting for 31.0% of all deaths and more than 18 million deaths annually. The 2008 World Health Report indicated that 144 (35%) of the 413 deaths per 100,000 in 2002 in the Kingdom of Saudi Arabia (KSA) were due to CVD. Primary prevention is an important focus of most of the cardiovascular prevention guidelines around the world. In this study, we aimed to describe the prevalence of extrinsic risk factors for CVDs in a high-risk population attending general practice in Jeddah, KSA. METHODS:We conducted a cross-sectional survey at King Abdulaziz University Hospital in Jeddah. Patients started on lipid-lowering and/or antihypertensive and/or antidiabetes treatments without a history of established cardiovascular disease were interviewed. The questionnaire was adopted from the EUROASPIRE III study. RESULTS:Two hundred and fifty high-risk individuals (80.0% female) were interviewed. Overall, 72% of the patients had been diagnosed with hypertension, 61.2% of patients had dyslipidemia, and approximately two-thirds of patients had diabetes mellitus. Most of the patients (88%) were non-smokers. The mean waist circumference of patients was 101.6 ± 14.1 cm, which suggests most were clinically obese. About 54.8% of the patients followed an unhealthy diet and 52.0% were physically inactive. There were significant differences between women and men in relation to dyslipidemia (p = 0.007), unhealthy diet (p = 0.034), being overweight (p = 0.018), and high blood cholesterol (p = 0.002). We observed significantly greater prevalence of hypertension (p = 0.073), unhealthy diet (p = 0.015), being overweight (p = 0.018), and high blood cholesterol (p = 0.000) in those patients with dyslipidemia. CONCLUSION:Our study presents novel findings in the KSA. Women were more likely to have high-risk CVD risk factors compared with their male counterparts in this sample. Gender-specific prevention programs in the KSA should be considered to more appropriately target at-risk individuals, to reduce preventable morbidity and mortality associated with CVDs.
Project description:BackgroundAcute kidney damage (AKI) is among the most severe consequences observed in surgical intensive care units (SICUs). We aim to observe the incidence, risk factors, and outcomes of acute kidney injury in SICU octogenarians.MethodsA cross-sectional retrospective study was conducted at the SICU of Jordan University Hospital (JUH), a tertiary teaching hospital in a developing country, between January 2018 and December 2019. Patients who were 80 years or older at the time of data collection were included. The definition of AKI was based on Kidney Disease Improving Global Outcomes (KDIGO) criteria. Demographic, clinical, and laboratory data were reviewed.ResultsA total number of 168 patients were included. The mean age was 84.0 ± 3.8 years, and 54.8% of the participants were women. Of those, 115 (68.5%) had surgery before or during ICU stay, and 28.7% of the patients' surgeries were an emergency surgery. Also, 47.8% of surgeries were considered by anesthesia to be high-risk surgeries. A total of 55 patients (32.7%) developed AKI during their SICU stay. The factors that were significantly associated with AKI in the ICU patients included use of beta blocker [AOR: 3.7; 95% CI: 1.2-11.8; p = 0.025], and inotropes [AOR:4.0; 95% CI: 1.2-13.3; p = 0.03]. The factors that were significantly associated with mortality in the ICU included using mechanical ventilation [AOR:18.7; 95% CI: 2.4-141.9; p = 0.005] and inotropes use [AOR: 12.3; 95% CI: 1.2-120.7; p = 0.031].ConclusionsThe incidence of AKI during SICU stay in this study was 32.7% and it was significantly associated with the use of beta blockers, mechanical ventilation, and inotropes. The mortality rate among octogenarians who developed AKI during SICU stay was 36.4%. Further studies are needed globally to assess the incidence of AKI in octogenarian surgical patients and identify risk factors to provide preventative measurements and strategies.
Project description:BACKGROUND:While there are advances in medicine and pharmaceutical care, the burden of medication use has also grown with polypharmacy. In this regard, cardiovascular patients are subjected to polypharmacy for a longer period. OBJECTIVE:The present study aimed to assess the prevalence and predictors of polypharmacy in cardiovascular outpatients attending the University of Gondar Comprehensive specialized hospital, northwest Ethiopia. METHODS:A hospital-based cross-sectional study was employed at the University of Gondar Comprehensive Specialized Hospital from March 30 -May 30, 2019. The unique medical registration number of 424 patients was selected by using systematic random sampling to trace the medical chart and followed with an interview to explore the factors related to polypharmacy. All the Statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) version 22. Bivariable and multivariable logistic regressions were used to identify the predictors of polypharmacy in cardiovascular patients. RESULT:The mean age of the respondents was 56.83 ± 15.27 years. The mean number of medications per patient was 3.3±1.6. The prevalence of polypharmacy was 24.8% in cardiovascular outpatients while cardiovascular specific polypharmacy was 9.2%. Elderly (aged ≥ 65 years and above) patients were nearly two times more likely to had polypharmacy prescriptions with AOR: 1.97; 95% CI: 1.08-3.61; p = 0.027. Patients with abnormal weight (underweight AOR: 4.51; 95% CI: 1.42-14.30; p = 0.010, overweight AOR: 3.78; 95% CI: 1.83-7.83; p<0.001 and obese AOR: 5.1; 95% CI: 2.04-12.75 p<0.001) are more likely to have polypharmacy. Having a family history of CVD increase the likelihood of polypharmacy more than double; AOR: 2.40; 95% CI: 1.17-4.93; p = 0.017. A unit increase in Charlson comorbidity index score resulted in a nearly threefold likelihood of polypharmacy with AOR: 2.83; 95% CI 1.91-3.89; p<0.001. CONCLUSION:One out of four cardiovascular patients attending the outpatient clinic was on polypharmacy. The elderly age, abnormal body mass index (non-normal weight), family history of cardiovascular diseases and increasing Charlson morbidity index were the predictors of polypharmacy in cardiovascular patients. Clinicians should ensure the relevance of all prescribed medications and pharmaceutical care targeting at the prevention of inappropriate polypharmacy would be pivotal to reduce polypharmacy associated burdens.
Project description:ObjectivesCOVID-19 and the lockdowns have affected health care provision internationally, including medical procedures and methods of consultation. We aimed to assess the impact of COVID-19 at two Australian hospitals, focussing on cardiovascular hospital admissions, the use of community resources and cardiovascular risk factor control through a mixed methods approach.MethodsAdmissions data from the quaternary referral hospital were analysed, and 299 patients were interviewed from July 2020 to December 2021. With the admissions data, the number, complexity and mortality of cardiology hospital admissions, prior to the first COVID-19 lockdown (T0=February 2018-July 2019) were compared to after the introduction of COVID-19 lockdowns (T1=February 2020-July 2021). During interviews, we asked patients about hospital and community health resource use, and their control of cardiovascular risk factors from the first lockdown.ResultsAdmission data showed a reduction in hospital presentations (T0=138,099 vs T1=128,030) and cardiology admissions after the lockdown period began (T0=4,951 vs T1=4,390). After the COVID-19-related lockdowns began, there was an increased complexity of cardiology admissions (T0=18.7%, 95% CI 17.7%-19.9% vs T1=20.3%, 95% CI 19.1%-21.5%, chi-square test: 4,158.658, p<0.001) and in-hospital mortality (T0=2.3% of total cardiology admissions 95% CI 1.9%-2.8% vs T1=2.8%, 95% CI 2.3%-3.3%, chi-square test: 4,060.217, p<0.001). In addition, 27% of patients delayed presentation due to fears of COVID-19 while several patients reported reducing their general practitioner or pathology/imaging appointments (27% and 11% respectively). Overall, 19% reported more difficulty accessing medical care during the lockdown periods. Patients described changes in their cardiovascular risk factors, including 25% reporting reductions in physical activity.ConclusionWe found a decrease in hospital presentations but with increased complexity after the introduction of COVID-19 lockdowns. Patients reported being fearful about presenting to hospital and experiencing difficulty in accessing community health services.
Project description:The emergence of blends of synthetic cannabinoids (SC) is an alarming public health concern in Jordan and worldwide. This study aimed to assess the knowledge and perceptions of university students of SC. A cross-sectional study employing a self-administered questionnaire was used to collect data from 1,789 university students in Jordan. The questionnaire measured the knowledge and perceptions of students of SC. Bivariate and multivariate logistic regression were used to investigate the potential predictors of good knowledge of SC. Perceptions of students regarding SC use, prevalence and availability were investigated using principal component analysis. Self-reported familiarity with SC was high (92.5%), while good knowledge was only demonstrated by (33.6%) of students. Predictors of good knowledge included being a smoker (aOR = 1.369, 95% Cl = 11.041-1.871, p = .026), an alcohol user (aOR = 2.134, 95% CI = 1.362-3.346, p = .001), being informed by traditional media (aOR = 1.367, 95% CI = 11.113-1.679, p = .003), social media (aOR = 1.241, 95% CI = 1.161-1.403, p = .021) and self-familiarity with SC (aOR = 2.499, 95% CI = 1.518-4.114, p < .0001). Students perceived SC use to be prevalent and ethically unacceptable, for religious, social, and legal reasons. There were significant differences in the ethical perceptions against the use of SC detected by gender (p < .0001), smoking (p < .0001) or alcohol use (p = .001), and being informed by both traditional media (p-.001) and social media (p = .001), but there were no differences by the level of knowledge (p = .057). Those of good knowledge and those of low knowledge did not differ on their ethical perceptions of using SC. This study showed that there was a low level of knowledge regarding SC among university students in Jordan, which may play a role in the use of SC in the country. Herein, many opportunities exist for public health education to raise awareness against SC use.
Project description:BackgroundThe education and training of healthcare workers (HCWs) about pandemic response plans, infection control protocols (ICP), and precautions are critical for breaking the virus transmission chain. This study aimed to assess the knowledge of HCWs regarding the COVID-19 pandemic response plan and the ICP. Concomitantly, evaluating the effectiveness and impact of institutional measures, policies, and training programs.MethodsA cross-sectional study using an electronic questionnaire was used to collect data from 267 HCWs at a University-affiliated-hospital during April 2020.ResultsIn this study, 90.7% of participants were nurses and 66% were females. 60.3% of participants received specific training about caring for COVID-19 patients while at least 94.3% reviewed the pandemic response plan and ICP for COVID-19. 47.5% and 29.2% of participants provided direct care for suspected or confirmed COVID-19 patients, respectively. Between 85.7% and 100% of the participants answered all items correctly regarding the COVID-19 pandemic response plan, measures, and precautions. Furthermore, the correct answers were above 95% for each item.ConclusionHCWs have a high level of knowledge about the COVID-19 pandemic response plan and ICP. Training and disseminating updated plans and protocols in different methods such as an intranet and onsite training in addition to regular methods were very effective.
Project description:The use of e-cigarettes has been increasing in popularity among people, especially young adults. Assessing young individuals' perceptions of e-cigarettes can help to identify factors that may influence their decision to use e-cigarettes. To examine prevalence, perceptions, and knowledge of e-cigarettes among university students in Jordan, an observational cross-sectional study using an online self-administered questionnaire was conducted among students from public and private universities between October 2020 and January 2021. A total of 1259 university students completed the questionnaire. Approximately, 11% of participants reported e-cigarettes use. Among users, 26.5% used it for the purpose of smoking cessation, while 22% of them used it out of curiosity, and 20.5% used it as they believed it is less harmful than other tobacco products. Multivariate analysis showed that conventional cigarette smokers were independently associated with a better knowledge about e-cigarettes (OR = 1.496, 95CI% = 1.018-2.197, p-value = 0.040). In addition, medical students showed a significantly better knowledge compared to non-medical students (OR = 1.710, 95CI% = 1.326-2.204, p-value = <0.001). In Jordan, e-cigarettes use is less popular compared to other countries. Nonetheless, educational interventions are needed to correct misconceptions about e-cigarettes among young adults.
Project description:Introduction:As hypertension is a chronic cardiovascular disease that contributes to a high proportion of morbidity and mortality worldwide, favorable knowledge is crucial to control it. Objective:The objective of this study was thus to assess knowledge and associated factors of blood pressure control among hypertensive patients at the chronic illness follow-up Clinic of the University of Gondar comprehensive-specialized hospital, Gondar, Ethiopia. Methods:An institution-based cross-sectional study was conducted from March to April 2018. A systematic random sampling technique was used to select participants. Bi-variable and multivariable logistic regressions were done to assess the relationship between dependent and independent variables. The adjusted odds ratio with a 95% confidence interval was used to determine the presence and strength of association between covariates and the outcome variable. Results:A total of 404 participants took part in the study with a response rate of 97.3%. The overall good knowledge about blood pressure control was 51.7% (95% CI=46.3-56.8). Females were 3.79 (AOR= 3.79, 95% CI: (1.55, 9.28)) more knowledgeable about blood pressure control than males. In the multivariable analysis, the odds of being knowledgeable were 2.80 (AOR= 2.80, 95% CI (1.44, 5.46)), 8.05 (AOR=8.05, 95% CI (2.93, 22.10)), and 7.53 (AOR=7.53, 95% CI (2.52, 22.49)) for can read and write, secondary, preparatory and above education, respectively, compared to cannot read and write. Occupation was significantly associated with the knowledge of plod pressure control. For example, merchants 7.66 (AOR=7.66, 95% CI (3.01, 19.47)), government employee 6.33 (AOR=6.33, 95% CI (1.90, 22.07)), and self-employed 4.58 (AOR=4.58, 95% CI (1.80, 11.70)) times more likely to be knowledgeable than farmers, respectively. Participants with family history of hypertension were 2.36 (AOR=2.36, 95% CI (1.42, 3.92)) times more knowledgeable than their counterparts. Conclusion:In this study, knowledge of blood pressure control was lower compared to the finding of a study done at Bishoftu hospital, Ethiopia. But it is higher than studies in other African countries. Both pharmacological and non-pharmacological awareness is vital for blood pressure control.
Project description:BackgroundInfant sunlight exposure in their early infancy is essential for the cutaneous synthesis of vitamin D. Vitamin D deficiency is highly prevalent due to inadequate exposure to sunlight. In Ethiopia, one in thirteen children had rickets, which could be prevented by sunlight exposure or supplementation. This study aimed to identify the practice of infants' sunlight exposure and associated factors among mothers attending the Expanded program immunization unit of Wolkite University Specialized Hospital.MethodThis study employed an institutional-based cross-sectional study design to collect data. Data were collected from 220 mothers using an interviewer-administered questionnaire. The study employed a systematic random sampling technique to reach the study participants. The collected data were entered into a computer using the software Epidata 3.1 version and exported to SPSS version 23 for statistical analysis. Descriptive and inferential analysis was conducted. Logistic regression analysis was done, and a statistical association was declared at a p-value < 5% and a 95% confidence interval(CI). Then the results were presented using a frequency table, figures, and description.ResultA total of 220 infant-coupled mothers who visited the Expanded program immunization unit were included in the study. According to the current study, 67.3% of mothers had good practice with infants' sunlight exposure. Mothers' practice of infant sunlight exposure was affected by age of mothers 30-34 years, [AOR = 3.10, 95%CI (1.13, 8.51)], and age ≥35 years, [AOR = 4.49, 95%CI (1.20, 16.86)], and living in urban, [AOR = 1.94, 95%CI (1.053, 3.57)].ConclusionThe current study showed that two-thirds (67.3%) of mothers had good practice of sunlight exposure to their infants. Factors that affect mothers' practice of infants' sunlight exposure are age and place of residence. Health professionals should provide health education for mothers on the benefits of infants' sunlight exposure.