EVALUATION OF MEDICATION COMPLIANCE IN PATIENTS WITH CONGESTIVE HEART FAILURE IN YEMEN

Objective: Non-compliance with heart failure medication is related to the highest mortality, morbidity, and health-care costs. The objective of this study was to evaluate medication compliance with patients with congestive heart failure. Methods:Inpatients of the cardiac care unit and medical ward of Republican Hospital, German Hospital, Revolutionary Hospital, and Chinese–Yemeni Friendship Hospital were recruited for this study. The study was conducted on patients that were diagnosed as having congestive heart failure and were receiving treatment. Questionnaires were distributed and personal interviews to evaluate the patients’ compliance was conducted to determine the reasons for their non-compliance in taking drugs. Results: Of 86 patients, 44% (n = 38) reported compliance and 56% (n = 48) reported non-compliance. The distribution of the patients in terms of sex was as follows: among men, 41% (n = 24) were compliant and 59% (n = 35) were non-compliant; among women, 52% (n = 14) were compliant and 48% (n = 13) were non-compliant. In addition, smoking status was too significantly linked with non-compliance (P = 0.001). Furthermore, the status of chewing of khat tree leaves was also significantly associated with non-compliance (P = 0.007). Conclusion: This study indicates that the reasons for non-compliance with medications among patients can be attributed to lack of education, chewing of khat tree leaves, lack of health insurance, and cigarette smoking. Therefore, healthcare professionals should create strategies to address these reasons in order to increase medication compliance with patients in heart failure

Neural Stem Cells Expressing bFGF Reduce Brain Damage and Restore Sensorimotor Function after Neonatal Hypoxia-Ischemia

Background/Aims: Neonatal hypoxia-ischemia (HI) causes severe brain damage and significantly increases neonatal morbidity and mortality. Increasing evidences have verified that stem cell-based therapy has the potential to rescue the ischemic tissue and restore function via secreting growth factors after HI. Here, we had investigated whether intranasal neural stem cells (NSCs) treatment improves the recovery of neonatal HI, and NSCs overexpressing basic fibroblast growth factor (bFGF) has a better therapeutic effect for recovery than NSCs treatment only. Methods: We performed permanent occlusion of the right common carotid artery in 9-day old ICR mice as animal model of neonatal hypoxia-ischemia. At 3 days post-HI, NSC, NSC-GFP, NSC-bFGF and vehicle were delivered intranasally. To determine the effect of intranasal NSC, NSC-GFP and NSC-bFGF treatment on recovery after HI, we analyzed brain damage, sensor-motor function and cell differentiation. Results: It was observed that intranasal NSC, NSC-GFP and NSC-bFGF treatment decreased gray and white matter loss area in comparison with vehicle-treated mouse. NSC, NSC-GFP and NSC-bFGF treatment also significantly improved sensor motor function in cylinder rearing test and adhesive removal test, however, NSC-bFGF-treatment was more effective than NSC-treatment in the improvement of somatosensory function. Furthermore, compared with NSC and NSC-GFP, NSC-bFGF treatment group appeared to differentiate into more neurons. Conclusion: Taken together, intranasal administration of NSCs is a promising therapy for treatment of neonatal HI, but NSCs overexpressing bFGF promotes the survival and differentiation of NSCs, and consequently achieves a better therapeutic effect in improving recovery after neonatal HI

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population