scholarly journals A Prospective Comparative Study of Efficacy and Pleiotropic Effect of Telmisartan versus Enalapril in Hypertensive Patients with Dyslipidaemia in a Tertiary Care Hospital in Visakhapatnam

2021 ◽  
Vol 8 (23) ◽  
pp. 1915-1921
Author(s):  
Supriya Sanke ◽  
Chitra Karuppiah ◽  
Hema Sundar Rao Dumpala ◽  
Sai Vishnu Vardhan Allu ◽  
Syamala Shanthi Kumari Bonela
Keyword(s):  
Blood Pressure ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Tertiary Care ◽  
Density Lipoprotein ◽  
Blood Levels ◽  
Care Hospital ◽  
Significant Difference ◽  
Enalapril Group

BACKGROUND Hypertension is a silent killer, an asymptomatic chronic disorder if left untreated which results in major health problems. Goal of treatment is to decrease the morbidity and mortality associated with cardiovascular and cerebrovascular complications of hypertension when it is associated with dyslipidaemia. The renin angiotensin system plays an important role in the regulation of blood pressure and in the pathogenesis of hypertension. Telmisartan is an ARB (angiotensin receptor blocker) and Enalapril is an ACE inhibitor. The purpose of this study is to compare the efficacy of Telmisartan with Enalapril in patients of essential hypertension with dyslipidaemia, and to observe the effects of Telmisartan and Enalapril on blood lipid levels of these patients. METHODS This is a prospective, randomized, comparative and open label study conducted among 70 patients who were included in the study and were divided in to two groups. Group A - consisting of 35 patients receiving Telmisartan 40 mg, and Group B receiving Enalapril 5 mg orally once a day. Informed consent was obtained from all the patients. Follow up was done after 4, 8 and 12 weeks. Blood pressure was recorded at every visit and lipid profile was done at the time of enrolment and after 12 weeks of study period. RESULTS Baseline demographic attributes were comparable between both the groups including total cholesterol and low-density lipoprotein (LDL). The mean reduction in systolic and diastolic blood pressure (BP) after 12 weeks was highly significant (P value < 0.001) in both the groups but when mean reduction in SBP & DBP was compared, there was no significant difference (P > 0.05) between the drugs. Blood levels of total cholesterol, LDL, triglyceride had significantly reduced (P < 0.05) in Telmisartan group compared to Enalapril group after 12 weeks of follow up and mean high density lipoprotein (HDL) level significantly increased in Telmisartan group (P < 0.05) but no increment was seen in Enalapril group. CONCLUSIONS Telmisartan and Enalapril had comparable antihypertensive effect and significant reduction in blood pressure was seen after 12 weeks of therapy in both the groups. In addition, Telmisartan showed more beneficial effects on lipid profile when compared to Enalapril. KEYWORDS Hypertension, Dyslipidemia, Lipid Profile, Telmisartan, Enalapril

scholarly journals Comparative study of lipid profile between clinical and subclinical hypothyroidism

2018 ◽  
Vol 5 (4) ◽  
pp. 978
Author(s):  
Tumbanatham A. ◽  
Jayasingh K. ◽  
Varun Vijayan Vijayan
Keyword(s):  
Lipid Profile ◽  
Total Cholesterol ◽  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Overt Hypothyroidism ◽  
Care Hospital ◽  
Mean Values ◽  
Significant Difference ◽  
The Mean

Background: Subclinical hypothyroidism (SH) is characterized by elevated levels of serum thyroid stimulating hormone in the presence of normal thyroxin levels. Subclinical hypothyroidism is often associated with elevated total cholesterol and other lipid profile parameters. This study was done to evaluate the lipid metabolism in subclinical hypothyroidism.Methods: This case control study was done to compare the lipid profile parameters between subclinical and overt hypothyroidism cases attending the outpatient facility of our tertiary care hospital of our medical college in Puducherry. Newly diagnosed cases of hypothyroidism were selected by convenient sampling. A total of 37 SH cases and 31 overt hypothyroidism cases were included. Blood samples were drawn to measure lipid profile. A 2D echocardiogram was done to evaluate cardiac function. Ultrasonogram was done to evaluate fatty liver.Results: The mean age of the participants in the subclinical hypothyroidism group was 34.2±12.2 years while in the clinical hypothyroidism group was 35.7±9.8 years. About 13.5% of the participants in subclinical hypothyroidism group and 12.9% of the participants in clinical hypothyroidism had fatty liver in ultrasound. A significant difference was observed in the mean values of total cholesterol, triglycerides and LDL levels between clinical and subclinical hypothyroidism.Conclusions: This study highlights the need for screening of subclinical hypothyroidism in order to prevent the incidences of cardiovascular complications and other diseases like metabolic syndrome.

SOCIOECONOMIC STATUS EFFECT ON MANAGEMENT OF HYPERTENSION IN COMMUNITY PHARMACY IN SOUTH- SOUTH ZONE IN NIGERIA

2021 ◽  
Author(s):  
Mgbahurike AA ◽  
Oduogu SO ◽  
Bagbi BM
Keyword(s):  
Blood Pressure ◽  
Socioeconomic Status ◽  
Alcohol Consumption ◽  
Peer Review ◽  
Tertiary Care ◽  
Research Centre ◽  
Community Pharmacies ◽  
Care Hospital ◽  
Co Morbidity ◽  
Significant Difference

Background to study: Effective management of hypertension is influenced by several factors that center on social and economic status of the patient. Identification of these factors will enable informed intervention in the management of hypertensive patients. Objective: The study aimed to determine possible association between blood pressure control and socioeconomic status of patients who are managed in community pharmacies in Rivers State. Method: A descriptive cross-sectional survey of thirty-nine community pharmacies was conducted between July and December 2018.  A total of 195 respondents participated in the study. Every patient’s consent was obtained. Further information on patients’ demographics were extracted from pharmacists’ documentation files. Such include age, medication patient is on, duration of hypertension, co-morbidity, income/ social status, and habits like smoking, alcohol consumption, educational status, and mean blood pressure over the study period. The outcome measure taken as controlled blood pressure was mean BP ≤140/90 mm Hg for the general population and BP 130/80 mmHg for patients with diabetes as co-morbidity. BP >140/90 mm Hg was considered as uncontrolled blood pressure. Result: A total of 195 respondents participated in the study, of which 105(53.8%) were male and 90(46.2%) were female. Out of this number 75(38.5%) were below 40yrs of age, 105(53.8%) were between 41–50yrs of age and only 15(7.7%) were 60yrs and above. More female had BP control compared to the male (OR 1.89, 95% CI (1.16 - 3.0), P=0.009. Patients within ages 41 - 59yrs had more controlled BP compared to older age, 60yrs and above, OR 1.48, 95% CI (0.84 - 2.42) p 0.18. Uncontrolled BP was found more among employed patients and patients with highest monthly income, OR 1.05 95% CI (0.58 - 2.00); OR 1.16 95% CI (0.49 - 2.78) P, 0.36 respectively. Exercise activities have significant impact on BP control as alcohol consumption increased OR of BP control with no significant difference in OR on amount of monthly expenditure on medications. Conclusion: Male gender, employment, and high income earning have negative effect on BP control while exercise is associated with BP control.                    Peer Review History: Received: 4 September 2021; Revised: 10 October; Accepted: 21 October, Available online: 15 November 2021 Academic Editor:  Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622,  Giza, Egypt, [email protected]  UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Dr. Muhammad Zahid Iqbal, AIMST University, Malaysia, [email protected] Dr. Vanina Doris Edo’o, University of Yaounde I, Yaounde, Cameroun, [email protected] Similar Articles: PRESCRIPTION PATTERN OF ANTI-HYPERTENSIVE DRUGS IN A TERTIARY CARE HOSPITAL IN KERALA AND ADHERENCE TO JNC-8 GUIDELINES

scholarly journals A Comparative Study of Lipid Profile in Obese and Nonobese Men attending Master Health Checkup

2017 ◽  
Vol 21 (2) ◽  
pp. 73-75
Author(s):  
S Vinod Babu ◽  
Anusha R Jagadeesan ◽  
Jothimalar Ramalingam
Keyword(s):  
Comparative Study ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
P Value ◽  
Health Checkup ◽  
Group I ◽  
Significant Difference

ABSTRACT Introduction Obesity is emerging as an epidemic worldwide. Obesity is associated with a number of comorbid conditions, such as diabetes mellitus, hypertension, cancer, dyslipidemia, cardiovascular abnormalities, anemia, obstructive sleep apnea, and psychosocial abnormalities. Aim This study aims at comparing the lipid profile levels of obese and nonobese men. Materials and methods This was a case—control study conducted at a tertiary care center. Totally, 80 men in the age group of 20 to 47 years attending the master health checkup were included in the study, out of which 40 men with normal body mass index (BMI) of 18 to 25 belonged to group I and 40 men with increased BMI of 30 and above belonged to group II. Lipid profile parameters, such as triglycerides (TGLs), total cholesterol, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol were estimated in them. The data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) software version 15.0. Results Statistically significant difference was found in the total cholesterol levels with a p-value of 0.040 while the difference in LDL cholesterol was statistically highly significant with a p-value of 0.040. Conclusion Among lipid profile parameters, only total cholesterol and LDL cholesterol showed significant difference between the obese and nonobese individuals. However, the other parameters like HDL cholesterol and TGLs did not show any significant difference. How to cite this article Babu SV, Jagadeesan AR, Ramalingam J. A Comparative Study of Lipid Profile in Obese and Nonobese Men attending Master Health Checkup. Indian J Med Biochem 2017;21(2):73-75.

Does Teaching Clinical Ethics to Medical Students Improve Knowledge, Attitude, and Practice of Medical Ethics Among Clinicians? An Observational Study in a Tertiary Care Hospital in Nepal.

2020 ◽  
Author(s):  
Carmina Shrestha ◽  
Jasmin Joshi ◽  
Ashma Shrestha ◽  
Shuvechchha Karki ◽  
Sajan Acharya ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical Ethics ◽  
Clinical Ethics ◽  
Core Curriculum ◽  
Tertiary Care ◽  
Medical Schools ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background: The importance of doctors being aware of medical ethics has been highlighted in a number of studies. Our first study (Study-1) aims to assess the knowledge, attitude, and practices of medical ethics among clinicians at Patan Academy of Health Sciences (PAHS). We then follow up with the effect of teaching clinical ethics to medical students (Study-2). The purpose of this study is to assess the awareness regarding appropriate ethical principles, application of medical ethics and the effect of teaching medical ethics to students. Methods: There are two studies presented: Study-1 is a cross-sectional questionnaire-based study. A total of 72 participants, selected by simple random sampling, included doctors working as interns, medical officers and consultants in six departments of PAHS. Study-2 was a follow-up, cross-sectional online questionnaire-based comparative study conducted at PAHS to compare KAP of medical ethics among medical officers with and without formal medical ethics training. We used the validated questionnaire from our previous study. All graduates of PAHS 2016 and all medical officers employed at PAHS at the time of study who had graduated from other medical schools that did not include Medical Ethics in their core curriculum were included. Results: Study-1: A positive correlation between Knowledge(p = 0.088), Attitude (p = 0.002), Practice of medical ethics(p = 0.000), and years of practice was found. No significant difference in KAP of medical ethics between MBBS graduates from Nepal and abroad (p = 0.190) was found. The majority scored poorly in issues concerning autonomy. The follow-up study found a statistically significant difference (p = 0.000) in the knowledge between the doctors who were taught medical ethics and those who were not. Conclusions: Doctors find it easier to discuss ethical dilemmas with their colleagues rather than department heads. The KAP of the consultants were found to be better than that of the interns and medical officers. Autonomy is the least understood ethical principle. ‘Medical Ethics’ as a part of the core curriculum in medical schools would improve ethical practice.

scholarly journals Gallstone disease and quantitative analysis of independent biochemical parameters: Study in a tertiary care hospital of India

2018 ◽  
Vol 10 (04) ◽  
pp. 448-452 ◽  
Author(s):  
Deepak Dhamnetiya ◽  
Manish Kumar Goel ◽  
BalRaj Dhiman ◽  
Om Prakash Pathania
Keyword(s):  
Logistic Regression ◽  
Total Cholesterol ◽  
Biochemical Parameters ◽  
Ldl Cholesterol ◽  
Tertiary Care Hospital ◽  
Gallstone Disease ◽  
Tertiary Care ◽  
Density Lipoprotein ◽  
North India ◽  
Care Hospital

ABSTRACT INTRODUCTION: Gallstone disease (GSD) represents a significant burden for health-care systems worldwide and is one of the most common disorders among patients presenting to emergency rooms with abdominal discomfort. This study was aimed to know the association of biochemical parameters and development of GSD. MATERIALS AND METHODS: We conducted a case–control study from January 2013 to December 2013 among patients attending outpatient department of general surgery at a tertiary care hospital of Delhi, North India; we recruited 120 cases and the same number of controls in the study. Data collection for both cases and controls was done on a self-designed pretested interview schedule and all the patients were investigated for relevant biochemical parameters. Logistic regression was used for univariate and multivariate analyses to find out different correlates and analyze the independent effects of these correlates on GSD. RESULTS: We have included 120 cases and the same number of age- and sex-matched controls in the study and final analysis. Almost 70% of the cases were females and 30% were males. In multivariate logistic regression, we have found maximum significant association with serum total cholesterol (odds ratio [OR]: 1.013, confidence interval [CI]: 1.003–1.024, P = 0.041) followed by low-density lipoprotein (LDL) cholesterol (OR: 1.017, CI: 1.001–1.034, P = 0.04) and triglycerides (OR: 1.009, CI: 1.001–1.018, P = 0.049). Fasting blood sugar (P = 0.18), high-density lipoprotein cholesterol (P = 0.07), aspartate transaminase (P = 0.21), alanine transaminase (P = 0.29), and total bilirubin (P = 0.13) were not found to be independently associated with GSD. Conclusions: Biochemical parameters such as plasma total cholesterol, triglycerides, and LDL cholesterol level were independently associated with GSD.

Effects of Carvedilol Compared to Nebivolol on Insulin Resistance and Lipid Profile in Patients With Essential Hypertension

2016 ◽  
Vol 22 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Ali Gokhan Ozyıldız ◽  
Serpil Eroglu ◽  
Ugur Bal ◽  
Ilyas Atar ◽  
Kaan Okyay ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Essential Hypertension ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Apolipoprotein B ◽  
Beta Blockers ◽  
Density Lipoprotein ◽  
Apolipoprotein Ai ◽  
New Generation

Background and aim: Beta-blockers have unfavorable effects on metabolic parameters in hypertensive treatment. New generation beta-blockers with vasodilatory capabilities are superior to traditional beta-blockers, but studies examining their effects on metabolic parameters are still lacking. This study aimed to compare the effects of 2 new generation beta-blockers, carvedilol and nebivolol, on insulin resistance (IR) and lipid profiles in patients with essential hypertension. Methods: This was a prospective, randomized, open-label, single-center clinical trial. A total of 80 patients were randomized into 2 groups: the carvedilol group (n = 40, 25 mg of carvedilol daily) and the nebivolol group (n = 40, 5 mg of nebivolol daily). Follow-up was performed for 4 months. Fasting plasma glucose, insulin levels, and the lipid profile (high-density lipoprotein [HDL], low-density lipoprotein [LDL], total cholesterol, triglyceride, apolipoprotein AI, and apolipoprotein B levels) were measured and IR was calculated by the homeostasis model assessment (HOMA) index. These variables were compared before and 4 months after treatment. Results: Blood pressure and heart rate were significantly and similarly reduced in the carvedilol and nebivolol groups after treatment compared to those before treatment (both P < .001). Serum glucose ( P < .001), insulin ( P < .01), HOMA-IR (P < .01), HDL ( P < .001), LDL ( P < .001), total cholesterol ( P < .001), and apolipoprotein B ( P < .05) levels decreased in a similar manner in the carvedilol and nebivolol groups after treatment compared to those before treatment. Serum triglyceride and apolipoprotein AI levels did not change after treatment with both drugs. Conclusion: New generation beta-blockers, carvedilol and nebivolol, efficiently and similarly decrease blood pressure. They have similar favorable effects on glucose, insulin, IR, and the lipid profile.

scholarly journals The effect of ladder approach on development of preterm low birth weight infants with HIE-2

2020 ◽  
Vol 7 (3) ◽  
pp. 520
Author(s):  
Tushar R. Jadhav ◽  
Shailaja S. Jaywant
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Premature Infants ◽  
Tertiary Care ◽  
Control Group ◽  
Care Hospital ◽  
Post Intervention ◽  
Low Birth Weight Infants ◽  
Significant Difference

Background: Premature infants with Peri-natal asphyxia leading to a hypoxic-ischemic encephalopathy (HIE) are at greater risk for cerebral palsy. HIE grade II infants have long term neurological complications due to maladaptive brain wiring during NICU stay. Ladder approach, with graded stimulation program is administered by Occupational therapist, plays a vital role to minimize the maladaptive responses to environment. Objective of this study was to effect of Ladder Approach on preterm low birth weight Infants with HIE-2 as compared to conventional treatment. Design of this study was to Prospective Block Randomized Convenient Sampling Control Trial, Experimental design study. The study was carried out in the NICU and PU ward of Tertiary care hospital in metropolitan city from April 2015 to October 2016. The study subjects included a convenient sample of 30 preterm Low birth weight HIE-2 infants randomly selected into study or control groups. Neonatal behavioural Assessment scale (NBAS), Infant Neurological International Battery (INFANIB).Methods: The preterm infants from study group who received Ladder Approach and control group who received routine conventional care only. Outcome measures NBAS was at baseline and first follow up. INFANIB was administered at second follow up to assess neurodevelopment.Results: Showed that the premature infants of the study had significant difference in neuro behavioral status with mean for all subcomponents from to post intervention mean 39.6 in experimental group and from baseline mean of 24.3 to post intervention mean score of 33.2 in control group on neurobehavioral scale. Further neurodevelopmental status showed similar results on INFANIB in experimental group.Conclusions: The premature Infants with HIE grade 2, receiving ladder approach have shown more mature responses resulting into well-organized Neurobehavioral status, and resulted in improved brain wiring as evident in INFANIB.

scholarly journals Which LDL Value Should Clinicians Look at?

2021 ◽  
Author(s):  
Harshad Malve ◽  
Amit Asalkar
Keyword(s):  
Total Cholesterol ◽  
Direct Method ◽  
Tertiary Care ◽  
Colorimetric Method ◽  
Correlation Coefficients ◽  
Direct Methods ◽  
Estimation Methods ◽  
Care Hospital ◽  
Significant Difference ◽  
Indian Setting

Abstract Objectives LDL cholesterol is routinely estimated by the Friedewald formula to guide the treatment of dyslipidemia. However, Friedewald equation has certain limitations, especially with high triglyceride levels. Direct methods are available for LDL estimation but have received relatively little scrutiny in the Indian setting. This study was aimed at comparing the calculative and direct methods of LDL estimation in Indian hyperlipidemic patients. Materials and Methods In this observational study, data from 380 consecutive lipid profiles of patients visiting a tertiary care hospital in Mumbai were analyzed retrospectively. CHOD PAP method was used to estimate total cholesterol. Enzymatic colorimetric method was used to estimate triglycerides. Enzyme selective protection method was used to estimate HDL. Direct LDL was estimated by homogenous enzymatic colorimetric assay and very low-density lipoprotein was calculated, whereas Friedewald’s formula was used to derive calculated LDL. Results Total cholesterol values correlated positively with the LDL values measured by both methods. However, a statistically significant difference was noted between the correlation coefficients of both the methods. Triglyceride values correlated weakly with the LDL levels measured by both the methods. A weak negative correlation was observed with LDL by the calculated method, whereas a weak positive correlation existed between TG and LDL by the direct method. The difference between the correlation coefficients was statistically significant. Conclusion Both direct and calculated methods of LDL estimation have their limitations. A robust study with a larger sample size is needed to further investigate whether the differences in the different LDL estimation methods can translate to “clinical relevance” in the Indian setting.

scholarly journals Effectiveness of Probiotics, Metformin and Their Combination Therapy in Ameliorating Dyslipidemia Associated With PCOS

2019 ◽  
pp. 1-9
Author(s):  
Urooj Zafar ◽  
Jahan Ara Hassan ◽  
Kauser Ismail ◽  
Shanza Agha ◽  
Zahida Memon ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Lipid Profile ◽  
Low Density Lipoprotein ◽  
Tertiary Care ◽  
Density Lipoprotein ◽  
The Body ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Care Hospital ◽  
Low Density Lipoprotein Cholesterol

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous metabolic disorder affecting women of the child-bearing age. Alteration in lipid profile is one of the troublesome features faced by PCOS patients that need to be treated. Aim: The purpose of this study was to compare the effects of Probiotics, Metformin and their Combination therapy on lipid profile in women suffering from PCOS. Study Design: Single-Centered Randomized Controlled Trial. Setting: Gynecological clinic of Karachi at Tertiary care Hospital from December 2018 to May 2019. Patients and Methods: Total 78 PCOS patients of age between 18 to 40 years were involved in this trial rendering to Rotterdam criteria. After taking written and informed consent they were randomly allocated to three groups and were received: Metformin 500 mg B.D (n = 26), Probiotic Capsule 180 mg B.D (n = 26) and Combination of Metformin 500 mg B.D / Probiotic Capsule 180 mg B.D for 12-weeks. Lipid profile was measured at baseline and after 12-weeks of intervention along with the body weight. In the end, pre versus post therapy and comparison of different group’s results were analyzed. Results: Metformin and Met/Pro Combination groups resulted in a significant reduction in Total Cholesterol (TC) as compared to Probiotic group. Fall in Low-Density Lipoprotein Cholesterol (LDL-C) levels were noteworthy after Probiotics and Met/Pro treatment. Serum TG concentrations were significantly reduced in all the groups. High-Density Lipoprotein Cholesterol (HDL-C) levels were slightly elevated after Probiotics treatment, which was not statistically significant but Metformin and Met/Pro group increases it to the significant value. No substantial change was found in the Very Low-Density Lipoprotein Cholesterol VLDL-C levels in any of the three groups. Conclusion: Overall, Probiotics treatment in PCOS women for 12 weeks exhibited noteworthy changes in TG, and LDL-C levels. Metformin markedly improve Cholesterol, TG and HDL-C. However, Met/Pro improved all the lipid changes to the significant value except for VLDL-C.

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