Search

Objective: To assess the efficacy of continuous contactless vital signs monitoring with an automated Early Warning System (EWS) in detecting clinical deterioration among patients in general wards. Methods: A prospective observational cohort study was conducted in the medical unit of a tertiary care hospital in India, involving 706 patients over 84,448 monitoring hours. The study used a contactless ballistocardiography system (Dozee system) to continuously monitor heart rate, respiratory rate, and blood pressure. The study assessed total, mean, and median alerts at 24, 48, 72, 96, 120 h, and length of stay (LOS) before patient deterioration or discharge. It analyzed alert sensitivity and specificity, average time from initial alert to deterioration, and healthcare practitioners (HCP) activity. Study was registered with the Clinical Trials Registry-India CTRI/2022/10/046404. Results: Out of 706 patients, 33 (5%) experienced clinical deterioration, while 673 (95%) did not. The deterioration group consistently had a higher number of alerts compared to those who were discharged normally, across all time-points. On average, the time between the initial alert and clinical deterioration was 16 h within the last 24 h preceding the event. The sensitivity of the Dozee-EWS varied between 67% and 94%. HCP spend 10% of their time on vital signs check and documentation. Conclusions: This study suggests that utilizing contactless continuous vital signs monitoring with Dozee-EWS in general ward holds promise for enhancing the early detection of clinical deterioration. Further research is essential to evaluate the effectiveness across a wider range of clinical settings. [ABSTRACT FROM AUTHOR]

Background: Individuals with high blood pressure in India often miss essential follow-up visits. Missed visits contribute to gaps across the hypertension care continuum and preventable cardiovascular disease. Widespread misconceptions around hypertension care and treatment may contribute to low follow-up attendance rates, but to date, there is limited evidence of the effect of interventions to debunk such misconceptions on health-seeking behavior. We conducted a randomized controlled trial to measure whether combining information debunking commonly-held misconceptions with a standard reminder reduces missed follow-up visits among individuals with high blood pressure and investigated whether any observed effect was moderated through belief change. Methods: We recruited 388 patients with uncontrolled blood pressure from the outpatient wards of two public sub-district hospitals in Punjab, India. Participants randomly assigned to the intervention arm received two WhatsApp messages, sent 3 and 1 days before their physician-requested follow-up visit. The WhatsApp message began with a standard reminder, reminding participants of their upcoming follow-up visit and its purpose. Following the standard reminder, we included brief debunking statements aimed at acknowledging and correcting common misconceptions and misbeliefs about hypertension care seeking and treatment. Participants in the control group received usual care and did not receive any messages. Results: We did not find evidence that the enhanced WhatsApp reminders improved follow-up visit attendance (Main effect: 2.2 percentage points, p-value = 0.603), which remained low across both treatment (21.8%, 95% CI: 15.7%, 27.9%) and control groups (19.6%, 95% CI: 14.2%, 25.0%). Participants had widespread misconceptions about hypertension care but our debunking messages did not successfully correct these beliefs (p-value = 0.187). Conclusions: This study re-affirms the challenge of continuity of care for chronic diseases in India and suggests that simple phone-based health communication methods may not suffice for changing prevalent misconceptions and improving health-seeking behavior. Trial registration: The trial began on July 18th. We registered the trial on July 18th (before recruitment began), including the main outcomes, on the German Clinical Trial Register [Identifier: DRKS00029712] and published a pre-analysis plan in the Open Science Framework [osf.io/67g35]. [ABSTRACT FROM AUTHOR]

Background: Antiretroviral therapy (ART) has transformed the life of PLHIV with a longer life expectancy. The rising coexistence of noncommunicable diseases (NCD)s especially type 2 diabetes mellitus (DM) and hypertension (HTN) among PLHIV (people living with HIV) is much more complicated and demanding for the health system, patients, and their families. To document the current status of type 2 DM and HTN among known diabetic/hypertensive PLHIV attending ART center, tertiary care hospital of South Gujarat. Materials and Methods: A mixed method study (cross-sectional survey followed by qualitative in-depth interview) was conducted among 184 PLHIV on ART with history of Type 2 DM and/or Hypertension who were registered and availing services from ART center, tertiary care hospital. Convenient sampling technique was used. All the participants were interviewed using pre-designed, semi-structured questionnaire, during their routine visits. In -depth interview (IDI) has been conducted to explore the delivery of NCD services at ART Centre. Results: Out of 184 PLHIV on ART, the most common co-morbidities were Type 2 DM (46.2%), HTN (39.13%), and 14.67% had both. Among total 184 participants, 64.1% were males and 35.9% were females. Only 22.3% of participants were availing treatment services for the above at tertiary care hospital. The study results showed a range of findings involving ART adherence, BMI, RBS, and BP measurements were included. IDI results described the NCD service delivery at ART Center. Conclusions: Study results suggest that the services received by PLHIV with NCD require an overhauling. Routine monitoring and strengthening of existing services should be focused to upgrade the quality and continuum of the care provided to PLHIV with NCD. [ABSTRACT FROM AUTHOR]

BACKGROUND The increasing prevalence of childhood obesity has led to a corresponding increase in hypertension among children, necessitating early identification of subclinical target organ damage for accurate cardiovascular risk assessment. However, in the pediatric population, there is a paucity of literature comparing ambulatory and home blood pressure monitoring, and this knowledge gap is exacerbated by limited access to ambulatory blood pressure monitoring (ABPM) facilities, particularly in developing countries, where pediatricians often resort to home blood BP monitoring as the preferred option. METHODS In this cross-sectional study with 60 obese children (aged 5–18 years) at tertiary health care in central India, we aimed to comprehensively characterize blood pressure profiles, including office, ambulatory, and home, and investigated their correlations with indicators of end-organ damage. RESULTS Among 60 children, 26 (43.3%) participants were found to be hypertensive based on 24-hour-ABPM evaluation. Masked hypertension (MH) and white coat hypertension (WCH) were observed in 21.6% and 13.3%, respectively. Surprisingly, 20% of participants were identified as hypertensive through 7-day home BP monitoring (HBPM). A notable discordance of 36.6% was between HBPM and ABPM results. Moreover, 26.7% of the children had end-organ damage, with higher odds associated with night-time systolic ambulatory hypertension in the adjusted regression model (OR = 1.06, 95% CI: 1.03–1.10, P  < 0.001). CONCLUSIONS The study highlights 24-hour ABPM's vital role in classifying hypertensive status, especially in high-risk children. The diagnostic performance of HBPM shows poor sensitivity in detecting MH and lower specificity in identifying WCH compared to ABPM. This limitation translates to missed opportunities for early preventive interventions. [ABSTRACT FROM AUTHOR]

Background: Considering the concerns of obesity problems, Mumbai Police authorities had launched full-day residential "Healthy Living Training Program" in February 2019 for obese policemen. We studied the effectiveness of the program by assessing health profile of the participants, and change in anthropometric measurements and blood pressure readings. Methods and Materials: Permission from the concerned authorities and approval from the Institutional Ethics Committee (IEC) were taken. Health profiles of 143 policemen were assessed. Anthropometric measurements and blood pressure recordings were done on the first and the last day of the 28-day program. The data were coded and entered in password-protected Microsoft Excel. Paired t-test was applied to test statistically significant differences. The association of some of the variables with weight change was assessed by the Chi-square test for categorical variables. Results: The mean age of participants was 49.6 ± 5 years. The proportion of hypertensive, diabetics, vision problems, and bone and joint problems were 48.2%, 23.2%, 57.1%, and 46.4%, respectively. Only 70% of them had home-cooked food in the lunch. Daily, 50% of the participants do physical activity. There was statistically significant weight reduction (105.6 ± 12.1s vs. 103.3 ± 12 kg), body mass index (BMI) (36.3 ± 3.4 vs. 35.5 ± 3.3), waist circumference (110.8 ± 7.9 vs. 109.5 ± 7.9), and hip circumference (115.6 ± 8.1 vs. 106.8 ± 15.0) of the participants after 28 days of training program. Conclusion: "Healthy Living Training Program" was effective in reducing weight, blood pressure, BMI, and waist and hip circumference. The program benefitted the participants by inculcating healthy lifestyles and raising awareness of health issues. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Malaria, a pervasive infectious disease, remains a critical health concern worldwide, particularly in regions with high transmission rates. This study investigates demographic patterns and prognostic factors influencing outcomes in malaria patients presenting to the emergency department (ED). MATERIAL AND METHODS: This retrospective cross-sectional study, conducted at ED of South coastal India, from September 1, 2017, to September 1, 2022, analysed data from approximately 12,000 annual visits. Mortality predictors were assessed in malaria-positive patients, including Shock Index (SI), Modified Early Warning Score (MEWS), Sequential Organ Failure Assessment (SOFA), Malaria Severity Index (MSA), Malaria Prognostic Score (MPS), Coma Acidosis Malaria (CAM) score, Respiratory and Bicarbonate-based CAM score (R-CAM and B-CAM), Glasgow Coma Scale (GCS), and GCRBS Score. RESULT: Analysis of 114 severe malaria cases revealed higher mortality (21.1%) among older rural patients. Non-survivors exhibited elevated pulse rates (139.83 ± 7.43), lower blood pressure (systolic: 62.58 ± 28.27, diastolic: 47.33 ± 20.73), and impaired consciousness (GCS: 6.63 ± 1.69). GCRBS, MSA, and SOFA scores demonstrated exceptional predictive accuracy (AUC = 1.00). CONCLUSIONS: Identifying crucial mortality predictors like MSA, MPS, CAM, and GCRBS scores in malaria patients can optimize ED management protocols effectively. [ABSTRACT FROM AUTHOR]

Objectives: The severity of pulmonary artery hypertension affects the outcomes of patients undergoing mitral valve replacement (MVR). Speckle-tracking derived strain is a new modality for the assessment of the right ventricular (RV) function as well as the longitudinal contractile pattern. Our main objective of this study was to evaluate the right ventricular (RV) function in patients undergoing MVR with pulmonary artery systolic pressure (PASP) of more than 50 mmHg at 1 and 4 weeks postoperatively. Material and Methods: This prospective cohort study included 40 patients with rheumatic heart disease (RHD) (mitral stenosis [MS] and mitral regurgitation [MR]) scheduled to undergo MVR between January 2022 and December 2023 in AIIMS, New Delhi. Serial 2D echocardiography, tissue Doppler imaging, as well as RV speckle-tracking echocardiography were performed, and serum brain natriuretic peptide (BNP) levels were measured during the pre-operative period, 1st week and 4th weeks postoperatively to evaluate RV function. Results: Tricuspid annular plane systolic excursion (TAPSE) and left ventricular ejection fractions (LVEFs) were significantly lower at 1 week after surgery, compared to pre-operative levels, and reached the pre-operative values at 4 weeks after surgery. The RV fractional area change (RVFAC) at 4 weeks postoperatively significantly increased compared to 1st week and baseline values. The tricuspid valve (TV) tissue velocity in systole (S′), TV velocity in diastole (E′), RV global strain (RVGLS), and RV free wall strain (RVFWLS) at post-operative 4 weeks were lower than pre-operative values, and this difference was statistically significant. Conclusion: Four weeks after MVR, in adult patients with RHD (MS and MR) having PASP >50 mmHg, it was observed that deformational indices or speckle-tracking echocardiography such as RVGLS and RVFWLS predict better RV dysfunction than linear indices like TAPSE. The BNP, PASP (delta TR), right atrial volume, left atrial volume, LV internal diameter in systole, and LV internal diameter in diastole decreased significantly in these patients. RVFAC increased significantly to compensate for the loss of longitudinal function. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were as follows: (1) To ascertain the prevalence of hypertension (HTN) among village women. (2) To determine the impact of an intervention strategy of Behavior Change Communication utilizing a camp approach supplemented with nukkad natak on the self-care capacity of village women for lifestyle modification for prevention of HTN. Materials and Methods: The study was conducted during June--July 2023 in the field practice area of Community Medicine of a medical college. Sample size was arbitrary (n = 200) out of all willing women attending outpatient departments during the study period. First, a baseline assessment of the study population was done. Street plays were held for the study population on HTN-related healthy lifestyle. Changes in their knowledge were documented. Appropriate statistical analysis was done using Excel sheets. Results: Most (79%) of the women in the village had normal blood pressure, with 19% of them having mild and 2% had moderate HTN. Most hypertensive women (72%) were not taking medications. Out of 12 hypertensive women who were taking antihypertensive medications, half of them were regular. There was a significant improvement in the score of self-care capacity, treatment HTN diet-related knowledge of the women after the intervention. Respondents liked the idea of organizing drama to propagate health-related messages. Conclusion: One in every five persons in the study population of rural health training centre (RHTC) had HTN. Most hypertensive women (72%) were not taking medications. Those who were taking antihypertensive medications, only half were regular in it. After Nukkad Natak based intervention, there was a significant improvement in the scores of HTN diet and treatment-related knowledge and self-care capacity of the respondents for prevention of HTN. Our respondents liked the idea of organizing drama to propagate health-related messages. [ABSTRACT FROM AUTHOR]

To compare blood pressure (BP), intraocular pressure (IOP), ophthalmic artery flow (OAF) velocity, retinal nerve fiber layer (RNFL) thickness, and visual fields in newly diagnosed hypertension (HT) patients (before treatment), chronic HT (on antihypertensive medications >5 years) and normotensives. A prospective, cross-sectional study at a tertiary care centre in India. Three groups of 45 patients each: group 1 - early HT, group 2 - chronic HT, and Group 3 - normotensives, underwent evaluation of BP, IOP by Goldmann applanation tonometry (GAT), OAF velocity by transcranial doppler (TCD), RNFL analysis by spectral-domain optical coherence tomography (SD-OCT), and visual fields. The BP was highest in early HT > chronic HT > normotensives (p < 0.001). The IOP of early HT, chronic HT, and normotensives were 15.87 ± 2.19 mmHg, 13.47 ± 1.92 mmHg, and 15.67 ± SD 1.75 mmHg (p < 0.001). The OAF velocity [peak systolic velocity (PSV), end-diastolic velocity (EDV) in cm/sec] was lowest in chronic HT (30.80 ± 7.05, 8.58 ± 1.58) < early HT (35.47 ± 5.34, 10.02 ± 1.74) < normotensives (36.29 ± 4.43, 10.44 ± 2.29), (p < 0.001). The average RNFL thickness was significantly lower in chronic HT (p = 0.022). The PSV, EDV, and MFV showed significant correlation with IOP (r = 0.247, p = 0.004; r = 0.206, p = 0.016; r = 0.266, p = 0.002) and average RNFL thickness (r = 0.309, p= <0.001; r = 0.277, p = 0.001; r = 0.341, p < 0.001) Patients with chronic HT demonstrated the lowest retrobulbar flows, IOP and lower RNFL measurements. Lower ocular perfusion may be associated with lower IOP and may be a risk factor for end-organ damage (RNFL) independent of IOP. [ABSTRACT FROM AUTHOR]

Introduction: Advancements in Computed Tomography (CT) have been continuously updated with the intravenous administration of contrast media, which enhances the visibility of internal organs and structures in CT scans. Contrast media administration often alters blood pressure. Aim: To observe the blood pressure variations among patients undergoing Contrast-enhanced Computed Tomography (CECT) thorax and Non Contrast Computed Tomography (NCCT) thorax. Materials and Methods: A cross-sectional study was conducted at the Department of Radiodiagnosis and Medical Imaging at Yenepoya Medical Hospital, Deralakatte, Mangaluru, Karnataka, India from February 2022 to August 2022. Patients who underwent examinations of NCCT thorax and CECT thorax within the age group of 20-80 years, involving 62 participants (31-CECT, 31-NCCT) were included. Intravascular contrast material was administered to the patient during a CECT thorax scan. One reader independently recorded the Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) five minutes before and five minutes after the venous phase in the CECT thorax and five minutes prior to and five minutes after in the NCCT thorax group. A paired t-test was used for the comparison of SBP and DBP within the group. Results: The mean SBP before the scan was 120.7 mmHg {Standard Deviation (SD)=13.6} and after the scan was 130.7±12.1 mmHg. The mean DBP before the scan was 78.9±8.9 mmHg, and after the scan was 84.2±12.0 mmHg, respectively, before and after the injection of contrast. Therefore, a significant difference was found in the mean SBP and DBP before and after the injection of contrast within the CECT thorax group. Conclusion: There was an increase in blood pressure in patients who had undergone CECT thorax in both males and females. Hence, evaluating BP will provide awareness of different risk factors that can be caused due to the administration of contrast media. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is the most common sustained supraventricular arrhythmia encountered in clinical practice. Due to the higher prevalence of rheumatic fever in several regions of India, rheumatic heart disease (RHD) is the most common etiological factor of AF. Aims and Objectives: The objective of the study was to study clinical features, electrocardiographic (ECG) and echocardiographic (ECHO) findings, complications, and incidence of AF in rheumatic mitral valve disease (R-MVD). Methods: It is an observational cross-sectional study of 40 indoor patients in a Tertiary Care Hospital in Vadodara, Gujarat, carried over a period of a year. Clinical data including symptoms, signs, systemic examination, and relevant investigations were studied. Results: 67.5% (n = 27) of patients having AF were below the age of 50 years with higher incidence among females (72.50%) as compared to males (27.5%). Fifteen (37.5%) had mitral stenosis (MS) and 13 (32.5%) had MS with regurgitation. Most of the patients 35 (87.5%) presented with breathlessness, followed by palpitation 28 (70%). The most commonly heard murmur was mid-diastolic (65%, n = 26), followed by pansystolic murmur (40%, n = 16) at the apex. Out of 40 patients, 15 (37.5%) had evidence of left ventricular hypertrophy on ECG, whereas only 5 (12.5%) had right ventricular hypertrophy. Four out of five patients with the evidence of cardioembolic stroke had left atrium (LA) size >45 mm which suggests an increased risk of embolic stroke with increased LA size. Only 3 (7.5%) patients had a visible LA clot in LA on two-dimensional ECHO, whereas only one patient had vegetation on valves. Twenty-seven out of 30 patients treated with diltiazem show good response. Heart failure was the most common complication affecting 85% (n = 34) of the patients with AF with R-MVD. Four (10%) patients out of 40 expired including 1 (25%) of the four pregnant patients, suggesting higher mortality among pregnant females due to superimposed physiological changes occurring during pregnancy. Conclusion: In developing countries like India, RHD is a major cause of AF affecting the younger population and more commonly females. Most of the patients in our study presented with breathlessness and palpitation. LA size was directly proportional to the risk of cardioembolic stroke and most of the patients developed heart failure as a complication. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mine workers face various health risks from occupational hazards, notably dust-related pulmonary dysfunction. This dysfunction is also attributed to diverse risk factors and health conditions. Despite the variety of underlying mechanisms, conflicting evidence persists regarding hypertension as a potential risk factor for such dysfunction. OBJECTIVE: To determine the predictors of pulmonary dysfunction vis-à-vis the hypertension status of mine workers. METHODS: We conducted a cross-sectional study among 444 mine workers from ten open-cast mines in Gujarat state (western part of India) from November 2020 to February 2022. We collected data on demographics, occupation, addiction, and comorbidities, including measurements like anthropometry, blood pressure, blood sugar, haemoglobin, and lipid levels. Hypertension was confirmed based on self-reported history and/or onsite blood pressure measurement, while pulmonary functions were assessed using a spirometer (expressed as forced expiratory volume in the first second FEV1 and forced vital capacity FVC). Multiple linear regression analysis was performed to determine the significant predictor of FEV1 or FVC vis-à-vis the hypertension status after adjusting for confounding variables. In addition, we assessed the effect of anti-hypertensive medications on pulmonary dysfunction. RESULTS: A total of 41% (95% CI: 36-45%) of mine workers were suffering from hypertension. On multiple linear regression, only being a male and work experience duration were the significant predictors of FEV1 [0.900 (0.475-1.092), p=<0.001; -0.029 (-0.034 - -0.021, p=<0.001] and FVC [1.088 (0.771-1.404), p=<0.001; -0.031 (-0.038 - -0.024, p = 0.001] respectively. While unadjusted analysis indicated hypertension led to FEV1 and FVC reduction, this effect lost significance after adjusting for confounders. Nevertheless, subgroup analysis revealed those on antihypertensive medications had reductions in FEV1 and FVC by -0.263 (95% CI: -0.449 - -0.078, p = 0.006) L and -0.271 (95% CI: -0.476 - -0.067, p = 0.009) L respectively. CONCLUSION: In our study among mine workers, alterations in lung function (FEV1 and FVC) on spirometry were predicted by gender and duration of work experience, while hypertension did not serve as a predictor. It is noteworthy that antihypertensive drugs were found to reduce lung functions on spirometry, highlighting the need for further research. [ABSTRACT FROM AUTHOR]

Obesity is considered as one of the major public health burden and it is predictor of cardiovascular risk factor. Yoga is a mind-body medicine helps to promote health. This study was aimed to explore whether Laghoo Shankaprashalana (LS) reduce the body weight in obese individuals. This was a single group pre-post study. A total of 40 subjects (9 Male, 31 Female) aged between 18 and 40 years were recruited. This study was conducted in government yoga and naturopathy medical college, Chennai. Subjects were practiced weekly once LS for eight weeks (eight sessions). Subjects were assessed pre and post on body weight, body mass index, waist circumference, hip circumference, waist hip ratio, pulse rate and blood pressure. Variables were analyzed using Paired sample t test except waist hip ratio, which were analyzed using Wilcoxon's signed ranks test. There was significant reduction in the body weight (p<0.001, 5.81 %), Body Mass Index (p<0.001, 5.88 %), Waist Circumference (p<0.001, 7.20 %), Hip Circumference (p<0.001, 5.04 %), and Waist Hip Circumference (p<0.001, 3.19 %) after LS. However, there was no statistical significance difference in pulse rate, blood pressure. Eight sessions of Laghoo Shankaprakshalana helps to reduces body weight, body mass index, waist circumference, hip circumference and waist hip ratio. Reduction in the waist circumference might helps to reduce the cardiovascular risk. LS may be one of the cost effective intervention that can be incorporated in the weight loss regimen. [ABSTRACT FROM AUTHOR]

Objective: The Global Adult Tobacco Survey conducted in India has divulged that 28.6% of the populace aged 15 years and above partakes in tobacco consumption in various modalities. Despite the availability of numerous studies on the correlation between smoking and hypertension, the nexus between tobacco smoking and hypertension remains enigmatic. Smoking has predominantly been linked to blood pressure, with scant investigations exploring the plausible association that may subsist between smoking and pulse pressure. Methodology: This study is based on secondary data analysis from the fifth National Family Health Survey (NFHS-5). 17 Field Agencies gathered information from 636,699 households, 724,115 women, and 101,839 men. The data related to only men was included and analysed in this present study. Results: Male participants had a mean age of 32.2+1.2 years, an average waist circumference of 80.4+12.2 cm, and mean systolic and diastolic blood pressure of 123.4+13.8 mmHg and 80.5+10.2 mmHg. Daily smokers had a slightly higher likelihood of hypertension compared to non-smokers (OR = 1.2, p <0.001). Male quitters had significantly lower odds of hypertension (OR = 0.9, p <0.001). Quitters had reduced odds of narrow pulse pressure but increased odds of wide pulse pressure (OR = 0.81 and 1.14, respectively). Conclusion: The study found that regular smoking was associated with hypertension, while factors such as age, obesity, urban dwelling, wealth, and tribal residence were linked to increased blood pressure. Male quitters had a lower likelihood of hypertension, and middle-aged men and those with central obesity showed distinct associations with deranged pulse pressure. [ABSTRACT FROM AUTHOR]

Background: Globally, eclampsia is the leading cause of maternal and neonatal morbidity and mortality. Objective: The present community‐based study was conducted among rural tribal women of reproductive age in remote villages of central India to determine their awareness of eclampsia and its likely impact. Methods: This cross‐sectional analytic study included randomly selected 4500 tribal women, between 15 and 45 years of age, residing in 140 villages in the proximity of one village with a health facility (study center), and who were willing to undergo a personal interview. In‐depth face‐to‐face interviews (each lasting 15–30 min) of study subjects regarding awareness, knowledge, practices, and perceptions about eclampsia were conducted using a predesigned tool completed by research assistants (not the subjects). Results: Of the 4500 women interviewed, the majority (62.4%) were 20–29 years old, minimally educated (40.6%), laborers (41.3%), and of a low socioeconomic class (40.8%). Of all the participants, only 35.9% were aware of eclampsia, associated events during pregnancy, labor, and the immediate post‐delivery period; 81.7% of those who were aware understood about symptoms and signs like headache, blurring of vision, dizziness, swelling over the body, ad high blood pressure. Of all the women who knew about eclampsia, 73.9% were aware that the occurrence of convulsions during antenatal and postnatal periods was an emergency and required urgent management, whereas 88.4% were not aware that severe convulsions affected maternal and neonatal health seriously, only 38.2% knew that eclampsia was a preventable condition. Conclusion: There was lack of awareness about eclampsia in many women and, of those who knew, some were not aware that it was dangerous. There is a need for awareness among women and their families of the disorder, its impact, and what action is needed in case it occurs. [ABSTRACT FROM AUTHOR]

Background: Pregnancy-related hypertension is a common condition that can lead to both maternal and fetal death as well as morbidity. Even if the condition is getting better, there is still a public health issue. Objectives: To evaluate the prevalence of PIH in a tertiary care hospital as well as the consequences and foeto-maternal problems that are related to it. Materials and methods: It was an institutional based prospective observational study. It was conducted in Department of Gynaecology and Obstetrics in Burdwan Medical College and Hospital, West Bengal, India. After receiving the clearance from the ethical committee study was conducted within 6 months period (March 2023 to August 2023). Total 100 patients were included in this study. All deliveries during this period were analysed for incidence of PIH, all PIH cases were analysed for maternal and foetal outcome. The data were entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Result: In present study higher percentage of PIH was noted among 18-22 years of age group 44 (44%). Pregnancy induced hypertension was more prevalent among Nulliparous (62%). 56 (56%) women were primigravida and 44 (44%) were multigravida. Out of 40 women 18 (18%) have past h/o of PIH, 7 (7%) had previous preterm delivery and 12 (12%) had previous LSCS. Out of 100 PIH patients 74% and 96% of had mild PIH with systolic blood pressure 140-160 mmHg and diastolic blood pressure 90-110 mmHg respectively. Out of 100 PIH mother 62 (62%) had preterm delivery, 6 (6%) had post term delivery. 48 (48%) of babies are low birth weight, 8 (8%) are IUGR. Conclusion: One prevalent medical condition linked to pregnancy is pregnancy-induced hypertension. We observed that nulliparous moms and younger age groups are more likely to experience PIH. PIH can have a variety of clinical manifestations, some of which can be used to identify the condition early. PIH also increases the risk of unfavorable fetal outcomes. Therefore, early identification and institutional management of PIH patients can reduce fetal morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension is the commonest cardiovascular disorder and a major public health problem. The Seventh Report of the Joint National Committee (JNC 7) defined pre-hypertension as persons with blood pressure (BP) above optimal levels [systolic BP (SBP) of 120-139 mm Hg or diastolic BP (DBP) of 80-89 mm Hg]. Community-based studies in India have demonstrated close to a third of the studied population with pre-HTN.(1,2) The incidence of pre-hypertension and hypertension among young adults is increasing day by the day.(3,4) In a multicenter study across 11 cities in India, the prevalence of prehypertension was found to be 40.2% among males and 30.1% in females. The prevalence of prehypertension among medical students in a study conducted in Orissa was 67%. Aims: To Study the prevalence of pre-hypertension and risk factors among resident doctors and to correlate pre-hypertension and risk factors in this specific Population. Materials and Methods: It was a Cross sectional study. this study was conducted from June2017 to June 2020 at the department of Medicine at Jawaharlal Nehru Medical College, Wardha.155 patients were included in this study. Result: Of the 155 patients, men made up 58.1% and females 41.9%. While 55.5% of the people surveyed had normal blood pressure, 44.5% showed signs of prehypertension. Importantly, just 23.9% of patients admitted to smoking, whereas 76.1% denied doing so. In 36.1% of instances, alcohol usage was prevalent, while 63.9% abstained. Regarding their way of life, 54.2 percent acknowledged eating junk food and 51.1 percent were regularly active. Overall, 57.4% said they eat fruit often, while 30.4% said they eat extra salt. The average age was 26.59 and the body mass index was 23.8 kg/m². Conclusion: this study reiterates the importance of risk factors in the causation of prehypertension, let alone hypertension and it is emphasised that prehypertension and risk factors should be vigorously sought in the general population and necessary interventions be implemented. This will go a long way in saving manhours and health care expenditure and improve the productivity of nation. [ABSTRACT FROM AUTHOR]

Introduction: Cis-atracurium has a neuromuscular blocking capacity approximately three times that of atracurium besylate. The Effective Dose (ED) 95 of cis-atracurium is 0.04 mg/kg, while that of atracurium is 0.2 mg/kg. Cis-atracurium is preferred over atracurium due to the lack of histamine release, providing better cardiovascular stability. This study compares these two drugs in terms of haemodynamic parameters, neuromuscular blocking properties, intubating conditions, and safety profiles. Aim: To assess the efficacy of atracurium and cis-atracurium from various perspectives, including neuromuscular blockade, haemodynamic stability, and safety profiles. Materials and Methods: A double-blinded, randomised clinical study was conducted from January 2019 to October 2019 in Rajkot, Gujarat, India. Sixty patients undergoing abdominal surgeries under general anaesthesia were allocated to two groups. Group A received a loading dose of atracurium 0.5 mg/kg followed by a maintenance dose of 0.1 mg/kg, while Group B received a loading dose of cis-atracurium 0.2 mg/kg followed by a maintenance dose of 0.03 mg/kg. During the surgical procedure, parameters studied included neuromuscular blockade, hemodynamic changes, intubating conditions, and safety profiles in terms of complications. Student's t-test was used to analyse normally distributed continuous variables, and the chi-square test was used for qualitative variables. Results: The demographic profiles were comparable in both groups in terms of age (p-value=0.800), sex (p-value=0.393), weight (p-value=0.101), and American Society of Anaesthesiologists (ASA) grading (p-value=0.509). A significant increase in heart rate (99.46±8.06 (/minute) vs. 91.66±9.11 (/minute)) and mean arterial blood pressure (104.44±10.16 (mm of Hg) vs. 93.4±12.77 (mm of Hg)) was noted post-intubation in Group A compared to Group B. Patients in Group A (3.5±0.62 minutes) had a faster onset of neuromuscular blockade compared to Group B (4.6±0.49 (minutes)), while the duration of action of the first loading dose and the 25% recovery time from the last supplemental dose was longer in Group B (52.86±5.18 minutes and 41.66±3.60 minutes) than in Group A (31.2±4.82 minutes and 20.86±4.37 minutes). Fewer patients experienced complications (hypotension, erythema of the skin) in Group A compared to Group B. Conclusion: Cis-atracurium releases less histamine compared to atracurium and has a longer duration of action. Cis-atracurium can be a better alternative to atracurium as it offers better haemodynamic, neuromuscular, and safety profiles with similar intubating conditions. [ABSTRACT FROM AUTHOR]

Introduction: India is known as capital of Diabetes all over the world. Diabetes is a lifestyle disease which affects all age groups. Objective: To identify the risk of developing Diabetes in adults using Indian Diabetes Risk Score (IDRS) and identify associated factors. Material & Methods: A cross sectional study was done among 200 adults who were non-diabetic by systematic random sampling in urban area, Diphu, Assam using pre-designed semi structured questionnaire, validated IDRS and anthropometric measurements. SPSS Version 20.0 was used for data analysis. Predictors of risk of Diabetes was identified by logistic regression. Results: Among 200 participants, moderate risk was found in 106 subjects and high risk was found in 71 subjects. On multiple regression analysis, age, marital status, education, fruit consumption, blood pressure, Body mass index and physical activity were significantly associated with risk of developing Diabetes. Conclusion: Individuals at risk of diabetes should be identified by screening so that appropriate interventions can be done to prevent/delay the onset of diabetes. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study is to evaluate the outcomes of live‑donor renal allografts with multiple and single renal arteries taking into consideration ischemia times, graft function, and other complications including vascular and urological. Materials and Methods: We conducted a retrospective study by analyzing a prospectively maintained database from January 2021 to December 2021 of all patients undergoing live‑related renal allograft transplants at a tertiary care center in North India. A total of 239 live donor kidney transplants were performed during this period. Patients were divided into two groups – Group 1: Single artery single anastomosis and Group 2: Multiple arteries with two or more anastomoses. Duplex imaging of the graft was done at 6 months. Recipients were followed up for possible graft dysfunction, arterial insufficiency, and major urological complications. Results: Mean ischemia times in the two groups were 20.62 ± 1.05 and 30.45 ± 1.77 min, respectively. Failure to normalize creatinine (<1.2 mg/dl) within 72 h was seen in 6/183 and 3/56 (P > 0.05). Slow graft function was encountered in 6 cases in Group 1 and 3 cases in Group 2. Delayed graft function occurred in two patients in both groups. One‑year graft survival among the groups was 5/183 and 2/56, respectively (P > 0.05). One patient from Group 1 developed transplant renal artery stenosis. Six patients from Group 1 developed ureteric complications. Conclusion: Donor grafts with multiple renal arteries may be accepted safely with careful surgical reconstruction and close surveillance posttransplant. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to determine the prevalence and determinants of ever-measured blood pressure, prehypertension, and raised blood pressure at national, state and district levels in India. Methods: We analysed data from the National Family Health Survey (NFHS-5), on 743,067 adults aged 18-54 years. The sample consisted of 87.6% females and 12.4% males. We estimated prevalence rates and determined adjusted odds ratios for various dependent variables related to blood pressure. Geographical variations were visualized on the map of India, and multivariate logistic regression was employed at state and district levels, with significance set at p < 0.05. Results: The prevalence of ever-measured blood pressure varied widely, from 30.3% to 98.5% across districts, with southern and northern regions showing higher rates. Prehypertension affected 33.7% of the population, with varying prevalence across districts. Raised blood pressure was there in 15.9%, with notably higher rates in southern region (16.8%). Determinants included age, gender, education, wealth, lifestyle, obesity, and blood glucose levels. Conclusion: These findings demonstrate the subnational variations in blood pressure, can guide evidence-based interventions at the state and district level, towards reducing the burden of raised blood pressure and enhancing overall population health. [ABSTRACT FROM AUTHOR]

Context: Teaching is regarded as one of the most stressful occupations, making them more vulnerable to cardiovascular diseases, especially hypertension. Aims and Objectives: We explored this study to estimate the prevalence of pre-hypertension and hypertension and its risk factors among school teachers. Settings and Design: This cross‑sectional study was conducted for one year among 400 school teachers working in primary and secondary schools in southern Andhra Pradesh. Materials and Methods: Cluster sampling technique was used for sampling, where each school was considered as a cluster. A validated proforma with a questionnaire developed based on the WHO STEPS manual was used to collect data on socio-demographic details, blood pressure recordings, anthropometric measurements, and other related factors. Statistical Analysis: Odds ratio, the Chi‑square test, and regression analysis was used to test the significance, where p < 0.05 was considered significant. Results: Among 400 subjects, 52.3% had normal blood pressure, 32.0% had pre-hypertension, and 15.7% had hypertension, with a total of pre-hypertension/ hypertension 47.7%. Prevalence of pre-hypertension/hypertension was significantly higher among the males (47.6%) [UOR: 2.4 (1.6-3.6)], the age group of 40 years and above (39.8%) [UOR: 4.6 (2.8-7.6)], and married subjects (90.1%) [UOR: 3.2 (1.8-5.6)]. Those who perceived moderate/severe stress at work (32.5%) [UOR: 3.9 (2.3-6.6)], teaching work of 11 years and above (59.7%) [UOR: 4.0 (2.7-6.2)], inadequate intake of fruits/vegetables (81.7%) [UOR: 1.6 (1.0-2.6)], adding extra salt to food (56.0%) [UOR: 2.0 (1.4-2.9)], and those who were overweight/obese (67.5%) [UOR: 3.4 (2.2-5.1)] had a higher prevalence. Conclusions: The prevalence of pre-hypertension and hypertension was considerably high among school teachers, and several factors were significantly associated with hypertension. Coordinated efforts in early diagnosis, control, and prevention of hypertension among teachers are the need of the hour. [ABSTRACT FROM AUTHOR]

Background: Akara, Ukara, Makara (OUM) chanting regulates emotions and removes negative emotions by inactivating the processing in the amygdala. At the same time, the prefrontal complex was inhibited followed by chanting OUM. Further, there was an increase in the oxygenation levels followed by chanting OUM. Hence, OUM chanting has multiple benefits and offers improvement in the quality of life. Though there are multiple benefits followed by chanting OUM, the scientific evidence for the same is comparatively less. Hence, there is a need for more studies in this area. Aims and Objectives: The present study aimed to find out the variations in the perceived stress, negative affectivity, and social inhibition in prehypertensive individuals and also to observe the effectiveness of Om chanting on perceived stress, negative affectivity, and social inhibition in pre-hypertensive individuals. Materials and Methods: The present study was conducted at the St Peter’s Medical College Hospital and Research Institute, Hosur, Tamil Nadu, India. A total of 50 young adults with prehypertension were recruited in the study after obtaining written informed consent. Age- and gender-matched 50 healthy participants were recruited after obtaining the voluntary, informed consent. Diamond digital sphygmomanometer was used to record the blood pressure. All the parameters were recorded at 9 am for the convenience of the participants and also to avoid diurnal variation. The perceived stress scale was used to assess the stress levels. Negative affectivity and social inhibition were recorded using a type D (DS-14) questionnaire. Cases practiced the OUM chanting for 6 weeks after they were trained by an expert yoga therapist. Results: Perceived stress scores were significantly decreased followed by the OUM chanting. There was a significant decrease in the scores of negative affectivity of cases after the intervention when compared with control group participants. There was a significant decrease in the scores of social inhibition of cases after the intervention when compared with control group participants. Conclusion: Perceived stress, negative affectivity, and social inhibition were significantly higher in the pre-hypertensive individuals. The study results provide further evidence that practicing OUM chanting causes stress relief and also decreases the negative emotions that is negative affectivity and social inhibition in pre-hypertensive individuals. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome consists of cardiometabolic risk factors that promote the development of atherosclerotic cardiovascular disease, type 2 'DM' and obesity. These are associated with increased cardiovascular mortality and morbidity. Metabolic disorders (MD) are becoming more prevalent both in developing countries and developed countries and are now considered as lifestyle diseases. In women of reproductive age group, especially pregnancy, the blood glucose level is increasing which adversely affects the health of mother and child. Similarly, high blood pressure also precipitates the problems. This study was carried out to find the prevalence of hypertension, diabetes mellitus, obesity and 'MD' among the women living in remote rural set-up. Materials and Methods: This cross-sectional study was done among women of reproductive age group in 15 villages from 5 panchayats of field practice area of Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan. They were screened for 'MD' through investigative procedures (weight, height, BMR, abdominal girth, blood pressure through sphygmomanometer, blood glucose through the glucometer method), serum HDL and triglycerides. Respondents from the family were asked about the common/general information of house. The tool used for collecting general and relevant information from the respondent was a questionnaire, which was pretested for validity before being used in the field. Results: Four-hundred and sixty-seven women of reproductive age group participated in the study. Half of the participants were with qualification of matriculate and 9.2% participants were illiterate. Three-fourths of the participants were married women and 89% were vegetarian. Sixty-four per cent of participants were housewives. Half of the participants had a normal BMI, whereas 28.9% were overweight and 10% were obese. The prevalence of hypertension and diabetes among the participants were 12.5% and 9.8%, respectively. Forty-seven per cent participants had a waist circumference above 80 cm. Conclusion: The level of non-communicable diseases is related with the MD which has the adverse effect on the various systems and organs of the subjects. The MD can be controlled with the certain changes in the life style pattern. The GOI is also concerned with such scenarios in the country. It is recommended that women of reproductive age group undergo regular blood pressure and blood sugar screenings to detect hypertension and diabetes early and take appropriate measures to manage them. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic Syndrome (MetS) is one of the most significant global public health concerns. Leptin, adiponectin, and the Leptin-adiponectin (LA) ratio have been shown to be informative biomarkers for obesity, Type 2 Diabetes Mellitus (T2DM), and Cardiovascular Diseases (CVD). Many contributing factors, such as Insulin Resistance (IR), adipose tissue dysfunction, chronic inflammation, and genetic factors, are proposed to be the aetiological factors of MetS. Leptin and adiponectin have opposite effects on IR, so the combined use of these adipokines may serve as a better biomarker in MetS. Aim: To determine serum leptin levels, adiponectin levels, and the LA ratio in patients with and without MetS. Materials and Methods: This cross-sectional study was conducted in the Department of Biochemistry and Medicine at the Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India, from January 2021 to October 2022. The study included 50 diagnosed cases of MetS and 50 individuals without MetS. Leptin, adiponectin, and parameters of MetS {Body Mass Index (BMI), weight, Waist Circumference (WC), skinfold thickness, High-density Lipoprotein (HDL), Triglycerides (TG), and Blood Pressure (BP)} were assessed in the study. The data were statistically analysed using Independent Sample t-test and Pearson's correlation test. Results: There were 23 males and 27 females in the study group. The mean age was found to be 61.10±12.52 years in cases and 57.08±10.67 years in controls. Leptin levels were significantly higher in cases (26.58±14.6 ng/mL) compared to controls (12.99±8.59 ng/mL). However, adiponectin levels were significantly decreased in cases (7.16±4.19 μg/mL) compared to controls (12.18±9.4 μg/mL). The LA ratio was found to be higher in cases (5.38±4.71 ng/μg) than in the controls (1.84±1.99 ng/ μg). Multiple linear regression analysis demonstrated that the LA ratio was strongly associated with MetS among Leptin, Adiponectin, and the LA ratio (p<0.05). Conclusion: Metabolic syndrome was strongly associated with an increased LA ratio, leptin, and decreased adiponectin levels. The LA ratio can better discriminate the risk of MetS than leptin and adiponectin alone and may be used as a sensitive clinical surrogate biomarker of MetS. [ABSTRACT FROM AUTHOR]

Introduction: Plasminogen Activator Inhibitor-1 (PAI-1), a serine protease inhibitor expressed in adipose tissue, causes inflammation in hypertension and vice versa. The excess adipose tissue increases the production of PAI-1. There have been no relevant studies conducted on PAI-1 in southern Odisha in relation to Body Mass Index (BMI) and hypertension. Aim: To compare the BMI, Waist Hip Ratio (WHR), Waist Circumference (WC), and serum levels of PAI-1 in hypertensive cases with controls, and also to correlate the serum level of PAI-1 with BMI and blood pressure. Materials and Methods: This cross-sectional study was conducted in the Department of Biochemistry in collaboration with the Department of Medicine of MKCG Medical College and Hospital, Berhampur, Odisha, India from November 2020 to August 2021. A total of 45 newly diagnosed primary hypertensive patients and 43 healthy age and sex-matched individuals between the ages of 18 to 60 years were enrolled in the study. Serum PAI-1 was measured by Enzyme-Linked Immunosorbent Assay (ELISA). BMI, WC, hip circumference, WHR, and blood pressures of the controls as well as cases were recorded. Data were statistically analysed using the Student's t-test and Pearson's correlation coefficient. Results: The proportion of males was higher (56%) than females (44%). The cases had a significantly higher level of serum PAI-1 (203.36 ng/mL) compared to the control group (60.11 ng/mL) (p-value<0.001). The cases had a higher BMI, WC (meters), and WHR compared to the control group. The serum PAI-1 level positively correlated with Systolic Blood Pressure (SBP) (r-value=0.852, p-value<0.001), Diastolic Blood Pressure (DBP) (r-value=0.726, p-value=0.000), BMI (r-value=0.620, p-value=0.001), WC (r-value=0.444, p-value=0.002), and WHR (r-value=0.593, p-value<0.001). Conclusion: A high serum PAI-1 level was found in the newly diagnosed hypertensive cases, and a significant positive correlation was observed between PAI-1 and systolic and diastolic blood pressure, along with BMI, WC, and WHR. [ABSTRACT FROM AUTHOR]

Background: Despite increased awareness, poor adherence to treatments for chronic diseases remains a global problem. Adherence issues are common in patients taking antihypertensive therapy and are associated with Increased risks of coronary and cerebrovascular events. Aim and Objective: The present study aimed to analyze medication adherence and its effect on blood pressure (BP) control and assess the prevalence of treatment-resistant hypertension (TRH) among newly treated hypertensive patients. Method and Material: A cross-sectional, observational study was conducted in department of general medicine, Rani Durgawati Medical College, Banda, Uttar Pradesh. 100 adults (age 18 years) with hypertension on treatment for at least 6 months, fulfilling the criteria of apparent treatment resistance, were Observation and Result: Males constituted 70% and females constituted 30% of the study population. The mean age was 52.11 years. 48% were diabetics, 38% had CKD, 27% had COPD, and 22 had CKD. 51% were smoker, and 18% were alcoholics. Almost all the patients with aTRH were found to have low adherence (98%). Female s ex, financial dependency, lower socioeconomic status, alcohol, smoking, knowledge about medication and the presence of depression were significant factors associated with low medication adherence in a RTH. Conclusion: Our study find that significant low medication adherence among patients with TRH. The study stresses that medication adherence be checked in each and very aTRH patient, and specific underlying causes must be addressed. [ABSTRACT FROM AUTHOR]

Background: The main contributors to death and disability from chronic illnesses in developing nations are elevated blood pressure (hypertension), blood sugar (diabetes mellitus), and blood cholesterol (dyslipidaemia). Even though there are affordable treatments, the treatment gap for these conditions is still significant. Few pilot studies from industrialized nations discuss the value of peer-led interventions for achieving community-level management of blood pressure and blood sugar. This study aims to evaluate the effectiveness of peer-led intervention compared to standard care in achieving control of selected non-communicable diseases (NCDs) in Indian context at 1 year of intervention among people of 30–60 years with hypertension and/or diabetes mellitus and/or dyslipidaemia. Methods: A cluster-randomized controlled trial will be conducted in villages of two rural blocks of the Khordha district of Odisha from August 2023 to December 2024. A total of 720 eligible participants (360 in the intervention group and 360 in the control group) will be recruited and randomized into two study arms. The participants in the intervention arm will receive a peer-led intervention model for 6 months in addition to standard care. The sessions will be based on the six domains of NCDs — self-care, follow-up care, medication, physical activity, diet, limiting substance use, mental health and co-morbidities. The mean reduction in blood pressure, HbA1C, and blood cholesterol in the intervention arm compared to the standard care arm will be the main outcome. Discussion: The increasing burden of NCDs demands for newer strategies for management. Peer-led interventions have proven to be useful at the international level. Incorporating it in India will have remarkable results in controlling NCDs. Trial registration: Clinical Trial Registry of India (CTRI) CTRI/2023/02/050022. Registered on 23 February 2023. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension, the "Silent, Invisible killer" - is a modern day's universal epidemic. The adult populations in slum area are more vulnerable for hypertension as they are so busy in the fulfilment of even day to day basic needs and care, family commitments and economic stress. Aim and objectives: To estimate the prevalence of hypertension among the adults (25-44 years) and to study the effect of sleep on blood pressure levels. Methodology: The present cross-sectional study was carried among adults aged between 25 to 44 years residing in the slums of Meerut District. 30 Cluster Sampling technique was used. The slum was selected as a cluster unit. During the visit by house-to-house survey, members of the family were listed and eligible person were interviewed and examined. Data collected on a structured and pretested questionnaire. Results: Prevalence of hypertension among those who had sleep duration of >8 hours per day was 44.8% followed by 20.1% and 17.5% among those who had 7-8 hours and less than 7 hours of sleep time respectively. It was found that 24.2% monophasic sleep pattern follower were hypertensives while the prevalence was 19.4% in biphasic pattern. Conclusion: Majority (55.4%) had a sleep duration between 7-8 hours, followed by 33.9% and 10.7% with <7 hours and >8 hours of sleep time respectively. Majority (61.3%) of the study population were having monophasic sleep pattern, while 36.3% were biphasic and 2.4% were multiphasic. [ABSTRACT FROM AUTHOR]

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting numerous women of reproductive age, marked by hormonal imbalances, irregular menstruation, and ovarian cysts. Beyond fertility concerns, PCOS correlates with metabolic issues like insulin resistance, obesity, and heightened risks of type 2 diabetes and heart disease. This study explores the pathophysiology of PCOS in Bengali-speaking Hindu and Muslim women from Kolkata, West Bengal, India. It involved 723 young adult women, aged 15 to 30, split between 371 Hindus and 352 Muslims. The research gathered data on PCOS prevalence, associated general and socio-demographic characteristics, menstrual patterns, dietary habits, anthropometric data, and clinical variables such as blood pressure, random blood glucose, and hemoglobin levels. The findings indicate that despite sharing the same locale, Hindu and Muslim women show distinct PCOS manifestations and burdens due to their ethnic and cultural differences. [ABSTRACT FROM AUTHOR]

The commercial professional drivers are at risk of developing hypertension, diabetes, and obesity as they are exposed to many risk factors due to the nature of their work. The study highlighted various risk factors in order to better clarify the burden of this health issue in the Sagar district of Central India. A cross-sectional analytical study was carried out on a cohort of 496 drivers in a city located in Central India. We measured participants' blood pressure, blood glucose, height, and body weight. The lifestyle-related risk factors along with dietary patterns were assessed using a pretested questionnaire. For the purpose of statistical analysis, both the Student's t-test and the Chi-square test were employed. A significance level of P < 0.05 was adopted as the threshold for determining statistical significance. Out of 496, 226 (45.5%) were hypertensive and 150 (30.2%) were diabetic. The patients who were found to be hypertensive were more than 30 years of age, mostly belonging to rural areas with a high school degree. Most of them were smokers with more than 10 cigarettes per day along with occasional alcohol intake and daily tobacco chewing habit. The sleep quality and physical activity was found to be inadequate. The diabetic patients were mostly greater than 30 years of age belonging to rural areas with intense smoking and tobacco chewing habit. The sleep habit and physical activity was found to be inadequate. The patients in the BMI range of ≥30 were found to be more hypertensive and diabetic. In light of current findings, there is a clear need for focused interventions to promote healthier lifestyles among drivers. This is essential to reduce the prevalence of diabetes, hypertension, and overweight conditions within this group. Such interventions have the dual benefit of improving drivers' well-being and as well as enhancing passenger safety. [ABSTRACT FROM AUTHOR]

Introduction: The course of outcome in non traumatic neurological illnesses, such as acute encephalitis syndrome, meningitis, paediatric stroke, metabolic encephalopathy, etc., can be affected by various risk factors. While there have been many studies evaluating the effects of blood pressure on outcomes in traumatic brain injury, there is a dearth of studies assessing Mean Arterial Pressure (MAP) in non traumatic injury, particularly in the paediatric age group. Aim: To examine the association between MAP and outcomes in children with acute non traumatic neurological illnesses in the Paediatric Intensive Care Unit (PICU), focusing on mortality and length of PICU stay. Materials and Methods: This prospective cohort study was conducted at Gandhi Medical College, Bhopal, Madhya Pradesh, India from September 2021 to August 2022. A total of 249 children aged between 1 to 14 years with acute non traumatic neurological illnesses were included, and their mean blood pressure was recorded. Associated co-morbidities (severe anaemia, respiratory failure, sepsis, and acute kidney injury), mean length of hospital stay, and outcome were also assessed. Categorical variables were analysed using either the Chi-squared (χ² ) test or Fisher’s exact test, while continuous variables were assessed using the Analysis of Variance (ANOVA) test for mean length of stay. Results: Out of the 249 subjects, 157 (63.1%) were male, and 143 (57.4%) belonged to the age group of 1-5 years. Among them, 36 (14.5%) experienced hypotension, and 17 (6.8%) had hypertension during their PICU stay, while 196 (78.7%) had normal blood pressure. Abnormal MAP was significantly associated with a higher mortality rate among the study subjects (p-value<0.001), and the mean length of PICU stay was significantly longer (p-value<0.001) in study subjects with abnormal MAP. Conclusion: Both high and low MAP were significantly associated with higher mortality and longer duration of stay in children with acute non traumatic neurological illnesses. [ABSTRACT FROM AUTHOR]

Introduction: Prehypertension is the precursor to high Blood Pressure (BP), which can lead to severe consequences such as cardiovascular disease, stroke, acute myocardial infarction, heart failure, peripheral arterial disease, and cerebrovascular complications, ultimately resulting in mortality. Vagal stimulation is frequently employed by therapists, along with various therapeutic exercises, to treat or manage Heart Rate (HR) and BP in prehypertensive individuals. The vagus nerve plays a vital role in maintaining internal physiological balance, known as homeostasis, which includes reflex pathways that regulate cardiac function. Auricular neuromodulation of the vagus nerve can be achieved through stimulation of the ear lobule, cymba concha, or tragus in the outer ear. Aim: To compare and determine the optimal anatomical site for vagal stimulation, specifically the ear lobule, cymba concha, or tragus, to improve HR, BP, and skin hydration in prehypertensive individuals. Materials and Methods: The present pilot study conducted a pre-post comparative analysis in the Outpatient Department (OPD) of Physiotherapy at the Institute of Applied Medicines and Research Centre, Ghaziabad, Uttar Pradesh, India. The study duration was nine months, from January 2022 to September 2022. A total of 30 subjects aged 30-55 years were divided into three groups (10 participants in each group: A, B, and C) using sealed envelopes. Group A received vagal stimulation on the ear lobule, Group B received vagal stimulation on the cymba concha, and Group C received vagal stimulation on the tragus. Baseline measurements were taken prior to treatment, including HR, BP, and skin hydration. Vagal stimulation was administered using a low-frequency Transcutaneous Electrical Nerve Stimulation (TENS) machine at 25 Hertz and a pulse width of 120 ms. The stimulus was continuously applied for 30 minutes, five days a week, for four weeks. After a 10-minute relaxation period, HR, BP, and skin hydration were measured both pre and post-intervention. The data was statistically analysed using Statistical Package for Social Sciences (SPSS) version 24.0, employing paired t-tests to compare means within groups and Analysis of Variance (ANOVA) to compare between the three groups. Results: There were no statistical differences in the baseline among all three groups. Group C, which received vagal stimulation on the tragus, demonstrated statistically significant improvements in BP and skin hydration. The t-value and p-value for Systolic Blood Pressure (SBP) were 11.513 and p<0.001, for Diastolic Blood Pressure (DBP) were 10.411 and p<0.001, for HR were 15.231 and p<0.001, and for skin hydration were 9.474 and p<0.001, respectively. When comparing HR, BP, and skin hydration among the groups using one-way ANOVA f-value and p-value showed significant difference between the groups in all parameters. Conclusion: The study concludes that vagal stimulation on the tragus is a superior intervention compared to vagal stimulation on the cymba concha or ear lobule for controlling HR, BP, and skin hydration in prehypertensive individuals. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension (HTN) is a major public health challenge across the world and is a major cause for mortality as well as disability-adjusted life years. The health problems of the people are closely associated with various socioeconomic factors including lifestyle of the people. with 29.8% overall, 33.8% urban and 27.6% rural area prevalence, HTN is a major public health problem and a leading non-communicable disease (NCD) in India. Materials and Methods: A cross-sectional study was conducted at the Department of Community Medicine, National Institute of Medical Sciences and Research (NIMS&R), Jaipur, Rajasthan from January 2022 to December 2022. The study subjects were interviewed at their house and all information recorded in the pre-designed and pretested schedule. A second home visit was given to collect data when people who were not able to be contacted on first occasion. Altogether 410 subjects consented for the study. Age, sex, education, occupation, socioeconomic status, religion, additional salt intake, physical activity, body weight, height, body mass index (BMI) and blood pressure were taken as different variable for this study. Results: Out of the 410 participants, 66 (16 %) subjects were having hypertension. Subjects with age above 49 years were having high proportion (20.6 %) of hypertension in comparison to age less than 49 years. In comparison to females (12.1%), males were having higher proportion (18.6%) of hypertension. It appeared from the Table 2 that out of 66 hypertensives, 30.3 percent participants were taking additional salt, 22.2 percent were involved in drinking alcohol and 43.5 percent were smokers. The hypertension proportion was highest in participants with body mass index >25 (36.4%) among all variables. The role of Risk factors like age, gender, BMI, extra salt intake, and alcohol drinking in development of hypertension among study population was found be statistically significant (p<0.01). Conclusion: The prevalence of hypertension among tribal population in a rural area was found to be high. They appear equally affected by the changing lifestyle due to migration, acculturation and urbanization overshadowing their heavy working attitude. [ABSTRACT FROM AUTHOR]

Aim- Metabolic fuel detectors regulate energy balance at peripheral and central levels. The aim of this study is to assess association of serum Orexin levels with Metabolic risk markers in women of reproductive age group. Material And Methods- The study was conducted in campus of King George Medical University (KGMU), Uttar Pradesh Lucknow, INDIA. 150 apparently healthy women of reproductive age group i.e. 20-40 years of age were randomly selected. Fasting serum orexin and Serum insulin levels were measured using ELISA and weight, Body mass index, Fasting blood glucose, Lipid prole and Blood pressure were estimated in women. Result- The results show that Serum orexin levels has signicant positive correlation with fasting blood glucose, weight, BMI and waist circumference along with a weak negative correlation with serum Insulin level. Conclusion- In present study Serum orexin levels signicantly correlate with weight, BMI, Fasting blood glucose and weak negative correlation with serum Insulin levels. serum orexin levels did not correlate with lipid prole of women of reproductive age group. [ABSTRACT FROM AUTHOR]

Background: Hypertension care cascade in resource-limited settings is compromised with a majority of patients with hypertension remaining undiagnosed, untreated, non-adherent, and poorly controlled at every stage. However, there is paucity of information on care and management of hypertensive patients in community-based settings of low-income urban neighbourhoods in India. Methods: This was a community-based cross-sectional study conducted in an urban resettlement colony and slum area in the Northeast District of Delhi. The adult population was screened for hypertension using standardized methods, and adherence to medications was assessed using the Morisky Green Levine scale. Binary logistic regression analysis was conducted to ascertain the sociodemographic predictors of the outcome (presence of hypertension, adherence to antihypertensive medication, blood pressure control). A p-value < 0.05 was considered statistically significant. Results: We included 8850 adult participants including 5295 females and 3555 males in this study. Nearly 29% of the participants were hypertensive, of which 61.77% were newly diagnosed cases. Furthermore, nearly 81% of the previously diagnosed cases had been initiated on antihypertensive medication, of which 57.54% were adherent to their medications while 36.12% attained controlled blood pressure levels. The odds of having hypertension were significantly higher among males (AOR = 1.87, 95% CI: 1.63 to 2.15), age ≥ 60 years (AOR = 9.15, 95% CI: 7.82 to 10.70), high waist circumference (AOR = 2.24, 95% CI: 1.86 to 2.70) and Body Mass Index of ≥ 25.00 (AOR = 2.55, 95% CI: 2.00 to 3.26). Furthermore, on adjusted analysis, patients of hypertension having diabetes (DM) comorbidity had significantly higher odds of being adherent to anti-hypertensive medications (AOR = 1.81, 95% CI: 1.31 to 2.51) compared to those without DM comorbidity, while tobacco users had significantly lower odds of being adherent to antihypertensive medication (AOR = 0.50, 95% CI: 0.31 to 0.82). Conclusions: Hypertension care cascade in urban slum-resettlement colony setting revealed a high burden of undiagnosed hypertension, low rates of medication adherence, and poor blood pressure control. Strengthening community screening and primary care continuum of care is necessary to improve the hypertension care cascade from early diagnosis to effective management with optimal health outcomes to reduce patient complications and increase longevity. [ABSTRACT FROM AUTHOR]

Background: Chronic hypertension, a major global health concern, contributes significantly to cardiovascular diseases, stroke, and chronic kidney disease. In India, it stands as the seventh leading cause of death. Understanding the dynamics of blood pressure (BP) is crucial for effective management, especially in resource-constrained settings. This study explores the interplay between systolic (SBP) and diastolic (DBP) blood pressure in hypertensive patients, investigating the variables influencing their longitudinal variations. Methods: A prospective follow-up research was conducted at the hypertension clinic in SLN Medical College and Hospital, Odisha. Structured questionnaires captured socio-demographic and clinical variables from 1100 hypertensive patients aged 18 or older, resulting in 4400 observations. Bivariate longitudinal mixed effect models were employed for joint analysis of SBP and DBP evolution over time. Results: The mean SBP and DBP decreased over the 6-month follow-up period. Significant factors influencing SBP and DBP included sex, age, diabetes, coffee consumption, alcohol use, khat chewing, and physical exercise. A joint model indicated a positive correlation between SBP and DBP developments. Discussion: The study revealed a declining trend in both SBP and DBP over time, emphasizing the impact of modifiable risk factors. Sex, age, lifestyle choices, and medical history played significant roles in influencing blood pressure parameters. Regular exercise emerged as a protective factor. Conclusion: The joint mixed effect model provided valuable insights into the correlated dynamics of SBP and DBP. Targeted prevention and management strategies should focus on modifiable risk factors identified in the study. Healthcare professionals can use these findings to tailor interventions for hypertensive patients and impede the progression of hypertension. [ABSTRACT FROM AUTHOR]

Objectives: The present study aims to compare body adiposity and blood pressure (BP) in two climatically and ethnically diverse populations, examining whether thermoregulatory adaptive mechanism may protect Indigenous populations from exhibiting adverse consequences of increased adiposity. Methods: A cross sectional sample of 404 subjects, of which 200 were Monpa and 204 were Santhal, from two ethnically and geographically distinct populations of India were studied. Body mass index (BMI; kg/m2), fat mass (FM; kg), fat free mass (kg), and percent body fat (%BF) were calculated for evaluation of body adiposity. Multivariate multiple regression analysis was adopted to examine the influence of age and sex of populations under study, on body adiposity and BP variables. Results: BMI, %BF, and FM were found to be significantly higher (p ˂.001) among the Monpa males and females compared with their Santhal counterparts. In contrast, the prevalence of hypertension among Monpa and Santhal is comparable (3.5%Monpa vs. 3.9%Santhal for systolic BP; 8.5%Monpa vs. 8.3%Santhal for diastolic BP). Adiposity, as quantitated by the fat mass index and %BF was significantly (p ˂.001) correlated to age and sex of study population, explaining ~75.3% and ~75.4% of total variations of these variables, respectively. Conclusions: Overall the present study suggests that modern human populations follow thermoregulatory mechanism for adaptation to different climatic conditions. Consequently, greater adiposity was evident among the Monpa who adapt to the cold climate, in comparison to their Santhal counterparts who dwell in warm climate. [ABSTRACT FROM AUTHOR]

Aim. The leading cause of early cardiovascular death worldwide is systemic hypertension (HTN). It is accountable for 57% of stroke and 24% of coronary heart disease deaths in India. Vitamin D indirectly regulates blood pressure through regulating the RAAS across clinical, pathophysiological, and molecular domains. This study examines Vitamin D deficiency in South Indian hypertensives. Materials and Methods. In this cross-sectional observational study, 500 routine health checkup patients at our clinic were assessed and enrolled. Demographics, symptoms, and lifestyle were collected using a standard questionnaire. Patients with chronic and newly diagnosed hypertension were included in the study. Blood was drawn to test Vitamin D (25-OH) levels. The data was evaluated to compare hypertensives who were already on medication and those who were newly diagnosed. Results. The population showed hypovitaminosis D, with an average Vitamin D level of 20.2 ± 10.3 ng/mL. A considerable number of newly diagnosed hypertensives had Vitamin D deficiency, with an average value of 17.7 ± 8.7 ng/mL. The observed value was significantly lower than the chronic hypertensive group (17.7 ± 8.7 ng/mL vs. 21.4 ±10.9, p <0.001). LDL, HDL, cholesterol, creatinine, and HbA1C levels were not significantly different across groups. Vitamin D levels were similar for outdoor and indoor workers (p = 0.727). Conclusion. Our study demonstrates there is a high prevalence of vitamin D insufficiency in the hypertensive South Indian population. There were substantially lower levels of Vitamin D identified in those who were newly diagnosed hypertensives compared to chronic hypertensives on treatment. [ABSTRACT FROM AUTHOR]

Introduction: Preeclampsia, a serious pregnancy complication, poses significant risks to both maternal and foetal health, potentially leading to morbidity and mortality. This condition is characterised by changes in lipid profiles, hepatic enzymes, Malondialdehyde (MDA), and uric acid levels. Despite significant medical advancements, identifying precise biomarkers for preeclampsia remains complex. Moreover, there is a lack of epidemiological research on preeclampsia within the southern Indian population. Aim: To estimate the levels of serum lipid profiles, hepatic enzyme levels, MDA, and uric acid levels in pregnant women with preeclampsia. Also, to examine the association between MDA and uric acid levels among women with preeclampsia and those with normal pregnancies. Materials and Methods: This cross-sectional study included 162 pregnant patients aged between 18 and 35 years, who attended the Outpatient Department (OPD) or were admitted to a tertiary care hospital in Visakhapatnam, Andhra Pradesh, India between February 2021 and October 2021. The participants were divided into three groups: Group A (54 normotensive pregnant women), Group B (54 pregnant women with non severe preeclampsia), and Group C (54 pregnant women with severe preeclampsia). Lipid profiles, hepatic enzymes, MDA, and uric acid were evaluated in all subjects, and their relationship with preeclampsia severity was assessed. The data were statistically analysed using one-way Analysis of Variance (ANOVA) followed by the Tukey post-hoc test. Results: The study groups (A, B, and C) had comparable age and gestational periods. However, significant variations were observed in lipid profiles, hepatic enzymes, MDA, and uric acid levels among them, which associated with the severity of preeclampsia. Increasing severity was associated with higher cholesterol and triglyceride levels, as well as a decrease in High Density Lipoprotein (HDL) cholesterol. Furthermore, disease progression led to significant elevations in Alkaline Phosphatase (ALP), uric acid, and MDA levels. In particular, Group A displayed total cholesterol levels of 138.3±20.32 mg/dL, triglycerides of 109.98±15.22 mg/dL, and a negative association with HDLcholesterol at 30.57±3.65 mg/dL. In contrast, Group C exhibited considerably higher levels of total cholesterol, triglycerides, AST, ALT, uric acid, and MDA compared to Group A. Conclusion: As preeclampsia worsens, cholesterol and triglyceride levels increase, while HDL-cholesterol decreases, indicating a deteriorating metabolic profile. Additionally, ALP, uric acid, and MDA levels rise, indicating increased oxidative stress and liver function impact with the progression of the ailment. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension is one of the major risk factors for heart attack and stroke, often referred to as the "silent killer." Non pharmacological therapy can be used to manage hypertension in addition to pharmacological therapy. Exercise such as continuous and interval training are types of physical exercises. Findings indicate that Moderate-Intensity Continuous Training (MICT) and High-Intensity Interval Training (HIIT), lower average blood pressure in Stage-1 hypertensive patients. Need of the study: To evaluate the effectiveness of interval training and continuous training on patients with Stage-1 hypertension and to prevent the progression to the next stage of hypertension. Aim: To compare the effects of continuous training versus interval training on blood pressure, heart rate, and Rate of Perceived Exertion (RPE) in Stage-1 hypertension. Materials and Methods: This randomised clinical study will be conducted at the Cardiovascular and Thoracic Surgery Unit, Acharya Vinobha Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India, for a duration of six months. In this study, 130 patients diagnosed with Stage-1 hypertension will be divided into two groups. The first 65 will be randomly assigned to Group A as the interval training group, while the remaining 65 will be assigned to Group B as the continuous training group. Each patient's demographic information, including name, age, gender, height, and weight, will be recorded. Before the intervention, patients' blood pressure and heart rate will be measured, taking an average of three readings. Training will then commence, and patients will be reassessed to determine the effectiveness. Statistical analysis will be performed using paired and unpaired t-tests. [ABSTRACT FROM AUTHOR]

Introduction: In the management of hypertension and diabetes mellitus, a systematic response like modifications in lifestyles is needed along with the medication. The study was conducted to determine the impact of comprehensive lifestyle modifications on hypertension and diabetes and to compare it with that of physical activity alone as a health education intervention. Materials and Method: A risk factor-based community intervention trial was conducted for one year in 3 villages in coastal Karnataka. The sample of 305 was calculated depending on the expected change in blood pressure and an equal sample size was drawn from each of the villages using a systematic random sampling method. Baseline data on blood pressure level, random blood sugar, and HbA1c levels were recorded. After 1 year of intervention, all the parameters were further recorded along with the adherence to medication for these non-communicable diseases. Results: The mean difference between the groups suggested that participants with physical activity intervention reported a statistically significant reduction in systolic blood pressure. In the comprehensive lifestyle modification group, there was a significant reduction in both diastolic blood pressure and glycated hemoglobin levels (21 mmHg and 2.1%; p < 0.001). Conclusion: The study indicates that in the management of hypertension and diabetes mellitus, the impact of comprehensive lifestyle modifications was more significant compared to physical activity alone. [ABSTRACT FROM AUTHOR]

Background: Living with hypertension (HTN) has been found to cause distress, which adversely affects one's self-care and may lead to elevated blood pressure. There is a paucity of data regarding the prevalence of HTN-related distress. This study was conducted to estimate the prevalence of HTN-related distress among adults with HTN attending an outpatient department in an urban primary health centre and to determine the factors associated with distress. Methods: This was a cross-sectional study conducted at the outpatient department of an urban primary health centre in Delhi, India. The enrolled participants were administered a questionnaire, which included a Distress Scale for patients with diabetes mellitus and/or hypertension (DSDH17 M) (to assess for HTN-related distress) and Health-Related Quality of Life, Healthy Days Measure. A descriptive analysis was performed. Factors associated with HTN-related distress were tested using logistic regression. Results: One hundred forty-one participants were enrolled in this study. Most were women (73.76%) with a mean age of 60.15 years (standard deviation [SD]: 0.78). The prevalence of HTN-related distress (average DSDH17 M score ≥3) was 14% (95% confidence interval [CI]: 9.30-21.03). Patients with HTN-related distress had significantly poor health and reported a greater number of days where they were physically or mentally unhealthy. Patients with uncontrolled blood pressure had six times the odds (95% CI: 1.69-21.77, P value = 0.006) of HTN-related distress compared to those with controlled blood pressure. Conclusions: Hypertension-related distress was present in 14% of adults with HTN. Patients with uncontrolled blood pressure had six times the odds of HTN-related distress. [ABSTRACT FROM AUTHOR]

Introduction: Obesity is a known risk factor for hypertension. Baseline Heart Rate (HR) and blood pressure are known to scale linearly with Body Mass Index (BMI) values. Recent studies have reported an exaggerated acute response of blood pressure and HR to exercise. Aim: To assess the effect of isotonic exercise on cardiovascular parameters among individuals with different body mass indices in students at Osmania Medical College and look for any association between BMI and cardiovascular responses to isotonic exercise. Materials and Methods: A cross-sectional study was conducted in the Department of Physiology at Osmania Medical College, Hyderabad, Telangana, India, from January 2022 to December 2023, involving 100 healthy individuals with different body mass indices in the age group of 17 years-30 years. The subjects were divided into four groups based on their BMI. Baseline HR, Systolic Blood Pressure (SBP), and Diastolic Blood Pressure (DBP) were measured for all participants. Subsequently, the participants performed isotonic exercise for three minutes. Post-exercise HR, SBP, and DBP were measured immediately. One-way ANOVA was used to determine the significance of HR, SBP, DBP, Mean Arterial Pressure (MAP), and Pulse Pressure (PP) among the different BMI groups. A p-value of <0.05 was considered statistically significant. Results: A total of 100 subjects (28 males, 72 females) with a mean age of 18.64±0.92 years participated in the study. Significant differences were observed in pre-exercise HR (p=0.0002), SBP, DBP, and MAP (p<0.001), and post-exercise HR, SBP, DBP, and MAP (p<0.001) among the different BMI groups. Overweight and obese individuals showed an increased tendency for an exaggerated increase in HR. Changes in PP and MAP, affected by a combination of SBP and DBP, also showed statistical significance. Furthermore, there was an increased tendency for an exaggerated increase in blood pressure in the overweight and obese BMI groups. Conclusion: Individuals with higher BMI exhibit exaggerated increases in SBP, Mean and PP, as well as HR. Additionally, obese individuals demonstrated a significant elevation in DBP. The response of blood pressure and HR after exercise in overweight/obese individuals suggests a higher risk of developing hypertension and other cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Background: Estimating the morbidity and mortality in the emergency department (ED) only allows the pediatricians to assess the prognosis of the patient and plan therapies accordingly. This study was conducted to develop and validate a simple scoring system and establish a correlation between clinical parameters and the outcome of the patient. Subjects and Methods: Nine parameters, i.e., body temperature, respiratory rate, heart rate, blood pressure (BP), pulse oxygen saturation (SpO2), capillary refill time, level of sensorium, presence of seizure, and random blood sugar level, were documented, at the time of admission. Parameters were assigned a score of "0" if it is normal. An abnormality in the above parameters were indicated by a score ranging from 1 to 3. The primary outcome was assessed in terms of death/survival. Results: Out of the total, 57.2% required critical care, and mortality was reported in 14.75% of cases. On univariate analysis, seven clinical parameters were significantly associated with mortality. In multivariate logistic regression analysis, abnormalities in BP, SpO2, and temperature were independent predictors of mortality (P < 0.05). The receiver operating characteristic was 0.798 (95% confidence interval, 0.755-0.836; P < 0.0001) for the outcome of mortality (the predictive ability of score of 79.8%). The patients with scores 1-5, 6-10, and >10 had 4.923, 23.143, and 112.0 higher odds of mortality, respectively. Conclusions: This scoring system predicts the severity of illness and outcome with a sensitivity of 71.19% and specificity of 72.14%, respectively, in the ED. Higher scores predict unfavorable outcomes in these children. [ABSTRACT FROM AUTHOR]

Background: The application of cold to the spine is documented as favourable for reducing blood pressure in patients with hypertension (HTN). However, hydriatic application in the form of a cold spinal spray (CSS) has not yet been explored. Objective: To find the effectiveness of CSS on cardio autonomic variables among males with HTN. Methods: One hundred male patients with HTN visiting the outpatient service were included in this randomized controlled trial. A single session of CSS (15°C-19°C) was given to 50 patients for a period of 20 minutes for the study group, and the control group was made to lie down on the spinal spray tub for 20 minutes without any intervention. Baseline blood pressure and short-term heart rate variability (HRV) measurements were obtained prior to the intervention, followed by a subsequent assessment after a 20-minute interval for both groups. Results: Following 20 minutes of CSS a significant decrease was observed in systolic blood pressure (136.48±14.15 mmHg to 126.20±13.18 mmHg, p<0.001), diastolic blood pressure (87.96±6.77 mmHg to 84.06±6.84 mmHg, p<0.006), pulse pressure (48.44±11.99 mmHg to 42.08±10.88 mmHg, p<0.007), and mean arterial pressure (104.09±8.12 mmHg to 98.05±7.88 mmHg, p<0.001). No significant changes were noted in HRV variables in either of the two patient groups. Conclusion: The current study findings suggest that a single session of CSS intervention could lower both systolic & diastolic blood pressure, pulse pressure and mean arterial pressure in male hypertensive patients. Further studies are needed to find the long-term effect of CSS among patients with HTN. [ABSTRACT FROM AUTHOR]

Background: The rising incidence of Chronic Obstructive Pulmonary Disease (COPD) has made it a significant public health concern, particularly in India where it ranks as the second leading cause of mortality. This study aims to explore the cardiovascular autonomic reactivity in COPD patients compared to normal subjects. Previous research has shown autonomic imbalance in COPD patients, making this a critical area for investigation to enhance management strategies and mitigate cardiovascular complications. Material & Methods: This prospective observational study was conducted over 18 months at a tertiary care center with 78 participants, comprising both normal subjects and individuals diagnosed with COPD. Various tests, such as deep breathing, isometric handgrip, postural change, and the Valsalva maneuvre, were administered to assess cardiovascular autonomic reactivity. Statistical analyses including t-tests, were utilized to interpret the data. Results: The study revealed significant differences in BMI, resting heart rate, and blood pressure between normal subjects (Group A) and COPD patients (Group B), with p-values of 0.00004, 0.002, and <0.0001 respectively. Cardiovascular autonomic reactivity tests, including E:I Ratio (P=0.001) and ?SBP (P<0.0001), also showed marked disparities. Conclusion: The study highlights significant differences in cardiovascular autonomic reactivity between normal individuals and COPD patients, particularly in parameters like BMI, heart rate, and blood pressure. These disparities suggest compromised autonomic flexibility in COPD patients, underlining the need for a multisystem approach in their clinical management. [ABSTRACT FROM AUTHOR]

Background: Hypertension is one of the most important risk factors for cardiovascular diseases particularly Ischemic Heart Disease & stroke. According to a nationally representative study on burden of high blood pressure in India, 70% of the people suffering from hypertension are not aware of it. Deaths due to hypertension are largely preventable. In comparison to other evidence-based interventions for non-communicable diseases, control of hypertension has the largest potential to save lives. Objective: 1. To estimate the magnitude of hypertension in a rural community. 2. To determine the significance of factors associated with hypertension Design and Methodology: A Community based cross sectional study was conducted in two pre-selected villages near Kakaramanahalli, rural field practice area of RajaRajeswari Medical College for a duration of six months among the people aged 18 years and above. A person was considered to be a hypertensive if he/she were already diagnosed case of hypertension and / or on treatment or with a current SBP of = 140 mm Hg or DBP = 90 mm Hg and a person was considered as pre hypertensive if he/she were with a current SBP of 120 - 139 mm Hg or DBP 80 - 89 mm Hg. Results: Out of 101 participants, the mean age was 52.13±16 years. Majority of the people were in the age group of 60 years & above accounting for 44 (43%). Females outnumbered the males accounting for 66 (65%). Illiterates were more among the study participants accounting for 54 (53.5%). Majority of the people in the study were agriculturists accounting for 51 (50.5%). Overall, the magnitude of Hypertension among the study population was found to be 33.7% and 32.7% were falling under the category of pre-hypertensive. There was no statistically significant association between blood pressure and age, gender, type of family, BMI and waist circumference. Conclusion: Our study concluded that more screening activities to be implemented at rural levels for the population who are above the age of 40 years. There is a need for frequent monitoring of Blood pressure irrespective of BMI, waist circumference in the population above the age of 40 years. [ABSTRACT FROM AUTHOR]

Blood pressure (SBP: systolic blood pressure; DBP: diastolic blood pressure) is positively correlated with cardiac output and vascular resistance is related to height, weight, body surface area (BSA) and body mass index (BMI) in adult women. In the present study, an attempt was made to study the relationship between blood pressure and age, body mass index (BMI) and body surface area (BSA) among adult Irula women in Nilgiri district, Tamilnadu, India. This study was conducted among the Irula of Tamilnadu, an indigenous community belonging to the Scheduled Tribe (ST) and speaking Dravidian. The results of the present study show the association between age, height, weight and BMI with SBP, DBP and BSA in Irula women. The R2 values show a higher magnitude of relationship between age and SBP, age and DBP and BMI and SBP. In the case of BMI and DBP, BSA and SBP and BSA and DBP, however, a very low correlation is observed. This trend confirms the change in the socioeconomic environment and blood pressure in the population studied. [ABSTRACT FROM AUTHOR]