Online ISSN: 2515-8260

Keywords : Hypertension


PREVALENCE OF HYPERTENSIVE DISORDERS IN THIRD TRIMESTER OF PREGNANCY AND ITS ASSOCIATED FACTORS AMONG PREGNANT WOMEN

Dr. Rashmi gupta, Dr. Abhishek kawatra, Dr. Kirti Sekhawat, Dr. Gautam lunia

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 4, Pages 1350-1355

Hypertensive disorder of pregnancy is a global public health concern both in developed and developing countries. Aim: To find out the prevalence of hypertensive disorders in third trimester of pregnant women. Methods: A health care facility Cross sectional descriptive type of observational study was carried out to find out the prevalence of hypertensive disorders in 100 third trimester of pregnant women and associated factors at ANC clinic of RHTC, department of community medicine, SP Medical College Jaipur, Rajasthan, from sept. 2021 to dec. 2022. Results: mean age of 24.30± 3.26 years, Prevalence of hypertensive disorder was 10%. Out of 10, 6(6%) were preeclampsia, 2 (2%) Gestational hypertension, 1(1%) chronic hypertension, 1 (1%) Eclampsia. Conclusion: Primary care physicians have a critical role to play in the early identification and management of hypertension during early antenatal care.

Rare case report of PRES in Eclampsia

Dr. Sahil Mittal, Dr. Aakriti Kumar, Dr. Garima Sharma .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 3, Pages 489-491

Eclampsia is one of the most common entity in pregnant women all across the globe including India. Cases with posterior reversible encephalopathy syndrome in this condition has been rarely reported in literature. Its clinical manifestations is similar to eclampsia with predominant weakness and altered consciousness. In addition, there is a need to look for neurological abnormalities. Treatment of this condition is symptomatic after early recognition and physicians should be vigilant and aware of this condition.

Comparison of renal functions amongst obese and non-obese adults of rural population area of Northern India

Dr. Prerna Panjeta, Dr. Piyush Bansal, Ashutosh Kumar, Komal Saini, Dr. Vikram Kala .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 64-69

Introduction: Obesity has become the leading global health problem. In numerous large population-based studies-Higher BMI associated with presence and development of low estimated GFR and many other renal diseases.
Objective: To study the renal functions in obese adults of rural area.
To do comparative analysis of renal functions with age and sex matched non obese adults.
Material and Methods: The present cross-sectional study was carried out in the General Medicine OPD of BPS GMC for Women, Khanpur Kalan, Sonipat, Haryana. A sample of convenient 100 obese patients were taken. A total of 200 patients attending General Medicine OPD were taken, out of which 100 were obese and 100 were non obese.
Results: Statistically significant P values were obtained for Blood Urea, Serum Creatinine, Serum Calcium, Serum Phosphorus, and urine albumin among obese and non-obese adults. Study shows no significant gender differences between obese and non-obese. Statistical analysis shows some age-related differences among obese and non-obese large population studies-showing positive association of BMI with chronic kidney disease.

Clinical Study Of Acute Ischemic Stroke Outcome At Tertiary Care Hospital

Prasanna sudhakar Deshmukh, Sachin Ramesh Babhalsure, Deepak Ganpatrao Patil, Dope Santoshkumar Ankushrao .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 4674-4679

Background: Stroke or cerebrovascular accident is a leading cause of mortality and morbidity throughout the world including both developed and developing countries. Identification of potential prognostic factors for ischaemic stroke may enable better prediction for outcome and conducting early interventions may improve the prognosis. Present study was aimed to study outcome of patients of acute ischemic stroke at tertiary care hospital. Material and Methods: Present study was prospective, observational study, conducted in patients with ischemic stroke, confirmed by CT scan of brain, presenting within 72 hours of onset of symptom, willing to participate in study. Results: In present study 126 patients with acute ischemic stroke were included.  Most common age group was 61-70 years (34.13 %) followed by 51-60 years (24.6 %) age group. Male patients (65.38 %) were more than female patients (34.13%). Male to female ratio was 1.9:1. Common risk factors observed were stage 1 hypertension (19.84 %), stage 2 hypertension (SBP>160, DBP>100) (25.4 %), diabetic (36.51 %), smoker (29.37 %), alcoholic (22.22 %), dyslipidemia (20.63 %), history of cardiovascular disease (18.25 %), obesity (15.87 %), family history of stroke (14.29 %) & tobacco chewing (10.32 %). On admission, according to NIHSS scale severity majority had minor stroke (37.3 %) followed by moderate stroke (35.71 %), moderate to severe stroke (18.25 %) & severe stroke (8.73 %). Functional outcome was assessed using the modified ranking score (MRS) at 6 months. Majority had MRS score 3 (44.29 %) followed by MRS score 2 (38.06 %), MRS score 1 (7.96 %). Conclusion: Areas for improvement in management of stroke are  public awareness, lifestyle modification (modifiable risk factors are hypertension, smoking, dyslipidemia, alcohol consumption, and diabetes mellitus), early diagnosis, treatment &  availability of facilities and expertise.

Prevalence of hypertension among sanitary workers in a tertiary care center, Shahjahanpur, Uttar Pradesh: A cross-sectional study

Saumitra Swaroop Sinha, Vishal Sukhdev Rathod, Snehal N Pawar

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1863-1868

Hypertension is an important public health problem and it has no obvious
signs or symptoms making the persons unaware of condition. World Health
Organization (WHO) has stated that around 1.3 billion people around the world suffers
from hypertension and less than one in five have their blood pressure under control
Methods: A cross sectional study, Study setting: Community medicine department of
Tertiary care center. Study population: The study population included all the sanitary
workers in tertiary care center. Study duration 2 months. Sample size: 311 Results:
Only 10.7% of the workers were current tobacco users, while almost 15% were current
alcohol users. More than three fourth of the study participants were physically active.
More than 50% of the participants were obese (≥ 25.00 kg/m2). Abdominal obesity was
present in about 35% of the participants. Prevalence of hypertension among the
sanitary workers was 36.6% (95% CI: 31.3-41.3%). Only 34 (10.9%) participants were
aware of their hypertension status and 80 (25.7%) of the participants were newly
diagnosed to have hypertension. Prehypertension was present in 114 out of 277
participants (41.1%; 95% CI: 35.3-47.2%) without any known history of hypertension.
Among the 34 patients with known history of hypertension, only 12 (35.3%) belonged to
controlled status category. Current tobacco users had 1.61 times higher prevalence of
hypertension when compared to those who are not current users and this was
statistically significant (P = 0.003). Current alcohol users had significant association
with hypertension (aPR-1.25; P = 0.02). Conclusions: The current study found that
more than one-third of the sanitary workers had hypertension. However, almost threefourth
of the hypertensives were not aware about their status.

Metabolic Syndrome and Acute Ischemic Stroke: An Analysis of Clinical Characteristics

Shailendra Mane, Mahesh Patil, Rajashri Mane, Rajesh Khyalappa

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 3435-3448

The components of metabolic syndrome ‘X,' which include elevated insulin levels, poor glucose tolerance, high triglyceride levels, central obesity (sometimes known as an "apple body"), and high blood pressure, are significant in the Indian setting. Those who suffer from metabolic syndrome are at an elevated risk of developing coronary heart disease and ischemic stroke by a factor of two to three. This research aimed to compare the components associated with metabolic syndrome and neurological examination in patients with metabolic syndrome with non-metabolic syndrome patients in cases with the acute ischaemic syndrome.

Hypertension induced by pregnancy and neonatal outcome in preterm under 34 weeks

Dr. Chandrakant Verma, Dr. Asmita Singh, Dr. Pankaj Mishra

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 2283-2287

To study hypertension induced by pregnancy and neonatal outcomes.
Materials & methods: A total of 200 premature newborns of gestational age (GA) between 20 and 35 weeks and 5 days, born alive were included. In total, 90 infants were born to hypertensive mothers (G1) and 110 to normotensive mothers (G2). The data was recorded. The results were analysed using SPSS software.
Results: The anthropometric measurements of birth weight were significantly lower in G1. Resuscitation in the delivery room and the need to use surfactant and oxygen dependence at 36 weeks of gestational age did not differ between groups.
Conclusion: There was no difference in weight and survival at 18 months of chronological age.

A VARIABLE SELECTION IN ORDERED LOGISTIC REGRESSION MODEL USING DECISION TREE ANALYSIS FOR THE CLASSIFICATION: A CASE STUDY OF HYPERTENSION MODELING

Wan Muhamad Amir W Ahmad, Hazik Bin Shahzad, Mohamad Nasarudin Adnan, Farah Muna Mohamad Ghazali, Noraini Mohamad, Norhayati Yusop, Nor Farid Mohd Noor, Nor Azlida Aleng, Mohamad Shafiq Mohd Ibrahim

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 3367-3378

Hypertension is a public health issue that depicts high blood pressure in which the force of the blood vessels increases persistently. According to the WHO, one in four men and one in five women have hypertension. Twenty to thirty percent of the adult population and more than five to eight percent of pregnancies worldwide suffer from hypertension, which is frequently curable when detected and treated early. Recognizing the significance of statistical modeling in hypertension, this study aims to develop a method that stakeholders can use to predict and manage hypertension cases. Two approaches used in this study were decision tree and ordinal regression. Both methods will be harmonized in the R syntax with some modification and extension. Materials and Methods: In this paper, we developed the method of decision tree analysis using R syntax with embedding the prediction classification. The classification for prediction with accuracy will indicate the successful classification analysis. This study used hypertension data consisting of one thousand observations to illustrate the development method. Before further testing, each pre-selected variable's clinical relevance and significance will be evaluated. Four selected variables will be tested using the decision tree. The selected variables are blood pressure, glucose, height, and triglycerides. The classification obtained will be used as input for the ordinal regression modeling. Result: It has been found that the level of hypertension can be determined by systolic blood pressure, glucose, and triglycerides, according to the most recent published research. These four variables are chosen and used for the input of the ordinal regression. The suggested variables will apply to the ordered logistic regression, and the goodness of measurement is conducted using the developed syntax. The significance level is set at 0.05 level. Conclusion: We can conclude that our proposed method yields excellent results with the highest level of forecasting precision possible. The method approach provides an accurate evaluation of the fit of the final model. The superior performance of the model led to improved outcomes and effective decision-making management.

Comparative evaluation of Doppler and contrast enhanced Magnetic Resonance Angiography of carotids in ischemic stroke patients

Dr Sarath Chandran C, Dr Anila Punchiry

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 3077-3086

Non communicable diseases are responsible for 71% of all deaths globally, that is 41 million people each year. Each year 85% of the premature death occurs due to non communicable disease in low and middle income courtiers. Cerebrovascular accident or stroke is one of the most common causes of death. Ultrasonography of the carotid arteries is an easily available, costeffective, noninvasive method of evaluation. Treatment of stroke depends on reaching the most accurate diagnosis. Accurate and prompt diagnosis is crucial because timely and appropriate therapy can significantly reduce the risk of stroke and long term sequelae. Several modalities of investigation are available to determine carotid arterystatus

A CASE OF CORTICAL BLINDNESS SECONDARY TO PRES

Dr. Shailaja Anand, Dr. Varsha Singh, Dr. Abhay Lune, Dr. (Col) O.K. Radhakrishnan, Dr. Neha Chaudhary, Dr. Yurica Moirangthem, Dr Sudebi Roy

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 1420-1424

Blindness brought on by an intact anterior visual pathway but due to bilateral occipital lobe involvement is known as cortical blindness. Compared to partial blindness, it is less frequent. The posterior reversible encephalopathy disease has a well-documented history of reversible cortical visual blindness (PRES). The neurological condition PRES is characterised by reversible subcortical vasogenic brain oedema and sudden onset neurological symptoms. This illness can be reversed with prompt diagnosis and treatment. It frequently occurs in conjunction with disorders like eclampsia, cancer, kidney disease, hypertension, and hypertension. This case involves a male teenager who was infected with COVID and later developed PRES. The presence of Anton's blindness complicated PRES. Utilizing radiological investigation, an early diagnosis was obtained, and once therapy was started, all symptoms disappeared.

In Silico Identification Of Human Mir-26a-1 From Hypertension Genome Sequence

Ridha Azimudin; Lavanya Prathap; Auxzilia Preethi K; Sushmaa Chandralekha Selvakumar; Dr. Durairaj Sekar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 685-693

Hypertension is a non-communicable condition that affects about half of the world's adult population. MicroRNAs (miRNAs), also known as non-coding RNAs, govern biological processes such as Proliferation and apoptosis are two processes that can be employed as treatment targets in the treating of diseases like hypertension. The current study aims in identifying miRNAs in hypertension from genome sequences found in public genomic databases.
In this study, we have used the National Centre for Biotechnology Information (NCBI) web portal to identify miR-26a for hypertension using a bioinformatics approach and RNA fold was used to create the secondary structure.

Study of left ventricular mass in essential hypertension with left ventricular hypertrophy through 2D echo

Dr. Pradeep Kumar Gupta Dr. Prasanna Yadav Dr. Bushra Khanam Dr. Sumit Solanki

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 3199-3205

Left Ventricular Hypertrophy (LVH) is an adaptive state of the heart to increase the wall stress. It is common in hypertension. The prevalence of LVH increases with the age, severity of hypertension and the duration of hypertension. So, presence of LVH indicates a long run of uncontrolled hypertension.
There are many ways of diagnosing LVH like by electrocardiography (ECG), roentgenography and echocardiography (ECHO). Though ECHO is superior to ECG, it is economically expensive and not widely available in rural parts of our country.
Left ventricular hypertrophy (LVH) is widely recognized as an independent and significant predictor of cardiovascular disease (CVD) and sudden cardiac death (SCD) as risk factor.
It is also assumed that the predictive value of LVH is increased by its accurate assessment based on LV mass (LVM). However, LVH definition along with LVM reference values, demonstrate wide variability among imaging modalities, technicians, indexing methods and institutions.
In addition, currently autopsy studies measure total heart weight rather than LVM, which makes them difficult to correlate with imaging data. Therefore, we conducted a systematic literature review for existing data on methods used and reference values for both normal and diseased hearts.
Echocardiography remains the most widely used diagnostic tool for the evaluation of LVH, with the optimal body-size indexing formula remaining controversial and in urgent need of more standardization Future forensic studies are needed to directly compare total cardiac mass to left ventricular mass and in order to update reference values considering significant changes in the population's height and weight

Prevalence Of Diabetic Retinopathy In Non- Insulin Dependent Diabetes Mellitus Patients

Shamsheer R P, Meena Lakshman .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 1901-1905

Background: To assess prevalence of diabetic retinopathy in non- insulin dependent diabetes mellitus (NIDDM) patients.
Materials and Methods: One hundred thirty non- insulin dependent diabetes mellitus (NIDDM) patients of both genders were enrolled and the prevalence of DR was recorded. Retinopathy was classified as mild non-proliferative retinopathy, moderate non-proliferative retinopathy and severe retinopathy.
Results: Out of 130 patients, males were 70 (53.8%) and females were 60 (46.2%). Out of 70 males, 42 (60%) males and out of 60 females, 28 (46.6%) females had diabetic retinopathy. The difference was significant (P< 0.05). Out of 70 diabetic retinopathy patients, mild non-proliferative retinopathy was seen in 14 males and 8 females, moderate non-proliferative retinopathy was seen in 18 males and 12 females, severe non-proliferative retinopathy was seen in 10 males and 8 females. The difference was significant (P< 0.05). Duration of diabetes was <5 years was seen in 14, 5-10 years in 26 and >10 years in 30. In 45 patients with DR, family history was positive. DR was present in patients with BMI <24.9 in 13, 25-29.9 in 15 and >30 in 42. Hypertension was seen in 48. The difference was significant (P< 0.05).
Conclusion: Results showed that maximum cases of diabetic retinopathy were seen in patients with BMI >30, hypertension and with 5-10 years of diabetes and with positive family history of diabetes.

Clinical Profile Of Patients With Obstructive Sleep Apnea Attending Tertiary Care Hospital

Prasanna sudhakar Deshmukh, Deepak Ganpatrao Patil, Sachin Ramesh Babhalsure, Dope Santoshkumar Ankushrao .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 1843-1848

Background: Obstructive sleep apnea (OSA) is being recognized as an important public health problem worldwide. The timely diagnosis and treatment of OSA with underlying etiology leads to decreased symptoms and increases quality of life among OSA patients. Present study was aimed to study clinical profile of patients with obstructive sleep apnea attending tertiary care hospital. Material and Methods: Present study was single-center, prospective, observational study, conducted in patients more than 18 years of age, had symptoms suggestive of Sleep Disordered Breathing such as, excessive daytime somnolence, disruptive snoring, fragmented sleep, choking and gasping, un-refreshing sleep, morning headache, personality changes and Impaired concentration, insomnia, daytime headache. Sleep study parameters collected from polysomnography were Apnea–Hypopnea Index (AHI). Results: During study period, total 66 patients underwent evaluation. Mean age was 47.9 ± 14.2 years. Majority were male (62.12 %) as compared to female (37.88 %). Mean body measurements such as mean height was 1.59 ± 0.14 meters, mean weight 91.2 ± 23.3 kgs, mean Body Mass Index was 30.4 ± 6.1 kg/m2, mean neck circumference was 35.2 ± 4.2 cms & lowest saturation % in sleep study was 82.2 ± 9.6 %. Common co-morbidities noted were hypertension (57.58 %), overweight (48.48 %), smoking (31.82 %), obesity (30.3 %), diabetes mellites (25.76 %), asthma (13.64 %) & COPD (10.61 %) In present study, majority patients had Severe OSA (56.06 %) followed by moderate OSA (28.79 %), mild OSA (9.09 %) while 4 patients had no OSA (6.06 %). Conclusion: Obesity, Hypertension and diabetes were common associations in patients with significant obstructive sleep apnea. Polysomnography is a useful investigation which helps in diagnosis of OSA.

HYPERTENSION MEDICATION ADHERENCE AND ASSOCIATED FACTORS IN ADULT HYPERTENSIVE PATIENTS

Dr. Abhi Patel, Dr. Sarita Mulkalwar, Dr. Krushal Pabari, Dr. A. V. Tilak, Dr. B. T. Rane .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 2520-2528

Background: The inability to effectively regulate high blood pressure makes it the most difficult public health issue in the world. For better blood pressure control, medication adherence is crucial.Treatment adherence can be influenced by various factors like patient behaviour, the presence of comorbid illnesses, awareness of the disease severity, and also factors like patients’ age, gender, and education level. To improve treatment adherence, it is important to comprehend the factors that affect patient adherence.
Aim: The aim of the present study was to estimate the level of medication adherence in hypertensive patients and to determine the factors associated with it.
Methods: All adults who were diagnosed as hypertensive patients for more than one month and willing to participate in the study were included in this study, however pregnant mothers and lactating women were excluded. Patients’ medication adherence was noted by using Morisky Green Levine Medication Adherence Scale (MGL).
Results: Out of 217 patients, 78 (35.94%) had high adherence, while 55 (25.35%) had low adherence, patients’ forgetful nature was a major factor (57.60%) contributing to low adherence. High adherence was noted in, females (43.14%); in patints age <30 years (43.33%), with postgraduate education (48.28%), checking blood pressure monthly (51.61%), taking medication for >5 years (49.02%), without any comorbidity (57.47%) and in patients who were aware of complications of hypertension (41.44%).
Conclusion: Patients’ forgetful naturewas more responsible for low adherence than their carelessness.Patients’ education level has a significant impact on medication adherence. Patients’ awareness of their blood pressure level and complications of hypertension makes them more adherent to treatment.

Study of the prevalence of hypertension and complications of hypertensive disorders in pregnancy

Valarmathi S, Indirani D, Monica R

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 1982-1989

Hypertension is one of the common problems associated with pregnancy that may be followed by eclampsia, acute renal failure, maternal death, premature delivery, intra-uterine growth restriction and other. This study was conducted to determine the results of pregnancies associated with hypertension in patients visiting in the Delivery Ward of Govt. Thanjavur medical college hospital (Tertiary care Centre) Thanjavur. Methods: A descriptive study was conducted on all the patients admitted to the aforementioned department and who possessed the inclusion criteria for hypertensive pregnancy. Results: Among the 7004 delivery cases examined, 1315 cases had hypertension (18.8%). Among these, 983 (74.7%) had gestational hypertension; 209 (15.9%) had preeclampsia- eclampsia; 38 (2.9%) had preeclampsia superimposed on chronic hypertension; 83 (6.3%) cases had chronic hypertension; and 3 (0.2%) had associated comorbid conditions like Liver & Renal disorders. Ninety-six point three percent (96.3%) had a systolic blood pressure (BP) of 140 - 190 mmHg, and 3.7% had a systolic BP greater than 190 mmHg. Whereas 61.1% of diastolic blood pressure 90 - 110 mmHg and 38.9% of the mothers had diastolic BP greater than 110 mmHg. The HELLP (Hemolysis, Elevated Liver enzymes & Low Platelet count) syndrome was present in 3.4% of cases; 22.1% experienced premature delivery; 2.5% had IUFD (intra uterine fetal death); 28.1% had IUGR (intrauterine growth retardation); and 21% had LBW babies. Conclusions: Based on our results, hypertensive mothers who are younger and have lower weight babies at birth experience more perinatal complications. The unpleasant effects of hypertension in pregnancy warrant the need for training, routine prenatal care, the early detection and treatment of hypertension at younger ages of pregnancy, and follow-up after delivery.

Serum Electrolytes as Mortality Indicators in Hypertension Cases

Syeda Parveen Fatima, Deva Pragna Prashanthi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3721-3727

Background: According to the pressure natriuresis theory, monogenic hypertension, and dietary salt reduction studies, Na+ is a primary predictor of blood pressure and mortality. The evolved response to a salt or water shortfall is more efficient than the response to salt surplus. Cl is the most abundant anion outside of cells and derives from food. The current epidemiological investigation examined the relationship between blood electrolyte levels and hypertension in a salt-consuming community. Fluid and electrolyte balance is necessary for postoperative and critically ill patients' metabolic care, gastrointestinal function, and nutrition. Artificial nutrition should be prescribed with the same care as other nutritional and pharmaceutical needs.
Materials and Methods: Secondary study of epidemiological study was carried out at the Government Medical College, Jagitial, India, which was carried out between the December 2021 to November 2022. Using regression models, the relationship between the amounts of sodium, potassium, chloride, total calcium, phosphate, and magnesium in the serum and blood pressure and the presence or absence of hypertension was investigated.
Results: 81 previously diagnosed hypertension patients were included in this study. 56% of participants experienced electrolyte problems. 62% of hypercalcaemic subjects had hypertension, followed by hypokalaemia (56%) and hypernatremia (54%). Hypercalcemia was linked to IH and PDH. Higher serum calcium quartile increased IH and PDH risk. Serum salt and hypertension were unrelated. PDH U-shaped serum potassium. Higher chloride quartile had lower PDH chances. Highest phosphate quartile was solely related with lower IH probabilities, although higher magnesium lowered IH and PDH odds.
Conclusions: We found a link between IH/PDH and serum calcium, magnesium, and chloride. Patients with IH may have concurrent electrolyte issues, such as hypercalcemia, which may reflect additional underlying etiologies. When prescribing fluid and electrolytes, it's important to understand the relationship between internal and external balance, starvation, and injury to reduce physiological and clinical side effects. Prescriptions need detail and education

Socio-demographic risk factors and their association with prevalence of Hypertension among adolescents- A comparative study

Dr. Govind Nikam; Dr. Prakash Mahadev Durgawale

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 5178-5190

Background: Studies in adolescents provide important epidemiological information and aetiology bywhich prevention and modifyingof subsequent coronary risk factors can be achieved. No studies are available for sociodemographic risk factors and knowledge of hypertension forkarad region.
Objective: To study and compare associated socio-demographic risk factors of elevated blood pressure among adolescents and to find out the prevalence of elevated blood pressure and to assess the knowledge about hypertension in adolescents of urban and urban slum areas of Karad.
Methodology: Comparative cross-sectional study was conducted in Karad during the period of 2017 to 2019. Adolescents from Urban (n=310) andurban slum area (n=310) of Karad who satisfied the inclusion criteria were included. A pretested, validated and reliable proforma was developed. Apart from socio-demographic information, other parameters such as behavioural and lifestyle related risk factors, anthropometric measurements and blood pressure were recorded. Analysis was done using IBM SPSS for Windows software version 20.0. Chi square test evaluated categorical variables. p value equal to or less than 0.005 was considered to be statistically significant for a 95% confidence interval.
Result: Out of 310, the prevalence of Hypertension (HTN) in urban adolescents was 54(18.7%), similarly among urban slum adolescents the prevalence of HTN was 46(14.9%). Majority had good knowledge about hypertension in the urban area with 123(39.7%) and 165(53.2%) had satisfactory knowledge in the urban slum area.Diet, added salt intake, sleep inadequacy, addiction to alcohol and tobacco products, obesity and overweight, physical inactivity and family history of hypertension were principal risk factors for elevated blood pressure in adolescents with statistical significance (p<0.05).
Conclusion: The study identified age, level of education,lifestyle and behavioural factors as risk factors for elevated blood pressure in adolescents. Early detection will decrease risk of cardiovascular complications in adulthood.

A RANDOMISED CONTROLLED STUDY OF TRACHEAL EXTUBATION RESPONSE FOLLOWING NITROGLYCERINE (NTG) SUBLINGUAL SPRAY IN HYPERTENSIVE PATIENT

KORI ANIL, RAI PARTH, MISHRA SHAILESH, AJMANI TEJINDER, JAIN ABHILEKH, AGARWAL ADITYA, BATRA MAHIMA, TAGALPALLEWAR AMEYA

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 99-110

The prospective randomized open controlled study was done to compare tracheal extubation response following nitroglycerine (NTG) sublingual spray in hypertensive patients

Clinico-radiological profile and outcome of patients with posterior reversible encephalopathy syndrome

Basavaraj P G, Sidaraya Hanjagi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2915-2919

Background: Posterior reversible encephalopathy syndrome (PRES) is usually diagnosed according to the presence of typical neuroimage showing vasogenic edema predominately involving the posterior brain area. Present study was aimed to study clinicoradiological profile and outcome of patients with posterior reversible encephalopathy syndrome at our tertiary hospital.
Material and Methods: Present study was retrospective, case-record based study, conducted in patients with clinical and imaging features suggestive of PRES.
Results: 32 case records were studied. Mean age was 39.8 ± 10.7 years. Male (34.38 %) to female (65.63 %) ratio was 1: 0.52. Common clinical features noted were seizure (71.88 %), headache (68.75 %), altered mental status (59.38 %), vomiting (34.38 %), fever (25 %) & visual impairments (18.75 %). Eclampsia (50 %) was most common etiology for PRES, followed by hypertension (18.75 %), renal diseases (15.63 %), postpartum sepsis (9.38 %), poly-trauma (3.13 %) & cardiac disease (3.13 %). MRI Neuroimaging finding in study were involvement of parieto-occipital lobes (65.63 %), subcortical (46.88 %), frontal lobe (34.38 %), temporal lobe (18.75 %), asymmetric involvement of brain (18.75 %), cerebellum (12.50 %), basal ganglia (9.38 %), cortical (9.38 %), subarachnoid bleed (6.25 %), brainstem (3.13 %) & deep white matter (3.13 %), Mortality was observed in 2 cases (6.25 %) (both were antepartum eclampsia, reported to hospital in unconscious state & required intubation on admission). Good prognosis was noted in 30 cases (93.75 %). Conclusion: Early recognition of PRES is associated with good prognosis & good recovery, particularly if underlying etiology is treated satisfactorily.

Study of correlation between stress and risk factors of hypertension: An original research

Dr. Monica Krishnappa, Dr. Kaila Sidhardha Ambedkar, Dr. Faziljot Singh, Dr. Sachin Yadav, Dr. Rahul VC Tiwari, Dr. Heena Dixit Tiwari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2468-2471

Aim: The purpose of the present research was to assess the co-relation between stress and hypertension.
Methodology: In this correlation study 30 individuals were selected. Basic demographic data was collected and were asked to fill up the Perceived stress scale. Blood pressure was measured at the brachial artery three times and average of the three was taken. To study the relation between stress score and BP, correlation was done. As data were not normally distributed, Spearman correlation test was done (P < 0.001).
Results: According to the analysis done, PSS shows moderate correlation with SBP while DBP shows weak correlation with r values 0.47 and 0.202 respectively and p values 0.806 and 0.283 respectively.
Conclusion: Stress is significantly related to hypertension and is an independent risk factor for hypertension.

Homocysteine as a risk factor in patients with acute vascular events

Achyut Kannawar, Dany John, Ramesh Kawade, Vijaysinh Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 4712-4716

Background: Acute arterial vascular events are the leading cause of premature death and disability in the developed world. The present study was conducted to assess homocysteine as a risk factor in patients with acute vascular events.
Materials & Methods: 74 patients of ischemic heart disease,peripheral vascular disease, deep vein thrombosis and pulmonary thromboembolism of both genders underwent estimation of fasting plasma homocysteine estimation was done by fluorescence polarization immunoassay. Symptoms and risk factors such as hypertension, smoking, alcohol, diabetes, BMI and family history was recorded.
Results: Out of 74 patients, males were 40 and females were 34. Symptoms such as chest pain was seen in 62, headache in 57, breathlessnessin 52 and palpitations in 40. Risk factors were hypertensionin 34, diabetesin 30, alcohol in 16, smoking in 23, dyslipidaemia in 65 and family h/o CADin 40. The difference was significant (P< 0.05).
Conclusion: Plasma homocysteine is an independent risk factor for the development of acute vascular event

PLATELET COUNT IN WOMEN WITH PREGNANCY INDUCED HYPERTENSION

Mrs. K. Ayesha Siddikhakhatoon, Dr. Macherla Bikshapathy

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2672-2679

Objective:  One of the most common and potential life threatening complications of pregnancy is pregnancy induced hypertension. This cross-sectional study aimed to investigate the relationship between platelet count and pregnancy induced hypertension.
Materials and Methods: This is a present cross-sectional study was carried out in the Department of Medicine and Obstetrics and Gynecology, Maheshwara Medical College & Hospital over a period of 1 year among 60 subjects. The subjects for this cross-sectional study included consecutively - recruited Normotensive (n = 130) serve as a control, Non-Sever Pre-eclamptic (N = 35) and Severe pre-eclamptic (n = 35). All consenting, adult (≥ 18 years) pregnant women who were confirmed to have pregnancy induced hypertension by an Obstetrician constituted the subjects for these subjects.
Results: A total of 200 pregnant women were included in the study. Platelet count and platelet crit levels tend to decrease as pre-eclampsia becomes more severe. In this study, no statistically significant differences were observed between the three groups in age, residence, number of pregnancies (gravidity), number of deliveries (parity), gestational age, and BMI, but there was a significant difference between the three studied groups with regards to SBP, DBP and MAP which increased with severity of preeclampsia (P<0.001). The value of PLT accounts 180(97–352) ×103/μl for pre-eclamptic women and 260(139–445) ×103/μl for normotensive pregnant women (p<0.001).
Conclusion: Platelet indices, including platelet count, mean platelet volume, platelet distribution width, and Platelet crit, have been identified as promising candidate markers for predicting preeclampsia in pregnant women. In the future, a serial examination of these indicators during several trimesters of pregnancy should be conducted.

Color Doppler Evaluation Of Extracranial Carotid Arteries And Risk Factors In Predicting Cerebro Vascular Accident In Patients With Carotid Atheromatous Disease: A Clinical And Radiological Correlation.

Dr Sarath Chandran C, Dr Anila Punchiry

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 7931-7939

Back ground: WHO defines stroke as “the rapid development of clinical signs and symptoms of a focal neurological disturbance which lasts for more than 24 hours or leading to death with vascular origin as the cause. Stroke is a clinical syndrome, which describes a sudden neurological deficit of presumed vascular origin.The risk factors for stroke are diabetes mellitus, smoking, alcohol and hypertension. Colour doppler ultrasound is one of the important tool for the evaluation of exracranial insufficiency of the carotid arteries. This study was performed to assess the carotid arteries with the help of color doppler in carotid artery disease. Aims and objectives: To elaborate the color Doppler evaluation of extracranial carotid arteries and risk factors in predicting cerebro vascular accident in patients with carotid atheromatous disease. Materials and Methods: Of the 102 patients who had come to our department during the study period with symptoms of cerebrovascular disease such as transient episodes of neurological dysfunction, sudden weakness or numbness, hemiparesis, focal neurological deficits, sudden loss of consciousness, altered sensorium, aphasia, slurring of speech, diminution or loss of vision were included into the study. CT scan of brain and color doppler evaluation for the extracranial carotid arteries was done for all the patients to assess the atheromatous disease of extracranial carotid arteries and comparison with brain changes in cerebrovascular disease patients.

Mechanism of action of herbs present in the Siddha formulation Veppampoo mathirai against hypertension - A Review

Dr.S.M. Chitra

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 6296-6308

Hypertension is one among the leading non communicable disease that affects the people worldwide. It is the most prevalent trigger for morbidity and mortality associated with CVD’s and its complications. Although, so many conventional drugs are prevalent for high blood pressure, people are still in search for traditional herbal medicines due to their safety and efficacy. The different constituents in herbal medicine plays a multitarget and synergistic role in the treatment of Hypertension. Veppampoo mathirai, a polyherbal siddha formulation containing fifteen herbs was found to be effective in reducing blood pressure which had been practised since decades. But, the mechanism of action is not known yet. However, it is very important to validate the potential of the herbal medicines scientifically, which are in practise, so that it might help them to establish with authentication for further use

Incidence and Potential Co-Morbidities in Facial Pigmentary Demarcation Lines in Indian Populations

Lakkireddygari Sujana, Savitha L Beergouder, Alekhya Rallapalli, Sujatha Alla, Prasanthi Chidipudi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 138-145

Background: The most noticeable part of human body is face. The obvious boundaries on the skin known as Pigmentary Demarcation Lines (PDL) found over face and have clear borders of abrupt transition between more hyper-pigmented skin and areas of normal skin pigmentation due to differences in melanocyte distribution that may be influenced by multiple factors. Facial pigmentary demarcation lines (PDL) directly reflect on patient’s physical appearance and self-image as they may contribute to dysmorphism and even central to depressive illness in susceptible individuals posing cosmetic concern for the patient and a challenge for dermatologist. Therefore, it is important for early identification and management of facial skin disorders. Until now, nine different types of PDLs have been described which are designated as Type A to I of which Type F to H PDLs are most common on the face. Etiology involving the whole spectrum of PDL continues to be an enigma and needs further research among Indian population.
Materials and Methods: Total 304 patients between 15 to 75 years of age range were included in study lead between May 2018 to May 2020 after thorough examination for inclusion and exclusion criteria, informed consent and Ethics committee approval. Statistical analysis was done using descriptive and inferential statistical approach using Chi-square test and Fisher’s exact test and p value was calculated and considered to be significant if <0.05.
Results: Out of 304 study subjects the frequency of facial PDL type H (50.65%) was most common than type G (29.60%) and type F (19.73%) with male predisposition (79.60%) with agricultural occupations (59.86%) than females and with significant family history from father (41.44%). Most of the present study subjects were of Fitzpatrick skin type IV (50.01%) with hyper-pigmented macules (12.5%) and shown unilateral PDL symmetry (58.22%) with sharp PDL line margins (81.25%). The most common aggravating factor was prolonged exposure to sun light (56.90%) and most of (25.98%) the subjects experienced periorbital melanosis at different times. Diabetes (38.15%) and hypertension (29.60%) were the most common co morbidities observed in study subjects. Using Fishers exact test, p value was calculated and it was found to be highly significant (p=0.003).
Conclusion: Present study pronounces the incidence of facial PDL (types F-H) are sharply common especially amongst the males who are in agricultural occupations with prolonged sun exposure and with other co morbidities like diabetes, hypertension and tuberculosis. In females the prevalent type was Type H PDL during and after pregnancy. The agricultural occupations with prolonged sun exposure, diabetes, hypertension, tuberculosis and positive paternal family history were shown strong correlation with facial PDL among Indian population irrespective of gender and it was found to be highly significant (p=0.003).

Current scenario of masked and white coat hypertension in medical professionals in Bundelkhand region

Dr. Mahak Lamba; Dr. Archana; Dr. Mamta Dwivedi; Dr. Sandeep Kumar; Dr. Nutan Agarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 2022-2031

Background &Objective: Medical profession is believed to be one of most stressful profession. Present study was done to evaluate current scenario of masked and white coat hypertension among medical professional in Bundelkhand region. Methods: This cross-sectional observational study was conducted at department of Medicine, M.L.B. Medical College, Jhansi, over a period between Jan 2014 to June 2015 on 300 medical professionals which included undergraduates, PG students, Consultants, Nursing staff and ministerial staffs. All patients underwent history taking, physical examination, laboratory analysis, office BP and ABPM. Results: 4 groups were identified based on office and ambulatory blood pressure monitoring: i) True normotensive patients (BPs are normal both clinically and by ABPM) 197 (65.7%). ii) True hypertensive patients (both office and ABPM were high 23 (7.7%)). iii) White coat hypertensive patients (clinical BP were above limits, but ABPM were normal) 73 (24.3%). iv) Masked hypertensive patients (clinical BP were normal, but ABPM were high 7 (2.3%). Out of 300 subjects, there were 158 UG students, 49 PG students, 6 consultants, 66 nursing staff and 21 ministerial staff. White coat hypertension was more prevalent in undergraduates. Out of total 147 subjects, who were pre-hypertensives by office blood pressure, 140 subjects (95.2%) were true normotensive and 7 (4.8%) were having masked hypertension. None of the pre-hypertensive subject was having true hypertension. Out of total 96 subjects, who were hypertensives by office blood pressure, only 23 (23.9%) subjects were true hypertensive and majority of 73 subjects (76.1%) were having white coat hypertension. Conclusion: White coat hypertension was more prevalent in undergraduates and masked hypertension was more seen in nursing staff in this study. We did not find any target organ damage in white coat hypertensives and masked hypertensives. They don’t warrant antihypertensive treatment at this stage. These subjects may develop hypertension and target organ damage in upcoming years but earlier than the normal subjects. These subjects should be followed for development of hypertension and target organ damage.

Clinical profile and short-term outcome in adult patients with new onset seizures

Dr.Praveen Chowdary Meduri; Annam , Jayamadhavi; Penchala Sudheer; Susmitha Yella

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1694-1703

Background: Since ancient times, seizures have affected individuals worldwide. Up to 10% of the population will have a seizure in their lifetime, most often in early childhood and late adulthood. Adult seizures have a distinct aetiology than childhood seizures and require special attention. Head trauma, CNS infections, space-occupying lesions, cerebrovascular accident, metabolic diseases, and medications are possible causes of adult-onset seizures

Prevalence of diabetes mellitus and its associated risk factors in a tertiary care center, Rajasthan, India

Dr. Ajesh Kumar Damor; Dr. Guru Kumar Sain; Mahesh Kumar Kharadi; Dr. Praful Bala Honta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1829-1835

Background: Diabetes mellitus (DM) is a chronic, debilitating disease constitutes a global health threat and burden, especially in developing countries. The objective of the study was to assess the prevalence of diabetes mellitus type-2 and its associated risk factors.

A Study Of Morbidity Profile And Occupational Injuries Among Firefighters In A Metropolitan City

Aftab Ahmed Siddiqui; Shreekanth K Jakkula; Sujay Jaju; Alhad Mulkalwar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 2081-2089

Background: Firefighters work to reduce threats and minimize the potential harm from fire hazards. The nature of firefighters’ work is demanding, often unpredictable and in stressful environments where they are routinely exposed to both mental and physical occupational hazards. This cross-sectional study was conducted to assess prevalence of occupational injuries and the morbidity profile of firefighters in a single metropolitan city.
Methods: In this study, 253 firefighters from the area under Municipal Corporation of Greater Mumbai (MCGM) were included using stratified random sampling method. All consenting firefighters were interviewed in office located in fire brigade using a pre-validated interview schedule and the data was analyzed using SPSS version 22.
Results: From the study, it was found out that abrasion was the most common occupational injury among firefighters. Pre-hypertension and Body Mass Index (BMI) in the overweight category were prevalent findings among firefighters. Association between cadre and years of service with occupational injuries was found out to be statistically significant. Also, the association between diabetes mellitus (DM) and hypertension (HTN) with occupational injuries was found out to be statistically significant. There was no clear association between ages of firefighters and BMI with occupational injuries.
Conclusion: There is a need to conduct more studies in Indian setup on occupational hazards and injuries amongst firefighters. Awareness about normal BMI, management of DM and HTN, healthy food practices, aerobic exercises, prevention and treatment of addictions, a drive for Hepatitis B vaccination, appropriate management of injuries and health insurance will serve a bigger role in diminishing morbidity in this occupation.

Prevalence and associated risk factors of hypertension among adults in Rajasthan, India

Dr. AjeshKumar Damor; Dr. Guru Kumar Sain; Mahesh Kumar Kharadi; Dr. PrafulBala Honta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1823-1828

Background::Hypertension is a major public health problem among India. It is a important area of research due to its high prevalence and being major risk factor for cardiovascular diseases and other complications.

Evaluation of Clinical Features and Risk Factors Among Stroke Patients: A Hospital Based Study

Anjum Joban, Sohail Badi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 625-629

Introduction: Identification of risk factors for stroke as well as awareness of relative importance of each, and of their interaction should facilitate stroke prevention. The understanding of stroke in a clinical setting is pivotal to create awareness among masses to prevent the burden of vascular diseases as well as to educate people regarding modifiable and non-modifiable risk factors. Hence, the present study was conducted to reveal signs, symptoms, and risk factors of stroke in patients with this condition.
Materials and Methods: The current cross-sectional observational study comprised of 100 patients who were diagnosed as stroke cases. The clinical profile of all enrolled patients was noted as per the proforma. Relevant clinical history was taken, and laboratory investigations was carried, and lipid profile was studied. CT scan of brain was conducted. For statistical analysis of the study, X2 with k<0.5 and a p-value<0.01 was considered as significant value.
Results: In this study 4% cases of stroke were below 40 year, 16% cases in age 40-50 years, 27% in 51-60 years, 34% in 61-70 years, 15% in 71-80 years, 3% in 81-90 years, 1% in 91-100 years. Regarding clinical symptoms, 62% patients present with right hemiplegia, 38% patients presented with left hemiplegia, 48% patients present with cranial n palsy, 30% present with altered sensorium. 55% patients had a history of (h/o) smoking, 50% patients had h/o hypertension, 34% patients had h/o ischemic heart disease, 15% patients had transient ischemic attack, 13% patients were alcoholics, 57% had diabetes mellitus while 51% were presented with intermittent claudication.
Conclusion: The present study concludes that age, gender, smoking tobacco, alcohol intake, hypertension, diabetes as well as dyslipidemia are the most common risk factor for the stroke. Active lifestyle with moderate physical activity and diet control can help in prevention of substantial proportion of stroke incidence.

A STUDY ON CORRELATION BETWEEN MORTALITY AND CO-MORBIDITIES IN PATIENTS WITH COVID 19 INFECTION

Dr. Chirayu Vijaykumar Vaidya, Dinker NGoswami, Sashikumar Mundra, Parth Rameshbhai Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 928-939

Background: Coronavirus disease 2019 (COVID-19) is a new respiratory infection caused by a coronavirus known as SARS coronavirus 2. (SARS- CoV-2). The virus is a member of the coronavirus family, which are zoonotic pathogens that cause and transmit infections between humans and various animals. The World Health Organization (WHO) has designated coronavirus disease 2019 (COVID-19) a pandemic, with 20% of infected individuals requiring hospitalisation and 6% requiring critical care and invasive ventilatory support. Co-morbidities are thought to be a greater risk for reducing the survival probability of SARS-CoV-2 patients. Different types of pre- existing diseases have been identified as co-morbidities in SARS-CoV-2 infection, which increases susceptibility and poses risks of more severe outcomes and deaths in COVID-19 patients.Thisstudy is to identify different co-morbidities of the patients who died due to COVID-19 admitted in GMERS medical college and general hospital in city Gandhinagar in Gujarat state.
Methods:This is a retrospective study of patients admitted to covid hospital, GMERS medical college and hospital, Gandhinagar who had been reported positive either with RT-PCR Test or rapid antigen test and died in hospital during the period of April 2020 to April 2021.
Results: In present study, majority (62.9%) of the study participants were in the age group of 51 to 70 years. The mean age of the study participants was61.91 years.58.4% of the COVID-19 patients were males while 41.6% were females. 93.2% of the COVID-19 patients were having any comorbidity while among 6.8% of the patients were without any comorbidities withhypertension was most common(57.5%) followed by diabetes(53.4%). 44.8% of the study patientswere having only single comorbidity while 55.2% were having more than or equals to two comorbidities. The mean interval between hospital admission and death of the patients was 4.5 days.
Conclusion: It has been concluded that old age, male gender has more severe outcome in case of COVID-19. Hypertension and diabetes mellitus were also reported among more than 50% of the patients who died from COVID-19.

Association of lichen planus with metabolic syndrome–acasecontrol study in a tertiary care center.

Nishant Saurabh Saxena , Nimisha Saxena , Animesh Saxena, Harsh Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 421-428

Background: Lichen planus is an inflammatory papulosquamous dis- ease which affects skin and mucous membrane and cause metabolic derangements.
Methods: This is an hospital based case control study during a span of 2 year (Jan2018-Dec 2019) which includes 60 cases of lichen planus and 60 age and sex matched controls. Relevant clinical history and physical examination was done and collaborated with blood investigations. Diagnosis was made based on IDF criteria.
Results: No significant association can be established between lichen planus and metabolic syndrome ( p=0.278) Although prevalence of hypertension was higher in cases as compared to controls (36% vs. 26%, p=0.027) , TG levels (12% vs. 6%, p=0.030 and low HDLC levels (47% vs. 33%, p=0.039). No significant association was established between FBS and waist circumference with lichen planus.
Conclusions: Although no significant association can be established between lichen planus and metabolic syndrome but its components such as hypertension, TG and HDLC were found to be associated with LP as per the study. Therefore screening of these parameters in LP patients is necessary to avoid future complications in these patients.

Hyperhomocysteinemia in diabetic and/or hypertensive patients with CKD: A cross sectional study

Dr. Mohan CN, Dr. Arvind MN, Dr. Harsha V Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3657-3664

Background & Objectives: Chronic kidney disease (CKD) is a commonly seen clinical condition resulting from different etiologies, diabetes and hypertension contributing to majority of CKD. Hyperhomocysteinemia is observed in CKD, which contributes to increased cardiovascular morbidity and mortalities according to many studies. Reduction of homocysteine level may help to decrease the cardiovascular morbidity and mortality which are leading cause of death in CKD patients.
Material and Methods: 90 patients with diabetes and/or hypertension, diagnosed as CKD with eGFR <90ml/min visiting the hospitals attached to BMCRI were chosen and their fasting plasma homocysteine level were measured. Patients less than 18 years age and had history of cerebral vascular disease, coagulopathy, Alzheimer’s disease were excluded from the study. The data was summarized using mean, standard deviation for parametric data and median, interquartile range for non-parametric data and chi-square test was used for analyzing categorical variables.
Results: Hyperhomocysteinemia was observed in 63.33% of patients with CKD, majority of patients (26.3%) belonged to 50-59 years age group with a significant male (73.7%) preponderance in CKD with hyperhomocysteinemia group. Prevalence of Diabetes and Hypertension in CKD with hyperhomocysteinemia were 73.7% and 82.5% respectively and with a mean duration of Diabetes and Hypertension of 9.82 ± 7.073 years and 7.3 ± 6.545 years respectively. 12.3% patients in CKD with hyperhomocysteinemia were found to have underlying causes for CKD, among them around 57.1% of them had Chronic Interstitial Nephritis. Prevalence of hyperhomocysteinemia was more in end stages of CKD i.e. stage 3B (8.8%), stage 4 (15.8%) & stage 5 (75.4%). Homocysteine elevation was found in both CKD without dialysis and with intermittent hemodialysis.
Conclusion: Serum homocysteine levels appear to be closely associated with CKD and serum homocysteine levels are negatively associated with GFR. Thereby, serum homocysteine levels can be used as a marker of renal dysfunction in patients with diabetes and hypertension.

A study of serum uric acid levels in metabolic syndrome

Dr. Vanja Swarna Latha, Dr. Jonnadula Mohana Lakshmi, Dr. Maraju Sireesha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3708-3714

Background and Objectives: The aim of this study is the association between uric acid levels and metabolic syndrome in individuals undergoing general health screening. Serum uric acid levels have been reported to be associated with a variety of cardiovascular conditions. Previous epidemiological studies have suggested that hyperuricemia may be a risk factor for cardiovascular diseases. However, on the other hand, many studies argue that the observed association between uric acid and atherosclerosis is attributable to an indirect association of hyperuricemia with cardiovascular risk factor or clustering of these metabolic and hemodynamic risk factors, designated “metabolic syndrome”.
Materials and Methods: The study comprised of metabolic syndrome cases visiting the general medicine outpatient at Government General Hospital, Guntur. Age and sex matched healthy volunteers served as controls. Total 100 out of which 50 cases and 50 controls. Physical Parameters like Waist Circumference (WC), Blood Pressure, Systolic (SBP) & Diastolic (DBP) and Biochemical parameters like Fasting Plasma Glucose (FPG) and Lipid profile Total Triglycerides (TTG), Total Cholesterol (TCH), HDL Cholesterol (HDL-C). Metabolic syndrome is diagnosed using the diagnostic criteria provided by the International Diabetes Federation.
Results: The total numbers of study participants were 100. Out of them 50 cases of central obesity were selected with increased waist circumference and 50 age and sex matched controls were selected with normal waist circumference. Out of 50 obese individuals metabolic syndrome was detected in 23 (46%) of subjects, in 14 (60.86%) of men and in 9 (39.1%) of women and hyperuricemia was detected in 21 (42%) of individuals. The overall serum uric acid (SUA) analysis in the 50 obese group, 21 (Twenty one) are with increased SUA levels. The mean± standard deviation values of all physical (waist circumference, blood pressure) and biochemical parameters (FPG, lipid profile, SUA) of obese group when compared to controls were statistically highly significant.
Discussion: In the present study risk analysis was done among the obese group (waist circumference >90cms in men and >80cms in women) and control group who were non obese. The difference between all the variables (physical and biochemical) of both groups based on the standard error of difference was statistically significant and also the p value (<0.001) that was obtained from Student t test was statistically significant.
Conclusion: in the present study, an elevated serum uric acid concentration was found to be correlated with hypertension, insulin resistance and the risk factors of metabolic syndrome.

Evaluation of Heart Rate Variability in Hypertensive Subjects

Parul Singh .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3270-3276

The autonomic nervous system, which is divided into sympathetic and parasympathetic divisions, plays a vital role in cardiovascular regulation. It has been demonstrated that heart rate variability can provide an objective measure of autonomic function. The Peripheral Pulse Analyzer has been used to research heart rate variability in healthy and hypertensive people in order to better understand the effects of hypertension on autonomic activity. Subjects were separated into two age groups: 18-30 years and 31-44 years, and variability factors were compared in terms of gender, age, and disease stratification. Statistical analysis revealed a significant reduction in the coefficient of variation for the variability parameter represented as a logarithm (to the base 10) in contrast to the raw or average value of the parameter, resulting in greater discriminatory strength in various stratified groups. Excluding age and gender sensitive factors, there is a significant difference in the amplitude of the low frequency component for lower age group male/female hypertensives and the amplitude and area of the low frequency component for higher age group female hypertensives. These findings are consistent with earlier research of a comparable scope. However, higher age group male controls and hypertensives could not be distinguished by variability study, most likely because to comparable changes indicated by senility and hypertension. As a result, the amplitude and area of the low frequency component in the heart rate variability spectrum have been identified as hypertension-specific parameters

A study of clinical profile of hemorrhagic stroke from government hospital, Gandhinagar, Gujarat

Dr. Chirayu Vijaykumar Vaidya, Dinker N Goswami, Dr. Drusty K Majmudar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2309-2315

Background: Cerebrovascular diseases rank first in frequency and importance among all neurologic diseases. Of all the cerebrovascular diseases, intracerebral hemorrhage is the most dramatic and catastrophic. Various clinical and radiological parameters have been proved useful as predictors of prognosis in spontaneous intracerebral hemorrhage. This study is to identify the risk factors, assess various clinical and radiological features with patients attending GMERS medical college and general hospital in city Gandhinagar in Gujarat state.
Methods: This is a retrospective study of all new patients managed for hemorrhagic stroke of GMERS Medical College and Hospital, Gandhinagar, Gujarat from January1 2012 to December 31, 2013.
Results: The mean age of patient was 61.77 yrs with highest number( 30.5%) of total pts in the age group of 61-70 yrs. Young hemorrhagic stroke (age ≤45 yrs) was in(13.4%). The male to female ratio was 1.05:1 with (51.2%) males & (48.8%) females. Equal percentage (35.1%) patients presented with right and left hemiplegia respectively followed by (29.9%) patients with global stroke. Most common clinical presentation was hemiplegia which was (44.6%) followed by altered sensorium (21.5%) and speech involvement (13.2%). Most common risk factor was Hypertension with (49.3%) incidence. It followed by previous H/o Cerebrovascular accident (13.7%), Smoking (11%). Most common site of hemorrhage was thalamus and basal ganglia (78%), lobar (28%) followed by ventricular (13.2%).
Conclusion: Incidence of hemorrhagic stroke was more in the age group of 61-70 yrs with male predominance with hypertension as the most common risk factor and most common area of hematoma was in thalamoganglionic region.

A study on prevalence of elevated blood pressure and hypertension among healthy school children at an altitude of 4000-5000 feet

Dr. Divyabh Gehlot, Dr. Neelam Grover, Dr. Hemant Gupta, Dr. Rajeev Vinayak, Dr. Amudeep Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 430-437

Introduction: Early diagnosis of hypertension is an important strategy in its control which is usually
missed in OPD practice. Kumarhatti, Solan, was selected as the place of study based on the new AAP
2017 criteria to find the prevalence of elevated blood pressure and hypertension at an altitude of 4000-
5000 feet.
Objective: To measure blood pressure of school going children and to classify BP measurements into
normal BP, Elevated BP and Hypertension.
Methods: 600 children between 10 to 17 years of age were selected from urban and rural schools. The
final diagnosis of HTN was made if a child or adolescent had auscultatory confirmed BP readings
≥95thpercentile on 3 different visits. Data collected was analyzed using SPSS20.
Results: Prevalence of EBP, stage 1 and stage 2 hypertension was found to be 15, 8%, 4.5% and 1%
respectively in the study. Prevalence of EBP and stage 1 hypertension was higher in urban population
(17.2% and 5.3% respectively) whereas stage 2 hypertension was almost equal in both population
(P<0.05). Prevalence of EBP, stage 1 and stage 2 hypertension was maximum in obese category as
38.6%, 13.63%, 6.8% followed by overweight 24%, 11.25%, 2.5% respectively (P<0.05). The prevalence
of positive family history among study subjects was 15% (N=90) with P value<0.05.
Conclusion: Prevalence of hypertension was 5.5% in the study subjects. Prevalence of EBP and stage 1
hypertension was higher in urban population. Our study revealed that prevalence of elevated blood
pressure and hypertension was significantly more in overweight and obese children and with positive
family history compared to normal children proving obesity and positive family history as an important
risk factor for hypertension in children.

A prospective study on effect of controlled hba1c levels and normotension in the development of diabetic retinopathy in type 2 diabetics

Dr. Chaithra CM, Dr. Kshama K

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1410-1416

Aim: To determine the importance of HbA1C levels and normotension in predicting the development of diabetic retinopathy and the relationship between them.
Method: Prospective clinical study comprising of a group of 125 diabetics above 40 years visiting for routine eye checkup and clinically diagnosed diabetic retinopathy including both out-patient and in-patients at Department of Ophthalmology, KIMS, Bangalore. Men and women >40years with type 2 diabetes mellitus with HbA1C levels <7.5% and non-hypertensives (<140mmHg systolic and <90mmHg diastolic pressure) were included. Patient’s HbA1C levels and blood pressure were measured. The diabetic retinopathy status was classified according to the ETDRS system. Statistical analysis was done.
Results: At 3rd month follow up, the mean HbA1C levels was 7.25±0.22.At the end of 12th month, the mean HbA1C was 7.42±0.11At baseline, in group A 8.8% showed mild NPDR and 1.6% moderate NPDR. At the end of the study it was 8.8% mild NPDR, 1.6% moderate NPDR. No further progression was seen in a year span. All values showed statistical significance and absence of hypertension also goes in favour of mild diabetic retinopathy changes.
Conclusion: HbA1C levels and systemic hypertension are the two major modifiable risk factors in the development and progression of diabetic retinopathy

Assessment of awareness towards hypertension management in general practitioners

Dr. Ratandeep Lamba

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2121-2125

Background: Hypertension is a common chronic disease worldwide and a major risk
factor for cardiovascular disease. The present study was conducted to assess awareness
towards hypertension management in general practitioners.
Materials & Methods: 125 general practitioners of both genders were enrolled. A
questionnaire was prepared and was distributed among all participants and response
was recorded.
Results: Out of 125 subjects, males were 65 and females were 60. The number of
readings of blood pressure was 1 by 15%, 2 by 40% and 3 by 35%. Cuff placement
covering 2/3 of arm at heart level was recommended by 78%. Preferred position of
patient was sitting by 48%, supine by 32% and standing and supine by 20%. The
difference was significant (P< 0.05). Investigation preferred by GP were RBS by 85%,
ECG by 96%, ultrasound of abdomen by 42%, serum creatinine by 85%, lipid profile
by 87%, serum potassium level by 70% and urine examination by 67%. The difference
was significant (P< 0.05).
Conclusion: Most of the general practitionershad sufficient awareness regarding
techniques and symptoms of hypertension.

A COMPARATIVE STUDY OF LABETALOL AND NIFEDIPINE IN THE MANAGEMENT OF HYPERTENSIVE DISORDERS OF PREGNANCY

Akaraonye, Mercy. A, Confesora Valdez Aquino, Chinelo Igweike, Adaugo Nwanguma, Ayesha Fonseca, Luwaji Aderinmola, Oluwaseun Christiannah Konigbagbe, Srinidhi Cheeti

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2327-2333

Background: Hypertensive disorders of pregnancy are one of the major causes of morbidity and mortality in both the mother and fetus. The present study was conducted to compare labetalol and nifedipine in the management of hypertensive disorders during pregnancy.
Materials & Methods: 72 pregnant between the ages of with hypertension were divided into two groups Was this a blind study? Oral Labetalol was initially started at a dose of 100 mg twice daily (BD) and a maximum dose of 200 mg thrice daily (TDS) was given. Oral What type of Nifedipine? XR, regular? was initially started with a dose of 10 mg BD and titrated upwards to 20 mg TDS.  Pregnant subjects were monitored daily for blood pressure and fetal well- being.    
Results: Group I received 100 mg labetalol and group II received 10 mg Nifedipine. Gravida I patients were noted to have 62% and 60%, Gravida 2, 24% and 27%, and Gravida 3 14% and 13% reduction in group I and group II respectively. The difference was significant (P< 0.05). SBP (mm Hg) before treatment was 153.4 and 152.4 and after treatment was 126.8 and 138.2 in group I and group II respectively. DBP (mm Hg) before treatment was 104.2 and 106.4 and after treatment was 90.5 and 99.2. MAP (mm Hg) before treatment was 120.2 and 122.6 and after treatment was 101.5 and 112.8 in group I and group II respectively. The difference was significant (P< 0.05).
Conclusion: Labetalol proved to be a better antihypertensive than nifedipine in controlling maternal hypertension and fetal outcome. This effect was significant in systolic blood pressure control compared to diastolic blood pressure control ( p < .05) and (p <.12). This difference was also remarkable in terms of parity as shown in the chart comparing Gravida 1, 2 & 3.

A Cross-sectional study on Coronary risk factors among students of a medical college in Dakshina Kannada District of Karnataka, India

Dr.Nanjesh Kumar S,Diwakar Kumar Singh, Animesh Gupta, Shahul Hameed

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 707-714

Background:Cardiovascular Diseases (CVDs) like ischaemic heart disease,
cerebrovascular diseases account for 17.7 million deaths and are the leading causes.
CVDs occurs in Indians a decade earlier than the western population.Lifestyle-related
behavioural risk factors are mainly implicated for the increased burden of CHD, and
research related to these risk factors among medical students is essential, considering
their role as future healers and role models in public health intervention programs.
Objective: Study the prevalence of coronary risk factors among students of a Medical
college in Mangalore.
Methodology: A cross sectional study was done among M.B.B.S students of a Medical
College from November 2017 to March 2018. The study comprised of 500 students. A
pre-tested semi structured questionnaire was used for collection of data. Data was
collected by interview cum, clinical examination and relevant laboratory investigations.
Statistical analysis was performed using SPSS software.
Results: Out of 500 subjects 293 were females and 207 were males. 380 (76%) subjects
were consuming transfattyacid food items. 150 (30%) subjects had overweight and 40
(8%) subjects had Obesity. 80 (16%) subjects had Truncal obesity, 135 (27%) subjects
were consuming alcohol and smoking was seen in 58 (11.6%) subjects.107(21.4%)
subjects had high cholesterol. 90 (18%) subjects had lack of physical activity, 71
(14.2%) subjects had family history of CHD. 8 (1.6%) subjects had Hypertension and
10 (2%) subjects had impaired fasting blood sugar.

A Study Of Liver Function In Normal Pregnancy And Pregnancy Induced Hypertension

Dr. Gunjan Jain ,Dr. NamrataKaushik, Dr. Santosh Kumar Sah ,Dr. Manoj Kumar Jain, Jay Prakash Singh Rajput

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11421-11429

Background: Hypertensive disorders of pregnancy are one of the commonest complications of pregnancy which accounts for 12% of the maternal and perinatal mortality and morbidity and affects 3% to 10% of all pregnancies worldwide. Liver function Test (LFT) abnormalities occur in 3% of the pregnancies and probably the lesion that causes elevated serum liver enzymes. Hence, this study was done to assess and correlate liver function in the development of pregnancy induced hypertension.
Method: This Case Control study was done to correlate liver function in pregnancy induced hypertension and normal pregnancy. In the present study 140 subjects, 70 women with diagnosed pregnancy induced hypertension at gestational age of > 20 weeks as a case and 70 normotensive pregnant women at gestational age of > 20 weeks as a control were included after applying inclusion & exclusion criteria. Distribution of subject according to Gestational Hypertension is Group A, Pre-Eclampsia is Group B and Eclampsia is Group C of case and control.
 
Result: Mean Difference in SGOT, SGPT were observed in subjects with Pre-Eclampsia and Eclampsia  as compare to  Gestational Hypertension. However, no significant difference between case and control group were noted.
 
Conclusion: Our study shows that there is no significant difference in Gestational Hypertension,Pre-Eclampsiaand Eclampsia of case and control group.
 

A study on association of serum uric acid and blood pressure in hypertensive patients at a tertiary hospital

Premaraja R, Bethiun S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1244-1249

Background: Hypertension is an increasing important medical and public health issue. Uric acid exerts a pro-inflammatory effect on endothelial cells which may be associated with MetS risk factors such as elevated triglyceride (TG) levels, hypertension and insulin resistance.5 Present study was aimed to study of association of serum uric acid and blood pressure in hypertensive patients at a tertiary hospital.
Material and Methods: Present study was prospective, comparative, observational study, conducted among cases (Subjects of either gender, age >18 years, diagnosed as hypertensive (first time) were enrolled in this study during a regular routine health check-up at general medicine OPDs) & controls (Age & gender matched normotensives subjects at general medicine OPDs).
Results: In present study, 100 subjects each were studied in hypertensive as well as normotensive group. Mean levels of age, gender, BMI & co-morbidities among both groups were comparable & difference was not significant statistically. Mean pulse rate & respiratory rate were comparable among both groups & difference was not significant statistically. The mean levels of SBP and DBP were significantly more in the hypertensive subjects as compared to normotensive subjects (p<0.001). In present study, prevalence of hyperuricemia was 9% (1% in normotensive and 8% in hypertensive subjects). Hypertensive subjects had increased mean levels of SUA than in the normotensive subjects (p<0.001). In Pearson’s correlation coefficient test, SUA levels were significantly related with SBP and DBP (p<0.001). The average level of TG and HDL were also significantly different between the groups (p<0.05).
Conclusion: A stronger co-relationship for higher levels of SUA concentration was noted with blood pressure hypertension and prehypertension in the participants.

COMPARISON OF HAEMODYNAMIC RESPONSE TO INDUCTION WITH THIOPENTONE AND ETOMIDATE IN HYPERTENSIVE PATIENTS SCHEDULED FOR ELECTIVE SURGERY-A CLINICAL STUDY

Dr.Ramlal Porika, Dr. Joshua Dhavanam Y ,Dr.P.AnandVijaya Bhasker, Dr.KommuriSudha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5962-5970

Aim: To compare the hemodynamic response to anaesthetic induction with thiopentone sodium or
etomidate in adult treated hypertensive patients posted for elective surgeries.
Materials and methods:A prospective randomised blind clinical study conducted in 60 adult treated
hypertensive patients(29-61 years) of ASA II posted for elective surgeries under general anaesthesia.
Patients were randomly allocated to two groups of 30 each. Group T-Thiopentone sodium 5mg/kg
body weight Group E-Etomidate 0.3mg/kg body weight. Pulse,systolic blood pressure, diastolic
blood pressure and mean arterial pressure were noted down every minute for five minutes post
induction.
Results: Both groups were comparable statistically for age, gender and weight.There was no
statistically significant variation in the extent of over all change in heart rate, systolic, diastolic and
mean arterial pressures between the two group of patients (p >0.05).All the studied hemodynamic
variations with respect to HR,SBP,DBPand MAP in the two groups were self corrective and did not
require any treatment. Patients in both groups did not have any side effects perioperatively and for 24
hours post operatively except for vomiting in one patient in group E.
Conclusion: Both thiopentone (5mg/kg) and etomidate (0.3mg/kg) have similar hemodynamic effects
when used for induction of anaesthesia in adult treated hypertensive patients and can be safely used in
them. However thiopentone comparatively has better cost effectiveness and ease of availability.

A PROSPECTIVE STUDY ON SINGLE STEP 75 GRAMS ORAL GLUCOSE TOLERANCE TEST FOR SCREENING AND DIAGNOSIS OF GESTATIONAL DIABETES MELLITUS AND ITS FETOMATERNAL OUTCOME AT A TERTIARY CARE CENTRE

Dr. Mortha Sulochana, Dr. N. Swetha Goud, Dr.O.Balajojamma .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 793-804

Gestational diabetes is defined as “carbohydrate intolerance of variables everity with onset or first recognition during pregnancy irrespective of the treatment with diet or insulin”. The prevalence of GDM in India varies from 3.8 to 21% in different parts of the country. Clinical recognition of GDM is important because timely intervention can reduce the well-described associated maternal and fetal complications.
The study was conducted at Department of Obstetrics & Gynecology, Ayaan Institute of Medical Sciences, Kanakamamidi, Telangana conducted with sample size of 400. All the antenatal women attending outpatient department during the study period are included as per the Inclusion & Exclusion criteria.
400 women had undergone 75grams OGTT test at 24weeks of gestational age and were followed up till 7days of postpartum for maternal and fetal outcome. In initial screening, 19 women had GDM out of 400 women accounting for 4.7%. After rescreening in 183 high risk women for GDM, 2 had GDM out of accounting for 1%. Out of 400 cases, 21 had GDM. GDM incidence was 5.2% using the DIPSI method. There was significant correlation between age>26 years and GDM. Incidence of GDM among primigravidawas5% and among multigravida was 5.4%. There was no significant correlation between gravida and incidence of GDM. Number of women who had pregnancy complications likegest. HTN, polyhydramnios, preterm labour, PPH in GDM group were 6(28.5%), 3(14.2%), 3(14.2%), 3(14.2%), Where as in the non GDM women number of women having these complications were 27(7.1%), 10(2.6%), 17(4.4%), 15(3.9%). There was a significant correlation between GDM and developing pregnancy complications.
Some of the local factors contributing to this high incidence are poverty and ignorance. Peopleare usually not aware of the nutritional and caloric values of food and its implication on body weight and health.

Etilogical and Recovery Factors Among Patients with Isolated Oculomotor Nerve Paralysis Attending a Tertiary Care Setting-A Prospective Observational Study

Dampuru Chandana, Tirumuru Divya, Gantela Sirisha, Nallabantu Lakshmi Chowdary, Triveni Chimata .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3122-3130

Background: To analyze the etiology, clinical presentation and outcome of oculomotor nerve paralysis.
Materials and Methods: It is a prospective study. All cases for the study is collected from the patients presenting themselves directly to Department of Ophthalmology, some cases are referred from Department of Neurology and Neurosurgery, NRI Medical College and General Hospital, Chinakakani from 2017 to 2019.
Results: Most of the patients belong to 51- 60 yrs age group (9) followed by age group 41-50 yrs (7). Among 30 patients right eye was involved in 13 patients, and the left eye was involved in 17 patients. No patients had bilateral palsy. The most common cause of isolated oculomotor cranial nerve paralysis is DM and HTN (microvascular ischemia) in 19 patients. In the present study, out of 9 hypertensives patients with third cranial nerve paralysis eight not recovered and one recovered, out of 21 patients, ten recovered and 11 not recovered. 18 had pupil sparing oculomotor nerve paralysis and 12 had pupil involving paralysis among 30 patients .Patients with pupil sparing oculomotor cranial nerve paralysis recovered completely within six months.
Conclusion: Finally we concluded that microvascular ischemia i.e. diabetes and hypertension, incomplete paresis and pupil sparing paralysis has high chances of complete recovery.

A study on association of serum uric acid and blood pressure in hypertensive patients at a tertiary hospital

Premaraja R, Bethiun S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2013-2019

Background: Hypertension is an increasing important medical and public health issue. Uric acid exerts a pro-inflammatory effect on endothelial cells which may be associated with MetS risk factors such as elevated triglyceride (TG) levels, hypertension and insulin resistance.5 Present study was aimed to study of association of serum uric acid and blood pressure in hypertensive patients at a tertiary hospital.
Material and Methods: Present study was prospective, comparative, observational study, conducted among cases (Subjects of either gender, age >18 years, diagnosed as hypertensive (first time) were enrolled in this study during a regular routine health check-up at general medicine OPDs) & controls (Age & gender matched normotensives subjects at general medicine OPDs).
Results: In present study, 100 subjects each were studied in hypertensive as well as normotensive group. Mean levels of age, gender, BMI & co-morbidities among both groups were comparable & difference was not significant statistically. Mean pulse rate & respiratory rate were comparable among both groups & difference was not significant statistically. The mean levels of SBP and DBP were significantly more in the hypertensive subjects as compared to normotensive subjects (p < 0.001). In present study, prevalence of hyperuricemia was 9% (1% in normotensive and 8% in hypertensive subjects). Hypertensive subjects had increased mean levels of SUA than in the normotensive subjects (p < 0.001). In Pearson’s correlation coefficient test, SUA levels were significantly related with SBP and DBP (p < 0.001). The average level of TG and HDL were also significantly different between the groups (p < 0.05).
Conclusion: A stronger co-relationship for higher levels of SUA concentration was noted with blood pressure hypertension and prehypertension in the participants.

Prevalence and Risk Factors of Pterygium in a Semi Urban Area

Dr. Rasna Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1031-1037

Introduction: Pterygium is one of the very common ophthalmic disorders with an unknown etiology and pathogenesis. Growth of pterygium into the cornea can result in visual impairment, astigmatism, loss of corneal transparency, visual axis obstruction.
Materials and methods: This cross sectional study was done on 500 patients, where demographic details was taken from all the patients including living environment, status, time outdoors, familial history, drug abuse, history of smoking, type of work and education, use of glasses. All of them underwent regular ophthalmic examinations including systemic and comprehensive examination as well as refraction.
Results: The prevalence of Pterygium was 12.6%. 35.6% of the patients were females and 64.4% were males. 51.2% belonged to the 30-39 year age group. 33.3% were farmers and 54% were manual labourers, 61.9%) of the patients had passed their high school while 28.6% were illiterate, 73% had no familial history of pterygium, 61.9% were regular smokers and 25.4% were occasional smokers. 36.5% of the patients had hypertension and 25.4% were obese.
Conclusion: Pterygium formation in our geographical area is quite high and the most common risk factor is exposure to sunlight. Male gender, hypertension and smoking also appear to be associated risk factors. Use of sunglasses may help in reduction of the prevalence of Pterygium.

Lipid abnormalities in patients with newly diagnosed hypertension

Harkamalpreet Kaur, Abhishek, Jaikirat Singh Gugnani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2859-2862

Background: The present study was conducted for assessing lipid abnormalities in patients with newly diagnosed hypertension.
Materials & methods: A total of 50 hypertensive subjects and 50 healthy controls were enrolled. Complete demographic details and clinical data of all the patients were obtained. Blood samples were obtained and sent to the laboratory where an auto-analyser was used for evaluation of serum lipid profile. High density lipoproteins (HDL-C), Low density Lipoproteins, Total cholesterol (TC) and triglycerides levels (TG) were evaluated. All the results were recorded and analysed by SPSS software. Student t test was used to evaluate the level of significance.
Results: Significant results were obtained while comparing the TG levels, LDL-C levels and TC levels among the patients of the two study groups. While assessing the lipid abnormalities, it was seen that 58 percent of the patients in the study group and 12 percent of the patients in the control group had a minimum of one lipid abnormality (p-value <0.05).  
Conclusion: Lipid abnormalities are highly prevalent among newly diagnosed hypertensives.

A study on correlation between mortality and co-morbidities in patients with covid 19 infection

Dr. Chirayu Vijaykumar Vaidya, Dinker N Goswami, Sashikumar Mundra, Parth Rameshbhai Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11894-11903

Background: Coronavirus disease 2019 (COVID-19) is a new respiratory infection caused by a coronavirus known as SARS coronavirus 2. (SARS- CoV-2). The virus is a member of the coronavirus family, which are zoonotic pathogens that cause and transmit infections between humans and various animals. The World Health Organization (WHO) has designated coronavirus disease 2019 (COVID-19) a pandemic, with 20% of infected individuals requiring hospitalisation and 6% requiring critical care and invasive ventilatory support. Co-morbidities are thought to be a greater risk for reducing the survival probability of SARS-CoV-2 patients. Different types of pre- existing diseases have been identified as co-morbidities in SARS-CoV-2 infection, which increases susceptibility and poses risks of more severe outcomes and deaths in COVID-19 patients. This study is to identify different co-morbidities of the patients who died due to COVID-19 admitted in GMERS medical college and general hospital in city Gandhinagar in Gujarat state.

To evaluate the Pre-hypertension among MBBS students and its associated factors

Dr. Sameer Srivastava,Dr.AnupamTyagi, Dr.Nandini Srivastava, Dr.Shyam Sunder Keshari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1639-1647

Aim: To evaluate the Pre-hypertension among MBBS students and its associated factors.
Methods: 200 students of MBBS were included in this study. Out of these 200 participants,
60% were males and 40% were females. The mean age of the students was 22.55±7.66. As
per JNC 7 guidelines BP was measured, with a mercury sphygmomanometer.
Anthropometric measurements and basic laboratory parameters for blood glucose and lipid
profile estimation were measured in the study.

The effects of antihypertensive drug therapy on the health related quality of life of the patient

Dr. Syed Sujat Pasha, Dr.Lakshmipathi BS, Dr.Sha NaseeruddinMakandar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 946-950

Hypertension is one of the leading causes of the global burden of disease. Approximately 7.6
million deaths (13-15% of the total) worldwide were attributable to high blood pressure in
200l.The 2003 global report showed that 7 million people die of hypertension each year and
approximately 4.5% of serious diseases are caused by it. Written informed consent was
obtained from every patient satisfying the inclusion criteria and they were thoroughly
explained in writing as well as orally in English/Kannada about the study, methodology and
possible risks during the study. In Amlodipine with Atenolol group 86% patients had good
quality, and 14% had average physical quality compared to Amlodipine with Enalapril group
which had 66.7% in good and 33.3% in average physical quality.In Amlodipine with Atenolol
group nearly 88% patients had good quality and 12% had average physical quality compared
to Amlodipine with Enalapril group which had 89% in good and 11% in average physical
quality.

Correlation analysis of serum calcium level with the blood pressure among patients with essential hypertension in rural population of Himachal Pradesh

Vijay Kumar, Jagjit Singh Bahia, Sharad Lodhi, Sameer Singh Faujdar, Harharpreet Kaur, Sahil Chhabra

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1475-1481

Introduction: A high blood pressure that doesn't have a known secondary cause is called as essential hypertension, is a leading cause of death worldwide. Calcium supplementation known to reduce the blood pressure in normal healthy individuals.
Objective: The present study aims towards analysing the correlation between serum calcium level with the blood pressure among patients with essential hypertension.
Methods: 30 cases of essential hypertension patients as cases and 30 suitable healthy age sex matched individuals with normal blood pressure as controls, as per JNC-8 guidelines were recruited in study. Serum calcium level and blood pressure was analysed in all patients.
Results: Systolic Blood Pressure in control group was 111.1 ± 7.570 and in cases was 158.1 ± 9.066. Diastolic Blood Pressure in control group was 72.80±6.183 and in cases was 92.33±6.456. Serum calcium in control group was 9.207 ± 0.7249 and in cases was 8.130 ± 0.4843.
Conclusion: Patients with lower calcium level tends to have raised blood pressure and vice versa. Thus, routine dietary restriction salt in hypertensive individuals can help in better management of hypertension.

STUDY OF CLINICAL, BIOCHEMICAL, HISTOLOGICAL PROFILE OF PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE

A. Praveen Naik, Md. Masood Ahmed Shareef

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1640-1648

Background: Non-alcoholic steatohepatitis is a clinicopathological syndrome, characterized by the development of histological features comparable to those induced by excessive alcohol intake without alcohol abuse. This study is an attempt to evaluate the clinical, biochemical and histological profile of non-alcoholic steatohepatitis in this tertiary hospital in Rayalasema.
Material and Methods: Present study was single-center, prospective, observational study, conducted in patients of all ages, either gender, who are found to have increased echo texture of liver on routine ultra-sound scan.
Results: The present study was conducted on 60 patients, comprised of 36(60%) males and 24(40%) females. Majority were from the age group of 41 to 50 years there were 22 (36.66%) cases of which 12 (54.54%) were males and 10 (45.46%) were females.  The commonest symptom was fatigability and malaise (66.66%), followed by right upper abdominal discomfort (46.66%), Jaundice (10%), ascites (10%), UGI Bleed (8.3%) patients and 20 (33.33%) patients were asymptomatic at the time of diagnosis and diagnosis was established due to abnormal sonographic finding and abnormal liver function tests during investigations for other causes. Hyperlipidemia (61.67%), diabetes mellitus (58.33%), obesity (46.67%) & overweight (50%) were the most commonly associated risk factors noted. 7 patients underwent biopsy. Of these 4.28% patient showed steatohepatitis, 42.86% patients showed simple fatty change and 14.28% patient had cirrhosis. Other 28.57% had no specific changes.
Conclusion: This study demonstrates that features suggestive of the metabolic syndrome are observed more frequently in patients with non-alcoholic steatohepatitis, share many of the systemic disorders that constitute insulin resistance syndrome, hyperlipidemia, hypertension, obesity, type 2 diabetes and hepatic steatosis.

A study on pharmacoeconomics analysis of antihypertensive drugs

Dr. Syed Sujat Pasha,Dr.Sha NaseeruddinMakandar, Dr.Lakshmipathi BS

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 951-957

Hypertension is one of the leading cause of global burden of diseases and as it is a chronic
condition with significant detrimental effects on the wide range of health outcomes, cost
effective management of hypertension appears to be a great challenge for both developed as
well as developing countries. Even though recently there have been lot of studies on
pharmacoeconomics and outcome research in the field of hypertension globally, but the
results cannot be exactly extrapolated to Indian scenario as the economic status and
socioeconomic factors are different in India as compared to the countries. Hence a study was
undertaken to evaluate the cost effective antihypertensive drugs in our hospital. An
observational comparative study is planned on 100 patients attending the outpatient
Department of General medicine with a follow up period of 6 months. Written informed
consent is obtained from all the patients satisfying the inclusion criteria. Multitherapy was
frequently prescribed (74%), out of that Atenolol with Amlong combination was most
common (54%). Diabetes was the most common co-morbid condition (24%). Multitherapy
was most frequently prescribed, and Amlodipine with Enalapril combination proved to be
most cost effective therapy. HRQoL was not much different in all the treatment groups.

ASSESSING THE CORRELATION BETWEEN LEVELS OF GLYCOSYLATED HB AND SERUM ALBUMIN IN SUBJECTS WITH TYPE 2 DIABETES MELLITUS

Dr. Bharat Kumar Parmer,Dr. Roshan Mandloi, Dr. Sanjay Kumar Dubey

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 401-406

Background: Diabetes mellitus has a high prevalence globally with rising incidence in the
world. Despite the identification of diabetes mellitus and associated complications for a long
time, the measures to reduce mortality and morbidity in subjects with diabetes mellitus are
focused only for a few decades.
Objective: The present study was conducted to assess the correlation between levels of
glycosylated Hb and serum albumin in subjects with type 2 diabetes mellitus.
Method: The present institution-based observational study included subjects with a
confirmed diagnosis of diabetes mellitus type 2 where levels of glycosylated hemoglobin
(HbA1c) and serum albumin were assessed and correlated.
Result: It was seen that in subjects with glycosylated hemoglobin of <7%, mean serum
albumin level was 3.87±0.88 mg/dl, in subjects with glycosylated hemoglobin of 7-9%, mean
serum albumin level was 2.95±0.53 mg/dl, and in subjects with hemoglobin of >9%, it was
seen that mean serum albumin was 2.46±0.69 mg/dl. A negative correlation was noted where
lesser HbA1C% was related to higher mean values of serum albumin.
Conclusion: The present study concludes that subjects having higher values of glycosylated
hemoglobin have lower serum albumin levels compared to subjects where lower glycosylated
hemoglobin levels in subjects were associated with near-normal or normal serum albumin
levels.

DEVELOPMENT AND CHARACTERIZATION OF CONTROLLED RELEASE TABLET BEARING ANTI HYPERTENSIVE DRUG

NIDHI SHARMA,PRANAV KUMAR UPADHYAY

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 623-636

Propranolol hydrochloride is used to treat high blood pressure, thyrotoxicosis, capillary
hemangiomas, performance anxiety, and essential tremors and used to prevent migraine
headaches. In this investigation-controlled release tablet of Propranolol Hcl was prepared
using different polymers such as xanthan gum, tragacanth, sodium carboxy-methylcellulose,
HPMC K4M, Eudragit S100, ethyl cellulose by direct compression method. All the precompression
and post compression parameters of designed formulations of F1-F8 were
evaluated and found to be within permissible limits. The optimized formulation (F7) showed
a maximum percentage of drug release (100%) within 6hrs when compared to other
formulations. From the FT-IR study it was concluded that there were no possible drug and
polymer interactions. The short-term stability studies were carried out at 40±2°C and 75±5%
RH and confirmed no changes in the weight, hardness and friability. Based on study results
it may be concluded that tablets prepared will emerge as eminent candidates in treatment of
hypertension.

RELATIONSHIP BETWEEN FAMILY SUPPORT AND COMPLIANCE IN IMPLEMENTING DIET PROGRAMS FOR ELDERLY PEOPLE WITH HYPERTENSION

Nina Sumarni; Citra WindaniMambang Sari; Dadang Purnama

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 99-106

Family support plays an essential role in understanding lifestyle changes associated with chronic illness, changes needed to help sick members. Family support for patients with hypertension can improve health, and intensive support can reduce pain and help carry out a more disciplined diet program to be maximized. Low adherence to treatment makes it difficult to control his blood pressure. The purpose of this study was to determine the relationship between family support and commitment in implementing a diet program for elderly Hypertension in Muarasanding Village, Garut Regency.The type of correlative descriptive study that describes the relationship of family support with hypertension diet compliance. This study's population is hypertension sufferers in the Muara Sanding village located in the SiliwangiGarut Health Center working area. The sample is a total sampling of 51 respondents. The instrument used was a questionnaire. The validity test uses the product-moment correlation technique; the reliability test in GarutJayaraga Village is 20 elderly. Data analysis uses chi-square.The results of this study received as much support as 57% with a level of adherence to carrying out a diet of 55%, and categories that lacked family support 43% and who did not carry out dietary compliance 45%. Results of analysis Sig = 0.42 (a <0.05) means that HO is rejected and accepts H1. There is a relationship between family support and adherence in implementing a diet in the elderly with hypertension. The analysis also found a significant correlation value, with an equivalent odds ratio of 3,889, meaning families who support have the possibility of 3,889 times to comply with the hypertension diet program. Conclusion: There is a relationship between family support with adherence to implementing the diet.

PREVALENCE OF DIABETES MELLITUS AND HYPERTENSION AMONG PATIENTS UNDERGOING DENTAL IMPLANT TREATMENT - A HOSPITAL BASED ASSESSMENT

Vaishnavi Devi. B Priya lochana Gajendran Delphine Priscilla Antony. S

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3308-3324

The aim of this study is to retrospectively analyse the prevalence of diabetes mellitus and hypertension among patients undergoing  dental implant treatment in a dental hospital. All the patients reported in the month of June 2019 to March 2020 for implant placement was chosen for the study. Implant placement data of patients with diabetes mellitus and hypertension was collected from the dental hospital record system. Result data was tabulated in excel and statistical analysis was done using Statistical Software for the Social Sciences (SPSS) software. The non parametric Chi square test was done for statistical analysis. The prevalence of diabetes mellitus in patients undergoing implant placement is 4.2%, hypertension is 2.2% and coexisting diabetes mellitus and hypertension is 1.7% with a higher incidence in the male population and more common in the age group of 40 to 60 years. Knowledge about the prevalence of these conditions will be helpful to the clinician for proper management setup and precise diagnosis before implant therapy can prevent surgical and postoperative complications resulting in long term success of dental implants

EFFECT OF ULTRASOUND CAVITATION VERSUS PHOSPHATIDYLCHOLINE IONTOPHORESIS ON CENTRAL OBESITY IN HYPERTENSIVE WOMEN

Mina Nashat Halim Farag; Ramez Yousry Fawzy Bakhoom; Ahmed Assem Abd El Rahim; Ahmed Aref Ahmed Hussein; Mahmoud Y Elzanaty

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 821-832

Background/aim: Central obesity (CO) confers a great threat on the cardio-metabolic health of
population. Central obesity is directly matched with increased visceral abdominal fat and it is also
matched with endothelial dysfunction, insulin resistance, hypercholesterolemia, and cancer.
Purpose of the study: This study was designed to compare between the effect of ultrasound
cavitation and phosphatidylcholine iontophoresis on central obesity in hypertensive women.
Material and methods:It is a randomized controlled trial performed on 40 hypertensive centrally
obese females divided into two equal groups. Group (A) consisted of 20 females received
ultrasound cavitation, Group (B) consisted of 20 females received phosphatidylcholine
iontophoresis. The primary outcome measures were waist circumference, visceral fat range,
systolic and diastolic blood pressure. Results: the results showed that there was statistically
significant improvement in central obesity and hypertension in Group A but there was statistically
significant improvement in central obesity but non-significant improvement in hypertension in
Group B. Improvement in Group A is more significant than in Group B regarding the percent of
decline in WC, VFR and DBP. Conclusion: there was improvement in central obesity and blood
pressure in women after applying ultrasound cavitation and phosphatidylcholine iontophoresis
with better results in ultrasound cavitation than phosphatidylcholine iontophoresis.

THE ROLE OF PHYSICAL PSYCHOTHERAPY ON QUALITY OF LIFE IN PATIENTS WITH HYPERTENSION WITH ALEXITHYMIA.

Atefeh Haghighat; Raheleh Haghighat

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 2345-2353

Studies have shown that it is easier for people, who are emotionally capable, to cope with life challenges and therefore they are healthier psychologically. Alexithymia exacerbates vulnerability to physical illness and predisposes to chronic illness. The aim of this study was to determine the role of physical psychotherapy on the quality of life of patients with hypertension with alexithymia. In this clinical trial with a pre-test post-test design, 60 patients with hypertension with alexithymia were purposefully selected from the patients referred to the health centers of Semnan and randomly assigned to the experimental and control groups. The intervention was performed during 1.5 months in the experimental group according to the steps designed in the protocol of physical psychotherapy. Data were collected using the Demographic Questionnaire, Toronto Alexithymia and Quality of Life Questionnaire (WHOQOL-BREF) and analyzed by descriptive, inferential and MANCOVA statistics. In multivariate analysis of covariance, there was a significant difference in the linear composition of alexithymia components and quality of life. Overall, physical psychotherapy has had a significant effect on improving alexithymia, blood pressure and quality of life. Therefore, according to the research findings, it can be said that physical psychotherapy hasbeen effective in improving the quality of life and controlling blood pressure in patients with high blood pressure with alexithymia and performing this treatment in the above patients is recommended as a suitable complementary treatment.

STUDY OF PREHYPERTENSION AND HYPERTENSION AMONG URBAN SCHOOL ADOLESCENTS AND THE DIETARY DETERMINANTS OF CHILDHOOD HYPERTENSION

Haris M. M; Soundarya M; Ravikumar G; Kamalakshi G Bhat; Basavaprabhu Achappa

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1664-1674

Background: Adolescent health is important as theyare under a great amount of stress due to academic and peer pressures. This study aims to determine prevalence of pre-hypertension and hypertension in school adolescents and to identify diet as a risk factor in these children.Methodology - Cross sectional study was conducted among school adolescents(11- 14years). Anthropometric and blood pressure measurements were taken. 24 hour recall method was used to record the dietary intake and the total sodium, potassium, fat, fructose, caffeine, uric acid and fiber in the diet was estimated. Results - 500 adolescents were studied. Among the study population 6.4% were pre-hypertensive and 7.4% hypertensive with increased prevalence in girls. 9.8% were obese and 14.2% overweight. 14.3% obese and 11.3% overweight children had pre-hypertension. 30.6% obese and 9.9% overweight children had hypertension. Dietary analysis showed that normotensive children consumed lesser fructose (258mg), fat (12.8gm), sodium (89mg), and uric acid with more potassium (89mg), and fiber (10.2gm) per day as compared to the hypertensive children. Conclusions: There is high prevalence of asymptomatic hypertension among obese and over-weight school adolescents. Dietary differences were found between the hypertensive and normotensive adolescents with increased fat consumption showing statistical correlation with hypertension

The role of physical psychotherapy on quality of life in patients with hypertension with alexithymia

AtefehHaghighat .; Raheleh Haghighat .

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 2154-2162

Studies have shown that it is easier for people, who are emotionally capable, to cope with life challenges and therefore they are healthier psychologically. Alexithymia exacerbates vulnerability to physical illness and predisposes to chronic illness. The aim of this study was to determine the role of physical psychotherapy on the quality of life of patients with hypertension with alexithymia. In this clinical trial with a pre-test post-test design, 60 patients with hypertension with alexithymia were purposefully selected from the patients referred to the health centers of Semnan and randomly assigned to the experimental and control groups. The intervention was performed during 1.5 months in the experimental group according to the steps designed in the protocol of physical psychotherapy. Data were collected using the Demographic Questionnaire, Toronto Alexithymia and Quality of Life Questionnaire (WHOQOL-BREF) and analyzed by descriptive, inferential and MANCOVA statistics. In multivariate analysis of covariance, there was a significant difference in the linear composition of alexithymia components and quality of life. Overall, physical psychotherapy has had a significant effect on improving alexithymia, blood pressure and quality of life. Therefore, according to the research findings, it can be said that physical psychotherapy has been effective in improving the quality of life and controlling blood pressure in patients with high blood pressure with alexithymia and performing this treatment in the above patients is recommended as a suitable complementary treatment.

The Oxidative Effect Of Nlrp3 And Cyp2e1 In Development Of Renal Failure Associated With Hypertension And Diabetes Mellitus Diseases

Alyaa Abdulhadi Salih; Kareem Hamadx Kareem Hamad Ghali2

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 636-644

Renal Failure (RF) is devastating pathology with several causative factors, resulting in dialysis or kidney transplantation needed by end-stage renal disease (ESRD. The progression of RF is closely related to systemic oxidative stress, which causes various complications such as hypertension and diabetic mellitus . The current study was focusing on the oxidative effects of NLRP3 and CYP2E1 gene expression in the pathological development of renal failure disease with hypertension and diabetic mellitus as complications associated diseases. This study involved 100 patients diagnosed clinically and seriologicaly with renal failure 52 males and 48 females, their age from 17 to 80 years . Also the study comprise (18 males and 12 females) healthy volunteers as control group. RNA extracted from blood samples and converted to cDNA which subjected to real-time PCR for detection gene expression . The results detected that Hypertension and diabetic mellitus are the important risk factors that causes and advances renal failure disease . NLRP3 and CYP2E1 have significantly overexpression (1.60 folds and 5.37 folds ) respectively in RF patients compared with healthy group ( p <0.05). However, the expression of NLRP3 and CYP2E1 increase in diabetic mellitus (2.16 and 1.58 ) respectively than hypertension in RF patients with and control group (p<0.05). Diabetic mellitus generate free radical consequently causes ROS, hence elevated expression in oxidative NLRP3 and CYP2E1 genes in diabetic RF patients .

EFFECT OF YOGIC PRACTICES ON LOW DENSITY LIPOPROTIEN (LDL) AND HIGH DENSITY LIPOPROTIEN (HDL) AMONG HYPERTENSIVE MIDDLE AGED WOMEN

M. Subha; S. Murugesan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 1090-1095
DOI: 10.31838/ejmcm.07.09.112

To access the influence of the yogic behaviours of Low density lipoprotein (LDL) and High Density Lipoprotein random group laboratory study was accessed which is the aim.  Using the Chennai random sampling group method 30 middle aged hypersensitive women were randomly selected in the age group of 35-45 years which were further divided into two groups of 15 participants, I and II. In hypertensive middle aged women than in control group low density lipoprotein (LDL) and high density lipoprotein (HDL) have been predicted for important differences in selected biochemical variables.  Before the launch of the training programme a preliminary test for two types of low density lipoprotein (LDL) and high density lipoprotein (HDL) was performed. Yogic practice for 60 minutes, 6 days a week for a total period of eight weeks were given to Group I subjects.  For group II (Control Group) there was an active resting place.  On the same selected dependent variables after the experimental period the two groups were retested again.  Between the experimental group and the control group to determine the important discrepancies the study of (ANCOVA) was used.  The significance test was set at a degree of confidence of 0.05.  Due to the Yogic behaviours among hypertensive middle aged people such as Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL) the experimental group showed important differences on selected biochemical variables which was revealed by the study.

Effects of Psychological Distress on Hypertension among Liquefaction Refugees in Petobo Shelter

Herawanto .; Vidyana Aulia Rahma; Muh. Jusman Rau; Sendhy Krisnasari

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 89-96

The purpose of this research is to know the psychological disorder in the incidence of hypertension among liquefaction refugees in Petobo Shelter. A cross-sectional design was performed. The total number of patients who visit the health post at a Petobo shelter is 3,079 people taken in accidental sampling. The analysis uses the univariate and bivariate analyses at a degree of confidence of 95% (α = 0.05). The chi-square test results show that anxiety (ρ = 0,031), depression (ρ = 0,008), and stress (ρ = 0,000) are associated with the incidence of hypertension. It is expected that hypertension sufferers should do breathing exercises, perform physical activity and meditation relaxation to avoid anxiety, negative thoughts, also avoiding depression, stress and do interact with someone else so that the mind is not saturated and easy to forget the negative thoughts.

Distribution Of Metabolic Syndrome Components In Patients Younger Than 50 Years Of Age Of Indian Population

Dr. Inder pal Singh; Dr. Kamaldeep kaur; Dr. Lovleen Bhatia; Dr. Ajay pal

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 4786-4793

Background: Prevalence of the metabolic syndrome (MetS) is associated with increased risk of cardiovascular disease and diabetes. Present study aimed to assess the frequency distribution of various components of metabolic syndrome in patients younger than 50 years of age.
Materials and method: The study group consisted of 100 patients less than 50 years of age admitted at Rajindra Hospital with acute coronary disease.
Results: Most common age group was 45-50 years in both males and females, with 66% patients belongs to this age group. 37 patients of ACS with MS, most common component in males was raised blood pressure (SBP and DBP), in females most common component was impaired fasting plasma glucose (FPG). Waist circumference was statistically significantly raised in patients of ACS with MetS as compared to patients of ACS without MetS. Systolic blood pressure (SBP) was statistically significantly raised in patients of ACS with MS as compared to patients of ACS without MS. Systolic blood pressure (SBP) was statistically significantly raised in patients of ACS with MetS as compared to patients of ACS without MetS. Fasting plasma glucose (FPG) Serum triglycerides(TGc) and Serum high density lipoproteins (LDL) was statistically significantly raised in patients of ACS
Conclusion: All the five components of metabolic syndrome i.e. waist circumference, systolic blood pressure, fasting plasma glucose, serum triglycerides, serum high density lipoproteins were significantly associated with patients of acute coronary syndrome with metabolic syndrome as compared to patients of acute coronary syndrome without metabolic syndrome.

ERYTHROCYTE TRANSMEMBRANE FLUX AND MEMBRANE TRANSPORT ABNORMALITY IN PATHOGENESIS OF HYPERTENSION LEADING TO NEPHROLITHIASIS

RENUGADEVI KARTHIKEYAN; JULIUS AMALDAS; PRAKASH DHARMALINGAM

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1698-1705

The epidemiological relationship between nephrolithiasis and hypertension is well-known. Patients with hypertension are at increased risk for nephrolithiasis and those with nephrolithiasis are at risk for hypertension. An anomaly in RBC Oxalate transport and reduced activities of adenosine triphosphatases has been reported in patients with hypertension when compare to control subjects. This study presents an abnormal increase in transmembrane flux of oxalate in RBC of hypertensive subjects and it might be due to membrane degradation caused by oxalate-induced free radicals depleting erythrocyte thiol contents and impaired adenosine triphosphatases activity resulting in tissue injury and defective membrane transport. Thus relative risk of hypertension was significantly associated with increased oxalate flux rate and impaired adenosine triphosphatases activity in stone formers. This association is important when treating patients with nephrolithiasis since those with hypertension may require unique dietary and medical therapy.

Preparation And Characterization Of Immediate Releasefilm Coated Tablets Of Valsartan -Hydrochlorothiazide (160/12.5mg)

Rakesh Kumar Sharma; Vikas Bansal; Amit Mittal; Mamta Sharma

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 2915-2948

Objective:The motive of the currentworkwas to Preparation and Characterization of Immediate Release film coated tablets Valsartan -Hydrochlorothiazide (160/12.5mg) to reduce the multiple dosing and to achieve more effective reduction of hypertension.
Background: The oral route is the very effective and favoured method for the introduction of medications to systemic circulation because of ease of diagnosis, patient compliance and flexibility.
Materials and Methods: Valsartan - Hydrochlorothiazide tablet tends to film coated to prevent the drug from degradation. Preliminary studies were performed out with the excipients and the drug and their physical & chemical compatibilities were checked and the drugs and they found compatible.The method of preparation was the wet granulation method.
Results:A maximum of nine formulation batches (f1-f9) have been prepared.Prepared formulations have also been tested for weight variance, friability, disintegration, analysis, in vitro drug release profile.The criteria tested are contained within the guidelines.The parameters tested were found within the limits. Among all formulations, the product of batch f9 has acceptable friability, assay and dissolution profile. It was further exposed to an advanced stability test at 40±20C/75±5 per cent RH.

AWARENESS, KNOWLEDGE AND PREVALENCE OF HYPERTENSION, SLEEP APNEA AND SLEEP - DISORDERED BREATHING DIFFICULTIES IN MALES AMONG CHENNAI POPULATION

Shruthi Manivannan; Karthik Ganesh Mohanraj; Murugan Thamaraiselvan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 810-821

Hypertension, sleep apnea and sleep disordered breathing are the important Global public health challenges the world is facing nowadays with the highest prevalence rate all over the world. Recently a large body of work has been going on in finding the association of sleep- disordered breathing, sleep Apnea and Hypertension in the Male population.The aim of this study is to determine the association of sleep- disordered breathing, sleep Apnea and Hypertension in the young, Adult and aged Male population.Standard survey questions based on sleep disordered breathing, sleep apnea and hypertension were designed and was uploaded in an online survey platform and circulated among the males. A total of 100 responses were collected and were statistically analysed. In this study we observed that there is an association of sleep disordered breathing, sleep apnea with hypertension (p<0.001, independent sample t-test).Since there were no previous studies to encounter this association in India. This study serves as an eye opener for the early diagnosis and treatment of sleep disordered breathing, sleep apnea and hypertension in the young, Adult and aged Male population. This study will be beneficial in the awareness of health care professionals to consider the evaluation of patients with hypertension, sleep apnea and sleep disordered breathing

BLOOD PRESSURE PROFILE IN SCHOOL CHILDREN IN RURAL AND URBAN AREA IN AND AROUND KARAD

D. B. Potdar; Prashnt P. Shah; Naredra P. Porval

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 4168-4174

A cross sectional study among 1000 school going children of age group 6 – 16 years was conducted to study the relation of Blood Pressure with variables Like Body Mass Index, Socio Economic Status, Family History of Hypertension, Age and Sex at our tertiary care hospital Krishna Institute of Medical Sciences Deemed University, Karad. 1.The study group had 100 (10%) children of 13, 14, 15 and 16 years, 90 (9%) children of 6, 8, 9 and 12 years and 80 (8%) children of 7, 10 and 11 years. 12.Systolic hypertension was observed in 13.3% of overweight and 6.7% of obese children. Systolic prehypertension was observed in 11.7% of overweight and 13.3% of obese children. BMI was significantly associated with pre hypertension and hypertension (SBP) in children (p<0.001). Diastolic hypertension was observed in 16.7% of overweight and 6.7% of obese children. Diastolic prehypertension was observed in 18.3% of overweight and 20% of obese children. Only 1.7% and 0.9% of prehypertension and hypertensive children had normal BMI.

ORAL NIFEDIPINE VERSUS ORAL LABETALOL IN THE TREATMENT OF PREGNANCY INDUCED HYPERTENSION

R.P. Patange; Archna V. Rokadhe; Ghori R. Shinde; Sanjay N. Jadhav; Ashitosh Bahulekar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 4136-4141

This study was undertaken to determine the effectiveness of two anti-hypertensive drugs: oral Nifedipine and oral Labetalol in cases of extreme preeclampsia in terms of their side effect profile, BP regulation, time taken to lower BP, and number of doses required. The objective of the study was to calculate the time required to reduce the blood pressure to the target level of 90 / 100 mmHg diastolic and less than 160mmHg systolic.In the labetalol group the mean SBP before treatment was 158mm of Hg which was reduced to 140 mm of Hg. The decline rate in the labetalol group was 11.77%. This study proved that labetalol reduces the BP more effectively than nifedipine and also has minimal side effects with less frequent dosing schedule as compared to nifedipine thus indicating that labetalol is better than nifedipine in lowering the BP in cases of preeclampsia.