Articles

NAFLD is characterized by accumulation of fat in the liver that can lead to health complications. Previous studies have found the obesity phenotype and its components to be risk factors for the development of NAFLD. This study aims to examine the relationship between the obesity phenotype and NAFLD among each racial-ethnic group. We analyzed data from the NHANES III survey (1988-1994). The obesity phenotype was defined based on BMI and metabolic syndrome. NAFLD was defined by abdominal ultrasounds among non-alcoholics with no infection or taking drugs affecting the liver. A higher prevalence of NAFLD was found among the metabolically unhealthy obese group (43.1%) and the metabolically unhealthy overweight (29.4%) than the metabolically unhealthy normal weight (11.8%). Mexicans-Americans had higher odds of NAFLD relative to whites (adjusted odds ratio (AOR) = 1.3, 95% confidence interval (CI) = 1.01-1.9, p = 0.04). The metabolically healthy obese phenotype was associated with NAFLD (p > 0.05) in the overall sample and in Whites. The metabolically healthy overweight was associated with NAFLD only among Mexican-American (p < 0.05). Metabolically unhealthy overweight or obese had higher odds of NAFLD relative to the metabolically healthy normal weight and this relation is consistent in all the racial/ethnic groups (p < 0.05). Metabolically healthy overweight and obese individuals had a high chance of NAFLD and it varied by race/ethnicity. Healthcare providers should pay more attention to care for those who are part of the metabolically healthy overweight or obese group especially among the Mexican-American population.

SARS-CoV2 can induce multiple immunological and endocrinological changes. We report the case of a COVID-19 associated hyperthyroidism in a young female. Per definition the patient – because of having given birth six weeks previously - had a postpartum thyroiditis. However thus no antibodies were detected, the thyroiditis ceased without medication after the dissolving of the virus disease and the fT3/fT3-ratio proved a destructive thyreopathy as well as there was a close time link onset of the symptoms with the novel corona virus infection we argue it to be a COVID-19 induced thyrotoxicosis. This proves the ability of SARS-CoV-2 to alter thyroid function, therefore all COVID-19 patients should be monitored regarding endocrinological changes and TSH, fT3, fT4 should be assessed.

Objective: This study discusses strategies to overcome hypertension patient compliance to manage self-care. The purpose of the study is to provide a summary of the importance of attention to managing hypertension. Method: a review of literature relevant to hypertension, policies, and management, both pharmacological and non-pharmacological, through cross-programs or sectors. Result: This study found that the ministry of health had compiled various policies to reduce the prevalence of hypertension, including technical guidelines for its implementation, but the strategy has not yet fully reached the minimum service standard, which is because it has not fully involved the relevant cross sectors. Conclusion: Improve the coordination system by “Joint Decree” between the Ministry of Health and the Ministry of Villages, PDT and Transmigration, the Ministry of Social Affairs, Indonesian National Army, police, and NGOs to carry out activities simultaneously to the community.

Background: Meclizine is a commonly prescribed medication for patients discharged from the Emergency Department (ED) with a diagnosis of peripheral vertigo, however it is on the Beers list of medications to avoid in elderly patients. Objectives: This study aims to determine the correlation between use of meclizine and return visits to the ED within 1 week in patients > 65 years old. Methods: This is a retrospective observational study conducted at 2 urban tertiary care EDs over 5 years. Inclusion criteria included patients > 65 years who were given meclizine in the ED or discharged with a prescription. Charts were reviewed for diagnosis, prescriptions and return visits within 7 days. Results: There were a total of 1608 patients over 65 years of age who met inclusion criteria, 669 patients identified as receiving meclizine in the ED and 962 who received no meclizine (ED or ED plus home prescription). Of the meclizine patients, 548 (84.8%) were given home prescriptions, of which there were 36 (6.6%) return visits within 7 days. Patients who were given meclizine while in the ED without home prescriptions (121) had 16 return visits (13.2%). Among the non-meclizine group, 102 patients (10.6%) had a return visit within 7 days. Conclusion: There was no increase in return visits in elderly patients discharged from the ED with a prescription for meclizine after a diagnosis of benign dizziness. Meclizine prescriptions at discharge were associated with fewer return visits to the ED within 1 week. Ongoing dizziness was the most common reason for return visits; there were no documented chief complaints of weakness, syncope/falls, or hypotension.

Tyrosine kinase inhibitors (TKIs) are widely used in Oncology practice. Hypertension may develop during cancer treatment and TKIs are well known drugs that are associated with drug related hypertensive toxicity. TKI related hypertensive toxicity is not always the indicator of worse clinical outcomes and it may be the sign of treatment efficacy.

The measures put in place by many governments around the world to fight the spread of COVID-19 have drastically reduced visits to diabetes centres. To keep providing people with diabetes the professional support they need and reduce the inconvenience caused by the interruption of traditional assistance, the typical control visit can be carried out by virtual visit, telemedicine (TM) that should have the necessary characteristics to provide a correct execution. Especially this is important for pregnant women first diagnosed with gestational diabetes mellitus (GDM), they have the necessity to frequent checks in a short time due to the pregnancy.

Background: An event involving drug therapy that actually or potentially interfers with the desired health outcomes is known as drug therapy problem. Objective: The study aimed to identify and resolve potential drug related problems encountered among adult hypertensive patients receiving care in a Nigerian Tertiary Hospital. Methods: This was a prospective cross sectional study. The data were collected from the patients’ medical records using the Pharmaceutical Care Network Europe (PCNE) Classification tool Version 6.2 (PCNE, 2010). For each of the 171 medical records, the DTPs experienced within the study period were identified. Data were analyzed using the IBM Statistical Product and Service Solutions (SPSS) for Windows, Version 21.0 (IBM Corp, Version 21.0, and Armonk, NY, USA). Results: Majority of the patients were above 65years of age 64(37.4%), while about half of the patients were females. A total of 644 drug therapy problems were identified. The major cause of DTP was prescribing error 189(29.3). Other causes of drug therapy problem identified in this study were inappropriate drug selection 122(18.9), no indication for drugs 52(8.1), inappropriate drug combination 87(13.6), new indication presented 61(9.5), dose too high 62(9.6), dose too low 44(6.8), wrong drug taken/administered 27(4.2). Majority of the interventions made were accepted 586(91.0%) while only 3(0.5%) of the interventions made were not accepted. Conclusion: This study demonstrates that a pharmacist, with adequate training and support can play a vital role in identifying and resolving drug therapy problems. Also, there is a need for an educational intervention among prescribing physicians to update them regularly on hypertension guidelines.

Our research aimed to check the impact of some significant risk variables on diabetes growth and the specific goal of this study was to evaluate the connection of industrial fields with diabetes risk variables. The current research also informs us about the most important risk factor for male and female people with diabetes. A cross-section and convenient sample of 100 people, male and female, without discernment of risk factors and diabetes mellitus (Meta-Analysis on the effect of major risk factors on the diabetic patients form Jinnah Hospital Lahore). The risk factors in the general assessment i.e. lack of exercise, kidney problems, high ranges of tests and residence in industrial areas are found to be significant. Assessment of these factors is helpful in early diagnosis and in prognosis of diabetes.

Background: Poor knowledge about hypertension can lead to poor attitude towards the disease which may directly affect patients self-care practices towards hypertension. Objective: This study aimed to assess the knowledge, attitude and practice towards hypertension of hypertensive patients receiving care in Kogi state Specialist hospital, Lokoja, Kogi state Nigeria. Methods: This was a cross sectional study conducted among Hypertensive patients receiving care in the Kogi State Specialist Hospital in Lokoja, Kogi state. All hypertensive patients visiting the Kogi State Specialist Hospital during the period of study and have given consent were allowed to participate in the study. A well designed questionnaire was used to collect patients soci-demographic and clinical variables. Also, a validated questionnaire was used to assess patients Knowledge, attitude and practice towards hypertension. Data were analysed using the Statistical Package for Social Sciences (SPSS for windows, Version 16.0. SPSS Inc. 2007.Chicago, USA) software. Continuous data were presented as mean± standard deviation while categorical data were presented as percentages and frequencies. Chi square and correlation test was also used to examine association between the variables in the data collected. Results: A majority of the patients were aged 46-55 years 89 (27.5%), while almost half of the patients were males 161 (54.6%). About half of the patients 141 (43.5%) were selfemployed while a majority of the patients had at least a tertiary education 173 (53.4%). Only 4 (1.2%) of the patients reported that they had no formal education. About 60% of the patients reported to have had hypertension for 6-10 years while only 170 (57.4%) of the patients reported not to have any family history of hypertension. Also, only half of the patients 164 (50.6%) had their blood pressure controlled. Only one quarter of the patients had good knowledge and attitude towards hypertension. Also, only 4 (1.3%) patients had a good practice towards hypertension. There is a significant positive correlation between knowledge and attitude (r = 0.287, p < 0.001). Also, there is a fair positive correlation between Knowledge and practice (r = 0.254, p =

Introduction: Hypertension is the leading remediable risk factor for cardiovascular disease, affecting more than 1 billion people worldwide, and is responsible for more than 10 million preventable deaths globally each year. Hypertension can be described as the ‘Sleeping snake’, which bites when it wakes up. Objectives: To detect hypertension and its associated factors among staffs of Dessie town government schools from December 10, 2018 to February 15, 2019 G.C. Methods and materials: An institution-based cross-sectional study design was conducted among 225 Dessie town government school staffs whose age of 35 years and above. Systematic random sampling technique to select sample size of participants. Data was cleaned manually, coded and entered into Epi-info and analyzed by SPSS version 22 software. Multivariable logistic analysis AOR, 95% CI and p - value < 0.05 was used to identify variables which have significant association. Results: From the total of 225 study participant’s 31(13.8%) of them diagnosed with hypertension. Multivariable logistic analyses had shown that 1st degree holders AOR (CI) = 3.05 [0.91,13.43], source of information from news AOR(CI) = 2.1 [0.816, 4.89], being protestant in religion AOR (CI) = 5.65 [0.74, 42.86], age from 41-60 years AOR (CI) = 1.96 [0.18,18.90], being divorced AOR (CI) = 2.35 [0.91,5.84], and teachers AOR (CI) = 3.4 [1.2, 9.825] maintain their significant association with detection of hypertension. Conclusion and Recommendation: From this study significant numbers of respondents have hypertension. Educational status, source of information, marital status, occupation, religion and age of respondents were predictors for the occurrence of hypertension. Newly diagnosed hypertension on this was high among government school staffs which have no information about their blood pressure; which shows there was poor coverage of health screening.