Volume 2 Issue 1
Research Article: Influence of C-reactive protein and Metabolic Syndrome on the Prevalence of Subclinical Left Ventricular Diastolic Dysfunction
Jani Ylber1*, Rexhepi Atila2, Pocesta Bekim3, Xhunga Sotiraq4, Serani Artur4, Ferati Fatmir4, Lala Dali5, Zeqiri Agim6, Mirto Arben7 and Ahmet Kamberi Ahmet8
Background: Metabolic Syndrome (MetS) has been associated with subclinical changes in cardiac structures and function, including Left Ventricular Diastolic Dysfunction (LVDD). Subclinical LVDD, is strong risk factors for the future development of clinical Heart Failure (HF). Inflammation has a pivotal role in cardiac remodeling and markers of systemic inflammation such as C-Reactive Protein (CRP) independently predict future Heart Failure (HF).
Objective: We sought to determine the influence of CRP and MetS on the prevalence of subclinical LVDD in the patient with MetS.
Methods: We conducted a multicenter observational cross-sectional study. Recruited were 550 consecutive participants, 450 with MetS (mean age 50 years, 49% women) stratified by presence of subclinical LVDD (179 participants with MetS and subclinical LVDD and 271 participants with MetS and normal LVDF), and 100 controls (no risk factors for MetS (mean 51 years, 57% women), who attended outpatient visits at general cardiology Health Care Clinics in 6 town on western region Republic of Macedonia, during 1 calendar year. Participants underwent echocardiography with tissue Doppler imaging.
Results: The overall prevalence of subclinical LVDD in participants with MetS was (39, 7%; p = 0.0005). The prevalence of subclinical LVDD in participants with MetS and CRP levels above 3.0 mg/ L was higher when compared with participants with MetS and CRP levels below 3.0 mg/ L{(117 vs. 63 (65% vs. 35%) p = 0.001)}.
CRP levels, was significantly higher in the group with MetS and subclinical LVDD when compared with MetS and normal diastolic function group. (6.6 ± 1.4 vs. 3.7 ± 0.6 p = 0.000).
There were significant association of increased levels of CRP and: subclinical LVDD (OR = 2.171; 95% CI 1.869-2.522), increased number of risk factor for MetS (OR = 1.7; OR = 2.3), Body Mass Index (BMI). (OR = 1.5) and presence of Diabetes Mellitus Type 2{(T2DM), (OR = 1.2)}.
Conclusions: Patients with MetS and higher levels of CRP have higher prevalence of subclinical LVDD than patients with MetS and lower levels of CRP. CRP a marker of inflammation, may be a marker of subclinical LVDD in MetS patients, underlining the importance of inflammation in evolution of MetS to subclinical cardiac damage.
Keywords: C-reactive protein; Subclinical left ventricular diastolic dysfunction; Metabolic Syndrome
Cite this Article: Ylber J, Atila R, Bekim P, Sotiraq X, Artur S, et al. Influence of C-reactive protein and Metabolic Syndrome on the Prevalence of Subclinical Left Ventricular Diastolic Dysfunction. American J Epidemiol Public Health. 2018;2(1): 027-033
Published: 16 November 2018
Research Article: Accelerated Failure Time Model with Application to Data on Tuberculosis/Hiv Co-Infected Patients in Nigeria
Ogungbola OO1*, Akomolafe AA1 and Musa AZ2
In this research, we considered the Accelerated Failure Time (AFT) model for analyzing survival data on Tuberculosis/HIV co-infected patients in Nigeria We apply the methods to a cohort of these patients managed in tertiary Directly Observed Treatment Short Course (DOTS) Centre, Nigerian Institute of Medical Research (NIMR) for the period of 6-8 months. The effect of the accelerated failure time model was examined in determining the time to sputum smear and culture conversion following initiation of DOTS treatment and study the factors that influence it on TB patients who are co-infected with HIV. The research established that the model provides a better description than other commonly used models of the dataset because it allows prediction of Hazard function, survival functions as well as time ratio. AFT model was able to prepare some insights into the form of the baseline hazard. The result revealed that the weibull AFT model provided a better fit to the studied data. Hence, it is better for researchers of TB/HIV co-infection to consider AFT model even if the proportionality assumption is satisfied.
Keywords: Accelerated failure test model; Survival ratio; TB/HIV infection; Absolute lymphocyte count; Body mass Index
Cite this Article: Ogungbola OO, Akomolafe AA, Musa AZ. Accelerated Failure Time Model with Application to Data on Tuberculosis/Hiv Co-Infected Patients in Nigeria. American J Epidemiol Public Health. 2018;2(1): 021-026.
Published: 03 September 2018
Research Article: Population Health a Tool for Enhanced Aggregate Health performance in Emerging Economies
Kingsley Akarowhe*
Government of every nation of the world seeks to improve the health condition of their country aggregately. This over time induces them to adopt various health terminologies such as community health and public health for their health sector. Government of the emerging economies of the world (developing countries), often concentrate their interest on either public health or community health, but adoption of public health and community health by these governments seems to yield little in aggregate health performance in their country. Inspite of this bedeviling fact, governments of emerging economies have no shifted their attention from either public health or community health. It is due to this undesirable situation that the paper sought to enlighten governments of these emerging economies on the need for them to shifts their attention to population health as a means to enhanced aggregate health performance in their respective countries. The paper focused on the concept of population health; benefits of adopting population health; importance of population health as compared to community health and public health; difference in design/content of population health practices from community health practices and public health practices; how current measurements using community and public health practices deter aggregate health performance in emerging economies; reasons for adoption of population health in emerging economies; evaluating population health; global variables for measuring population health; measuring population health; measuring community health, public health and population in emerging countries; reasons for measuring population health; tracking population health; potential limitations to population health conceptual framework; and strategies for effective and efficient population health in the emerging economies. It was recommended among others that training and retraining should be encouraged among person for population health, which will assist them to be equipped with the needed skills and competencies for them to effectively/efficiently perform their duties, so as to actualize the mandate of population health.
Keywords: Population health; Aggregate health performance; Emerging economies; Enhanced aggregate health performance
Cite this Article: Akarowhe K. Population Health a Tool for Enhanced Aggregate Health performance in Emerging Economies. American J Epidemiol Public Health. 2018;2(1): 014-020.
Published: 24 May 2018
Brenden A. Bedard1,4*, Kristine N. Voos2, Paul A. Pettit1,4, Connie L. Ferris3 and Sarah R. Balduf1
In July 2017, the Orleans County Health Department investigated a report of gastrointestinal illness from a corporate picnic that was catered. An environmental and epidemiological investigation identified 28 individuals who met the outbreak case definition. A detailed questionnaire based on the food that was served at the picnic was administered to the corporate employees that attended the picnic and respondent data was statistically analyzed.
Cite this Article: Bedard BA, Voos KN, Pettit PA, Ferris CL, Balduf SR. A Salmonellosis Heidelberg Outbreak Traced to Roast Beef Served By Caterer. American J Epidemiol Public Health. 2018;2(1): 010-013.
Published: 20 April 2018
Research Article: Depression, Gestational Diabetes Mellitus and the Impact on Pregnancy Outcomes: A Hospital based study from Bangladesh
Khurshid Natasha1-3*, AK Azad Khan2,3
Background: Data regarding Gestational Diabetes Mellitus (GDM) and Depression in Bangladesh are inadequate. Though we have sufficient information on depression and diabetes especially during pregnancy but information about depression and gestational diabetes and the consequences are very scanty in Bangladesh. This comparative, longitudinal research study was done to better understand the relationship between gestational diabetes and depression, and the outcome of pregnancy. GDM effects fetal growth is well stablish but whether and how depression aggravates the condition was another specific objective to find out from this study. Mode of delivery, fetal morbidity and mortality and postpartum depression as a consequent was also tried to explore. Moreover this study focused on other principal social factors which might have influence over this condition.
Methods: 748 pregnant women participated in the study (366 with GDM, 382 without GDM) among them 734 completed the whole. Depressive symptoms was scored following MADRS scale. To detect GDM, Blood glucose was measured following WHO and ACOG criteria. Delivery procedure, Complications, Birth weight and APGAR score at 1st and 5th minute were assessed for the outcome measurement.
Results: Prevalence of Post-Partum Depression (PPD) was 8.6% (lower than antenatal) and the mean depressive score was 18.63 ± 6.98 (more than antenatal). Six subjects experienced neonatal death. Prevalence of persistent diabetes after delivery was 1.6%. Prevalence of PPD was higher in groups; aged between 26-35 years (73%), housewives (71.4%), dependents (73%), coming from rich family (47.6%) and urban dwellers (71.4%). GDM subjects with PPD delivered slightly earlier (36.58 ± 1.19) than women without GDM and without PPD (37.35 ± 1.00). GDM and PPD both had significant associations (p < 0.001) with Gestational Age at delivery, Neonatal birth weight and APGAR scores.
Conclusion: This study supported the trend of PPD and GDM but need more qualitative and longer follow-up to specifically chalk-out the problem. As maternal health being the ultimate necessity to keep the future generation free of non-communicable diseases, developing countries should focus more on mental health.
Keywords: Pregnant mother; Depression; Postpartum depression; Gestational Diabetes Mellitus; Pregnancy outcome; Neonate; Bangladesh.
Cite this Article: Natasha K, Azad Khan AK. Depression, Gestational Diabetes Mellitus and the Impact on Pregnancy Outcomes: A Hospital based study from Bangladesh. American J Epidemiol Public Health. 2018;2(1): 001-009.
Published: 28 March 2018
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