Management Practices in Hypertension : Results of WIN-OVER — A Pan India Registry.

Hypertension is a common disease seen in clinical practice and is associated with high morbidity and mortality. Many patients require combination therapy for the management of hypertension. Objective: To evaluate co-morbidities, risk factors and management practices of hypertension in Indian population. Material and methods: A total of 1596 hypertensive adult patients received antihypertensive medications were studied in a cross-sectional, multi-centric, non-interventional, observational registry. Statistical analysis: Categories or nominal data was expressed as numbers with percentages. Continuous variables were analyzed by descriptive statistics using mean, SD, and range Chi square test was used for in between group comparison. Results: The study included 73.50% males and 26.50% females. Overweight (50.50%) and obesity (30.01%) was common in the hypertensive patients (n=903). A total of 54.76% patients had history of smoking. Alcohol use (33.08%), sedentary life style (32.96%) and history of tobacco chewing (17.92%) were the other lifestyle habits of hypertensive patients. Diabetes (36.03%) and dyslipidemia (39.79%) history was common in these patients. Family history of hypertension and diabetes was seen in 82.21% and 45.99% patients respectively. Most (89.16%) patients were treated with combination of antihypertensive agents. ARBs were the by far most commonly used agents (91.98%) followed by calcium channel blockers (68.23%) and diuretics (60.21%). ARB was the most (80.35%) preferred agent as monotherapy. ARB was also the most common agent as a component of dual therapy, four drug and five drug combinations. Conclusion: Most of the hypertensive patients need combination treatment with antihypertensive agents. ARBs are the most preferred agents as monotherapy for the management of hypertension. ARBs are also very commonly used as a component of combination therapy during hypertension management.

How precise is manual CT-MRI registration for cranial radiotherapy planning

Manual fusion [MF] is a readily available image registration technique that does not require matching algorithms. The operator performs rigid-body transformations interactively. The precision of MF [as implemented on the Philips Pinnacle treatment planning system] was required for cranial CT-MR images used in radiotherapy planning for typical centrally located planning target volumes [PTVs]. A multi-stage MF procedure was developed which 11 observers followed to match the head contour, bones, soft tissues and contoured structures for 5 patient image-sets. Registration parameters were calculated by solving the transformation matrix following a consistent order of translations [T] and rotations [R]. The mean position of centre of each PTV averaged over all observers was used as the reference. The effect of misregistration on the PTV co-ordinates and the volume increase resulting from application of a margin for registration uncertainty were calculated. Mean intra- and inter-observer T/R SDs were 0.5mm/0.4, respectively. Mean intra- and inter-observer registration error and 1.1mm/1.0 [3D distance of each PTV centre from the mean position for all observers] was +/- 0.7 mm respectively, the latter reducing to 1.4 +/- 0.3 mm [1 SD] and 1.6 +/- 0.7 0.6 mm excluding the 3 least experienced operators. A subsequent 2 mm margin for misregistration on average increased the PTV volume by 27%. Moderately trained operators produced clinically acceptable results while experienced operators improved the precision. MF still has an important role in the registration of cranial CT and MR images for radiotherapy planning especially for under-resourced centers