Category: Nevin Manimala

Wiad Lek. 2023;76(1):90-96. doi: 10.36740/WLek202301113.

ABSTRACT

OBJECTIVE: The aim: To determine the effectiveness of application of special therapeutic physical exercises to improve the indicators of body weight, anthropometric parameters and quality of life of obese women in the conditions of quarantine restrictions.

PATIENTS AND METHODS: Materials and methods: We examined 10 women aged 37 ± 5 years with obesity of various degrees, which was determined by the body mass index (BMI, kg/m2). All women for two months were involved in specially designed therapeutic exercises in the remote mode. Evaluation of the effectiveness of therapeu¬tic exercises use was performed using the survey method to determine the quality of life of obese women according to a short version of the questionnaire “The world health organization quality of life (WHOQOL-BREF)”; anthropometric measurements of body parts sizes; bioimpedance analysis of body weight composition; statistical methods of data processing.

RESULTS: Results: The effect of therapeutic gymnastics according to the proposed programme on the component composition of body weight of obese women was proved, which indicates a decrease in total body weight, reduction of body fat, increase in total body water and muscle component of body weight. It is shown that under the influence of corrective physical exercises the proportions of the body of women changed, as evidenced by the dynamics of the circumferences of all measured parts of the body of obese women. The improvement of women’s quality of life in all indicators was identified.

CONCLUSION: Conclusions: The use of special complexes of physical exercises, aimed at correction of the body weight of obese women,showed its significant effectiveness and led to the expected result.

PMID:36883496 | DOI:10.36740/WLek202301113

Wiad Lek. 2023;76(1):84-89. doi: 10.36740/WLek202301112.

ABSTRACT

OBJECTIVE: The aim: To evaluate and compare the prevalence of gingivitis according to the PMA index in children aged 5 to 6 years in preschool with ASD and without disorders (Kyiv, Ukraine).

PATIENTS AND METHODS: Materials and methods: Oral assessment was conduct on 69 children with ASD and 23 children without ASD aged 5 to 6 years. To determine the periodontal status it was used the papillary-marginal-alveolar index – PMA (according to Schour, Massler, in the modification of Parma).

RESULTS: Results: Children with ASD (18.84%) were 3.7 times less likely to have a clinically healthy periodontium than children without disorders (69.57%). The average PMA index among the main group was 6.8 times higher (15.31 ± 1.49%) than in the control group (2.25. ± 0.73%), but this difference was not statistically confirmed (p> 0.05). The most common pathology of periodontal tissues was chronic catarrhal gingivitis. 49.28% of children in main group with ASD had mild catarrhal gingivitis, while just 30.47% of children in control group without ASD had this pathology. Catarrhal moderate gingivitis was diagnosed in 31.88% of children from main group, symptoms of moderate gingivitis were not detected in the control group without disorders.

CONCLUSION: Conclusions: ASD children 5-6 years old may have major risk of developing such periodontal lesions as mild and moderate gingivitis. Further investigations need to be done to clarify prevalence of other oral pathologies in ASD individuals to understand the effect of the disorder on oral health.

PMID:36883495 | DOI:10.36740/WLek202301112

Wiad Lek. 2023;76(1):71-76. doi: 10.36740/WLek202301110.

ABSTRACT

OBJECTIVE: The aim: To detect the main problems regarding available high-quality stomatological service in Ukraine and define their main solutions.

PATIENTS AND METHODS: Materials and methods: The authors used general scientific methods of synthesis, generalization, scientific data interpreting, systemic approach method, medical statistic method, and analysis of the activity of state and private institutions dealing with stomatological service in Ukraine. The paper is based on the materials of a representative selective study of Ukrainian households, held by the State Committee of Statistics of Ukraine to study people’s self-estimation of their health and the availability of certain medical services.

RESULTS: Results: Most citizens of Ukraine (60-80%) are treated in the state/public healthcare sector. Though, during the last century, a decrease in dental visits per citizen in the state and public institutions has been noted, as well as a decrease of all medical service types’ volume, offered in the mentioned institutions. In Ukraine the observed trends are represented as the decrease in the network institutions number, insufficient budgeting of state/public medical institutions, prevailing commercial characteristics of stomatological service and people’s low income, which leads to decreased affordability, and quality of medical service, thus negatively affecting people’s health.

CONCLUSION: Conclusions: The fundamental studies of the quality assessment show that the medical service requires strong structure, process quality, and result quality. The quality of medical service organization is extremely important and it should be maintained high on all levels of management and treatment processes, regarding the conditions of medical process and resources of medical organizations. Medical service should be patient-centered. To solve the problem, the entire state system of quality management is required in Ukraine.

PMID:36883493 | DOI:10.36740/WLek202301110

Wiad Lek. 2023;76(1):52-57. doi: 10.36740/WLek202301107.

ABSTRACT

OBJECTIVE: The aim: To determine the opinion of 6th year students and interns in the specialty “General Practice – Family Medicine” on vaccination against COVID-19.

PATIENTS AND METHODS: Materials and methods: We conducted an anonymous online survey of 268 sixth-year students, interns of the first and second year of study in the specialty GP/FM. Research design: 1.Creating a pilot version of the questionnaire based on a literary search. 2.Approbation and discussion of the questionnaire in the focus group. 3.Online surveys of respondents and statistical processing of the data.

RESULTS: Results: The questionnaire was completed by 188 students, 48 interns in 1 year of study and 32 interns in 2 years of study. Among interns in 1st and 2nd year of study, the vaccination rate was 95.8% and 93.8%, respectively, among students – 71.3%, which is twice as much as among the general population. 30% did not receive the vaccine they considered most effective, but were vaccinated with the one that was available.

CONCLUSION: Conclusions: The level of vaccination against COVID-19 in future doctors was 78.3%. The most significant reasons for refusing COVID-19 vaccination were past illness (COVID-19) – 24%, fear of vaccination – 24%, uncertainty about the effectiveness of immunoprophylaxis – 17.2%. Reasons that stimulated vaccination: the desire to protect against severe COVID-19 – 62.8%, the need to work in the medical field – 49.5%, the desire to protect others from the risks of COVID-19 infection – 38%.

PMID:36883490 | DOI:10.36740/WLek202301107

Wiad Lek. 2023;76(1):35-40. doi: 10.36740/WLek202301104.

ABSTRACT

OBJECTIVE: The aim: To determine the features of daily shifts in blood pressure (BP), the influence of the presence of rheumatoid arthritis (RA) on BP control and identify factors that affect BP among patients with RA in combination with resistant hypertension (RH).

PATIENTS AND METHODS: Materials and methods: All material for writing this scientific work were the results of a comprehensive survey of 201 people with RH and RA, hypertension (H) and RA, RA without H, H without RA and relatively healthy individuals. A laboratory study was performed: rheumatoid factor, C-reactive protein (CRP), K+ serum, and creatinine levels. All patients underwent office BP measurement and ambulatory BP monitoring for 24 hours. Statistical processing of the study results was carried out using “IBM SPSS Statistics 22”.

RESULTS: Results: Among patients with RA in combination with RH non-dippers (38.7%) are the most common type of BP profile. Patients with RH in combination with RA are characterized by an increase in BP more at night (p <0.003), which corresponds to the high frequency of night-peackers (17.7%). The presence of RA determines worse control of diastolic BP (p <0.01) and more vascular overload on organs and systems during the night (p <0.05).

CONCLUSION: Conclusions: An increase in BP in patients with RA in combination with RH is more significant at night, characterized by poorer BP control and greater vascular load at night indicating the need for tighter control of BP during sleep. Non-dippers are most often detected among patients with RA in combination with RH, which is prognostically unfavorable for the development of nocturnal “vascular accidents”.

PMID:36883487 | DOI:10.36740/WLek202301104

J Hypertens. 2023 Mar 2. doi: 10.1097/HJH.0000000000003394. Online ahead of print.

ABSTRACT

PURPOSE: To explore the predictive value of liver fibrosis scores [fibrosis-4, AST/platelet ratio index, BAAT score (BMI Age ALT TG), and BARD score (BMI AST/ALT Ratio Diabetes)] for the risk of cardiovascular disease (CVD) in a hypertensive population.

METHODS: A total of 4164 hypertensive participants without history of CVD were enrolled in the follow-up. Four liver fibrosis scores (LFSs) were used, including the fibrosis-4 (FIB-4), APRI, BAAT score, and BARD score. The endpoint was CVD incidence which was defined as stroke or coronary heart disease (CHD) during the follow-up period. Cox regression analyses were used to calculate hazard ratios between LFSs and CVD. Kaplan-Meier curve was used to show the probability of CVD in different levels of LFSs. Restricted cubic spline further explored whether the relationship between LFSs and CVD was linear. Finally, we assessed the discriminatory ability of each LFS for CVD was assessed using C-statistics, net reclassification index (NRI), and integrated discrimination improvement (IDI).

RESULTS: During a median follow-up time of 4.66 years, 282 hypertensive participants had CVD. Kaplan-Meier curve showed that four LFSs were associated with CVD and high levels of LFSs significantly increase the probability of CVD in hypertensive population. In the multivariate Cox regression analysis, the adjusted hazard ratios for four LFSs were 3.13 in FIB-4, 1.66 in APRI, 1.47 in BAAT score, and 1.36 in BARD score. Moreover, after adding LFSs to original risk prediction model, we find that all four new models have higher C-statistics of CVD than the traditional model. Furthermore, the results of both NRI and IDI were positive, indicating that LFSs enhanced the effect on the prediction of CVD.

CONCLUSIONS: Our study showed that LFSs were associated with CVD in hypertensive populations in northeastern China. Furthermore, it suggested that LFSs could be a new tool for identifying patients at high risk of primary CVD in a hypertensive population.

PMID:36883472 | DOI:10.1097/HJH.0000000000003394

J Hypertens. 2023 Mar 2. doi: 10.1097/HJH.0000000000003400. Online ahead of print.

ABSTRACT

OBJECTIVES: It has been reported that an increase in arterial stiffness precedes an increase in blood pressure (BP) in the general population. Whether BP lowering results from of reducing arterial wall or vice versa in antihypertensive treatment is unclear. This study aimed to investigate the association between arterial stiffness and BP in patients with treated hypertension.

METHODS: This study included 3277 participants who were treated with antihypertensive agents and with repeated measurements of branchial-ankle pulse wave velocity (baPWV) and BP during 2010-2016 from the Kailuan study. Temporal relation between baPWV and BP was assessed by cross-lagged path analyses.

RESULTS: After adjustment for potential confounders, the standard regression coefficient from baseline baPWV to follow-up SBP was 0.14 [95% confidence interval (95% CI), 0.10-0.18], which was significantly greater than that from baseline SBP to follow-up baPWV (0.05; 95% CI, 0.02-0.08) (P < 0.0001 for difference). Similar results were observed for the cross-lagged analysis with changes of baPWV and mean arterial pressure. Further analysis showed that the yearly rate of change in SBP during the follow-up period significantly varied across increasing quartiles of baseline baPWV (P < 0.0001), whereas the yearly rate of change in baPWV showed a nonsignificantly varied trend across quartiles of baseline SBP (P = 0.2443).

CONCLUSION: These findings provided strong evidence that reduction in arterial stiffness through antihypertensive treatment could precede BP lowering.

PMID:36883462 | DOI:10.1097/HJH.0000000000003400

BJOG. 2023 Mar 8. doi: 10.1111/1471-0528.17447. Online ahead of print.

ABSTRACT

OBJECTIVE: physical and mental health of women prior to conception can have a significant impact on pregnancy and child outcomes. Given the rising burden of non-communicable diseases, the aim was to explore the relationship between mental health, physical health and health behaviour in women planning a pregnancy.

METHODS: cross-sectional analysis of responses from 131,182 women to a preconception health digital education tool, providing data on physical and mental health and health behaviour. Logistic regression was used to explore associations between mental health and physical health variables.

RESULTS: physical health conditions were reported by 13.1% and mental health conditions by 17.8%. There was evidence for an association between self-reported physical and mental health conditions (OR 2.22; 95% CI 2.14 to 2.3). Those with a mental health condition were less likely to engage with healthy behaviour at preconception such as folate supplementation (OR 0.89; 95% CI 0.86 to 0.92) and consumption of the recommended amount of fruit and vegetables (OR 0.77; 95% CI 0.74 to 0.79). They were more likely to be physically inactive (OR 1.14; 95% CI 1.11 to 1.18), smoke tobacco (OR 1.72; 95% CI 1.66 to 1.78) and use illicit substances (OR 2.4; 95% CI 2.25 to 2.55).

CONCLUSIONS: greater recognition of mental and physical co-morbidities is needed and closer integration of physical and mental healthcare in the preconception period, which could support people to optimise their health during this time and improve long term outcomes.

PMID:36883460 | DOI:10.1111/1471-0528.17447

J Hypertens. 2023 Mar 2. doi: 10.1097/HJH.0000000000003381. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Uncontrolled hypertension is a major risk factor for cardiovascular diseases (CVDs). The present study aimed to conduct a systematic review and meta-analysis to estimate the pooled prevalence of control status of hypertension in India.

METHODS AND RESULTS: We carried out systematic search (PROSPERO No.: CRD42021239800) in PubMed and Embase published between April 2013 and March 2021 followed by meta-analysis with random-effects model. The pooled prevalence of controlled hypertension was estimated across geographic regions. The quality, publication bias and heterogeneity of the included studies were also assessed. We included 19 studies with 44 994 hypertensive population, among which 17 studies had low risk of bias. We found statistically significant heterogeneity (P ≤ 0.05) and absence of publication bias among the included studies. The pooled prevalence of control status among patients with hypertension was 15% (95% CI: 12-19%) and among those under treatment was 46% (95% CI: 40-52%). The control status among patients with hypertension was significantly higher in Southern India 23% (95% CI: 16-31%) followed by Western 13% (95% CI: 4-16%), Northern 12% (95% CI: 8-16%), and Eastern India 5% (95% CI: 4-5%). Except for Southern India, the control status was lower among the rural areas compared with urban areas.

CONCLUSION: We report high prevalence of uncontrolled hypertension in India irrespective of treatment status, geographic regions and urban and rural settings. There is urgent need to improve control status of hypertension in the country.

PMID:36883453 | DOI:10.1097/HJH.0000000000003381

J Am Heart Assoc. 2023 Mar 8:e028290. doi: 10.1161/JAHA.122.028290. Online ahead of print.

ABSTRACT

Background Atrial fibrillation (AF) is the most common, clinically relevant arrhythmia in adults and associated with ischemic stroke and premature death. However, data are conflicting on whether AF is independently associated with risk of dementia, particularly in diverse populations. Methods and Results We identified all adults from 2 large integrated health care delivery systems between 2010 and 2017 and performed a 1:1 match of incident AF: no AF by age at index date, sex, estimated glomerular filtration rate category, and study site. Subsequent dementia was identified through previously validated diagnosis codes. Fine-Gray subdistribution hazard models were used to examine the association of incident AF (versus no AF) with risk of incident dementia, adjusting for sociodemographics and comorbidity and accounting for competing risk of death. Subgroup analyses by age, sex, race, ethnicity, and chronic kidney disease status were also performed. Among 196 968 matched adults, mean (SD) age was 73.6 (11.3) years, with 44.8% women, and 72.3% White. Incidence rates (per 100 person-years) for dementia over a median follow-up of 3.3 (interquartile range, 1.7-5.4) years were 2.79 (95% CI, 2.72-2.85) and 2.04 (95% CI, 1.99-2.08) per 100 person-years in persons with versus without incident AF, respectively. In adjusted models, incident AF was associated with a significantly greater risk of diagnosed dementia (subdistribution hazard ratio [sHR], 1.13 [95% CI, 1.09-1.16]). With additional adjustment for interim stroke events, the association of incident AF with dementia remained statistically significant (sHR, 1.10 [95% CI, 1.07-1.15]). Associations were stronger for age <65 (sHR, 1.65 [95% CI, 1.29-2.12]) versus ≥65 (sHR, 1.07 [95% CI, 1.03-1.10]) years (interaction P<0.001); and those without (sHR, 1.20 [95% CI, 1.14-1.26]) versus with chronic kidney disease (sHR, 1.06 [95% CI, 1.01-1.11]; interaction P<0.001). No meaningful differences were seen by sex, race, or ethnicity. Conclusions In a large, diverse community-based cohort, incident AF was associated with a modestly increased risk of dementia that was more prominent in younger patients and those without chronic kidney disease but did not substantially vary across sex, race, or ethnicity. Further studies should delineate mechanisms underpinning these findings, which may inform use of AF therapies.

PMID:36883422 | DOI:10.1161/JAHA.122.028290