scholarly journals ADHERENCE TO ESSENTIAL HYPERTENSION TREATMENT GUIDELINES IN A TERTIARY HOSPITAL IN NIGERIA

2020 ◽  
pp. 106-110
Author(s):  
ISAAC CHIJIOKE IBEZIM ◽  
IAN NAYLOR ◽  
ABDULMUMINU ISAH ◽  
NNEKA UCHENNA IGBOELI
Keyword(s):  
Blood Pressure ◽  
Treatment Guidelines ◽  
Beta Blockers ◽  
Study Groups ◽  
University Teaching ◽  
World Health ◽  
Channel Blockers ◽  
Cross Sectional ◽  
Group A ◽  
Group B

Objective: This study determined the level of prescribers’ adherence to the World Health Organization/International Society of Hypertension (WHO/ISH) guidelines for the management of hypertension at the Lagos University Teaching Hospital (LUTH), Nigeria. Methods: This study employed a retrospective cross-sectional design. Two groups were used: Group A (300 patients) were treated before the guidelines review in 2003, while Group B (200 patients) were treated after. The two study groups were compared, and systolic blood pressure of 130 mm Hg or above was taken as the index of hypertension. Results: There were 198 (66%) male patients in Group A, while Group B had 136 (68%) males. The highest age for Group A was 50–59 y for 89 (30%) patients, unlike group B that had 58 (29%) patients in aged 40–49 y as the highest. The highest blood pressure range for patients in Group A was 150–159 mm Hg for 64 (21%) patients, unlike Group B that had 43 (22%) patients as the highest in the same range. Furosemide was present in 282 (24%) prescriptions for group A patients. However, atenolol was present in 61 (20%) prescriptions for the same group. In group B, Furosemide was prescribed in 197 (97%) encounters, while Nifedipine was found in 81(40%) prescriptions. Conclusion: Prescribers at LUTH complied substantially with WHO/ISH guidelines in the management of hypertension. Diuretics and beta-blockers were used before the guideline review. After the review, diuretics and calcium channel blockers were the most frequently prescribed antihypertensives.

scholarly journals COMPARISON STUDY OF IVABRADINE WITH METOPROLOL IN MANAGEMENT OF ACUTE CORONARY SYNDROME

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Rishman Tandi ◽  
Tanvi Kumar ◽  
Amritpal Singh Kahlon ◽  
Aaftab Sethi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Beta Blocker ◽  
Beta Blockers ◽  
Coronary Syndrome ◽  
Group A ◽  
Group B

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed.   Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.

scholarly journals Effect of lactation on serum total cholesterol & triglyceride

2014 ◽  
Vol 29 (1-2) ◽  
pp. 1-7
Author(s):  
Khadiza Begum ◽  
Rokeya Begum ◽  
Qazi Shamima Akhter ◽  
Nusrat Sultana ◽  
Shamima Bari
Keyword(s):  
Total Cholesterol ◽  
Study Groups ◽  
Cross Sectional Study ◽  
Serum Total Cholesterol ◽  
Cross Sectional ◽  
Medical College ◽  
Data Collection Sheet ◽  
Group A ◽  
Group B ◽  
High Level

Background: There is an association between breast feeding & maternal lipid profile. Pregnancy related hyperlipidaemia reverse quickly with lactation. Objective: To observe Serum Total cholesterol & triglyceride in lactating & nonlactating mother. Method: The present cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, during the period of July 2010 to June 2011. A total 300 subjects were included within the age limit from 20 to 40 years of women. Among them100 were normal healthy subjects & had child above 3 years were considered as group A (control). The rest 200 women were selected as study subject (group B) having child between the age 6 weeks to 2 years. Group B is again subdivided into group B1 (100 lactating mother) & group B2 (100 nonlactating mother). The subjects were selected from pediatric ward & OPD of pediatrics, DMCH and BSMMU, Dhaka. Data were collected in data collection sheet after taking informed written consent of the subjects. The study parameters total cholesterol & Triglyceride were done in the Department of Physiology, Dhaka Medical College. The data were analyzed by computer with SPSS programs using unpaired Student ?t’ test.Results: In group B1 total cholesterol & triglyceride levels were non significantly higher than that of group A but in group B2 these values were significantly higher than that of group A. Within the study groups all these values were significantly higher in nonlactating mother than lactating mother. It was observed that high level of study parameters were more in B2 than that of group B1. Conclusion: From the results of the present study it may be concluded that lactation has effect on lowering serum total cholesterol & triglyceride which may preferably related to health education for the mother. http://dx.doi.org/10.3329/bjpp.v29i1-2.20060Bangladesh J Physiol Pharmacol 2013; 29(1&2) : 1-7

scholarly journals EFFICACY OF PHENYLEPHRINE OVER EPHEDRINE IN CONTROLLING FALL OF BLOOD PRESSURE: A CROSS SECTIONAL STUDY IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Keshav Saran Agrawal ◽  
Aruna Mahanta
Keyword(s):  
Blood Pressure ◽  
Spinal Anesthesia ◽  
Cross Sectional Study ◽  
Age Group ◽  
Lower Segment ◽  
Cross Sectional ◽  
Lower Segment Caesarean Section ◽  
Block Level ◽  
Group A ◽  
Group B

Background: most of the lower segment caesarean sections are done under spinal anesthesia and in more that 80% of the cases, maternal fall in blood pressure can be observed intraoperatively. Throughout history many vasopressor drugs have been evaluated for the treatment. Aim: our research was conducted to compare the effect of phenylephrine with ephedrine given for the prophylaxis of prevention of intraoperative fall in blood pressure in females who are undergoing LSCS. Materials and Methods: a total of 100 cases were considered for our study and were randomly distributed in two groups. Group A cases were administered Phenylephrine while ephedrine was given to group B cases just after spinal anesthesia. Results: most of our study subjects were in the age group of 21-25 years who were in the range of 51-55 kgs. Spinal anesthesia was given by using bupivacaine & block level was checked at 2 & 5 mins. Phenylephrine was found to be superior in control of fall in blood pressure as more than 90% of the cases were brought back to their preoperative levels in less than 4 mins after spinal anesthesia. Whereas in group B, ephedrine took much more time of around 10 mins for control of BP. Conclusion: with proper monitoring of heart rate, phenylephrine is superior to ephedrine in controlling the fall in blood pressure. Keywords: Ephedrine, Phenylephrine, Hypotension, Bradycardia.

scholarly journals Changing trends and determinants of caesarean section using robson criteria in a government tertiary level hospital

2021 ◽  
Vol 10 (3) ◽  
pp. 1066
Author(s):  
Anjali Singh ◽  
Renuka Malik
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Study Groups ◽  
World Health ◽  
Tertiary Level ◽  
Study Group ◽  
Group A ◽  
Group 2 ◽  
Group B ◽  
Level Hospital

Background: Robson Ten group classification system (TGCS) was proposed by World Health Organisation in 2014 for assessing, monitoring and comparing caesarean section rate between and within healthcare facilities. This tool was used in this study to analyse the determinants of caesarean section and compare with data of past.Methods: This observational comparative study was conducted at tertiary level hospital and included in study group A, 300 women delivered by caesarean section from November 2018 to November 2019 and in study group B, 300 women delivered by caesarean section from November 2015 to December 2016. The caesarean sections were classified as per TGCS to determine relative and absolute contribution made by each group to the overall caesarean section rate. The results were analysed to for determinants and change in trend.Results: In this study, the caesarean section rate in group A was 29.32% and group B was 28.03%. Group 2, 5, 1, 10 made the maximum contributions to overall caesarean section rate in both study groups. Group 2 was the largest contributor (25.00%) in study group A and 27.33% in study group B to overall caesarean sections.Conclusions: Implementing Robsons TGCS can help in comparing caesarean in an institution over a period of time and also among different institution at national and international level as a method of internal auditing, paving a way to rationalise and decrease Caesarean rate. 

Arterial stiffness and subclinical aortic damage of reclassified subjects as stage 1 hypertension according to the new 2017 ACC/AHA blood pressure guidelines

VASA ◽  
2019 ◽  
Vol 48 (3) ◽  
pp. 236-243 ◽  
Author(s):  
Theodore G. Papaioannou ◽  
Evangelos Oikonomou ◽  
George Lazaros ◽  
Evangelia Christoforatou ◽  
Georgia Vogiatzi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Aortic Stiffness ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Group A ◽  
New Guidelines ◽  
Group B ◽  
Stage 1

Abstract. Background: The 2017 ACC/AHA blood pressure (BP) guidelines generated controversies due to the new proposed BP cut-off values defining hypertension. We aimed to assess aortic stiffness of subjects who are reclassified as stage 1 hypertensive according to the new guidelines and compare them with the subjects of “elevated BP” category. Patients and methods. Data from the “Corinthia” study, an observational, cross-sectional survey of 2,043 participants were analyzed. Subjects were classified into 4 groups: group A: systolic pressure (SBP) 120–129 and diastolic pressure (DBP) < 80 mmHg, group B: SBP 130–139 or DBP 80–89 mmHg, group B1: SBP 130–139 and DBP < 80 mmHg and group B2: SBP 130–139 and DBP 80–89 mmHg. Aortic stiffness was assessed by carotid-to-femoral pulse wave velocity (PWV). A value of PWV > 10m/s was consider indicative of asymptomatic organ damage while values of PWV exceeded the 90 % percentile for each age group were consider as abnormal. Results: Groups B, B1 and B2 have significantly increased PWV compared to group A, independently from age and other risk factors (PWV: 9.2 ± 2.8 vs 9.4 ± 2.7 vs 8.6 ± 2.5 vs 8.1 ± 2.3 m/s, p < 0.01, respectively). The prevalence of PWV > 10 m/s and abnormal PWV values in group A was significantly lower than the corresponding prevalence in randomly selected, age-matched subjects from group B (13.5 % vs 24.4 %, p = 0.027 and 5.6 % vs 14.2 %, p = 0.022, respectively). Conclusions: The reclassified subjects as stage 1 hypertensive by the new guidelines have a significantly increased aortic stiffness and greater prevalence in asymptomatic aortic damage compared to subjects with elevated BP. This finding may indirectly explain the increased cardiovascular risk of this group.

scholarly journals Blood Pressure Parameters Among Smokers and Smokeless Tobacco Users in a Tertiary Level Hospital

2013 ◽  
Vol 25 (1) ◽  
pp. 28-31
Author(s):  
N Habib ◽  
M Rashid ◽  
USN Begum ◽  
N Ahter ◽  
D Akhter
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Smokeless Tobacco ◽  
Cross Sectional Study ◽  
College Hospital ◽  
Cross Sectional ◽  
Group A ◽  
The Mean ◽  
Group B

This cross-sectional study was carried out to assess blood pressure parameters among adult male smokers and smokeless tobacco users. For this purpose, 105 male respondents were selected. They were divided into two groups; Group A-consisting of 30 were smokeless tobacco users and group B consisting of 75 smoker patients The participants were selected from medicine outdoor of Dhaka Medical College Hospital. In this study, the mean (±SD) of systolic blood pressure were 154.50±26.793 mm of Hg in Group A and 151.67±19.248 mm of Hg in group B respectively. Statistical analysis was done by unpaired‘t’ test, there were no statistical significant differences (P>0.05) of systolic blood pressure between Group A and Group B. The mean (±SD) of diastolic blood pressure were 96.67±10.933 mm of Hg in Group A and 86.47±14.745 mm of Hg in group B respectively. The mean (± SD) of diastolic blood pressure were significantly higher (P<0.05) in Group A than Group B. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.16066 Medicine Today 2013 Vol.25(1): 28-31

Demographic information and risk factors of stroke patients younger than 65 years old

2021 ◽  
Author(s):  
Naeimeh Hosseinzadeh ◽  
Alireza Ala ◽  
Sama Rahnemayan ◽  
Elyar Sadeghi-Hokmabadi ◽  
Aylar Gholami Milani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Oral Contraceptive Pill ◽  
Female Gender ◽  
Study Groups ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Group A ◽  
Artery Disease ◽  
Group B ◽  
Time Of Admission

Objective: The main objective of this study is to evaluate the prevalence of risk factors for and demographics of patients younger than 65 years old with stroke. Methods: This retrospective cross-sectional study took into consideration all patients younger than 65 years old who were admitted to the emergency department from 2016 to 2018. Some significant criteria such as age, sex, type of stroke, stroke risk factors, and modified Ranking Scale (mRS) were extracted from patients’ medical records. Based on their age, these patients were divided into three groups: younger than 35 years old (Group A), between 35-50 years old (Group B), and older than 50 years old (Group C). Data analysis was carried out using IBM® SPSS® Statistics 20.0 software. Results: A total of 392 patients with stroke were included in this study. Groups A, B, and C included 31, 124, and 237 patients, respectively. Among them, 313 patients (79.84%) were admitted to the hospital in cold seasons, while 73 patients (18.6%) had no symptoms related to stroke at the time of admission. The most common adjustable risk factor among the patients was hypertension (HTN) with a frequency of 230 (58.7%). Of note, the frequency of HTN, diabetes, atrial fibrillation (AF), oral contraceptive pill (OCP) consumption, and coronary artery disease (CAD) in patients was significantly different among these three groups. Conclusion: According to the findings of the present study, the prevalence rate of stroke probably varies for male and female (gender) in the studied groups, which is significantly correlated with age. Among the adjustable risk factors for stroke, HTN, diabetes, AF, OCP consumption, and CAD are significantly correlated with the age.

scholarly journals Effect of Intradialytic Change in Plasma Volume on Blood Pressure in Patients Undergoing Maintenance Hemodialysis

2010 ◽  
Vol 2 (02) ◽  
pp. 066-069 ◽  
Author(s):  
Ali-Reza Khalaj ◽  
Suzan Sanavi ◽  
Reza Afshar ◽  
Muhammad-Reza Rajabi
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Plasma Volume ◽  
Calculated Data ◽  
Study Groups ◽  
Maintenance Hemodialysis ◽  
Blood Levels ◽  
Diabetic Patients ◽  
Group A ◽  
Group B

ABSTRACT Background: Hypervolemia is a common complication in patients on hemodialysis (HD). To determine the effect of volume change on blood pressure in HD population, this cohort was conducted. Materials and Methods: The study population was composed of 60 non-diabetic patients on maintenance HD, with mean age of 59.95±15.28 years. They were divided into hypertensive group A (n=26) and normotensive group B (n=34). Data were collected by a questionnaire. Pre and post-dialysis blood levels of urea, sodium, total protein, and hemoglobin were measured and intradialytic change of plasma volume were calculated. Data analyses were performed by the SPSS v.16. Results: Out of 60 patients, 58.3% were male and 41.7% female. Post-dialysis systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly lower than pre-dialysis values in both groups (P=0.001, each). No correlation was found between intradialytic change in plasma volume or body weight and alterations of SBP or DBP during HD in the study groups (P>0.05, each). Intradialytic changes of body weight did not correlate to intradialytic changes of plasma volume (P=0.15). Conclusion: HD effectively reduces blood pressure and volume expansion, however, intradialytic changes of plasma volume and body weight do not influence on SBP and DBP.

Age related volume of cadaver-prostates in Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara
Keyword(s):  
Prostate Gland ◽  
Age Groups ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Group A ◽  
Key Words Prostate ◽  
The Mean ◽  
Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

Evaluation of Drug Use Based on WHO Prescribing Indicator in Mizan- Tepi University Teaching Hospital, south Western Ethiopia: A Cross Sectional Study

2020 ◽  
Vol 15 ◽  
Author(s):  
Solomon Hambisa ◽  
Rediet Feleke ◽  
Ameha Zewudie ◽  
Mohammed Yimam
Keyword(s):  
Drug Use ◽  
World Health Organization ◽  
Teaching Hospital ◽  
Cross Sectional Study ◽  
University Teaching ◽  
World Health ◽  
Sectional Study ◽  
Hospital Data ◽  
Cross Sectional ◽  
Health Organization

Background:: Rational drug use comprises aspects of prescribing, dispensing and patient use of medicines for different health problems. This study is aimed to assess drug prescribing practice based on the world health organization prescribing indicators in Mizan-Tepi University teaching hospital. Methods:: An institutional based retrospective cross sectional study was conducted to evaluate prescribing practices in Mizan-Tepi University teaching hospital. Data were collected based on World health organization drug use indicators using prescription papers. 600 prescriptions dispensed through the general outpatient pharmacy of the hospital were collected by systematic random sampling method from prescriptions written for a 1-year time in Mizan-Tepi University teaching hospital. Results:: The present study found that the average number of drugs per prescription was 2.04 ± 0.87 in Mizan-Tepi University teaching hospital with a range between 1 and 5. Prescribing by generic name was 97.6 % and 47.8% of prescriptions contained antibiotics in the hospital. 27.7% of prescriptions contained at least one injectable medication in Mizan-Tepi University teaching hospital. From prescribed drugs, 96.7% of them were prescribed from Ethiopian essential drug list. Conclusion:: Present study indicated that the average number of drugs prescribed per encounter, the percentage of generic prescribing and prescribing from the EDL were close to optimal value. However, the percentage of encounters with antibiotics and injections prescribed were found be very high. Thus, the study highlights some improvements in prescribing habits, particularly by focusing on the inappropriate consumption of antibiotics and injections.

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