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Article
Serum Lipids in Diabetic and Hypertensive Patients Attending Clinic in Aba Metropolis, South-Eastern Nigeria

Authors: U. L. Udodirim --- Adikema N. A
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2014 Volume: 11 Issue: 1 Pages: 7-17
Publisher: Babylon University جامعة بابل

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Abstract

Systolic and diastolic blood pressures and body mass index were carried out in 150 patients attending Abia State Teaching Hospital, Aba, South-Eastern part of Nigeria, and in another 50 persons from the same locality, who were neither hypertensive nor diabetic (controls); bringing to total number of participants to 200. The result showed that the mean total cholesterol (TC) 6.73±1.19 mm/L, triglyceride (TG) 2.66±0.83 mm/L, low density lipoprotein cholesterol (LDL-C)3.84±1.07mm/L, and fasting blood glucose (FBS)10.19±3.69mm/L were significantly higher (P<0.05) in hypertensive diabetic subjects compared with the control subjects with values: TC 4.59±0.94mm/L, TG 1.59±0.33mm/L, LDL-C 2.8±0.49mm/L. The systolic and diastolic blood pressures were also significantly higher (P<0.05) in hypertensive diabetics 172.00±12.21 mmHg, and 105.50±9.96mm/Hg, respectively, compared with the control subjects 120.56±13.79mmHg, and 76.8±8.5mmHg respectively. The mean serum levels of high density lipoprotein cholesterol (HDL-C) in hypertensive and diabetic patients: 0.89±0.58mm/L was significantly lower at (P<0.05) than of control: 1.71±0.40mmHg. The mean levels of TC, TG and LDL-C, were significantly higher (P<0.05) in hypertensive non diabetic subjects compared with normal healthy subjects studied. The HDL-C of non diabetic hypertensive subjects: 0.96±0.45mm/L was significantly lower at (P< 0.05) than values obtained in control subjects:. 1.71±0.40mm/L. The mean glucose level showed no significant difference (P>0.05) between the hypertensive non diabetic subjects and control subjects. No significant difference was found in the mean body mass index (BMI) of the hypertensive, diabetic and control subjects. The findings, which provide data from the South –Eastern part of Nigeria, agree with literature report on effect of diabetes and hypertension on the blood level of these parameters in persons from other localities. Of particular interest is the level of HDL-C and TC in both hypertensive and diabetic patients which is suggestive of the higher risk of developing cardiovascular disease. The results underscore the necessity of carrying out complete lipid assay and FBS in patients who present either of these conditions. This should be in addition to looking out for other clinical manifestations of the diseases and following up treatment.


Article
Comparative Effects of Telmisartan versus Valsartan on serum Leptin level, in hypertensive type 2 diabetes mellitus patients

Author: Najlaa Saadi Ismael Fathel Abaas Al-hamamy
Journal: Iraqi Journal of Pharmacy المجلة العراقية للصيدلة ISSN: 16802594 / EISSN 22642522 Year: 2014 Volume: 14 Issue: 1 Pages: 95-104
Publisher: Mosul University جامعة الموصل

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Abstract

Objective: The aim of this study was to compare the effects of telmisartan and valsartan onblood pressure and serum leptin in hypertensive type 2 diabetesMellitus patients.Study design:A randomized control comparative clinical trial with open label design.Study period: From 1st February, 2012 to 30th March, 2013.Patients and method: Eighty eight type 2 diabetic hypertensive patients were randomly assigned to received either telmisartan (n = 46) or valsartan (n = 42) with body mass index (BMI) 31.52±4.73 kg/m², 30.39±3.95 kg/m² respectivly. Forty one diabetic normotensive patients (n=41), age, sex, BMI, duration of diabetic disease, duration of diabetic treatment matched to the diabetic hypertensive patients groups were kept as control group. blood pressure (BP), leptin levels were measured at baseline and after 2 months of treatment.Results: The study showed a significant higher systolic blood pressure (SBP), diastolic blood pressure (DBP) and serum leptin in the diabetic hypertensive patients before starting therapy as compared with the diabetic normotensive patients. Both telmisartan and valsartan significantly reduced serum leptin and BP. More reduction in DBP seen with valsartan than with telmisartan.Conclusion: Monotherapy with telmisartan and valsartan produce a beneficial reduction effects on BP and reduce leptin level. The improvement of leptin sensitivity may play a role directly or indirectly in the induction of hypertension control.


Article
Abnormal Blood Pressure Load by Ambulatory Blood Pressure Monitor as a Predictor for Left Ventricular Hypertrophy in Hypertensive Patients.
حمل ضغط الدم بجهاز قياس ضغط الدم المحمول كدليل لتثخن جدران القلب في المرضى المصابين بارتفاع ضغط الدم الشرياني.

Authors: Laith Abdulhussein Aldabbagh --- Abdulhamza Rajooj Hmood
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2014 Volume: 4 Issue: 3 Pages: 113-122
Publisher: University of Kufa جامعة الكوفة

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Abstract

Aim:The aim of this study is to assess the accuracy of ambulatory blood pressure load as a predictor for LVH in comparison with echo in hypertensive patients.Methods: We report ECG, echo study, and then ABPM findings in 53 individuals during 1 year. All of the referred subjects were hypertensive with variable socio-demographic characteristics.Results: We found 31 patients having LVH on echo study; most of them were male and significantly correlated with duration of hypertension, average 24-hours SBP and DBP, mean day-time and mean night-time SBP and DBP, and with the circadian rhythm. The association between LVH and BP load was also significant.Discussion: Echo was more sensitive than ECG in detecting LVH and ABPM was rather more sensitive than echo. The study had found that BP load measurement had very high sensitivity with an acceptable specificity and an excellent negative predictive value in rolling out LVH. The association between LVH and parameters of ABPM was also significant.Conclusions: Abnormalities on ABPM are very common in hypertensives and are strongly indicated to identify the BP profile. Recommendations: ABPM was more sensitive than ECG and echo study in the detection of LVH. Echo, on the other hand is rather more sensitive than ECG for the same purpose.Male hypertensive should be offered an ABPM at every opportunity for early detection of LVH.

الهدف: يعتبر فحص القلب بجهاز الايكو من الفحوصات المهمة لتشخيص تثخن جدران القلب نتيجة ارتفاع ضغط الدم وذلك لوجود علاقة وثيقة بين تثخن جدار القلب وارتفاع ضغط الدم. في هذه الدراسة تمت المقارنة بين جهاز الضغط المحمول وجهاز الايكو لتشخيص تثخن الجدران.المنهجية: تم بحث 53 شخص مصاب بارتفاع ضغط الدم باستخدام تخطيط القلب الكهربائي وعمل فحص ايكو القلب لدراسة كتلة البطين اليسر ومقارنتها بحمل ضغط الدم بجهاز قياس ضغط الدم المحمول.النتائج: تم تشخيص 31 مريضا لديهم تثخن في جدران القلب. معظمهم كانوا ذكورا وفترة ارتفاع ضغط الدم كانت طويلة. النسبة الإحصائية كانت وثيقة بين تثخن الجدران ومعدل الضغط العالي والواطئ وكانت أيضا وثيقة بين تثخن الجدران وحمل الضغط الذي تم قياسه عن طريق جهاز الضغط المحمول.الاستنتاجات: جهاز الضغط المحمول كان دقيقا في تشخيص تثخن جدران القلب مقارنةبجهاز الايكو. حمل الضغط كان لديه حساسية عالية جدا في التشخيص وخصوصية مقبولة. بالإمكانأيضا استبعاد إمكانية وجود تثخن في جدران القلب لدى المرضى اللذين يكون حمل الضغط لديهم طبيعي.التوصيات: يجب على جميع المرضى المصابين بارتفاع ضغط الدم أن يتم إحالتهم لغرض الفحص باستخدام جهاز الضغط المحمول خصوصا اذا كانوا ذكورا ولديهم المرض منذ فترة طويلة.


Article
Analysis of Patients with White Coat Hypertension by Ambulatory Blood Pressure Monitoring

Authors: Abdulhamza Rajooj Hmood --- Hassan Salim Abdulsada --- Ala'a Abdulhussain Abdulzahra --- Sami Adil, CABMS (Psychiatry)
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2014 Volume: 22 Issue: 9 Pages: 2567-2559
Publisher: Babylon University جامعة بابل

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Abstract

Ambulatory blood pressure measurement is the best method of detecting white coat hypertension. We report ambulatory blood pressure measurement findings in 100 individuals during 1 year. All of the referred subjects underwent casual and ambulatory blood pressure measurement.Mean age (± SD) was 36 (± 13) years; 82% male and 18% female; 68% were non-smokers and 32% were smokers . white coat hypertension is found in 68% of individuals who had completely normal blood pressure profile. Among the hypertensive group (32%), blood pressure load was normal in 96% and rose in 4%. Studying of the nocturnal drop had categorized the hypertensive group into reverse dipper (1%), non-dipper (3%), extreme dipper (0%), and dipper 96%. No significant correlation between ambulatory blood pressure measurement and socio-demographic characteristics. Thirty-two were hypertensive and 68% were normotensive on ambulatory blood pressure measurement with a statically significant value. Blood pressure load was elevated in 50%. There was a significant association between ambulatory blood pressure measurement results and blood pressure load and blood pressure drop, abnormalities on ambulatory blood pressure measurement are common in individuals with hypertension and are strongly indicated to identify the blood pressure profile. Indeed, ambulatory blood pressure measurement should be strongly indicated in individual with suspected white coat effect to avoid false diagnosis of hypertension and long term costly therapy.

جهاز مراقبة ضغط الدم المحمول يعتبر افضل طريقة لتشخيص المرضى المصابين بارتفاع ضغط الدم نتيجة الرداء الابيض. هولاء الاشخاص يكون معدل ضغط الدم لديهم عاليا عند قياسه في العيادة بينما يكون طبيعي عند قياسه خارج العيادة، تم بحث 100 شخص خلال سنة كاملة حيث تم قياس الضغط في العيادة والتأكد من كونه مرتفعا وتم بعد ذلك استخدام جهاز الضغط المحمول لمدة 24 ساعة. معدل العمر كان 36 سنة وبنسبة 82% ذكور و18% اناث. 68% كانو غير مدخنين و32% مدخنين. لم يرتفع ضغط الدم في 68% من المرضى هولاء الاشخاص يعتبر لديهم ارتفاع ضغط الدم نتيجة الرداء الابيض. 32% تم تشخيصهم مصابين بأرتفاع ضغط الدم. في هذه المجموعة تم ملاحظة ارتفاع حمل الضغط في 50%. بعد دراسة هبوط الضغط اثناء الليل تم ملاحظة ان 96% ينخفض الضغط لديهم بصورة طبيعية و3% ينخفض الضغط بدرجة اقل و1% ارتفع لديهم الضغط ولم يلاحظ اي انخفاض اكثر من المتوقع، لم تكن النسبة الاحصائية مهمة لكن النسبة الاحصائية كانت وثيقة بالنسبة لحمل الضغط وانخفاض الضغط. يجب على جميع المرضى المصابين بأرتفاع ضغط الدم الرداء الابيض ان يتم احالتهم لغرض الفحص باستخدام جهاز الضغط المحمول كما ويجب ذلك للمرضى المصابين بأرتفاع ضغط الدم لمعرفة تفاصيل ارتفاع ضغط الدم.


Article
Assessment of Coronary Heart Disease Risk Factors and Relation to Nutritional State

Authors: Hussein Abdulzahra Hussein. --- Hadeel Fadhil Farhood --- moshtak Abdul-Atheem Wtwt --- Ameer Njah Al-Husony
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2014 Volume: 22 Issue: 6 Pages: 1829-1847
Publisher: Babylon University جامعة بابل

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Abstract

Background: The Coronary heart disease (CHD) is a leading cause of mortality morbidity, and disability in the world. The Framingham,s risk score had been used for CHD risk assessment that examine the distribution of lifestyle and emerging risk factors by 10 years risk of CHD. Aims of study: To assess the risk of CHD development and to identify the relationship between obesity and the risk of developing CHD. Patients and Methods: A hospital-based cross-sectional study has been carried out on (150) patients with no history of CHD, attending to Merjan Teaching Hospital in Al-Hillah City from March to June 2013. Data has been obtained by questionnaire, measurement of anthropometric indices Blood pressure measurement, Electro–Cardio-Graph (ECG), echo study. With laboratory investigations including fasting blood glucose and fasting serum lipid's profile.Results: The average age was meam ±SD (49.64 ± 11.11). (45% ) female and (55%) were male out of which (29%) were diabetic, (22%) were smoker, and (6%) had high total cholesterol level > (above 6.2 mmol/l) , (21 %) have high triglyceride level > (2.26 mmol/l and above), 23% have high LDL-c (4.1mmol/l and above, (71%)have low HDL-c (<1 in male and <1.3 in female), (58 %) hypertension , and (86% )of them were physically inactive, ( 59%) were obese (BMI >30kg/m2) The Framinghams risk score as total mean ± SD were (97.30±5.65) The very low risk (<10%) was ( 47%), low risk (10-15%) was (14%), moderate risk score (15-20%) was (18%), high risk score (>20% risk score) was (21%). There was significant association between that risk and physical inactivity and body mass index and waist/hip ratio. There was significant association between that risk and physical inactivity. There was significant association between coronary heart disease risk and body mass index , (68%) of patients with high risk of development of coronary heart disease were pre-obese and obese . Conclusion There is a high prevalence of standard coronary heart disease risk factors so need specific lifestyle modification by the people ,community and specific programs from the health authority to decrease these risk factors.

خلفية البحث يعتبر مرض اتضيق الشرايين التاجية من الامراض المهمة في دول العالم ويعتبر مقياس فرامهام من المؤشرات المستخدمة للتحديد مؤشر الاصابة بامراض القلب التاجية خلال العشر سنوات والتي تحدد تاثير نمط الحياة اليومي وبعض عوامل الخطورة على الاصابة بالمرض .اهداف البحث: والغرض من هذه الدراسة لتقييم نسبة عوامل الخطورة التي قد تكون مسؤولة عن الاصابة بامراض الشرايين التاجية في البالغين و العلاقة بين البدانة وخطر الاصابة بها العينة وطريقة البحث: دراسة مقطعية أجريت لمرضى تم اختيارهم عشوائيا والذين يرتادون مستشفى مرجان التعليمي في مدينة الحلة للفترة الاول من اذار الى الثلاثين من حزيران عام 2013 . البيانات تم الحصول عليها عن طريق الاستبيانات بسيطة ، وقياس مؤشرات قياس الجسم البشري وتشمل مؤشر معامل كتلة الجسم ، و محيط الخصر ، و نسبة محيط الخصر إلى محيط الورك ،قياس ضغط الدم مع اخذ بعض الفحوصات المختبرية فحوصات مختبرية. النتائج: كان معدل الاعمار في هذة الدراسة فوق الاربعين سنة واعلى نسبة كانت للرجال(55%) ,ووجدت نسبة عالية لعوامل الخطورة المؤدية للاصابة بتصلب الشرايين التاجية لدى عينة الدراسة ,حيث سجل ( 86%) من العينة عدم ممارسة الرياضة وسجل ارتفاع ضغط الدم لدى( 58 %) من العينة والسمنة 59% وداء السكري 29% اضافة لقلة نسبة الدهون الجيدة. وكان مؤشر قياس الخطورة 97.30±5.65وكان 47% من المرضى لديهم مؤشر ضعيف جدا للاصابة بتصلب الشرايين التاجيةو 14% لديهم مؤشر ضعيف و 18% لديهم مؤشر متوسط و21% لديهم مؤشر عالي للاصابة بتصلب الشرايين التاجية . كما وجد علاقة احصائية بين خطر الاصابة وعدم ممارسة الرياضة وبين المرضى الذين لديهم مؤشر عالي لخطر الاصابة مع البدانة حيث وجد 68% من اولئك المرضى لديهم زيادة في الوزن وبدانة . الاستنتاج: هناك نسبة عالية من عوامل الخطورة المؤدية لامراض الشرايين التاجية ومن هذه الدراسة نستنتج الحاجة لتغيير نمط الحياة من قبل المريض نفسة و المجتمع لتقليل هذه المخاطر

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