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Huq FN, Momenuzzaman NAM, Chowdhury AW, Hoque MM, Khan KN, Begum F, Shafique AM, Anis R, Rahman MA, Nahar S, Chakraborty S, Ahmad T, Khan TA, Ullah R, Rahman MM. Effect of telephone-monitored home-based cardiac rehabilitation exercise on functional capacity and quality of life in heart failure patients in a lower-middle-income country. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Chronic heart failure (CHF) prevails as one of the major cardiovascular diseases in lower-middle-income countries (LMICs) like Bangladesh. Home-Based Cardiac Rehabilitation (HBCR) is a cost-effective method of secondary prevention of chronic heart failure which, if provided, might not only improve the health status of the patients but might also reduce the financial and hospitalization burden on the health care system of these countries. The study aims to assess the scope and benefits of HBCR in such low resource settings.
Purpose
The study evaluates the effect of telephone-monitored HBCR exercise programme in improving the functional capacity and quality of life (QoL) in patients of CHF with reduced ejection fraction due to ischemic heart disease (IHD).
Method
This self-controlled interventional study was conducted from August 2019 to July 2020 at a heart failure clinic, a tertiary healthcare centre in Bangladesh. A total of 115 patients of CHF with ejection fraction <40% and in NYHA class II and III were included in the study according to selection criteria. The functional capacity of the patients was evaluated by NYHA classification and 6-minute walk test. The quality of life of the patients was evaluated by Minnesota Living with Heart Failure Questionnaire (MLHFQ). All patients were advised to perform HBCR exercise as per recommended guideline and were telephone-monitored 2-weekly. After the 3-months study period, the participants were divided into compliant and partial compliant groups based on their adherence to the guideline. Repeat evaluation of patients' condition was carried out. Results were then compared within the groups and data was analyzed through appropriate statistical methods.
Results
Significant improvement of NYHA class (p<0.05), and 6-minute walk test distance (6MWTD) (1102.01±215.90 feet vs 1243.30±217.86 feet; p<0.001) were noticed after the rehabilitation programme. Improvement of total MLHFQ score was also observed (35.53±14 vs 28.22±12.84; p<0.001) at 3-months follow up. The functional capacity and quality of life of the patients in both the compliant and partially compliant groups showed significant improvement after the rehabilitation programme (p<0.001); though no difference was found in the indicators when compared between compliant vs partially compliant groups after rehabilitation except for 6MWTD (1302.86±219.61 feet vs 1230.71±212.284 feet, p<0.001).
Conclusion
From the results, it can be concluded that any amount of routine exercise tends to improve quality of life and symptoms in patients of chronic heart failure with reduced ejection fraction. However, to achieve the best effect in functional capacity and overall health status, the addition of a structured exercise programme like HBCR can be beneficial for proper rehabilitation in low resource settings. Further validation of the results is recommended through randomized control trials in larger study groups.
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Affiliation(s)
- FN Huq
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | | | - AW Chowdhury
- Dhaka Medical College Hospital, Cardiology, Dhaka, Bangladesh
| | - MM Hoque
- Bangabandhu Sheikh Mujib Medical University (BSMMU), Biochemistry, Dhaka, Bangladesh
| | - KN Khan
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - F Begum
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - AM Shafique
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - R Anis
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - MA Rahman
- Sorkari Karmachari Hospital, Cardiology, Dhaka, Bangladesh
| | - S Nahar
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | | | - T Ahmad
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - TA Khan
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - R Ullah
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - MM Rahman
- Keraniganj Upazila Health Complex, Dhaka, Bangladesh
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Salman S, S A Shehata M, Ibrahim AM, Awad M, Sarsik S, El-Shirbiny H, Fathi M, Agha NY, Anis R, Abdel Daim MM. Efficacy of retinoids alone or in combination with other remedies in the management of warts: A systematic review and network meta-analysis. Dermatol Ther 2021; 34:e14793. [PMID: 33480148 DOI: 10.1111/dth.14793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 12/28/2020] [Accepted: 01/17/2021] [Indexed: 11/29/2022]
Abstract
The use of combined systemic retinoids and intralesional immunotherapy in the management of warts is still debatable without straightforward evidence. Through network meta-analysis, the current study evaluated the efficacy and safety of systemic retinoids alone or combined with other remedies in the treatment of warts. We searched six literature databases for clinical trials that compared systemic retinoids to local treatments or placebo in wart management. Outcomes were calculated as odds ratios (OR) with 95% confidence-interval. We used the R software to perform conventional and network meta-analyses (with a frequentist approach). Network meta-analysis of eight trials showed that oral acitretin plus intralesional Candida Ag (OR = 367.71), INF-α plus oral isotretinoin (OR = 223.77), oral acitretin (OR = 117), Candida Ag (OR = 91.93), oral isotretinoin (OR = 62.26) and topical isotretinoin (OR = 17.69) had higher complete recovery rates than placebo. Regarding the P-score, oral acitretin plus intralesional Candida Ag had the highest efficacy in achieving complete response (P-score = 0.88), followed by INF-α plus oral isotretinoin (P-score = 0.79), then oral acitretin (P-score = 0.60). Variable baseline characteristics and lack of data on some outcomes. The current study shows the efficacy for systemic retinoids in the treatment of warts, especially reluctant or recurrent types. Moreover, combinations of systemic retinoids with intralesional immunotherapy yield higher rates of complete clearance with lower recurrence.
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Affiliation(s)
- Samar Salman
- Faculty of Medicine, Department of Dermatology and Venereology, Tanta University Hospital, Tanta University, Tanta, Egypt
| | | | | | - Mina Awad
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sameh Sarsik
- Faculty of Medicine, Department of Dermatology and Venereology, Tanta University Hospital, Tanta University, Tanta, Egypt
| | | | - Mohamed Fathi
- Kasr Al-Ainy Medical School, Cairo University, Cairo, Egypt
| | | | - Ruba Anis
- Kasr Al-Ainy Medical School, Cairo University, Cairo, Egypt
| | - Mohamed M Abdel Daim
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia.,Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
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Salman S, Awad M, Sarsik S, Ibrahim AM, Fathi M, Agha NY, Anis R, El Ashal G, Salem ML. Treatment options for autoimmune bullous dermatoses other than systemic steroids: A systematic review and network meta-analysis. Dermatol Ther 2020; 33:e13861. [PMID: 32558137 DOI: 10.1111/dth.13861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/09/2020] [Accepted: 06/05/2020] [Indexed: 02/05/2023]
Abstract
Autoimmune blistering diseases can eventually cause life-threatening complications if left untreated. Although there is no cure for these bullous diseases; their therapy is based on suppressing the immune system to cease the de novo formation of the generated antibodies. The current study aimed to assess the safety and efficacy of using standing alone alternative therapies beyond systemic steroids for management of autoimmune bullous diseases. We searched six literature databases for both randomized and quasi-randomized clinical trials that assessed the efficacy of drugs other than systemic steroids in autoimmune bullous diseases. Outcomes were calculated as odds ratios with 95% confidence-interval. We used the R software to perform conventional and network meta-analyses with a frequentist approach. The network ranking order for 629 bullous pemphigoid patients, from the best to the worst was, clobetasol propionate cream (40 mg; (P-score = .87), clobetasol propionate cream (10-30 mg; P-score = .77), nicotinamide plus tetracycline (P-score = .56), steroids (P-score = .29) and doxycycline (P-score = .01). Limitations of this study are the small sample of the included studies except for blister trial and lack of randomization in most trials. To conclude, Combined doxycycline and nicotinamides are safer and more effective option for extensive bullous pemphigoid patients than the usual use of systemic steroids. For limited disease, topical corticosteroid (40 mg/d) use provides a safer and better response modality than the other proposed treatments.
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Affiliation(s)
- Samar Salman
- Department of Dermatology and Venereology, Tanta University Hospital, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mina Awad
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sameh Sarsik
- Department of Dermatology and Venereology, Tanta University Hospital, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Mohamed Fathi
- Kasr Al-Ainy Medical School, Cairo University, Cairo, Egypt
| | - Nadim Y Agha
- Kasr Al-Ainy Medical School, Cairo University, Cairo, Egypt
| | - Ruba Anis
- Kasr Al-Ainy Medical School, Cairo University, Cairo, Egypt
| | - Gehad El Ashal
- Kasr Al-Ainy Medical School, Cairo University, Cairo, Egypt
| | - Mohamed L Salem
- Immunology and Biotechnology Division, Zoology Department, Faculty of Science, Tanta University, Tanta, Egypt
- Center of Excellence in Cancer Research, Tanta University, Tanta, Egypt
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Ketata J, Hajer D, Messelmeni M, Anis R, Sayhi S, Bousetta N, Arfaoui B, Ajili F, Ben Abdelhafidh N, Louzir B, Mrissa R. Syndrome de Gougerot-Sjögren et Parkinsonisme. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Shaikh S, Rizvi S, Anis R, Shakil S. Prevalence of CTX-M resistance marker and integrons among Escherichia coli
and Klebsiella pneumoniae
isolates of clinical origin. Lett Appl Microbiol 2016; 62:419-27. [DOI: 10.1111/lam.12567] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 03/15/2016] [Accepted: 03/15/2016] [Indexed: 11/28/2022]
Affiliation(s)
- S. Shaikh
- Department of Biosciences; Integral University; Lucknow India
| | - S.M.D. Rizvi
- Department of Biosciences; Integral University; Lucknow India
| | - R. Anis
- Department of Bio-engineering; Integral University; Lucknow India
| | - S. Shakil
- KACST Technology Innovation Center for Personalized Medicine at King Abdulaziz University; Jeddah Saudi Arabia
- Department of Medical Laboratory Technology; Faculty of Applied Medical Sciences; King Abdulaziz University; Jeddah Saudi Arabia
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