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The prevalence of hypertension in india over the last 30 years is known to have increased rapidly. Hypertension is a chronic disease that needs to be managed within its sociological context as experienced by individuals. This study was conducted to identify the quantitative and qualitative determinants of healthcare-seeking behavior among hypertensive individuals in a rural population of north india., Methodology: A mixed-method study involving 100 adult hypertensive patients was employed. Data were collected on demographic characteristics, health-seeking behavior, and the reasons for choosing a particular health service using a structured questionnaire and interview guide. Descriptive statistics were used to examine the influence of determinants on health-seeking behavior and utilization of healthcare facilities and expressed as percentages. Qualitative data were thematically analyzed., Results: A total of 100 participants with hypertension between 38 and 76 years of age were included in the study. Out of the total study participants, 66.0% of the respondents were males and 34.0% were females. Participants demonstrated a generalized knowledge of hypertension and showed significant gaps and misconceptions in their understanding of the disease and the need for seeking expert care. There was also a lack of sense of trust in the healthcare system. Various demographic, sociocultural, and economic determinants of healthcare-seeking behavior in these rural patients' services were explored. This evidence can prove helpful in streamlining interventional programs and realigning the existing interventions to prevent and control hypertension in rural settings., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Family Medicine and Primary Care.)

Background: Antihypertensive drug therapies have been reported to be associated with new onset of type 2 diabetes mellitus in some hypertensive patients after prolonged use. Angiotensin converting enzyme (ACE) gene has been found to affect essential hypertension, response of antihypertensive therapies, and glycemic disturbances. Therefore, ACE gene I/D polymorphism may be associated with risk of new onset of type 2 diabetes via metabolic disturbances, glycemic dysregulation, and insulin resistance., Aim: To assess the correlation between ACE gene I/D polymorphism and glycemic disturbance under influence of diuretic and other antihypertensive drug therapies., Materials and Methods: We recruited 270 normotensive patients as control (150 men and 120 women), 270 hypertensive patients (95 men and 175 women), and 240 hypertensive with new onset of diabetes patients (80 men and 160 women). All samples were genotyped for ACE gene polymorphic alleles and relationship between different genotypes and anthropometric and clinical parameters along with drug therapies was established and analyzed., Results: Baseline clinical (systolic blood pressure, diastolic blood pressure, and fasting blood glucose level) and anthropometric parameters (height, weight, waist circumference, hip circumference, waist-hip ratio, and body mass index) of study populations were found highly statistically significant ( P  < .05) when compared among study groups. Furthermore, genotype wise comparison of all these parameters in essential hypertensive (EH) and essential hypertensive with onset of diabetes (EHNOD) patients found most of them nonsignificant and no variation was found with respect to different genotypes of ACE gene. The genotype wise comparison of clinical parameters among different antihypertensive drug therapy was found statistically nonsignificant in both EH and EHNOD patients., Discussion: Anthropometric parameters can be taken as the risk indicator factors for hypertension and diabetes. However, ACE gene polymorphism may not be a risk factor for development of diabetes in hypertensive patients., Conclusion: The present study suggested that ACE gene polymorphism did not show any significant association with the risk of new onset of diabetes in EH patients and more detailed studies with large population size are needed., Competing Interests: Declaration of Conflicting Interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Different antihypertensive therapies (especially diuretics) are reported to induce the new onset of diabetes in some hypertensive patients. α-adducin-1 (ADD1) gene is salt sensitive gene which has its role in etiology of hypertension via salt sensitivity. Therefore, the G460T polymorphism of ADD1 gene may be associated with new onset of diabetes under the influence of diuretic and other antihypertensive therapies., Aim: To assess the correlation between genetic polymorphism (ADD1 G460T polymorphism) and glycaemic disturbance under influence of diuretic and other antihypertensive drug therapies., Materials and Methods: We recruited study subjects, 270 normotensive as control (150 male and 120 females), 270 hypertensive patients (95 male and 175 females) and 240 hypertensive with new onset of diabetes patients (80 male and 160 females). All study samples were genotyped for ADD1 polymorphic alleles and analyzed the relationship between different genotypes with respect to anthropometric and clinical parameters along with drug therapies., Results: Clinical and anthropometric parameters (such as age, SBP, DBP, FBG, height, weight, WC, HP, W/H ratio, and BMI) of study population were found highly statistically significant (p<0.05) at base value. Further, genotype wise comparison of all the above parameters revealed most of them as non-significant (p>0.05). Whereas, comparison between genotype and different antihypertensive drug therapy of hypertensive patients, specifically, diuretic therapy as mono in male (p=0.0227) and female (p=0.0292) and in combination with BBs in both male (p=0.0023) and female (p=0.0079) revealed a higher FBG level in variant T allele. In case of hypertensive with new onset of diabetes patients, only female population showed a slightly statistically significant (p=0.0413) difference in FBG level with diuretic mono therapy. Other antihypertensive drug therapies were safe and effective either as mono or in combination therapy., Discussion: Anthropometric parameters may be the indicative factors for hypertension and diabetes. Variant T allele of ADD1 gene may be considered as the risk factor for the development of diabetes in hypertensive patients. Diuretics as mono therapy and in combination with BBs may be considered as the risk factor for new onset of diabetes in EH patients carrying variant T allele (either as TG or TT)., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

In 2010, the Indian Society of Gastroenterology's Task Force on Inflammatory Bowel Diseases undertook an exercise to produce consensus statements on ulcerative colitis. This consensus, produced through a modified Delphi process, reflects our current understanding of the definition, diagnostic work up, treatment and complications of ulcerative colitis. The consensus statements are intended to serve as a reference point for teaching, clinical practice, and research in India.

Eighty-seven patients underwent endoscopic sphincterotomy (ES) for common bile duct (CBD) stones. Out of these, 66 patients had post-cholecystectomy CBD stones and 21 had CBD stones with gall bladder 'in situ'. In post-cholecystectomy group, 15 patients had 'T' Tube 'in situ'. The presenting symptoms in the post-cholecystectomy group were: pain abdomen, jaundice and cholangitis in 51, 20 and 11 patients respectively. The fifteen patients with 'T' tube used to experience pain after clamping of 'T' tube. Those with gall bladder 'in situ' had cholangitis in 12 and jaundice only in 9 patients. CBD clearance was achieved in 80 patients (91.95%). The sphincterotomy cut had to be extended in 19 patients. There was no mortality following sphincterotomy. Nine patients (10.3%) had minor complications such as bleeding (4), cholangitis (3), pancreatitis and impaction of Dormia basket in one patient each. Thus ES is a safe and effective treatment for CBD stones with or without gall bladder/'T' tube 'in situ'.