Background
Conflicting data were found regarding the anemia’s effect on percutaneous coronary intervention (PCI) outcomes. We directed our study to investigate anemia’s effect on clinical in-stent ...restenosis (ISR) following PCI.
Results
A prospective multi-center cohort study was performed on 470 consecutive participants undergoing elective PCI. We classified the participants into two groups: group 1 who were anemic and group 2 who were non-anemic as a control group. At 1, 3, 6, and 12 months by clinic visits, we followed up with the patients to assess anemia’s clinical ISR effect. We found that 20% of the patients undergoing PCI had anemia. Anemic patients showed a statistically significant higher rate of impaired renal function and diabetes and a higher percentage of the female gender. Multivariate regression analysis for major adverse cardiovascular events (MACEs) after adjusting for confounding factors revealed that anemia represents a more risk on MACE (adjusted hazard ratio (HR) was 4.13; 95% CI 2.35–7.94;
p
value < 0.001) and carries a higher risk upon clinical ISR (adjusted HR was 3.51; 95% CI 1.88–7.16;
p
value < 0.001) over 12 months of follow-up.
Conclusion
Anemic patients going through PCI are generally females, diabetics, and have renal impairment. Anemia might be considered another indicator for clinical ISR and is fundamentally associated with an increased MACE incidence.
Background: Sacubitril/valsartan effectively treats HFrEF complications by combining vasodilatory and RAAS inhibitory actions. Its effects on myocardial and hepatic stiffness are possibly due to its ...anti-inflammatory and anti-fibrotic properties but still under study. Objectives: To assess sacubitril/valsartan therapy's impact on myocardial and hepatic stiffness in HFrEF patients. Patients and methods: This prospective cohort study at Qena University Hospitals from March 2023 to February 2024 included 50 HFrEF patients. Clinical examinations, echocardiography, and hepatic stiffness assessment were conducted pre and post-sacubitril/valsartan therapy. Results: Mean age of 49.98 years (±6.98), comprised 20 males (40%) and 30 females (60%), with a mean BMI of 24.69 kg/m^2 (±1.41). None of the participants tested positive for HBsAg or HCV Ab. Pre-management, the ejection fraction (EF) averaged 30.82% (±3.19), significantly increasing to 43.24% (±3.33) post-management (p<0.0001). LVEDD decreased significantly from 60.8 mm (±1.71) to 53.85 mm (±4.32) post-management (p<0.0001). Global longitudinal strain (GLS) improved significantly from -6.16% (±1.75) to -9.44% (±2.62) post-management (p<0.0001). Liver stiffness measurement (LSM) decreased significantly from 7.67 kPa (±1.86) to 6 kPa (±1.39) post-management (p < 0.0001), with a significant decrease in stage F3 fibrosis (p=0.0002). CAP score decreased significantly from 287.2 dB/m (±23.21) to 273.82 dB/m (±28.18) post-management (p<0.0001), with no significant changes in overall steatosis levels. Conclusion: Our findings demonstrates that Sacubitril/valsartan has significant therapeutic benefits in HFrEF, supporting the evidence based guidelines in recommending that patients with HFrEF should be established on Sacubitril/valsartan as one of the “four pillars” of heart failure treatment.
Maternal mortality is a worldwide problem. Measuring maternal mortality and identifying its causes is essential, and should be assessed regularly for the purpose of planning, monitoring and ...evaluation of provided maternal health care. Quality of care indicators such as case fatality rate is used to measure the facility performance, in particular, quality and promptness of care. This descriptive study aimed to calculate maternal mortality ratio, quality of care indicators such as maternal mortality index, case fatality and direct obstetric case fatality rate for the Women's Health Hospital and identify causes of maternal mortality, and the main deficits in medical records. The Maternal mortality ratio was alarmingly high in Women's Health Hospital, Assiut University, Egypt reaching 225/100,000, however, those who delivered in the hospital, the MMR was 100.5/100,000. The leading causes of maternal death were obstetric haemorrhage (38.3%), complications of caesarean sections (27.7%) and pre-eclampsia/eclampsia (23.4%). Nearly half (42%) of the deaths occurred during vacations. Quality indicators revealed poor quality of health care.
The Egyptian Red Sea coast, a mountainous coastal region, is periodically exposed to landslide that cause severe man and economic losses. That is due to its geological, hydrogeomorphological, and ...seismological nature. This research aims to map landslide susceptibility in the study area using a multi-criteria overlay analysis approach. Slopes, elevations, aspects, curvature, lineaments, faults, earthquakes, rainfall, stream network, and rock units are the factors used to derive the landslide's susceptibility map. The data were obtained from research organizations and open-source geospatial platforms. The landslide susceptibility map of the area under investigation ranges from low to high as follows: 1) low (23 %), 2) moderate (43 %), and 3) high (34 %) from total area. The used model is validated using direct field check and statistical analysis by Receiver operating characteristic (ROC) curve test 40 landslides events. Based on ROC, the multi-criteria overlay analysis approach can predict landslides by 82 % at a 95 % confidence level. The leading causes of landslides are geological, topographical, hydrogeomorphological, and seismological. For long-term development, the study's findings would assist decision-makers in lowering the risks connected with landslides in the areas. To reduce the chance of landslides, the study recommended it is important to take into account the rugged topography of zones where landslides are likely to occur and implement rockfall protection systems like barriers, embankments, or mesh.
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