Estimation of Urinary Calcium as a Predictor of Pregnancy Induced Hypertension

Hypertensive diseases are still a leading cause of death among mothers all over the world. It’s complicated aetiology, which begins with aberrant placentation and ends with endothelial dysfunction, is yet unknown. The goal of this study is to learn about changes in serum and urine calcium levels in women who have Gestational Hypertension. 200 normotensive pregnant women between 24-28 weeks were included in the study based on inclusion and exclusion criteria. Urine calcium and creatinine and serum uric acid, total protein, albumin and serum sodium were estimated in corresponding samples collected from patients. The study showed a sensitivity of 80%, specificity of 71%, positive predictive value was 77%, negative predictive value 74%, and diagnostic accuracy as 74%. A single estimation of calcium to creatinine ratio in asymptomatic pregnant women between 24-28 week of gestation is a simple and cost-effective test.

Avoidable mortality from circulatory system diseases in Moldova

Mortality from avoidable circulatory system diseases causes one of the major losses in life expectancy, especially in males and population of working ages. The main contributors are the deaths caused by ischaemic heart diseases, cerebrovascular diseases, and hypertensive diseases. This article analyses the trends in avoidable mortality caused by diseases of the circulatory system and estimates the possible increases in life expectancy due to the elimination of these causes of death. In this regard, the author uses methods of standardization, mortality decomposition and cause-elimination model. The study shows a decline in avoidable mortality from circulatory system diseases during the analyzed period, especially for earlier ages. At the same time, there is a significant differentiation in mortality dynamics depending on sex. In 2016–2018, avoiding these deaths could assure an increase in life expectancy by 3.8 years in males and 2.8 years in females. This possible increase in life expectancy could be partially achieved by improving the quality of the health care system and introducing policies and programs aimed at improving the health of the population. Moreover, programs aimed at preventing diseases of the circulatory system might influence on mortality diminution from other non-communicable diseases and external causes of death.

Comorbidity Patterns of Mood Disorders in Adult Inpatients: Applying Association Rule Mining

This study explored physical and psychiatric comorbidities of mood disorders using association rule mining. There were 7709 subjects who were patients (19 years old) diagnosed with mood disorders and included in the data collected by the Korean National Hospital Discharge In-depth Injury Survey (KNHDS) between 2006 and 2018. Physical comorbidities (46.17%) were higher than that of psychiatric comorbidities (27.28%). The frequent comorbidities of mood disorders (F30–F39) were hypertensive diseases (I10–I15), neurotic, stress-related and somatoform disorders (F40–F48), diabetes mellitus (E10–E14), and diseases of esophagus, stomach, and duodenum (K20–K31). The bidirectional association path of mood disorders (F30–F39) with hypertensive diseases (I10–I15) and diabetes mellitus (E10–E14) were the strongest. Depressive episodes (F32) and recurrent depressive disorders (F33) revealed strong bidirectional association paths with other degenerative diseases of the nervous system (G30-G32) and organic, including symptomatic and mental disorders (F00–F09). Bipolar affective disorders (F31) revealed strong bidirectional association paths with diabetes mellitus (E10–E14) and hypertensive diseases (I10–I15). It was found that different physical and psychiatric disorders are comorbid according to the sub-classification of mood disorders. Understanding the comorbidity patterns of major comorbidities for each mood disorder can assist mental health providers in treating and managing patients with mood disorders.

The changing trends and tendencies in maternal mortality: a compare and contrast spanning two decades

Background: Though the maternal mortality ratio has been on the constant decline over two decades we shall strive forward to prevent all preventable maternal deaths and we have a long way to reach the SDG 3.1 goal. So, it becomes imperative to further reduce the mortality rates by continuously reviewing and upgrading our health policies. The aim of the study was to compare the trends in maternal mortality in 2002-2011 to the current predicament in 2017- 2019 in our hospital.Methods: Data was collected for all maternal deaths in the Institute of obstetrics and gynaecology, Egmore, Chennai- a centre of excellence for maternal care in South India, in terms of age at time of death, parity, period of death, mode of delivery, the cause of death and the admission to delivery interval and compared between the time periods of 2002-2011 and 2017-2019 to identify the changing patterns.Results: The maternal mortality ratio has consistently declined over the years from 220 in 2002 to 110 in 2019. The age group of 20-29 years and primigravidae continue to amount for most mortality. The postpartum period remains the most susceptible period. There is a significant increase in the number of caesarean deaths (64% from 46%). Significant transition in the cause of death from haemorrhage (20% to 7%) to hypertensive disease of pregnancy (23% to 35%) as leading cause of maternal mortality has been witnessed.Conclusions: Significant difference in the trends over two decades in maternal mortality lies in the fact that the leading cause of maternal mortality has changed from haemorrhage to hypertensive diseases and sepsis and they have continued to occupy the top spots for the past decade. Preventive measures are the solution to reduce maternal mortality due to either of the causes.

Analysis Of Family Support And Diet Compliance In Hypertension Patients

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p>Hypertension is a disease that suffered by many people in the world, including in Indonesia. Patients with hypertension must make a diet to consume foods that can increase the sufferer's blood pressure. A hypertension diet is one of the important factors in maintaining the health of hypertension sufferers to prevent disease complications. This study aimed to analysis family support, and compliance with hypertension diet in hypertensive sufferers.</p><p>This study used a cross-sectional design conducted in the Hulu Village of Pancur Batu Public Health Center, Deli Serdang Regency. The sample size in this study was the entire population, namely hypertension sufferers. Sample (saturated sample), so that the total sample is 108 people. This study will conduct a Prevalent Rate (PR) analysis to see the risk of dietary adherence in hypertensive patients.</p><p>This study showed family support in the category of bad as many as 85 people (78.7%), the implementation of hypertension diet in the non-compliant category as many as 76 people (70.4%) and adhered to the implementation of hypertension diet as many as 32 people (29.6%). of avoided foodstuffs (hypertension triggers) it is known that for this type of foods high in cholesterol is (a) grilled/boiled meat, which is as much as 76 people (70.4%), (b) meat or chicken skin, which is as much as 55 people (50.9%), and (c) chicken yolks, which is as many as 67 people (62.0%). The type of food high in Sodium is; chips, which is as many as 55 people (50.9%).</p><p>Pancur Batu Public Health office, seeks to increase counselling about hypertension diet, namely recommended foodstuffs, restricted foodstuffs, avoided foodstuffs and carried out continuously in place and the right time. Families to increase knowledge about the primary prevention of hypertensive diseases so that they can conduct prevention independently and provide motivation (support) to hypertension sufferers to implement the hypertensive diet</p><p> </p></td></tr></tbody></table></div>

Discovery of Association Rules Patterns and Prevalence of Comorbidities in Adult Patients Hospitalized with Mental and Behavioral Disorders

The objectives of this study were to identify the prevalence of comorbidities of mental and behavioral disorders and to identify the association rules related to comorbidities as a way to improve patient management efficiently. We extracted comorbidities of 20,690 patients (≥19 years old) whose principal diagnosis was a mental disorder from the Korean National Hospital Discharge In-depth Injury Survey (KNHDS) between 2006 and 2016. Association rules analysis between comorbid diseases using the Apriori algorithm was used. The prevalence of comorbidities in all patients was 61.98%. The frequent comorbidities of mental and behavioral disorders were analyzed in the order of hypertensive diseases (11.06%), mood disorders (8.34%), diabetes mellitus (7.98%), and diseases of esophagus, stomach, and duodenum (7.04%). Nine major association pathways were analyzed. Significant pathways were analyzed as diabetes mellitus and hypertensive diseases (IS scale = 0.386), hypertensive diseases, and cerebrovascular diseases (IS scale = 0.240). The association pathway of diabetes mellitus and hypertensive diseases was common in subgroups of mental and behavioral disorders, excluding mood disorders and disorders of adult personality and behavior. By monitoring related diseases based on major patterns, it can predict comorbid diseases in advance, improve the efficiency of managing patients with mental and behavioral disorders, and furthermore, it can be used to establish related health policies.

Abstract 052: Hypertensive Diseases In Pregnancy And Hemodynamic Stress Later In Life

Background: Hypertensive diseases in pregnancy have been associated with cardiovascular diseases later in life. However, less is known about the relationship between hypertensive diseases in pregnancy and hemodynamic stress later in life. We evaluated the relationship between hypertensive diseases in pregnancy and plasma levels of biomarkers of hemodynamic stress later in life in the Genetic Epidemiology Network of Arteriopathy (GENOA) study. Methods and Results: We investigated 1605 women from the GENOA study (mean age 61±10 years, 57.1% African American).Women were classified as self-reported as nulliparous women (n=140), a history of normotensive pregnancies (n=1,195), a history of a hypertensive pregnancy (n= 229), or a history of preeclampsia (n= 41). We compared adjusted associations among this groups with 4 biomarkers of hemodynamic stress using generalized estimating equations to account for familial clustering. After adjusting for age, race, level of education, smoking history, hypertension, body mass index (BMI), history of coronary artery disease, and diabetes, women with a history of preeclampsia had higher levels of C-terminal proendothelin (CT-proET) compared to women with a history of normotensive pregnancies (Table, p=0.01). There were no significant differences in the levels of midregional proatrial natriuretic peptide (MR-proANP), midregional proadrenomedullin (MR-proADM), and C-Terminal proarginine vasopressin (CT-proAVP) in this groups. Conclusions: Elevated levels of CT-proET (a precursor to the potent vasoconstrictor Endothelin 1) demonstrates a strong relationship among those with a history of preeclampsia. Future studies are warranted to further explore the relationship between CT-proET in the pathogenesis of preeclampsia as well as subsequent changes in cardiovascular structure and function associated with a history of preeclampsia later in life.