Search

Introduction: Dengue rarely affects the heart but clinical symptoms of cardiac involvement mayrange greatly from silent illness to severe myocarditis resulting in death. Clinical features areasymptomatic and most are transient among patients with DF/DHF. Material and methods: It wasan observational study conducted at the Department of General Medicine, Peoples College of MedicalSciences and Research Centre, Bhopal. The total duration of the study was One and a half yearsfrom November 2016 to APR 2018. All normotensive diabetic patients less than 45 years of agepresenting to the Department of General Medicine, Peoples College of Medical Sciences and ResearchCentre, Bhopal during one and half years from which data was collected using as per givenproforma. Results: In the present study, It was found that significant Pearson's correlation betweenage of diabetics and diastolic changes in ECHO, and serum creatinine and diastolic changes in ECHO.The rest of the parameters like blood urea, blood pressure, RBS, FBS, PPBS, and duration ofdiabetes were not significantly correlated. Conclusion: It was concluded that in the present study,diabetes mellitus is itself a risk factor for developing diastolic dysfunction though its prevalenceincreases with increasing age, serum creatinine and there is no association found between durationof diabetes and diastolic dysfunction. So screening of every young normotensive diabetic for diastolicdysfunction should be done to prevent early cardiovascular disease.

Objective: This study aims to compare the average levels of IL-10 with preeclampsia and normotensive in four different tribe populations in South Sulawesi, including Makassar, Bugis, Mandar, and Toraja. Method: This research is a cross-sectional study conducted in March–May 2020 in several Health Centre and Hospitals in four areas, namely in the UNHAS Hospital, Jumpandang Baru Health Center, Barabaraya Health Center, Mattirobulu Health Center, Salo Health Center, Lasinrang Pinrang General Hospital, Totoli Health Center, Majene Regional General Hospital, Makale Health Center, Elim General Hospital, Lakipadada Tana Toraja Regional General Hospital. Samples in this study were 88 pregnant women with gestational age >20 weeks which were divided into two groups, namely 44 cases (preeclampsia) and 44 control groups (normotensive). The criteria for the sample in this study are single pregnancy, no systemic disease, and are native Makassar, Bugis, Mandar, and Toraja tribes. Data collected included age, education, occupation, parity, Body Mass Index (BMI), history of preeclampsia. Serum IL-10 levels were examined using the Human Interleukin 10 ELISA Kit. Results: There were significant differences in IL-10 levels in preeclampsia pregnant women in the Makassar, Bugis, Mandar, and Toraja tribes (p = 0.020, p 0.05). The Bugis, Mandar, and Toraja tribes show significant differences in IL-10 levels between preeclampsia pregnant women and normotensive pregnant women with mean rating values of pregnant women who have preeclampsia have lower IL-10 levels than normotensive pregnant women, while the Makassar tribe has valued insignificant difference in IL-10 levels between preeclampsia and normotensive (p = 0.309, p > 0.05). Conclusion: There are differences in IL-10 levels in preeclampsia pregnant women in Makassar, Bugis, Mandar, and Toraja tribes. The mean concentration of IL-10 in pregnant women with preeclampsia was significantly lower than in controls.

Background Hypovitaminosis D in pregnancy is associated with adverse health outcomes in mothers, newborns and infants. This study assessed the levels of 25-hydroxyvitamin D [25(OH)D] in normotensive pregnancies and in preeclampsia, evaluated the association between vitamin D deficiency and preeclampsia risk; and determined the foeto-maternal outcome in preeclamptic women with vitamin D deficiency. Methods This case-control study was conducted among pregnant women who visited the Comboni Hospital, in Ghana from January 2017 to May 2018 for antenatal care. A total of 180 pregnant women comprising 88 preeclamptic women (PE) and 92 healthy normotensive pregnant women (NP) were recruited. Socio-demographic, clinical and obstetric data were obtained using validated questionnaires. Blood pressure and anthropometrics were measured, and blood samples were collected for the estimation of 25- hydroxyvitamin D [25(OH)D] using enzyme-linked immunosorbent assay technique. Lipids (total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol) were also estimated. Results A total of 81.7% of the study participants had vitamin D deficiency. Of these, 88.6% of the women with PE had vitamin D deficiency compared to 75.0% in the NP. Vitamin D levels were significantly reduced in the PE women compared to the normotensive pregnant women (p = 0.001). A higher proportion of the preeclamptic women who were vitamin D deficient had preterm delivery (p p p p p = 0.008), LDL (p p = 0.017) and a significantly reduced HDL (p = 0.001) as compared to NP. In the preeclamptic women, serum 25(OH) D showed an inverse, but not significant association with TC (β = − 0.043, p = 0.722, TG (β = − 0.144, p = 0.210) and LDL (β = − 0.076, p = 0.524) and a positive, but not significant association with HDL (β = 0.171, p = 0.156). Conclusion The prevalence of vitamin D deficiency is high in both normotensive pregnancies and pregnancies complicated by preeclampsia but amplified in preeclampsia. Higher proportion of pregnant women with hypovitaminosis D had preterm babies and delivered low birth weight neonates. Additional studies are needed to explore the potential benefits and optimal dosing of vitamin D use in pregnancy, especially in sub-Saharan Africa.

Introduction: Cord blood would be a feasible and simple method for detecting cholesterol level at birth. Neonatal lipids level could serve as a guide to know the physiological levels of lipids required for maintaining the normal bodily mechanisms. Aim: To compare the cord blood lipid profile of 300 newborn babies born to hypertensive and normotensive mothers. Materials and Methods: The case-control study was done in the Department of Paediatrics, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India, for the period of one year from Jan 2019 to Jan 2020. A total of 300 pregnant ladies were included in the study. They were divided in two groups: group A consisted of 150 newborns who were born to 150 hypertensive mothers and group B consisted of 150 newborns who were born to 150 non hypertensive mothers. Five millilitres of cord blood were collected from the placental end of the umbilical vein, and then the serum was separated by centrifugation. Data was collected and mean±SD were calculated. Chi-square test and Mann Whitney test were done for statistical analysis. Results: When the cord blood was evaluated for the cholesterol, Triglyceride (TG) (p-value 0.001), High Density Lipoprotein (HDL) (p-value 0.001) and Low Density Lipoprotein (LDL) (p-value 0.001) level; it was found that in group A the levels were more in mean value as compared to the non hypertensive group, where the level was found to be lower than the mean value. The difference was found to be statistically significant. Conclusion: Hypertensive status of mother could impact neonatal lipid profile; however, larger prospective studies are required to validate these results.

Circadian heart rate (HR) is influenced by hypertension and other cardiovascular risk factors particularly smoking, obesity and dyslipidemia. Until now, to evaluate the HR changes due to presence of these risk factors, a single HR office measure or a mean evaluated on day time or night time or 24h was used. However, since HR shows a circadian behavior, a single value represents only a rough approximation of this behavior. In this study, we analyzed the influence of smoking, obesity and dyslipidemia on the circadian rhythm in normotensive and hypertensive subject groups presenting only one of these risk factors. The 24h HR recordings of 170 normotensive (83 without risk factors, 20 smokers, 44 with dyslipidemia, 23 obese) and 353 hypertensive (169 without risk factors, 32 smokers, 99 with dyslipidemia, 53 obese) subjects were acquired using a Holter Blood Pressure Monitor. Results highlighted a specific circadian behavior with three characteristic periods presenting different HR means and rates of HR change in the eight subject groups. The slopes could be used both to estimate the morning HR surge associated with acute cardiovascular effects in the awakening and to evaluate the decline during the night. Moreover, we suggest to use three HR mean values (one for each identified period of the day) rather than two HR values to better describe the circadian HR behavior. Furthermore, smoking increased and dyslipidemia decreased mean HR values from 10:00 to 04:00, both in normotensive and hypertensive subjects in comparison with subjects without risk factors. In this time interval, hypertensive obese subjects showed higher values while normotensive ones presented quite similar values than subjects without risk factors. During the awakening (05:00–10:00) the slopes were similar among all groups with no significant difference among the mean HR values.

Epidemiological and animal studies assert an inverse relationship between calcium intake and risk of clinical hypertension. Nonetheless, there is a paucity of information on the effect of calcium and vitamin D co-administration on sodium chloride (NaCl)-induced blood pressure (BP) elevation in apparently healthy normotensive subjects. Hence, this study evaluated this relationship. For a 5-day study period, a group of 10 subjects (Group A) was placed on placebo while another group of 5 subjects (Group B) had dietary NaCl (200 mmol/day) and a third group of 5 subjects (Group C) had dietary NaCl (200 mmol/day) with calcium/vitamin D supplement (625 mg/200 IU). Before and after the 5-day regimen, blood pressure (BP) was measured, and blood, as well as urine samples, were collected from the subjects for evaluation of electrolyte status. Mean arterial BP (MABP) increased (p0.01) only in group C, after the 5-day regimen. Urinary excretion of calcium increased and decreased (p

Background and aim Chronic kidney disease is a major public health problem with increased global incidence and prevalence, especially in Egypt, poor quality of life, and high risk of morbidity and mortality. The aim of the work was to determine the prevalence and the risk factors of incidental kidney diseases among apparently healthy adults. Patients and methods A total of 300 healthy normotensive and normoglycemic individuals were assessed for creatinine, proteinuria, and glomerular filtration rate, with correlation to their BMI and systolic and diastolic blood pressures. Results Microalbuminuria was positively correlated to age, BMI, and systolic blood pressure, with a significant P-value of less than 0.001. Conclusion The prevalence estimates and risk factors for those with microalbuminuria as a marker of occult renal disease include age, BMI, high systolic blood pressure, and family history of renal problems.

BackgroundCo-existence of hypertension is known in three quarter of Indian type 2 diabetics, this duo having adverse additive effect on cardiovascular health including dysautonomia. Later can be measured by simple 5min heart rate variability (HRV) using simple electrocardiogram, which if reduced indicates cardiac risk.ObjectiveWe compared HRV parameters between hypertensive and normotensive type 2 diabetics, looking for significant difference if any.Materials and methods98 hypertensive and 40 normotensive type 2 diabetics treated as outpatients were evaluated for disease control and risk stratification. 5min resting HRV was measured by Variowin HR, software based instrument, using standard protocols to record time domain, frequency domain and Poincare plot parameters. They were compared between groups for difference with p

Purpose Δ9-Tetrahydrocannabinol-valine-hemisuccinate, a hydrophilic prodrug of Δ9-tetrahydrocannabinol, synthesized with the aim of improving the ocular bioavailability of the parent molecule, was investigated in a lipid-based nanoparticle dosage form for ocular delivery. Methods Solid lipid nanoparticles (SLNs) of Δ9-tetrahydrocannabinol-valine-hemisuccinate and Δ9-tetrahydrocannabinol, along with a nanoemulsion of Δ9-tetrahydrocannabinol-valine-hemisuccinate, were tested for glaucoma management in a normotensive rabbit model by using a multiple-dosing protocol. Marketed formulations of timolol maleate and pilocarpine HCl were also tested for their pharmacodynamic profile, post-single dose administration. Results A peak intraocular pressure (IOP) drop of 30% from baseline was observed in rabbits treated with SLNs loaded with Δ9-tetrahydrocannabinol-valine-hemisuccinate at 90 minutes. Treated eyes of rabbits receiving Δ9-tetrahydrocannabinol-valine-hemisuccinate SLNs had significantly lower IOP than untreated eyes until 360 minutes, whereas the group receiving the emulsion formulation showed a drop in IOP until 90 minutes only. In comparison to marketed pilocarpine and timolol maleate ophthalmic solutions, Δ9-tetrahydrocannabinol-valine-hemisuccinate SLNs produced a greater effect on IOP in terms of both intensity and duration. In terms of tissue concentrations, significantly higher concentrations of Δ9-tetrahydrocannabinol-valine-hemisuccinate were observed in iris-ciliary bodies and retina-choroid with SLNs. Conclusion Δ9-Tetrahydrocannabinol-valine-hemisuccinate formulated in a lipid-based nanoparticulate carrier shows promise in glaucoma pharmacotherapy. Translational Relevance Glaucoma therapies usually focus on decreased aqueous humor production and increased outflow. However, such therapy is not curative, and there lies a need in preclinical research to focus efforts on agents that not only affect the aqueous humor dynamics but also provide neuroprotection. Historically, there have been bench-scale studies looking at retinal ganglion cell death post-axonal injury. However, for a smooth translation of this in vitro activity to the clinic, animal models examining IOP reduction, i.e., connecting the neuroprotective activity to a measurable outcome in glaucoma management (IOP), need to be investigated. This study investigated the IOP reduction efficacy of cannabinoids for glaucoma pharmacotherapy in a normotensive rabbit model, bringing forth a new class of agents with the potential of IOP reduction and improved permeation to the back of the eye, possibly providing neuroprotective benefits in glaucoma management.

We have investigated the vasoactive effects of the coupled nitro-sulfide signaling pathway in lobar arteries (LAs) isolated from the nephrectomized kidneys of cancer patients: normotensive patients (NT) and patients with arterial hypertension (AH). LAs of patients with AH revealed endothelial dysfunction, which was associated with an increased response to the exogenous NO donor, nitrosoglutathione (GSNO). The interaction of GSNO with the H2S donor triggered a specific vasoactive response. Unlike in normotensive patients, in patients with AH, the starting and returning of the vasorelaxation induced by the end-products of the H2S-GSNO interaction (S/GSNO) was significantly faster, however, without the potentiation of the maximum. Moreover, increasing glycemia shortened the time required to reach 50% of the maximum vasorelaxant response induced by S/GSNO products so modulating their final effect. Moreover, we found out that, unlike K+ channel activation, cGMP pathway and HNO as probable mediator could be involved in mechanisms of S/GSNO action. For the first time, we demonstrated the expression of genes coding H2S-producing enzymes in perivascular adipose tissue and we showed the localization of these enzymes in LAs of normotensive patients and in patients with AH. Our study confirmed that the heterogeneity of specific nitroso-sulfide vasoactive signaling exists depending on the occurrence of hypertension associated with increased plasma glucose level. Endogenous H2S and the end-products of the H2S-GSNO interaction could represent prospective pharmacological targets to modulate the vasoactive properties of human intrarenal arteries.

Background: Calcium deficiency in pregnancy is linked to the risk of development of hypertensive disorders of pregnancy. At present, hypertensive disorders of pregnancy are among leading causes of maternal death in Nigeria. This study was aimed to compare the serum calcium level of women with hypertensive disorders of pregnancy and normotensive controls. Methodology: This was a comparative descriptive study among patients with hypertensive disorders of pregnancy (45 pre-eclampsia [PE] and 45 gestational hypertension [GH]) and comparative group of 45 normotensive pregnant women at Federal Medical Center, Abeokuta. Results: The serum calcium level in normotensive controls (mean ± standard deviation) was 2.64 ± 1.38 mmol/l, women with GH was 2.39 ± 1.15 mmol/l, and PE was 2.08 ± 0.76 mmol/l (P = 0.065). Hypocalcemia was found to have an incidence rate of 33% in normotensive controls, 51.1% among GH, and 51.1% among PE. Conclusion: Pregnant women with hypertensive disorders of pregnancy showed nonsignificant difference in mean serum calcium level.

Background Hypertension and prehypertension pose significant public-health and clinical challenges for both economically developed and developing nations. Prevalence of these conditions are frequently underreported because of its often-silent nature. Population-based studies that explore the occurrence and correlates of these conditions are scarce in Saudi Arabia. This study aimed at estimating the prevalence and associated factors of hypertension and prehypertension on a representative sample of males and females living in Al-Kharj town in Saudi Arabia. Methods Cross-sectional analysis was performed from January 2016 until June 2016 by recruiting a representative sample (n = 1019; aged 18 to 67 years) of the Al Kharj population. All participants completed a self-administered questionnaire, followed by a physical examination and blood test. Statistical analysis was carried out using SPSS version 24.0 for Windows. Results The prevalence of prehypertension was 66.1, 48.1 and 54.9% in male, female and all subjects, respectively. The prevalence of hypertension was 6.0, 4.2 and 4.9% in male, female and all subjects, respectively. Being overweight was associated with the highest risk of hypertension (OR = 4.98 [95% C.I. = 1.98–12.52], P = 0.001). People who were classified as class I obese had 3.5 times the risk of hypertension compared with the non-obese group (OR = 3.49 [95% C.I. = 1.42–8.63], P = 0.007). Risk of pre-hypertension was significantly lower in females (OR = 0.48 [95% C.I. = 0.32–0.71]) and tends to increase with obesity status. Gender-specific analyses found that males in the lowest education attainment level had a significantly increased risk of pre-hypertension (OR = 6.56 [95% C.I. = 1.27–33.85], P = 0.003). Conclusion This population-based study in Saudi Arabia shows that hypertension and prehypertension are common conditions particularly among males. Overweight and obesity was associated with both conditions. In addition, lower education attainment was a significantly associated factor among males. Future prospective studies are needed to confirm the etiological nature of such associations.

Objectives The present study examined hemodynamic responses of normotensive and untreated hypertensive participants under simulated long working hours (LWH) – 13 hours – in an experimental laboratory study. Methods Thirty-five men participated in this study. Twenty-two of these participants were categorized into the normotensive group (systolic blood pressure (SBP) ≤140 mmHg and diastolic blood pressure (DBP) ≤90 mmHg); one participant was excluded due to missing data, leaving twenty-one participants with a mean age of 49.2 years. Another thirteen participants were categorized into the high blood pressure group (SBP=140–160 mmHg or DBP=90–100 mmHg) with a mean age of 51.9 years. The hemodynamic responses at the resting state from 09:00–09:10 hours (baseline) and during LWH from 09:10–22:00 hours (12 sessions) were measured. In each session, participants performed mental tasks. Changes in the hemodynamic response (Δ) were calculated by subtracting the individual values at each session from the baseline values. Results The values for the ΔSBP, ΔDBP, and Δmean arterial pressure increased with work time. Additionally, we found a significant interaction between the group and sessions for the ΔSBP (P

Background Small dense low density lipoprotein-cholesterol (sdLDL-C), cholesterol ratios and carotid-femoral pulse wave velocity (cf-PWV) impart risk for all-cause morbidity and mortality independently of conventional cardiovascular disease (CVD) risk factors. This study was designed to identify feasible indicators for predicting arterial stiffness progression. Methods We followed up 816 normotensive participants without diabetes or CVD for nearly 5.0 years. Cholesterol parameters, ratios and other clinical and laboratory data were collected at baseline. cf-PWV were measured at baseline and the end of follow-up. Results PWV progression subjects had higher levels of PWV parameters, sdLDL-C and TG/HDL-C ratio. sdLDL-C and TG/HDL-C were significantly correlated with all PWV parameters. Multiple regression models showed that sdLDL-C was closely associated with follow-up PWV (β = 0.222, p

WOS: 000343527100008 PubMed ID: 24525047 Background: It has been shown that left ventricular diastolic dysfunction (LVDD) develops in patients with metabolic syndrome (MetS). However, there is not sufficient evidence in the literature to determine whether this condition is due to increase in blood pressure, which is frequently encountered in MetS. The purpose of this study was to test the hypothesis whether LVDD in MetS is independent from the presence of hypertension. Methods: A total of 60 patients diagnosed with MetS and 30 healthy people, who were age- and gender-matched with the patient group, were included in the study as the control group. In the study group, 30 of the patients were normotensive whereas the other 30 had hypertension. Conventional echocardiographic examinations and tissue Doppler imaging were performed besides measurements of demographic and biochemical parameters. Results: In the hypertensive MetS group, early diastolic filling flow (E), early diastolic mitral annular velocity (E'), and E/A ratio were significantly lower compared to the control group. Late diastolic filling flow (A), deceleration time (DT), late diastolic mitral annular velocity (A'), and E/E' ratio were higher in the hypertensive MetS group than the control group. In the normotensive MetS group, E, E', and E/A ratio were also lower compared to the control group whereas DT, A', and E/E' ratio were higher. Conclusion: These findings support the idea that LVDD may develop in patients with MetS even in the absence of hypertension. In addition, co-existence of hypertension with MetS contributes to further worsening of diastolic functions. (C) 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

WOS: 000312869700007, PubMed ID: 22630818, Mean platelet volume (MPV) is a determinant of platelet activation. Atherogenic index of plasma (AIP), which is defined as the logarithm of the ratio of plasma level of triglycerides to the level of high-density lipoprotein (HDL)-cholesterol (log[TG/HDL-C]), has recently been used as a marker of atherogenicity. This study included 104 normotensive individuals. Mean platelet volume and AIP were measured in all patients. Nondipper individuals (8.6 +/- 0.9 fL, 0.3 +/- 0.2) demonstrated higher values of MPV and AIP compared with dippers (7.9 +/- 1.1 fL, 0.1 +/- 0.2) (P

Cardiovascular disease is increased in individuals with type 1 or type 2 diabetes mellitus (DM). Left ventricular hypertrophy (LVH), which is an ominous prognostic sign and an independent risk factor for cardiac events, is often present in type 2 DM patients. The aim of our cross-sectional study was to evaluate the prevalence of LVH, and risk factors for its development, in normotensive type 2 diabetic patients without antihypertensive medication. The objectives of the study were to find out the prevalence of high left ventricular mass (LVM) in normotensive type 2 diabetic patients and compare it with nondiabetics and to uncover the risk factors for the development of high LVM in normotensive type 2 diabetic patients. A total of 130 age- and sex-matched subjects were selected (65 cases, diabetic normotensive, and 65 controls, nondiabetic normotensive) and baseline data were collected. LVM and left ventricular mass index (LVMI) were calculated using echocardigraphic parameters and body surface area. LVMI was significantly higher in patients with type 2 DM compared with age-, sex-matched healthy population (104.9 ± 21 vs. 78.5 ± 22.7 g/m(2), respectively; P < 0.05). BMI, HbA1c, and duration of diabetes were significantly associated with LVH whereas sexes, age, PPBS, were not.

Background: Preeclampsia is identified as an important cause for mother and newborn mortality. Inspite of extensive research, the exact etiological relations have not been established. Hence, an attempt has been made in this study to evaluate the relationship between the preeclampsia and maternal periodontal disease. Materials and Methods: The case–control study comprised of thirty pregnant women distributed equally in the case (preeclampsia) and control (healthy) group. Gingival index, plaque index, bleeding on probing, clinical probing depth, and clinical attachment level were measured in both groups. Microbiologic examination for identification of one red complex organism Porphyromonas gingivalis and one orange complex organism Fusobacterium nucleatum were done in plaque and placental blood of cases and controls. The clinical examinations and collection of placental blood were done 24 h before delivery. Results: Periodontal condition in the preeclamptic women was statistically worse compared with the normotensive women. There was no statistically significant association between microorganisms in plaque and placental blood between normotensive control and preeclamptic pregnant women. The preeclamptic women had significantly higher chances of having newborns weighing

INTRODUCTION: Left ventricular diastolic dysfunction (LVDD) represents the first stage of diabetic cardiomyopathy preceding changes in systolic function, reinforcing the importance of early examination of ventricular function in individuals with diabetes mellitus (DM). This cross-sectional study was conducted to determine the incidence of asymptomatic LVDD in newly diagnosed normotensive cases of type 2 diabetes subjects, and its relation to glycosylated haemoglobin (HbA1C), age at the time of diagnosis, body mass index (BMI) and serum total cholesterol. AIM AND OBJECTIVE: To study the incidence of left ventricular diastolic dysfunction (LVDD) and its correlation with HbA1C in normotensive, newly diagnosed type 2 diabetic patients. MATERIALS AND METHODS: This cross-sectional study was done in western U.P. on 100 patients of newly diagnosed (within 1 month) type 2 DM between patients 30 and 60 years of age, visiting the Medicine and Endocrinology outpatient Department of LLRM Medical College, Meerut. Patients with established type 2 diabetes and already taking antidiabetic treatment, cardiac diseases like valvular heart disease, ischemic and hypertensive heart disease, congestive heart failure, cardiomyopathy, renal failure, chronic pulmonary disease, severe anaemia and haemoglobinopathies were excluded from the study. These patients were informed about the study and informed consent was obtained before proceeding with the investigations. Patients selected were evaluated with relevant investigations like fasting and post prandial blood sugar, HbA1C level, lipid profile and 2D echocardiography to assess LVDD. These selected patients were divided in 2 groups; one with left ventricular diastolic dysfunction (LVDD) and second group of subjects without LVDD. Various parameters like HbA1C, age, body mass index and serum cholesterol were evaluated between these 2 groups. Statistical analysis was performed using Student t-test, Chi-square and Fisher Exact-test. RESULTS: Out of 100 patients 65 were males and 35 females. Mean age of the population was 50.08 ± 6.32 years. Overall incidence of LVDD was 41%. Grade 1 LVDD was most common. Mean HbA1C level of LVDD group was found higher as compared to those without LVDD. CONCLUSION: LVDD is very common at the time of diagnosis of type 2 DM even in normotensive patients independent of confounding effect of hypertension, ischemia and BMI. HbA1C and age, were found to be strong indicators of LVDD in newly diagnosed cases of Type 2 DM.

Biventricular diastolic dysfunction in patients with autosomal-dominant polycystic kidney disease. Background Left ventricular diastolic dysfunction has been shown in patients with autosomal-dominant polycystic kidney disease (ADPKD). However, there is no study evaluating right ventricular functions in these patients. Methods In the present study, diastolic functions of both ventricles in normotensive and hypertensive ADPKD patients with well-preserved renal function were investigated. Fifteen hypertensive and 16 normotensive patients with ADPKD with well-preserved renal function, 16 patients with essential hypertension, and 24 healthy subjects were included in the study. Conventional left and right ventricular echocardiographic measurements were performed in all subjects. Left and right ventricular functions were investigated both by myocardial performance index (MPI) [calculated by dividing the sum of isovolumic contraction time and isovolumic relaxation time (IVRT) by ejection time] and by tissue Doppler imaging (TDI). Results Left ventricular deceleration time and IVRT were significantly prolonged in hypertensive patients with ADPKD compared with patients with essential hypertension and even in normotensive patients with ADPKD compared with healthy subjects. Left and right MPIs were significantly higher in patients with ADPKD compared with healthy subjects, showing systolic and diastolic dysfunction. Moreover, by using TDI, the peak early diastolic mitral annular velocity (Em) to peak late diastolic mitral annular velocity (Am) ratio and the peak early diastolic tricuspid annular velocity (Et) to peak late diastolic tricuspid annular velocity (At) ratio were decreased in patients with ADPKD, suggesting biventricular diastolic dysfunction. Conclusion Both hypertensive and normotensive patients with ADPKD show significant biventricular diastolic dysfunction, suggesting cardiac involvement very early in the course of ADPKD.

High salt intake has been related to the development to chronic kidney disease (CKD) as well as hypertension. In its early stages, symptoms of CKD are usually not apparent, especially those that are induced in a “silent” manner in normotensive individuals, thereby providing a need for some kind of urinary biomarker to detect injury at an early stage. Because traditional renal biomarkers such as serum creatinine are insensitive, it is difficult to detect kidney injury induced by a high-salt diet, especially in normotensive individuals. Recently, several new biomarkers for damage of renal tubular epithelia such as neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (Kim-1) have been identified. Previously, we found a novel renal biomarker, urinary vanin-1, in several animal models with renal tubular injury. However, there are few studies about early biomarkers of the progression to CKD associated with a high-salt diet. This review presents some new insights about these novel biomarkers for CKD in normotensives and hypertensives under a high salt intake. Interestingly, our recent reports using spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY) fed a high-salt diet revealed that urinary vanin-1 and NGAL are earlier biomarkers of renal tubular damage in SHR and WKY, whereas urinary Kim-1 is only useful as a biomarker of salt-induced renal injury in SHR. Clinical studies will be needed to clarify these findings.

Introduction: Essential hypertension begins due to mutation of specific genes that contribute to the risk of developing hypertension. Genetic contribution was recognized 25 years ago, now formulated from time to time. Some studies have also proven that the hypertension in father had strong contribution in their individual than mother. The aim of the study is to compare the cardiovascular reactivity in male and female subjects with hypertensive and normotensive parents. Materials and methods: This comparative study was conducted in physiology department of Teerthanker Mahaveer medical college and research center, Moradabad. The research work was initiated after taken the ethical clearance from the ethical committee of the college. Three different stressors: cold pressor task, cycling and videogame were used. Total 120 subjects were taken for the study in which 77 were male and 43 were female. Result: Male subjects of normotensive parents had slightly higher HR rate (mean: 76.73/min) compared to the female subjects (mean: 75/min) with p value >0.05. Female subjects of hypertensive parents had higher HR rate (mean: 82.72/min) compared to the male subjects (mean: 73.95/min) with p value

Introduction: Lignocaine with epinephrine as local anesthetic (LA) provides hemostasis and decreases the risk of systemic toxicity. The purpose of the present study was to investigate and compare the response of lignocaine with and without epinephrine to evaluate hemodynamic and metabolic response in normotensive and type II controlled diabetic patients. Material and Methods: A total of 50 patients (25 healthy and 25 controlled type II diabetics) undergoing multiple tooth extractions (age group of 20–80 years) were included in this prospective, randomised, clinical study. On their first visit, the patients were given 2% lignocaine HCl with 1:200,000 epinephrine, and 2% lignocaine HCl was given on the second visit, to carry out tooth extractions. Blood pressure (BP), pulse rate, oxygen saturation, and blood glucose estimations were done at definite intervals (before, immediately after, and 20 min after the administration of LA) on both the visits. Results: The increase in blood glucose concentration following the administration of 2% lignocaine HCl with 1:200,000 epinephrine was statistically significant (P < 0.05) in controlled diabetic patients. Statistically significant variability in diastolic BP (DBP) was also noted in controlled diabetic patients. Both systolic BP and DBPs were statistically significantly elevated after the administration of 2% lignocaine HCl. Conclusion: 2% lignocaine HCl with 1:200,000 epinephrine in type II diabetics and 2% lignocaine HCl should be used with caution in normotensive as well as type II controlled diabetic patients.

Background: Type 2 diabetes mellitus (T2DM) is a proven threat of cardiac dysautonomia with paucity of studies from India. Poor disease control makes it further worse with co-existence of hypertension in majority. Heart rate variability (HRV) is a validated noninvasive tool to assess cardiac autonomic status. Aim: We studied HRV parameters of type 2 diabetics looking for effects of disease control and other co-existing risk factors. Materials and Methods: Ninety-eight hypertensive and forty normotensive under–treatment, Gujarati type 2 diabetics were evaluated for disease control and risk stratification. Five minutes resting, HRV was measured by Variowin HR, software-based instrument, using standard protocols to record time domain, frequency domain, and Poincare plot HRV parameters. They were compared between subgroups for the difference with P < 0.05 defining statistical significance. Results: All HRV parameters were reduced in type 2 diabetics, having mean age 56 years, mean duration 6 years with poor glycemic but comparatively better pressure control. HRV parameters were significantly not different in good compared to poor glycemics or in subjects with optimum pressure control than those without it. Results did not differ significantly, by the presence of individual cardiovascular risk factor in diabetics except resting heart rate. Conclusion: Our findings of HRV suggest that type 2 diabetics with poor glycemic control do not have a significant difference of cardiac dysautonomia by pressure control, glycemic control, and absence of risk cardiovascular factor. It suggests diabetes as a major cause for cardiac dysautonomia, residual risk despite treatment and need for HRV screening, strict glycemic control, and further studies.

Hypertension is an increase of blood pressure over 140/90 mmHg. Hypertensionin along period of timecaninterfere withkidney function. Impaired kidney functioncan be caused byhigh levelsof uricacidin the bloodthatis directly associatedwithperipheralvascular resistanceandrenalvascular. Measurement ofrenal functioncan be measuredbycreatininetest, becauseconcentrations in serumandurineexcretionin24 hoursis relativelyconstant. The aim of this research was to measure and compare creatinine and uric acid on serum and urine in hypertensive and normotensive. The parameters were measured by Mindray BS-300 clinical chemistry analyzer. Ex Post Facto used as method and Cross- sectional used as design. A total of 36 blood and urine samples collected from Hypertensive (N1=18) and normotensive (N2=18) from February to March 2014. SPSS 16.0 was used to analyze the datas, t-test was used to compare value of creatinine urine and uric acid serum while U Mann-Whitney test was used to compare value of creatinine serum. The result of this research showed that the mean value of creatinine serum was 0.80 mg/dL in hypertensive and 0.86 mg/dL in normotensive (p=0.14). The mean value of creatinine urin was 87.28 mg/dL in hypertensive and 74.47 mg/dL in normotensive (p=0.35). The mean value of uric acid serum was 4.06 mg/dL in hypertensive and 4.5 mg/dL in normotensive (p=0.41). The resultsofthe urineuricacidwere foundnegativeofthe presence ofuricacid crystals.In conclusion, there was no different of creatinine and uric acid on serum and urine in hypertensive and normotensive. Keywords: hypertension, normotensive, creatinine, uric acid