ABSTRACT
The objective of this study was to study the prevalence of metabolic syndrome among patients with essential hypertension and to correlate metabolic parameters. It was a noninterventional, observational study in which 172 patients having essential hypertension who fulfilled the inclusion criteria were included and all were subjected to a uniform questionnaire, medical examination and investigations. Prevalence of metabolic syndrome was 55.23% in patients with essential hypertension in this study, more common in females and most common in age group between 40 and 50 years (39.60%). Low high-density lipoprotein cholesterol (HDL-C) level was the most common metabolic abnormality detected in patients with metabolic syndrome followed by an abnormal fasting blood sugar (FBS), abnormal waist circumference and abnormal triglyceride (TG) level. The females had an abnormal HDL-C levels in 92.06% (z = 16.19, p < 0.05) followed by an abnormal waist circumference in 61.90% (z = 6.85, p < 0.05). The FBS and TG were abnormal in 60.3% (z = 3.34, p < 0.05) and 50.7% (z = 2.57, p < 0.05), of female patients, respectively, while in males, the most common abnormality was low HDL-C in 87.5% (z = 12.54, p < 0.05) followed by abnormal TG levels in 65.62% (z = 3.71, p < 0.05), abnormal FBS 62.5%, (z = 2.92, p < 0.05) and abnormal waist circumference 40.62% (z = 2.14, p < 0.05). TG/HDL-C ratio of ≥3 was the variable that had the best correlation (p = 0.534) with the presence of metabolic syndrome.
ABSTRACT
Two hundred and fifty cases of biliary tract disease were studied as regards case history, physical and laboratory investigations, surgery and follow-up. It was found that females especially multipara were frequently affected; majority of cases were in 3rd to 5th decade of their life, rise in age showing decline in incidence. Majority of cases (82.4%) were vegetarians and had used vegetable fats (oriental diet). Most of the cases (98.8%) belonged to middle and poor class and were lean and thin. Pain in the right upper quadrant of the anterior abdominal wall had been the commonest symptom, in about half the cases it got aggravated by fatty meals. A mass was felt in the right hypochondrium in 29.6% and Murphy's sign was positive in 55.5% of cases. Radio-opaque calculi were present in 8% of cases, in another 10.8% the calculi were demonstrated by oral cholecystography, radiography could detect calculi in 47 (25.4%) cases and its overall diagnostic success rate has been low (56.8%). Ultrasonography proved more valuable tool for diagnosis; bile culture was positive in 8.8% of cases only for Esch coli, proteus, klebsiella, staphylococci or paracolon. Right subcostal incision gave the best results. Chronic cholecystitis with cholelithiasis (74%) was more common than acalculus cholecystitis (26%), incidence of carcinoma was 2.8%, and in 5 out of 7 cases malignancy was associated with cholelithiasis. Early diagnosis and cholecystectomy for gallstones can prevent malignancy. Surgery on the whole proved beneficial and it can be more rewarding if pre-operatively other causes of dyspepsia are either excluded or confirmed. Excluding cases of malignancy, the mortality has been quite low and thus acceptable.