Five Years Trends in Antihypertensive Monotherapy and Blood Pressure Control in Patients Referred to Tertiary Care Centre

2017 ◽  
Author(s):  
Dr. Abhishek Singhai
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Tertiary Care ◽  
Pressure Control ◽  
Care Centre ◽  
Tertiary Care Centre

Review of children with Takayasu’s arteritis at a Southern African tertiary care centre

2018 ◽  
Vol 28 (9) ◽  
pp. 1129-1135 ◽  
Author(s):  
Antoinette M. Cilliers ◽  
Paul E. Adams ◽  
Hopewell Ntsinjana ◽  
Udai Kala
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Abdominal Aorta ◽  
Takayasu’S Arteritis ◽  
Tertiary Care ◽  
Renal Arteries ◽  
Takayasu's Arteritis ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Fractional Shortening

AbstractIntroductionTakayasu’s arteritis is a rare idiopathic arteritis causing stenosis or aneurysms of the aorta, pulmonary arteries, and their branches. It usually occurs in women, but has been described in children.ObjectiveThe objective of this study was to determine the clinical presentation, demographic profile, vascular involvement, origins, management, and outcome of children diagnosed with Takayasu’s arteritis at a Southern African tertiary care centre between 1993 and 2015.MethodsThis is a retrospective analysis of all children with Takayasu’s arteritis captured on a computerised electronic database during the study period.ResultsA total of 55 children were identified. The female:male ratio was 3.2:1, and the mean age was 9.7±3.04 years. Most originated outside the provincial borders of the study centre. The majority presented with hypertension and heart failure. In all, 37 (67%) patients had a cardiomyopathy with a mean fractional shortening of 15±5%. A positive purified protein derivative test was documented in 73%. Abdominal aorta and renal artery stenosis were the predominant angiographic lesions. A total of 23 patients underwent 30 percutaneous interventions of the aorta, pulmonary, and renal arteries: eight stents, 22 balloon angioplasties, and seven had nephrectomies. All patients received empiric tuberculosis treatment, immunosuppressive therapy, and anti-hypertensive agents as required. Overall, there was a significant reduction in systolic blood pressure and improvement in fractional shortening (p<0.05) with all treatments.ConclusionTakayasu’s arteritis is more common in girls and frequently manifests with hypertension and heart failure. The abdominal aorta and renal arteries are mostly affected. Immunosuppressive, anti-hypertensive, and vascular intervention therapies improve blood pressure control and cardiac function.

scholarly journals A Study on Knowledge, Awareness, and Medication Adherence in Patients with Hypertension from a Tertiary Care Centre from Northern Sri Lanka

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
S. Pirasath ◽  
T. Kumanan ◽  
M. Guruparan
Keyword(s):  
Blood Pressure ◽  
Sri Lanka ◽  
Target Organ Damage ◽  
Tertiary Care ◽  
Disease Status ◽  
Daily Routine ◽  
Care Centre ◽  
Drug Compliance ◽  
Tertiary Care Centre ◽  
Hypertensive Patients

Objective. To assess the patient’s knowledge and awareness about hypertension and adherence to antihypertensive medication among hypertensive patients with validated Morisky questionnaires in a tertiary care centre of northern Sri Lanka. Methods. A cross-sectional descriptive comparative study was carried out at Teaching Hospital Jaffna, from January 2017 to April 2017. Hypertensive patients were recruited by systematic randomized controlled sampling and interviewed with validated Morisky questionnaires to assess their knowledge about hypertension. Data were analyzed using SPSS (version 21) analytical package. Results. 73 of 303 patients were males. 69.9% of patients had adequate knowledge about hypertension. 40.5% of patients were unaware of their disease status. 75.8% of patients could not recall their blood pressure values at the time of diagnosis. 72.3% of patients were unaware of their values of blood pressure during their last outpatient clinic visit. 48.2% of patients had awareness of target organ damage due to hypertension (kidney, 72, 23.7%; heart, 128, 42.2%; brain, 140, 46.7%; eye, 42, 13.8%). Most of the patients had poor drug compliance. The most common reasons for nonadherence were forgetfulness (70, 23.1%) and interruptions of daily routine (53, 17.5%). Conclusion. The knowledge about hypertension among majority of patients was reasonable. But they were unaware of their disease status. The drug compliance among them was poor. Forgetfulness and interruptions of daily routine were common reasons attributed for nonadherence.

scholarly journals Association between serum ca-125 levels and severity of pre-eclampsia: a case-control study conducted in a tertiary care centre, West Bengal

2020 ◽  
Vol 9 (10) ◽  
pp. 4176
Author(s):  
Bijoya Mukherjee ◽  
Amiya Das
Keyword(s):  
Blood Pressure ◽  
Predictive Value ◽  
Screening Test ◽  
Case Control Study ◽  
Tertiary Care ◽  
Case Control ◽  
Ca 125 ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Control Study

Background: Screening test for pre-eclampsia has been a topic of extensive research in last few decades, and to identify a cost effective and accurate one is of immense importance. This study was conducted to determine an association between serum CA-125 levels and severity of pre-eclampsia, and thus to specify clinical utility of this biochemical marker in prediction, diagnosis and follow-up of pre-eclampsia.Methods: A case-control study involving 40 women with non-severe pre-eclampsia, 40 women with severe pre-eclampsia and 40 healthy pregnant women matched for age, parity and gestational age at enrolment were taken in a tertiary care centre in West Bengal.Results: The CA-125 levels in three categories of participants were: normotensive (15.76±2.95), non-severe pre-eclampsia (26.98±2.28), severe pre-eclampsia (44.99±11.23), p<0.001. CA-125 levels correlated positively with systolic blood pressure (r=0.78, p<0.001), diastolic blood pressure (r=0.79, p<0.001), negatively with platelet levels (r=-0.67, p<0.001) and with birth weight of baby (r=-0.54, p<0.001). When cut-off for serum CA-125 levels was accepted as 35 IU/ml, the sensitivity and specificity of the marker was found to be 92.1% and 97.1% respectively. Positive predictive value 95.5%, Negative predictive value 94.4%.Conclusions: We can infer from this study that maternal serum CA-125 levels are associated with pre-eclampsia and its severity. As it is much more available and less expensive, it seems to be a promising as a screening test.

Abstract 18: Determinants of Adequate Blood Pressure Control in Stroke Patients Post-Discharge

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Laura Bishop ◽  
Martinson Arnan ◽  
Ellen Petryna ◽  
Cheryl Bushnell
Keyword(s):  
Blood Pressure ◽  
Hospital Discharge ◽  
Blood Pressure Control ◽  
Care Center ◽  
Tertiary Care ◽  
Pressure Control ◽  
Home Health ◽  
Poor Control ◽  
Once Daily

Objective: Hypertension (HTN) is a major risk factor for stroke and transient ischemic attack (TIA). After a stroke or TIA, blood pressure control becomes even more essential for secondary prevention of stroke. Prior literature has shown that once-daily dosing of blood pressure (BP) medications improved adherence. We hypothesized that once daily BP medications may also improve BP control at follow up and aimed to determine factors that predict adequate BP control after stroke. Methods: We analyzed blood pressures at discharge and at follow-up in 172 adult stroke and TIA patients admitted to a single tertiary care center. Only those with known HTN at time of discharge and seen in follow-up were included in the analysis. Medication dosing was categorized as once-daily dosing vs. more than once daily dosing. Univariate and multivariate logistic regression analyses (adjusted for sex, age, and race) were performed to compare patients with adequate blood pressure control at follow up to those with poorly controlled blood pressure at follow up. Poor BP control was defined as systolic blood pressure (SBP) greater than 140mmHg. Results: The average age of this cohort was 65 yrs (+/- 14) and 51% (88 of 172) of patients were female. Sixty nine percent (118 of 172) of patients were white, 29% (50 of 172) of patients were black, and the remaining 2% (4 of 172) of patients were of other race-ethnicities. One hundred of the 172 patients (58%) were discharged on once daily blood pressure medications and at follow up, 59% (59 of 100) of them had adequate blood pressure control compared to 78% (54 of 69) of the patients on BP meds dosed more frequently. Once daily blood pressure medication frequency was associated with inadequate blood pressure control at follow up (p=0.0089, OR 3.00 CI 1.34-6.71). Fifty eight percent (50 of 87) of patients who did not receive home health, nursing, or therapy visits had adequate BP control at follow up compared to 76% (59 of 77) of patients who did. Patients with home health nurse or therapy visits were more likely to have adequate BP control at follow up (p=0.0095, OR 0.44; CI 0.21-0.96). Mean discharge SBP of those patients with adequate BP at follow-up was 135mmHg, whereas those with poor control at follow-up had a mean discharge SBP of 145mmHg. Adequate SBP at the time of discharge also predicted adequate blood pressure at follow up (p=0.0006, OR 1.42; CI 1.15-1.77). Conclusions: Contrary to our hypothesis, once daily dosed BP medications did not improve the effectiveness of BP control at follow-up. Elevated SBP at the time of hospital discharge was associated with poor blood pressure control. Those patients receiving outpatient home health and therapy visits after hospital discharge had better blood pressure control. Further studies need to be done to assess medication adherence to determine whether the poor control was related to choice of medication or patient medication-taking behavior.

scholarly journals Analysis of risk factors in patients admitted with epistaxis

2021 ◽  
Vol 7 (6) ◽  
pp. 975
Author(s):  
Tabish Maqbool ◽  
Sajad Qadri ◽  
Showkat Ahmed Showkat ◽  
Rauf Ahmed ◽  
Kulvinder Singh Mehta
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Indirect Evidence ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Severe Epistaxis

<p class="abstract"><strong>Background:</strong> Epistaxis can be classified into anterior and posterior epistaxis. All bleeding occurs as a result of disruption of the intact nasal mucosa, whether due to trauma, inflammation, or neoplasm. Management depends on the severity of the bleeding and its underlying cause.</p><p class="abstract"><strong>Methods:</strong> This study was done in department of otorhinolaryngology in a tertiary care centre from September 2018 to December 2020. A total of 143 patients were studies. All patients admitted in our department as a case of epistaxis were analysed for the risk factors present in them which could be the cause of epistaxis.</p><p class="abstract"><strong>Results:</strong> In our study it was seen the risk factor involved in majority of patients was hypertension (70%), followed closely by diabetis mellitis and deranged coagulogram (65%). Chronic kidney disease was an associated risk factor in 64% of patients. All these factors cause microangiopathies which in turn lead to bleeding.</p><p class="abstract"><strong>Conclusions:</strong> The current study can be taken as indirect evidence that while raised blood pressure is seen in patients with severe epistaxis but in general the diseases associated with microangiopathies.</p>

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