ABSTRACT
Background: Early detection of hypertension and assessment of target organ functions is vital for maintenance of health. Associated comorbid conditions like diabetes mellitus, obesity, hyperlipidemia, smoking and old age increases the risk for early target organ involvement. Our aim was to study the prevalence of target organ damage in essential hypertension, effect of duration and severity of hypertension on target organ damage and to study the effect of comorbid conditions on target organ damage. Methods: We included patients with recently detected hypertension as well known cases of hypertension. Both inpatients admitted in wards as well as outpatients attending the hypertension clinic and admitted in the wards were registered for this study after taking valid informed consent. Patients underwent clinical examinations after detailed clinical, family and medication related history and followed by routine and specific investigations. Results: 100 patients were included in the study, of which 61 were males, mean age of 54 years (±2.4 years). Common modes of presentation of the patients were headache, giddiness and chest discomfort. We observed that controlling hypertension in patients resulted in significant changes when investigated with fundoscopy, electrocardiogram and 2 D echocardiogram. Additionally, duration and severity of hypertension had an effect on target organ damage, which came out as statistically significant. Conclusion: Smoking, alcohol, obesity, diabetes mellitus and dyslipidaemia are independent risk factors for hypertension and target organ damage. As the duration and severity of hypertension increases the incidence of target organ damage increases. Hypertension along with other risk factors like smoking, alcohol, dyslipidaemia, obesity and diabetic mellitus magnifies the risk of complications.
ABSTRACT
Background: The protean manifestations of enteric fever make this disease a true diagnostic challenge. Untreated, typhoid fever is a grueling illness that may progress to delirium, obtundation, intestinal hemorrhage, bowel perforation, and death within 1 month of onset. Survivors may be left with long-term or permanent neuropsychiatric complications. This is a prospective study of fifty confirmed enteric fever adult patients done in Kasturba Hospital Mumbai. Methods: Fifty enteric fever patients with clinical and laboratory diagnosis were included in the study. They were admitted in wards with the aim of documenting the epidemiological pattern, clinical picture, therapeutic response and complications of Salmonella. Their history and detailed physical examination were recorded and tests including antibiotic sensitivity and resistance were done. Results: In the study incidence of fever 100%, chills 26%, vomiting 44%, diarrhea 28%, abdominal pain 64%, headache 26%, and signs as splenomegaly 36%, hepatomegaly 42%, rose spots 6%, relative bradycardia 34% were reported. Anemia, leukocytosis and leukopenia and elevated liver enzymes were found in 42.9%, 10%, 21% and 45% respectively. Incidence of Salmonella Typhi, Salmonella Paratyphi was 80% and 20% respectively. There was no mortality in the study. Conclusion: Clinical presentation, signs and symptoms of Typhoid fever patients are varying. For the confirmatory diagnosis in addition to a high index of suspicion, Widal test and blood culture are required. For the proper treatment of Typhoid fever in view of emergence of resistant strains of S. Typhi antibiotic sensitivity and resistance test should be done whenever facilities available.