Effects of diet on hypertensive disorders during pregnancy: A cross-sectional study from a teaching hospital.

BACKGROUND: Pregnancy is a positive, fulfilling experience for many, but it can put the mother at the risk of suffering ill-health, disability, or even maternal death. The common causes of maternal death include pregnancy-induced hypertension (PIH) or gestational hypertension or hypertensive disorders in pregnancy (HDP), post-partum hemorrhage, and pulmonary embolism. Modifications in lifestyle and diet have been widely advocated as a cost-effective strategy to prevent PIH. OBJECTIVES: To assess the role of dietary factors in PIH attending antenatal care services at a teaching hospital. MATERIALS AND METHODS: Pregnant women who were attending the antenatal clinic who were diagnosed with hypertension in pregnancy and normotensive before the pregnancy were included in the study. As per the protocol, informed written consent, demographic details with clinical data were obtained from the patients. A total of 225 antenatal cases having hypertension in pregnancy were included in our study. RESULTS: Majority of the study subjects (81.8%) were taking mixed diets, 50.2% consumed additional salt in their diet, the intake history of visible fat was given by 25.3% and 96.4% consumed tea while 52.9% had a history of consuming junk food. Among the 41 vegetarian study subjects with hypertension in pregnancy, the maximum subjects (73.1%) had preeclampsia followed by gestational hypertension in 23.6% the subjects. The relation between the type of diet and hypertension in pregnancy was found to be statistically insignificant. The relation between visible fat consumption and hypertension in pregnancy was found to be statistically significant. DISCUSSION: The association of dietary factors with HDP could be explained by several factors. One being the high-calorie intake by women with known HDP and those without HDP. The imbalance between the energy intake and expenditure is a potential risk factor and leads to overweight or obesity. CONCLUSION: The consumption of additional salt in the diet, visible fat, and obesity was found to be associated with HDP in our study.

Amended GWO approach based multi-machine power system stability enhancement.

The conception of electromechanical oscillations initiates in the power network when there is an installation of the generator in parallel with the existent one. Further, the interconnection of multiple areas, extension in transmission, capricious load characteristics, etc. causes low-frequency oscillations in the consolidated power network. This paper proposes variants of a booming population-based grey wolf optimization (GWO) algorithm in the tuning of power system stabilizer parameters of a multi-machine system in damping low-frequency oscillations. The parameters have been tuned by framing an objective function considering the improving damping ratios for the system states with lesser damping ratios and shifting the system eigenvalues towards the left-hand side of s-plane for the improved settling characteristics for the oscillations in the system. The requisites of stabilizer strategy are mapped with the hallmarks of prevalent algorithms and designed hybrid versions of GWO for the enhancement of the multi-machine power system stability. Four variants of GWO technique are nominated based on the competent stabilizer performance namely, modified grey wolf optimization (MGWO), hybrid MGWO particle swarm optimization (MGWOPSO), hybrid MGWO sine cosine algorithm (MGWOSCA) and hybrid MGWO crow search algorithm (MGWOCSA) for the designed multi-machine power network. The proposed methods have been realized with the statistical analysis on the 23 benchmark functions. Nonparametric statistical tests, namely, Feidman test, Anova test and Quade tests, have been performed on the test system, further analysed in detail. A detailed comparative analysis under the self-clearing fault is presented to illustrate the suitability of the proposed techniques. For the analysis purpose, the location of system eigenvalues has been observed along with their oscillating frequencies and corresponding damping ratios. Further, the damping nature offered with considered system uncertainty for the system states also presented with the PSS parameters obtained by the proposed algorithms.

Identifying the risk factors for the prevention of hypertensive disorders in pregnancy in a tertiary care hospital: A cross-sectional study.

INTRODUCTION: Hypertensive disorders in pregnancy accounts for maternal morbidity and mortality globally. AIM AND OBJECTIVES: We conducted this study to know the demographic profile and risk factors pertaining to lifestyle and behavioral aspects for hypertension among the pregnant women. METHODOLOGY: It was a hospital-based cross-sectional study. During the routine antenatal checkups, those antenatal cases found hypertensive, were included in the study after taking written consent. A semi-structured questionnaire was prepared and pretested before conducting the actual study. Statistical analysis was done by SPSS (version 17) software. Participants' sociodemographic characteristics were described using descriptive statistics. Results are presented using graphs, tables, mean, percentages, standard deviation, frequency, and significance. RESULTS: We observed that most of the study subjects 110 (48.9%) were educated up to secondary level followed by primary level 47 (20.9%) while 25 (11.1%) of the subjects were illiterate. We also found that 113 (50.2%) of the study subjects consumed additional salt in their diet and 57 (25.3%) of the study subjects had a history of intake of visible fat. Among 225 study subjects, 174 (77.3%) did not consume tobacco in any form. Among the 225 study subjects, 142 (60.9%) did not have a family history of hypertension. It was observed that 121 (53.77%) subjects had normal BMI while 16 (7.11%) subjects were underweight while 51 (22.6%) subjects were pre-obese. A total of 32 (14.22%) subjects were obese class 1 followed by 5 (2.22%) subjects who were obese class 2. It was observed that among 225 study subjects, 155 (68.9%) subjects had mild hypertension while 70 (31.1%) subjects had severe hypertension. DISCUSSION: The scarcity of data regarding hypertension in pregnancy in low and middle income countries despite this, a comparatively high prevalence of hypertension in pregnancy was observed due to behavioral risk factors, which is mostly preventable at the primary care level. RECOMMENDATIONS: It is possible to prevent PIH by eliminating behavioral risk factors through education and counseling to the pregnant ladies, at the primary care level by family physicians or primary care physicians which will reduce maternal mortality to a great extent.

Serum bile acid patterns are associated with the presence of NAFLD in twins, and dose-dependent changes with increase in fibrosis stage in patients with biopsy-proven NAFLD.

BACKGROUND: The fasting-state serum bile acid profile in nonalcoholic fatty liver disease (NAFLD) has been reported to differ when nonalcoholic steatohepatitis is compared to nonalcoholic fatty liver. However, there are few data comparing changes in NAFLD vs non-NAFLD, or whether the bile acid profile differs according to the degree of fibrosis. AIM: To examine the serum bile acid profile across the entire spectrum of NAFLD. METHODS: We performed a cross-sectional analysis of two complementary cohorts: a Twin and Family cohort of 156 participants, and a biopsy-proven-NAFLD cohort of 156 participants with fasting bile acid profiling using liquid chromatography/mass spectrometry. RESULTS: In the Twin and Family cohort (mean age 46.3 years and body mass index (BMI) 26.6 kg/m2 ), 36 (23%) participants had NAFLD (magnetic resonance imaging proton density fat fraction ≥ 5%). Higher chenodeoxycholyl conjugates (9.0% vs 6.5%, P = 0.019) and lower glycohyocholate (1.2% vs 3.6%, P < 0.001) were observed in NAFLD compared to non-NAFLD-controls. In the biopsy-proven-NAFLD cohort (mean age 49.8 years, BMI 32.0 kg/m2 ), no differences in total bile acid were seen between nonalcoholic fatty liver vs nonalcoholic steatohepatitis. The total unconjugated bile acid significantly decreased across nonalcoholic steatohepatitis categories (P = 0.044). The distribution of stage of fibrosis was F0: 42.3%, F1: 32.7%, F2: 10.3%, F3: 8.3% and F4: 6.4%. The total serum bile acid increased with increase in fibrosis stage (P < 0.001). The primary conjugated bile acid proportion increased (P < 0.001) whereas unconjugated bile acid (P = 0.006), unconjugated cholyl (P < 0.001) and chenodeoxycholyl conjugates (P < 0.002) significantly decreased with increase in liver fibrosis stage. CONCLUSIONS: Fasting-state serum bile acid profile alterations are seen across the entire spectrum of NAFLD. The total serum bile acids did not differ significantly between NAFLD vs non-NAFLD and nonalcoholic fatty liver vs nonalcoholic steatohepatitis, but were significantly perturbed progressively as liver fibrosis increases.

Clinical profile of dengue fever and coinfection with chikungunya.

OBJECTIVE: Arthropod-borne viral diseases are a major burden on the health-care system worldwide. Only a few studies have reported on coinfection of dengue fever (DF) with the chikungunya virus in North India. We investigated the seroprevalence and significance of the clinicobiochemical profile of dengue and chikungunya coinfection. Besides this, the authors try to emphasize rationalize platelets transfusion. MATERIAL AND METHODS: The present study was conducted at the Heritage Institute of Medical Science, Varanasi, India, from July to December 2016. A total of 1800 suspected cases with acute viral febrile illness (age >18 years) were investigated to exclude other causes of acute febrile illnesses. Of these, 121 patients (6.72%) were diagnosed as seropositive for dengue and chikungunya mono or coinfection using IgM ELISA and were included in the study. RESULTS: The male gender was predominant. The majority were in the 20-30-year age group with cases peaking in November. There were 102 (84.29%) cases of dengue, 6 (4.95%) cases of chikungunya, and 13 (10.74%) cases positive for coinfection. Fever was present in all cases. Headache followed by nausea/vomiting and generalized weakness were the most common symptoms in patients with DF while body aches and joint pain were most common in those with chikungunya fever. Deranged liver function and leukopenia were the most common complications in dengue. CONCLUSION: Joint-related symptoms (pain and restricted movements) were statistically significant in chikungunya monoinfection. Two patients with DF were died. There was no significant added severity of clinical features and blood investigations in patients with coinfection with dengue and chikungunya compared to those with monoinfections.

Assessment of Levels of Glycosylated Hemoglobin in Patients with Periodontal Pathologies: A Comparative Study.

INTRODUCTION: One of the potential sources for the occurrence of various systemic pathologies, such as cardiovascular diseases, cerebrovascular diseases, and respiratory diseases is periodontitis. Testing of glycosylated hemoglobin (HbA) is a highly standardized procedure and is becoming increasingly popular these days due to its cost-effectiveness and ease of use. Literature quotes numerous studies associating the peri-odontal diseases with various hemoglobin markers in diabetic and nondiabetic patients. Hence, we planned the present study to assess the levels of HbA in patients with periodontitis among nondiabetic patients. MATERIALS AND METHODS: For the present study, a total of 50 nondiabetic subjects who reported to the department with the chief complaint of periodontitis were included. Another set of 50 nondiabetic individuals were included in the present study of comparable age in whom no periodontitis was detected clinically. Clinical examination and radiographic evaluation was performed for the selection of the cases for the study group. The patients were sent to the laboratory after the clinical examination, for the testing of HbA. Testing of the hemoglobin A1c (HbA1c) levels of all the subjects and controls was performed and values were noted and evaluated. RESULTS: Nonsignificant results were obtained while comparing the mean HbA1c concentrations among the study group and the control group. Nonsignificant results were obtained while comparing the mean HbA1c levels among males and females. While comparing the mean HbA1c levels between the study group and the control group divided on the basis of body mass index, nonsignificant results were obtained. CONCLUSION: In nondiabetic subjects, no significant correlation could be observed between periodontitis and HbA1c levels. CLINICAL SIGNIFICANCE: The HbA1c cannot be used as a reliable maker for differentiation of patients with periodontal pathologies from patients free of periodontal pathologies.