RESUMO
Background: The overall prevalence of heart failure (HF) is thought to be increasing, in part because current therapies for cardiac disorders such as myocardial infarction (MI), valvular heart disease and arrhythmias, are allowing patients to survive longer. Aims of the study were to know the presentation, causes, outcome of HF patients and to know the proportion of patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).Methods: This was a cross-sectional observational study of heart failure patients for duration of one year, admitted in medicine department of medical college and SSG hospital, Vadodara, Gujarat, India.Results: Males constituted more than half of patients; however, HFpEF was more common in females in all age groups. Majority of patients had HFrEF. Breathlessness was the common presenting symptom. Common aetiologies found were ischaemic heart disease (IHD), hypertension (HTN), diabetes mellitus (DM) and valvular heart disease. 50-64 year patients constituted the major age group. IHD and DM were more common in this age group. Rheumatic heart disease (RHD) was seen commonly in 20-34 year of age group. In-hospital mortality rate though low has not much changed and contributes significantly considering the prevalence.Conclusions: Like developing countries, IHD contributes a major portion of patients with HF with risk factors like DM and HTN. Though, the contribution from RHD still cannot be ignored. There is little decrease in mortality but considering prevalence the burden is still high.
RESUMO
In the present study, a high chitinase producing strain Pantoea dispersa was isolated from the sea dumps at Bhavnagar, India. Chitin, urea, CaCl2 and MgSO4 x 7H2O were variables used in central composite design for chitinase production. Chitinase, biomass and pH were the responses used in different models to evaluate individually fit ones. Quadratic model was found to be fit for chitinase response whereas in the case of biomass and pH, linear model was found to be fit without the effect of others. Chitinase production was optimized with respect to other responses such as biomass and pH in multiresponse analysis of response surface design by using desirability approach. In multiresponse analysis, following medium formulation (g/l), chitin, 15; urea, 0.32; CaCl2, 0.10 and MgSO4 x 7H2O, 0.08 was found to predict optimum chitinase production of 482.77 units/ml with overall highest desirability of 0.854 as compared to other formulations. The selection of model was done on the basis of high Adjusted R-squared value and lowered p-value for each model in individual analysis of each response. In multiresponse experiment, it was found that for response chitinase quadratic model and for responses pH and biomass linear models were well fit. Through desirability analysis, it was found that in the chitinase production, pH was essential as compared to biomass in P. dispersa. Endochitinase and chitobiase actvities were also studied.