Role of ambulatory blood pressure monitoring in hypertensive patients having controlled office blood pressure.

BACKGROUND AND OBJECTIVES: Ambulatory blood pressure (BP) monitoring has become useful in the diagnosis and management of hypertensive individuals. In this study we tried to know the role of office and ambulatory BP in treated hypertensive patients. METHODS AND PATIENTS: Prospective cohort of 561 treated hypertensive patients were enrolled in the study. Hypertension definitions were according to JNC 8 classification. Office BP and ambulatory BP monitoring was done according to defined protocol. RESULTS: From a subgroup of 158 treated hypertensive patients, 91(16.2%) patients were having white coat hypertension (p value 0.00 by Pearson chi square test). In a subset of 403 patients who were having controlled BP on the day of enrolment as well as on the day of attaching ambulatory BP monitor; 98 (17.4%) patients were having masked uncontrolled hypertension (MUCH). In addition there was very significant percentage of non-dippers and reverse dippers. In our study we found that office BP has a moderate to low specificity and sensitivity and low negative predictive value for overall control in treated hypertensive patients. CONCLUSION: Ambulatory BP monitoring should be included in the management protocol of treated hypertensive patients, for the optimal BP control.

Analysis of Physiological Variations and Genetic Architecture for Photosynthetic Capacity of Japanese Soybean Germplasm.

The culmination of conventional yield improving parameters has widened the margin between food demand and crop yield, leaving the potential yield productivity to be bridged by the manipulation of photosynthetic processes in plants. Efficient strategies to assess photosynthetic capacity in crops need to be developed to identify suitable targets that have the potential to improve photosynthetic efficiencies. Here, we assessed the photosynthetic capacity of the Japanese soybean mini core collection (GmJMC) using a newly developed high-throughput photosynthesis measurement system "MIC-100" to analyze physiological mechanisms and genetic architecture underpinning photosynthesis. K-means clustering of light-saturated photosynthesis (Asat ) classified GmJMC accessions into four distinct clusters with Cluster2 comprised of highly photosynthesizing accessions. Genome-wide association analysis based on the variation of Asat revealed a significant association with a single nucleotide polymorphism (SNP) on chromosome 17. Among the candidate genes related to photosynthesis in the genomic region, variation in expression of a gene encoding G protein alpha subunit 1 (GPA1) showed a strong correlation (r = 0.72, p < 0.01) with that of Asat . Among GmJMC accessions, GmJMC47 was characterized by the highest Asat , stomatal conductance (gs ), stomatal density (SDensity ), electron transfer rate (ETR), and light use efficiency of photosystem II (Fv'/Fm') and the lowest non-photochemical quenching [NPQ(t)], indicating that GmJMC47 has greater CO2 supply and efficient light-harvesting systems. These results provide strong evidence that exploration of plant germplasm is a useful strategy to unlock the potential of resource use efficiencies for photosynthesis.

Etiology, presentation and management outcome of pneumothorax.

BACKGROUND: This study was carried to determine etiology, presentation, complications and management outcomes of pneumothorax in patients presenting at two hospitals in NWFP province of Pakistan.. METHODS: Pneumothorax patients reporting at the chest unit of Post Graduate Medical Institute, Lady Reading Hospital, Peshawar, and Pulmonology unit of Ayub Teaching Hospital, Abbottabad from 1999 to 2002 were included in the study. Patients of all ages were included. They were admitted and followed up to the full recovery/late complications. RESULTS: A total of 146 pneumothorax patients reported during this period. Majority of the patients were diagnosed to have pneumothorax due to pulmonary tuberculosis making about 36.30% of the total cases. Second most common cause was primary spontaneous pneumotihorax (19.86%). Bacterial infections were also sizeable at 16.43%. Other causes included COPD, Asthma, latrogenic, Interstitial lung disease, tuberous sclerosis and bronchiectasis. CONCLUSION: It was concluded from this study that pulmonary tuberculosis is the commonest cause of pneumothorax in our setup.