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Background: Gastric cancer (GC) is a heterogeneous, multifactorial disease. It endangers human physical and psychosocial wellbeing, causing a significant public health and economic burden in developed and developing countries. To compare the early postoperative outcome between linear cutting stapling device gastro-jejunostomy & traditional hand sewn gastro-jejunostomy for gastric cancer. Material & Methods: The study was a Prospective observational study which was conducted in Department of Surgery, Dhaka Medical college & Hospital, over Six months period after approval of protocol using a semi-structured questionnaire through face to face interview. Data were analysed using a computer programme SPSS 24.0 version. Results: Total 40 patients were enrolled in this study among them 20 patients underwent traditional hand sewn gastro-jejunostomy (Group-A) and 20 patients underwent Linear Cutting Stapling Device gastro-jejunostomy (Group-B). The mean age of the total participants was 57.45±7.04 years where in Group A mean age was 57.30±7.14 years and in Group B mean age was 57.60±6.83 years. The overall mean BMI of the patients was 21.94±1.61 kg/m2. Among all the respondents 25% had comorbidity. Operation time and time for anastomosis were significantly higher in Group A than Group B but no significant difference was found in relation to hospital stay and post-operative blood loss. About 15% had Anastomotic hemorrhage, 10% had Anastomotic leak, 5% had Intra-abdominal abscess and 5% had bowel obstruction in Group A beside 5% had Anastomotic hemorrhage, 5% had Anastomotic leak and 5% had SSI in Group B. Among all 10% needed blood transfusion in Group A and 5% needed blood transfusion in Group B. No significant difference has been found with post-operative complications between both groups. Conclusion: Observed advantages of Linear Cutting Stapling Device Gastro-Jejunostomy in this study were the significantly reduced operation time and anastomosis time.
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Background: Diabetes mellitus (DM) involves a series of metabolic conditions associated with hyperglycaemia which is caused by defects in insulin secretion and./or insulin action. The aim of this work was assessment of the relationship between Aortic Root (AOR) diameter and type 2 diabetes mellitus (T2DM) in Hypertension (HTN) cases. Methods: This prospective case control study was carried out on 80 HTN cases. Cases were divided in to three groups: Group A (30 HTN cases) with type 2 DM with good metabolic control (Hb AIC ? 7.0), group B: (30 HTN cases) with type 2 DM with poor metabolic control (Hb AIC > 7.0) and C (Control group) 20 HTN, non-DM subjects of the same age and sex group with no other comorbid conditions. Results: FS had a significant decline in group A (P2 = 0.001) and in group B (P3 <0.001) than C. EF had a significant difference among all groups (P <0.001). Early wave declaration time (DT) had a significant decline in group A (P2 = 0.049) and in group B (P3= 0.023) than C. Tissue doppler early velocity wave had a significant difference among all groups (P = 0.004). Tissue doppler early velocity wave had a significant decline in group A and B than C. (P2 = 0.038. P3 = 0.003). Conclusions: AOR in HTN cases had a significant decline in DM cases compared with non-DM cases. In our results, glycaemic control didn’t play a significant role in aortic root.
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The aim of this study was to compare the clinical features of patients with elevated blood pressure and to detect variables associated with the diagnosis of primary hypertension. We identified 383 (69%) hypertensive children (197)[51.5%] with primary hypertension, and 186 [48.5%] with secondary hypertension) out of 553 children referred to our clinic with a history of elevated blood pressure. The primary hypertension group was significantly older and had higher BMI, positive family history of hypertension, and lower prevalence of preterm birth compared with those with secondary hypertension. No difference was found between the two groups in terms of the frequency of target organ damage. Multiple regression analysis showed that a family history of hypertension, obesity, age over 10 years, elevated uric acid, and presence of higher systolic blood pressure values at admission were independent predictors of primary hypertension; therefore, these parameters can be considered important clues for diagnosing primary hypertension.
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Introducción: la presión arterial elevada es el principal factor de riesgo de enfermedad global. En la República Dominicana el 31 % de la población padece de hipertensión arterial (HTA) y de este, un 60 % lleva tratamiento médico. Objetivo: determinar los niveles tensionales en individuos no hipertensos entre 18-65 años en la comunidad de Pizarrete Abajo, durante el período agosto-septiembre 2018. Metodología: estudio prospectivo, descriptivo y de corte longitudinal, en el que se analizaron 85 individuos que residen en la comunidad de Pizarrete Abajo, de los cuales 44 resultaron con niveles tensionales alterados. Resultados: el 51.7 % de los encuestados presentó niveles de tensión arterial alterados, sin haber sido anteriormente diagnosticado con hipertensión arterial. Un 24 % de las personas mostró niveles alterados una semana después de la primera toma de presión arterial. Conclusiones: en una muestra de 85 personas se encontraron niveles tensionales alterados en 44 individuos. Se procedió a una segunda toma de presión arterial una semana después de la primera y se observó que un 56.8 % correspondió a valores tensionales elevados, un 20.4 % a valores de HTA estadio 1 y un 18.1 % a valores de HTA estadio 2.
Introduction: High blood pressure is the main risk factor for global disease. In the Dominican Republic, 31% of the population suffers from arterial hypertension (HTN) and of these, 60% have medical treatment. Objective: To determine blood pressure levels in non-hypertensive individuals between 18-65 years of age in the community of Pizarrete Abajo during the period of August - September 2018. Methodology: Prospective, descriptive, and longitudinal study in which 85 individuals residing in the community of Pizarrete Abajo were analyzed, of which 44 resulted in altered blood pressure levels. Results: 51.7% of the individuals presented altered blood pressure levels without previously being diagnosed with hypertension. 24% of people showed altered levels one week after the first blood pressure measurement. Conclusions: In a sample of 85 people, altered blood pressure levels were found in 44 individuals. A second blood pressure measurement was carried out one week after the first measurement and it was observed that 56.8% corresponded to high blood pressure values, 20.4% corresponded to stage 1 HTN levels, and 18.1% corresponded to stage 2 HTN levels.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Mass Screening , Hypertension/diagnosis , Risk Factors , Dominican Republic , Sedentary BehaviorABSTRACT
Introduction: Magnesium is the second most common intracellular cation found in the body that is required as cofactor in numerous enzymatic reactions, smooth functioning of cardiac and neurological systems. Magnesium deficiency is often overlooked in critically ill patients and is linked with risk of electrolyte imbalance, difficulty weaning off ventilator, sudden cardiac deaths and poorer outcome. Objective- To assess prevalence of magnesium deficiency in critically ill patients admitted to Medical ICU and its association with requirement & duration of mechanical ventilation, ICU stay, APACHE-II & mortality. Methods- Prospective descriptive study was conducted on 69 critically ill patients admitted in medical ICU. After taking informed consent serum magnesium level of patients were collected and entered in spreadsheet and final analysis was done with help of Open EPI and SPSS software. Results-It was concluded that patients having hypomagnesemia were at increased risk of electrolyte abnormalities, longer ventilatory support, longer hospital and ultimately poorer outcome stay as compared to patients with normal magnesium levels. Conclusion- Magnesium remains an important but often side-lined cation in critically ill patients. However, Hypomagnesemia is a repeated finding seen in critically ill patients and is significantly associated with a higher mortality rate and frequent need for mechanical ventilation.
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Introduction: Microalbuminuria has relationship on thedevelopment of coronary heart disease and it may identify asa new risk factor of this disease. The MA happens more oftenin diabetic patients with AMI but it has been reported evenin non –diabetic patients with AMI. The aim of the presentstudy was to assess the prevalence of microalbuminuria innon diabetic and non hypertensive patients suffering fromAMI. To evaluate the relationship between MA and AMI innon- diabetic and non hypertensive patients admitted in ICCUcardiology department at Rajshree Medical Research InstituteBareilly (UP).Matereial and methods: The study was carried out in thedepartment of Biochemistry and ICCU in RMRI, Bareilly(UP) to establish the correlation between MA with 50non diabetic, non hypertensive patients of AMI and in50 healthy age matched controls. MA was determined byimmunoturbidimetric method and plasma glucose weremeasured by enzymatic method.Result: There was a significant increase in the level of MA inpatients with AMI who were non diabetic, non hypertensive ascompare to those in the healthy control.Conclusion: MA may have an association with AMI inabsence of traditional risk factors like diabetes and HTN. SoMA can be used as an adjunct biochemical parameter in nondiabetic, non hypertensive AMI patients.
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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.
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Background: Pregnancy induced hypertensive disorders are one of the commonest complication of pregnancy which accounts for 12% of the maternal and perinatal mortality and morbidity. Dyslipidemias are associated with endothelial dysfunction that may result in proteinuria and hypertension which is a clinical hallmark of PIH. It affects both maternal health as well as fetal growth. Hence, this study was done to assess the role of altered lipid profile in the development of PIH.Methods: A Case Control study was conducted at the Department of Biochemistry, Kurnool Medical College and Govt General Hospital, Kurnool in collaboration with its Obstetrics Dept during the period of November 2015-2017. A total of 300 pregnant women, primigravida /multigravida with singleton pregnancy, in the age group of 18‐ 35 years with >20 weeks of gestation were included in the study. Subjects were divided into gestational hypertensives, n=39 (BP ≥140/80) and preeclamptic women, n=111 (≥140/80 and proteinuria) as cases. Age matched normotensive pregnant women, n=150 (BP 120/80) were recruited as Controls. Subjects with history of multiple pregnancies, pregnancy with congenital anomalies, chronic hypertension, diabetes mellitus, cardiac/thyroid/hepatic/renal disease, dyslipidemia were excluded. Total cholesterol, TG, HDL, LDL, VLDL were performed.Results: A comparison of these values between hypertensive and normotensive women showed a significant rise in TC, TG, LDL and VLDL. HDL-C showed a significant decrease in hypertensive women compared to normal pregnant women. LDL: HDL and TG:HDL ratios were higher in PIH group.Conclusions: The results of this study suggests an abnormal lipid metabolism, predominantly high TG concentrations and low HDL-C, which may add to the promotion of vascular dysfunction and oxidative stress seen in PIH. This association is significant in understanding the development of hypertension during pregnancy and is useful in early diagnosis and prevention of PIH.
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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.
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Background: The prevalence of hypertension (HTN) associated with alpha-1 antitrypsin deficiency (AATD) has been studied with indeterminate results. The aim of the study was to prospectively compare the prevalence of HTN before testing in 3 groups of individuals with subsequently normal, moderately deficient, and severely deficient genotypes of AATD with adjustment for differences in demographics and clinical variables. Methods: We performed a cross sectional study using data from the Alpha-1 Coded Testing (ACT) study. The univariate demographic and clinical factors associated with HTN were further analyzed by logistic regression analysis. Results: The prevalence of HTN was 27.2%, 20.6%, and 27.9% for individuals with normal, moderate and severe AATD, respectively (p<0.02). The prevalence of HTN increased with age and an interaction between age, alpha-1 antitrypsin deficiency genotype and HTN was identified. The relative risk of HTN among young moderately deficient individuals was 0.53 (95% CI 0.37-0.76) the risk of young PiMM and PiMS (normal genotype) individuals. There was no significant difference in the risk in older moderately deficient individuals 1.02 (95% CI 0.76-1.37) and individuals with severe AATD 1.10 (95% CI 0.71-1.68) when compared to normal genotypes. Conclusion: Moderate deficiency genotypes (PiMZ, PiSS, PiMNull) have less HTN than normal or severe deficiency genotypes, particularly in young individuals. We speculate that protease inhibitor deficiency over a lifetime allows unopposed proteolysis of vascular connective tissue.Measured comorbidities do not explain these findings. Validation of this data should occur in other AATD cohorts.
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Pseudo tumor cerebri is a clinical entity of uncertain etiology characterized by intracranial hypertension. The syndrome classically manifests with headaches and visual changes in women with obesity. This case is being presented for the following points: raised ICT, bilateral CN VI palsy, bilateral papilledema (left > right), neck rigidity present without Kernig's and Brudginski signs. Keeping the history, Neurological findings, investigative results, point to the possibility of raised intracranial pressure with CN VI involvement. The final clinical diagnosis, to the above syndrome, points out to ‘Pseudo-tumor cerebri’.
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Background & objectives: Diabetes Mellitus (DM) & hypertension (HTN) are common diseases causing premature atherosclerosis; and associated hyperlipidemia causes cardiovascular morbidity & mortality. They impose tremendous burden on healthcare system. Carotid intima-media thickness (IMT), an early marker of atherosclerosis and For every 0.1-mm increase in carotid IMT, the relative risk of ischemic heart disease increases by 15% and that of cerebrovascular disease by 18%.3 in type 2 diabetes Mellitus (DM2) patients. This study was carried out with objectives of : 1. To evaluate the prevalence of altered lipid profile in type 2 DM & stage 2 HTN & its relationship with carotid intima media thickness ( CMT) as a marker of atherosclerosis.2. To study prevalence of altered lipid profile in type 2 DM & stage 2 HTN patients with respect to control subjects.3. To study additive effect of diabetes & hypertension on lipid profile & CMT . 4. Quantitative correlation of altered lipid profile & diabetic control HbA1c with CMT. 5. Relation of CMT with other established parameters like age, BMI >26kg/m2 , total cholesterol, LDL & HDL cholesterol. Methods: The current prospective study has been carried out at Shree Sayaji General Hospital. From 1st September 2010 to 30th August 2011 with following group of patients who attended outdoor patient department in medicine department.1. A group of 15 type 2 Diabetes mellitus patients.2. A group of 15 stage 2 hypertensive patients.3. A group of 15 control patients. Results: In HTN patients, total cholesterol has positive and poor correlation while HDL cholesterol has negative & good correlation with CMT. LDL cholesterol has positive & very good correlation & VLDL cholesterol has positive &very good correlation with CMT. TC/LDL has positive & very good correlation with CMT. In DM patients, total cholesterol has positive & good relation, while HDL cholesterol has negative & good correlation with CMT.LDL cholesterol has positive & very good correlation with CMT. While VLDL cholesterol has positive & very good.TC/LDL has positive & very good correlation with CMT. While HBA1c has negative & poor correlation with CMT. The other parameters which were found to be associated with increased carotid intima media thickness were increasing age, BMI > 25 Kg/m2, post prandial blood glucose levels, high total cholesterol & low HDL cholesterol.HbA1c has not shown to be important correlation with CMT. CMT values are highly significant at p<.05 level in HTN & DM group of patients in comparison to controls.
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Envelope glycoprotein 1 (G1) and glycoprotein 2 (G2) of Hantaan (HTN) virus are believed to be major viral antigens that can induce neutralizing immunity against HTN virus infection. The purpose of this study is to clone and express G1 gene in an E. coli expression system. The truncated G1 gene (amino acid residues 35 to 123) of the HTN virus strain 76-118 was amplified by polymerase chain reaction (PCR). The 0.28 kb PCR product was cloned into pCR2.1 vector and named as pCGS1. The truncated G1 gene was excised from the pCGS1 and subcloned into the BamHI and SalI sites of pGEX-4T-2 and named pGGS1. The nucleotide sequence of the 0.28 kb truncated G1 gene was determined. It is revealed four non-silent nucleotide substitutions between the published sequence of strain HTN virus strain 76-118 and our stock of HTN virus strain 76-118 (passaged several times in our laboratory). The first G1 mutation was found to constitute an A to G nucleotide substitution, giving raise to an asparagine to serine mutation at residue 64. The second G1 mutation was found to constitute an A to C nucleotide substitution, giving raise to an lysine to threonine mutation at residue 112. The third G1 mutation was found to constitute an A to C nucleotide substitution, giving raise to an lysine to threonine mutation at residue 112. The fourth G1 mutation was found to constitute an G to A nucleotide substitution, giving raise to an glutamic acid to lysine mutation at residue 117. The truncated G1 gene was expressed as a 37 kDa protein fused to glutathione-S-transferase (GST). The GST fusion protein was purified by Glutathione Sepharose 4B affinity chromatography and reacted with the sera from patients of hemorrhage fever with renal syndrome (HFRS). One of 12 serum samples from HFRS patients was reactive with the 37 kDa fusion protein strongly. Three sera reacted moderately with the fusion protein. Six sera reacted only weakly with the protein, while remaing two were non-reactive. Control sera from patients with scrub typhus leptospirosis, or negative HFRS did not react with the recombinant fusion protein.