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Peripartum cardiomyopathy (PPCM) is an unusual form of dilated cardiomyopathy which manifests as acute heart failure in the last trimester of pregnancy or early postpartum period. Choice of anaesthesia is based on the urgency of lower segment caesarean section and severity of PPCM. Here we report a 31year old female G3P2L2 36weeks + 2days diagnosed as Peripartum Cardiomyopathy came with complaints of leaking per vagina was taken up for emergency caesarean section under general anaesthesia. In this case report, we discuss the anaesthetic management of a case of PPCM posted for emergency caesarean section with intra-operative event of desaturation. Anaesthetic management was directed towards optimization of desaturation, myocardial contractility, preload and after load. No adverse events or complications were observed.
RESUMO
Background: Hypertension seen in childhood can progress into adulthood thereby increasing morbidity and mortality due to cardiovascular diseases in adulthood. Younger the age of onset of hypertension, the greater is the reduction of life expectancy if left untreated. With increase in incidence of elevated blood pressure and hypertension in children; it is important to measure and record blood pressure along with weight and height at least once a year as recommended by National Institute of Health (NIH) task force of USA. Aims and objectives was to determine the prevalence of pre-hypertension and hypertension and to identify the associated risk factors for them in school going adolescents.Methods: An observational/cross-sectional study conducted among adolescents studying between Std 5th to Std 9th. A total 507 students belonging to the age group of 10-17 years were examined. Anthropometric measurements were taken to calculate Body Mass Index (BMI) and Blood pressure was measured by using mercury sphygmomanometer. Gender, age and height were considered for determining hypertension.Results: Amongst the 507 children, prevalence of pre-hypertension was 15.4% and that of hypertension was 10.85%. The study also revealed statistically significant higher prevalence of hypertension in males than in females. Family history of hypertension and dietary habits, obesity were positively correlated with higher prevalence of hypertension. A higher prevalence of pre-hypertension and hypertension was seen in the present study group compared to the similar studies in the state.Conclusions: The prevalence of pre-hypertension and hypertension among adolescent school children was 15.38% and 10.8% respectively. Possible risk factors for this current trend may be the increasing sedentary life style, faulty eating habits, and increased fat/salt contents of diet. The results suggest the need for more public awareness and prevention programs for childhood obesity and hypertension.
RESUMO
BACKGROUND: Human immunodeficiency virus (HIV) observational cohorts, which are established worldwide, support comparative studies across different regions. They have played an important role in developing international and country-specific HIV treatment and care guidelines. We describe the YRG CARE Chennai HIV observation database (YCHOD) and highlight its utility in monitoring trends in antiretroviral treatment use and HIV disease outcomes in India. METHODS: The baseline characteristics, time trends in antiretroviral treatment, trends in incidence of acquired immune deficiency syndrome (AIDS)-defining illness and mortality following the introduction of highly active antiretroviral therapy (HAART) in India were assessed using YCHOD. RESULTS: Till January 2005, 7647 HIV-positive patients had registered in YCHOD. A majority of the patients were men (69%) and had a mean age of 32 years. At baseline, 14% had an existing AIDS-defining illness. Among patients who required therapy by the WHO criteria, 14% initiated antiretroviral therapy (ART) in 1996 and 35% in 2000. Since the dramatic cost reduction of generic HAART in 2001, there has been an increase in the proportion of patients receiving ART to 57% in 2004. In patients who were started on HAART, the incidence of at least one AIDS-defining illness was 2% in 2001, and this decreased to 0.48% in 2004. CONCLUSION: We feel observational cohorts are useful as a surveillance tool for monitoring trends in treatment and disease progression. Standardized observational data collected systematically on HIV-infected individuals will help to assess the cost-effectiveness of ART and in planning ART strategies for India.