Search or add a thesis

Advanced Search (Beta)
Home > Long-Term Outcomes and Factors Associated With Mortality Among Patients With Moderate to Severe Pulmonary Hypertension in Kenya

Long-Term Outcomes and Factors Associated With Mortality Among Patients With Moderate to Severe Pulmonary Hypertension in Kenya

Thesis Info

Author

Abdulaziz Mansur Abeid

Department

Internal Medicine (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2018

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728055032

Similar


Background: Pulmonary hypertension (PH) is a condition that carries significant morbidity and mortality. Studies done in sub-Saharan Africa have reported poor short-term outcomes. However, data on long-term outcomes and prognostic factors are lacking. Objectives: This study sought to determine the one and two-year survival rates and prognostic factors associated with mortality in patients with moderate to severe PH. Methods: A retrospective review of moderate to severe PH patients [pulmonary artery systolic pressure (PASP), ≥45 mmHg] diagnosed at Aga Khan University Hospital, Nairobi from 2014 to 2017 was carried out. Demographic, clinical and in hospital outcome data were extracted from medical charts; and telephone interviews were conducted to determine out of hospital outcomes. Kaplan-Meier method was used for survival analysis and log rank tests were done to assess for differences between subgroups. Cox regression modelling with multivariable adjustment were used to identify factors associated with all-cause mortality. Results: A total of 659 patients were enrolled in this study, of which 50 (7.6 per cent) were lost to follow-up. The median PASP was 56 mmHg (interquartile range, 49–68 mmHg). After a median follow-up of 626 days, the one and two-year overall survival rates were 73.8 and 65.9 per cent, respectively. Using multivariate cox regression analyses, mortality was significantly associated with age, diabetes mellitus, atrial fibrillation, WHO functional class III and IV, severe pulmonary artery systolic pressures, right ventricular and left v ventricular systolic dysfunction. However, gender, systemic arterial hypertension, rheumatic heart disease and presence of significant valvular abnormalities had no significant association with mortality. Conclusion: Pulmonary hypertension is associated with poor long-term outcomes in African patients with overall survival rate of 65.9 per cent at two years. Identification of poor prognostic factors can assist in identifying high-risk patients.
Loading...
Loading...

Similar Books

Loading...

Similar Chapters

Loading...

Similar News

Loading...

Similar Articles

Loading...

Similar Article Headings

Loading...

سید حسام الدین راشدی

جناب سید حسام الدین راشدی
شروع اپریل میں پاکستان ریڈیو سے یہ خبر نشر ہوئی کہ جناب سید حسام الدین راشدی اﷲ کو پیارے ہوئے، یہ خبر راقمِ حروف کے لئے بڑی جانکاہ تھی۔
وہ دارالمصنفین کے بڑے قدردان اور پرستار رہے، انھوں نے اتنی کتابیں لکھیں کہ ان کا شمار کرنا آسان نہیں، مگر کہتے کہ خدا کی قسم میں نے دارالمصنفین کی کتابوں ہی سے لکھنا سیکھا، وہ علامہ شبلیؒ اور مولانا سید سلیمان ندویؒ کے بڑے مداح تھے، دارالمصنفین سے جو بھی کتاب شائع ہوتی اس کو ضرور منگواتے اور اپنی الماری میں نمایاں جگہ دیتے اس ادارے سے غیر معمولی محبت کی وجہ سے ۱۹۴۷؁ء کے بعد کراچی میں اس کے لئے زمین کا ایک بڑا پلاٹ خرید لیا تھا کہ وہ اس کو وہاں منتقل کرالیں، لیکن یہ وہاں کیوں منتقل ہوتا، آخر میں وہ برابر کہتے رہتے کہ یہ ہندوستان ہی میں رہ کر بہتر کام کرسکتا ہے، اور اس کو اسی سرزمین میں رہنا چاہئے جہاں قائم ہوا ہے، تقسیم ہند کے بعد پاکستان کے ناشرین نے اس ادارہ کی مطبوعات کو چھاپ کر جو نقصان پہنچایا، اس سے وہ بہت رنجیدہ رہے، ان کے خلاف قانونی کاروائی کے لئے ایک کمیٹی بنائی، جب یہ موثر نہ ہوسکی تو وہاں کے تمام انگریزی اور اردو کے اہم اخبارات میں مضامین لکھے کہ حکومت پاکستان اس ادارہ کی مطبوعات کا حق طباعت و اشاعت خرید کر اس کو گراں قدر معاوضہ دے، یہ اخباری مہم ایسی مفید ثابت ہوئی کہ اس خاکسار کو حکومت پاکستان نے اسلام آباد بلایا اور ایک طویل مدت کی دفتری کاروائی کے بعد پندرہ لاکھ روپے دارالمصنفین کو دے کر اس کی مطبوعات کا حق طباعت و اشاعت اپنے ایک ادارہ نیشنل بک فاؤنڈیشن کے سپرد کردیا۔
اس کے لیے دارالمصنفین زیادہ تر جناب سید حسام...

غربت کے خاتمہ کے لیے ازواجِ مطہرات کی مساعی

Islam as a religion is not based on empty or futile theories. Infact it intensely educates in altering a practical approach towards ones exixtence both as an individual and or a social being. It is the only religion which lead the way towards welfare/ "Falah" and Qura Calls such people Muflihon. Falah is for both render, either it is a man or a woman. Women especially Holy Prophet's wives are never leave behind in poor's uplift and public welfare. From the very beginning of UMMAHATUL-MOMINEEN (Holy Prophet's wives) are playing vital role in social or public welfare an till in this modern era and patriarchal society, they are role model to help plebians. The Islamic values as the world knows of them today were brought to light through our last messanger (P.B.U.H), assigned with the most important task in probably the most crucial era of human history. With the injustice all over the globe and the leaders of super powers in a rift with each other to dominate the world, exhausted the most important of resouces i.e. The humanity. The divine manifiesto of the Prophet Muhammad (P.B.U.H) and the lives of wives of Holy Prophet was actually based upon justice among masses and the preservation of conflict torn humanity. The intellectual wisdom of Holy Prophet's wives in the given situation was to restore order while restoring justice based upon the reformative rule of law as depicted by the Islamic ideology. The main aim of this very importatnt initiative was to reintroduce the humanity with the most important elements such as humility, mutual respect an retoration of long forgotten code of ethics. The basic foundation of our last Prophet's wives idealogy was to uplift poor whether they are Muslims or not. They successfully ordained the resurfacing, prevalence and practice of the same code of ethics. Now days many of such examples are prevalent in the world, not as a whole yet, though to a certain extent which is holding it together. The war torn and devastated west of the medieval found its solution in applying the same Islamic rule of law in their society in late 17th century and onward. It therefore can be deduced that the same code of ethics, which can be referred to the Quran, the sacred Islamic book, possibly offers the most effective solutions in order to ensure the societal and social development in current era.

Stakeholders Perceptions and Action for Addressing Students Dropout in a Government Secondary School in Karachi

This exploratory case study aimed at investigating the stakeholders' perceptions of student dropout during middle and secondary classes. The stakeholders included parents, head teacher, teachers, and dropped out students, and their views were collected for this study. The study was also aimed at exploring the actions of the school management in improving the situation. The study conducted in a government boy's secondary school of a less privileged context. The study aimed to understand the contextual circumstances that led to students' dropout. The sample collected was of students who had dropped out of school in the last three years. In addition, the school identified some students at-risk, who were interviewed as probable dropouts. They were also considered as part of the sample, albeit of a different category. The stakeholders were interviewed in order to locate what factors actually contributed to the dropping out of students. The findings of the study confirm previous studies. Some of the factors contributing to student dropout are socio-economic, academic performance of the students, and repeating the class as a result of failures in examinations. Another factor was peer pressure and low value of education both from parents as well as students. This study also brought out some other interesting factors like school policies that allow students choices to stay away from classes and only appear in examinations, lack of any remedial support to students facing difficulties to cope with the academic demands, and an uninviting school environment. Another factor that was considered both by parents and students was the local environment in which the school was located that was neither very conducive nor safe for students to access school.