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103. To study the effects of knee osteoarthritis on hip flexibility among elders.

Author

Sheraz, Sadia, Sarwar, M. Usman, Saeed, Hafiz Salman, Manqoos-Ur-Rehman, Manzoor, Imran, and Abbas, Naeem

Subjects
*KNEE osteoarthritis, *KNEE joint, *OLDER people, *HIP joint, *OSTEOARTHRITIS
Abstract

Objectives: To determine the effect of knee osteoarthritis on hip flexibility by using Modified Thomas Test. Study Design: Observational study. Setting: Department of Physiotherapy and Orthopedic, Shalamar Hospital, Lahore. Period: 1 July 2021 to 31 December 2021. Material & Methods: This study recruited 40 participants of either sex, age between 30-70 years. Results: The response of study was 100%. Frequency of females with osteoarthritis was 82.5 males was 17.5%. Among the patients 33 were females and 7 were males. T-Test was performed for parameters of age in years, height in inches, weights in kgs for females and males. The mean age was 51.79±9.303 years for female and 55.43±8.404 years for male. Weight in kgs for female was 76.03±9.133 and for male was 94.57±20.911. In T test the height in inches for female was 61.45±2.399 and for male was 65.57±3.735. The co-relation between hip flexibility and knee osteoarthritis was moderately significant and flexibility was reduced because of osteoarthritis. Conclusion: It was concluded that hip flexibility is reduced with osteoarthritis of knee joint and due to reduced mobility of hip joint routine daily activities of patient was hampered. [ABSTRACT FROM AUTHOR]

Published
2022
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104. Comparison of efficacy of intra articular steroid injection versus manipulation under anesthesia (MUA) in idiopathic frozen Shoulder.

Author

Saeed, Hafiz Salman, Manzoor, Basharat, Qureshi, Sumair, Sarwar, M. Usman, Rasheed, Nusrat, and Manzoor, Imran

Subjects
INJECTIONS, ANESTHESIA, INTRA-articular injections, SHOULDER, DISEASE duration, UNIVERSITY hospitals
Abstract

Objective: To compare efficacy of intra-articular steroid (IAS) injection with manipulation under anesthesia (MUA) in idiopathic FS. Study Design: Randomized Control Trail. Setting: Department of Orthopedic, Independent University Hospital, (IMC) Faisalabad. Period: 1st January 2021 to 30th June 2021. Material & Methods: Diagnosis of FS was based upon detailed history and proper physical. Group A (n=50) included intra-articular injection patients and Group B (n=50) was patients receiving MUA. Pain was measured by VAS and disability was measured by Disability Index (SPADI) scale. Results: Mean age of sample was 37 ± 10.52 in group A and 39.14± 9.48 in group B. Age of patients ranges from 35 to 50 years. Female patients were greater in both the groups. Most of the patients have duration of disease for more than 1 month. The ratio of patients with right side disease was more than 50% in both the groups as compared to left side. In group A. there was a significant decrease in mean pain from 3.45 ± 1.12 to 2.16 ± 0.8 In group B, mean pain score decreased from 3.65 ± 0.88 to 2.35 ± 0.68 1. Overall group A was more effective as compared to group B but the results were not significant statistically. Conclusion: The intra-articular injection method was superior to MUA because it was easier, safer, and less expensive, and it produced early results. [ABSTRACT FROM AUTHOR]

Published
2022
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105. Treatment of club foot with serial casting by ponsetti technique.

Author

Saeed, Hafiz Salman, Manzoor, Basharat, Sarwar, M. Usman, Rasheed, Nusrat, Manzoor, Imran, and Elahi, Muhammad Omer Imran

Subjects
CLUBFOOT, UNIVERSITY hospitals, TENOTOMY, EXPERIMENTAL design
Abstract

Objective: To determine efficacy of serial casting of ponseti technique for treating club foot. Study Design: Cross Sectional study. Setting: Department of Orthopedics Surgery, Independent University Hospital, Faisalabad. Period: 1st July, 2019 to 30th June, 2020. Material & Methods: All clubfoot patients who presented to the Orthopedics department were included in the study. Patients were first classified using the Pirani scoring system, followed by manipulation and weekly above-knee casts. Equinus was assessed after 4th to 6th cast and percutaneous tenotomy was done if required. Follow-up of patients were kept for 5 months after final cast removal. All the data was entered and analyzed in SPSS Version 25. Results: Mean age of the patients was 37 weeks. From total 41 patients, 27 children presented between age of 0-6 months, 5 between 6 to 12 months and 9 between 1-2 years. Among the 41 children, 25 had unilateral while 16 had bilateral involvement. Among 41 children, 26 were male and 15 were females. Mean casts needed in our study was 6.29±0.93. By using, the 10-point Pirani scoring system, the mean Pirani score was 3.46±0.515 at baseline while mean Pirani score after treatment was 0.0317±0.130. The results were excellent in 82%, good in 12% and fair in 4%. Conclusion: Ponseti is reliable and effective method. Results of our study are good and satisfying and all clubfeet in our institution can be treated with this procedure. [ABSTRACT FROM AUTHOR]

Published
2022
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111. Controlled drug release behavior of metformin hydrogen chloride from biodegradable films based on chitosan/poly(ethylene glycol) methyl ether blend

Author

Ghaffar, Abdul, Duran, Hatice, Islam, Atif, Sarwar, M. Sohail, Tuncel, Eylül, Oluz, Zehra, Yasmin, Farhat, Qaiser, Asif Ali, Ghaffar, Abdul, Duran, Hatice, Islam, Atif, Sarwar, M. Sohail, Tuncel, Eylül, Oluz, Zehra, Yasmin, Farhat, and Qaiser, Asif Ali

Abstract

In this study, novel smart drug release films were prepared by blending chitosan with polyethylene glycol methyl ether (PEGME), also named as methoxy polyethylene glycol (mPEG), for controlled drug release applications. The polymeric films were characterized by Fourier transform infra-red for functional groups analysis, scanning electron microscopy for morphology and X-ray photoelectron spectroscopy for chemical and surface analysis followed by mechanical and thermal analysis. The mechanical properties showed that with the addition of PEGME (40%), the tensile strength and elongation break were increased up to 34.14 MPa and 26.40%, respectively as compared to the controlled sample (without PEGME). The developed biodegradable films were tested for Metformin hydrogen chloride release ability at a particular rate in phosphate buffer saline solution at pH 7.4. The results showed that chitosan/PEGME blends could be employed for controlled drug release and other biomedical applications. (C) 2017 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University.

Published
2020

112. Controlled drug release behavior of metformin hydrogen chloride from biodegradable films based on chitosan/poly(ethylene glycol) methyl ether blend

Author

Islam, Atif, Yasmin, Farhat, Sarwar, M. Sohail, Ghaffar, Abdul, Duran, Hatice, Oluz, Zehra, Tuncel, Eylül, Qaiser, Asif Ali, Islam, Atif, Yasmin, Farhat, Sarwar, M. Sohail, Ghaffar, Abdul, Duran, Hatice, Oluz, Zehra, Tuncel, Eylül, and Qaiser, Asif Ali

Abstract

In this study, novel smart drug release films were prepared by blending chitosan with polyethylene glycol methyl ether (PEGME), also named as methoxy polyethylene glycol (mPEG), for controlled drug release applications. The polymeric films were characterized by Fourier transform infra-red for functional groups analysis, scanning electron microscopy for morphology and X-ray photoelectron spectroscopy for chemical and surface analysis followed by mechanical and thermal analysis. The mechanical properties showed that with the addition of PEGME (40%), the tensile strength and elongation break were increased up to 34.14 MPa and 26.40%, respectively as compared to the controlled sample (without PEGME). The developed biodegradable films were tested for Metformin hydrogen chloride release ability at a particular rate in phosphate buffer saline solution at pH 7.4. The results showed that chitosan/PEGME blends could be employed for controlled drug release and other biomedical applications. (C) 2017 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University.

Published
2020

113. Effect Of Different Biochemical Traits On Seed Cotton Yield : An Application Of Liu Linear Regression

Author

Qasim, Muhammad, Amin, M., Sarwar, M. K. S., Qasim, Muhammad, Amin, M., and Sarwar, M. K. S.

Abstract

This article aimed to study the associations among the biochemical traits and their effects on seed cotton yield using the regression analysis and to assess the alternative approach for reducing the impact of multicollinearity problem in estimating the regression coefficients. The field experiment was conducted where five explanatory variables (chlorophyll 'a', chlorophyll 'b', total chlorophyll, total soluble protein and total soluble sugar) and one dependent variable seed cotton yield were measured. The correlation matrix of X'X showed that biochemical traits were significantly correlated. The multicollinearity problem among the biochemical traits was determined by condition index and correlation matrix. Using the least square regression analysis, the effects of biochemical traits on seed cotton yield were not satisfactory since least square regression model has high value of MSE (3352475), AIC (366.7) and inconsistent estimates of traits. The Liu regression analysis was efficient (MSE = 57212 and AIC = 363.8) and reliable in reducing the adverse effects of multicollinearity. The Liu regression results indicated that total chlorophyll and total soluble protein were contributed a significant (P <= 0.05) role in seed cotton yield. In contrast, ordinary least square regression analysis was showed insignificant (P > 0.05) effect of total chlorophyll on seed cotton yield.

Published
2020
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117. Vulnerability Analysis for the Authentication Protocols in Trusted Computing Platforms and a Proposed Enhancement of the OffPAD Protocol

Author

Mada Alhaidary, Sarwar M Haque, Mohammed Zakariah, M. Shamim Hossain, Brij B. Gupta, Atif Alamri, and Sk. Md. Mizanur Rahman

Subjects
General Computer Science, Computer science, 0211 other engineering and technologies, Attack tree, Vulnerability, 02 engineering and technology, Computer security, computer.software_genre, Data origin authentication, vulnerability analysis, Vulnerability assessment, Server, biometric authentication, 0202 electrical engineering, electronic engineering, information engineering, General Materials Science, Protocol (object-oriented programming), Private information retrieval, 021110 strategic, defence & security studies, Authentication, General Engineering, 020206 networking & telecommunications, Trusted Computing, Service provider, offline personal authentication device (OffPAD), Authentication protocol, lcsh:Electrical engineering. Electronics. Nuclear engineering, computer, lcsh:TK1-9971, entity authentication
Abstract

Trusted computing architecture ensures the behavior of software that runs on a user machine by protecting software-level attacks. Due to the potential of exposing a user’s private information while accessing a system, many studies have focused on analyzing existing protocols to develop new methods based on biometrics or additional devices to add new layers of security to the authentication process. For a few years, the idea of utilizing the combination of something you know with something you have and a personal authentication device (PAD) has become common in verification protocols. Very recently, a more secure PAD, namely the Offline Personal Authentication Device (OffPAD), was invented to improve the authentication process. This single device can be used to manage the identities of both users and service providers as well as support the authentication process, while being offline most of the time. In this paper, a rigorous vulnerability analysis for OffPAD-based authentication techniques is conducted using an attack tree analysis. Finally, to overcome the vulnerabilities, mitigation techniques are proposed.

Published
2018

140. A New Type of Scaling Relations to Assess the Accuracy of Computational Predictions of Catalytic Activities Applied to the Oxygen Evolution Reaction

Author

Briquet, L.G.V., Sarwar, M., Mugo, J., Jones, G., Calle Vallejo, F., Calle-Vallejo, F., and Calle-Vallejo, F.

Subjects
Chemical substance, Thermodynamics, 02 engineering and technology, 010402 general chemistry, 01 natural sciences, Catalysis, Inorganic Chemistry, adsorption energy, symbols.namesake, Adsorption, Computational chemistry, Physical and Theoretical Chemistry, Scaling, density functional theory, scaling relations, Chemistry, Organic Chemistry, Oxygen evolution, Solvation, volcano plot, 021001 nanoscience & nanotechnology, 0104 chemical sciences, Volcano plot, oxygen evolution reaction, symbols, Density functional theory, van der Waals force, 0210 nano-technology
Abstract

Experimentally, it is well known that the overpotentials for the oxygen evolution reaction (OER) on RuO2 and IrO2 are similar and rather low. The question is whether widespread computational electrochemistry models based on adsorption thermodynamics are capable of reproducing such observations. Making use of DFT results of RPBE and PBE functionals from six different codes and various types of pseudopotentials, we show that while IrO2 is consistently predicted to have low overpotentials, RuO2 is predicted to have large overpotentials. A new methodology based on adsorption-energy scaling relations shows that the inaccurate prediction for RuO2 stems from its anomalous adsorption energies of oxygen/oxygenates. Including explicit water solvation and using functionals that account for van der Waals interactions such as vdW-DF, vdW-DF2 and optPBE-vdW modifies appropriately the adsorption energies so that both oxides are predicted to be highly active.

Published
2017
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141. COMPARATIVE EFFICACY OF MAGNETIC FIELD SEED TREATMENT AND PRIMING IN IMPROVING GROWTH AND PRODUCTIVITY OF OKRA.

Author

Ziaf, K., Amjad, M., Ghani, M. A., Ahmad, I., Ayub, M., Sarwar, M., Iqbal, Q., and Nawaz, M. A.

Subjects
OKRA, WATER efficiency, FRUIT yield, SEED storage, PHOTOSYNTHETIC rates, PLANT yields, SOWING, SEED treatment
Abstract

Seed priming (halo- and hydro-priming) and magnetic seed treatments have been used to invigorate seeds. Primed seeds cannot be stored for long duration due to start of gemination processes, although dried to initial seed moisture content at the end of lag phase of germination. On the other hand, magnetic seed treatment invigorates the seeds without starting germination processes and so considered safe for storage of seeds. The comparative evaluation as well as their impact on various physiological aspects of okra plant has been scarcely evaluated. A field experiment was conducted to compare the impact of seed priming (hydro-priming and halo-priming) and magnetic field seed treatments, on growth, photosynthesis related attributes and yield of two okra cv. Sabz Pari and Super Green during summer 2016. Seeds of both cultivars, primed in water (hydro-priming), salt solution (halo-priming using NaCl 1%, ZnSO4 0.1%, CuSO4 0.1%, H3BO3 1%, KNO3 1% and 2%), or exposed to magnetic field of 100 or 200 mT for 10 or 20 minutes, were sown in field according to randomized complete block design under factorial arrangements. Results revealed that magnetic field seed treatment, specifically 100 mT for 20 minutes, improved emergence (25-34% over control), seedling fresh and dry weight, leaf weight, pod length, number of fruits per plant and fruit yield per plant (27-38% over control). Chlorophyll contents of both okra cultivars were highest in response to seed priming with 1% KNO3. Transpiration rate and net photosynthetic rate of both okra cultivars were also high for plants grown using 100 mT for 20 minutes treated seeds of both cultivars. While, sub-stomatal conductance of cv. Sabz Pari and Super Green was highest in response to 100 mT for 10 minutes and 1% NaCl, respectively. However, water use efficiency of Sabz Pari and Super Green was highest for plants raised using seeds primed in 1% KNO3 and 1% H3BO3, respectively. It may be inferred that pre-sowing magnetic field treatment of seed (100 mT for 20 minutes) can be effectively used to improve okra crop stand establishment, growth and yield followed by seed priming in 1% KNO3. Moreover, magnetic seed treatment, being less damaging to seed, is more suitable than priming; the later one decreases storage life of seed. [ABSTRACT FROM AUTHOR]

Published
2022
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142. Thermodynamics of Bardeen regular black hole with generalized uncertainty principle.

Author

Merriam, Areeba and Sarwar, M. Zain

Subjects
*BLACK holes, *THERMODYNAMICS, *WKB approximation, *HEAT capacity, *ELECTROMAGNETIC spectrum, *HAMILTON-Jacobi equations, *HAWKING radiation, *HEISENBERG uncertainty principle
Abstract

This study explores the emission of massive charged spin-1 particles from the background of Bardeen regular spacetime by the semi-classical method used to study the Hawking radiation spectrum. We employed the Hamilton–Jacobi method and Wentzel–Kramers–Brillouin approximation technique with the suitable form of the wave function to solve the Proca field equation. We calculated the tunneling probability of outgoing spin-1 particles and the corresponding thermodynamic temperature. Furthermore, we obtained the modified thermodynamic quantities like temperature, entropy as well as heat capacity by utilizing the quadratic form of generalized uncertainty principle (GUP) and minimal length. In the end, we investigated the local stability as well as phase transitions of the Bardeen black hole in the context of GUP-modified heat capacity. [ABSTRACT FROM AUTHOR]

Published
2022
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143. Intra-Firm Value Co-Creation: Role of High-Performance Work Practices.

Author

Haque, Raheela, Azhar, Sarwar M., Shaikh, Saifullah, Maitlo, Qamaruddin, and Khaskheli, Ghulam Akbar

Subjects
CUSTOMER cocreation, HIGH performance work systems, VALUE creation, EMPLOYEE reviews, VALUE orientations, INFORMATION sharing
Abstract

Organizations, who intend to abide by their desire to engage in value co-creation with their customers, need to introspect and focus on knowledge sharing and inter-functional coordination as core drivers and enablers of the firm's desired behaviors. These behaviors encourage employees, departments, and other stakeholders to take collective responsibility in creating value internally, thus enabling an internal value co-creation orientation. In this regard, high-performance work practices such as recruitment and selection, training and development, performance appraisal, compensation and rewards, work design and teamwork; theoretically hold the HRM key to ensure firms'desired behaviors. Moreover, the benefit of adopting this new orientation within the firm's behavioral paradigm is to create capabilities that lead to the creation of an intra-firm value co-creating system. [ABSTRACT FROM AUTHOR]

Published
2021

144. Effect of Different Potting Mixes on Germination and Vegetative Growth of Sweet Pepper Plant (Capsicum Annum L.) Under Greenhouse Conditions

Author

Sarwar M. R. Ahmed, Omar A. O. Rekani, and Hajar Ameen Ameen

Subjects
Municipal solid waste, Germination, engineering.material, Biology, Crop, Sweet Pepper, 0404 agricultural biotechnology, Peatmoss, Pepper, lcsh:Science, Yield production, Compost, fungi, food and beverages, 04 agricultural and veterinary sciences, General Medicine, 040401 food science, Manure, Horticulture, Agronomy, Organic fertilizer, engineering, lcsh:Q, Fertilizer
Abstract

Sweet pepper is a high nutrient demanding vegetable crop. Fertilizer use and management is therefore of highly important to sustain growth and high yield. However, this study aimed to evaluate the effect of using different types of organic fertilizer on germination and vegetative growth of sweet pepper plant, that have bell-shaped (Capsicum annum L), grown in pots culture under greenhouse condition. The study was conducted at the College of Agriculture, Duhok Governorate, Kurdistan region, Iraq during March 15th, 2015, to June 25th, 2015. The treatments that have been compared in this study were: T1 (Control 100% soil); T2 Municipal Solid Waste compost taken from Kashe factory (1:1 V/V); T3 Sheep manure (1:1 V/V); and T4Peat moss (1:1 V/V).The experiment was randomized complete design with three replicate. The parameters that have been measured were: germination percentage, plant height; number of leave per plant; leaf area and plant fresh and dry weight per pot. In most cases all the studied growth parameters were significantly higher in pot treated by peatmoss and sheep manure compared to control and Municipal Solid Waste compost. Germination percentage was also significantly enhanced in treatment amended by peatmoss and sheep manure. Municipal waste compost was significantly reduced the all the plant growth parameter and germination percentage as well. Depending on these results it can be suggested that organic fertilizers particularly peatmoss and sheep manure can be used to enhance growth and productivity in plant pepper. It was also claimed that the amount of municipal waste compost that was used in this experiment might be too high so further study should be conducted with different ratio on the quality of this type of organic fertilizer.

Published
2016
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147. Enhancing Branch Predictors using Genetic Algorithm

Author

Muhammad Aliyu Sulaiman, Sarwar M Haque, Joarder Kamruzzaman, Arifuzzaman, Rafiul Hassan, and Salami Onoruoiza

Subjects
0209 industrial biotechnology, 020901 industrial engineering & automation, Computer science, Genetic algorithm, Work (physics), 0202 electrical engineering, electronic engineering, information engineering, 020201 artificial intelligence & image processing, 02 engineering and technology, Hardware_CONTROLSTRUCTURESANDMICROPROGRAMMING, AC power, Branch predictor, Algorithm
Abstract

Dynamic branch prediction is a hardware technique used to speculate the direction of control branches. Inaccurate prediction will make all speculative works useless while accurate prediction will significantly improve microprocessors performance. In this work, we have shown that Genetic Algorithm (GA) can be used to select (near) optimal parameters for branch predictors in most cases. The GA-enhanced predictors take time to find suitable parameters, but once the values of these parameters are determined, the GA-enhanced predictors take the same time to execute as the basic predictors with increased accuracy.

Published
2019
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148. Physicians' guideline adherence is associated with long-term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry

Author

Komajda, M. Schöpe, J. Wagenpfeil, S. Tavazzi, L. Böhm, M. Ponikowski, P. Anker, S.D. Filippatos, G.S. Cowie, M.R. Aleksanyan, A. Atayan, L. Avetisyan, A. Davtyan, N. Drambyan, M. Gevorgyan, K. Grigoryan, M. Hakobyan, Z. Hayrapetyan, H. Kocharyan, L. Kramarevskaya, T. Melqonyan, A. Muradyan, F. Nanyan, R. Ordyan, A. Ordyan, M. Piruzyan, A. Podosyan, G. Safaryan, K. Sargsyan, T. Sarkisyan, A. Sisakyan, H. Ter-Grigoryan, V. Ustyan, T. Alexopoulos, C. Amerena, J. Arstall, M. Ayres, B. Barron, G. Beltrame, J. Bou-Samra, J. Brown, M. Cross, D. Dwyer, N. Eccleston, N. Hare, D. Ho, B. Hopper, I. Jackson, B. Korczyk, D. Lattimore, J.D. Levendel, A. Macfadyen, R. Pandeli, V. Playford, D. Richardson, M. Senior, J.A. Shah, A. Shetty, P. Soward, A. Srivastava, P. Swale, M. Vogl, E. Wai, B. William, M. Worthington, A. Wright, S. Brunner, B. Fuhrmann, W. Horer, L. Maca, T. Nahler, A. Ortner, H. Racz, G. Scheibner, P. Sebald, C. Abdullayev, A. Abdullayev, R. Ahmadov, A. Alakbarov, E. Aliyev, F. Aliyev, F. Bakhshaliyev, A. Bakhshiyev, M. Dadashova, G. Dashdamirov, R. Faradjova, N. Guliyev, A. Guliyev, F. Guliyeva, S. Hajiyev, G. Ibrahimov, F. Imanov, G. Isayeva, A. Isayeva, M. Jabrailova, U. Jafarov, R. Jahangirov, T. Khalilov, A. Khalilov, S. Mehdiyev, S. Najafov, R. Samedova, H. Shahhuseynov, S. Yusifly, R. Yusifov, T. Zahidova, K. Zeynalov, A. Abdullatif, A. Al-Banna, R. Haiky, W. Husain, A. Jamsheer, A. Barbuk, O. Belskaya, M. Borodko, V. Kurlianskaya, A. Mackevich, S. Mankevich, N. Moroz-Vodolazhskaya, N. Ravtovich, O. Saevich, A. Troyanova, T. Chughtai, A. Johar, S. Luqman, N. Nair, T.C.-R. Deyoung, P. Ezekowitz, J. Frenette, M. Howlett, J. Huynh, T. Nguyen, V. Toma, M. Orenstein, T. Rinne, M.R.C. Virani, S. Zieroth, S. Ailiman, M. Cong, H. Ding, W. Dong, W. Dong, Y. Gao, C. Li, L. Li, Z. Liang, Y. Liu, X. Liu, S. Luo, S. Shi, H. Tian, Q. Wang, D. Wang, J. Wei, M. Wu, C. Xu, D. Yang, X. Yang, Z. Zhang, C. Zhang, Q. Zhang, Y. Zhang, R. Zheng, Y. Zhao, L. Zhou, J. Buch, P. Davidsen, F. Eiskjær, H. Bruun, N.E. Kragh-Thomsen, N.E. Franow, H. Køber, L. Korup, E. Madsen, B.K. Mikkelsen, K. Nielsen, K.A. Nørgaard, A. Refsgaard, J. Rickers, H. Kaiser, P. Sykulski, R. Zeuthen, E.L. El Fottoh, A.A. El Badry, M. El Hady, Y.A. El Kady, E. El Khatib, H. Fawzy, M. Hegazy, H. Salama, M.K. Mortada, A. Mostafa, T. Mwafy, A. Ossama, M. Samir, S. Seleem, M. Sobhy, B. Bregadze, G. Chelidze, K. Chumburidze, V. Jalabadze, K. Khabeishvili, G. Kiphiani, Z. Klimiashvili, Z. Kvitsiani, A. Mamatsashvili, M. Melia, I.M.A. Oragvelidze, T. Orjonikidze, S. Paposhvili, K. Petriashvili, S. Phaghava, Z. Shushania, M. Tsetskhladze, E. Tsinamdzgvishvili, B. Abdel-Qader, M. Al-Zoebi, A. Böhm, G. Bosch, R. Brune, S. Bunge, K. Dominick, K. Duda, S. Erdogan, A.E. Faber, G. Fach, C. Fechtrup, C. Frickel, S. Giokoglu, K. Haas, J. Hagenow, A. Haj-Yehia, A. Hansen, C. Hartung, W.M. Hauser, E.R. Hofmeister, A. Hohensee, H. Hüttemann, M. Keim, M. Krämer, A. Langwasser, K. Lodde, B.P. Lorch, G. Lüer, C. Müller, K. Placke, J. Plesch, B. Potolidis, L. Richter, F. Rieker, W.A. Schlichting, J. Stenzel, G. Theuer, J.D. Marcin, A. Warkentin, R. Wegner, M. Wilke, A. Agrafiotis, I. Aleksandridis, I. Farmakis, D. Giannakoulas, G. Karavidas, A. Lamprou, A. Ninios, V. Panagiotopoulos, K. Papadopoulos, K. Siachos, S. Dékány, M. Borbéy, A. Borsányi, T. Forster, T. Gavallér, H. Gyuricza, I. Heltai, K. Herczeg, B. HŐgye, M. Losonczi, I. Merkely, B. Metz, E. Muk, B. Nagy, K. Ökrös, M. Piry, K. Poós, G. Sárszegi, Z. Somogyi, T. Sziliczei-Németh, E. Tátrai, T. Zima, E. Zsigmond, A. Daly, C. Mahon, N. Meany, B. Abbdi, I. Awaysheh, R. Azouka, M. Hamoudeh, S. Nammas, A. Okkeh, O. Aimakova, G. Ismagulova, Z. Issabekova, A. Junusbekova, G.A. Koshumbayeva, K. Madaliyev, K. Mekebekova, D. Mukatova, A. Ospanova, G. Sadvakassova, G. Sunkarbekova, Z. Yegorova, Y. Zhangelova, S. Kim, K.H. Al-Mutairi, M. Gaber, Y. Ghali, I. Ghanem, A. Hafez, H. Haiba, M. Koushy, T. Mahmoud, A. Raafat, G. Sallam, M. Senousi, O. Soliman, M. Massih, T.A. Ali, S.A. Jaoude, S.A. Azzi, N. Badaoui, G. Bayeh, H. Beydoun, A. Chammas, E. Dib, H. Gebran, M. Ghanem, G. Haidar, H. Hamadeh, M. Hamoui, O. Hobeika, R. Jazra, C. Kabbani, S. Kadri, Z. Karanaminassian, R. Kassab, R. Kleit, M. Mansour, H. Mousallem, N. Semaan, C. Simonian, A. Sarkis, A. Succar, S. Zalloum, R. Zind, R. Anusauskiene, J. Grigaliuniene, A. Karaliute, R. Kavoliuniene, A. Kozlovaite, V. Miliuniene, D. Rinkuniene, D. Rudys, A. Stasaityte, D. Aziz, F.A.A. Rahim, A.A.A. Ahmad, R. Ahmadsah, S.H.K.A. Ang, C.C. Ang, S.H. Cham, Y.L. Chee, K.H. Chooi, K.C. Chu, C.M. Fam, T.L. Fong, A. Ismail, O. Ismail, J.R. Kamarulzaman, M.H. Kasim, S.S. Khiew, N.Z. Krishnan, C. Krishinan, S. Lau, G. Lee, L.Y. Liew, H.B. Lim, C.W. Mahendran, K. Dass, R.D.M. Mohamad, R. Arshad, M.K.M. Unit, H.M. Mustapha, Z. Ng, W.K. Ong, T.K. Oon, Y.Y. Ramli, A.W. Ramanathan, G.R.L. Ross, N.T. Said, A. Sarwar, M. Tan, E. Tan, S.K. Voon, C.Y. Yusoff, M.R. 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Kaya, O.K. Keser, A. Pinar, P. Taș, M.H. Tosun, H.B. Yazlar, A.S. Yilmaz, S. Yuksel, Y. Bagriy, A. Ivchyna, N. Lyashenko, A. Matviychuk, N. Shchukina, O. Tkach, N. Tseluyko, V. Vasylieva, L. Abdallah, A. Agrawal, A. Basleeb, F. Bazargani, N. Hatou, E. Al Kaddour, A.R. Al Kasser, M. Al Mulla, A. Radaideh, G. Salustri, A. on behalf of the QUALIFY Investigators

Abstract

Background: Physicians' adherence to guideline-recommended therapy is associated with short-term clinical outcomes in heart failure (HF) with reduced ejection fraction (HFrEF). However, its impact on longer-term outcomes is poorly documented. Here, we present results from the 18-month follow-up of the QUALIFY registry. Methods and results: Data at 18 months were available for 6118 ambulatory HFrEF patients from this international prospective observational survey. Adherence was measured as a continuous variable, ranging from 0 to 1, and was assessed for five classes of recommended HF medications and dosages. Most deaths were cardiovascular (CV) (228/394) and HF-related (191/394) and the same was true for unplanned hospitalizations (1175 CV and 861 HF-related hospitalizations, out of a total of 1541). According to univariable analysis, CV and HF deaths were significantly associated with physician adherence to guidelines. In multivariable analysis, HF death was associated with adherence level [subdistribution hazard ratio (SHR) 0.93, 95% confidence interval (CI) 0.87–0.99 per 0.1 unit adherence level increase; P = 0.034] as was composite of HF hospitalization or CV death (SHR 0.97, 95% CI 0.94–0.99 per 0.1 unit adherence level increase; P = 0.043), whereas unplanned all-cause, CV or HF hospitalizations were not (all-cause: SHR 0.99, 95% CI 0.9–1.02; CV: SHR 0.98, 95% CI 0.96–1.01; and HF: SHR 0.99, 95% CI 0.96–1.02 per 0.1 unit change in adherence score; P = 0.52, P = 0.2, and P = 0.4, respectively). Conclusion: These results suggest that physicians' adherence to guideline-recommended HF therapies is associated with improved outcomes in HFrEF. Practical strategies should be established to improve physicians' adherence to guidelines. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology

Published
2019

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