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.

Seasonal Variation in Arterial Blood Pressure.

Background: There is need to evaluate influence of weather changes on blood pressure in human population that has often been ignored in clinical practice guidelines. Objectives: Present study was planned to find the seasonal variation of blood pressure. Methods: Seasonal variation in blood pressure was examined in 1081 participants of age 18 years and over from both genders, 540 from rural and 541 from urban practice area of Department of Community Medicine of tertiary care teaching hospital of Ludhiana. Information was obtained on demographic and socioeconomic characteristics and socio-economic status followed by clinical examination. Anthropometric measurements included weight, height, waist circumference, hip circumference, waist and hip ratio, Body Mass Index. Blood pressure was recorded and classified based on JNC VII criteria. Data was obtained on four different seasons (winter, summer, monsoon and post-monsoon) as defined by Indian meteorological department. Results: Present study showed that there is significant increase in the blood pressure in study population during winter and significant fall in summer in both systolic (SBP) and diastolic blood pressures (DBP) irrespective of age, sex, socioeconomic status, occupation. The variation in SBP between summer and winter season was maintained across all the age groups except in elderly where maximal difference was observed in monsoon - summer seasons. Mean SBP and DBP were higher in 41 to 50 years and more than 60 year age group; females have a higher increase in both mean SBP and DBP. Advancement in age and females gender confirmed more significant changes in blood pressure across ambient temperatures. Conclusion: Our study showed that climatic changes influence the blood pressure recordings and should also be considered for management of hypertension.

Status of lipid peroxidation and plasma iron level in bronchial asthmatic patients.

Low antioxidant levels and oxidative stress due to airway inflammation may be determinant of asthma severity. The study was conducted to find the extent of lipid peroxidation and change in the levels of plasma iron in asthmatic patients with severity of disease. Study included 155 asthmatic and 156 healthy volunteers of the age groups 18-45 of either sex. Asthmatic patients were grouped into mild, moderate and severe groups on the basis of Forced Expiratory Volume in first second percent (FEV1%). Level of plasma malondialdhyde (MDA) was used as index of lipid peroxidation. A significant increase (P<0.01) in plasma MDA and plasma iron levels was found in asthmatic subjects as compared to controls. There was maximum increase in plasma MDA and iron levels in moderate asthmatic group. A positive correlation between plasma MDA and iron (r = +0.3) has been found in asthmatic patients. An increased plasma iron levels in asthmatics may contribute to aggravate lipid peroxidation.

Impact of bed side communication with fathers on their anxiety about newborn.

This study assessed the impact of bedside communication with fathers (N = 100) on their anxiety about sick neonates admitted in SCNU. The control group consisted of fathers of 100 sick babies communicated outside the unit. Anxiety was measured in both the groups on day 1 (at admission) and day 7, by using 5 point Likert Scale. At the time of admission there was no difference in the level of anxiety between the study group and controls (p >0.05; Mann Whitney test). There was a statistically significant difference (p <0.01; Mann Whitney test) in the level of anxiety between the study and control group at 7 days. When compared within the group, the anxiety in the fathers of study group was significantly less (p <0.01) at 7 days than at admission. In the control group there was no such significant difference. To conclude, bed side communication with fathers of admitted neonates reduces their anxiety significantly.

Basopenia as an indicator of ovulation (a short term clinical study).

In the present study 60 cases age ranging from 18-40 years were studied for variation in the absolute basophil count on the different days of menstrual cycle. At the time of ovulation a statistically significant decrease in the number of basophil count was noted. The decrease in the number of basophil at mid cycle coincided with the irregular follicle seen by sonography, which indicated ovulation. The basophil count then increased during the luteal phase. Basopenia at the time of ovulation was probably due to migration of these cells from the peripheral blood towards the rupturing follicle for the release of histamine required for ovulation.

The role of secondary sex ratios in the declining sex ratio of India.

The sex ratio in India has been gradually declining since the beginning of this century during the intercensus period of 1981-91, this ratio declined from 933 to 929. In the past the difference in sex ratios was wholly attributed to higher mortality amongst the females. However date for the years 1990-92 on secondary sex ratios i.e. sex ratio at birth presented in this paper suggest that the difference in sex ratio can also be attributed to a statistically significant higher number of males being born most probably as a result of selective abortion of female fetuses.

Diagnostic and prognostic significance of lactate dehydrogenase in cerebrospinal fluid in patients of meningitis.

Activity of lactate dehydrogenase was measured in cerebrospinal fluid in 60 cases of meningitis (35 pyogenic, 18 tuberculous and 7 viral). Thirty age and sex matched healthy controls were taken to find out its diagnostic and prognostic significance in meningitis. The cerebrospinal fluid lactate dehydrogenase activity was significantly higher (p < 0.001) in cases of pyogenic meningitis and tuberculous meningitis as compared to the control group. The maximum elevation was seen on the 1st day in all types of meningitis but the activity declined significantly thereafter in patients of pyogenic meningitis who recovered without complications. However, in 2 cases of pyogenic meningitis and 5 cases of tuberculous meningitis who survived with complications, the lactate dehydrogenase activity on subsequent estimations increased serially. Further, the basal lactate dehydrogenase activity in 9 cases of pyogenic meningitis (who expired) was higher than those who survived without complications. The basal lactate dehydrogenase activity in pyogenic meningitis was significantly higher (p < 0.05) as compared to tuberculous meningitis and viral meningitis patients (p < 0.02) in this study.

Sleep pattern and night awakening in healthy infants.

Sleep pattern and night-awakening were studied in 500 healthy infants by a semistructured interview method. A total of 92.2% infants shared bed with their mothers, 6.8% with grand parents and 1% with fathers. Paternal participation at bedtime was observed to be insignificant. Infants of non-working mothers and families with vegetarian habits slept significantly more as compared to the working mothers and families with non-vegetarian habits. Night-time awakening was reported in 96% of the infants. If a child is functioning well in other areas of life, parents can be assured that the problem is not of serious concern and unnecessary medication of infants should be avoided.

Cicatrical occlusion of the external nares following small-pox

Complications and sequelae of small-pox met with in practice are mentioned in brief. Two cases of cicatricial occlusion of the external nares following the disease are recorded.