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Background: With the demonstration of origin and nature of RIF mass by high-resolution ultrasound and multidetector CT scan, the patients presenting with clinically palpable mass in RIF need not to undergo time consuming, uncomfortable and unpalatable barium study. The objective is to evaluate the diagnostic precision of CT and ultrasonography in the diagnosis of right iliac fossa masses and to assess the effectiveness of USG in diagnosing various right iliac fossa masses in comparison with CT scan in terms of sensitivity, specificity, and predictive accuracy. Methods: The study was conducted on 35 patients presenting with right iliac fossa mass who were stable enough to undergo USG followed by CT scan. The time gap between these studies had kept to minimum to make the studies comparable. USG and CT scan was performed by 2 expert radiologists, who had been blinded of each other findings. Results: More than 50% cases were related to appendicular pathology. Ultrasound abdomen had a sensitivity and specificity of 88.9% and 94.11% in diagnosis of appendicular mass, 71.42% and 96.42% in diagnosis of appendicular abscess, 66.7% and 96.6% in diagnosis of ileo-caecal tuberculosis, 50% and 100% in diagnosis of carcinoma caecum respectively as compared to CT scan. Conclusions: USG is the most easily available bed side investigation and excellent screening test for RIF mass. However, CECT whole abdomen remains the gold standard investigation for etiological diagnosis of RIF mass.
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Background: Cardiovascular diseases are a leading cause of morbidity and mortality worldwide. The prevalence and risk factors of CVDs vary across different populations and regions. This study aimed to observe the cardiac profile among the adult population of Sreemangal, Bangladesh, to identify the prevalence and risk factors of CVDs in this population. Methods: This prospective observational study was conducted over a six-month period at a public health camp in Sreemangal, Bangladesh. A total of 137 adult participants were purposively selected. Data were collected through a structured questionnaire and physical examination, including measurements of blood pressure and laboratory analysis of blood samples. Results: The study found that 44.53% of participants had elevated blood pressure, and 21.90% had stage 1 hypertension. Interestingly, 36.50% of participants were unaware of their hypertension status. Furthermore, 26.28% of participants had a known history of diabetes, but blood glucose level analysis revealed an additional 14.85% of participants were prediabetic, and 6.93% were diabetic based on fasting blood glucose levels. A statistically significant association was found between increasing age and the stage of hypertension (p<0.001), and between fasting and normal blood glucose levels and the stage of hypertension (p<0.005 and p<0.05, respectively). Conclusions: The findings of this study underscore the need for targeted interventions to prevent and manage CVDs in the adult population of Sreemangal, Bangladesh. These interventions should include regular screening for CVD risk factors, health education to increase awareness of these risk factors, and strategies to promote healthy lifestyle behaviors.
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Pests and pathogens inflict enormous financial harm on the global farming industry. Monitoring plant health and early pathogen detection is essential for facilitating successful management strategies and preventing the spread of disease. Various traditional methods and serological techniques have been found to be time-consuming and require handling skill. Also, the reliability of the result is uncertain, and it is hard to diagnose the pathogen during asymptomatic stages. Hence, the innovative sensors based on host reactions assessment, phage display-based biosensors, and bio-photonics in combination with other systems, remote sensing techniques integrated with spectroscopy-based approaches allow for high spatialization of data; these techniques could mainly be of immediate benefit for initial identification of infection and early control with limiting the use of Systemic Fungicides and developing a sustainable environment with high yield.
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Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease of the axial spine that can manifest with various clinical signs and symptoms. Chronic back pain and progressive spinal stiffness are the most common features of this disease. It is an autoimmune disease which also leads to the involvement of skeletal, cardiac, nervous tissues, and other systemic organs. Aim and Objectives: This study was conducted to assess the correlation between the Bath AS Disease Activity Index (BASDAI) score/visual analog scale (VAS) and various age groups in the patients suffering with AS using standard questionnaire. Materials and Methods: Forty-eight AS patients having BASDAI scores of ?4 were included in this study. The height and weight were taken and responses to the standard questionnaire were recorded. BASDAI Score, body mass index (BMI), and VAS were computed. The patients with history of chronic diseases such as hyper/hypothyroidism, diabetes mellitus, and hypertension or the use of any medication such as ?/? blockers, calcium channel blockers, and antiepileptics were excluded from the study. Results: The patients were divided into six different age groups, i.e., 15–20 years, 21–25 years, 26–30 years, 31–35 years, 36–40 years, and 41–45 years. The mean ± SEM values of the BASDAI score in various age groups were 6.8 ± 0.34, 6.3 ± 0.33, 6.2 ± 0.26, 7.1 ± 0.41, 6.5 ± 0.30, and 5.8 ± 0.48, respectively. The mean ± SEM values of VAS are shown in relation to the various age groups, i.e., 15–20 years, 21–25 years, 26–30 years, 31–35 years, 36–40 years, and 41–45 years and the values were 6.88 ± 0.312, 6.58 ± 0.22, 6.55 ± 0.66, 6.00 ± 0.23, 6.72 ± 0.25, and 6.0 ± 0.50, respectively. Conclusion: This study indicates that in the young age group, patients BASDAI score is higher and BMI is lower, and in the older age group, patients BASDAI score is lower and BMI is higher than each other indicating higher disease activity in the younger patients than older patients. An inverse correlation between VAS and age further substantiates our previous finding.
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Myocardial bridging is a developmental anomaly characterized by intramural course of a short segment of epicardial coronary artery which mostly remains silent in the initial few decades of life. A 42 years old male non diabetic, hypertensive on single regime therapy presented with atypical chest pain for the last two hours. Serial 12 lead ECGs on an interval of half-hour showing nonspecific dynamic ST changes in lead II, III and aVF suggesting of inferior wall changes with negative bio markers like troponin-T and troponin-I. Coronary angiography reveals myocardial bridge in mid segment of left anterior descending artery (LAD). Considering superficial type of bridging in this case, a conservative management strategy was planned accordingly. Physicians should be more vigilant on possibilities of underlying myocardial bridging as a major differential in emergency scenarios with low suspicion of atherosclerosis but with a picture equivalent to acute coronary syndrome (ACS). Myocardial bridge carries a wide array of complications depending on variabilities like depth of tunnelling, collapsibility, loss of wall sheer stress and vasospastic changes. Hence it needs to be promptly diagnosed with immediate treatment.
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Background: Bronchoalveolar lavage or BAL is a minimally invasive procedure that involves instillation of sterile normal saline into a subsegment of the lung, followed by suction and collection of the instillation for analysis. This procedure is typically facilitated by the introduction of a flexible bronchoscope into a sub-segment of the lung. The purpose of this study was to investigate the pathological variations in the tracheobronchial tree in various respiratory diseases. Methods: The study evaluated the bronchoscopic profile of 150 patients who underwent flexible bronchoscopy in the respiratory medicine department of MGM Medical College in Aurangabad, India from October 2020 to September 2022. Results: The majority of the patients were males (65%) and above the age of 50. The most common reason for bronchoscopy was radiological opacity (80% of cases), followed by diffuse pulmonary infiltration (10%). The study found that bronchoscopy was useful in obtaining samples for diagnosis of various respiratory diseases, including malignancies, tuberculosis, bacterial pneumonia, and hematological malignancies. The study also noted the therapeutic utility of bronchoscopy in managing inoperable stenosis of the central airways. Conclusions: The authors concluded that bronchoscopy is an important diagnostic and therapeutic tool for the management of pulmonary diseases.
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Background: The major risk factors for development of tuberculosis are extremes of age, malnutrition, overcrowding and immune deficient states like AIDS, diabetes mellitus, measles, whooping cough and leukaemia. Chronic malaria and worm infestation are less important risk factors. Tobacco smoking, high alcohol consumption, corticosteroid therapy and immunosuppressive drug therapy reduce body defences there by increasing the susceptibility to tuberculous infection. This study was undertaken to analyse the various clinical presentations in patients with pulmonary tuberculosis and extra pulmonary tuberculosis. Methods: This was a retrospective study of patients from October 2020 to September 2022 (2 years). Data collected from 300 patients who were diagnosed with pulmonary and extrapulmonary tuberculosis visited. The subjects were divided into subjects who had pulmonary TB (PTB), and who had extrapulmonary TB (EPTB). Results: The most common systemic disorders accompanying EPTB were DM (n=11; 8.8%) and chronic renal failure (n=8; 6.4%); while DM (n=16; 9.1%) and chronic obstructive pulmonary disease (n=13; 7.4%) were those detected frequently in PTB group. Conclusions: Present study showed higher percentage of males and greater predominance of pulmonary TB. It is also observed high percentage extrapulmonary TB. High percentage of positive treatment outcomes with fewer relapses and failures was observed in this study. A high positive treatment outcome noted may be attributed to the availability of specialist doctors and diagnostic facilities in the tertiary care centre.
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Background: The recognition of obstructive airway disease as a public health problem, however, has failed to keep pace with its increasing impact on health-care resources. This study is conducted to evaluate the prevalence of obstructive airway disease in pulmonary function tests (PFT) of patients visiting respiratory medicine out patient department (OPD). Methods: This is a retrospective study of patients from October 2020 to September 2022 (2 years), on 80 subjects reporting to respiratory medicine OPD, MGM medical college, Aurangabad. Data collected from 80 subjects who were diagnosed with obstructive airway disease in PFT. Results: The study population had a COPD prevalence of 16 (19.7%). GOLD criterion revealed that 54.2% (9/16) of COPD patients had mild COPD. This research showed no evidence of very severe COPD. In terms of gender distribution, 8 (16.6%) of 46 males and 7 (19.5%) of 34 women had COPD. However, there was no statistically significant (p=0.167) difference in COPD prevalence between sexes. Furthermore, univariable analysis revealed no significant differences in marital status (p=0.836), co-morbidities (p=0.541), family size (p=0.535), educational status (p=0.827), employment status (p=0.643), and medical visits (p=0.366) between persons with and without COPD. Conclusions: According to the findings of this research, the variables that increase a person's likelihood of developing COPD are as follows: advancing age, prolonged exposure to smoke from biomass burning, tobacco use, and inadequate ventilation in the kitchen.
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COVID-19 epidemic is still going on and various SARS-CoV-2 vaccines are available for emergency administration since December 2020. It has many side effects as other vaccines, but as it is a new vaccine, different side-effects are not well-known to us. Here, we are reporting one side-effect, appearance of distant delayed hypersensitive reaction lesions after covid vaccine.
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Background: Squamous cell carcinomas of the oral cavity are relatively common among the head and neck cancers. The increasing depth of invasion (DOI) and the microvascular proliferation caused by neoplastic growth might determine proximity to blood vessels and lymphatics, thus facilitating the tumor’s ability to metastasize. The role of tumour DOI as a prognostic parameter for the development of nodal metastases and for the survival of patients with OSCC are important. Aim of the study was to determine the relationship of the DOI of tumor with the neck node metastasis in squamous cell carcinoma of the oral cavity. Methods: This study is conducted in the State cancer institute, Gauhati medical college over a period of 1 year from June 2021 to June 2022 among 100 patients. All patients underwent tumor resection with neck dissection, and the DOI is measured. Results: Out of 100 patients included in the study 66 were males and 34 were females. Maximum number of cases 30% were seen in the age group of 51-60 years. Gingivobuccal sulcus (32%) is the most commonly involved site. Maximum number of nodal meta-stasis present in tumours with DOI>11 mm and minimum nodal metastasis present in tumours with DOI<3 mm. Conclusions: We conclude that tumor DOI is significantly related with neck nodal metastasis in oral cavity squamous cell carcinoma.
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Background: Peripheral blood vessels are concerned with sensing the perivascular nociceptive information and signaling it to the higher centers through ipsilateral somatic nerves, thereby regulating the cardiorespiratory parameters by means of vasosensory reflex responses. Aims and Objectives: The present study was conducted to compare the potency of nociceptive responses elicited by bradykinin (BK) with the capsaicin-induced responses. Materials and Methods: Charles-Foster rats were anesthetized with urethane and injected intraperitoneally. After tracheostomy, the right femoral artery was cannulated with a 24G, double ported cannula for administering the chemicals/saline through vertical port and to record the blood pressure (BP) through horizontal port. BP, Electrocardiogram, and respiratory movements were recorded. Results: Injection of capsaicin into a segment of femoral artery evoked instantaneous transient tachypnoeic, hyperventilatory, and hypotensive responses. BK also produced similar pattern of nociceptive responses along with a transient fall in heart rate. In addition, the vasosensory responses produced by BK are of greater magnitude as compared to the capsaicin. Conclusions: BK is more potent in eliciting reflex nociceptive responses as compared to capsaicin. Further, BK has an additional cardioprotective role by slowing the heart, in the events of acute inflammation.
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Introduction: Autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. Individuals with autism spectrum disorder usually have problems with social responsiveness which in turns effects their social communication and results in confined repetitive pattern of behaviour and interests. However the existing literature is limited in demonstrating the importance of social responsiveness and its impact on gender and ASD categories. Objective: The purpose of this study was to determine the impact of ASD categories on social responsiveness in adults with ASD and investigate social responsiveness among male and female adults with ASD. Methodology: The study utilized data from 60 adults diagnosed with autism spectrum disorder with categories mainly, mild, moderate and high functioning. Adults of both genders (male and female) participated in this study with Social Responsiveness (SR) as a variable over 7 months from October 2021 to February 2022, using the Social Responsiveness Scale-2 (SRS-2 Adult Relative/Other online form). Results and Conclusion: One-way ANOVA test showed significant difference (p<0.001, df=2) between ASD categories. Tukey's Post Hoc Analysis revealed significant (p<0.001) difference between ASD categories from each other. Gender had no significant impact on ASD, and the severity of ASD varies between groups. Thus, this study fills a large knowledge gap on the influence of gender, categories and social responsiveness on adults with ASD.
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Paravertebral block, especially thoracic paravertebral block, is an effective regional anesthetic technique that can provide significant analgesia for numerous surgical procedures, including breast surgery, pulmonary surgery, and herniorrhaphy. The technique, although straightforward, is not devoid of potential adverse effects. Proper anatomic knowledge and adequate technique may help decrease the risk of these effects. In this brief discourse, we discuss the anatomy and technical aspects of paravertebral blocks and emphasize the importance of appropriate needle manipulation in order to minimize the risk of complications. We propose that, when using a landmark-based approach, limiting medial and lateral needle orientation and implementing caudal (rather than cephalad) needle redirection may provide an extra margin of safety when performing this technique. Likewise, recognizing a target that is not in close proximity to the neurovascular bundle when using ultrasound guidance may be beneficial.
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Background Outcomes of primary percutaneous coronary intervention (PCI) for acute STEMI (ST-segment elevation myocardial infarction) in smokers are expected to be better than non-smokers as for patients of acute STEMI with or without fibrinolytic therapy. Objectives This comparative study was designed to evaluate the outcomes of primary PCI in patients with acute STEMI in smokers and non-smokers. Clinical and angiographic profile of the two groups was also compared. Methods Over duration of two year, a total of 150 consecutive patients of acute STEMI eligible for primary PCI were enrolled and constituted the two groups [Smokers (n = 90), Non-smokers (n = 60)] of the study population. There was no difference in procedure in two groups. Results In the present study of acute STEMI, current smokers were about a decade younger than non-smokers (p value = 0.0002), majority were male (98.9% vs 56.6%) were male with a higher prevalence of hypertension and diabetes mellitus (61.67% vs 32.28% and 46.67% vs 14.44%, p = 0.001) respectively. Smokers tended to have higher thrombus burden (p = 0.06) but less multi vessel disease (p = 0.028). Thirty day and six month mortality was non-significantly higher in smokers 4.66% vs 1.33% (p = 0.261) and 5.33% vs 2.66% (p = NS) respectively. Rate of quitting smoking among smokers was 80.90% at 6 months. Conclusion The study documents that smokers with acute STEMI have similar outcomes as compared to non smokers with higher thrombus burden and lesser non culprit artery involvement. Smokers present at much younger age emphasizing the role of smoking cessation for prevention of myocardial infarction.
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La luxacion tibioperonea proximal es poco comun, se relaciona con lesiones deportivas, como consecuencia de un trauma en rotacion con el pie en inversion y flexion plantar, la rodilla en flexion y la pierna en rotacion externa simultaneamente. Provoca dolor en la region lateral de la rodilla y la pierna, con arcos de movilidad completos de la rodilla, pero dolorosos. El diagnostico es clinico y radiologico. Es una entidad que pasa inadvertida en el Servicio de Urgencias (60%), con consecuencias funcionales y biomecanicas si no se diagnostica oportunamente. El objetivo es describir la experiencia diagnostica y el tratamiento ortopedico de una entidad inusual en trauma de rodilla. Se presenta a un paciente de 23 anos que sufrio una caida patinando y refiere protuberancia proximal en la cara lateral de la pierna izquierda, edema, dolor y limitacion para extender la rodilla. Nivel de Evidencia: IV
Proximal tibiofibular dislocation is uncommon, and it is related to sport injuries as a result of an external rotation trauma with the knee in fully flexed position, and foot pointing inwards and downwards. It causes pain in the anterolateral aspect of the knee, motion is complete but painful. Diagnosis is clinical and radiological. This entity goes unnoticed in the emergency department (60%), with functional and biomechanic consequences if diagnosis is no immediate. The objective is to describe diagnostic experience and orthopedic treatment of an unusual knee condition. We present a 23-year-old patient who fell while skating. He refers a proximal protuberance in the lateral face of the left leg, edema, pain, and limitation for knee extension. Level of Evidence: IV
Sujet(s)
Adulte , Fractures du tibia , Luxation du genou/diagnostic , Luxation du genou/thérapie , Luxation du genou/imagerie diagnostique , Réduction de fracture fermée , Maladie aigüeRÉSUMÉ
Background: Laparoscopy involves insufflation of the abdomen by gas so that the endoscope can view the intra-abdominal contents without being in direct contact with the viscera or tissue. Access to the abdomen is the one challenge of laparoscopy that is particular to the insertion of surgical instruments through small incisions. Materials and Methods: The study was a prospective, randomized, double-blind, and comparative study conducted on 100 consenting patients who underwent laparoscopic surgeries at Father Muller Medical College Hospital, for a period of 3 years from December 2014 to 2017 for various conditions needing laparoscopy who fulfilled a pre-determined the inclusion and exclusion criteria. Results: In our study, the least age was 20 years, and maximum age was 61 years. Age ranged from 18 to 65 years with mean age of 40 years. Most cases were males 86%. There was no difference in the two groups in terms of demography and perioperative factors such as type of surgery and body mass index; hence, the data were statistically comparable. The mean time needed to create pneumoperitoneum was 2.31 ± 1 min in Veress needle technique and 3.99 ± 1 in open method (P = 0.000) gas leak was observed in 11 patients in open group whereas no patient had a gas leak in Group B (P = 0.000). Pneumoperitoneum was achieved in all 100 cases. There were 7 cases of abdominal wall hemorrhage 4 acute that was managed laparoscopically by harmonic cauterization. No vascular injury, bowel, omental was noted in both groups. Neither open nor closed needed with conversion to open due to inadequate access into the peritoneal cavity. One closed as access could not be gained was converted to open method. 3 (6%) patients had post-operative hematoma at the umbilical port site in open Group A whereas no one developed this complication in a closed group 9 (9%) patients presented with surgical site infection at the umbilical trocar site and 4 in the closed group
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Introduction: Abdominal pain remains the foe runner of complaints’ presenting to the general surgeon in the present world. Acute appendicitis is the most common of the acute abdominal conditions presenting which requires immediate surgical intervention. Materials and Methods: The study was a prospective experimental study conducted on 100 cases evaluated and diagnosed as acute appendicitis and was admitted to Father Muller Hospital who underwent laparoscopic appendectomy from the time period September 2014 to August 2016. Results: In present study, the enrolled patients above the age of 16 years, in our study most patients who were treated with laparoscopic appendectomy were in the age group 21–30 years with 39%, females accounted for 51% of the study. In our study, we found that the serum glutamic pyruvic transaminase levels serum glutamic oxaloacetic transaminase levels, unconjugated bilirubin levels increased postoperatively statistically significantly with a P < 0.001 and returned to the baseline levels 7th day postoperatively.
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Introduction: The HIV pandemic has become a human, social as well as economic disaster, with far reaching inferences for individuals, communities and countries. The distribution of some of the specific oral manifestations is reported to differ between adults and children. Thus, the present study was carried to compare the oral manifestations in HIV positive children and HIV negative children. Materials and methods: The present study comprised a total of 90 subjects, divided into 3 groups, 30 HIV positive pediatric patients with HAART, 30 HIV positive pediatric patients without HAART and 30 healthy controls (HIV negative patients). The present study was conducted in the ART centre in Ranchi, Chattisgarh, India. The details to be taken from these children for subsequent analysis include age, CD4+ T cell count and oral lesions. Chi- square test was used to compare the lesions with Pvalue of 0.05 or less was considered for statistical significance and a P-value of 0.02 or less was considered for statistical highly significance. Results: Statistical analysis showed that patients with low CD4+ T cell counts (Group IA) had more number of lesions when compared to the patients with higher CD4 T cell count (Group IB). Dutta N, Gupta VK, Shetty R, Roy A, Dani G, Pandey V. A comparative study of oral manifestations of HIV among pediatric patients. IAIM, 2016; 3(5): 46-52. Page 47 According to individual lesion percentage distribution, it was observed that except hyperpigmentation most of the other lesions where more prevalent in group II than in group I. Mucocele was seen in group III and was not seen in group I and II. Dental caries was prevalent in all the three groups. Conclusion: HIV infected patients receiving HAART, had a significantly lower prevalence of oral lesion as compared to patients without HAART therapy
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OBJECTIVE: To report the prevalence of metabolic syndrome (MetS) as found by the Central American Diabetes Initiative (CAMDI) study for five major Central American populations: Belize (national); Costa Rica (San José); Guatemala (Guatemala City); Honduras (Tegucigalpa); and Nicaragua (Managua). METHODS: Study data on 6 185 adults aged 20 years or older with anthropometric and laboratory determination of MetS from population-based surveys were analyzed. Overall, the survey response rate was 82.0%. MetS prevalence was determined according to criteria from the Adult Treatment Panel III of the National Cholesterol Education Program. The study's protocol was reviewed and approved by the bioethical committee of each country studied. RESULTS: The overall standardized prevalence of MetS in the Central American region was 30.3% (95% confidence interval (CI): 27.1-33.4). There was wide variability by gender and work conditions, with higher prevalence among females and unpaid workers. The standardized percentage of the population free of any component of MetS was lowest in Costa Rica (9.0%; CI: 6.5-11.4) and highest in Honduras (21.1%; CI: 16.4-25.9). CONCLUSIONS: Overall prevalence of MetS in Central America is high. Strengthening surveillance of chronic diseases and establishing effective programs for preventing cardiovascular diseases might reduce the risk of MetS in Central America.
OBJETIVO: Notificar la prevalencia del síndrome metabólico (SMet) observada en el estudio de la Iniciativa Centroamericana de Diabetes (CAMDI) llevado a cabo en cinco importantes poblaciones centroamericanas: Belice (nacional); Costa Rica (San José); Guatemala (Ciudad de Guatemala); Honduras (Tegucigalpa); y Nicaragua (Managua). MÉTODOS: Se analizaron los datos de estudio obtenidos de las encuestas poblacionales dirigidas a 6 185 adultos de 20 años de edad o mayores con determinaciones antropométricas y de laboratorio relativas al SMet. En términos generales, la tasa de respuesta a las encuestas fue de 82,0%. Se determinó la prevalencia del SMet según los criterios del tercer informe del Grupo de Expertos en el Tratamiento de Adultos (Adult Treatment Panel III) del Programa Nacional de Educación sobre el Colesterol. El protocolo del estudio fue examinado y aprobado por el comité de bioética de cada uno de los países incluidos en el estudio. RESULTADOS: La prevalencia general estandarizada del SMet en Centroamérica fue de 30,3% (Intervalo de confianza de 95% (IC): 27,1-33,4). Se observó una amplia variabilidad según el sexo y las condiciones laborales, con mayor prevalencia en mujeres y trabajadores no retribuidos. El menor porcentaje estandarizado de población libre de cualquier componente del SMet se observó en Costa Rica (9,0%; IC: 6,5-11,4) y el mayor en Honduras (21,1%; IC: 16,4-25,9). CONCLUSIONES: La prevalencia general de SMet en Centroamérica es alta. Se podría reducir el riesgo de SMet en Centroamérica mediante el fortalecimiento de la vigilancia de las enfermedades crónicas y el establecimiento de programas eficaces de prevención de las enfermedades cardiovasculares.