Background: Infective endocarditis (IE) is an infection affecting the endocardial lining and contributed to socioeconomic burden due to prolonged admission, invasive procedure, and expensive treatment. The high prevalence of intravenous drug user intravenous drug user (IVDU) shifts the paradigm of the disease, and thus, we aim to determine the clinical characteristics, outcome, and inhospital mortality of IE among IVDU patients. Materials and Methodology: This is a retrospective cohort by analyzing case records for IVDU patients admitted to Hospital Tengku Ampuan Afzan diagnosed with IE from January 2014 until June 2017. Results: A total of 32 patients were included, with a median age of 35 years old (standard deviation: 6.5). Only 56.3% presented with fever, whereas most of them complained of nonspecific symptoms such as reduced exercise tolerance (59.4%) and weight loss (56.3%). Seventy-five percent had concomitant hepatitis C, but only 6.3% of them were HIV positive. Valvular heart disease accounted for 46.9%, while chronic rheumatic heart diseases and previous IE infection accounted for 28.1% and 18.8%, respectively. For microbiological characteristics, Staphylococcus aureus accounted for 62.5%, followed by streptococci (15.4%) and others (2%). The most common valve affected in IVDU was tricuspid valve (62.5%), followed by mitral valve (21.9%) and pulmonary valve (9.4%). Furthermore, mortality was reported at 25%, while severe valvular complications (62.5%) were observed with elevated episodes of emboli (62.5%) and cardiogenic shock (40.6%). Conclusion: Hence, IVDU is an essential predictive factor and is associated with various severe complications and thus warranted for aggressive preventive measurement to reduce the morbidity.

Background: Hepatitis C is one of the most common causes of liver disease worldwide. Health impacts of hepatitis C are not limited to physical morbidity but include psychosocial dimensions such as quality of life (QOL), depression, anxiety, and stigmatization. In Malaysia, modifiable factors that can improve QOL among hepatitis C patients have not been adequately studied. Resilience – defined as the capacity to endure hardships and rebound from life adversities – is associated with mental health and well-being. Our study aims to test the association between resilience and QOL among hepatitis C patients. Methods: Employing a cross-sectional design, 195 hepatitis C patients who attended Hospital Tengku Ampuan Afzan (HTAA) – the main public tertiary hospital in Pahang – were recruited through convenience sampling. Resilience was assessed using the Connor-Davidson resilience scale while Health-Related Quality of Life (HRQOL) was measured by 36-item short-form survey (SF-36v2). Multiple linear regression was run to determine the association between resilience and HRQOL. Results: We found significant associations between resilience and the physical (b=0.35; 95% CI: 0.11, 0.30; p<0.001) and mental dimension of HRQOL (b=0.47; 95% CI: 0.21, 0.42; p<0.001). Patients with higher resilience scores were more likely to have better HRQOL compared to those less resilient. Conclusion: Resilience may be a protective factor in the disease trajectory of hepatitis C in terms of QOL. Health care providers should incorporate resilience into the management of hepatitis patients, through a multidisciplinary approach. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 165-170