Introduction: Obesity defined as increased fatty mass is progressively rising in recently, even though its affects begins to all systems in childhood and adolescence periods, the most important morbidity and mortality reason of obesity is its effects on the cardiovascular system. Researches point out endothelial dysfunction and atherosclerosis as the reason of the cardiovascular system disease in obesity. The studies conducted on childhood period related to this subject are highly limited and the results of these are also controversial. Therefore in our study the effects of obesity on endothelial functions in children and adolescents was assessed by flow mediated dilation (FMD) method. In addition to that, effects of epidemiological, biochemical, hormonal and clinical features of cases to FMD were investigated.
Material and method: A total number of 104 cases were cover in this study. Obese group (group 1) was consisted of 59 children whose body mass index (BMI) was ≥ 95th percentile and mean age was 12 ± 2.8 years old. The control group (group 2) consisted of 45 children whose body mass index (BMI) was between 25th -84th percentil and mean age was 11.4 ± 2.9 years old. The detailed history, epidemiological data and physical examination were performed. The population classified three groups according to sport activities. 97th percentile and higher values were accepted as morbid obesity. The blood pressure was measured with a mercury sphygmomanometer with utilizing the proper size cuff in compliance with the criterion used by the “National High Blood Pressure Education Program Working Group”. The complete blood count and biochemistry tests (renal and liver function tests, electrolytes, lipids, hsCRP) of the cases were analysed with biochemistry Roche Cobas Integra 800 and hormon assays of the cases (thyroid function tests, diurnal cortisol, ACTH, 17 OHP, prolactin, DHEA-S) were analysed by ECLIA method on Roche Elecsys 2010 device in the laboratory of our hospital. IR-HOMA values > 2.5 in prepuberal and > 4 in pubertal were defined as the insulin resistance. Bone ages of cases were evaluated with left hand wrist X-ray by using Greulich and Pyle Bone Age Atlas. flow mediated dilation (FMD) was used to assess the endothelial functions of all cases. The brachial artery was evaluated with SPG 12 MHz surface probes by using GE voluson ultrasound system in this method. FMD was expresses as percent (%) increase according to the basal vein dimension. 7% mean value was taken as the limit in the comparisons.
Results: The ratio of male and female was 20/39 in group 1 and 14/31 in group 2. 32.3% of the cases in group 1 and 47.6% of the cases in group 2 were prepubertal. The waist and hip circumferences ratio of the group 1 (0.86 ± 0.05) was significantly higher than group 2 (0.80 ± 0.07). While there was no difference between groups 1 and 2 in terms of the birth weight, using duration period of vitamin D and beginning time to additional nutrition, breastfeeding duration of group 1 (10.6 ± 7.8 months) was significantly shorter than group 2 (14 ± 7.4 months). BMIs of the mothers in group 1 were statistically higher than the mothers in group 2 (27.5 ± 4.8 kg/m² and 24.3 ± 3.2 kg/m² respectively. The mean of IR-HOMA was 4 ± 2.9 in group 1 and 1.9 ± 0.8 in group 2 and there was the insulin resistance in 51% of the obese cases. The dyslipidemia was diagnosed in 38.5% of the cases in group 1. The systolic and diastolic blood pressures in group 1 (117 ± 12.2 mmHg and 73.7 ± 9.4 mmHg respectively) were significantly higher than in group 2 (107.5 ± 9.1 mmHg and 68.2 ± 7.1 mmHg respectively). Hypertension was determined in 25% of the cases included in group 1. The minimum values of FMD in groups 1 and 2 were 1.01% and 3.1% respectively. The maximum values of FMD in groups 1 and 2 were 9.7% and 15% respectively. The mean values of FMD was %5 ± 2.3 in group 1 and %8.1 ± 3.5 in group 2. Compared with group 2, group 1 demonstrated significantly impaired FMD. There was no association between FMD and the birth weight, breastfeeding duration, physical exercises in two groups. A negative correlation was found between FMD and BMI (p < 0.01, r = -0.402). The correlation was determined between FMD and BMI of the mother (p = 0.017, r = -0.305) and the presence of obese individuals in the family (p = 0.021, r =-0.413). It was found that a significant negative correlation between FMD and waist-hip circumference ratio (p = 0.003, r = -0.421). When each groups were assessed in terms of biochemical and hormonal characteristics, there was low negative correlation between FMD and uric acid level and strong negative correlation between FMD and ALT level were determined in group 1.
Conclusion: In our study showed that the obesity begins in the childhood period may cause to the endothelial dysfunction. For this reason, according to our opinion, recognition prior indicators of endothelial dysfunction in early time may be helpful both to take the precautions required and to prevent cardiovascular complications in childhood and influences to the adult period.
The rising sizes of the waist and hip circumferences, positive family history for obesity and obesity of the parents were determined as the most important parameters negative affecting FMD. Unlike the literature, the association between endothelial dysfunction and GGT level the indicator of the hepatosteatosis in obese children was also found as well as FMD and ALT have also a close association independent from BMI in this study. Thus, a different point of view was formed since ALT may possibly have a predictor value in the assessment of the endothelial functions and it is also found as a highlighted risk factors for the endothelial dysfunction in this study. Because of this reason, it can be recommended that when the liver function tests carry out in obese children it does not show only hepatosteatosis but also can be used as an early indicator of the cardiovascular complications of obesity. Another important subject to be emphasize that the ALT level in the childhood period may be an early cardiovascular risk indicator in both obese and nonobese children.
Broad-spectrum sunscreens are now widely used worldwide as an adjunct to help prevent sunburn, skin cancers and premature skin aging. In the United States, all persons older than 6 months are recommended to apply sunscreen to all sun-exposed skin from toes to head except eyes and mouth even on cloudy days. Such a recommendation is apparently based on concepts that exposure to sunlight damages the skin, the damage is cumulative and hence any sun exposure should be minimized or prevented. This communication raises several questions suggesting that the above recommendation may need to be reconsidered. For example, numerous previous studies have indicated many potential health benefits from non-burning sun exposure including protection against sunburn, melanoma, colorectal cancer, breast cancer and prostate cancer, increasing vitamin D synthesis, helping sleep, reducing blood pressure, heart attack and stroke. Recent studies suggested that regular lifetime non-burning sun exposure may not result in premature skin aging and the skin aging is mainly caused by the intrinsic factor. Skin aging or whole-body aging has been recently postulated to be mainly attributed to a gradual reduction in cardiac output/index with age and a new anti-aging or age-reversing nutritional theory has been proposed. An apparent lack of long-term cumulative sunray damage was also supported by reported age independence in incidences of sunburn and skin cancers. It is of interest that the current US policy is different from that of World Health Organization and Australia recommending the need of sun protection only when UV Index is 3 or greater. In view of the above, some general guidelines regarding when to best apply sunscreen are proposed.
Purpose: The purpose of the study was to examine the health status of rural adolescents and young adults in the United States through a comprehensive review of detailed health information, behavior and health awareness. The disparity in health awareness between rural and non-rural residents compared and evaluated.
Methods: Rural-Urban Commuting Area (RUCA) codes were combined with respondent-level data from the Longitudinal Survey of Adolescent to Adult Health (Add Health) to classify individuals as rural/non-rural residents. Health characteristics and perceived health awareness was tested for statistically significant differences using ANOVA. Differences in weight perception accuracy was compared for systematic differences controlling for self-selection into rural areas using a two-stage logistic selection model.
Findings: Analysis revealed that rural residents have a higher incidence of major health conditions including epilepsy, high cholesterol, high blood pressure and diabetes. Additionally, they have a higher prevalence of unhealthy behaviors including drinking and drug use. Rural residents are less likely to be insured, but more likely to be overweight or obese. While rural adolescents are more likely to mis-classify their body weight, this misclassification is a result of the higher incidence of overweight rather than the residential location.
Conclusion: The higher prevalence of chronic conditions combined with the income and education levels suggests the rural environment is a unique and potentially challenging context for adolescent health. Improving rural adolescent health will require innovative solutions appropriate for rural environments and changes in individual health literacy. Solutions must be multisectoral, engaging education, economic development, and other community perspectives to establish key drivers for health equity.
Background: Pathological and nighttime sleep deprivations have substantial adverse effects on regulation of weight, sugar and blood pressure because of endothelial dysfunction, sympathetic nervous system stimulation, regulation and activation of systemic inflammation. Thus, this study was aimed to assess quality of sleep among patients with chronic illness and its associated factors at South Wollo Zone Public Hospitals, Northeast Ethiopia.
Methods and Materials: The study was conducted at South Wollo Zone Public Hospitals, Northeast Ethiopia from February 15 2019 till April 15 2019. Institutional based cross sectional study design was employed. All patients with chronic illness who are on follow up in South Wollo Zone Public Hospitals were sources of population. Sample size was calculated by using EPI info version 7 and the total sample size was 344. The study employed stratified random sampling technique and study participants were selected by systematic sampling. After taking ethical approval from College of Medicine and Health Sciences Ethical Approval Committee, permission from selected Hospitals and informed verbal consent from patients, the data were collected by a tool which has 3 parts: Sociodemographic data, Pittsburgh Sleep Quality Index and factors affecting sleep quality. Data were entered in to Epi data version 4.1 and exported to Statistical Package for Service Product 25 for analysis. Different data presentation tools and binary logistic regression were enrolled by considering 95% confidence level and p value of 0.05.
Result: Among the total study participants, near to one third (31.7%) of them got sleep after 30 minutes. More than one fourth of them slept for less than 7 hours. Less than half of the study participants had habitual sleep efficiency of more than 85% however 296(86%) of them did not face day time dysfunction
Conclusion and recommendations: more than one third of patients with chronic illness had poor sleep quality. One third of study participants had sleep duration of less than the recommendations(less than 7 hours). Age, educational status, residence, and perception of prognosis of disease were factors that have associations with poor sleep quality among patients with chronic illness. Health care providers who are doing in chronic illness follow up clinic should be initiated to assess and screen those patients with poor sleep quality.
Metabolic syndrome composed of abdominal obesity, atherogenic dyslipidemia, raised blood pressure, insulin resistance and/or glucose intolerance, proinflammatory state and prothrombotic state is a complex multisystem disorder. It is well known that patients with metabolic syndrome have increased cardiovascular risk and risk of developing diabetes type II. But besides these well known risk states, there are other conditions such as polycystic ovary syndrome, fatty liver, cholesterol gallstones, asthma, sleep disturbances and some forms of cancer associated with a metabolic syndrome. In this case report we will present a patient who developed many of these conditions related to the metabolic syndrome and will highlight the novel efforts regarding to the lifestyle changes, primarily weight loss.
MMK Mbula*, B Longo-Mbenza, HNT Situakibanza, GL Mananga, JRR Makulo, MM Longokolo, MN Mandina, NN Mayasi, MM Mbula, B Bepouka, GL Mvumbi, EN Amaela, DN Tshilumba, O Odio, BM Ekila, A Nkodila, T Pindi and BBT Buasa
Background: The survival of people living with HIV (PLWHIVs) is increased and Health systems will have to deal with the early-aging-associated medical conditions.Objective: The objective of this study is to compare the clinical and biological profiles of PLWHIVs aged 50 and over and those aged less than 50 years.Material and methods: This study conducted at Kinshasa University Teaching Hospital (KUTH) covers 6 years. The clinical and biological characteristics of PLWHIVs aged 50 and over were compared with those under 50. Statistical analysis used the means ± SD, the calculation of frequencies, Student’s t-test and Chi-square.Results: PLWHIVs aged 50 or over represented 35.1%. Their average age was 58.0 ± 4.8 years. Women predominate among those under 50 and men among those 50 and over. Married people were more numerous (54% among those under 50). There were more unemployed (50% of PLHIV under 50). Patients 50 years and older were significantly classified as WHO stage 4 with a high frequency of history of tuberculosis, genital herpes, high blood pressure, smoking, vomiting, hepatomegaly, moderate elevation of diastolic blood pressure (DBP) and sytolic blood pressure (SBP), tuberculosis and anemia.Those under 50 had a significantly increased frequency of shingles, hepatitis B-hepatitis C, headaches and more survivals. The mean of Hb, HDL-C, and CD4s+ were significantly lower in patients 50 years and older, and urea, LDL-c, and ALAT levels were significantly higher. Conclusion: The average age was higher from 50 years old. These PLWHIVs were more frequently in WHO stage 4 with more common TB and anemia. Their Hb, HDL-C, and CD4s+ levels were lower while their urea, LDL-C and ALAT levels were significantly elevated.
Background: Control of increased athrogenic index of plasma and lipid parameters in the early stage of diabetes mellitus helps diabetic patients to improve their quality of life and treatment outcomes. Limited studies were conducted on the assessment of dyslipidemia and its correlation with clinical and anthropometric variables among diabetes patients but no study was conducted on the correlation of the athrogenic index of plasma with anthropometric measurements among diabetes patients in this study area. The objective of this study was to assess the correlation of dyslipidemia and athrogenic index of plasma with anthropometric measurements and clinical variables among diabetic patients in Dessie Compressive specialized hospital, Northeast Ethiopia.Methods: Institution-based comparative cross-sectional study was conducted from August 2020 to June 2021. A total of 250 diabetic and healthy control respondents were included in the study with convenience sampling. Semi-structured questionnaire of a modified WHO stepwise Approach to Surveillance for chronic disease was used to collect data. Finally, descriptive statistics and correlation analysis were conducted to assess the correlation between variables. A P-value of less than 0.05 was declared as the level of significance.Results: Athrogenic Index of Plasma, Triglyceride to High-density Lipoprotein Ratio, Very-Low-Density Lipoprotein, systolic blood pressure, diastolic blood pressure, triglyceride, waist circumference, WHtR and BMI were statistically significantly higher among type 2 DM groups. There was a significant positive linear correlation between triglycerides and waist circumference, between TG / HDL and WHtR, and between cholesterol and WHtR, but a significant negative linear correlation between HDL and waist circumference among the Type 2 DM group. Systolic blood pressure and pulse showed a significant positive linear correlation with WC, BMI, and WHtR among diabetics groups only. Our study showed that the pattern of lipid abnormalities observed among DM patients was high AIP in 68%, moderate AIP in 16% and all four groups of hyperlipidemia were found in 9% of diabetic patients. All lipid profiles showed a significant very strong positive linear correlation with AIP, but DHL has a significant very strong negative linear correlation with AIP among type 2 DM groups.Conclusion: The proportions of high athrogenic index of plasma and lipid profile disorders were higher in DM patients compared to healthy controls. Dyslipidemia and a high athrogenic index of plasma had a considerable correlation with anthropometric measurements and clinical outcomes of type II DM patients. DM patients who have a higher athrogenic index of plasma and higher lipid parameters should be strictly followed based on their anthropometric measurements.
Feng-feng Ding, Ji-hong Hu*, Zeng-wu Wang, Xin Wang, Chun-juan Yan, Ming-yan Ma and Xue-lian Chen
Published on: 30th August, 2022
Coronary heart disease (CHD) is the leading cause of death worldwide [1]. In China, the prevalence of CHD has kept continually increasing, with the number of patients being approximately 11.39 million, at present [2] and CHD poses a substantial threat to human health. Hypertension and diabetes both are the major risk factors for CHD [2,3] and the risk of CHD in patients with coexisting hypertension and diabetes is higher than that in patients with either of the two diseases [4].
Daniel Miller, Karim Makhoul, Allison Foster and Asma Ul Hosna*
Published on: 24th November, 2022
Chronic thromboembolic pulmonary hypertension is a notoriously underdiagnosed cause of severe pulmonary hypertension. It is a form of precapillary pulmonary hypertension (PH) that results from intraluminal thrombus organization and fibrous formation which ultimately results in the complete obliteration of pulmonary arteries, resulting in increased pulmonary vascular resistance which leads to the development of pulmonary hypertension and as a result right heart failure. The mechanism involves the narrowing of the pulmonary artery which increases blood pressure within the lungs and impairs blood flow which increases the workload of the right side of the heart ultimately causing right heart failure. Pulmonary hypertension can also cause arrhythmias, blood clots, and bleeding in the lungs. Even though CTEPH is a deadly condition, among all forms of pulmonary hypertension, CTEPH is the only curable form. Echocardiography is the initial assessment tool for suspected PH. A right heart catheterization may be performed to confirm the presence of pulmonary hypertension. Confirmation of CTEPH requires a V/Q scan. Although ventilation/perfusion scintigraphy has a major role in the evaluation of patients with suspected CTEPH, nowadays CTA chest is being used widely as it produces much better-quality images compared to V/Q scan. Without treatment, the prognosis is very poor. Out of three treatment modalities such as; pulmonary endarterectomy (PEA) surgery, balloon pulmonary angioplasty (BPA), and medical therapy, surgery is the gold standard. The physician must be familiar with the disease entity, early diagnosis, and appropriate treatment to improve survival. Here we present a literature review on this topic.
Vasiliki Christou, Fedra Zoi Karataraki, Omar Eid, Rasha Eid and Joseph A Moutiris*
Published on: 6th December, 2022
Coronary Artery Disease (CAD) is the most common type of heart disease and a major cause of mortality worldwide. This study highlights the significance of hypertension as a risk factor in patients with CAD and compares its prevalence to those of EUROASPIRE IV (EUS-IV), ESC Atlas of Cardiology (Atlas) and Cyprus Survey of Coronary Heart Disease of 2006 (CY-2006). A retrospective, observational study was conducted, by the Registry of Cyprus Heart Survey, where 375 individuals with chronic CAD were examined in Nicosia General Hospital Cardiology Clinics, between the years 2011 and 2014. Their medical history regarding hypertension was noted and the data was analyzed using Microsoft Excel software. The total prevalence of hypertension, based on the past medical history of the patients was 59%.Out of these, 52% were found to have elevated blood pressure on their visit to the Cardiology Clinic. The total mean systolic blood pressure amongst the study group was 136 mmHg, with no significant differences between males and females (136 mmHg and 134 mmHg respectively).The findings of the present study are the same compared to those of the CY-2006 (52% both), but slightly higher than the findings of EUS-IV (52% vs. 42.7%) and significantly higher than those recorded in the Atlas (52% vs. 24.8%). The results show that there is still much potential to improve hypertension management in patients with established CAD.
Carles Cañameras Fugasot, Oriol Rodríguez-Leor, Josep Riera Sadurní, Edgar Fadeuilhe, Javier Paul Martínez, Marina Urrutia Jou, Jordi Bover and Maribel Troya-Saborido*
Published on: 16th March, 2023
Hypertension is a risk factor for the development of heart failure and has a negative impact on the survival of these patients. Although patients with these two conditions usually take different antihypertensive medications, some patients do not achieve adequate blood pressure control and their hypertension becomes resistant or refractory. In this scenario, percutaneous renal denervation has emerged in recent years as an alternative to achieve blood pressure control goals. We present the case of a 53-year-old woman with a medical history of essential hypertension, hypercholesterolemia, unipolar depression, and diabetes, who was diagnosed with dilated cardiomyopathy with reduced left ventricular ejection fraction (33%). Despite the initiation of multiple antihypertensive medications and placement of a cardiac resynchronization therapy pacemaker, the patient remained hypertensive with a left ventricular ejection fraction of 40%. At that time, percutaneous renal denervation was performed without complications, and one year after the procedure, the patient had improved better blood pressure control and the left ventricular ejection fraction increased to 51%. This case illustrates one of the clinical scenarios in which it has been suggested that renal denervation may be more beneficial, as in the situation of patients with refractory hypertension and heart failure.
Aerobic capacity of young men (19 years - 24 years) is high, but can be influenced by many factors like physical activity, smoking, and air pollution with environmental PM 2.5. Objectives: (a) - to estimate the aerobic capacity in young men (smokers and non-smokers) living in areas with higher PM 2.5 using Queen’s College Step Test (QCT). (b) - to find whether aerobic capacity is associated with the International Physical Activity Questionnaire (IPAQ)’ three classes, for smokers and non-smokers. Methods: In a cross-sectional study using criteria-based sampling a total of N = 60 smokers & non-smokers were included from the Delhi NCR region. IPAQ, Peak Expiratory Flow Rate (PEFR), Heart Rate, Systolic Blood Pressure, Diastolic Blood Pressure, and PM 2.5 and PM 10 levels were recorded. A comparison of smokers and non-smokers was performed using z test. Smokers and non-smokers were divided into three classes using physical activity levels and compared for aerobic capacity. The correlation of aerobic capacity with variables was seen using Pearson’s correlation coefficient. Multiple R was checked to study the model of cause and effect for aerobic capacity. Results: Significant difference is seen between smokers and non-smokers in the aerobic capacity (Mean ± SD smokers - 65.22 ± 8.73 ml/kg/min; Mean ± SD non-smokers 60.04 ± 7.7 ml/kg/min p value = 0.00). For non-smokers, a low level of physical activity shows a strong correlation with aerobic capacity (r = 0.78; p = < 0.05). No correlation of aerobic capacity is seen with physical activity levels among smokers. Aerobic capacity shows a significant negative and moderate correlation with PM 2.5 (r = -3.1; p = 0.016). The multiple R coefficient value for the model of cause and effect is 6.99 with a p - value of 0.0449 for this. Conclusion: Smoking affects aerobic capacity significantly for young men. High and moderate levels of outdoor physical activity do not increase aerobic capacity in areas with high PM 2.5, whereas low levels show a positive correlation among non-smokers only.
Georgina George Balyorugulu, Emmanuela Ambrose, Patrick S Ngoya, Yusuf S Jamnagerwalla, Iddi S Buri, Primrose Songoro and Protas D Komba
Published on: 28th July, 2023
Background: Stroke occurs in 11% of patients with SCA before 20 years of age. In Northwestern Tanzania, the prevalence of stroke among children living with SCA under the age 15 years is 16.9%, of which might be attributed to the absence of routine screening for the risk of stroke by using Transcranial Doppler Ultrasound (TCD). Screening with TCD allows preventive measures such as chronic blood transfusion to be done which has led to the reduction of stroke by 92%.Methods: This was a prospective analytical cross sectional study which enrolled 267 SCA children aged 2 to 16 years attending Bugando Medical Centre Pediatric Sickle Cell Clinic from July 2019 to June 2020. Assessment of factors associated with elevated TCD included a clinical history of stroke in sibling, death in sibling, temperature, oxygen saturation in room air, blood pressure, hemoglobin level and total white blood cell count. TCD was done by accessing transtemporal window and recording the highest time average mean of maximum velocity (TAMMV) of major vessels mainly, middle cerebral artery (MCA) and distal internal carotid artery (dICA).Results: The median age of enrolled was 6.6 (IQR: 4-9) years. The prevalence of elevated TCD (> 170 cm/s)was found to be 21% (56/267). By multivariate logistic regression, low oxygen saturation in room air, p - value = 0.037, OR 1.08 [95% CI 1.00-1.17] and low hemoglobin level, p - value = 0.001, OR 1.76 [95% CI 1.26-2.45] were statistically significantly associated with elevated TCD among children living with SCA.Conclusion: The high prevalence of elevated TCD velocity, with low hemoglobin and low oxygen saturation in room air as associated factors under multivariate logistic regression, warrants routine TCD screening for children with SCA aged 2 to 16 years.
Aim: To evaluate the serum sodium and potassium levels in the three trimesters of pregnancy in women. Methods: Four groups of healthy women between the ages of 20 and 30 years, volunteered for this study. Group 1: Non-pregnant women (control), Group 2: Pregnant women in their first trimester, Group 3: Pregnant women in their second trimester, Group 4: Pregnant women in their third trimester. Blood samples were collected by standard aseptic method and serum samples were analyzed for serum levels of sodium and potassium by the ion selective electrode method. Results were presented as MEAN ± SEM in tables and figures, p < 0.05 was regarded as statistically significant. Results: The serum sodium concentrations in mmol/L were 135.3 ± 3.09, 136.3 ± 1.55, 139.0 ± 0.78, 139.8 ± 0.91 for control, first-trimester, second-trimester, and third-trimester subjects respectively. The potassium concentrations in mmol/L were 3.678 ± 0.26, 3.687 ± 0.13,3.820 ± 0.11, 3.767 ± 0.07 for control, first-trimester, second trimester and third-trimester subjects respectively. The Bodyweight values in kg were 72.13 ± 2.11, 74.73 ± 2.05, 75.00 ± 1.72, 81.56 ± 4.24 for control, first-trimest, second-trimester, and third-trimester subjects respectively. Conclusion: Results indicate that the hormones of pregnancy altered the body weight of pregnant women, but did not change the serum sodium and potassium level across the three trimesters of pregnancy in women. This is an indication that the kidneys of healthy pregnant women can handle serum electrolyte load during the period of pregnancy.
Background/Aim: There has been a progressive rise in the incidence and prevalence of End Stage Renal Disease (ESRD). It has also been observed that the most important reasons for a rapid increase in Chronic Kidney Disease (CKD) patients are the rapidly increasing worldwide incidence of diabetes and hypertension. The present study evaluates the effect of diabetes, hypertension, and comorbid state of hypertension and diabetes (hypertensive-diabetic) on renal function using serum creatinine and urea as markers. Method: A total number of 120 persons were recruited for the research; 30 controls, 30 hypertensive, 30 diabetic, and 30 hypertensive-diabetic persons. Of the 30 control persons, 18 were females and 12 were males; of the 30 hypertensive subjects, 17 were females and 13 were males; of the 30 diabetics subjects, 20 were females and 10 were males, whereas of the 30 hypertensive-diabetic subjects, 21 were females and 9 were males. In total, there were seventy-six (76) females and 44 males. The respondents were pulled from Central Hospital (Auchi) Diabetic and General Clinic and Auchi Polytechnic Cottage Hospital. Verbal consent was sort and questionnaires were used to extract information regarding biodata and patients’ history of diabetes and hypertension. Height and weight were measured, and blood pressure was determined taken. Blood samples were collected into fluoride oxalate and lithium heparin bottle for the assessment of FBS and (serum urea and creatinine) respectively. Results: The mean (±SD) serum creatinine was higher in the hypertensive-diabetic group (2.08 ± 1.06) and declined as follows: diabetic group (1.75 ± 1.01), hypertensive group (1.34 ± 0.96) and control group (0.70 ± 0.14). The mean (±SD) serum urea was also found to be higher in the hypertensive-diabetic group (17.5 ± 9.06) and declined as follows: diabetic group (14.5 ± 6.13), hypertensive group (12.7 ± 6.23) and control group (7.18 ± 5.06). There was a positive correlation between serum creatinine and fasting blood sugar The study also established a positive correlation between serum creatinine and blood pressure but not between serum urea and blood pressure with r values of 0.31 and 0.16 respectively. Conclusion: Good control of blood glucose and blood pressure levels reduces the likelihood of the development of renal impairment which is usually associated with both diabetes and hypertension. Co-morbidity of diabetes and hypertension poses a higher risk of developing renal disease than individual problems of diabetes and hypertension. Serum creatinine and serum urea are important biomarkers for renal impairment hence the two should be monitored on a regular basis for diabetic and hypertensive patients and much more frequently for hypertensive-diabetic patients.
Sumbal Javed, Muhammad Faizan Hamid*, Ahsan Javed, Javaria Azeem, Jawad Ahmad and Eeraj Chaudhry
Published on: 5th September, 2023
Background: Factors like emotions, lifestyle choices, and physical activities, including posture changes, have a significant impact on cardiovascular indicators like blood pressure and heart rate. The study aims to examine the cardiovascular reactions in individuals with type 2 diabetes while performing the head-down crooked kneeling (HDCK) or Sujood position, resembling poses found in hatha yoga. This position emphasizes relaxation, body awareness, and meditation. Those with type 2 diabetes who engage in yoga have reported enhancements in their management of blood sugar levels and insulin resistance. Methodology: A cross-sectional study was conducted in different hospitals. The sample size was 312 which was calculated by using the Rao soft calculator. The participants were selected by non-probability convenience sampling technique. Inclusion Criteria were male and Female diagnosed with Type 2 DM, Subjects with a history of smoking, Cognitive Impairment, Sepsis, Cardiac pathology, Respiratory disorders, and Malignancy were excluded. Blood pressure and heart rate were monitored initially, during the Crooked Down Kneeling position, and after the Crooked Down Kneeling Position. A Digital Sphygmomanometer was used to measure blood pressure and a pulse rate-demographic Assessment form was used to collect data. Ethical consideration is maintained. Informed consent was taken from participants. Results: The result shows a significant effect of head down crooked kneeling position on cardiovascular response in type 2 diabetic patients (p < .001). Systolic, diastolic blood pressure, and heart rate before, during, and after HDCK were significantly increased (p < .001) as compared to the baseline value, and after 5 min returning to the upright position it reverted to the initial value. Conclusion: This study revealed a significant increase in systolic and diastolic blood pressures and an increase in pulse rate during HDCK. Also, our findings showed no significant gender difference in the effect of HDCK on all the other cardiovascular parameters except systolic bp.
Adetunji OMONIJO*, Paul OLOWOYO, Azeez Oyemomi IBRAHIM, Segun Matthew AGBOOLA, Oluwaserimi Adewumi AJETUNMOBI, Temitope Moronkeji OLANREWAJU and Adejumoke Oluwatosin OMONIJO
Published on: 19th September, 2023
Background: Spirituality has been strongly associated with good blood pressure control as it forms a strong coping mechanism in hypertensive patients. This hospital-based cross-sectional study was done to determine the relationship between spirituality and blood pressure control among adult hypertensive patients in rural Southwestern Nigeria to achieve good blood pressure control.Method: The selection was done by systematic random sampling technique. Socio-demographic and clinical information were obtained through semi-structured interviewer-administered questionnaires. The level of spirituality was assessed using the Spiritual Perspective Scale. Data were analysed using the Statistical Package for Social Sciences version 20.0. Statistical significance was set at p ≤ 0.05.Results: The mean age of the respondents was 61.1 ± 11.1 years. More than half (52.6%) had a high level of spirituality and more than two-thirds (67.1%) of respondents had controlled blood pressure. Respondents with a high level of spirituality were 4.76 times more likely to have good blood pressure control {p < 0.001, 95% CI (1.05-14.99)} than those with a low level of spirituality. Conclusion: Proper understanding and effective utilization of this relationship will assist health professionals and researchers in the appropriate integration of this concept into patients’ holistic care with the aim of achieving better blood pressure control among hypertensive patients.
In this research, for the purpose of social implementation, we conducted a near-miss demonstration experiment using a car driving in the city and a drive-simulator. Next, we conducted a demonstration experiment to evaluate the reliability of biometric information measured on patients in a medical facility's recuperation ward and residents of a special nursing home. NBC-1100 emits radar waves from a distance of up to 3 meters from an object and uses the reflected waves to measure biological information such as pulse waves and breathing waves. The multi-element pyroelectric effect was used to measure body temperature by detecting infrared radiation emitted from distant objects. This device is unique in that it can measure biological information without being restrained while wearing clothes. In the demonstration test, simultaneous measurements were conducted on nine healthy men aged 45 to 65 using a pharmaceutically approved product (μBP-mp) and a prototype non-contact biological monitor (NBC-1100 manufactured by K&S Co., Ltd.). The demonstration experiments at medical institutions and nursing care facilities were conducted with the consent of residents and their families and were conducted on 30 men and women between the ages of 70 and 94 who were undergoing treatment or in need of care. The tests were conducted on residents with chronic diseases such as dilated gastrostomies, symptomatic epilepsy, hypertension, Alzheimer's disease, and progressive supranuclear palsy. The evaluation method was simultaneous measurement using a master meter (μBP-mp) and a test meter (NBC-1100).
Martin Rosas-Peralta, Héctor Galván-Oseguera, Luis Alcocer, Humberto Álvarez-López, Ernesto Cardona-Muñoz, Silvia Palomo-Piñón, Enrique Díaz-Díaz, Adolfo Chávez-Mendoza and José Manuel Enciso-Muñoz
Published on: 11th December, 2024
Background: High blood pressure and dyslipidemia are risk factors that begin silently and share many pathophysiological mechanisms of tissue damage.Aim: Draw attention to this binomial (Hypertension and dyslipidemia) that is highly prevalent in Mexico and is mainly responsible for the leading atherothrombotic process as a cause of death in Mexico and the world.Methods: Reflective analysis of the evidence accumulated in the last 20 years. We launch key messages and support why every hypertensive patient should be treated with a statin.Results: We call for awareness to measure lipid levels and blood pressure twice a year from the age of 20 and to detect these devastating nosological entities as soon as possible. We remove the myth that PCSK9 inhibitors as well as the small interfering RNA of its synthesis are only for familial dyslipidemia. Measurement of serum Lp(a) should be routine, especially if you have a history of your own and family cardiovascular events.Conclusion: We should be aware of the little impact that health strategies have had to stop the main cause of death in Mexico. Every hypertensive patient should receive a statin, even if their serum LDLc levels are apparently normal. The great challenge of optimal control of the population with hypertension and/or dyslipidemia continues. The small interfering RNA synthesis PCSK9 should also be considered when conventional therapies are not sufficient and this situation is not infrequent.
Afaf Alsharif*, Zainab Said, Fatima Mokabes, Leena Ameen, Alya Alqadri, Thekra Musaed, Bushra Musaed, Ala’a Ahmed and Halaa Rigih
Published on: 18th February, 2025
Background: Preterm Birth (PTB) is the largest direct cause of neonatal mortality and the second leading cause of under-five mortality following pneumonia. Although there are studies conducted before, the magnitude of PTB remains a major issue in most developing countries including Yemen. Therefore, this study aims to assess the prevalence and associated factors of premature birth among newborns delivered in Jiblah University Hospital in Ibb governorate, Yemen.Objectives: No studies have previously been conducted about preterm labour in Jiblah University Hospital in Ibb governorate, Yemen.Methods: This retrospective observational study was conducted in the Department of Obstetrics & Gynecology, Jiblah University Hospital in Ibb Governorate, from 1 December 2023 to 29 February 2024.Results: A total of 1350 pregnancies, 252 (18.67%) were preterm deliveries and 1089 (80.66%) were full-term deliveries at Jiblah University Hospital, Ibb. Our study shows the distribution of participants based on socio-demographic factors. The data that out of the total 252 female participants, with ages mean ± std = 27.43 ± 6.34 roughly 18.67% experienced preterm deliveries. Our study demonstrates that several factors are significantly linked to preterm birth, including the number of siblings, blood pressure, gravida, and abortion number, where the Chi-square p - value was < 0.05. On the other hand, the results from the logistic regression analysis indicated the predictive potential of certain socio-demographic factors in relation to preterm birth. Conclusion: In this study, the number of siblings, blood pressure, gravida, and abortion number are the risk factors for premature delivery. Recognizing the most common risk factors for PTB will help to increase awareness about high-risk pregnancy, improve the preventive measures of preterm risk factors, and modify preterm care protocol in nurseries.
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