ABSTRACT
Vascular Diseases [CVDs] are the main cause of death among elderly over 65 years and the main threat to the occurrence of heart failure [HF], Heart failure is an important cause of chronic disability, rehospitalization and even death particulary among persons over 65 years of age this study aimed to identify the relationship between rehospitalization of patients with heart failure and their adherence to the their adherence to the therapeutic regimen. Non- adherence to treatment regimen is one of the important factors leading to rehospitalization. The study was conducted at the inpatient cardiology department of the specialized Medical Hospital affiliated to the Main University Hospital in Mansoura. Elderly patients males and females, diagnosed with heart failure for at least one year and attending the clinic during a period of three months were included in the study. This number amounted to 120. A structured interview sheet was designed by the researcher to collect data. The tool comprised sociodemographic data of the elderly, his medical history and medical regimen such as adherence medications, diet modification, activity and follow up schedule. The results revealed that elderly patients adherence to diet modification was reported by 65.8% followed by 56.7% adherence to drug therapy, follow up visits by 44.0% and exercises by 24.2%. The main causes of non adherence were lack of knowledge to treatment regimen or the elderly patients forget, to take his medicine or need assistance. The main recmmendations are risk factors for non adherence. should be examined arefully during follow up visits, and the active involvement of the patients and their families in post discharge plan
Subject(s)
Humans , Male , Female , Aged , Hospitalization , Patient Readmission , Risk Factors , Follow-Up StudiesABSTRACT
Type 2 diabetes mellitus [DM] and hyperhomocysteinaemia are both associated with premature vascular disease. This study aimed to assess plasma total homocysteine [P tHcy] level in type 2DM and its relation to nephropathy and retinopathy. P tHcy level was estimated in 20 type 2 diabetic patients with retinopathy and microalbuminuria and 20 patients with retinopathy and macroalbuminuria versus 20 type 2 diabetics with no retinopathy nor nephropathy and 20 healthy controls matched for age, sex and race. Other assessment included funduscopic examination, complete urine analysis, estimation of urinary albumin excretion rate, blood urea, serum creatinine, crentinine clearance, fasting plasma glucose, glycosylated haemoglobin [HbA[IC]]. serum lipid profile. as well as ultrasonographic examination of the kidneys and renal arteries. Mean P tHcy concentration was significantly higher in both the albuminuric groups than in normal albuminuric. group and controls, however mean P tHcy was inversely correlated with creatinine clearance versus no correlation with the other studied parameters, and no relation to retinopathy. Creatinine clearance is the only parameter associated with P tHcy, denoting that the degree of renal functional impairment is the determinant of its plasma concentration in patients with type 2 DM