{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:16:12Z","timestamp":1777576572207,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Asian Cardiovasc Thorac Ann"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We conducted this study to assess the compliance with secondary rheumatic prophylaxis among preoperative patients with rheumatic mitral valve disease undergoing valvular heart surgery at a tertiary care cardiac hospital in a developing country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a descriptive cross-sectional study conducted at a tertiary care cardiac hospital in Karachi, Pakistan. The inclusion criteria encompassed patients of any sex, aged between 18 and 80 years, who had been diagnosed with rheumatic mitral valve disease through transthoracic echocardiography and had undergone valvular heart surgery. The level of compliance with secondary rheumatic prophylaxis and barriers toward noncompliance was assessed during routine preoperative interview session. This preventive measure plays a crucial role in reducing the progression of the disease and improving patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of the 239 patients included in the study, 125 (52.3%) were females, with a mean age of 38.8\u2009\u00b1\u200911.8 years. The majority of patients (88.7%) came from rural areas. Among the patients, 79 (33.1%) received rheumatic prophylaxis, while 160 (66.9%) did not adhere to it regularly. The common barriers for receiving rheumatic prophylaxis were non availability (41.0%) and nonaffordability (40.6%). Additionally, 28.0% of patients had lacked awareness of the importance of rheumatic prophylaxis, and 2.5% expressed fear of injection site pain and subsequent symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A concerning level of noncompliance with secondary rheumatic prophylaxis was observed. The barriers identified in patients who did not receive rheumatic prophylaxis were primarily related to affordability, availability, lack of awareness, and fear of injection site pain and subsequent symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02184923241256409","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T01:32:08Z","timestamp":1716427928000},"page":"200-205","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lack of awareness of secondary rheumatic prevention in preoperative candidates for mitral valve surgery \u2013 alarming situation"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0827-8086","authenticated-orcid":false,"given":"Raheela","family":"Khowaja","sequence":"first","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aamir","family":"Khowaja","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali Raza","family":"Mangi","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Ammar","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waqar","family":"Khan","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nehrish","family":"Patel","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabia","family":"Nizar","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munawar","family":"Khursheed","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jawaid Akbar","family":"Sial","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rizwan Aziz","family":"Memon","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,5,22]]},"reference":[{"key":"bibr1-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.13.3.470"},{"key":"bibr2-02184923241256409","first-page":"12","volume":"4","author":"Binotto MA","year":"2002","journal-title":"Images Paediatr Cardiol"},{"key":"bibr3-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30360-2"},{"key":"bibr4-02184923241256409","first-page":"203","volume":"10","author":"Dodu SR","year":"1989","journal-title":"World Health Forum"},{"key":"bibr5-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1093\/med\/9780198784906.003.0065"},{"key":"bibr6-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.024769"},{"key":"bibr7-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603693"},{"key":"bibr8-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.06.063"},{"key":"bibr9-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa282"},{"key":"bibr10-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezx324"},{"key":"bibr11-02184923241256409","unstructured":"WHO Study Group on Rheumatic Fever and Rheumatic Heart Disease (2001: Geneva, Switzerland) & World Health Organization. 2004. Rheumatic fever and rheumatic heart disease : report of a WHO expert consultation, Geneva, 20 October \u2013 1 November 2001.\n                      World Health Organization\n                      , https:\/\/apps.who.int\/iris\/handle\/10665\/42898"},{"key":"bibr12-02184923241256409","volume":"2002","author":"Manyemba J","year":"2002","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr13-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0203864"},{"key":"bibr14-02184923241256409","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1056_19"},{"key":"bibr15-02184923241256409","doi-asserted-by":"publisher","DOI":"10.47144\/phj.v56i1.2463"},{"key":"bibr16-02184923241256409","doi-asserted-by":"publisher","DOI":"10.18203\/2349-3291.ijcp20204536"},{"key":"bibr17-02184923241256409","doi-asserted-by":"publisher","DOI":"10.2174\/1573403X13666170116120828"},{"key":"bibr18-02184923241256409","doi-asserted-by":"publisher","DOI":"10.47144\/phj.v54i2.2094"},{"key":"bibr19-02184923241256409","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2016.v106i8.10864"},{"key":"bibr20-02184923241256409","first-page":"52","volume":"95","author":"Robertson KA","year":"2005","journal-title":"S Afr Med J"},{"key":"bibr21-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.025981"},{"key":"bibr22-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2008.143982"},{"key":"bibr23-02184923241256409","doi-asserted-by":"publisher","DOI":"10.4103\/JCPC.JCPC_25_17"},{"key":"bibr24-02184923241256409","first-page":"37","volume":"15","author":"Osman GM","year":"2015","journal-title":"Sudan J Paediatr"},{"key":"bibr25-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2014.10.001"},{"key":"bibr26-02184923241256409","volume":"119","author":"Grayson S","year":"2006","journal-title":"NZ Med J"},{"key":"bibr27-02184923241256409","volume":"77","author":"Writing Committee Members","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"bibr28-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024517"},{"key":"bibr29-02184923241256409","doi-asserted-by":"publisher","DOI":"10.1038\/s41394-022-00503-z"}],"container-title":["Asian Cardiovascular and Thoracic Annals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02184923241256409","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02184923241256409","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02184923241256409","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T19:28:45Z","timestamp":1777404525000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02184923241256409"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1177\/02184923241256409"],"URL":"https:\/\/doi.org\/10.1177\/02184923241256409","relation":{},"ISSN":["0218-4923","1816-5370"],"issn-type":[{"value":"0218-4923","type":"print"},{"value":"1816-5370","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]}}}