Left Ventricular Geometry and Function in Patients with Gray Zone Hypertension

Background: Hypertension is considered as the silent killer of human because the hypertensive patient may be not aware that he has hypertension and death can occur at any time without the reason being known. We aim to study the effect of gray zone hypertension [SBP from 120-139] and or [DBP from 80-89] which was classified as prehypertension under JNC-7 on the structure, geometry, and operation of the left ventricle using echocardiography Methods: This study included 100 patients who asymptomatic apparent healthy subjects visited cardiology outpatient department (OPD) for routine checkup. Patients were grouped into two equal groups: Group A whose blood pressure was in the gray zone hypertension [SBP from 120-139] and or [DBP from 80-89], and group B with SBP <120 mmHg & DBP <80 mmHg. Results: The two groups being studied were statistically significant different as regard LV geometrical pattern (p=0.028). They were also statistically significant in LV geometrical pattern between the males and females (p<0.05). The two groups were statistically significant different regarding GLS (p =0.001). Conclusions: Gray zone hypertension affects ventricular diastolic function and LV geometry, although systolic function was normal; GLS showed that subclinical LV dysfunction can occur.

Concentrations of total, bioavailable, and free 25OHD in individuals with and without primary hyperparathyroidism and their correlations to DXA and trabecular bone score

ABSTRACT Objective: This study aimed to investigate the association between 25OHD (total, bioavailable and free) with bone mass and microarchitecture among primary hyperparathyroidism (PHPT) patients and controls. Subjects and methods: Sixty-four patients in the preoperative period of PHPT and 63 matched controls, who had not taken vitamin D in the last three months. To calculate the bioavailable and free 25OHD, the genetic variants of the vitamin D-binding protein (DBP) were determined. Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometry (DXA). The distributions of total, bioavailable and free 25OHD and their correlation with TBS and DXA were evaluated. Results: PHPT showed BMD and TBS values lower than CTRL in all locations (p < 0.05). There were no statistical differences in the levels of free, bioavailable and total 25OHD between the PHPT and CTRL groups [mean, min-max: 3.4 (1.4-8.6) vs. 3.1 (1.0-9.8) pg/mL, 1.51 (0.43-3.58) vs. 1.41 (0.38-3.48) ng/mL, 22.6 (11.0-39.9) vs. 20.6 (8.9-35.3) ng/dL, respectively; (p > 0.05). The distribution of DBP haplotypes was similar between groups. DXA showed no correlation with any form of 25OHD in both groups. TBS presented a weak correlation with the total 25OHD in PHPT (r = 0.28; p = 0.02) and a moderate correlation with the total, free and bioavailable 25OHD in CTRL (r = 0.42; r = 0.42; r = 0.43; respectively, p < 0.01). Conclusion: The concentrations of total, free and bioavailable 25OHD were similar in both the PHPT and control groups. 25OHD concentrations correlated positively with TBS and not with DXA, especially in controls, suggesting that this method may be more sensitive to assessing the consequences of vitamin D deficiency on bone quality in individuals without PHPT.

VNFns vs. CPAPn como métodos de extubación y rescate en recién nacidos con dificultad respiratoria / VNFns vs. CPAPn as methods of extubation and rescue in newborns with respiratory distress

Resumen Introducción: La ventilación nasofaríngea no sincronizada (VNFns) y la presión positiva continua de la vía área nasal (CPAPn) son métodos de asistencia ventilatoria no invasiva. Objetivo: Comparar la eficacia de los dos métodos como estrategia de extubación y rescate. Material y métodos: Pacientes que hubiesen estado en alguna de ambas estrategias del 2008 al 2012, categorizándolos como extubación o rescate y midiendo el éxito o fracaso. Resultados: El éxito como estrategia de extubación fue del 83.3% para la VNFns contra el 68.7% de la CPAPn (OR: 2.26). Hubo diferencia para VNFns, en relación con los días de hospitalización, con una media de 38.6 contra 65.4 días (p = 0.0001). En cuanto a la displasia broncopulmonar, hubo disminución de riesgo (OR: 0.64; p = 0.01) para la VNFns. Hubo mayor número de complicaciones para la CPAPn, lesión de la columnela, neumomediastino, neumotórax y sangrado nasal. En la VNFns se presentó con mayor frecuencia la hipocarbia. Conclusión: La VNFns mostró ser una estrategia efectiva y segura, en comparación con la CPAPn.

Abstract Background: Non-synchronized nasopharyngeal ventilation (VNFns) and continuous positive pressure of the nasal airway (CPAPn) are methods of non-invasive ventilatory support. Objective: To compare the efficacy of the two methods as an extubation and rescue strategy. Material and methods: Patients who had been in one of both strategies from 2008 to 2012, categorizing them as extubation or rescue and measuring success or failure. Results: Success as an extubation strategy was 83.3% for VNFns against 68.7% for CPAPn (OR: 2.26). There was a difference for VNFns, in relation to hospitalization days, with a mean of 38.6 versus 65.4 days (p = 0.0001). Regarding bronchopulmonary dysplasia, there was a decreased risk (OR: 0.64; p = 0.01) for VNFns. There was a higher number of complications for CPAPn, columella injury, pneumomediastinum, pneumothorax and nasal bleeding. Hypocarbia was more frequent in VNFns. Conclusion: VNFns was shown to be an effective and safe strategy, compared to CPAPn.

The high-risk factors of different severities of bronchopulmonary dysplasia (BPD) based on the national institute of child health and human development (NICHD) diagnosis criteria in 2018 / Os fatores de alto risco de diferentes gravidades de displasia broncopulmonar (DBP) com base no instituto nacional de saúde infantil e desenvolvimento humano (NICHD): critérios de diagnóstico em 2018

ABSTRACT Objective To investigate the clinical characteristics of preterm infants with different severities of bronchopulmonary dysplasia (BPD) and disclose the high-risk factors of exacerbating BPD. Methods Collection of clinical data of 91 preterm infants admitted to the NICU and diagnosed with BPD, categorized in groups according to the disease severity: 41 mild cases,, 24 moderate cases, and 26 severe cases. Comparison and analysis of perinatal risk factors, treatment, complications and prognosis of the infants with different severity degrees. Results The severe group had a higher proportion of infants with congenital heart disease (CHD) higher than the moderate group (P < 0.05), and a higher ratio of pneumonia and mechanical ventilation (MV) ≥ seven days than the mild group (P < 0.05). The severe group also presented higher reintubation incidence than both the mild and moderate groups (P < 0.05). The groups presented different (P < 0.05) incidence rates of hemodynamically significant patent ductus arteriosus (hsPDA) . Ridit analysis suggested that the premature infants (PIs) with hsPDA, multiple microbial pulmonary infections, or Klebsiella pneumoniae pneumonia had more severe illness. Conclusion CHD, hsPDA, MV ≥ seven days, reintubation, pneumonia, especially multiple microbial pulmonary infections, and Klebsiella pneumoniae pneumonia are correlated with the severity of BPD and can be used as BPD progression predictor.

RESUMO Objetivo Investigar as características clínicas de prematuros com diferentes gravidades de displasia broncopulmonar (DBP) e divulgar os fatores de alto risco para a DBP. Métodos Coleta de dados clínicos de 91 prematuros internados em UTIN com diagnóstico de DBP, categorizados em grupos de acordo com a gravidade da doença: 41 casos leves, 24 casos moderados e 26 casos graves. Foram feitas a comparação e a análise de fatores de risco perinatais, tratamento, complicações e prognóstico de lactentes com diferentes graus de gravidade. Resultados O grupo grave teve uma proporção maior de bebês com doença cardíaca congênita (DCC) do que o grupo moderado (p < 0,05) e com pneumonia e ventilação mecânica (VM) ≥ 7 dias do que o grupo leve (p < 0,05). O grupo grave também apresentou maior incidência de reintubação do que os grupos leve e moderado (p < 0,05). Os grupos apresentaram diferentes (p < 0,05) taxas de incidência de persistência do canal arterial hemodinamicamente significativa (PCAhs). A análise de ridit sugeriu que os bebês prematuros (BPs) com PCAhs, infecções pulmonares microbianas múltiplas ou pneumonia por Klebsiella pneumoniae tinham doenças mais graves. Conclusão DCC, PCAhs, VM ≥ 7 dias, reintubação, pneumonia, principalmente infecções pulmonares microbianas múltiplas, e pneumonia por Klebsiella pneumoniae estão correlacionadas com a gravidade da DBP e podem ser usadas como preditoras de progressão da DBP.

Effect of Cold Pressor Test (CPT) on Pulse Rate and Blood Pressure amongst Individuals with and without Family History of Hypertension.

It is an established fact that primary and secondary hypertension and related cardiovascular disorders have a familial predisposition. We also know that essential hypertension is the most common amongst hypertensives. The aim of our study was to find out effect of cold pressor test (CPT) on heart rate and blood pressure amongst individuals with and without family history of hypertension. MethodsPresent study was undertaken using within group design consisting of measurements at basal and CPT and the parameters studied were pulse rate and Blood pressure. ResultsIn our study we found that in males with family history of HT (n=15), the mean basal pulse rate was 78.33 beats/min and following CPT it increased to 85.73. Similarly, in males without family history of HT (n=18) mean basal pulse rate was 77.28 beats/min and following CPT it increased to 86.72 beats/min. In both cases it was statistically significant. But it is observed that in case of females with family history of HT (n= 20) mean basal pulse rate was 80.9 beats/min and following CPT it increased to 89.1. Similarly, in Females without family history of HT (n=26) mean basal pulse rate was 77.15 beats/min and following CPT it increased to 84.73 beats/min and in both these cases, it was statistically significant. In males with family history of HT (n=15), mean basal SBP was 115.13 mmHg and following CPT increased to 123.93 and this was statistically significant and the mean DBP was 74.67 mmHg and following CPT it increased to 79.82 mmHg and it was not statistically significant. In males without family history of HT (n=18) mean basal SBP was 114.67 mmHg and following CPT it was increased to 122.89 mmHg and increase was statistically significant and mean DBP was 74.44 mmHg and following CPT it increased to 76.33 mmHg and this increase was not statistically significant. In females with family with family history of HT (n=20) the mean SBP was 114.2 mmHg and following CPT it increased to 121.9 mmHg and it was statistically significant and the mean DBP was 73.75 mmHg and following CPT it increased to 78.80 mmHg and it was not statistically significant. In females without family history of HT (n= 26) the mean basal SBP was 108.23 mmHg and following CPT it increased to 117.08 mmHg and the mean basal DBP was 69.92 mmHg and following CPT it was increased to 76.69 mmHg this increase in both the cases was statistically significant (table 1,2). In both the groups, none of the subjects was found to be hyperreactive to either systolic or diastolic blood pressure when they were subjected to CPT. ConclusionsIn both the groups, subjects were found to be hyporeactive or normoreactive to either systolic or diastolic blood pressure when they were subjected to CPT. But increase in basal blood pressure response is known to be due to CPT.

Study of Effect of Shavasana on Handgrip and Cold Pressor Test on Heart Rate and Blood Pressure in Young Adults.

Shavasana or a corpse pose is the final pose of a yoga flow. When practiced regularly it is known to restore the body and mind. Aim of our present study was to investigate the effects of shavasana on handgrip and cold pressor test on heart rate and blood pressure in apparently healthy young adults. In today’s world all of us are under constant stress and majority of individuals with sedentary lifestyle suffer from hypertension and each of us react differently to varied internal and external stimuli.METHODSFor convenience, we took 300 apparently healthy medical students of both sexes in the age group of 18 to 22 years and a comparative study was carried out among them. Their basal pulse and BP were recorded from dominant hand. For Hand Grip Test (HGT) handgrip dynamometer (INCO) was used by left hand, and pulse and BP from right hand was recorded and similarly Cold Pressor Test (CPT) was carried out by immersing left hand up to wrist joint in cold water mixed with ice cubes to maintain temperature at 40C and pulse and BP was recorded from right hand. Shavasana was performed for 15 minutes by lying down on the wooden couch, with eyes closed and lying on back, keeping arms six inches away from the body and legs and feet “drop” open and palms facing upwards and concentrating on their breathing, after which pulse and BP was recorded. This was carried out for a period of 30 days.RESULTSData was collected and analysed using paired ‘t’ test and paired differences were calculated using 95% confidence interval of the difference and p value of < 0.05 was taken as scientifically significant. In our study we found that there is significant decrease in basal pulse rate, when compared with CPT, immediately and after performing shavasana for a period of one month, and there was significant increase in pulse rate following HGT (p< 0.001) (table 1 and graph 1). Compared to basal, SBP and DBP, it was observed that there is significant decrease; immediately and after performing shavasana for one month and significant increase with HGT and CPT was observed (p<0.001) (table 1 and graph 1).CONCLUSIONSThere is a significant decrease in basal pulse rate, when compared with CPT, immediately and after performing shavasana for a period of one month, and there was significant increase in pulse rate following HGT (p< 0.001) (table 1 and graph 1). Compared to basal, SBP and DBP it was observed that there is significant decrease; immediately and after performing shavasana for one month and significant increase with HGT and CPT was observed (p<0.001) (table 1 and graph 1).

Correlation of Risk Factors with Severity of Diabetic Retinopathy - A Retrospective Study.

Diabetic retinopathy (DR) is a major microvascular complication of diabetes. It is the most common cause of blindness in the working-age population in developed countries. We wanted to analyse the correlation between risk factors of blindness like duration of diabetes, dyslipidaemia, hypertension, HbA1c with severity of diabetic retinopathy in order to design appropriate strategies for prevention and treatment of diabetic retinopathy.METHODSThis was a retrospective study of all diabetic patients with diabetic retinopathy who presented to the eye OPD at KS Hegde Medical Academy from April 1st 2018 to March 31st 2019 that fulfilled the inclusion criteria. A dilated fundus examination was done to note the grade of diabetic retinopathy. The demographic data along with the duration of diabetes, HbA1c values, Cholesterol levels and Blood pressure were documented and correlated with the severity of diabetic retinopathy.RESULTSThe study included 92 patients, of which 63 were males and 29 were females with a mean age of 54.5±2.8 years. We found that there was statistically significant association between the duration of diabetes and HbA1c levels with severity of diabetic retinopathy (p= 0.022 and 0.034 association), whereas there was no statistically significant correlation between blood pressure and cholesterol levels with severity of diabetic retinopathy (p= 0.52 and 0.456 respectively)CONCLUSIONSDiabetic retinopathy showed a male preponderance, with risk factors like duration of diabetes and HbA1c levels having a significant association with the severity of diabetic retinopathy. Therefore, it is essential to have a good systemic control of diabetes with diet and suitable medications. Diabetic retinopathy is a preventable cause of blindness when diagnosed early and screening of diabetic retinopathy must be done in all diabetics to prevent the progression of the disease.

A 12 week prospective clinical evidence of empagliflozin efficacy in uncontrolled type 2 diabetes mellitus treated with metformin and a sulfonylurea

Background: The main aim of the study is to evaluate the efficacy of empagliflozin 10 mg once daily over 12 weeks as add-on therapy to metformin plus sulfonylurea in patients with type 2 diabetes mellitus with inadequate glycemic control.Methods: It is a prospective, observational, study conducted in patients of Sri Badhrakali Diabetic Center located in Warangal, Telangana, India. The efficacy of empagliflozin 10 mg was assessed by measuring the change in the glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI) at the baseline and 12 weeks, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the baseline and after 24 hours of treatment.Results: In the present study, the addition of empagliflozin to metformin and Sulfonylurea therapy for 12 weeks provided 0.87 % reduction in HbA1c. The mean changes of FPG from baseline to 12-week is -26 mg/dl. At 24 hours empagliflozin significantly reduced blood pressure with mean changes of SBP and DBP -4.147 and -1.526 mmHg respectively. The mean changes in BMI from baseline to week 12 is -0.638 kg/m2.Conclusions: Empagliflozin 10 mg provided ancillary reduction in HbA1c outside of metformin and sulfonylurea. Controlled body weight, HbA1c, blood pressure decreases diabetes progression, decreased risk of diabetic complications and reduced risk for cardiovascular disorders.

Comparative Study to Evaluate Efficacy, Safety and Quality of Life of Metoprolol and Telmisartan versus Metoprolol and Ramipril in Patients of Hypertension

Background: Hypertension(HTN) is a major cardiovascular disease and is a major worldwide clinical problem. The prevalence of hypertension increases in urban and rural areas. The treatment of hypertension began in the 1960s with oral diuretics. The other modalities of treatment of hypertension are beta – blockers, calcium-channel blockers, alphareceptors blockers, ACE inhibitors and ARBs. The better compliance occurs with single-pill combination, and may be even double or even triple pill combination therapy should be used. Also quality of life was improved better with Metoprolol and Telmisartan as compared with Metoprolol and Ramipril. Quality of life was assessed by SF -36 Quiestionnare. Objective: To compare the effect of Metoprolol and Telmisartan versus Metoprolol and Ramipril on BP and quality of life in patients of hypertension. Material and Methods: In this prospective, open, randomized, parallel group, comparative study, 80 patients of hypertension attending the Cardiology Outpatient Department, Govt. Medical College & Rajindra Hospital, Patiala were recruited. This randomized comparative study was done on 80 patients for 4 months. Quality of Life: In my project of Quality of life, I had taken total 80 patients and the patients were divided into two groups and 40 patients each of Metoprolol and Ramipril versus Metoprolol and Telmisartan. To assess quality of life questionnaire SF-36 was administered to the patients. Results: There was a marked decrease in SBP and DBP with the use of Metoprolol and Telmisartan than Metoprolol and Ramipril. There was also no change in demographic parameters. There was significant improvement in the quality of life with Metoprolol and Telmisartan. Conclusion: Metoprolol and Telmisartan was a better choice than Metoprolol and Ramipril in treating hypertension as this combination causes more reduction in BP and little effect on HR.

Comparison Of Propofol, Etomidate And Propofol-Etomidate Combination As Induction Agent On Haemodynamic Parametres During Endotracheal Intubation In Patients Undergoing Laparoscopic Cholecystectomy

Endotracheal intubation during general anaesthesia has been associated with change in haemodynamic parameters such as pulse rate and blood pressure. In this study we have compared propofol, etomidate and propofol-etomidate combination as induction agent in patients undergoing laparoscopic cholecystectomy. Material & Methods:After approval from the institutional ethical committee and informed written consent, prospective randomised double blind study was done with ASA physical status I and II. Three groups propofol(P),etomidate(E) and propofol-etomidate combination(PE) including 30 patients in each group were assigned. Haemodynamic parameters heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP),mean bood pressure(MBP),side effects and complications were seen just before induction, at 0 hr soon after intubation, than from 1min to 7min and at 10 min after intubation. Result:There was no significant differences in HR,SBP,DBP,MBP after intubation and post intubation in etomidate group as compared to propofol-etomidate and propofol group. Conclusion: Etomidate has better haemodynamic stability than etomidate-propofol combination alone at 1 min after intubation, though propofol-etomidate combination was equally stable.

Cardiovascular Responses to Isometric Handgrip Training in Normotensive Medical Students

Background: Dynamic handgrip exercise evaluates autonomicresponses to physical activity. The isometric hand gripexercises training effect on cardiovascular system so thatsimilar benefits if any could also be obtained to same extent insimilar age group if they practice physical training regularly.Though there is a vast knowledge on exercise, but data onexercise and its effects on the cardiovascular system and longterm survival are still limited.Material & Methods: A Randomized cross sectional studydone on 100 MBBS students from Mulayam Singh YadavMedical College Meerut. Subjects were evaluated before andafter the training sessions of isometric handgrip exercise forhemodynamic changes like blood pressure, Pulse rate andmaximum volumetric contraction.Results: In present study the mean value of SBP weresignificant but DBP non- significant (P=0.001, 0.005NSrespectively) in Male and Female (P=0.001, 0.005NSrespectively).Conclusion: Thus the arterial pressure reduction reported inthis study would have an important impact on thesecardiovascular related illnesses. Furthermore, our resultssupport the concept that isometric training is an effectivemodality in the prevention of hypertension.

Cisatracurium Pretreatment with Tourniquet - Role in Propofol Injection Pain: A Prospective, Randomized, Double Blind and Control Study

Introduction: Propofol is an anaesthetic drug which is given toinduce and maintain anaesthesia in adults undergoing surgery.This prospective, randomized, controlled study was designedto evaluate the efficacy of cisatracurium as a pretreatment drugin reducing incidence and severity of propofol injection pain.Material and methods: Patient undergoing generalanaesthesia were randomized in four groups of 25 patientseach. Group A received normal saline (control group), GroupB received Cisatracurium 0.05mg/kg IV, Group C receivedCisatracurium 0.1mg/kg IV, Group D received Cisatracurium0.15mg/kg IV. All drugs were administered into the largestdorsal vein of the hand with venous occlusion for 30 sec,followed by propofol (0.5mg/kg). Pain was evaluated usinga four point scale.Result: Cisatracurium 0.15mg/kg significantly lowers bothincidence and severity of propofol induced pain. Cisatracurium0.1mg/kg and cisatracurium 0.05mg/kg both significantlylower the severity of pain but not the incidence as comparedto control group.Conclusion: Cisatracurium is an effective drug in reducingpropofol induced pain. It reduces the incidence and severityboth of pain in 0.15mg/kg dose. Whereas only severityis decreased with 0.10 mg/kg and 0.05 mg/kg dose ofcisatracurium without any significant complications.

Monitoring effects of atenolol versus olmesartan medoxomil on metabolic parameters

Background: The increase in CVS morbidity and mortality could be significantly reduced by control of SBP and DBP, as well as reduction in Hyperlipidemia.Methods: The patients of stage-1 HTN with either sex according to JNC VII criteria were included and were followed up every 2 weeks from baseline upto 12 weeks. The randomized patients were divided into two groups to receive beta blocker viz. Atenolol 50 mg (group A, N=50) and ARB Olmesartan medoxomil 40 mg (group B, N=50).Results: The average Total cholesterol measured among Group A subjects was significantly increased by 1.8% by the end of 12th week whereas the average cholesterol measured among Group B subjects at baseline period was reduced by 7.9% after 12 weeks therapy. The average HDL measured among Group A subjects at baseline period significantly reduces by 5.9% by the end of 12th week whereas the HDL levels measured among Group B subjects at baseline period was significantly increased by after 12 weeks therapy. The average Triglyceride (TG) levels measured among Group A subjects at baseline period was significantly increased by 12.4% by the end of 12th week whereas the Triglyceride (TG) levels measured among Group B subjects at baseline period was significantly reduced by 9.5% after 12 weeks therapy. The average LDL levels measured among Group A subjects at baseline period was significantly increased by 1.5% by the end of 12thweek whereas the average LDL measured among Group B subjects at baseline period was significantly reduced by 11.2% to after 12 weeks therapy. The average VLDL levels measured among Group A subjects at baseline period was significantly increased by 12.4% by the end of 12th week whereas the average VLDL measured among Group B subjects at baseline period was significantly reduced by 9.5% after 12 weeks therapy.Conclusions: ARB- Olmesartan medoxomil is a better drug than beta blocker-Atenolol as it leads to greater deduction in lipid profile.

Phthalate contamination of some plants and herbal products / Contaminación de algunas plantas y productos herbales con ftalatos

Phthalate derivatives cause a number of risks to human health and the environment. Essential oil and volatile fractions of some vegetables and herbal products were extracted by hydrodistillation and percolation methods to analyze using gas chromatography and mass spectrometry (GC-MS) for evaluation of phthalate contaminations. The results revealed that four vegetables and all aromatic waters were contaminated by phthalate derivatives including di-n-butyl phthalate (DBP), diisobutyl phthalate and di-(2-ethylhexyl) phthalate (DEHP) (0.1-7.95%). Butylated hydroxytoluene (BHT), a widely used synthetic antioxidant, was also found in the most of the aromatic waters in the range of 3.15-61.3%. In addition, three vegetable samples contained diazinon (0.36-4.61%), an organophosphorus insecticide. Plants and herbal preparations may be contaminated by the absorption of phthalates from contaminated water or soil or by the migration of phthalates from inexpensive recycled plastic. Regarding the widespread use and associated health risks of phthalates, effective quality and safety regulations for herbal products should be implemented with respect to their phthalate content.

Los derivados de ftalato causan una serie de riesgos para la salud humana y el medio ambiente. El aceite esencial y las fracciones volátiles de algunos vegetales y productos a base de hierbas fueron extraídos mediante hidrodestilación y métodos de percolación y luego fueron analizados mediante cromatografía de gases y espectrometría de masas (GC-MS) con el propósito de identificar contaminación con ftalatos. Los resultados revelaron que cuatro productos herbales y todas las aguas aromáticas analizadas estaban contaminadas con derivados de ftalato, incluyendo el ftalato de dibutulo (DBP), ftalato de diisobutilo y ftalato de bis(2-etilhexilo) (DEHP) (0.1-7.95%). El butilhidroxitolueno (BHT), un antioxidante sintético ampliamente utilizado, también se encontró en aguas aromáticas en el rango de 3.15- 61.3%. Además, tres muestras vegetales contenían diazinón (0.36-4.61%), un insecticida organofosforado. Las plantas y las preparaciones herbales pueden ser contaminadas a partir de absorción de ftalatos del agua o el suelo contaminados o por la migración de ftalatos desde plástico reciclado de bajo costo. Con respecto al uso generalizado y los riesgos asociados a la salud de los ftalatos, deben implementarse normas efectivas de calidad y seguridad para los productos a base de hierbas con respecto a su contenido de ftalato.

Isolation and Characterization of Vaccine Candidate Genes Including CSP and MSP1 in Plasmodium yoelii

Malaria is an infectious disease affecting humans, which is transmitted by the bite of Anopheles mosquitoes harboring sporozoites of parasitic protozoans belonging to the genus Plasmodium. Despite past achievements to control the protozoan disease, malaria still remains a significant health threat up to now. In this study, we cloned and characterized the full-unit Plasmodium yoelii genes encoding merozoite surface protein 1 (MSP1), circumsporozoite protein (CSP), and Duffy-binding protein (DBP), each of which can be applied for investigations to obtain potent protective vaccines in the rodent malaria model, due to their specific expression patterns during the parasite life cycle. Recombinant fragments corresponding to the middle and C-terminal regions of PyMSP1 and PyCSP, respectively, displayed strong reactivity against P. yoelii-infected mice sera. Specific native antigens invoking strong humoral immune response during the primary and secondary infections of P. yoelii were also abundantly detected in experimental ICR mice. The low or negligible parasitemia observed in the secondary infected mice was likely to result from the neutralizing action of the protective antibodies. Identification of these antigenic proteins might provide the necessary information and means to characterize additional vaccine candidate antigens, selected solely on their ability to produce the protective antibodies.

Cardiovascular Response to Exercise: Static v/s Dynamic.

Background: Limited research has been carried out to compare acute cardiovascular responses to static and dynamic exercise in older adult. So in our study we compared the responses to static and dynamic exercise in older adults to find out and support the inclusion of resistance exercise as a part of fitness program designed for healthy subjects of older age group. Aims & Objective: The purpose of this study was to compare the acute cardiovascular responses of healthy older adults to static and dynamic exercise. Methods: In the present study 8 healthy normotensive volunteers, recruited in age group of 40-60 years, performed IHG exercise. Their HR and BP were recorded prior to and after one minute of 40% maximum voluntary contraction of the forearm. Then after a gap of two weeks subjects, performed dynamic exercise using ergo metric cycle. Their HR and BP were recorded prior to and after one minute of completion of exercise. All the recordings were compared before and after both types of exercise. Results: Both types of exercise led to significant rise in SBP, & HR. The rise in DBP was significant in subjects who performed static exercise only. From BP and HR responses, it is clear that acute responses to both exercises are almost similar, supporting the inclusion of static exercise in exercise programs for older adults. Conclusion: This study indicates that the press or response is well regulated in both exercise groups. This supports the inclusion of resistance exercise as part of an overall fitness program designed for healthy older adults.

Assessment of overweight, obesity and metabolic variables among students of a private medical college in Dhaka city.

Background: Overweight and obesity are recognized as recent threat which affecting both developing and developed countries. Obesity and its associated morbidities are leading cause of most non-communicable diseases. Few recent studies have indicated the presence of increase in overweight and obesity among children and adolescent but there is no study among adult groups. Method and material: This cross sectional study was done to assess the prevalence of overweight, obesity and metabolic variables with their relation among medical students. Result: Our result reveals that 8.6% & 1.9% male and 15% & 3.2% female are suffering from overweight and obesity (based on BMI) respectively. More females (31.3% and 65.2%) are centrally obese than males (3.5% and 34.8%) (According to Waist Hip ratio and Waist Height ratio respectively). But according to Waist circumference more males (30.7%) are obese than females (24%). There is also significant difference of male and female BP. DBP and SBP of male (79.22mmHg & 118.9 mmHg) have high normal level than female (72.71mmHg and 108.67mmHg) (P<0.001). There is no significant difference of glycaemic status (p<.286) and lipid profile (p<.347) with central obesity. Conclusion: Although male students have high upper level of blood pressure, female students are more obese than males (both according to BMI and central obesity). High blood pressure and obesity both acts as risk factors for the development of non communicable disease. Student’s awareness therefore should be increased to reduce central obesity and BP within normal range.

Haemodynamic Responses to Tobacco Smoke Inhalation in Male Adolescents in Lusaka, Zambia.

Background: Tobacco smoke is said to cause changes in the levels of catecholamines in the blood, this leads to an increase in blood pressure and heart rate. This is due to nicotine which has also been noted to cause a decrease in vasodilatory activities leading to an increase in both the blood pressure and heart rate. Aim: To determine the acute effects of tobacco smoke on haemodynamics in black male adolescents in Lusaka, Zambia. Study Design: This was an observational study done at the University of Zambia School of Medicine Cardiovascular Research Laboratory in the month of December, 2014. Methodology: Twenty-two (22) black, male-adolescent (age range 19-25 years), active-smokers, consented to participate in the study. The Diasys Ambulatory Blood Pressure Monitoring system (Novacor, France) was used to obtain the Systolic and Diastolic blood pressures (SBP and DBP) and the heart rate. These were obtained 15 minutes before smoking at 5 minute intervals and averaged to obtain the baseline, during the 15 minutes of smoking and on immediate cessation of smoking and thereafter every 15 minutes up to an hour after smoking. Results: There was a significant rise in SBP (mmHg) during smoking (127.9±13.80 mmHg) from baseline values (113.5±13.15 mmHg) (P < .001). It took 30 minutes for the SBP to return to baseline after cessation of smoking. DBP (mmHg) also increased from baseline (79.5±8.79 mmHg) to 85.6±10.92 mmHg during smoking (P <.01). It returned to baseline values immediately after cessation of smoking. The heart rate (bpm) was also noted to significantly increase during smoking (95.2±16.72 bpm) from the values noted before smoking (74.3±13.75 bpm) (P < .05). The mean value for heart rate returned to baseline value by the 15th minute of recovery. Conclusion: The present study demonstrates that smoking may be the cause for the acute increases in SBP, DBP and heart rate in smokers. The smoking caused significant increases in all the haemodynamic indices considered in this study within 15 minutes. Both SBP and DBP increases are indices for stroke and coronary heart disease respectively. The effect of increased SBP was noted to last for 30 minutes while DBP returned to baseline immediately after smoking. A significant increase in heart rate was also noted in the study.

Effect of candesartan in the treatment of stress-induced hypertension / 中国基层医药

Objective To investigate the clinical effect and complications of candesartan in the treatment of stress-induced hypertension.Methods 60 patients with stress-induced hypertension were randomly divided into experimental group and control group.Experimental group was treated with candesartan,the control group was treated with benazepril.The efficacy of the two groups was compared.Results After the treatment for 4 weeks,8 weeks,SBP/DBP in the two groups had significant differences compared with before treatment (t =5.32/3.76,5.94/3.99,8.61/5.83,2.34/5.67,all P ＜ 0.05).The incidence rate of complications in the experimental group was 6.7％,which was significantly lower than 25.0％ in the control group (x2 =4.32,P ＜ 0.05).Conclusion Candesartan in the treatment of stress-induced hypertension has significant effect,the incidence of complications is lower.

Clinical validation of aneroid sphygmomanometer.

Recent concerns about the mercury toxicity and its ill effects on the environment and health has led to widespread use of aneroid manometers. Present study was conducted to analyse whether this change would lead to any systematic shift in measured blood pressure or consistency of blood pressure measurement in clinical setting. The clinical accuracy of the Welch Allyn aneroid sphygmomanometer model 7670-04 was studied against the mercury sphygmomanometer on 83 volunteers from Dehradun. Two blood pressure reading of each study subject was recorded with pretested instruments (aneroid and mercury sphygmomanometer). Data analysis showed the difference of means between the reading of two devices against mean of the observer reading for both systolic (-3.62±4.88) and diastolic (-2.36±3.77) blood pressure were not statistically different. The corresponding values of the SBP and DBP from both the instruments showed significant correlation. Regression analysis of mercury versus aneroid showed regression line (Y = 9.52 + 0.95X for SBP, Y = 0.36 + 0.96X for DBP) significantly different from line of equality (P<0.001). The study has demonstrated that the aneroid device (model: 7670-04) achieved grade B performance according to the British Hypertensive Society criteria.