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1.
Article Dans Anglais | IMSEAR | ID: sea-92651

Résumé

OBJECTIVES: To study the clinical profile of hypertension in the elderly, development of end organ complications and the effect of hypertension with other risk factors in producing these complications. METHODS: One hundred and thirty six elderly patients attending the Hypertension Clinic were included in the study. A detailed history was taken that included presenting illness, family history of hypertension, diabetes, coronary artery disease, dyslipidaemia and history of addictions. Physical examination included systemic examination with measurement of waist to hip ratio and fundoscopy for retinopathy. Renal and liver function tests (RFT, LFT), blood sugar, lipid profile, X-ray chest, electrocardiography (ECG), 2-D echocardiography, abdominal ultrasound and computed tomography (CT) scan head (if indicated) were other important investigations done. RESULTS: Seventy-nine patients were in the age group of 60-65 years, of which 42 (30.9%) were males. Headache was the commonest chief complaint in 77.9% patients; whereas 24 patients were asymptomatic. Obesity, diabetes, alcohol, dyslipidaemia and family history were important determinants of hypertension. Lipid profile was abnormal in 55.9% patients. Isolated systolic hypertension (ISH) was found in 56.6% patients. Grade II hypertensive retinopathy was observed in 29.4% patients with uncontrolled blood pressure. Left ventricular hypertrophy (LVH) was the commonest ECG manifestation seen in 36.8% patients of which 26.5% had uncontrolled blood pressure. LVH could be diagnosed in 46.4% patients by 2-D echo. Patients with uncontrolled blood pressure and ISH had increased incidence of cardiovascular and cerebrovascular complications. Cardiovascular complications were seen in 19.1% patients having dyslipidaemia and hypertension. Cerebrovascular complications were seen in 15.4% patients having hypertension with LVH. Treatment included calcium channel blockers and/or other drugs. CONCLUSIONS: The elderly hypertensive patients tend to have ISH. Family history of hypertension is an important determinant of hypertension. Uncontrolled hypertension, ISH, LVH and other associated risk factors are responsible for cardiovascular and cerebrovascular morbidity.


Sujets)
Répartition par âge , Sujet âgé , Antihypertenseurs/administration et posologie , Études de cohortes , Femelle , Humains , Hypertension artérielle/diagnostic , Incidence , Inde/épidémiologie , Mâle , Adulte d'âge moyen , Pronostic , Facteurs de risque , Indice de gravité de la maladie , Répartition par sexe
2.
Article Dans Anglais | IMSEAR | ID: sea-86819

Résumé

A reliable method for identification of the subset of population predisposed to coronary heart disease (CHD) would aid a targetted implementation of intervention strategies. To this end, a mathematical formula was developed based on stepwise linear discriminant analysis. Age, body mass index, the number of associated coronary risk factors and a large number of biochemical markers were analysed by computerised discriminant analysis on a test sample of 203 subjects. Unstandardised canonical discriminant coefficients of statistically significant independent variables were used to derive the total discriminant score or the 'risk score'. The 'low-risk' persons not in need of immediate preventive measures of CHD could be distinguished from the 'high-risk' individuals with an almost 90% correctness. As compared with the existing methods such as clinical evaluation and cardiac stress test, the risk scores derived by the new method, and based chiefly on blood markers besides clinical and anthropometric variables, appeared to correctly predict the future coronary episodes in members of the test sample selected at random. The risk scores were also tested on a new sample of 50 subjects; while low scores were not associated with CHD, high scores in some patients were associated with myocardial ischemia. It appears that the preventive measures of CHD may be directed at people who have no clinical manifestations of CHD, but whose risk scores are greater than 0.1. On the other hand, if the score is less than -1.0, immediate preventive measures may not be necessary. If the score is between -1.0 and 0.1 (borderline), no immediate action may be taken but the score may be determined after six months, and action taken accordingly.


Sujets)
Facteurs âges , Algorithmes , Anthropométrie , Marqueurs biologiques/sang , Indice de masse corporelle , Maladie coronarienne/sang , Complications du diabète , Analyse discriminante , Épreuve d'effort , Femelle , Prévision , Humains , Hypertension artérielle/complications , Modèles linéaires , Mâle , Adulte d'âge moyen , Analyse multifactorielle , Ischémie myocardique/sang , Reproductibilité des résultats , Facteurs de risque , Fumer/effets indésirables
5.
Article Dans Anglais | IMSEAR | ID: sea-92605

Résumé

The predictive association of triglyceride (TG) in coronary heart disease (CHD). In patients without CHD levels were elevated in those coronary risk factors, as compared to those without the risk factor the elevation of TG may occur in asymptomatic subjects before the onset of clinical manifestation of CHD. The high-risk, asymptomatic subjects with high levels of TG may be on the "threshold" of the sysptomatic phase of CHD. The levels had a positive correlation with body mass index and increased with increasing number of coronary risk factors.


Sujets)
Adulte , Sujet âgé , Indice de masse corporelle , Maladie coronarienne/sang , Électrocardiographie , Épreuve d'effort , Femelle , Humains , Mâle , Adulte d'âge moyen , Facteurs de risque , Triglycéride/sang
10.
Article Dans Anglais | IMSEAR | ID: sea-87202

Résumé

A case of Hypokalemic paralysis is reported which had an atypical onset and clinical features. The paralysis totally recovered on replacement of potassium.


Sujets)
Adulte , Humains , Hypokaliémie/complications , Mâle , Paralysie/traitement médicamenteux , Potassium/usage thérapeutique
11.
Article Dans Anglais | IMSEAR | ID: sea-88333

Résumé

Total anomalous pulmonary venous connection (TAPVC) is an uncommon cyanotic heart disease and survival beyond infancy is rare. We report a patient of TAPVC of the supracardiac variety who has survived till the age of 50 years without surgery.


Sujets)
Échocardiographie , Cathétérisme cardiaque , Cardiopathies congénitales/diagnostic , Communications interauriculaires/diagnostic , Humains , Mâle , Adulte d'âge moyen , Veines pulmonaires/malformations
12.
Article Dans Anglais | IMSEAR | ID: sea-94139

Résumé

A rare form of plasma cell dyscrasia, primary plasma cell leukemia is presented. The clinical picture resembled an acute leukaemia with a fulminant course and a rapidly fatal outcome.


Sujets)
Humains , Leucémie à plasmocytes/diagnostic , Mâle , Adulte d'âge moyen
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