Prevalence of Hypertension and Risk Factors associated with it in Subjects attending Health Camp in Rishikesh, Uttarakhand

Background: One of the most important causes of death in the world is hypertension and its epidemic seems to be growing. By the year 2025, around 1.5 billion adults will be living with hypertension. Aim & Objectives: To find prevalence of hypertension in subjects attending a health screening camp at SPS government hospital, Rishikesh and to identify various risk factors related to hypertension. Material & Methods: A cross-sectional study was conducted among subjects attending a health screening camp at SPS Government hospital, Rishikesh. The camp was conducted for seven days period, from 11th October- 17th October, 2017. All subjects that attended the health camp and were either 30 years old and/or above were included in this study. An informed written consent was taken from all subjects that consented to participate in this study after explaining to them the purpose of the study. A questionnaire that was predesigned, pretested, structured was used to obtain demographic data, personal data and history of hypertension in the family, behavioural aspects, including, use of tobacco, alcohol and dietary habits. Blood pressure (BP) and anthropometric measurements were also recorded in this study. Total of 207 people attended the health camp, from which 196 agreed to participate in study. Results: Out of total of 207 people that attended the camp, 196 people gave their consent to participate in the study. In this study, out of 196 subjects 66 (33.7%) were found to be hypertensive. Risk factors like increasing age, family history of hypertension, increased BMI and waist hip ratio, use of tobacco and alcohol and increased blood sugar levels were found to be associated significantly with hypertension. Conclusion: There is high prevalence of hypertension in Rishikesh. Efforts are required to regularly screen for blood pressure at the community level to help tackle this iceberg disease.

Plasma chitotriosidase activity in children with lysosomal storage disorders.

Chitotriosidase (ChT) is an enzyme that is selectively activated in tissue macrophage. This property of ChT makes it a potential marker for many disease process and prognostication. Present study has been carried out to know the significance of ChT as a screening marker in lysosomal storage disorders (LSDs) where tissue macrophage activation is commonly observed due to accumulation of substrate in various organs of the body. Study comprises of 20 healthy children in the age range of 10 days to 5 yrs and 56 children in the age range of 2.5 months to 13 yrs with regression of milestones, skeletal dysplasia, neuroregression and hepatosplenomegaly were selected for plasma ChT who had confirmed LSDs as carried out by specific lysosomal enzyme study from the leukocytes or fibroblasts. Plasma ChT was 55.21 ± 20.81 nmol/ml /hr in twenty healthy age matched controls. Plamsa ChT level was 42.88 to 79.78 nmol/ml/hr in thirteen of 56 (23.21%) children with LSDs like Morquio- B, Pompe, Metachromatic leucodystrophy (MLD), Sandhoff and Niemann-Pick disease type C (NPD-C). While in 43 (76.78%) children it was in the range of 213.74 to 23,511.40 nmol/ml/hr. who had LSDs like Morquio-B, Sly syndrome, MLD, GM2 Gangliosidosis, NPD-A/B and Gaucher disease (GD). Marked elevated ChT (4,000 to 23,511 nmol/ml/hr) was observed in all cases of GD (n=7) and NDP-A/B. It can be concluded from the present study that moderately raised activity of ChT can be utilized as a positive predictive test for certain LSD’s. Those with marked elevated ChT have confirmed GD or NPD-A/B making it a strong screening marker for this group of diseases.

Role of intrauterine Rubella infection in the causation of congenital deafness.

Background : Rubella is a contagious viral infection associated with rash. 10-15% of women are susceptible to this infection in their childbearing years and the disease is usually transmitted to the developing fetus causing abortion or stillbirth or congenital Rubella syndrome (CRS). Sensorineural hearing loss is one of the most common abnormalities associated with CRS. Aims : The study was undertaken to determine the prevalence of Rubella induced congenital deafness in south India. Materials and Methods :The present study is carried out on 1076 hearing impaired children below 14 years of age to determine etiological factors for congenital hearing impairment. Various audiometric tests such as PTA, OAE and BERA were carried out to know the type and degree of hearing impairment. Development histories including the prenatal, perinatal and postnatal histories were collected using a standard questionnaire. Results :The results indicated very less percentage (1.57%) of cases with the history of maternal Rubella infection indicating a significant reduction of Rubella-induced deafness in the developing countries. Conclusions : The main reason behind the low percentage of children with rubella- induced hearing impairment may be due to appropriate immunization of mothers to the rubella infection during their child bearing years. The increasing awareness in the developing countries of this infection and its consequences is another important reason behind the low percentage of the affected population.

Fetal cells in maternal blood for prenatal diagnosis.

Advances in molecular genetics have led to prenatal DNA diagnosis, using either invasive or noninvasive approach. Fetal cells are one of the sources for prenatal diagnosis. Standard prenatal genetic diagnosis currently involves chorion villus sampling (CVS) or amniocentesis, which are invasive techniques. Noninvasive methods such as maternal serum biochemical screening (triple markers) in combination with ultrasonography can now detect a large percentage of chromosomal and congenital anomalies. However their lack of optimal specificity and sensitivity compels the use of invasive techniques, which pose a small but significant risk of pregnancy loss. The presence of fetal cells in maternal circulation as early as 6 weeks of gestation has opened new avenues of noninvasive approach to prenatal diagnosis in identifying successfully both Chromosome and molecular genetic abnormalities. Several attempts have been made to detect and retrieve fetal nucleated cells including nucleated erythrocytes (NRBCs), leucocytes and trophoblasts in maternal blood. A number of clinical and laboratory studies are continuing throughout the world to determine the feasibility of isolation of fetal cells from maternal blood and its subsequent use in genetic diagnosis by FISH and PCR technology. This article thus reviews the latest literature on fetal cells from maternal blood with an intention of pursuing research with this novel noninvasive approach, which is the need of today in India.