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Background: Hypertension and chronic kidney disease are inextricably intertwined. Most patients with hypertension associated CKD die of heart attack and stroke before renal function. Ambulatory BP monitoring provides automated measurements of BP during a 24hrs period while patients engaged in their usual activities including sleep. Recommended normal value include an average daytime BP <135/85mmHg/night time BP <120/70mmHg and 24 hr BP <130/89mmHg. In patients with chronic kidney disease the control of hypertension slows the progression of end stage renal disease. This study was undertaken to define the prognostic role of ABPM in dialysis dependent and non-dialysis CKD patients so that better treatment strategies could be initiated to prevent adverse outcomes.Methods: This prospective cross sectional study was conducted at Aarupadai Veedu Medical College and hospital, Puducherry in both dialysis dependent and non-dialysis CKD patients admitted in both ICU and medical wards. APBM was performed by using the properly validated ambulatory blood pressure monitor. The monitor records BP on the non-dominant arm every 20 minutes while awake and hourly while sleep for a total duration 24hrs in both hemodialysis dependent and non-hemodialysis patients. In hemodialysis dependent patients ABPM was recorded on the second day of hemodialysis.Results: The mean maximum systolic blood pressure in dialysis dependent and non-dialysis CKD patients recorded was 146.23 and 166.12 mmHg respectively. The mean minimum systolic blood pressure in dialysis dependent and non-dialysis CKD patients recorded was 122.11 and 122.45 mmHg respectively. The mean maximum diastolic blood pressure in dialysis dependent and non-dialysis CKD patients recorded was 100.24 and 110.65mmHg respectively. The mean minimum diastolic blood pressure in dialysis dependent and non-dialysis CKD patients recorded was 78.65 and 80.67 mmHg respectively. In our study the prevalence of non-dipping in dialysis and non-dialysis CKD patients were 28% and 16% respectively.Conclusions: Ambulatory blood pressure monitoring is considered the gold standard for the diagnosis of hypertension. Tight BP control is needed to limit the progression of renal disease and lessen cardiovascular morbidity and mortality. To achieve this goal ABPM should be widely adopted in patients with CKD.
ABSTRACT
Inflammation plays a vital role in accentuating the formation of atherosclerotic plaque in diabetes mellitus. So, the measurements of inflammatory markers provide a method of assessing cardiovascular risk. Among the inflammatory markers, highly sensitive C-reactive protein (hs-CRP) is used to detect the low-level inflammation when it is within the normal range. Also, hs-CRP measurement may be useful for assessment of the risk of complication in diabetes patients. So, the present study is conducted to measure plasma hs-CRP level in T2DM and to determine adequate glycaemic control reduces hs-CRP level. The objectives of this study were to correlate HbA1c and hs-CRP in T2DM and predict cardiovascular risk with glycaemic status.Methods: Authors took 50 diabetic patients. The investigation includes FBS, PPBS, hs-CRP and HbA1c. hs-CRP is measured by immunoturbidimetry method. The reports were collected and compared with normal reference range.Results: The correlation between hs-CRP levels and HbA1c level after six months show a significant relationship where mean HbA1c values on day 1 and after 6 months were 8.088±1.219 and 7.518±0.693 respectively. The hs-CRP values were 2.508±1.050 on day 1 and 2.15±0.927 after 6 months proving that better glycaemic controls decrease hs-CRP thereby decreasing cardiovascular risk.Conclusions: hs-CRP values are directly related to HbA1c and better glycaemic control reduces risk of CVD.
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Background: Cardiovascular diseases (CVD) are the leading cause of death throughout world population each and every year. Focus on dyslipidemia management is urgently required in India to halt the rising tide of CVD. The purpose of diabetic dyslipidemia study is a record based one, to find out the effect of Rosuvastatin plus Fenofibrate, in adult Type 2 diabetes with dyslipidemia, with high TGL/HDL ratio in Lipid profiles, in a tertiary care hospital in the Union territory of Puducherry.Methods: There were 101 patients hospital records were analysed in which male were 45 and females were 56. The various biochemical parameters like serum Total Cholesterol, HDL, LDL, TGL, Non-HDL, TCL/HDL Ratio and TGL/HDL ratio reports were collected before and after 12-weeks of Rosuvastatin 10 mg with Fenofibrate 145 mg combination, for the treatment period once daily for their lipid-lowering therapy.Results: The combination therapies of Rosuvastatin plus Fenofibrate were safe and feasible to achieve more TG goal and proved that has predominately decreased the elevated lipid profiles from the medical resources of our record based study. The use of combination medications of rosuvastatin (10mg) plus Fenofibrate (145mg) is often needed to effectively treat the lipid triad, by the potency of rosuvastatin to lower LDL-C and Fenofibrates effectiveness in lowering TG in treating mixed diabetic dyslipidemia.Conclusions: After Rosuvastatin (10mg) plus Fenofibrate (145mg), the lipid profile data proved that the importance of TGL/HDL ratio apart from the TCL/HDL ratio, for good lipid control in diabetic dyslipidemic patients.
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Background: Hypertension control is essential to prevent macro vascular complications in patients with chronic kidney disease. Ambulatory Blood Pressure Monitoring (ABPM) is the recognized gold standard for the assessment of hypertension and hence in this study ABPM assessment was done in 50 patients with dialysis dependant CKD to evaluate the adequacy of BP control and prevent adverse events.Methods: This study is a prospective observational study conducted at Aarupadai Veedu Medical College and Hospital, Pondicherry among hypertensive patients with dialysis dependant CKD patients as per standard criteria. A total of 50 patients participated in this study of both gender after obtaining written consent. Patients with coronary artery disease, diabetes mellitus, acute kidney injury were excluded from this study.Results: Out of the total 50 patients included in this study 72% had early morning dipping in BP and remaining 28% had non-dipping in systolic and diastolic pressure. The mean systolic pressure reached a maximum of 160.95mmHg to a minimum of 113.38mmHg and the mean diastolic pressure with a maximum of 98.47 to a minimum of 62.71mmHg on an overall 24 hours ABPM monitoring. The mean systolic and diastolic pressure was found to be more in the active period than in the passive period.Conclusions: Nocturnal BP is superior to day time BP in predicting CVD outcomes. This study shows both systolic and diastolic pressure variability over 24hrs maximum during night hours (nocturnal hypertension) and non-dipping of early morning BP. Both non-dipping status and nocturnal hypertension are associated with target organ damage and CV risk.
ABSTRACT
Background: Obesity is a disease process characterized by excessive body fat accumulation which is associated with a large number of debilitating and life-threatening disorders. It is necessary to curb obesity when its beginning in late childhood or adolescence and youngsters. Hence this study is aimed to determine the prevalence of obesity among medical college students.Methods: This is an observational cross-sectional study conducted at Aarupadai Veedu Medical College and Hospital, Puducherry. Height, weight, waist and hip circumference were measured, and BMI and Waist Hip ratio has been calculated according to WHO standards to determine obesity level in students.Results: Out of the total 94 students included in the study 56.4% students were in normal weight, 26.6% overweight, 6.4% were obese and shockingly 10.6 % were in the underweight category. Nearly 81.8% and 79.5% of female and male students respectively were in the substantially increased risk category showing insignificant difference between genders.Conclusions: This study shows that overweight and obesity is prevalent among medical students without much difference in gender basis. Frequent screening might create awareness among students and help them become more self-conscious regarding overweight and obesity.