Prevalence of Hyperuricemia in Indian Population with Hypertension.

Background and objective: The prevalence rate of hyperuricemia (HU) is comparatively higher in Asian countries than in the Western regions. Patients with coexisting HU and hypertension (HTN) are at greater risk of uncontrolled HTN, metabolic syndrome, and complications. This study aims to determine the prevalence of HU in individuals with HTN from the major geographical regions across India. Materials and methods: A cross-sectional, multicentric, observational study conducted in primary and secondary care centers from urban areas across different regions in India. Primary inclusion criteria were either a history of HTN or blood pressure systolic blood pressure (SBP) ≥140 and diastolic blood pressure (DBP) ≥ 90 mm Hg. A structured Google form was circulated among the participating healthcare practitioners from various participating centers to record the demographic, clinical, and biochemical parameters of patients visiting the respective centers. The data was consolidated and analyzed using Microsoft Excel. Screening for HU among individuals with HTN was based on two criteria-(1) self-reported diagnosed history of HU or (2) based on serum uric acid (SUA) levels >7 and > 6 mg/dL for men and women, respectively. The data were analyzed and represented using GraphPad Prism version 9. Results: Among the study population from 12 participating centers across different regions in India, 1,528 individuals had HTN. The mean age of the study participants was 57.4 ± 10.5 years with a male-to-female ratio of 1:1. The total prevalence rate of HU among individuals with HTN is 22.5% (N = 345). Gender-wise analysis indicated that 51.5% (177) of the males and 48.5% (168) of the females had HU. Among the patients with HTN and HU, 75% were overweight with a body mass index (BMI) of ≥25 kg/m2. The region-wise prevalence rate HU are North-17.4% (60), South-18% (62), Central-12.2% (42), East-29.6% (102), and West-22.9% (79). Conclusion: India's overall HU prevalence rate (22.5%) was comparable to that in other Asian countries (10-30%). However, the prevalence of HU among HTN patients varies between different regions of India (12.2-29.6%). Results from the participating centers located in an urban setting indicated that the eastern region had the highest HU prevalence (29.6%) and the Central region had the lowest HU prevalence rate (12.2%). The varying prevalence rate can be attributed to the diversity in geographical factors, genetic background or (family history of HU), sociocultural habits, and metabolic perturbations. Understanding this prevalence rate diversity can help strengthen the HU prevention measures to improve quality of life. How to cite this article: Patni B, Singh AN, Singh NK, et al. Prevalence of Hyperuricemia in Indian Population with Hypertension. J Assoc Physicians India 2023;71(10):45-48.

Non-adherence to anti-tubercular treatment during COVID-19 pandemic in Raipur district Central India.

BACKGROUND: Non-adherence is major factor in failure of any drug regimen. The significance of non-adherence is so much that WHO states that increasing the effectiveness of Adherence Interventions may have far greater impact on health of population than any improvement in specific medical treatments. Incidence of non-adherence to Anti Tubercular Treatment (ATT) usually ranges from 8.4% to 55.8%. This study aims to find out the reasons of Non-adherence to ATT in patients receiving anti-tubercular treatment at DIRECTLY OBSERVED TREATMENT SHORTCOURSE (DOTS) Centre at District Tuberculosis Centre (DTC), Kalibadi, Raipur during COVID-19 pandemic. METHODS: A cross sectional study was conducted at Department of Pharmacology, Pt. JNM Medical College and DTC Kalibadi Raipur. 55 Patients taking ATT fulfilling inclusion and exclusion criteria were interviewed using structured questionnaire. The data obtained was analysed to know causes of non-adherence. RESULTS: Study was carried out between March & April 2020. In our study, 80% subjects were male and 20% were female. The main reasons for Non-adherence were Side-effects of drug in 36% cases, missing medication intentionally in 34% cases, lack of encouragement by family members in 32% cases, patient's unawareness of consequences of skipping medication in 25% cases, unaware of treatment duration in 22%, not feeling any change, forgetting to take medication, and burden of concomitant medication besides ATT, each in 20% cases, 13% cases had difficulty in procuring medication due to lockdown, 5% cases did not go to collect their medicine due to fear of contracting COVID-19 infection. CONCLUSIONS: Our study shows reasons for Non-adherence are multi-factorial with drug side -effects & intentionally skipping medication being major factors.

Efficacy of Deferasirox as an Oral Iron Chelator in Paediatric Thalassaemia Patients.

INTRODUCTION: Thalassaemia Major patients require frequent blood transfusion leading to iron overload. Excessive iron gets deposited in vital organs and leads to dysfunction of the heart, liver, anterior pituitary, pancreas, and joints. Our body has limited mechanism to excrete iron, so patients with iron overload and its complications need safe and effective iron chelation therapy. AIM: To assess the efficacy of Deferasirox (DFX) as an iron chelator, with specific reference to reduction in serum ferritin level. MATERIALS AND METHODS: This is a prospective; observational study done in 45 multitransfused Thalassaemia Major Children receiving DFX therapy at registered Thalassaemia society Raipur Chhattisgarh. DFX was given in an initial dose of 20 mg/kg/day and according to response increased to a maximum of 40 mg/kg/day. Serum ferritin level was estimated at time of registration and at every three monthly intervals (four times during study period). The primary end point of the study was change in serum ferritin level after 12 months of DFX therapy. RESULTS: The mean serum ferritin before DFX therapy of all cases was 3727.02 ng/mL. After 12 months of mean dose of 38 mg/kg/day of DFX, the mean decline in serum ferritin was 1207.11 ng/mL (drop by 32.38%, p-value <0.001). CONCLUSION: DFX monotherapy has a good safety profile and effectively chelates total body iron in Thalassaemia major patients.