Factors affecting seasonal changes in blood pressure in North India: A population based four-seasons study

Objective There are no community based, longitudinal, intra individual epidemiological studies on effect of weather and season on blood pressure (BP). We evaluated the effect of season and temperature on prevalence and epidemiology of BP in tropical climate. Methods and results It was a longitudinal cross sectional survey of rural and urban subjects in their native surroundings. BP was measured in four different seasons in same subjects. A total of 978 subjects (452 rural and 521 urban) were included in the current analysis. Demographic characteristics such as age, gender, education, occupational based physical activity and body mass index (BMI) were recorded. Mean BP, both systolic and diastolic were significantly higher in winter season as compared to summer season. Mean difference between winter and summer was 9.01 (95% CI: 7.74–10.28, p < 0.001) in systolic BP and 5.61 (95% CI: 4.75–6.47, p < 0.001) in diastolic BP. This increase in BP was more marked in rural areas and elderly subjects. Prevalence of hypertension was significantly higher during winter (23.72%) than in summer (10.12%). Conclusion BP increases significantly during winter season as compared to summer season. Increase is more marked in rural areas and elderly subjects. Seasonal variation in BP should be taken into account while looking at prevalence of hypertension in epidemiological studies.

Steroid responsive prolonged thrombocytopenia in dengue.

Prolonged thrombocytopenia in a usual case of dengue virus infection is uncommon. Dengue-related thrombocytopenia is self-limiting and responds within 3-5 days. An underlying immunological disorder may be responsible for delayed return of platelet count to a normal level. We present a case of prolonged thrombocytopenia in a case of dengue hemorrhagic fever. The response to steroids suggests a possible immunological dysfunction.

Identification of infertile couples in a rural area of northern India.

An attempt was made to identify infertile couples in a rural area of India, utilizing the existing information structure. A three stage screening of the cases was done. Initial record based listing was done with the help of the health workers' records. Cases on initial list were screened on the basis of information obtained from key informants in villages. Verified cases were then individually contracted. Total catchment population (28839) in 40 villages of a Primary Health Centre (PHC) of north India was surveyed by a lady social worker. Of the total 4453 eligible couples in the PHC, 129 (2.9%) were infertile (46.5% primary and 53.5% secondary infertility). From the initial list of 298 cases, 161 (54%) were excluded during the survey. The yield from the health workers' record was 33 per cent whereas from key informants it was 93 per cent. The study revealed that the key informants and existing information structure can be utilized to identify conditions like infertility in rural areas, after proper verification of initial reports.