AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • Kenya Cardiac Society July 2023 12 Submission ID: 12 ECHOCARDIOGRAPHY IMAGING IN PATIENTS UNDERGOING CHEMOTHERAPHY WILLIAM KATIKU, BERNARD SAMIA MPSHAH HOSPITAL Introdution Echocardiography is non-invasive imaging modality that provides comprehensive evaluation of the heart at all stages in cancer treatment and is able to detect complications secondary to therapeutic regime used( Radiotherapy or chemotherapy).Echo remains to be the leader in imaging due to its accessibility ,portability and lack of exposure to radiation. Modalities 2D Echocardiography 3D Echocardiography Strain Echocardiography. Results Echocardiography is widely used technique in diagnosis, prevention and risk assessment in CTRCD (cancer therapy related cardiac dysfunction) Utility of advanced Echo has proved helpful in detecting changes in myocardial mechanics before changes in LV ejection Fraction occur. a period of 1 year. The areas include: Malindi, Kilifi, Msambweni, Kinango, Voi, Lamu, Garissa and Mandera.Both children and adults with congenital heart diseases as well children with acquired cardiac diseases were identified and various treatment plans and medications were provided. Results A total of 651 individuals were screened out of which 581 were children and 70 were adults. Among the 651 individuals screened 299 were diagnosed with a cardiac disease. This represents 45.9% of the total individuals screened. Of the 299 patients 12 (5%)were adult and 287(95%) paediatrics. Diagram Conclusion There are a lot of paediatrics cardiac cases in our community that are undiagnosed and a lot of these patients are dying. Different Echocardiography methods and their shortcomings. Advantages Disadvantages. 1.2D Echocardiography Widely available Easy assessment Powerful prediction of death and advanced outcomes in heart failure. Load dependent High observer variability compared to 3D echo Not sensitive to detect cardio toxicity. 2.3D Echocardiography Better in determination of LVEF compared to 2D Echo Better Reproducibility. High reliability on quality of images. Less available Depended on the experience of operator. 3.Global Longitudinal Strain Ability to detect subclinical cardio toxicity in early stages. Superior prediction of mortality compared to 2D LVEF Less Load dependent Dependent on image quality Operator dependent and experience. Vendor/software specific. International guidelines Definition of cardiotoxicity by echocardiography: LVEF: a decline in LVEF by > 10% (absolute percentage points) to a value < 50%, Definition of probable subclinical cardiotoxicity by echocardiography: LVEF: a decline in LVEF by > 10% (absolute percentage points) to a value ≥ 50% with an accompanying fall in GLS > 15% (where GLS measurement is available). Conclusion Echo remains to be the leader in imaging due to its accessibility, portability and lack of exposure to radiation. Echocardiography has been utilized in chemotherapy patients for monitoring heart function in all stages of chemotherapy adminstration.Major focus has been on the LVEF and any changes that arise in the course of treatment. Recent advances in echocardiography (Strain Echocardiography), has been in the forefront in monitoring the patients. Submission ID: 13 EVALUATING THE IMPACT OF ELECTRONIC MEDICAL RECORDS (EMR) SYSTEM IN IMPROVING THE CARE PROCESS, TREATMENT OUTCOMES AND DATA QUALITY IN HYPERTENSIVE CLINICS IN TWO COUNTIES - 2021/2022. MUTISO SM1,2, MWENDA V2, GATHECHA G.2 1KENYA FIELD EPIDEMIOLOGY AND LABORATORY TRAINING PROGRAM 2MINISTRY OF HEALTH DEPARTMENT OF NON-COMMUNICABLE DISEASES Introdution A quarter of the Kenyan adult population has hypertension with only 4% having adequate control. This study aimed to evaluate the impact of an EMR on care, outcomes, and data quality, by comparing a clinic using an EMR and one using a paper-based system. Methods We carried out a cross-sectional retrospective review of records to assess effectiveness of an EMR system in improving care as well as surveillance. Makueni and Nyeri were our intervention and comparison sites respectively. Analysis included descriptive statistics, bivariate analysis and logistic regression modelling. Data quality audits were carried out to assess completeness and consistency.
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