Microalbuminuria as an overrated indicator of target organ damage in hypertension: a hospital based cross sectional study.

Background: Hypertension is one of the leading causes of global burden of disease. Uncontrolled hypertension is associated with long term risk of damage to vital organs like brain, heart, kidney, blood vessels and eye i.e. Target Organ Damage (TOD). Medical scientists all over the world have been in search for an indicator which can accurately predict TOD. It is accepted that Microalbuminuria (MA) represents a more generalised vascular problem, not only confined to renal microcirculation. MA is found in a significant proportion of non-diabetic population, particularly in association with hypertension and is a predictor of cardiovascular disease. The objective of the study was to evaluate MA in hypertension and its correlation with TOD. Methods: A Hospital based cross sectional study carried out in the department medicine of central referral hospital, a well-equipped tertiary care hospital in East Sikkim, Gangtok. 200 patients were recruited fulfilling the inclusion criteria of pre hypertension, stage 1 & 2 hypertension as defined by JNC 7 report. Patients with secondary hypertension, DM, ESRD & hyperuricemia were excluded. MA was estimated by Immunoturbidimetry. Results: MA is associated with all TOD but significant correlation was found only with retinopathy. Out of 200 study subjects, 90 (45%) subjects had retinopathy out of which 54 (60%) had MA and 36 (40%) did not have MA. (P <0.0001) Conclusion: MA has established its position in DM where it indicates early end organ damage and heralds cardiovascular risk. Its role as a reliable indicator of TOD in non-diabetic hypertensives needs further evaluation.

Spectrum of visual impairment among urban female school students of Surat.

Aim: Eye morbidities with or without symptoms delineate a significant morbidity among adolescent schoolgirls in India. The study was undertaken to assess the extent of visual impairment and ocular morbidity to identify influencing factors and the impact on scholastic performance. Materials and Methods: A population-based cross-sectional study was undertaken among 3002 urban girl students of Surat in Gujarat, India. Overall prevalence of refractive error was found to be 15.22%; myopia affected 91.47%, hyperopia 4.60%, and astigmatism 0.04%. The prevalence of myopia and astigmatism was more in higher age groups, while hyperopia was more in lower age groups; even students with good vision reported ophthalmic symptoms. Of all spectacle users, in 29.73% cases the eyesight was not found to be with the best possible corrections. Refractive error was observed to be higher among the general caste (50.98%) and among Muslims (54.05%). Still, among those with problems of eyesight, 75.93% students had good academic performance. Associated ocular morbidity was noted in 20.35% participants along with the refractive error. Conclusion: This study highlighted the load of eye morbidities of adolescent Indian urban girls.

Scrofuloderma - A case series from rural India.

Summary: Cutaneous tuberculosis is the rarest presentation of all the forms of tuberculosis. Scrofuloderma is a frequent manifestation of cutaneous tuberculosis in Indian scenario. Males are affected one and half times more than females. The most common affected age group showing clinical infection is within the first three decades of life. A series of cases mostly malnourished children attending a tertiary care centre in a rural area of central India is being reported. They have presented with a wide spectrum of clinical features, forcing us to establish the final diagnosis by Mantoux test, fine needle aspiration cytology and histopathological examination. The mainstay of treatment remains medical therapy but the underlying cause for severe immunosuppression needs to be ruled out and treated.