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1.
Article | IMSEAR | ID: sea-194491

Résumé

Hypertension, often referred to as ‘The silent killer’, is christened so, as it is seldom preceded by any warning signs or symptoms. With the new ACC/AHA guidelines lowering the Blood Pressure (BP) threshold values, it has resulted in a 140% relative increase in the hypertension prevalence in India, which is 3 times higher than that of in United States. Imidazoline receptor agonists control BP effectively with minimal adverse effects of sedation and mental depression that are usually associated with centrally acting antihypertensives. While having a low affinity to the α2-adrenergic receptors, these new generation centrally acting antihypertensive agents are highly selective for imidazoline receptor. Moxonidine, a second-generation centrally acting antihypertensive drug having selective agonist activity on imidazoline I1 receptors and minor activity on imidazoline α2 adrenoceptors, reduces the activity of Sympathetic Nervous System (SNS) by activating I1 imidazoline receptors in Rostral Ventrolateral Medulla (RVLM). Studies of moxonidine have shown equal effectiveness in lowering BP like other well-established antihypertensive drugs such as nifedipine, atenolol or angiotensin-converting enzyme inhibitors, with minimal adverse events. At doses of 0.2-0.6 mg, moxonidine induces satisfactory BP reduction in patients with mild-to-moderate essential hypertension. In patients with mild-to-moderate hypertension, moxonidine (0.2-0.4 mg o.d.) significantly decreased Systolic Blood Pressure/Diastolic Blood Pressure (SBP/DBP), respectively, by 19.5/11.6 mmHg. In obese, non-controlled hypertensive patients, there is a 14% and 13.5% reduction in the mean SBP and DBP, respectively, from the baseline value after moxonidine treatment and during the follow-up with an additional reduction in body weight, plasma leptin levels and Body Mass Index (BMI) (p<0.01). Thus, moxonidine could be considered as a therapeutic option in obese patients with metabolic syndrome.

2.
Ann Card Anaesth ; 2015 Apr; 18(2): 265-266
Article Dans Anglais | IMSEAR | ID: sea-158194
3.
Indian J Public Health ; 2013 Jul-Sept; 57(3): 183-184
Article Dans Anglais | IMSEAR | ID: sea-158666
4.
Ann Card Anaesth ; 2013 Jan; 16(1): 63-65
Article Dans Anglais | IMSEAR | ID: sea-145397

Résumé

Antagonists of vitamin K dependant clotting factors are commonly used as treatment/prophylaxis for anticoagulation. Due to their narrow therapeutic window, a wide range of complications including death may occur. International normalized ratio (INR) is monitored to measure adequacy/excess of anticoagulation. There is a plethora of risk factors that may contribute to the uncontrollably high INR values. We describe our experience of a case of deep venous thrombosis wherein the patient had an overshoot of INR during anticoagulation therapy. We review the literature and discuss management in such scenarios.


Sujets)
Coagulation sanguine/effets des médicaments et des substances chimiques , Coagulation sanguine/prévention et contrôle , Troubles héréditaires de la coagulation sanguine/prévention et contrôle , Facteurs de la coagulation sanguine/effets des médicaments et des substances chimiques , Humains , Rapport international normalisé/statistiques et données numériques , Vitamine K/antagonistes et inhibiteurs
5.
Ann Card Anaesth ; 2012 Oct; 15(4): 279-286
Article Dans Anglais | IMSEAR | ID: sea-143920

Résumé

Acute kidney injury (AKI), a recognized complication of cardiac surgery with cardiopulmonary bypass (CPB) is associated with increased morbidity and mortality (15-30%) with approximately 1% of all the affected patients requiring dialysis. Early detection of AKI would enable intervention before occurrence of irreversible injury and might minimize the morbidity and mortality. Recently developed biomarkers of AKI facilitate its earlier discovery and help assessment of its severity and prognosis. In this article, we review the causes of well-known yet inexplicable association between CPB and AKI, the advances in pathophysiologic basis, the diagnostics and the management options.


Sujets)
Atteinte rénale aigüe/étiologie , Atteinte rénale aigüe/thérapie , Marqueurs biologiques , Procédures de chirurgie cardiaque/effets indésirables , Procédures de chirurgie cardiaque/mortalité , Pontage cardiopulmonaire/effets indésirables , Pontage cardiopulmonaire/mortalité , Humains , Morbidité , Mortalité , Dialyse rénale/méthodes , Chirurgie thoracique/effets indésirables , Chirurgie thoracique/complications , Chirurgie thoracique/mortalité
6.
Indian J Med Sci ; 2012 Sept-Oct; 66(9) 245-246
Article Dans Anglais | IMSEAR | ID: sea-147849
8.
Ann Card Anaesth ; 2012 Jan; 15(1): 86-87
Article Dans Anglais | IMSEAR | ID: sea-139643
10.
Ann Card Anaesth ; 2011 Sept; 14(3): 242-243
Article Dans Anglais | IMSEAR | ID: sea-139621
12.
Indian J Public Health ; 2010 Oct-Dec; 54(4): 228
Article Dans Anglais | IMSEAR | ID: sea-139313
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