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Issa R, Nazir S, Khan Minhas AM, Lang J, Ariss RW, Kayani WT, Khalid MU, Sperling L, Shapiro MD, Jneid H, Gupta R. Demographic and regional trends of peripheral artery disease-related mortality in the United States, 2000 to 2019. Vasc Med 2023; 28:205-213. [PMID: 36597656 DOI: 10.1177/1358863x221140151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Peripheral artery disease (PAD) is a common progressive atherosclerotic disease associated with significant morbidity and mortality in the US; however, data regarding PAD-related mortality trends are limited. This study aims to characterize contemporary trends in mortality across sociodemographic and regional groups. METHODS The Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (CDC WONDER) was queried for data regarding PAD-related deaths from 2000 to 2019 in the overall sample and different demographic (age, sex, race/ethnicity) and regional (state, urban-rural) subgroups. Crude and age-adjusted mortality rates (CMR and AAMR, respectively) per 100,000 people were calculated. Associated annual percentage changes (APC) were computed using Joinpoint Regression Program Version 4.9.0.0 trend analysis software. RESULTS Between 2000 and 2019, a total of 1,959,050 PAD-related deaths occurred in the study population. Overall, AAMR decreased from 72.8 per 100,000 in 2000 to 32.35 per 100,000 in 2019 with initially decreasing APCs followed by no significant decline from 2016 to 2019. Most demographic and regional subgroups showed initial declines in AAMRs during the study period, with many groups exhibiting no change in mortality in recent years. However, men, non-Hispanic (NH) Black or African American individuals, people aged ⩾ 85 years, and rural counties were associated with the highest AAMRs of their respective subgroups. Notably, there was an increase in crude mortality rate among individuals 25-39 years of age from 2009 to 2019. CONCLUSION Despite initial improvement, PAD-related mortality has remained stagnant in recent years. Disparities have persisted across several demographic and regional groups, requiring further investigation.
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Affiliation(s)
- Rochell Issa
- Division of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH, USA
| | - Salik Nazir
- Division of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH, USA
| | | | - Jacob Lang
- Division of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH, USA
| | - Robert W Ariss
- Division of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH, USA
| | - Waleed Tallat Kayani
- Section of Interventional Cardiology, Baylor College of Medicine, Houston, TX, USA
| | - Mirza Umair Khalid
- Section of Interventional Cardiology, Baylor College of Medicine, Houston, TX, USA
| | - Laurence Sperling
- Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Michael D Shapiro
- Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Hani Jneid
- Section of Interventional Cardiology, Baylor College of Medicine, Houston, TX, USA
| | - Rajesh Gupta
- Division of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH, USA
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Ulhaq O, Ali SA, Khalid U, Kayani WT. Primary Renal Synovial Sarcoma Presenting as Metastatic Right Atrial Obstruction. Tex Heart Inst J 2022; 49:487441. [PMID: 36228326 PMCID: PMC9632382 DOI: 10.14503/thij-20-7386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Owais Ulhaq
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | | | - Umair Khalid
- Department of Medicine, Baylor College of Medicine, Houston, Texas
, Medical Care Line, Section of Cardiology, Michael E. DeBakey VA Medical Center, Houston, Texas
| | - Waleed Tallat Kayani
- Department of Medicine, Baylor College of Medicine, Houston, Texas
, Department of Medicine, Section of Cardiology, Ben Taub General Hospital, Houston, Texas
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Srinivasan A, Brown J, Krishnamani PP, Cornett B, Kesavan RB, Sarva ST, Raza SA, Kayani WT. Aspirin use is associated with decreased inpatient mortality in patients with COVID-19: A meta-analysis. Am Heart J Plus 2022; 20:100191. [PMID: 35971534 PMCID: PMC9365516 DOI: 10.1016/j.ahjo.2022.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/07/2022] [Accepted: 08/07/2022] [Indexed: 06/09/2023]
Abstract
Thromboembolism is a major cause of death in patients who suffer from COVID-19. Studies examining the effects of aspirin (ASA) on mortality relating to this phenomenon have showed conflicting results with varying degrees and certainties of evidence. We performed an aggregate data meta-analysis of fourteen studies encompassing 164,539 COVID-19 patients, which showed a reduced risk of in-hospital mortality associated with ASA use in eight studies that reported risk ratios (RR 0.90; 95 % CI 0.82-0.98; I2 = 27.33 %, P = 0.01), six studies that reported hazard ratios (HR 0.56; 95 % CI 0.41-0.76, P ≤ 0.01; I2 = 85.92 %) and pooled effect size (0.71; 95 % CI 0.59-0.85, P = 0.00, I2 = 91.51 %). The objective of this study is to report the association between low dose ASA and a reduced risk of in-hospital mortality in patients with COVID-19.
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Affiliation(s)
- Aswin Srinivasan
- Department of Internal Medicine, HCA Kingwood/University of Houston College of Medicine, Kingwood, TX, United States of America
| | - Jonathan Brown
- Department of Internal Medicine, HCA Kingwood/University of Houston College of Medicine, Kingwood, TX, United States of America
| | | | - Brendon Cornett
- Department of Biostatistics, HCA Kingwood/University of Houston College of Medicine, Kingwood, TX, United States of America
| | - Ramesh Babu Kesavan
- Department of Internal Medicine, HCA Kingwood/University of Houston College of Medicine, Kingwood, TX, United States of America
- Department of Pulmonary Medicine, HCA Kingwood/University of Houston College of Medicine, Kingwood, TX, United States of America
| | - Siva T Sarva
- Department of Internal Medicine, HCA Kingwood/University of Houston College of Medicine, Kingwood, TX, United States of America
- Department of Pulmonary Medicine, HCA Kingwood/University of Houston College of Medicine, Kingwood, TX, United States of America
| | - Syed Arman Raza
- Department of Internal Medicine, HCA Kingwood/University of Houston College of Medicine, Kingwood, TX, United States of America
- Department of Cardiology, HCA Kingwood/University of Houston College of Medicine, Kingwood, TX, United States of America
| | - Waleed Tallat Kayani
- Section of Cardiology, Baylor College of Medicine, Houston, TX, United States of America
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Khalid N, Ahmad SA, Butt N, Kayani WT. Transcatheter aortic valve implantation in patients with chronic obstructive pulmonary disease. Clin Cardiol 2022; 45:149. [PMID: 35189002 DOI: 10.1002/clc.23756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nauman Khalid
- Section of Interventional Cardiology, Saint Francis Medical Center, Monroe, Louisiana, USA
| | - Sarah Aftab Ahmad
- Section of Cardiothoracic Surgery, Saint Francis Medical Center, Monroe, Louisiana, USA
| | - Nausharwan Butt
- Section of Internal Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Waleed Tallat Kayani
- Section of Interventional Cardiology, Baylor College of Medicine, Houston, Texas, USA
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Ariss RW, Minhas AMK, Nazir S, Meenakshisundaram C, Ali MM, Ahuja KR, Grande RD, Ramanathan PK, Kayani WT, Sheikh M. Outcomes and Resource Utilization of Atrial Fibrillation Hospitalizations With Type 2 Myocardial Infarction. Am J Cardiol 2021; 152:27-33. [PMID: 34130825 DOI: 10.1016/j.amjcard.2021.04.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 12/20/2022]
Abstract
Scarce data exist on the prognostic impact of type 2 myocardial infarction (MI) in patients with AF. The Nationwide Readmission Database 2018 was queried for primary AF hospitalizations with and without type 2 MI. Complex samples multivariable logistic and linear regression models were used to determine the association between type 2 MI and outcomes (in-hospital mortality, index length of stay [LOS], hospital costs, discharge to nursing facility, and 30-day all-cause readmissions). Of 382,896 weighted primary AF hospitalizations included in this study, 7,375 (1.9%) had type 2 MI. AF with type 2 MI is associated with significantly higher in-hospital mortality (adjusted OR [aOR] 1.76; 95% CI 1.30 to 2.38), LOS (adjusted parameter estimate [aPE] 0.48; 95% CI 0.35 to 0.62), hospital costs (aPE 1307.75; 95% CI 986.05 to 1647.44), discharges to nursing facility (aOR 1.38; 95% CI 1.24 to 1.54), and 30-day all-cause readmissions (adjusted hazard ratio 1.17; 95% CI 1.07 to 1.27) compared to AF without type 2 MI. Heart failure, chronic kidney disease, neurologic disorders, and age (per year) were identified as independent predictors of mortality among AF patients with type 2 MI. In conclusion, type 2 MI in the setting of AF hospitalization is associated with high in-hospital mortality and increased resource utilization.
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Khalid N, Pandey Y, Khalid U, Kamran H, Wermers JP, Chhabra L, Alam M, Jneid H, Kayani WT. Modes of failure with fractional flow reserve guidewires: Insights from the manufacturer and user facility device experience database. World J Cardiol 2021; 13:223-229. [PMID: 34367506 PMCID: PMC8326154 DOI: 10.4330/wjc.v13.i7.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/26/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fractional flow reserve (FFR) measurement is commonly used in the cardiac catheterization laboratory to assess the functional significance of coronary arterial plaques. Robust real-world data on complications and modes of failure of FFR guidewires are limited.
AIM To characterize these outcomes by analyzing the post-marketing surveillance data from the United States Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database for commonly used FFR guidewires.
METHODS The MAUDE database was queried from January 2010 through April 2020 for 3 FFR guidewires [PressureWireTM X (Abbott), CometTM (Boston Scientific), and VerrataTM (Philips)] by searching for the following events: “Injury”, “malfunction”, “death”, and “other”. This yielded 544 reports. After excluding incomplete reports, 486 reports were analyzed.
RESULTS Guidewire tip fracture was the most commonly reported mode of failure, in 174 (35.8%) cases followed by guidewire kinking (n = 152, 31.3%), communication failure (n = 141, 29.0%), and shaft fracture (n = 67, 13.8%). In total, 133 (27.4%) device failures resulted in patient adverse events. The most common adverse event was retained guidewire tip, in 71 (53.4%) cases, followed by freshly deployed stent dislodgment (n = 26, 19.6%) and coronary artery dissection (n = 23, 17.3%). Seven deaths were reported.
CONCLUSION FFR guidewire failures can occur because of various mechanisms and cause patient adverse events. The MAUDE database serves as an important platform for improved collaboration among clinicians, device manufacturers, and regulators to improve device performance and optimize patient outcomes. Our analysis provides mechanistic insights of FFR guidewire failure and associated adverse events but cannot verify causality or provide a comparison among different guidewires.
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Affiliation(s)
- Nauman Khalid
- Department of Interventional Cardiology, St. Francis Medical Center, Monroe, LA 71201, United States
| | - Yagya Pandey
- Department of Internal Medicine, Baylor College of Medicine, Houston, TX 77030, United States
| | - Umair Khalid
- Department of Interventional Cardiology, Michael E. DeBakey VA Medical Center, Houston, TX 77030, United States
| | - Hassan Kamran
- Department of Interventional Cardiology, Baylor College of Medicine, Houston, TX 77030, United States
| | - Jason P Wermers
- Health Sciences, University of Maryland Graduate School, Baltimore, MD 21201, United States
| | - Lovely Chhabra
- Department of Cardiology, Westchester Medical Center Network Advanced Physician Services, New York, NY 12601, United States
| | - Mahboob Alam
- Department of Interventional Cardiology, Baylor College of Medicine, Houston, TX 77030, United States
| | - Hani Jneid
- Department of Interventional Cardiology, Michael E. DeBakey VA Medical Center, Houston, TX 77030, United States
| | - Waleed Tallat Kayani
- Department of Interventional Cardiology, Baylor College of Medicine, Houston, TX 77030, United States
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Khalid N, Case BC, Ahmad SA, Kayani WT. Intravascular Lithotripsy-Facilitated Carotid Interventions. J Endovasc Ther 2021; 28:486. [PMID: 33475029 DOI: 10.1177/1526602821989355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Nauman Khalid
- Section of Interventional Cardiology, Saint Francis Medical Center, Monroe, LA, USA
| | - Brian C Case
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Sarah Aftab Ahmad
- Section of Cardiothoracic Surgery, Saint Francis Medical Center, Monroe, LA, USA
| | - Waleed Tallat Kayani
- Section of Interventional Cardiology, Baylor College of Medicine, Houston, TX, USA
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Khalid N, Ahmad SA, Butt N, Kayani WT. Transcatheter aortic valve implantation in patients with chronic obstructive pulmonary disease. Clin Cardiol 2020; 44:1487. [PMID: 33258493 PMCID: PMC8571549 DOI: 10.1002/clc.23523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 11/05/2022] Open
Affiliation(s)
- Nauman Khalid
- Section of Interventional Cardiology, Saint Francis Medical Center, Monroe, Louisiana, USA
| | - Sarah Aftab Ahmad
- Section of Cardiothoracic Surgery, Saint Francis Medical Center, Monroe, Louisiana, USA
| | - Nausharwan Butt
- Section of Internal Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Waleed Tallat Kayani
- Section of Interventional Cardiology, Baylor College of Medicine, Houston, Texas, USA
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Affiliation(s)
- Nausharwan Butt
- Section of Internal Medicine, 8405MedStar Washington Hospital Center, Washington, DC, USA
| | - Awais Arshid
- 473270Ayub Teaching Hospital, Ayub Medical College, Abbottabad, Pakistan
| | - Hasan Javed
- Section of Cardiology, 8405MedStar Washington Hospital Center, Washington, DC, USA
| | - Waleed Tallat Kayani
- Section of Interventional Cardiology, 3989Baylor College of Medicine, Houston, TX, USA
| | - Sarah Aftab Ahmad
- Section of Cardiothoracic Surgery, St. Francis Medical Center, Monroe, LA, USA
| | - Nauman Khalid
- Section of Interventional Cardiology, St. Francis Medical Center, Monroe, LA, USA
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Butt N, Arshid A, Ahmad SA, Khalid N, Kayani WT. Cardiovascular complications in COVID-19. Am J Emerg Med 2020; 45:540. [PMID: 32713605 PMCID: PMC7369167 DOI: 10.1016/j.ajem.2020.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/08/2020] [Accepted: 07/11/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Nausharwan Butt
- Section of Internal Medicine, MedStar Washington Hospital Center, Washington, DC 20010, USA.
| | - Awais Arshid
- Ayub Teaching Hospital, Ayub Medical College, Abbottabad, Pakistan
| | - Sarah Aftab Ahmad
- Section of Cardiothoracic Surgery, St. Francis Medical Center, Monroe, LA 71201, USA
| | - Nauman Khalid
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA
| | - Waleed Tallat Kayani
- Section of Interventional Cardiology, Baylor College of Medicine, Houston, TX 77030, USA
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Khan A, Tansel A, White DL, Kayani WT, Bano S, Lindsay J, El-Serag HB, Kanwal F. Efficacy of Psychosocial Interventions in Inducing and Maintaining Alcohol Abstinence in Patients With Chronic Liver Disease: A Systematic Review. Clin Gastroenterol Hepatol 2016; 14:191-202.e1-4; quiz e20. [PMID: 26256464 PMCID: PMC4805368 DOI: 10.1016/j.cgh.2015.07.047] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 07/13/2015] [Accepted: 07/31/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS We conducted a systematic review of efficacy of psychosocial interventions in inducing or maintaining alcohol abstinence in patients with chronic liver disease (CLD) and alcohol use disorder (AUD). METHODS We performed structured keyword searches in PubMed, PsychINFO, and MEDLINE for original research articles that were published from January 1983 through November 2014 that evaluated the use of psychosocial interventions to induce or maintain alcohol abstinence in patients with CLD and AUD. RESULTS We identified 13 eligible studies that comprised 1945 patients; 5 were randomized controlled trials (RCTs). Delivered therapies included motivational enhancement therapy, cognitive behavioral therapy (CBT), motivational interviewing, supportive therapy, and psychoeducation either alone or in combination in the intervention group and general health education or treatment as usual in the control group. All studies of induction of abstinence (4 RCTs and 6 observational studies) reported an increase in abstinence among participants in the intervention and control groups. Only an integrated therapy that combined CBT and motivational enhancement therapy with comprehensive medical care, delivered during a period of 2 years, produced a significant increase in abstinence (74% increase in intervention group vs 48% increase in control group, P = .02), which was reported in 1 RCT. All studies of maintenance of abstinence (1 RCT and 2 observational studies) observed recidivism in the intervention and control groups. Only an integrated therapy that combined medical care with CBT produced a significantly smaller rate of recidivism (32.7% in integrated CBT group vs 75% in control group, P = .03), which was reported from 1 observational study. However, data were not collected for more than 2 years on outcomes of patients with CLD and AUD. CONCLUSIONS In a systematic analysis of studies of interventions to induce or maintain alcohol abstinence in patients with CLD and AUD, integrated combination psychotherapy with CBT, motivational enhancement therapy, and comprehensive medical care increased alcohol abstinence. No psychosocial intervention was successful in maintaining abstinence, but an integrated therapy with CBT and medical care appears to reduce recidivism.
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Affiliation(s)
- Anam Khan
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Aylin Tansel
- Section of Gastroenterology and Hepatology, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Donna L. White
- Section of Gastroenterology and Hepatology, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA,Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA,Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA, 5Texas Medical Center Digestive Disease Center, Houston, Texas, USA,Dan L. Duncan Cancer Center; Houston, Texas, USA,Center for Translational Research in Inflammatory Diseases (CTRID) at the Michael E. DeBakey VA, Houston, Texas, USA
| | | | - Shah Bano
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Jan Lindsay
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA,Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA, 5Texas Medical Center Digestive Disease Center, Houston, Texas, USA,Department of Psychiatry, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Hashem B. El-Serag
- Section of Gastroenterology and Hepatology, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA,Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA,Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA, 5Texas Medical Center Digestive Disease Center, Houston, Texas, USA,Dan L. Duncan Cancer Center; Houston, Texas, USA
| | - Fasiha Kanwal
- Section of Gastroenterology and Hepatology, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas; Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, and Texas Medical Center Digestive Disease Center, Houston, Texas; Dan L. Duncan Cancer Center, Houston, Texas.
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Kayani WT, Huang HD, Bandeali S, Virani SS, Wilson JM, Birnbaum Y. ST elevation: telling pathology from the benign patterns. Glob J Health Sci 2012; 4:51-63. [PMID: 22980232 PMCID: PMC4776946 DOI: 10.5539/gjhs.v4n3p51] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 03/19/2012] [Accepted: 03/11/2012] [Indexed: 12/20/2022] Open
Abstract
Benefits of early reperfusion in patients presenting with acute ST elevation myocardial infarction (STEMI) are well known. The American College of Cardiology / American Heart Association guidelines recommend triage decisions are made within 10 minutes of performing initial electrocardiogram (ECG). Since many patients presenting with ischemic symptoms may have ST elevation (STE) at baseline, not all STE signify transmural ischemia. Benign patterns can be easy to find in some cases. However, patients with benign STE at baseline (left ventricular hypertrophy, early repolarization pattern) may have ongoing ischemia and present with Non-ST elevation myocardial infarction (NSTEMI) or even STEMI superimposed on the benign pattern. The ability of clinicians to distinguish between ischemic and non ischemic STE varies widely and is affected by prevalence of such changes in patient population. More studies need to be done to delineate the criteria to clearly distinguish between ischemic and non ischemic ST elevation.
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Ladha A, Khan RS, Malik AA, Khan SF, Khan B, Khan IN, Kayani WT, Saleem S. The health seeking behaviour of elderly population in a poor-urban community of Karachi, Pakistan. J PAK MED ASSOC 2009; 59:89-92. [PMID: 19260571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To presents socio-demographic characteristics and health seeking behaviour of elderly and to determine frequency of Diabetes Mellitus and Hypertension in elderly population of a poor peri-urban community in Karachi, Pakistan. METHODS A cross-sectional study was conducted, targeting population aged 65 or above. A total of 438 respondents were interviewed after taking informed consent, between November 2005 and December 2005. Frequencies and Chi square values were calculated for different variables using SPSS 13.0. RESULTS Total population surveyed comprised of 438 elderly, 158 (36%) women and 280 (63.9%) men. Mean age for the population was 71.44 +/- 7.74. A total of 238 (54.3%) elderly were found to be economically active. More than half (n = 269, 61.4%) of the elderly were found to be illiterate. Only 72 (16.4%) of the elderly population were Diabetic and 132 (30.1%) were Hypertensive. Common symptoms that prompted elderly of Azam Basti to seek health care were fever (61.2%), generalized body aches (43.4%) and cough (40.4%). Over half of the (n = 269, 61.4%) responders reported factors which deterred them from seeking health care, out of which 62% reported financial constraint as the commonest factor. Deterrence from seeking health care was associated with illiteracy (p = 0.001) and living alone (p = 0.06). CONCLUSION The elderly population of this peri-urban community has financial constraints in seeking health care. Hypertension was found to be more prevalent among women as compared to men, ratio being 1:2. Less number of people knew they were diabetics; this might be attributed to ignorance and non-availability of investigations and screening.
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Affiliation(s)
- Abdullah Ladha
- Department of Community Health Sciences (CHS), The Aga Khan University Hospital/Medical College, Karachi, Pakistan
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