BACKGROUND A comprehensive understanding of adult congenital heart disease outcomes must include psychological functioning. Our multisite study offered the opportunity to explore depression and anxiety symptoms within a global sample. OBJECTIVES In this substudy of the APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults With Congenital Heart Disease-International Study), the authors we investigated the prevalence of elevated depression and anxiety symptoms, explored associated sociodemographic and medical factors, and examined how quality of life (QOL) and health status (HS) differ according to the degree of psychological symptoms. METHODS Participants completed the Hospital Anxiety and Depression Scale, which includes subscales for symptoms of anxiety (HADS-A) and depression (HADS-D). Subscale scores of 8 or higher indicate clinically elevated symptoms and can be further categorized as mild, moderate, or severe. Participants also completed analogue scales on a scale of 0 to 100 for QOL and HS. Analysis of variance was performed to investigate whether QOL and HS differed by symptom category. RESULTS Of 3,815 participants from 15 countries (age 34.8 +/- 12.9 years; 52.7% female), 1,148 (30.1%) had elevated symptoms in one or both subscales: elevated HADS-A only (18.3%), elevated HADS-D only (2.9%), or elevations on both subscales (8.9%). Percentages varied among countries. Both QOL and HS decreased in accordance with increasing HADS-A and HADS-D symptom categories (P < 0.001). CONCLUSIONS In this global sample of adults with congenital heart disease, almost one-third reported elevated symptoms of depression and/or anxiety, which in turn were associated with lower QOL and HS. We strongly advocate for the implementation of strategies to recognize and manage psychological distress in clinical settings.
OBJECTIVE The aim of the study was to assess the effect of non-surgical periodontal therapy (NSPT) on periodontal and cardiac parameters as well as on the expression of calprotectin and periostin levels in periodontitis patients with and without coronary artery disease (CAD). METHODS Ninety subjects were categorised into three groups: Group H: periodontally and systemically healthy subjects, Group P: stage III grade B periodontitis subjects with no associated systemic diseases and Group P + CAD: stage III grade B periodontitis subjects diagnosed with CAD. Demographic, periodontal and cardiac parameters were recorded at baseline (0 day) and on the 180th day after NSPT. Gingival crevicular fluid was collected from all participants at baseline (0 day) and after the 180th day. Calprotectin and periostin expression were reassessed. RESULTS A significant increase in the levels of calprotectin (34.05 ± 11.72) was seen at baseline in the P + CAD group, whereas on the contrary, a decreased periostin (1.59 ± 0.41) was also noted at baseline. The study also showed a significant improvement in periodontal and cardiac parameters on the 180th day following NSPT. CONCLUSION Detection of calprotectin and periostin expression in GCF samples could represent a link to the association of periodontitis and CAD.
Recent data from the 2019 Global Health Metrics report indicates a troubling trend: more than five million deaths annually can be traced back to health issues related to being overweight or obese. This comprehensive review, scrutinizes the role of intermittent fasting (IF) in improving metabolic functions and aiding in weight loss among the adult demographic. This review, built on the solid foundations of the Cochrane and PRISMA protocols, thoroughly examines a plethora of research concerning IF as a viable approach to combat adult obesity and overweight conditions. Our extensive research canvassed several academic and scientific databases such as PubMed, Embase, PsycINFO, Web of sciences, Scopus and the Cochrane Library, up until the latter part of February 2023, with no barriers on language. We identified 3241 studies, which after deduplication procedures, narrowed down to 3065. Through meticulous evaluation, we shortlisted 386 studies. Ultimately, our synthesis includes 10 research papers with contributions from India (6 studies), as well as individual studies from Pakistan, Saudi Arabia, the USA, and China, collectively observing 845 adults. Our synthesis of the selected research posits that IF provides enduring and beneficial outcomes for adults suffering from obesity and excess weight. The intervention showcases a marked improvement in managing blood glucose, lipid concentrations, insulin sensitivity, and overall cardiovascular functioning. It is also observed that integrating IF with consistent physical activity serves as an effective dual strategy for not only weight control but also for fostering an enhanced state of general health.
Background: We aimed to understand the current practices of Indian practitioners in the management of hypertensive patients with ischemic heart disease. Methods: A quantitative, cross-sectional, questionnaire-based survey involving 145 cardiologists and consulting physicians who each saw 10 patients with hypertension and IHD in their clinical practice was conducted. The questionnaire consisted of 35 questions divided into three sections on prevalence and treatment of hypertension and IHD and role of fixed-dose combinations in therapy. Results: In all, 49.0% of physicians treated 25%-50% patients with hypertension and IHD in their routine practice, majority of whom were in the age group of 40-60 years regardless of gender. Telmisartan (97.0%) and metoprolol (86.0%) were the most preferred angiotensin receptor blocker (ARB) and beta-blocker, respectively, and 91.0% of physicians preferred a combination of metoprolol with telmisartan when monotherapy fails. In the opinion of the physicians, prevention of new cardiovascular events (63.0%) and improvement in quality of life (61.0%) were the leading benefits of telmisartan and metoprolol FDC, and all agreed that this FDC improves patient compliance and adherence to therapy. Furthermore, 97.0%, 90.0%, and 40.0% of physicians agreed/strongly agreed that the FDC could be prescribed to hypertensive patients with IHD, heart failure, and IHD and diabetes, respectively. Conclusions: In this pan-India survey, it was observed that FDCs of telmisartan and metoprolol could help in improving blood pressure, heart rate, patient compliance, and adherence to therapy. Nevertheless, large-scale, prospectively designed studies are warranted to validate these findings.
Background ABO blood group types are hereditary factors that have been shown to affect the blood levels of many antigens and proteins. Some blood groups have surprisingly been shown to be associated with some specific diseases, probably due to yet unexplained altering effects on the immune system or on the levels of other system-specific proteins. Studies conducted previously attempting to relate bronchial asthma and blood groups have had variable results and such studies on a large scale have not been ventured in India. Hence, the significance of the current study, which aims to search for an increased occurrence of bronchial asthma in any one of the ABO blood group phenotypes and additionally in Rh blood groups. Objective The objective of this study was to analyze the possible association of the ABO and Rh blood group types with bronchial asthma. Methods This is an observational study with 475 bronchial asthma patients, and 2052 non-asthmatic individuals belonging to the same geographical zone. After obtaining informed consent, ABO and Rh Blood group testing was done on the study subjects using the hemagglutination method. Chi-squared tests were employed for the comparison of proportions. Statistical significance was agreed upon for an error of 5%. Results The O blood group was predominant in both cases (46.9 %) and controls (36.1%). A chi-square analysis revealed a statistically significant higher percentage of O blood group in patients (χ2: 24.537; degrees of freedom (DF): 3; p-value = <0.01). The cases had more Rh -ve individuals (12%) than controls (8%), which too was statistically significant (χ2: 6.711; degrees of freedom (DF): 1; p-value = 0.01). Conclusion The present study shows a positive association between the O blood group and the Rh-negative blood group with bronchial asthma.
