Obesity, hyperlipidemia, and hyperuraecemia in young and old hypertensive patients

There is strong correlation among hypertension, obesity, hyperlipidemia and hyperuricemia which are important risk factor for the cardiovascular disease. Objective of this study was to assess and compare the prevalence of obesity, hyperlipidemia and hyperuricemia among young and old hypertensive patients in the local setting. This cross-sectional study was conducted at medical Out-patient Department at Shahina Jamil Teaching Hospital, Abbottabad, from September 2007 to February 2008. Eighty-six patients seen in the medical outpatient department were enrolled in the study. Patients with age 15 years or above and diagnosed as case of systemic hypertension were included. Patients with endocrine disease, pregnancy, coarctation of aorta, and renal disease leading to hypertension were excluded from the study. Total eighty-six patients with mean age of 53.7 +/- 12.9 years were included in the study. Patients were divided into younger age group [age <46 years] and older age group [age >/= 46 years]. Mean Body Mass Index [BMI] was 29.7 +/- 5.2 in the younger age group and 26.9 +/- 4.7 in the older age group, mean serum cholesterol level was 192.2 +/- 14.2 mg/dL in younger age group and 190.9 +/- 18.3 mg/dL in the older age group, mean serum triglyceride level was 170.5 +/- 13.7 mg/dL in younger age group and 166.6 +/- 21.4 mg/dL in the older age group and mean serum uric acid levels were 5.6 +/- 0.7 mg/dL in younger age group and 5.7 +/- 1.2 mg/dL in the older age group. Overweight and obese patients were 70.9% with its higher prevalence in younger [86.2%] as compared to older patients [63.2%]. Hypercholesterolemia was found in 27.9% of the patients, with a frequency of 24.1% in younger patients and 29.8% in the older patients. Hypertriglyceridemia was seen in 66.3% of the patients, with a frequency of 69.0% in younger patients and 64.9% in the older patients. Hyperuricemia was present in 37.2% of the hypertensive patients with a frequency of 34.5% in the younger patients and 38.6% in the older patients. Hypercholesterolemia, hypertriglyceridemia, and hyperuricemia are not associated with the age of the hypertensive patients. Increased BMI is more frequent in the young as compared to the old hypertensive patients

Compliance to antihypertensive drugs, salt restriction, exercise and control of systemic hypertension in hypertensive patients at Abbottabad

Hypertension is one of the most important cardiovascular risk factor but its control is still a challenge for physicians all around the world. Control of blood pressure can reduce cardiovascular morbidity and mortality, so the compliance to antihypertensive drugs and life style modification play an important role for the control of hypertension. This analytical [cross-sectional] study was conducted to assess prevalence of control of hypertension among hypertensive patients and to assess the relationship of control of hypertension with factors like compliance to antihypertensive drugs, salt restriction and exercise among the hypertensive patients. This study was conducted at outpatient clinic of medicine at Shahina Jamil Hospital Abbottabad from April 2007 to September 2007. Eighty-nine patients seen in the outpatient clinic of medicine were enrolled in the study. All the patients with age 15 years or above, diagnosed as a case of systemic hypertension were included. Among eighty-nine patients, 67 were female and 22 were male with mean age of 55.8 +/- 13.4 years, mean systolic and diastolic blood pressure of 160 +/- 28.6 and 97.8 +/- 14.1 mm Hg respectively, and pulse rate of 85.9 +/- 11.4 per minutes. Out of 89 patients, 25.8% were having controlled hypertension, 48.3% were compliant and 51.7% were not compliant to antihypertensive drugs, 55.1% were having salt restriction and 44.9% were having no salt restriction and 23.6% were used to do physical activity while 76.4% were not used to do physical activity. In group A consisted of patients with controlled hypertension, 95.7% patients were compliant to antihypertensive patients, 95.7% were having salt restriction, and 43.5% were used to do physical activity. In group B consisted of patients with uncontrolled hypertension, only 31.8% were compliant to antihypertensive drugs, 40.9% were having salt restriction, 16.7% were used to do physical activity. Hypertension can be controlled if the hypertensive patients have good compliance to antihypertensive drugs, salt restriction and do some sort of physical activity regularly and in this way, prevent themselves from the hypertensive complications

Aspiration and tetracycline sclerotherapy of primary vaginal hydrocoele of testis in adults

Primary Vaginal Hydrocoele of Testis is a common condition which is primarily treated surgically. Many patients with Hydrocoele of testis are either not willing or are unfit for surgery. This study was done to know the safety, efficacy and outcome of tetracycline induced sclerotherapy of Primary Vaginal Hydrocoele of Testis in adults. This quasi experimental study was done in Shahina Jamil Hospital, attached with Frontier Medical College and Ayub Teaching Hospital, Abbottabad from March 2006 to April, 2007. Thirty-seven patients with primary vaginal hydrocoele were included in the study. Aspiration and instillation of Tetracycline was done after spermatic cord block with 2% lignocaine. Procedure time, Peri and Post-procedure complications, number of injections for cure and patients' satisfaction with the procedure were recorded. Patients were discharged home 3 to 4 hours after the procedure and followed up after one week, one month, three months and six months. Direct admission and re-admissions were recorded. The mean age of patients was 47 years. Mean procedure time was 45 minutes. All patients were cured. Mild postprocedure pain occurred in 12 [40%], moderate pain in 14 [46%] patients and severe pain in 4 [13.3%] patients. No patient developed haematoma or local infection. One patient [3.3%] had micturition problem. Two [6.6%] patients had minimal recurrence. One injection was sufficient for cure in all patients. 28 [93%] patients were satisfied while 2 [6.6%] patients were not satisfied with this procedure. No patient was admitted in the hospital after the procedure. Aspiration and injection of tetracycline in Primary vaginal Hydrocoele of Testis in adults is safe, effective and very economical procedure

Diabetic foot ulcer grades; correlation with ankle brachial pressure index

Diabetic foot is one of the most common complications of diabetes mellitus. The management and out come is very much dependent on proper assessment of foot ulcer severity. To asses severity of diabetic foot and to find a correlation between Ankle Brachial Pressure Index [ABPI] and foot ulcer grades. Prospective study. Jan 2001 to Dec 2003. Patients with diabetic foot ulcers from all the medical and surgical units of Ayub teaching hospital Abbottabad were enrolled in the study. Ankle Brachial Pressure Index [ABPI] levels revealed 5 [5.8%] with ABPI < 0.5 for grade V, 8 patients [9.3%] ABPI 0.5 - 0.89 for grade IV, 18 patients [20.9%] ABPI 0.9-1 for grade III, 44 [51.2%] ABPI 0.9-1 for grade II, and 9 patients [10.5%] ABPI > 1 for grade I diabetic foot ulcer. This data was analyzed via SPSS version 8.0. Ankle brachial pressure index is a good diagnostic tool to assess the lower extremity arterial disease in diabetic foot patients. ABPI readings should be cautiously interpreted as these may be falsely elevated in atherosclerotic patients

Diabetes Mellitus type 2; assessment of body mass index [BMI]

To assess the body mass index in patients with diabetes mellitus type 2 in a tertiary care hospital. Analytical [cross-sectional] study. The outpatient clinic at Shahina Jamil Trust Hospital Abbottabad from November 2006 to April 2007. One hundred patients seen in the outpatient clinic were enrolled in the study. All patients were 30 years of age or above, diagnosed as a case of diabetes mellitus were included. Patients with diabetes mellitus type 1 and pregnant diabetic women were excluded. Sixty-seven percent were females and thirty three percent were males. Mean age of the patients was 53.4 +/- 11.0 years [F: 51.9 +/- 12.0, M: 56.5 +/- 7.8] and mean duration of diabetes mellitus type 2 was 7.1 +/- 6.5 years [F: 7.1 +/- 6.4, M: 7.9 +/- 6.8], mean height of patients with DM type 2 was 1.5 +/- .09 m [F: 1.5 +/- .08, M: 1.6 +/- .08], mean weight was 71.4 +/- 14.3 kg [F: 70.1 +/- 15.0, M: 74.2 +/- 12.6], and mean BMI was 28.3 +/- 6.4 [F: 28.7 +/- 6.9, M: 27.5 +/- 5.2]. Among all patients, 34% [F: 23, M: 11] had normal weight, 28% [F: 17, M: 11] were overweight, 32% [F: 23, M: 9] were obese and 6% [F: 4, M: 2] had morbid obesity. There was strong association of obesity with type 2 diabetes mellitus with no significant difference of mean BMIs among male and female patients