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Table of Contents
April-June 2018
Volume 7 | Issue 2
Page Nos. 39-83
Online since Friday, March 23, 2018
Accessed 68,268 times.
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EDITOR’S PAGE
Editor's Page April 2018
p. 39
Ravi R Kasliwal
DOI
:10.4103/2250-3528.228344
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ORIGINAL ARTICLES
Disease awareness, pharmacological adherence, and knowledge on further advanced therapeutic option among medically managed postmyocardial infarction patients: Experience from a Sri Lankan tertiary care cardiac center
p. 40
H G W A P Laksman Bandara, UI Hewarathna, T Kogulan, R M S P Karunarathne, NW Kodithuwakku, A Jegavanthan, A W D T Ambagaspitiya, D M J M H Ambagammana, R Tennakoon, SR Jayawickreme, S N B B Dolapihilla, G Weerakoon
DOI
:10.4103/JCPC.JCPC_28_17
Context:
Although most of the patients with ischemic heart diseases (IHD) are treated according to the guidelines, adequacy of the knowledge about their treatment is questionable.
Aims:
The study was aimed to explore the patients' awareness of their disease, state of pharmacological adherence, and the knowledge of their further advance therapeutic options on patients who were subjected to medical management following myocardial infarction (MI).
Settings and Design:
This study design was a cross-sectional descriptive study.
Subjects and Methods:
The study was conducted at Cardiology Unit, Teaching Hospital Kandy, Sri Lanka in 2015. Pretested interviewer-administered questionnaire and patients' health records were used to collect the data. All the patients who had MI and currently on medical management were included in the study. Patients who had a percutaneous coronary intervention and coronary artery bypass graft surgeries were excluded from the study.
Statistical Analysis Used:
Data analysis was performed by SPSS version 19 statistical package.
P
< 0.05 was considered statistically significant.
Results:
A total number of 103 patients with a mean age of 58 ± 9 years were included in the study. According to the four-item Morisky Medication Adherence Scale, 51.5% had high adherence to treatments, whereas moderate and low adherences were reported in 42.7% and 5.8%, respectively. The mean number of drugs in polymedicated patients was 7.5 ± 1.6. Only 28% had the awareness about the type of their IHD by pathophysiology in simple terms. Only 33% had discussed the necessity of advanced therapeutic options following their acute coronary event.
Conclusions:
Suboptimal drug adherence, lack of knowledge about their disease, and inadequacy of health communication are the major issues to be addressed in our post-MI patients.
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Diagonal earlobe crease: Prevalence and association with medical ailments
p. 49
Yugantara Ramesh Kadam, Yogesh M Shah, Parth Kore
DOI
:10.4103/JCPC.JCPC_26_17
Context:
It has been hypothesized that diagonal earlobe crease (DELC), “Frank's sign” is indicative of coronary artery disease (CAD) and/or diabetes mellitus (DM). Several studies have confirmed an association between DELC and cardiac morbidity, mortality, and hypertension (HTN). However, some studies have not found any significant association.
Aims:
This study aims to find out the prevalence of DELC and its association with CAD, DM, and HTN.
Settings and Design:
Sangli-Miraj-Kupwad Corporation area. This was a cross-sectional analytical study.
Subjects and Methods:
Study participants: Adults from 18 to 60 years age. Inclusion criteria: willing to participate in the study Exclusion criteria: Wearing heavy ear rings and excessive normal generalized wrinkling of the skin. Sample size: Sample size 6310, determined after a pilot study revealing DELC in 1.5%. Sampling technique: Two-stage cluster sampling. Duration of study: 6 months. Study tools: Predesigned, pilot tested pro forma.
Statistical Analysis:
Statistical analysis was done by using SPSS 22 software. Prevalence and percentages were calculated, and Chi-square test was applied.
Results:
Out of 6638 participants, 179 had DELC. The prevalence of bilateral DELC was 2.7%. The prevalence was significantly high among males (4.13%) and in the 51–60 years age group (5.29%). The prevalence of Grade 3 DELC was high and 91% of young adults had Grade 3 DELC. There were 408 (6.15%) participants who gave a history of CAD, 827 (12.46%) of DM, and 670 (10.09%) HTN. Significantly high association observed between DELC and CAD, DM, and HTN. CAD, DM, and HTN were significantly associated with Grade 3.
Conclusions:
The prevalence of bilateral DELC was 2.7% and is significantly associated with CAD, DM, and HTN.
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REVIEW ARTICLES
Peripartum cardiomyopathy: A contemporary review
p. 54
Akshai Bhandary, Tarak Rambhatla, Neil Coplan, Itzhak Kronzon
DOI
:10.4103/JCPC.JCPC_8_18
Peripartum cardiomyopathy (PPCM) is a rare, potentially life-threatening disorder affecting women in late pregnancy and the postpartum period. Historically, PPCM was not recognized as a separate disease entity until the 1930s. Further research has since led to the identification of at-risk demographics, theories on etiology, and new targets of therapy. Management to date has largely been focused on guideline-based treatment for heart failure with reduced ejection fraction. However, newer studies have shown the efficacy of novel therapies. In this article, we will review the pathogenesis and diagnosis of PPCM and conclude with some of the newest therapies being offered.
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The role of optimal medical therapy in patients with stable coronary artery disease
p. 60
JPS Sawhney, Dhiman Kahali, Bhupen Desai, Suresh KP Kumar, M Vishvanathan, Vishal Rastogi
DOI
:10.4103/JCPC.JCPC_43_17
Coronary artery disease (CAD) is a leading cause of mortality and morbidity around the globe. The fact that prevalence and mortality due to CAD are declining in developed countries cannot be held true in developing countries. Almost fourfold increase in CAD prevalence has been reported in India in the past 40 years. This incidence is likely to increase further in the coming years. The heterogeneity of the disease presentation is an important challenge in the management of these patients, and the current therapies are not universally effective in controlling these symptoms. Even with the advancements in medical therapies over the last two decades, it is unclear whether percutaneous coronary intervention (PCI) provides a prognostic advantage over optimal medical therapy (OMT) in the management of stable angina patients. The current review primarily focuses on the use of OMT for stable CAD patients and also discusses the role of coronary revascularization, especially PCI, in the management of these patients. This is based on evidence-based recommendations and guidelines.
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Prevention of cardiovascular disease in India: Barriers and opportunities for nursing
p. 72
Anice George, Sulochana Badagabettu, Kathy Berra, Linu Sara George, Veena Kamath, Latha Thimmappa
DOI
:10.4103/JCPC.JCPC_31_17
Currently, the nursing profession lacks specialized training, to be a part of preventive cardiovascular healthcare team. The article aims to describe the obstacles Indian nurses face in becoming active and valued members of the cardiovascular healthcare team and to propose solutions. Cardiovascular disease (CVD) imposes substantial and increasing physical, psychological, societal, and financial burdens. More emphasis needs to be placed on preventive measures, which should be made available and affordable in rural as well as urban areas. Nurses are well positioned to be leaders in these initiatives. However, nurses in India face numerous obstacles in providing optimal care, including a significant shortage of trained personnel. Nursing education at advanced levels needs to be standardized and should reflect core competencies. Appropriate use of nursing resources in CVD prevention can allow physicians to treat the sickest patients, reduce cost of care, and help relieve the human burden of morbidity and mortality due to CVD.
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VIEW POINT
Targeting anemia in heart failure
p. 78
Rakesh Agarwal
DOI
:10.4103/JCPC.JCPC_52_17
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RECENT LANDMARK TRIALS
Recent trials exploring newer approaches for incremental reduction in cardiovascular risk
p. 79
Showkat Hussain Bhat, Abinav Jain, Rahul Mehrotra
DOI
:10.4103/JCPC.JCPC_11_18
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