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Singh R.,Hamad Medical Corporation HMC | Tripathi V.,University of the West Indies
PeerJ | Year: 2015

Background. India accounts for 24% to all under-five mortality in the world. Residence in rural area, poverty and low levels of mother's education are known confounders of under-five mortality. Since two-thirds of India's population lives in rural areas, mothers employed in agriculture present a particularly vulnerable population in the Indian context and it is imperative that concerns of this sizeable population are addressed in order to achieve MDG4 targets of reducing U5MR to fewer than 41 per 1,000 by 2015. This study was conducted to examine factors associated with under-five mortality among mothers employed in agriculture. Methods. Data was retrieved from National Family Household Survey-3 in India (2008). The study population is comprised of a national representative sample of single children aged 0 to 59 months and born to mothers aged 15 to 49 years employed in agriculture fromall 29 states of India. Univariate andMultivariate Cox PH regression analysis was used to analyse the Hazard Rates of mortality. The predictive power of child mortality among mothers employed in agriculture was assessed by calculating the area under the receiver operating characteristic (ROC) curve. Results. An increase in mothers' ages corresponds with a decrease in child mortality. Breastfeeding reduces child mortality by 70% (HR 0.30, 0.25-0.35, p = 0.001). Standard of Living reduces child mortality by 32% with high standard of living (HR 0.68, 0.52-0.89, 0.001) in comparison to low standard of living. Prenatal care (HR 0.40, 0.34-0.48, p = 0.001) and breastfeeding health nutrition education (HR 0.45, 0.31-0.66, p = 0.001) are associated significant factors for child mortality. Birth Order five is a risk factor for mortality (HR 1.49, 1.05-2.10, p = 0.04) in comparison to Birth Order one among women engaged in agriculture while the household size (6-10 members and ≥11 members) is significant in reducing child mortality in comparison to ≤5 members in the house. Under-five mortality among mothers employed in agriculture in India discriminated well between death and survival (Area Under ROC was 0.75, 95% CI [0.73-0.77]) indicating that the model is good for appropriate prediction of child mortality. Conclusion. In a nationally representative sample of households in India, mother's age, breastfeeding, standard of living, prenatal care and breastfeeding health nutrition education are associated with reduction in child mortality. © 2015 Singh et al.

Al Jaber J.,Hamad Medical Corporation HMC
Angiology | Year: 2010

A 51-year old Middle-Eastern man presented with recurrent chest pain associated with ST-segment elevation. The patient was treated with placement of a stent in the right coronary artery. He was subsequently diagnosed with severe hyperthyroidism secondary to Graves disease, which is thought to be the cause of the coronary spasm. The patient was treated with neomercazole and potassium iodide solution, and diltiazem, and nitrates with resolution of his symptoms. This unusual case highlights the importance of considering hyperthyroidism in the differential diagnosis of recurrent chest pain and coronary artery spasm. We suggest routine thyroid function testing in patients with coronary spasm.

Al-Aqeedi R.F.,Erbil Teaching Hospital | Al Suwaidi J.,Hamad Medical Corporation HMC
Expert Review of Cardiovascular Therapy | Year: 2014

Generally, patients with prior coronary artery bypass graft (CABG) are often under-represented in acute coronary syndrome (ACS) clinical trials. Nevertheless, there is growing global attention concerning their short- and long-term prognosis. Some reports suggest prior CABG as an independent risk factor for increased mortality, while others report an equal or a more favorable prognosis despite their adverse baseline clinical characteristics. The reasons for this 'risk-mortality paradox' need to be further evaluated. More recent reports showed a significant reduction in in-hospital morbidity and mortality over a 20-year period of follow up that may be attributed to the improvement in surgical CABG techniques and increased use of evidence-based therapies over the past two decades. In the current review we discuss the available literature regarding outcomes of prior CABG patients who are presenting with ACS. © 2014 Informa UK, Ltd.

Al Suwaidi J.,Hamad Medical Corporation HMC
Current Cardiovascular Risk Reports | Year: 2016

Data about cardiovascular risk factors among Americans of Arab descent (AA) is limited. This article aims to provide an up-to-date review of cardiovascular risk factors and diseases among AA living in the United States (US). We summarize the limited existing data about the prevalence of the various cardiovascular risk factors and diseases among AA and compare that to Arabs living in Arab countries. We also outline challenges of conducting cardiovascular research among AA. In conclusion there is paucity of data about cardiovascular risk factors and diseases among AA. The current study suggests the urgent need for better ways to identify AA in the US and the development of large prospective studies on determinants of cardiovascular health including potential factors such as acculturation. © 2016, Springer Science+Business Media New York.

Tripathi V.,University of the West Indies | Singh R.,Hamad Medical Corporation HMC
PeerJ | Year: 2015

Background. Nepal is set to achieveMDG-5 goals by end of 2015.However, maternal health parameters will remain way below those of developed countries. This study was conducted to assess the factors contributing to utilization of ANC and safe delivery services with the aim of furthering overall maternal health parameters in Nepal. Material and Methods. Using survey data fromthe Nepal Demographic and Health Survey 2011, socio-economic and demographic factors associated with the utilization of ANC and safe delivery services among women aged 15-49 years who gave births during the last three years preceding the survey are examined. Data was segregated into three ecological zones: Mountain, Hill and Terai zones for univariate analyses. Data from all three zones was then pooled for univariate and multivariate logistic regression analyses of Antenatal Care and Safe Delivery services inNepal. Results and Conclusion. The analyses show that rural place of residence is at a disadvantage in receiving ANC (OR, 0.8; 95% CI [0.7-0.9]) and ensuring safe delivery (OR, 0.6; 95% CI [0.5-0.7]).Woman's education, husband's education and wealth quintile are significant factors in ensuring ANC and safe delivery services. Further, the analyses show that Budh/Muslim/Kirat/Christians are at a significant disadvantage in ensuring safe delivery (OR, 0.8; 95% CI [0.7-0.9]) as compared with Hindus. Though ecological zones lost their significance in receiving ANC, women in the Terai region are at a significant advantage in ensuring safe delivery (OR, 1.7; 95% CI [1.2-2.1]). Recommendation. Segregated targets should be set for the different ecological zones for further improvement in maternal mortality rates in Nepal. © 2015 Tripathi and Singh.

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