Evaluation of left ventricular diastolic function in hypertensives

Background: Recently much of attention is focused on the diastolic function of the heart. Since the systolic performance of the heart in hypertensive patients has been examined so far, but the study of the diastolic function of heart has emerged as a newer mode of study. Aim: To study non-invasively the diastolic function of left ventricle in patients with systemic hypertension. Materials and methods: Twenty patients either admitted or as outpatients in outpatients Department, Gandhi Hospital with isolated systemic hypertension. (HTN) who satisfied inclusion and exclusion criteria were taken up for the study with five age matched individuals who along served as controls assessed by Doppler Echo-cardiography and their findings were compared with five normotensive age matched controls. Results: Bedside post valsalva maneuver, this test was positive in 7 5% of the test subjects. Of the 25% who had a negative test, 40% had evidence of diastolic dysfunction as assessed by pulsed wave Doppler. Left ventricular hypertrophy was present in 55% of the patient subgroup and all (100%) of these patients had significant diastolic dysfunction. The rest of the 45% of the patients did not have left ventricular hypertrophy. 75% of these non-hypertrophic hypertensives had diastolic dysfunction as seen by PWD. Increased left ventricular mass index has been observed in 85% of the hypertensives but has not correlated statistically with either severity of blood pressure or diastolic filling variables or isovolumic relaxation time. The left atrial size an indirect indicator of LV diastolic function was increased in 50% of the hypertensive subjects when compared with the controls but the statistical C. Venkateshwarlu, B. Praveen Kumar, Md. Yousuf Khan. Evaluation of left ventricular diastolic function in hypertensives. IAIM, 2016; 3(10): 212-220. Page 213 difference was insignificant. LV diastolic function as assessed by PWD mitral flow velocity profile and isometric volume relaxation time was abnormal in 85% of the hypertensive subgroup and was highly significant statistically (P value <0.005). The deceleration time (MS) was similar in both the controls and the hypertensives making it an insignificant parameter for assessing LV diastolic function. The peak filling rate was reduced in the hypertensive subgroup and was of moderate statistical significance. Conclusion: Doppler Echocardiography, an easily available non invasive technique today, can be utilized for identifying hypertensives with diastolic dysfunction and thus treat this group with specific therapy (Beta Blockers) so as to arrest or reverse the pathological changes produced in left ventricle due to hypertension.

Study of incidence and risk factors of urinary tract infection in catheterized patients admitted at tertiary care hospital, Nizamabad, Telangana State, India

Background: Catheter-associated urinary tract infections (CAUTIs) are the most common hospital acquired infections and a leading cause of morbidity and mortality in hospitalized patients with various life threatening complications. Hence, this study was aimed to determine the incidence, risk factors of CAUTI in a tertiary care hospital so as to find out better preventive measures to reduce the prevalence of CAUTI and their complications so as to reduce the hospital stay and mortality. Materials and methods: Present study included 200 adult patients who received indwelling urethral foley’s catheter and urinary drainage system in various wards in Government General Hospital, Nizamabad from Jan 2015 - May 2016. Patients were diagnosed to have CAUTI according to CDC guidelines to study its incidence and associated risk factors which were analyzed using multi variate analysis. Results: Overall incidence of CAUTI was 59%. The incidence of CAUTI was maximum (70.58%) in the age group of 51-70 years. The incidence of CAUTI was more (69.44%) in females and was directly proportional to the duration of catheterization. The high incidence in the present study reflects the practice of frequent disconnections of urinary closed systems. Multi-variate analysis shows age, duration of catheterization, catheter- tubing disconnections, absence of antibiotic use and renal Md. Yousuf Khan, C. Venkateshwarlu, G. Sreenivas, P. Rahul. Study of incidence and risk factors of urinary tract infection in catheterized patients admitted at tertiary care hospital, Nizamabad, Telangana State, India. IAIM, 2016; 3(8): 83-92. Page 84 insufficiencies as important risk factors for CAUTI. 88.66% of CAUTIs were asymptomatic among 75 clinically evaluable CAUTIs. Conclusion: CAUTI is an important preventable hospital acquired infection seen in all age groups however incidence increases with age, common in both sexes, incidence can be reduced by minimizing the catheter procedures, taking the maximum aseptic precautions, reducing the duration of catheterization and avoiding frequent disconnections, this becomes more significant in patients with underlying renal disease , prophylactic antibiotics prevent CAUTI. As most of the CAUTI are asymptomatic, all catheterized patients should be screened for CAUTI and be treated depending upon antibiotic sensitivity of uropathogens.

Spectrum of K ras mutations in Pakistani colorectal cancer patients

The incidence of colorectal cancer (CRC) is increasing daily worldwide. Although different aspects of CRC have been studied in other parts of the world, relatively little or almost no information is available in Pakistan about different aspects of this disease at the molecular level. The present study was aimed at determining the frequency and prevalence of K ras gene mutations in Pakistani CRC patients. Tissue and blood samples of 150 CRC patients (64% male and 36% female) were used for PCR amplification of K ras and detection of mutations by denaturing gradient gel electrophoresis, restriction fragment length polymorphism analysis, and nucleotide sequencing. The K ras mutation frequency was found to be 13%, and the most prevalent mutations were found at codons 12 and 13. A novel mutation was also found at codon 31. The dominant mutation observed was a G to A transition. Female patients were more susceptible to K ras mutations, and these mutations were predominant in patients with a nonmetastatic stage of CRC. No significant differences in the prevalence of K ras mutations were observed for patient age, gender, or tumor type. It can be inferred from this study that Pakistani CRC patients have a lower frequency of K ras mutations compared to those observed in other parts of the world, and that K ras mutations seemed to be significantly associated with female patients.

TBARS level in socioeconomical poor rural sickle cell patients of Bilaspur Zone of Chhattisgarh State.

Sickle cell disease (SCD) is an inherited disorder of hemoglobin synthesis and the oxidative stress has major role in the pathogenesis of SCD. Thiobarbituric acid reactive substances formation by lipid peroxidation is a marker of oxidative damage in membrane.The study was under taken to measure the oxidative stress in sickle cell patients of Chhattisgarh rural population because of low natural antioxidants in their diet. The patients of sickle cell anemia group (homozygous, n=9) and sickle cell trait (heterozygous, n=21) shows TBARS level 2.28±0.66μM/l and 2.23±0.7μM/l respectively as compared to control (without S.C.D) 1.25±0.41μM/l. the study shows TBARS concentration is approximately double in sickle cell disease than control.

Localization of mycobacteral smegmatis adenosine deaminase.

The study was carried out to check the localization of M.smegmatic adenosine deaminase for its metabolic and clinical importance. The separation and washing of the membrane was done by using refrigerated high-speed centrifuge. The high activity was observed in crude extract while low activity in first washing of the membrane but after second washing there was no enzyme activity seen. Culture media also does not show any enzyme activity. Thus M.smegmatic adenosine deaminase may be a cytosolic enzyme and it does not excreted in to the surrounding media.