Charana Das M.,NRI Medical College |
Roja Raman Y.,MKCG Medical College
Journal of Clinical and Diagnostic Research | Year: 2013
Introduction: An increase in the Left Ventricular Mass as a result of muscle hypertrophy, has emerged as a powerful pressure independent risk factor for the cardiovascular mortality and morbidity. It is associated with a risk of death that is 3 times greater than the risk which is associated with hypertension alone. For the development of Left Ventricular Hypertrophy (LVH), in addition to a chronic increase in the pressure and/or volume overload, an elevation in the plasma ACE activity, plasma aldosterone levels, and the angiotensin-II concentrations play a major role.In this study, the effect of Telmisartan, a selective angiotension-II receptor blocker, was compared with that of Atenolol, a selective β1 adrenergic receptor blocker, on the regression of LVH in the patients of essential hypertension. Materials and Method: Essential hypertensive patients with LVH were selected for this study, as per the inclusion and exclusion criteria. This study was carried out on two groups of hypertensive patients with LVH: Group-1: The patients who were taking telmisartan 80 mg OD. Group-2: The patients who were taking atenolol 50 mg OD. The blood pressure was measured and echocardiography was done in both the groups, prior to the treatment and 6 months after the treatment in the Department of Cardiology, MKCG Medical College Hospital, Brahmapur, India. The data were analysed by using the Student's 't' test. Results: In the cases of Left Ventricular Mass Index (LVMI), which is a better indicator of LVH, in the Atenolol group, the mean value changed from 143.93 ± 2.44 gm/m2 to 130.16 ± 2.88 gm/m2 (t=5.83,p<0.01 versus baseline).In the Telmisartan group, the mean value changed from 184.67 ± 7.14 gm/m2 to 133.41 ± 4.24 gm/m2 (t=12.12, p<0.001 versus baseline). On comparing Telmisartan with Atenolol, Telmisartan was found to produce a greater (27.49%) reduction than Atenolol (9.68%). In the Telmisartan group, 13 patients out of 26 patients achieved a target value of LVMI that was <134 gm/m2 in males and <110 gm/m2 in females (50%). In the Atenolol group, only 9 patients out of 22 patients achieved a target value (40.90%). Conclusion: Thus, Telmisartan a selective AT1 antagonist, possesses pharmacological effects beyond a blood pressure reduction in which the blockade of the AT1 receptor may lead to attenuation of the growth promoting action of Ang II. From this study, it is clear that Telmisartan is superior to Atenolol in achieving a regression of LVH, which is a better indicator of the cardiovascular morbidity and mortality.
Tripathy R.M.,MKCG Medical College
Indian journal of public health | Year: 2014
The effective functioning of any health system requires an efficient public health service. Every human being has the right to enjoy "the highest attainable standard of health," which can be fulfilled by giving every man an affordable and equitable health system he deserves and demands. In these years, complex health changes have complicated the situation in India. Most important gaps in the health care include an understanding of the burden of the disease and what leads to and causes ill health, the availability and use of appropriate technology in the management of disease, ill health and health systems that have an impact on service delivery. Universal Health Coverage (UHC) has the potential to increase economic growth, improve educational opportunities, reduce impoverishment and inequalities, and foster social cohesion. Steps taken for achieving UHC will address the public health challenges and vice versa.
Prasad D.S.,Sudhir Heart Center |
Kabir Z.,Research Institute for A Tobacco Free Society |
Dash A.L.,MKCG Medical College |
Das B.C.,Kalinga Institute of Medical science
Journal of Cardiovascular Disease Research | Year: 2012
Objectives: To determine the prevalence of metabolic syndrome and to identify predictors for the same, specific to an underdeveloped urban locale of Eastern India. Materials and Methods: Study design: Population-based cross-sectional study, with multistage random sampling technique. Setting: Urban city-dwellers in Orissa one of the poorest states of Eastern India bordering a prosperous state of Andhra Pradesh of Southern India. Participants: 1178 adults of age 20-80 years randomly selected from 37 electoral wards of the urban city. Definition of Metabolic Syndrome: We followed a unified definition of the metabolic syndrome by joint interim statement of five major scientific organizations - the International Diabetes Federation, the National Heart, Lung, and Blood Institute, the American Heart Association, the World Heart Federation, the International Atherosclerosis Society, and the International Association of the Study of Obesity. Individuals who meet at least three of five clinical criteria of abdominal obesity, hypertriglyceredimia, low HDL, hypertension, and hyperglycemia are diagnosed as having the condition; presence of none of these criteria is mandatory. Explicit cut points are defined for all criteria, except elevated waist circumference, which must rely on population and country-specific definitions. Main Outcome Measure: Prevalence and significant predictors of metabolic syndrome. Statistical Analysis: Both descriptive and multivariable logistic regression analyses. Results: Age-standardized prevalence rates of metabolic syndrome were 33.5% overall, 24.9 % in males and 42.3% in females. Older age, female gender, general obesity, inadequate fruit intake, hypercholesterolemia, and middle-to-high socioeconomic status significantly contributed to increased risk of metabolic syndrome. Conclusion: Metabolic syndrome is a significant public health problem even in one of the poorest states of India that needs to be tackled with proven strategies.
Kota S.K.,Medwin Hospitals |
Meher L.K.,MKCG Medical College |
Jammula S.,Roland Institute of Pharmaceutical science |
Kota S.K.,Central Security Hospital |
Modi K.D.,Medwin Hospitals
Diabetes and Metabolic Syndrome: Clinical Research and Reviews | Year: 2012
Type 2 diabetes mellitus (T2DM) is among the most challenging health issues of the 21st century and is associated with an alarming rise in the incidence. The pathophysiological processes that lead to development of T2DM are still unclear, however impairment in insulin secretion and/or action is clearly indicated. Type 2 diabetes is a polygenic disorder with multiple genes located on different chromosomes contributing to its susceptibility. Analysis of the genetic factors is further complicated by the fact that numerous environmental factors interact with genes to produce the disorder. Only a minority of cases of type 2 diabetes are caused by single gene defects and one example is maturity onset diabetes of the young (MODY). Previous studies indicated that variants in genes encoding the pancreatic β-cell K+ATP channel subunits Kir6.2 (KCNJ11) and SUR1 (ABCC8) are associated with neonatal diabetes. Six different types of maturity onset diabetes of young (MODY) have been identified based on characteristic gene defect. The common Pro12Ala polymorphism in peroxisome proliferator-activated receptor-γ (PPAR-γ) gene was confirmed in several studies to be associated with type 2 diabetes as well. More recently, studies reported variants within a novel gene, TCF7L2, as a putative susceptibility gene for type 2 diabetes across many ethnic backgrounds around the world. MODY patients respond better to sulphonylureas and metformin, while neonatal diabetes patients with genetic mutations can be changed from insulin to oral drugs. We hereby provide a comprehensive review on the role of genetics in type 2 diabetes mellitus. © 2012 Diabetes India.
Mohanty S.,MKCG Medical College |
Sen M.,Sri Venkateswar Medical College and Research Center |
Sahu G.,SCB Medical College
Journal of Forensic and Legal Medicine | Year: 2013
Dowry deaths in the newly married brides are a burning problem of southern India. The objective of the current study was to identify the risk groups. This prospective study was carried out on 140 cases. Results revealed that majority of the victims (83%) were young aged between 18 and 26 years, childless (65.7%) and mostly died within 4 years of marriage (77.2%). About 80% of the victims were illiterates (53%), house wives of rural background (62.9%) and from middle socio-economic group (81%). Husband alone or along with in laws (75%) and joint family (85%) were mainly responsible for death. The common causes of death implicated are hanging, burning and poisoning. Mostly the place of occurrence was in-laws house. Suicidal deaths accounted in 57% and the rest being homicide. At the end some potential risk factors and their remedial measures suggested. © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.