Functional Status and Disability in Patients After Acute Stroke: A Longitudinal Study

2016 ◽  
Vol 25 (2) ◽  
pp. 144-151 ◽  
Author(s):  
Fidel López-Espuela ◽  
Juan Diego Pedrera-Zamorano ◽  
Pedro Enrique Jiménez-Caballero ◽  
José María Ramírez-Moreno ◽  
Juan Carlos Portilla-Cuenca ◽  
...  

Background Stroke is a major public health problem. Objective To use the Barthel Index to evaluate basic activities of daily living in stroke survivors and detect any predictors of functional outcome at 6 months after stroke. Methods In an observational longitudinal study, data were gathered on consecutive patients admitted to the comprehensive stroke unit at Hospital San Pedro de Alcantara, Cáceres, Spain. Sociodemographic and clinical data were obtained prospectively at hospital admission and during follow-up 6 months later. Information on type of stroke, score on the Barthel Index, findings from the neurological evaluation, and other relevant data were collected. Results Of 236 patients admitted, 175 participated in the study. Mean age was 69.60 (SD, 12.52) years, 64.6% were men, and mortality was 12.8%. Six months after experiencing a stroke, 84.8% of patients had returned to their own homes, 8.0% were institutionalized, and the others were residing at a family member’s home. Scores on the Barthel Index 6 months after stroke correlated with baseline scores on the National Institute of Health Stroke Scale (r = −0.424; P < .001) and with depressive mood 6 months after stroke (r = −0.318; P < .001). Age was negatively associated with Barthel Index scores at the time of hospital discharge and 6 months after stroke. Conclusions Functional status 6 months after stroke was influenced by age, sex, stroke severity, type of stroke, baseline status, mood, and social risk. Comorbid conditions, socioeconomic level, and area of residence did not affect patients’ functional status.

2019 ◽  
Vol 7 (5) ◽  
pp. 824-830 ◽  
Author(s):  
Mahdi Moshki ◽  
Abdoljavad Khajavi ◽  
Haydeh Hashemizadeh ◽  
Farveh Vakilian ◽  
Shima Minaee ◽  
...  

BACKGROUND: Heart failure (HF) is a major public health problem in different societies and has numerous impacts on quality of life (QOL). AIM: The present study was carried out with the aim to explore the experience of HF patients regarding the negative effects of the disease on their QOL. METHODS: In this qualitative exploratory study data collection was performed through face-to-face, semi-structured, in-depth interviews with 19 patients with HF, who were selected through purposive sampling method from April to September 2017. Data analysis was carried out based on the framework analysis method. RESULTS: The negative consequences of HF on QOL emerged in the form of 6 main themes including symptoms, disease complications, cognitive impairment, psychological distress, functional limitations and economic problems. Most of the participants (14 out of 19) assessed their QOL as well or very well. CONCLUSION: The majority of the patients in this study, despite the many negative impacts of HF, had a high QOL that could indicate their satisfaction and effective coping with HF by creating a positive outlook and the perceived positive effects of the disease.


Author(s):  
Hulisani Matakanye ◽  
Takalani Grace Tshitangano ◽  
Jabu Tsakani Mabunda ◽  
Thelmah Xavela Maluleke

Despite the implementation of global plans to end tuberculosis (TB), this disease remains a major cause of ill-health and is the second leading cause of death. In 2019, globally, an estimated 10.0 million people fell ill and about 1.4 million died of TB. During the same year, South Africa was among the eight countries with the highest tuberculosis burden, contributing to two-thirds of the world’s total. Due to the high burden of the human immunodeficiency virus (HIV) epidemic, TB in South Africa is a major public health problem. Limpopo is amongst the provinces that are hardest hit by TB and HIV in South Africa. Therefore, using a quantitative descriptive design, this study assessed the knowledge, beliefs, and perceptions of TB and TB treatment amongst TB patients in the Limpopo Province. A systematic random sampling method was used to sample 207 TB patients who agreed in writing to be part of the study. Data were collected using a self-administered questionnaire, however, about 3.9% of participants who could not read were assisted by the main researcher and health professional. About 33% of the participants with primary education were also assisted to clarify any questions that were not clear to them. Data were analyzed using the Statistical Package for Social Sciences® version 26.0. Validity and reliability of the instrument was ensured, and ethical considerations were observed in this study. The research findings revealed that about 93.25% respondents only came to know they had TB after diagnosis. About 75% indicated that they had visited faith healers and only 2% acknowledged that they had visited traditional healers after diagnosis. A total of 76% of the respondents stated that they strongly believed in their culture and religion. These findings highlight the need for health education efforts to strengthen accurate information to improve TB knowledge and correct misconceptions about TB among patients within the community.


Author(s):  
Siavaah CHALABIANI ◽  
Mina KHODADAD NAZARI ◽  
Nada RAZAVI DAVOODI ◽  
Mahdi SHABANI ◽  
Masoud MARDANI ◽  
...  

Background: Brucellosis as a zoonotic disease is widespread among human and animal that it continues to be a major public health problem. Due to the shortage of recent epidemiologic data regarding the brucellosis distribution in Iran, we convinced to evaluate the prevalence of brucellosis in provinces of Iran. Methods: In this descriptive study, data were collected from brucellosis suspected patients referred to Noor Pathobiology Laboratory, Tehran, Iran from 18 out of 31 provinces of Iran during 2013-2015. Results: Overall, 2635 out of 17103 attending cases (15.4%) were recognized as brucellosis patients. The most prevalent rate was found in patients aged 20-39 yr old (41%) which of them 67% were male. Patients with brucellosis were significantly diagnosed in spring season (Apr to late May). Among included provinces, Hamadan Province had the highest (25%) prevalence followed by Markazi and Mazandaran with 24.7% and 22.5%, respectively. Conclusion: Brucellosis is still considered as an important infectious disease with a high prevalence in many provinces of Iran. It is necessary to implement a national brucellosis control program by increasing medical education, public knowledge and various controlling plans for preventing, controlling and eradicating of brucellosis.  


Author(s):  
Baisakhi Maji ◽  
Sumana Samanta ◽  
Sreetama Banerjee ◽  
Tanjib Hassan Mullick ◽  
Sudhanshu Saharay ◽  
...  

Background: Eclampsia is a multi–system disorder with complex pathogenesis, causing 12% of global maternal deaths. It is a major public health problem specially in developing countries, contributing to maternal and perinatal morbidity as well as mortality. Majority of them are preventable if managed timely, promptly and with expertise. The objectives of the study were to identify the incidence of eclampsia in R G Kar Medical College and Hospital as well to identify the determinants of feto-maternal outcome.Methods: A retrospective, record-based cross-sectional study was conducted in an urban tertiary care teaching hospital. There were 354 pregnant women with eclampsia admitted and delivered during the study period which was 1st January-31st December’2015. Complete enumeration was done to get the sample for the study. Data were retrieved from eclampsia registers and log books of delivery kept in the labour room and hospital record section. After wards it was analysed with the help of SPSS 20.0 version to get different inferential statistics.Results: Incidence of eclampsia in that hospital in 2015 was18.4/1000 deliveries. Almost 72% patients had ante-partum eclampsia and rest had post-partum eclampsia. Emergency caesarean section was the most common (62.14%) mode of delivery. Perinatal mortality was found in 5.6% of the eclampsia patients. Majority (65%) of the babies delivered belonged to low birth weight. Muslim patients and the patients of gestational age more than 36 weeks had unfavourable outcome.Conclusions: There is need to educate and encourage the general public for antenatal care and institutional delivery. Along with this the socio-economic, cultural and educational status are to be uplifted for the improvement of the present scenario regarding eclampsia in our country.


2004 ◽  
pp. U141-U149 ◽  
Author(s):  
AR Ness

Childhood obesity is a major public health problem because the prevalence is increasing and because childhood obesity is associated with short- and long-term adverse consequences. By contributing to our understanding of the causes of childhood obesity epidemiological studies can help to inform preventive strategies. Prospective studies with all-of-life measures of exposures, objective measures of physical activity and more accurate measures of diet and body composition will be better able to identify modifiable environmental exposures that act cumulatively or at critical time periods across the lifecourse. The Avon Longitudinal Study of Parents and Children (ALSPAC) recruited around 14 000 pregnant women with estimated dates of delivery between 1991 and 1992. The children have been followed-up in detail ever since and now constitute probably the most intensively studied cohort of children ever recruited. Recent analyses have identified important modifiable risk factors and further analyses based on more accurate measures of diet, activity and body composition should provide further insights.


Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Annie Mino ◽  
Arnaud Bousquet ◽  
Barbara Broers

The high mortality rate among drug users, which is partly due to the HIV epidemic and partly due to drug-related accidental deaths and suicides, presents a major public health problem. Knowing more about prevalence, incidence, and risk factors is important for the development of rational preventive and therapeutic programs. This article attempts to give an overview of studies of the relations between substance abuse, suicidal ideation, suicide, and drug-related death. Research in this field is hampered by the absence of clear definitions, and results of studies are rarely comparable. There is, however, consensus about suicidal ideation being a risk factor for suicide attempts and suicide. Suicidal ideation is also a predictor of suicide, especially among drug users. It is correlated with an absence of family support, with the severity of the psychosocial dysfunctioning, and with multi-drug abuse, but also with requests for treatment. Every clinical examination of a drug user, not only of those who are depressed, should address the possible presence of suicidal ideation, as well as its intensity and duration.


2018 ◽  
Vol 7 (4) ◽  
pp. 197-201
Author(s):  
Mir M Hassan Bullo ◽  
Mirza Amir Baig ◽  
Jawad Faisal Malik ◽  
Ejaz Ahmad Khan ◽  
Muazam Abbas Ranjha ◽  
...  

Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Epi survey form. Blood samples were sent for laboratory confirmation. Results: A total of eight cases were identified through active case finding while three were reported by local practitioner. Mean age of cases were 20 months (range 8-36 months). Severely affected age-group was 1-2 years with attack rate of 46%. Around two-third (64%) of cases and a few (16%) of controls were unvaccinated against measles. Contact with measles patient [OR 25.2, CI 3.9-160.1, P=0.00], unvaccinated children [OR 9.2 CI 2.12-40.4, P=0.000], social misconception regarding vaccination [OR 7.8 CI 1.42-42.6, P=0.00], and distance from healthcare facility [OR 5.7 CI 1.15-28.35, P=0.02] were significant risk factors. Vaccine efficacy was 90%. Conclusion: Main reasons of the outbreak were contact with the cases, and low vaccination status. We recommended comprehensive measles vaccination and community awareness sessions. On our recommendations district health authority Islamabad carried out mop up of whole area.


2018 ◽  
Vol 4 (4) ◽  
pp. 513
Author(s):  
Rakhshan .

Mosquitoes are vectors of many pathogens which causes serious human diseases like Malaria, Filariasis, Japanese encephalitis, Dengue fever, Chikungunya, Yellow fever and Zika virus which constitute a major public health problem globally. Mosquito borne diseases cause high level of economic impact all over the world and result in millions of death every year. They infect around 700,000,000 people annually worldwide and 40,000,000 only in India. The continuous use of synthetic pesticides to control vector mosquitoes has caused physiological resistance, toxic effect on human health, environmental pollution and addition to these, its adverse effects can be observed on non-target organisms. Synthetic chemical pesticides have been proved to be effective, but overall in last 5 decades indiscriminate use of synthetic pesticides against vector borne disease control have originated several ecological issues due to their residual accumulation and development of resistance in target vectors and their chronic effects.


2012 ◽  
Vol 5 (1) ◽  
pp. 81-91
Author(s):  
Z Rahman ◽  
KK Karmaker ◽  
M Ahmed ◽  
M Aziz ◽  
S Chowdhury ◽  
...  

Hypertension is a major public health problem. Despite the increasing awareness of hypertension and its implications among patients and treating physicians, the prevalence of resistant hypertension    remains high.Resistant hypertension define as blood pressure that remains elevated above treatment goals despite administration of an optimal three drug regimen that include a diuretic1 The prevalence of resistant    hypertension is projected to increase, owing to the aging population and increasing trends in obesity, sleep apnea, and chronic kidney disease. It is estimated that at least 10% of all patients with hypertension are resistant to existing drugs. Management of resistant hypertension must begin with  a careful evaluation of the patient to confirm the diagnosis and exclude factors associated with “pseudo-resistance,” such as improper BP measurement technique, the white-coat effect, and poor patient adherence to life-style and/or antihypertensive medications. Despite the use of the appropriate dose and type of diuretic to overcome the management of resistant hypertension, we can’t achieve our goal. But there is at least two devices namely Baroreflex Activation Therapy and Catheter-based  renal sympathetic denervation make the new hope for the patient with resistant hypertension DOI: http://dx.doi.org/10.3329/cardio.v5i1.12278 Cardiovasc. j. 2012; 5(1): 81-91


2020 ◽  
Vol 38 (3) ◽  
pp. 145-149
Author(s):  
Md Golam Mustafa ◽  
Md Shahinul Alam ◽  
Md Golam Azam ◽  
Md Mahabubul Alam ◽  
Md Saiful Islam ◽  
...  

Worldwide, hepatitis B virus (HBV) infection is still a major public health problem. Bangladesh having a large burden of HBV infection, should be a major contributor towards it’s elimination by 2030. The country has been making progress in reducing incidence of HBV infection during the past decades. The progresses are mainly due to large vaccination coverage among children and large coverage of timely birthdose vaccine for prevention of mother-to-child transmission of HBV. However, Bangladesh still faces challenges in achieving target of reduction in mortality from HBV. On the basis of targets of the WHO’s Global health sector strategy on viral hepatitis 2016–2021, we highlight priorities for action towards HBV elimination. To attain the target of reduced mortality we propose that, the service coverage targets of diagnosis and treatment should be prioritized along with vaccination. Firstly, improvements are needed in the diagnostic and treatment abilities of medical institutions and health workers. Secondly, the government needs to reduce the costs of health care. Thirdly, better coordination is needed across existing national program and resources to establish an integrated system for prevention, screening, diagnosis and treatment of HBV infection. In this way, we can make progress towards achieving the target of eliminating HBV from Bangladesh by 2030 J Bangladesh Coll Phys Surg 2020; 38(3): 145-149


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