OBJECTIVE: To determine the effects of arginine in the rates of sputum conversion in patients with drug-sensitive pulmonary tuberculosis.

METHODS: Studies from PubMed, Medline, EMBASE, and Cochrane were reviewed and appropriate studies were included. Randomized controlled trials comparing arginine with placebo in adult patients with drug-sensitive pulmonary tuberculosis were included. The risk of bias was assessed using the Cochrane Risk of Bias tool. A meta-analysis of the rate of sputum conversion at 8 weeks, was conducted. Post hoc analyses of sputum conversion at 4 weeks and cough reduction at 4 and 8 weeks were done.

RESULTS: Three articles included in this study had a pooled population of 452 participants. This meta-analysis showed no significant difference in the sputum conversion at 4 and 8 weeks, with a relative risk of 0.96 (95% CI 0.77-1.20) and 1.07 (95% CI 0.96-1.19), respectively. However, the cough was significantly reduced at 4 and 8 weeks, with subtotal relative risks of 0.91 (95% CI 0.82-1.00) and 0.43 (95% CI 0.22-0.81), and total relative risk for cough reduction of 0.83 (95% CI 0.73-0.93).

CONCLUSION: While arginine may not significantly reduce sputum conversion rates, it may be used as an adjunct to decrease cough in patients with tuberculosis.

Human ; Arginine ; Tuberculosis, Pulmonary

BACKGROUND

Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels, which includes coronary heart disease, cerebrovascular disease, and peripheral artery disease. It is currently the leading cause of death worldwide. Currently, there is paucity in the available epidemiologic data of CVD in Southeast Asia (SEA).

OBJECTIVE

To determine the prevalence, mortality rate, and associated risk factors of CVD (specifically ischemic heart disease, stroke, and peripheral artery disease) among adult populations in SEA.

METHODS

A systematic review of published articles between 2015 and 2020 was conducted. The authors also searched the World Health Organization database and publicly available health department websites of Southeast Asian countries.

RESULTS

The overall prevalence of CVDs in SEA is 5.48%. Specifically, the prevalence of ischemic heart disease is 1.54% and is highest in Thailand (2.54%). Ischemic stroke has a prevalence of 1.03% and is highest in Indonesia (1.97%). Prevalence of peripheral artery disease is 1.36% and is also highest in Thailand (1.92%). Mortality rate from CVD in SEA is 13.41%. Hypercholesterolemia, smoking, and hypertension are the most common risk factors, with prevalence of 41.2%, 21.1%, and 20.9%, respectively.

CONCLUSION

The prevalence and mortality rate of CVD in SEA remain high and are associated with high prevalence of underlying risk factors. Interventions should be strengthened to improve the overall picture in the region. Collaborative efforts among Southeast Asian countries are essential not only in generating comparative epidemiologic data but also in sharing best practices in lowering CVD mortality and morbidity.

Cardiovascular Diseases ; Myocardial Ischemia ; ischemic heart disease ; Stroke ; Peripheral Arterial Disease ; Risk Factors ; Asia, Southeastern

Rationale: Coronary artery disease (CAD) is the leading cause of death worldwide and coronary angiography (CA) remains the gold standard for its diagnosis. However, proper patient selection for CA is important to avoid unnecessary risks and expense. The American College of Cardiology (ACC), with other major organizations, developed Appropriate Use Criteria (AUC) for CA. AUC assist clinicians in decision making on whether to use the tests according to indications and objectively assess if these tests are appropriately utilized. This is the first study to determine the appropriateness of CA performed and the clinical and angiographic profile among adult service patients in UP-PGH. Objectives: To determine (1) the indications for CA and its appropriateness based on 2012 AUC for Diagnostic Catheterization by the ACC, (2) the clinical profile of patients who underwent CA among adult service patients at UP-PGH and (3) the angiographic profile of these patients. Methods: This cross-sectional study included all CA studies performed on adult service patients from January to December 2019. Demographic and clinical profiles, non-invasive tests, and angiographic findings were collected. The primary outcome determined was the appropriateness of the indications for each CA performed based on AUC scores. Descriptive analysis using frequencies and mean values with standard deviations were used. Results: Among the 515 patients included, majority were males, above 50 years of age, with normal eGFR, presented initially with chest pain, and with a presenting diagnosis of chronic coronary syndrome. Majority of these patients had obstructive CAD (75%), with left anterior descending artery as the most frequently involved vessel. Non-obstructive CAD was found in 11% while normal coronaries were noted in 14% of these patients. Our findings showed that 99.8% of the CA performed were appropriate, of which majority (54%) had an AUC score of A9. STEMI or a suspicion of STEMI, with an A9 score, was the most frequently encountered indication at 33% of the time. Conclusion Majority (99%) of the CA studies performed in the PGH cardiac catheterization laboratory for the year 2019 were executed based on highly appropriate indications (AUC scores A7 to A9) and followed Class I and II recommendations from guidelines. The allocation of resources is deemed to be well-utilized based on the data generated from this study.
Coronary Angiography ; Cardiac Catheterization