-
Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India
Surendra Shamkant Borgharkar,
Soma Soumitra Das
Issue:
Volume 8, Issue 3, May 2020
Pages:
18-25
Received:
13 April 2020
Accepted:
30 April 2020
Published:
28 May 2020
Abstract: To evaluate concordance to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline on treatment of blood cholesterol for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in India. Concordance to 2013 ACC/AHA guideline was assessed by retrospectively analyzing statin therapy prescribing practice as per ASCVD risk score in four statin-benefit groups in 23,295 patients aged 40-79 years from health facilities across India between 2017 and 2018. Mean (±SD) age of patients was 58.9 (±9.2) years; 62% were men; 60% (n=14,070) had clinical ASCVD. Among patients without ASCVD (n=7,122), 3.9% (n=278) had low-density lipoprotein-cholesterol (LDL-C) ≥190 mg/dL, 94.0% (n=6,694) had diabetes mellitus and 2.1% (n=150) patients had 10-year ASCVD risk ≥7.5%. Among 18,795 patients (81%) eligible for high-intensity statins, only 34% were concordant whereas 63% were treated with moderate-intensity statins. Among 2,290 patients eligible for moderate-intensity statins, 76% were concordant and 18% received high-intensity statins. Among patients with ASCVD (<75 years), 43% received high-intensity statins, 55% received moderate-intensity statins, while 2% did not receive statins. Among patients with diabetes and ASCVD risk <7.5%, 86% received moderate-intensity statins, but those with risk >7.5%, 83% remained under-treated. Most patients (82%) with LDL-C >190 mg/dL were prescribed with moderate-intensity statins. Most patients were receiving statins at dose non-concordant to 2013 ACC/AHA guideline, reflecting gaps in real-world practice of prescribing statins for primary and secondary prevention of ASCVD. Addressing care gaps and promoting compliance to optimize statin therapy will help reduce cardiovascular disease, especially in high-risk population among South Asians.
Abstract: To evaluate concordance to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline on treatment of blood cholesterol for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in India. Concordance to 2013 ACC/AHA guideline was assessed by retrospectively analyzing statin therapy prescribin...
Show More
-
Low Mortality Rate of Novel Coronavirus Pneumonia (COVID-19) - Outside of the Main Epidemic Area Wuhan
Li Juan Feng,
Li Guo,
Qing Yang,
Qing Mei Yang,
Yue Yi Zhang,
Fei Fei Yang
Issue:
Volume 8, Issue 3, May 2020
Pages:
26-31
Received:
7 April 2020
Accepted:
19 May 2020
Published:
4 June 2020
Abstract: Objective: In December 2019, a new coronavirus is spreading in China at a faster pace. This paper focuses on the regional differences in mortality rate to provide useful references and suggestions for the prevention and control of 2019-nCoV pneumonia in other regions of the world. Material/Methods: Data resource: All date of cases In Yunnan Province was confirmed by the author. Another data came from the authority announcement which is update by hours. All data are beginning announced after January 29.2020 when WHO announces a new outbreak of coronavirus pneumonia as a public health emergency of international concern (PHEIC) at 4 a.m. on January 31.2020. Mortality Rate: All statistical analyses were made using SPSS13.0 for Windows software (SPSS Inc., Chicago). The data indicated are expressed as mean ± standard deviation. The t-test was used to compare the variables between groups. P-value greater than 0.005 was considered as statistically significant, Crude mortality (‰)=number of dead individuals per unit time/number of sicknesses per unit time × 1000 ‰. Results: As of 11:34 on April 16, 2020, In China, there were 83,797 confirmed cases, 63 suspected cases, Severe cases 95, 3,352 cases died, 78,504 cases were cured and 713,523 cases were released from medical observation. Hubei has reported 67,803 cases of new crown pneumonia (including 146 cases of clinical diagnosis), among which 50,008 cases (including 146 cases of clinical diagnosis) in Wuhan city, The oversea case is 1,426,071, and only 133818 case died. Crude mortality of Hubei is 47.52 (‰). The crude mortality rate of Hubei Province is significantly different from other provinces (P-value greater than 0.005). Conclusions: Recent COVID-19 case data show that there are not only more cases but also higher mortality rates in the source areas. It revealed a situation that the lack of medical resources and treatment capacity. Effective epidemic prevention can prevent such a situation. Paying attention to the treatment of light patients is conducive to their conversion into severe, and then reduce the mortality. Low mortality rate of Novel Coronavirus Pneumonia (COVID-19) outside of the main epidemic area Wuhan shows active medical treatment is the key to reduce mortality.
Abstract: Objective: In December 2019, a new coronavirus is spreading in China at a faster pace. This paper focuses on the regional differences in mortality rate to provide useful references and suggestions for the prevention and control of 2019-nCoV pneumonia in other regions of the world. Material/Methods: Data resource: All date of cases In Yunnan Provinc...
Show More
-
Qualitative Research on Yellow Fever Outbreak Responses in Wolaita Zone of SNNPR Region, Ethiopia
Yonas Assefa Tufa,
Yaregal Fufa,
Melaku Abebe,
Shambel Habebe,
Diriba Sufa,
Desalegn Bealy,
Adamu Tayachew,
Musse Tadesse,
Wadu Marshalo,
Bletete W/Mariam,
Mesfine Melese,
Zerihun Doda
Issue:
Volume 8, Issue 3, May 2020
Pages:
32-41
Received:
15 April 2020
Accepted:
5 May 2020
Published:
15 June 2020
Abstract: Background: Outbreak response basically entails preparedness which helps to establish arrangements in advance to enable timely, effective and appropriate responses to specific potential hazardous events or emerging disaster situations that might threaten society/environment. Researches about outbreak response or interventions that focus on post-incident communication have recently been published in a range of disciplinary journals, from organizational psychology to organizational communication one reason that the interventions are successful is because it provides team with a common time and place for purposeful discussion-based learning. Objective: To review outbreak response from the October 2018 Wolayta Zone yellow fever outbreak management in SNNPR, Ethiopia. Methods: Qualitative research approach, with Thematic Analysis. Purposive sampling method was used. Data were collected through FGDs, in-depth interviews, observation and document reviews. Results: However, it is worth-noting that the Review showed that despite late detection, a rapid response team was set up and was able to save the lives of many during the outbreak. The findings further showed there was good coordination among various stakeholders at different levels and with satisfying sharing of roles and responsibilities. Conclusion: The case was detected lately after one month of since the first case were detected and all case which admitted this period were miss-diagnosed of the cases and leading to some deaths. Even though there was a confusion on identifying the first case, after the confirmation of the first case, the case management went as per the standard guideline and SOPs, helping save so many lives through availing the service free of charge.
Abstract: Background: Outbreak response basically entails preparedness which helps to establish arrangements in advance to enable timely, effective and appropriate responses to specific potential hazardous events or emerging disaster situations that might threaten society/environment. Researches about outbreak response or interventions that focus on post-inc...
Show More
-
Vulnerable Population in Covid-19 Outbreak: A Look at Italy
Issue:
Volume 8, Issue 3, May 2020
Pages:
42-48
Received:
5 May 2020
Accepted:
27 May 2020
Published:
16 June 2020
Abstract: We examine the population groups most exposed to Covid-19 in the Italian social and health context. These groups include, firstly, elderly and disabled people with one or more pre-existing diseases and, secondly, health workers, especially doctors and nurses, who have paid a very high price in terms of contagion and death. If elderly people are infected with the virus and become ill with severe interstitial pneumonia, they are unlikely to be admitted to intensive care units and are destined to die in a short time. Therefore, in accordance with the principle of "equity" recommended by the World Health Organization, some resources should be devoted to protecting these elderly persons, so that they would not come into contact with the virus. Unfortunately, the measures taken by the Italian National Government and Regional Administrations have not been effective in protecting this elderly group, as is evident from the ongoing judicial disputes. Covid-19 health care professionals are the most exposed to the risk of contagion, which increases dramatically if there are no adequate personal protection equipment. And these protections were lacking, especially in the early stages of contagion. Meaningful demonstrations of a human solidarity have happened, which have crossed the boundaries of duty to the point of sacrifice of life.
Abstract: We examine the population groups most exposed to Covid-19 in the Italian social and health context. These groups include, firstly, elderly and disabled people with one or more pre-existing diseases and, secondly, health workers, especially doctors and nurses, who have paid a very high price in terms of contagion and death. If elderly people are inf...
Show More
