Management of hypertension: focus on current treatment algorithms.

One of the main obstacles in the treatment of hypertension is the largely asymptomatic nature of the disease, even with marked elevation in systemic blood pressure. This disconnect between symptoms and long term adverse consequences has earned hypertension the designation, “silent killer”. Fortunately, the number and spectrum of agents available to treat patients with hypertension have expanded dramatically over the past 2 decades. Current treatment algorithms recognize that any given drug will likely have effect on more than one of the interrelated systems that regulate circulatory functions.

Effects of yoga and physical exercise on cardio-respiratory parameters.

Background: Yoga includes combination of postural exercise (Asanas),Voluntary breathing exercise (pranayam) & relaxation techniques. The comparative study about effects of regular practice of yoga & physical exercise on cardio-respiratory functions and respiratory pressures (MIP,MEP) is very important to better understand it’s effect on health. Method: 200 healthy volunteers (146M-54F) from age group (17 -26)years were included in the study.They were divided in to two groups. Gr A Yoga group(n=100),Gr B Physical exercise group(n=100). Yoga group practiced some yoga exercises including Asanas,Pranayam & relaxation postures daily one hour for 3 months.While Physical exercise group practiced slow walk,calisthenic exercise & stretching exercises daily 1 hour for 3 months. Following parameters were recorded at start & end of the study. Resting cardiovascular parameters including HR,BP,PP,MAP,RPP & DoP were recorded. Pulmonary parameters (FVC,FEV1,FEV1/FVC,PEFR,MVV) were recorded. Apart from this MIP,MEP & 40mmhg endurance test were also recorded .Result: Yoga group shows significant reduction in Heart rate (p<.01),SBP & DBP (p<.05), MAP(p<.01),while exercise group shows only decreasing trend. FVC & FEV1 inreased significantly after yoga training. FEV1/FVC, PEFR & FEF25-75% shows increasing trend in both the groups,but only exercise group shows significantly raised PEFR & FEF25-75%. MVV was significantly improved in yoga group. MIP,MEP were significantly increased after yoga training. Timing of Respiratory Endurance test was also significantly raised(p<.05) in yoga group. Conclusion: 3 moths Yoga training produces a significant improvement in respiratory pressures (MIP,MEP), spirometric values.

Association Between ABO Blood Groups And Myocardial Infarction In Jodhpur City of India.

Background: Many reports have appeared in recent years showing an association between blood groups and Myocardial Infarction. Clinical studies have shown a significant association between MI and blood group B. Objective: To investigate correlation of ABO blood groups with risk of MI. Methods: The present cross sectional study analyzed ABO blood group among total 400 subjects of any age from the local population of Jodhpur city from July to December 2011.Among them 200 subjects were normal healthy(135 male and 65 female) students of Dr. S.N. Medical College, Jodhpur and another 200(135male, 65female) were MI patients admitted in the CCU of Mathura Das Memorial(MDM) Hospital, Jodhpur. ABO blood group of all subjects were determined by slide agglutination method. Risk of MI was expressed by risk ratio. Data were analyzed by one sample chi square test. Results: The results obtained in this study showed that the prevalence of MI in blood group B is significantly higher than in all other ABO blood groups. Conclusion: The results may conclude that there is a significant association between MI and blood group B. So this study reveals MI risk is associated with the blood group B.

Study On Harmful Effects Of Opium On Liver And Lungs In Chronic Opium Addicts Of Western Rajasthan.

Background: Today opium dependence is widely prevalent in certain states of India, especially Rajasthan, Punjab, Haryana, Madhya Pradesh (MP) etc. In rural areas of western Rajasthan crude opium is consumed with a social acceptance by a notable proportion (8.0%) of adult male population. Later on they become addicted to it. Objective: to observe the changes in some liver and lung function parameters in opium addicted subjects of Barmer city of Western Rajasthan. Methods:The present study was conducted in district hospital of Barmer, Rajasthan. Total fifty (50) adult male subjects with age ranged from 30 to 50 years were participated in this study. Among them 25 were opium addicted and were considered as study group (Group B) and another 25 apparently healthy adult male of same age group were designated as control group (Group A). Opium addicts were consuming about 5–11 gm/day opium for >2 years. Then liver function tests were evaluated by estimating serum aspartate amino transferase (AST), alanine amino transferase (ALT), alkaline phosphatase and lung function tests by measuring FVC, FEV1 , FEV1/FVC% , PEF, FEF 25-75% of both the groups. Results: In this study AST, ALT and alkaline phosphatase levels were found significantly (p<.05) higher in group B as compared to those of group A. Again, FVC, FEV1, FEV1/ FVC were significantly (p<.05) lower in group B as compared to those of group A. PEF (L/sec) and FEF25-75% were also significantly (p<0.001) lower in group B as compared to those of group A. Conclusion: it is concluded that chronic long term use of opium, increases the risk of hepatic and pulmonary damage.

Beneficial Effect Associated with Use of Watery and Alcoholic Extract of Garlic as a Supplement in Hyperlipidemic Guniea Pigs.

Background: Garlic is naturally occurring sulphur containing dietary agent belong to Allium family. Members of this family i.e. Garlic, Onions are found to have beneficial effect on atherosclerosis and ischemic heart diseases in both experimental animals and in human beings. Objective: To compare the potency of garlic as antihyperlipidemic and antiplatelet and antithrombotic between its watery and alcoholic extract for their effects. Methods: 25 guinea pigs were fed cholesterol (0.5g/kg body weight) for an initial period of 4 weeks. Cholesterol was then discontinued and the animals were divided into 3 groups. Group-I (n=7) was fed with stock diet and was taken as control. Group-II (n=9) was given 1ml of watery extract and Group-III (n=9) was fed with 1ml of alcoholic extract of garlic with normal diet daily for 4 weeks. The garlic content of both the extract was 2 gm/ml by wt/vol. Fasting blood samples were collected at the end 4 weeks and finally at the end of the study i.e.8 weeks for estimation of serum cholesterol, serum triglyceride, LDC-C, HDL-C, VLDL-C,atherogenic index and platelet adhesiveness index. Bleeding time and clotting time were also detected in all the 3 groups.Results: In the present study, the watery and alcoholic extract of garlic shows significant hypolipidemic activity as they reduced significantly serum cholesterol, serum triglyceride, LDC-C, VLDL-C and atheriogenic index in hyperlipidemic guinea pigs (p<0.01) compared to control. The significant rise in HDL-C was observed in group II but not in group III animals. On comparison between two extracts, watery extract of garlic was more potent hypolipidemic agent, compared to alcoholic extract. Both extract significantly reduces platelet adhesiveness and bleeding time. But between two extract the watery extract was found more potent anti-thrombotic agent as it showed significant decrease in platelet adhesiveness (P<0.01). BT was significantly increased in group II compared to group I and III. Conclusion: It can be concluded that watery extract of Allium Sativum is more potent hypolipidemic and antiplatelet, and anti-thrombotic agent.

Physiology of Starvation and Refeeding Syndrome.

Refeeding syndrome represents a series of metabolic complications that sometimes results by provision of nutrients, primarily carbohydrate, to a patient in a nutritionally compromised state. Refeeding syndrome is associated with hypophosphatemia, hypokalemia and hypomagnesaemia, fluid retention and vitamin deficiencies including thiamin are also of concern. If severe, refeeding syndrome may result in respiratory, cardiac, and neuromuscular dysfunction, especially in the stressed, elderly, or severely malnourished patient. This article discuss the physiology of starvation and the pathophysiology behind refeeding syndrome, identify the patients at greatest risk, and provide practical tips for prevention. As increased awareness and understanding of refeeding syndrome may help, prevent further such incidents and clinicians learn to recognize patients at risk and avoid overaggressive nutrition support regimes.