ABSTRACT
Introduction: Complementary and alternative medicine (CAM) includes all healthcare practices that are not part of conventional medicine. One of the most common eye disorders for visiting an ophthalmology clinic is dry eye disease (DED), and due to the increasing number of CAM used for eye conditions, 1 in 5 patients has been reported in previous studies to use CAM for eye treatment. This study aimed to estimate the prevalence of CAM use among patients with (DED). Methods: A web-based survey was used to collect the data, the first part of the questionnaire was about demographic data, and the second part included a validated Arabic version of the ocular surface disease index (OSDI). The third part was about practices that alleviate DED other than conventional medicine. Results: The total sample was 282, 61 were males, and 221 were females. Most participants (48.5%) were between 25 and 44 years old, 90% were Saudi, and only 10% were non-Saudi. Of the participant, 70% reported having attained a university or higher education level. The prevalence of the use of CAM among patients with dry eye was around 85%. The most frequently reported type of CAM used among the participants was faith healing (Ruqyah) (41%). This was followed by warm compressors (37%). There was no significant correlation between the severity of OSDI and using CAM, as the p-value was 0.909. Conclusion: In conclusion, our study shows that CAM is a popular choice among patients with dry eye syndrome. Faith healing and warm compressors are the most used types of CAM. However, the lack of correlation between OSDI severity and CAM use indicates that patients may use CAM for reasons other than symptom severity. Further research is needed to explore the reasons behind CAM use and its effectiveness in managing dry eye syndrome.
ABSTRACT
Background: Differences in clinical presentation and therapy outcomes between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) have been reported but described mainly among hospitalized patients. Because the population of outpatients with heart failure (HF) is increasing, we sought to discriminate the clinical presentation and responses to medical therapy in ambulatory patients with new-onset HFpEF vs. HFrEF. Methods: We retrospectively included all patients with new-onset HF treated at a single HF clinic in the past 4 years. Clinical data and electrocardiography (ECG) and echocardiography findings were recorded. Patients were followed up once weekly, and treatment response was evaluated according to symptoms resolution within 30 days. Univariate and multivariate regression analyses were performed. Results: A total of 146 patients were diagnosed with new-onset HF: 68 with HFpEF and 78 with HFrEF. The patients with HFrEF were older than those with HFpEF (66.9 vs. 62 years, respectively, P = 0.008). Patients with HFrEF were more likely to have coronary artery disease, atrial fibrillation, or valvular heart disease than those with HFpEF (P < 0.05 for all). Patients with HFrEF rather than HFpEF were more likely to present with New York Heart Association class 3 - 4 dyspnea, orthopnea, paroxysmal nocturnal dyspnea or low cardiac output (P < 0.007 for all). Patients with HFpEF were more likely than those with HFpEF to have normal ECG at presentation (P < 0.001), and left bundle branch block (LBBB) was observed only in patients with HFrEF (P < 0.001). Resolution of symptoms within 30 days occurred in 75% of patients with HFpEF and 40% of patients with HFrEF (P < 0.001). Conclusions: Ambulatory patients with new-onset HFrEF were older, and had higher incidence of structural heart disease, in comparison to those with new-onset HFpEF. Patients presenting with HFrEF had more severe functional symptoms than those with HFpEF. Patients with HFpEF were more likely than those with HFpEF to have normal ECG at the time of presentation, and LBBB was strongly associated with HFrEF. Outpatients with HFrEF rather than HFpEF were less likely to respond to treatment.
