Smoking and blood pressure levels in hypertensive patients: evaluating the role of gender, age and hypertension duration

Background: Hypertension is estimated to affect about 40% of adults above 25 years of age globally. While many of the risk factors of hypertension are well known, such is not the case with smoking. Pertinent published literature is heterogeneous, with a dearth of relevant local data. Objectives was to study the relationship between smoking and blood pressure levels in hypertensive patients and to assess the effects of gender, age and hypertension duration on such a relationship.Methods: A cross-sectional study was carried out on a total of 298 conveniently sampled patients, aged 18 or above, from the medical outpatient department of a secondary care hospital of Karachi. The relevant data were collected by means of a structured questionnaire whereas the blood pressure level was checked using sphygmomanometer with stethoscope. Mann Whitney U test was used for inferential analysis whereas the significance level was set at 0.05.Results: Overall, both the systolic and diastolic blood pressure levels were significantly associated with smoking history (p<0.05 for both) where they were found to be higher in smokers than in non-smokers. Furthermore, after gender, age and hypertension duration based stratifications; both the systolic and diastolic blood pressure levels were still significantly associated with smoking history in patients who were male, were ≥35 years old and had <5 years hypertension duration (p<0.05 for both) where they were again found to be higher in smokers than in non-smokers.Conclusions: The study results showed a significant association of positive smoking history with higher mean systolic and diastolic blood pressure levels, though after stratifying for gender, age and hypertension duration, this relationship persisted only in patients who were male, were ≥35 years old and had <5 years hypertension duration.

Strategies to cope claustrophobia during magnetic resonance imaging examination

Background: Claustrophobia associated with MRI scan is a well-recognized problem all over the world. The unpleasant psychological experience during MRI can lead to premature cancellation of the study resulting in non-interpretable data. In addition, performing future studies on the claustrophobic patient may not be possible leading to non-utilization of an important diagnostic modality. This study was conducted with the aim to determine a cheap and short intervention which can be applicable to small radiology set up as well.Methods: A prospective study was conducted at a tertiary care hospital from October 2016 to December 2016. Accompanying someone was the first strategy used to coped MR imaging claustrophobia followed by placebo (multivitamin), listening Quran and closed eye (blindfold). All those patients who failed to respond in these strategies were finally labeled as an unsuccessful candidate. Listening of Quran was selected as one of the tools as all the patients were Muslims in present study.Results: Among 84 claustrophobic patients, a closed eye was the most successful strategy found effective in (13) 81.2%, followed by placebo 66.7% patients, listening Quran (7) 30.4%, accompanying someone (15) 17.85% while 4% patients remained claustrophobic after application of all strategies. Significant association of accompanying someone and placebo was observed with education (p-value 0.037) and age of the patients (0.016) respectively.Conclusions: In general, placebo, being accompanied by someone and blindfold were found to be the most effective strategies to cope with MRI related claustrophobia. However, the success of these strategies is also dependent on certain factors like age, education status and socioeconomic status of the patients.

A Study Of Retromolar Foramen/canal In North Indian Population

The Retromolar foramen/canal are one of the non-metric variants of the mandible located in the retromolarfossa of the mandible behind the 3rd molar of mandible. These are obviously of profound dental and surgicalimportance. The aim of the study was to know the prevalence of retromolar canal/foramen in north Indianpopulation. In the present study, 35 dry mandibles of unknown sex of north Indian origin were examined bynaked eyes to know the incidence of retromolar foramen/canal. The retromolar foramen/canal was found in 6mandibles (17.14%), bilaterally in 2 mandibles and unilaterally in 4 mandibles. We conclude that retromolarforamen /canal is of profound clinical importance.

Is There Any Benefit of Drain Placement on Postoperative Complications in Patients Undergoing the Sistrunk Procedure?

Introduction Same-day, outpatient Sistrunk procedure is commonly performed to manage thyroglossal duct cyst anomalies and may lead to postoperative complications. Surgical drains are placed to prevent complications, but recent observations show no advantage and rather increased health care costs and patient discomfort. Objective The study evaluated if drain placement in the Sistrunk procedure offers any benefit on postoperative complications. Methods A retrospective analysis of patient records having undergone same-day, outpatient Sistrunk procedure from 2004 to 2014 was done. Of 58 (38 male and 20 female) patients included, 38 did not have drains placed and the remaining 20 had drains placed. Mean and median age of patients was 18.1 and 13.5 years, respectively. Postoperative complications of patients with drains versus those without drains were statistically analyzed. Results Overall, about 10% of patients had hematoma/seroma (H-S), with 6.9% of patients needing aspiration for H-S; 3.4% had wound infections; and 1.7% had pus formation. No statistically significant differences in Sistrunk-related complications between patient groups (with drain or without drain) were seen using Fisher exact (two-sided) test: H-S (p = 0.08); need for aspiration (p = 0.29); wound infection (p > 0.05); and pus formation (p = 0.35). Chi-square test also did not show any significant difference in the groups in terms of number of follow-ups. Conclusion Surgical placement of a drain in the Sistrunk procedure does not seem to offer any advantage in terms of reducing common postoperative complications. Sameday Sistrunk procedure without any drain placement may be a safer alternative without necessitating hospitalization. More studies with larger sample size are needed for further substantiation.(AU)

A Study of Zygomatico Facial Foramen in North Indian Crania.

Studies of non-metric cranial variants have been a field of considerable interest to research workers especially because of their racial and regional importance. 28 north Indian skulls of U.P. were studied for the zygomatico facial foramen, a cranial variant in the present study. Findings are discussed and compared with other global studies and are found to be of considerable regional and racial significance.

Correlation of Body Height By Foot Length and Knee Height Measurements in Population of North India.

Background: The body height measurement plays an important role in personal and medico legal identification and has become invaluable aid to scientific research in Anatomy, especially anthropological anthropometry. This study is conducted to find the correlation between body height and foot length & knee height measurements in both the sexes and to determine accurate and best predictor of height from above two parameters using Correlation Coefficient. Methods: Asymptomatic, healthy 1000 subjects (500 males and 500 females), residents of Teerthanker Mahaveer University of cosmopolitan origin age over 18 years old were studied. Their body height, Foot lengths and knee height were measured and all the readings were subjected to Statistical Analysis using mean + standard deviation, Pearson’s correlation coefficients and linear regression analyses. Result: In present study, correlation coefficients (r) values between body height, foot lengths and knee height were found to be statistically significant and positive in both males, females and in combined data, with highest ‘r’ value of knee height followed by foot lengths. Regression equations for estimating body height were developed for each of these parameters by Linear Regression. Conclusion: The study suggests the Knee height to be the best body height indicator developed for estimation of body height according to gender including age as a predictor variable in order to reduce the inherent problem of sample specificity and enhance accuracy confidence in the estimation.

Menstrual hygiene and sanitation practices among adolescent school going girls: a study from a South Indian town.

Background: Hygiene practices of women during menstruation are of importance as it has health impacts in terms of increased vulnerability to reproductive tract infection. Proper menstrual hygiene, correct perception and belief protect women folk from this suffering. This study is aimed to explore the knowledge, attitude, social practices during menstruation among adolescent secondary schoolgirls. Methods: This descriptive cross sectional study was undertaken among 150 adolescent school going girls by using provisional sampling in Thiruporur, India. Required data was collected through a pre-tested questionnaire during the study period and simple frequencies and comparative percentages were used to analyze the results. Results: Only 18.67% of adolescent girls had knowledge about menstruation before menarche. As high as 67% of them did not know the cause of menstruation. 23.33% of the girls believed that menstrual bleed comes from the same pathway from which urine comes. Nearly all girls (96.67%) reported sanitary pad usage during the duration of mensuration. Two-third (66%) of the girls were secluded during menstruation and majority (81.3%) were restricted to attend school. Conclusions: Though knowledge among the participant girls regarding mensuration and menstrual hygiene was not adequate, it was satisfactory to find that the sanitary pad usage among the sample was 100% due to government services which are provided free of cost. Definitely, it will improve the menstrual status of the girls from cloth to a safer sanitary absorbent usage.

Hepatitis B Seroconversion after Vaccination in Infants in Rural and Urban Areas of Rawalpindi, Pakistan.

Purpose: This study was designed to evaluate the immunogenicity of hepatitis B vaccine in infants of rural and urban Pakistan and to find out the vaccine efficacy. Methods: A sample of 400 subjects was taken by simple random method from the rural and urban areas (200 from Rural and 200 from urban areas) of Rawalpindi District Pakistan. The serum samples were analyzed by Enzyme Linked Immunosorbant assay (ELISA) for the quantitative determination of antiHBs antibodies. Results: As 88 (22%) infants out of the total 400 were found to be seropositive at baseline. The post vaccination results showed that about 15 (7.53%) of infants had inadequate levels of antibodies (i.e. <10 IU/L). Overall 92.46% infants showed a positive response to the vaccine. The females showed higher titers of antiHBs against vaccination as compared to that of males. Infants of urban areas showed higher titers as compared to that of rural areas. Conclusion: Our results reinforces that the Hepatitis B vaccine has a good tolerability and is highly immunogenic among infants. It is recommended that serosurvey of HBsAg and vaccine coverage at country level should be done.