Postpartum depression: a prospective observational cross-sectional study

Background: To determine the prevalence of postpartum depression in the puerperium and offer referrals to counsellor/mental health practitioner for at risk patients Methods: Sample size was 214 patients and duration of study was 1 year, it included all deliveries at HN reliance foundation hospital. It excluded women with pre-existing mental health problems or neurological disease on medications and those who declined participation. On day 7 and day 42 post-delivery the women were phoned and asked questions from the Edinburg postnatal depression scale which is a validated questionnaire. Interpretation used was; EPDS ≥13 or saying yes to question no 10, with depression and EPDS <13 without depression. Those identified with depression were appropriately referred. Results: Patient identified to be depressed were more likely to have perceived complications during delivery (p=0.02), problems with lactation (p=0.035), hospital stay of more than four days (p=0.002). There was no statistical association with help available and place where the mother stayed post-discharge. Conclusions: Out of 213 study participants, 32 study participants (15.02 percent) had post-partum depression. This was prevalent among those that felt their delivery was complicated, those with lactation difficulties and those with hospital stay of more than 4 days. The prevalence of post-partum depression at our hospital was significantly high to institute routine use of EPDS for new mothers

Effects of Supervised Exercise-based Telerehabilitation on Walk Test Performance and Quality of Life in Patients in India with Chronic Disease: Combatting COVID-19

Background: The world is currently undergoing a pandemic, caused by the SARS-CoV-2 virus (COVID-19). According to the World Health Organization, patients with chronic illnesses appear to be at the highest risk for COVID-19 associated sequelae. Inability to participate in outpatient-based rehabilitation programs and being home-bound can increase the risk for and potential worsening of chronic health conditions. This study evaluated the short-term effects of telerehabilitation on patients’ walk test performance and health related quality of life (HRQoL).  Methods: 47 patients (23 cardiovascular, 15 pulmonary, 9 oncology) participated in the telerehabilitation program. At baseline and following a 1-month intervention, patients had their 6-minute walk test distance (6MWTD) and HRQoL assessed. Average daily step counts were measured by the PACER App. Conclusion: Our results indicate that a short-term, supervised virtual telerehabilitation program had significant positive effects on 6MWTD and HRQoL in cardiac, pulmonary and oncology patients during COVID-19

Women-Focused Cardiac Rehabilitation Delivery Around the World and Program Enablers to Support Broader Implementation

BackgroundWomen are less likely than men to use cardiac rehabilitation (CR); thus, women-focused (W-F) CR was developed. Implementation of W-F CR globally was investigated, as well as barriers and enablers to its delivery. MethodsIn this cross-sectional study, a survey was administered to CR programs via Research Electronic Data Capture (REDCap) from May to July, 2023. Potential respondents were identified via the International Council of Cardiovascular Prevention and Rehabilitation’s network. ResultsA total of 223 responses were received from 52 of 111 countries (46.8% country response rate) in the world that have any CR, across all 6 World Health Organization regions. Thirty-three programs (14.8%) from 30 countries reported offering any W-F programming. Programs commonly did offer elements preferred by women and recommended, namely, the following: patient choice of session time (n = 151; 70.6%); invitations for informal care providers and/or partners to attend sessions (n = 121; 57.1%); CR staff that have expertise in women and heart diseases (n = 112; 53.3%); separate changerooms for women (n = 38; 52.8%); and discussion of CR referral with patients (n = 112; 52.1%). Main barriers to delivery of W-F exercise were physical resources (n = 33; 14.8%), space (n = 30; 13.5%), and staff time (n = 26; 11.7%) and expertise (n = 33; 10.3%). Main barriers to delivery of W-F education were human resources (n = 114; 51.1%), educational resources (n = 26; 11.7%), and expertise in the content (n = 74; 33.2%). Enablers of W-F education delivery were availability of materials, in multiple modalities, as well as educated staff and financial resources. ConclusionsDespite the benefits, W-F CR is not commonly offered globally. Considering the barriers and enablers identified, the International Council of Cardiovascular Prevention and Rehabilitation is developing resources to expand delivery.This study was funded by the Canadian Institutes of Health Research CIHR (#487149)

Fifteen Years of Advancing Cardiovascular Rehabilitation in Low-Resource Settings through the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) and a Look Ahead.

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, with a particular burden in middle-income countries (MICs). Cardiac rehabilitation (CR) is a secondary prevention model resulting in reduced CV mortality, morbidity, cost-effectively. However, CR is under-utilized globally, especially in MICs due to structural, social, and economic barriers. The International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) is a World Heart Federation-affiliated umbrella association founded ~15 years ago, now comprised of 50 Associations and 30 champions in countries without CR societies. ICCPR addresses delivery challenges through: CR guidelines tailored for MICs, the Global CR Audit to support advocacy, the International CR Registry (ICRR), Program Certification to support service quality, multi-disciplinary provider training (CR Foundations Certification; CRFC), women-focused CR initiatives, and partnerships with the World Health Organization. ICCPR continues to foster global CR accessibility through collaboration, communication, as well as research and advocacy with their upcoming Global CR Audit Update