Hypertension Family Research Articles

The Implementation of Local Wisdom to Improve the Health and Quality of Life the Hypertension Family as a New Strategy for Early Prevention of Stroke

Indonesia is well known as a country which has high ethnic diversity. Thus, each ethnic specifically has a local wisdom as their own identity. However, the economic growth, globalization, and modernization have eroded the local wisdom in which it is potentially forgotten by the next generation. The modernization also has been proved changing the behavior, lifestyle, and live quality of society. As the result, Hypertension are documented as the highest case diseases generated by the change of behaviour, lifestyle, and lack quality of life. However, the hypertension is possibly controlled by the intervention of life-style and improving the quality of life. This present study aims to implement the local wisdom of Aceh to improve the quality of life as new strategy to early prevention of stroke disease. The research design using Participatory Action Research including reconnaissance, planning, action, evaluation, and reflection based on Aceh local wisdom are specifically used as a new approach to reach the goal. The result shows that the local wisdom can be used as the main reason to change the society behaviour. The implementation of local wisdom potentially become the solution, because the society, especially the one who have the history of hypertension coming from their family, can empower family health problem by providing high attention to family health problem. Additionally, the local wisdom encourages the society to check their health status as control, whereas most of participant is only visiting the health center when they did not feel good. The result also proved that the local wisdom can initiate the society to modify their own environment, indicating the increase of awareness about the importance of cleaning the environment. The successful implementation of local wisdom should be supported and developed to follow the modernization without losing its identity because the fast growing of globalization cannot be hold but can be well maintained.

Brugada Syndrome Type 1 Electrocardiogram Pattern Induced by Fever in a Black African: A Case Report

Brugada syndrome is a channelopathy that can be familial or sporadic. It is a major cause of sudden death in young people with no obvious heart structural abnormality. The electrocardiogram can be dynamic over time with sometimes normalization. Several pathophysiological conditions are known to induce the electrocardiographic expression of the syndrome. We report here the case of a 65-year-old hypertensive man, without syncope or family sudden death history who was hospitalized for shigella gastroenteritis. Electrocardiogram during fever showed an incomplete block and ST segment elevation with negative T waves in V1 and V2 suggested type 1 Brugada syndrome. Troponin was negative. Electrocardiogram after fever recovered an incomplete right block and normalization of the ST segment. Electrocardiogram should be performed in patients admitted to the emergency unit for infectious syndrome in our countries. This may reveal a number of patients with Brugada syndrome abnormalities.

Diabetes and Insurance

AbstractIndia has healthcare expenditure of more than 5 billion dollars on diabetes-related healthcare management. Globally, approximately 12% of health expenditure is spent on diabetes and related comorbidities. Hospitalization includes hospital and laboratory expenses and cost of medications as the direct cost. India is among the countries, where if the insured dies during the time period specified in the insurance policy and the policy is active, or in force, then a death benefit will be paid. Studies in India reported that medical reimbursement is availed by 21.3% in the high-income group and only 6.4% of the urban low-income group. An average cost of management of diabetic complications like diabetic foot, retinopathy, and patients with two complications was almost close to the average cost of claimed amount. Patients may be advised to take insurance for diabetes when there is any indication of future disease and risk factors contributing to diabetes like a strong family history, obesity, hypertension, and other vascular diseases. Diabetes Safe from Star Health and Varistha Mediclaim from National Insurance were among the first insurance policies to be launched in India.

Status of outpatient service for cancer patients in Beijing Yuetan Community Health Service Center

Objective To analyze the outpatient service for patients with malignancies in Yuetan Community Health Service Center of Xicheng District in Beijing. Methods Two hundred and nine patients with malignancies visiting Yuetan Community Health Service Center in Beijing from January 2016 to January 2018 were included for analysis. There were 92 patients who visited fixed physicians (fixed group) and 117 patients who visited non-fixed physician (non-fixed group), and the influencing factors affecting fixed physician visit were analyzed. Results Of the 209 patients, 65 (31.10%) were males and 144 (68.90%) were females with a mean age of (69.4±10.0) year. There were 114 cases (54.55%) complicated with, hypertension 52 cases (24.88%) complicated with type 2 diabetes and 40 cases (19.24%) complicated with dyslipidemia. The mean number of visit per patients was (23.16±3.86) times; and the time of visits in fixed group was significantly higher than that in non-fixed group [(27.72±2.67) vs. (22.93±2.61), χ2=4.621, P=0.01]. The mean number of visit in 107 patients having contracted family doctor service was (25.64±7.60) times, while the time of visits in fixed group was significantly higher than that of the non-fixed group [(32.10±2.10) vs. (13.56±3.34), χ2=3.938, P<0.01]. Multivariate logistic regression analysis showed that hypertension (OR=0.445, 95%CI:0.213-0.971) and contracted family doctor service (OR=0.212, 95%CI:0.104~0.435) were significantly associated with fixed physician visits. Conclusion The outpatient visits of patients with malignant tumors in Yuetan Community Health Service Center meet the follow-up requirements for chronic diseases in the National Basic Public Health Service Regulations. The number of visits to fixed physicians is high, and patients with hypertension and contracted family doctor service have higher rate of fixed physician visits. Key words: Malignancies; Ambulatory care; Family doctor service

Does “obesity paradox” exist in the functional outcome of patients with subarachnoid hemorrhage? A retrospective cohort study in Saudi Arabia

Background Subarachnoid hemorrhage (SAH) is a sever type of stroke and the risk increased for persons with current smoking, positive family history and hypertension. However, an elevated body mass index (BMI) does not consider an independent risk factor, but it's related to poor neurological outcome or death. Few studies have been conducted to confirm the validity of obesity paradox on subarachnoid, but still the evidence is not conclusive. Methods A retrospective cohort study that depends on the retrieval and data extracting from the medical records for all the patient with SAH, in King Abdul-Aziz Medical City, Riyadh, Saudi Arabia. For total cases of subarachnoid who admitted over the past 11 years, only 80 patients confirmed aneurysmal by (digital subtracted angiography). All data analyses were conducted using the SPSS program. The institutional review board approval (IRB) has been obtained. Results A total of 80 patients included in our analysis. The mean age at onset was 47.3, 47 (58.8%) were male, 32 (40%) were obese, and 33 (41.3%) was a smoker. Majority of them didn’t suffer from diabetes 59 (73.8%), hypertension 43 (53.8%) or previous stroke 71 (88.8%). In our population, we observed that there is no significant influence of obesity paradox on functional outcome and mortality after SAH (p=0.430; p=0.235, respectively). Conclusion Obesity paradox appeared to affect neither functional outcome nor mortality after SAH.

P2804Initial experience with the novel BioMime Morph 40–60 mm long sirolimus-eluting tapered stent in long coronary lesions

Abstract Aims Aims: Long lesions treated with overlapping stents has been reported to be associated with healing problems and/or adverse events. The novel BioMime Morph is a 40, 50 and 60 mm long sirolimus-eluting cobalt chromium stent (65 μm strut thickness, biodegradable polymer) with a tapered design (0.5 mm taper from proximal to distal end) and is available in the following proximal and distal diameters (2.75–2.2 5mm, 3–2.5 mm and 3.5–3 mm). It can be a novel alternative for treatment of long coronary lesions, overcoming the limitations of overlapping stents. Methods and results Methods: Data was evaluated from our centre's prospective BioMime Morph database from August 2016 - January 2019. Primary endpoint was device oriented composite endpoint (DOCE: cardiac death, TV-MI, TLR and TVR). Secondary endpoints were technical (successful Morph implantation) and procedural success (successful procedure with Morph without in-hospital MACE). Results 103 patients had BioMime Morph stents implanted, with mean follow up of 411 (±214) days and a mean age of 66 (±11) years. Co-morbidities included hypertension (58%), hypercholesterolemia (38%), diabetes mellitus (28%), PVD (2%), CVD (5%), CKD (12%), previous MI (17%), smoking (40%) and positive family history (20%). There was history of previous PCI in 18% and CABG in 4%. Indication for PCI was predominantly ACS (78% including 13% STEMI), 15% were CTOs. 80% of the procedures were performed via radial access using 5–6F sheath in 73%. Vessels treated included LAD (43%), Cx (12%) and RCA (45%). Pre-dilatation was performed in 96% including use of non-complaint balloons in 51%, scoring balloons in 12% and rotablation in 4%. Post-dilatation was performed in 99%. Buddy wire was used in 41% while a guideliner used in 13%. Technical success (secondary endpoint) was achieved in 100 whilst procedural success was achieved in 96% (4 cases of contrast induced nephropathy). Cumulative DOCE (primary endpoint) was % (cardiac death 1%, TV-MI 1%, definitive ST 0%, possible ST 1%, TLR 2% and TVR 2%). OCT follow up at 1 month, 3 month and 6 months in 2 patients showed endothelialisation even at 1 month. Conclusions Our initial experience of the use of the novel BioMime Morph tapered DES for treatment of long coronary lesions exhibit promising results in short to medium follow-up. Elution of the drug in 1 month along with biodegradable polymer and ultra thin struts potentially helps early healing and raises the possibility of short DAPT even in these complex long lesions. BioMime Morph stents can potentially be an alternative to overlapping conventional stents for treating long coronary lesions.

Mediating role of self-efficacy in the relationship between family social support and hypertension self-care behaviours: A cross-sectional study of Saudi men with hypertension.

Self-efficacy and family social support are significantly associated with hypertension self-care behaviours. However, little is known about their mechanism in Saudi Arabia. This cross-sectional study aimed to examine the relationships among family social support, self-efficacy, and self-care behaviours among men with hypertension in Saudi Arabia. Data were collected from May to August of 2018. The Hypertension Self-Care Profile and the Perceived Social Support from Friends and Family scales were used to measure the study variables. Multiple linear regression was used to analyse the relationships between the variables, and the Baron and Kenny test was used to assess if self-efficacy mediated the relationship between family social support and hypertension self-care behaviours. Respondents (N = 158) from the Jizan and Al-Sharqia regions of Saudi Arabia completed the survey. Family social support and self-efficacy were significantly associated with hypertension self-care behaviours. In regression, self-efficacy was the only variable significantly associated with hypertension self-care behaviours. Self-efficacy fully mediated the relationship between family social support and hypertension self-care behaviours. Interventions to enhance hypertension self-care behaviours among Saudi men could focus on increasing individual's self-confidence to perform specific healthy behaviours. Family support can also contribute to the performance of hypertension self-care behaviours.

Frequency of Left Bundle Branch Block in Patients with Acute Myocardial Infarction; A Cross-Sectional Study.

Background: Cardiovascular disease (CVDs) is important problems in both developing and developed countries. Currently, non-invasive methods for diagnosis of CVD, especially myocardial infarction (MI), is an interesting subject in the cardiology field. Some evidence showed left bundle branch block (LBBB) is more prevalent among patients with MI. Hence, this study aimed to investigate the frequency of LBBB and their contributing factors in patients with MI. Materials and Methods: In this cross-sectional study, 150 patients with ST elevation or non-ST elevation on their admission electrocardiography who referred to Boo-Ali and Amir-Al-Momenin hospitals, Tehran from January 2016 to June 2017 entered the study. Frequency of LBBB and right bundle branch block (RBBB) in participants and the contributing factors were determined. Results: In this study, of 150 cases (mean age: 60.35±12.88 years), 109 (72.7%) were male, and 41 (27.3%) were female. Out of 150 cases, 12 (8%) had LBBB, 5 (3.3%) RBBB, and 133 (89.7%) had not RBBB or LBBB. Contributing factors were family history, hypertension, and history of ischemic heart disease (P<0.05). Conclusion: Eight percent of patients with myocardial infarction would develop LBBB, which is related to hypertension, and self and family history of ischemic heart disease.

Prevalence of cardiovascular risk factors and diseases in patients with osteoarthritis of knee attending orthopaedic out-patient department of a tertiary care hospital

Background: Osteoarthritis (OA) and cardio-vascular diseases (CVD) share similar risk factors. Since OA may increase the risk of CVD through several mechanisms, this study was taken up to find the prevalence of cardiovascular risk factors and diseases in patients with OA knee. We also assessed the relationship between cardiovascular risk factors and the socio-demographic characteristics of the participants.Methods: This cross-sectional study was conducted during August 2018 to January 2019 in an Orthopaedic Out-patient Department of a tertiary care hospital in a metropolitan city. Sample size was 384. Patients above the age of 45 years who were radiologically diagnosed to be OA knee grade 2 and above were included. Questionnaire was used to collect data. Lipid profile and blood sugar were done. Perceived stress scale-10 was used for calculating stress level.Results: Physical inactivity was the most prevalent risk factor (79.68%) followed by tobacco consumption (69.27%), obesity (64.84%), unhealthy diet (56.77%), positive family history (48.43%), dyslipidaemia (48.17%), diabetes (38.54%), hypertension (27.60%), smoking, mental stress and excessive alcohol intake. Prevalence of CVDs like heart failure, heart attack, stroke and other cerebral atherosclerotic conditions were 5.98%. Prevalence among male and female was 6.16% and 5.88% respectively.Conclusions: Risk factors for cardiovascular diseases are common in patients of Osteoarthritis Knee. Physical inactivity is the most common risk factor followed by tobacco consumption, obesity and unhealthy diet. Prevalence of CVDs were 5.98%.

PENGARUH PERIKLANAN TERHADAP KEPUTUSAN KONSUMEN (PENDERITA HIPERTENSI DAN KELUARGA PENDERITA HIPERTENSI) MEMILIH PENGOBATAN HERBAL

Background: The problem of hypertension is a frequent topic of discussion. Hypertension is classified as the silent killer. People have been good at choosing how to maintain their health in which advertising is one of the factors that influence them choose health products. Behavioral treatment itself is mostly done by the community so that it can lead to medication errors. Objective: This study is expected to determine the effect of advertising on consumer decision (hypertensive and hypertensive family) chose herbal medicine (a case study in Padukuhan, Pungkuran Pleret, Bantul, District of Yogyakarta) using theory of AIDA model. This study used Cross Sectional Research. Methode: The samples in this study are patients with hypertension and families who have family members living in hypertensive patients in Padukuhan Pungkuran with the number of respondents is 432 people, the sampling method used is total sampling. Techniques and instruments of data collection used library research and field research by means of interviews and questionnaires. Processing of data by multiple linear regression analysis, coefficient of determination (R2) with the results of buying interest is affected by variable interest and action. Result: Based on the data processing, F score is 19 503, only the factor of interest and action that together influential significantly on consumer buying interest towards herbal products. The most influence on consumer purchase interest is variable action, judging from the results of the t-value (4.609) or regression coefficient (0.197).

Lifestyle, Socio-demographic and anthropometric profile of the hypertensive patients visiting urban health centre of North Delhi

Introduction: The prevalence of hypertension has been reported to be increasing in India due to changes in the lifestyle of people. The current prevalence of hypertension in India has been estimated to be 42.2% in urban areas and is supposed to increase in future requiring huge resources for management of hypertension cases and related cardiovascular co-morbidities. So in this study the lifestyle related factors causing hypertension was explored. Materials and Methods: Diagnosed hypertensive patients visiting urban health centre were included as study subjects. The participants were asked information on life style, socio-demographic characteristics and physical activities levels in 24 hours in the form of walking, sitting and sleeping. History of hypertension in family, treatment history for hypertension, stress factors, clinical signs and symptoms were recorded. Simultaneously the anthropometric measurements including height, weight and waist circumference were measured. Information on diet intake to calculate total calorie and protein intake per day was collected. Results: Total 44 patients participated in the study. The mean age of the participants was 59.77±13.3 years. Family history of hypertension was in 47.72% participants. History of stress was in 68.18% participants. Calorie intake and protein intake per day was 1109.66±33.64 Kcal and 55.73±25.29gms. Spending time for walking of < 1hr>2hrs per day was in 27.27% participants. BMI > 25 were in 65.9% participants. Waist circumference was > 95cm in 25% of males and > 85cm in 50% of females. Conclusion: Majority of participants were found to be overweight and sedentary. Participants were spending less time in walking. So the study recommends increasing physical activity, limiting calorie and protein intake and eliminating stressors will restrict progression of hypertension in hypertensive patients. Keywords: Calorie intake, Hhypertension, Life style, Physical activity, Protein intake, Stress, Waist ci

Faktor-Faktor yang Berhubungan dengan Kejadian Hipertensi pada Masyarakat RW 009 Kelurahan Bojong Menteng Bekasi 2018

ABSTRACT&#x0D; Hypertension or often known as "high" is one of the non-communicable diseases, which is currently a big and serious problem. This study aims to determine the factors associated with the incidence of hypertension in RW 009 community in Bojong Menteng Bekasi Village in 2018. This research is analytic by using cross sectional study design. This research was conducted from January 2018 until July 2018 with a total sample of 161 people. The instruments used in this study were sphygmomanometer, microtoise, weight scales and questionnaires. Data analysis was carried out by univariate and bivariate using chi square test. The results of the study found 47.2% of respondents who experienced hypertension, who were at risk (≥40 years) as much as 58.4%, male gender as much as 47.2%, history of family hypertension as much as 60.2%, obesity as much as 59 , 6%, smoking as much as 26.1%, less active physical activity by 53.4% and alcohol consumption by 1.2%. Furthermore, variables related to the incidence of hypertension were age (p = 0,000) PR 1,996 (95% CI: 1,334-2,986), history of family hypertension (p = 0,000) PR 3,197 (95% CI: 1,926-5,308), obesity (p = 0,000) PR 1,647 (95% CI: 1,264-2,145), smoking (p = 0,041) PR 1,473 (95% CI: 1,072-2,024), physical activity (p = 0,029) PR 1,495 (95% CI: 1,055- 2,118 ) Whereas, variables that were not related to the incidence of hypertension were sex (p = 0.252) PR 1.243 (95% CI: 0.896-1.724) and alcohol consumption (p = 1,000) PR 1.060 (95% CI: 0.263-4.280).The advice given to the puskesmas is that it is necessary to encourage the community, together with the head of RW 009 to raise awareness on routine health checks and routine exercise every holiday.&#x0D; Keywords: Hypertension, Factors that cause hypertension

The Additive Interaction between Body Mass Index and Hypertension Family History in Han and Yugur: The China National Health Survey (CNHS).

Objective To estimate the additive interaction of body mass index (BMI) and family history of hypertension (FHH) on hypertension and explore whether the interaction could be influenced by behavioural risk factors. Methods The cross-sectional data on 5791 participants were from the China National Health Survey in Gansu province in 2016. We assessed the additive interaction by calculating the relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP), and the synergy index (SI). Results ORs for hypertension were highest in Han (13.52, 95% CI: 9.45 to 19.34) and Yugur (13.85, 95% CI: 8.48 to 22.63) with the combination of obesity and FHH. The interaction of BMI and FHH was significant in Han people, with the RERI, AP, and SI and their 95% CIs being 2.48 (1.13 to 3.82), 0.33 (0.19 to 0.47), and 1.61 (1.26 to 2.07) for overweight and FHH and 6.32 (1.91 to 10.73), 0.47 (0.27 to 0.67), and 2.02 (1.33 to 3.07) for obesity and FHH, respectively. The interaction of BMI and FHH was not significant in Yugur people. Adjustment for behavioural risk factors had little influence on the interactions, and risks of hypertension remained increased. Conclusions BMI and FHH were associated with hypertension, and the interaction of BMI and FHH on hypertension was significant in Han but not in Yugur people. Behavioural risk factors had little influence on the associations and interactions. The exacerbation of hypertension risks by overweight or obesity in hypertension families deserves attention in weight control and community care.

A Review of the Epidemiological Evidence for Adducin Family Gene Polymorphisms and Hypertension.

Hypertension is one of the most common cardiovascular diseases that seriously endangers human health and has become a significant public health problem worldwide. In the vast majority of patients, the cause of hypertension is unknown, called essential hypertension (EH), accounting for more than 95% of total hypertension. Epidemiological and genetic studies of humans and animals provide strong evidence of a causal relationship between high salt intake and hypertension. Adducin is one of the important candidate genes for essential hypertension. Adducin is a heterodimeric or heterotetrameric protein that consists of α, β, and γ subunits; the three subunits are encoded by genes (ADD1, ADD2, and ADD3) that map to three different chromosomes. Animal model experiments and clinical studies suggest that changes in single-nucleotide polymorphisms (SNPs) at part of the adducin family gene increase the Na+-K+-ATPase activity of the renal tubular basement membrane and increase the reabsorption of Na+ by renal tubular epithelial cells, which may cause hypertension. This review makes a summary on the structure, function, and mechanism of adducin and the role of adducin on the onset of EH, providing a basis for the early screening, prevention, and treatment of EH.

Modelling of Hypertension Risk Factors Using Penalized Spline to Prevent Hypertension in Indonesia

Hypertension is an increase in blood pressure that increases to a target organ, such as stroke, coronary heart disease, right ventricular hypertrophy. Hypertension occurs if the blood pressure reaches 140 mmHg or more and diastole reaches 90 mmHg or more. According to WHO, from 50% of hypertensive patients recovering, only 25% received treatment, and only 12.5% could be treated well. Nationally, 25.8% of Indonesia’s population suffers from hypertension. In this study, we modeled the risk of hypertension by considering age, heart rate, family hypertension, stress levels, and the body’s future index as factors that influence the risk of hypertension. The cross-sectional survey was conducted in August 2018 at the Surabaya Hajj Hospital. Based on previous research the method used is logit and gompit logistic regression method, but the results obtained are not maximal. Therefore, in this study the researchers proposed a method for constructing hypertension risk factor modeling using a nonparametric application using a penalized spline estimator. The result of classification accuracy by using non-parametrical is 96%. Based on the result, we conclude that non-parametrical approach has better than outcome so that it can be used to modelling the risk of hypertension.

HUBUNGAN ANTARA PENGETAHUAN, MOTIVASI, DAN DUKUNGAN KELUARGA DENGAN KEPATUHAN MINUM OBAT PADA PENDERITA HIPERTENSI DI PUSKESMAS PEUKAN BADA KABUPATEN ACEH BESAR

Hypertension is a disease that is known as the silent killer disease or quietly because in general people do not know he suffered from hypertension before they check their blood pressure. The purpose of this study was to look at factors related to adherence to taking anti-hypertension medication. Using descriptive analytic design through Cross Sectional approach. The data were collected by interview using questionnaire. Population in this research in Peukan Bada Public Health Center are 56 people. This study used Chi-Square statistic test. The result of the research showed that hypertension patient mostly good (55,4%), hypertension motivation mostly high (64,3%) and hypertension family support mostly good (60,7%). The result of the statistical test shows that there is correlation between knowledge (p value = 0,001), motivation (p value = 0,002) with adherence to taking anti hypertension medication in hypertension patient and no relation with family support (p value = 0,728) with adherence to taking anti hypertensive drugs in hypertensive patients.&#x0D; Keywords: Hypertension, knowledge, motivation, patient family support

DIABETES AS A RISK FACTOR OF IN – HOSPITAL MORTALITY IN PATIENTS WITH PREMATURE CORONAY DISEASE PRESENTING WITH ACUTE MYOCARDIAL INFARCTION.

Background; Recent data from various parts of the world have led to the conclusion that more than 80 % of CVD deaths occur in developing countries like Pakistan. This high burden of heart diseases is largely attributed to the industrial and technological progress which is associated with economic and social transformations which have lead to life style modification and sedentary life style. This study was planned to ascertain mortality rate of premature coronary artery disease in patients with AMI as it directly affects main workforce of our national economy. Objective; To determine role of diabetes with mortality in premature coronary artery disease patients with acute myocardial infarction. Material and methods; A total of 145 patients having premature coronary artery disease presenting with acute myocardial infarction were included in this descriptive study. This study was conducted in the department of medicine, Nishtar Hospital, Multan from June 2018 to May 2019. These patients were followed during current hospitalization to see mortality in these patients and all the findings were noted in the proforma. Results; Of these 145 study cases, 96 (66.2%) were male patients and 49 (33.8%) were female patients. Mean age of our study cases was noted to be 47.67 ± 7.59 years. Mean time taken before presentation at hospital was 113.79 ± 54.36 minutes. Hypertension was present in 58 (40%), smoking in 39 (26.9%), family history of IHD in 67 (46.2%) and obesity in 49 (33.8%) of our study cases. Mortality was noted to be in 19 (13.1%) of our study cases, post MI angina was seen in 36 (24.8%) and cardiogenic shock was noted in 29 (20%). Diabetes was present in 48 (33.1%) of our study cases while in – hospital mortality among diabetic patients was 18 /48 (37.5%) (p=0.001). Conclusion; Our study results indicate that diabetic patients with premature coronary artery disease having acute myocardial infarction (AMI) have high rates of mortality. Positive family history, hypertension, obesity and diabetes were major risk factors noted in our study. Life style modification and early screening of the cases with positive family history in first degree relatives can help prevent heart diseases in our population as it hits main workforce and has negative impact on national productivity. Keywords; Premature coronary artery disease, mortality, diabetes, Myocardial infarction. DOI : 10.7176/JMPB/55-14 Publication date :May 31 st 2019

Melatonin is an appropriate candidate for breast cancer treatment: Based on known molecular mechanisms.

Breast cancer is the most prevalent cancer and one of the most important causes of death in women throughout the world. Breast cancer risk factors include smoking, alcohol consumption, personal and family history, hypertension, and hormone therapy, long-term use of nonsteroidal anti-inflammatory drugs and tobacco usage. Surgery, chemotherapy, radiotherapy, immunotherapy, and neoadjuvant therapy are the current means for breast cancer treatment. Despite hormonal agents and chemotherapy, which have beneficial effects on lowering breast cancer death rate, the reaction of different people to these treatments is still a challenging point. Melatonin (N-acetyl-5-methoxy tryptamine) is a methoxy indole compound that is mainly secreted by the pineal gland at night; it is as an antioxidant, anti-inflammatory, and oncostatic agent. On the basis of recent studies, melatonin has antitumor properties on different cancer types and it may suppress cancer development in vitro and as well as in animal models. It is suggested that melatonin inhibits the development of breast cancer by various mechanisms. This paper summarizes the roles of melatonin in breast cancer treatment from the aspect of its molecular actions.

Aspirin for primary prevention of cardiovascular disease in diabetes.

Aspirin for primary prevention of cardiovascular disease in diabetes.

Correlation of Atherosclerotic Risk Factors with the Size of Abdominal Aortic Aneurysm (AAA).

Introduction:Abdominal aortic aneurysm represents a local pathological dilatation of the abdominal aorta. It is caused by structural weakness of aortic wall but there are many other risk factors that may positively correlate with incidence of AAA like hypertension, smoking, male gender, older age, family history etc.Aim:The purpose of the study was to evaluate the correlation of atherosclerotic risk factors and the size of aortic aneurysm in patients that were admitted for the surgical treatment at the Clinic for cardiovascular surgery in Sarajevo during period 2016-2019.Methods:The study was designed as a retrospective study with one group of patients that was conducted at the Clinical Center of the University of Sarajevo at the Clinic for Cardiovascular Surgery. It included 150 patients, 126 males and 24 females, all of them with infrarenal localization of AAA. From medical records we have collected relevant anamnestic data (age, gender, positive family history, diabetes mellitus, hypertension, hyperlipidemia, smoking, alcohol consumption and obesity). The size of aneurysm was determined by both ultrasound and CT arteriography. The data are processed in the Statistical Package for Social Sciences Ver. 22.0. The results are tabulated or graphically showed, and level of statistical significance was set at p <0.05.Results:Total amount of 129 of patients (86%) had hypertension, 57.3% (n=86) of them were smokers, 18.7% (n = 28) were former smokers, and 24% (n = 36) were non-smokers Blood lipid level analysis have shown that 44% (n = 66) of patients were normolipemic, while elevated blood lipid levels were found in 56% (n = 84) of patients. Diabetes mellitus was present in 17.3% (n = 26) of patients, 2.7% (n = 4) of them had an insulin-dependent form, while 14.7% (n = 22) of the analyzed patients had insulin independent DM. Almost half of total number of patients (46%, n = 69) were obese. 19.3% (n = 29) of patients consumed alcohol while the 80.7% (n = 121) denied alcohol consumption. Ratio of males in comparison to females was 5:1. The average age in males was 69.79 ± 8.16 years and 72.13 ± 9.11 years in females. Significant statistical correlation of AAA size and risk of atherosclerosis factor has not been established. We have found that there is a significant positive correlation between size of aneurysm and risk of rupture (p= 0,000<0,05).Conclusion:Although risk factors of atherosclerosis were present, statistically positive correlation was not confirmed between the size of AAA and analyzed risk factors.