Clinical Profile of Hypertensive Emergencies in an Intensive Care Unit.

AIMS AND OBJECTIVE: To study the prevalence of hypertensive emergencies in an ICU set up and to study the clinical presentation of hypertensive emergencies related to cardiovascular, neurological and renovascular system. METHODS: Type of Study: Cross-sectional, descriptive study. DURATION OF STUDY: Two years from 1st December 2011 till 30th November 2013. SAMPLE SIZE: 50 patients of hypertensive emergencies admitted to the intensive care unit of Dr. V.M. Govt. Medical College, Solapur were studied. Inclusion criteria All patients above 18 years of age. Systolic blood pressure > 180 mmHg Diastolic blood pressure > 120 mm Hg Exclusion criteria Pregnancy Patients with diabetes mellitus We classified as hypertensive emergencies all cases in which the increase in blood pressure was associated with one or more of the following types of acute or ongoing end-organ damage: hypertensive encephalopathy; stroke (cerebral infarction or intracerebral or subarachnoid hemorrhage, transient ischemic attack); acute pulmonary edema, left ventricular failure; acute myocardial infarction or unstable angina, progressive renal insufficiency features suggestive of retinopathy. All these conditions were diagnosed clinically or by approprriate diagnostic tests. CONCLUSIONS: most common presenting complaint in patients was breathlessness seen in 17 patients (34%), followed by neurological deficit in 14 patients (28%). Thirteen patients (26%) had complaints of headache, whereas 12 (24%) patients complained of chest pain on admission. Other symptoms included vomiting, giddiness, psychomotor agitation, and decreased urine output. Out of a total of 4076 admissions during the study period in the intensive care unit we had 50 cases of hypertensive emergencies with prevalence of 1.22% in our intensive care unit. Most common organ involvement was the retina followed by cardiovascular system, renal and then the central nervous system.

Foreign Body in Left Main Bronchus.

Tracheobronchial foreign body (TFB) aspiration is rare in adults, although incidence rates increases with advancing age. We report a case of foreign body in left main bronchus in an adult female who had no risk factor. She was successfully treated with removal of betel nuts by bronchoscopy. Unusual presentation and high index of suspicion can help in proper management.

Evaluation of Oxidative Stress in Type 2 Diabetes Mellitus and Follow-up Along with Vitamin E Supplementation.

Increased oxidative stress is a widely accepted participant in the development and progression of diabetes and its complications. The present study has been undertaken to evaluate oxidative stress in type 2 diabetes mellitus and effect of vitamin E supplementation on oxidative stress. In all 120 subjects were enrolled in the present study, 40 subjects are age and sex matched controls. Test group comprised of clinically diagnosed (n = 80) type 2 diabetic patients. Biochemical parameters like serum MDA, nitric oxide, superoxide dismutase, erythrocyte reduced glutathione and platelet aggregation were analyzed in control and diabetic group. Test group is further categorized as Group I (n = 40) diabetics were treated by only hypoglycemic drugs and Group II (n = 40) diabetics were treated by hypoglycemic drugs with vitamin E supplementation. All above biochemical parameters were again reassessed after 3 months follow-up in both group and its values were compared with its respective baseline levels. The study shows, reduction of oxidative stress, improvement in antioxidant enzymes and endothelial dysfunction in group II, those were on treatment of hypoglycemic drugs along with vitamin E supplementation. Hence the present study may conclude that vitamin E supplementation along with hypoglycemic drugs may be beneficial to type 2 DM patients to minimize vascular complications.