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Background National and statewide assessment of cardiovascular risk factors needs to be conducted periodically in order to inform public health policy and prioritise allocation of funds, especially in LMICs. Although there have be...
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Background National and statewide assessment of cardiovascular risk factors needs to be conducted periodically in order to inform public health policy and prioritise allocation of funds, especially in LMICs. Although there have been studies from India which have explored the determinants of cardiovascular risk factors, they have mostly been from high epidemiological transition states. The present study assessed the determinants of cardiovascular (CVD) risk factors in a low epidemiological transition state (Madhya Pradesh) using the WHO STEPwise approach to surveillance (STEPS). Methods A total of 5,680 persons aged 18–69 years were selected from the state of Madhya Pradesh through multi-stage cluster random sampling. Key CVD risk factors we sought to evaluate were from behavioural (tobacco, alcohol, physical activity, diet) and biological domains (overweight or obese, Hypertension, Diabetes, and Raised serum cholesterol). Key socio-demographic factors of interest were the caste and tribe groups, and rural vs urban location, in addition to known influencers of CVD risk such as age, gender and education level Results Those belonging to the scheduled tribes were more at risk of consuming tobacco (OR 2.13 (95% CI [1.52–2.98]), and a diet with less than five servings of fruits and vegetables (OR 2.78 (95% CI [1.06–7.24]), but had had the least risk of physical inactivity (OR 0.31 (95% CI [0.02–0.54]). Residence in a rural area also reduced the odds of physical inactivity (OR 0.65 (95% CI [0.46–0.92])). Lack of formal education was a risk factor for both tobacco consumption and alcohol intake (OR 1.40 (95% CI [1.08–1.82]) for tobacco use; 1.68 (95% CI [1.14–2.49]) for alcohol intake). Those belonging to schedules tribes had much lower risk of being obese (OR 0.25; 95% CI [0.17–0.37]), but were at similar risk of all other clinical CVD risk factors as compared to other caste groups. Conclusion In the current study we explored socio-demographic determinants of behavioural and biological CVD risks, and found that in Madhya Pradesh, belonging to a scheduled tribe or living in a rural location, protects against being physically inactive or being overweight or obese. Increasing age confers a greater CVD-risk in all domains. Being a male, and lack of formal education confers a greater risk for behavioural domains, but not for most clinical risk domains. Future efforts at curbing CVDs should be therefore two pronged –a population-based strategy targeting biological risk factors, and a more focussed approach directed at those displaying risky behaviour.
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Purpose Bevacizumab is a humanized monoclonal antibody targeting vascular endothelial growth factor. The aim of this study was to gain a better understanding of the overall incidence and risk of significantly raised blood pressure...
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Purpose Bevacizumab is a humanized monoclonal antibody targeting vascular endothelial growth factor. The aim of this study was to gain a better understanding of the overall incidence and risk of significantly raised blood pressure in cancer patients who receive bevacizumab therapy.
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Hemodialysis-associated hypotension, one of the more serious issues in hemodialysis patients, can be treated by passive leg raising (PLR) and ultrafiltration (UF) stopping. We investigated the effects of PLR and UF stopping on blo...
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Hemodialysis-associated hypotension, one of the more serious issues in hemodialysis patients, can be treated by passive leg raising (PLR) and ultrafiltration (UF) stopping. We investigated the effects of PLR and UF stopping on blood pressure in hemodialysis patients.
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Licorice, a plant indigenous to southern Europe, the Middle East, and northern China, exhibits several pharmacological properties, including estrogenic, anti-tumoral, anti-inflammatory, anti-allergenic, and anti-tussive activities...
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Licorice, a plant indigenous to southern Europe, the Middle East, and northern China, exhibits several pharmacological properties, including estrogenic, anti-tumoral, anti-inflammatory, anti-allergenic, and anti-tussive activities. Prolonged use of licorice is known to produce headaches, hypertension, cardiac arrhythmias, edema, lethargy, dyspnea, sodium retention and loss of potassium in humans. However, to date, the potential adverse health effects due to occupational inhalation exposure of licorice root dust remains unknown. This study was, therefore, undertaken to address this issue. In this cross-sectional study, individuals (30 workers) occupationally exposed to licorice root dust at a licorice producing plant in Shiraz, Iran were recruited. Similarly, 30 healthy male unexposed employees at a telecommunications industry, with identical demographic and socioeconomic status, without any past or current exposure to licorice dust or habitual ingestion of this compound, served as the referent group. Systolic and diastolic blood pressures were measured. Further, individuals underwent electrocardiography, clinical examination and blood chemistry tests. To assess the extent to which subjects were exposed to licorice root dust, atmospheric concentrations of this compound were also measured in the plant. There were no differences in age, weight, height and duration of exposure to licorice dust or length of employment between exposed and referent groups. Atmospheric measurement of licorice dust showed that concentration exceeded the permissible limit of 5mgm~(-3). Systolic and diastolic blood pressures of exposed subjects were significantly higher than those of the referent group. Similarly, blood analysis revealed that serum concentrations of potassium and platelet counts were significantly lower in exposed subjects than in referent individuals. Questionnaire data demonstrated that symptoms such as headaches, lethargy, and vertigo were more common in exposed subjects. No abnormal changes were noted in the electrocardiographs of exposed or referent subjects. Our findings provide evidence that inhalation exposure to high concentrations of licorice dust is associated with an increased prevalence of headache, lethargy, and vertigo, as well as hypertension and hypokalemia. None of these changes resulted in increased morbidity and mortality in exposed workers.
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The present study aimed to determine the role of job components and individual parameters on the raised blood pressure among male workers of textile industry who were exposed to continuous high noise level. Information of all elig...
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The present study aimed to determine the role of job components and individual parameters on the raised blood pressure among male workers of textile industry who were exposed to continuous high noise level. Information of all eligible subjects including demographic and individual characteristics, medical history and job characteristics were obtained by direct interview and referring to the medical records. All blood pressure measurements were done using mercury sphygmomanometer in the morning before work. The 8-hours equivalent A-weighted sound pressure level, the level of blood cholesterol and triglyceride, and noise annoyance was determined for each worker. As the result of weighted regression in path analysis (direct effect), only the work shift did not have a significant effect on blood pressure among the studied variables. It can be seen that variables including the level of triglyceride, cholesterol, and noise exposure have the most direct effects on blood pressure. The results of total effects showed that variables, including using the hearing protection device, age, work experience and visibility of sound source, did not have a significant effect on blood pressure. The results of this study indicate that occupational noise exposure alone and combined with other job components and individual parameters is associated with raised blood pressure. However, noise exposure was probably a stronger stressor for increased blood pressure.
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Only fifty percent of critically ill patients have still some cardiac preload reserve and respond to volume expansion by a significant increase cardiac output. This emphasizes the need for predictive factors of fluid responsivenes...
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Only fifty percent of critically ill patients have still some cardiac preload reserve and respond to volume expansion by a significant increase cardiac output. This emphasizes the need for predictive factors of fluid responsiveness to avoid ineffective or deleterious volume loading. Since clinical evaluation is of poor value, sophisticated parameters have been proposed to help the caregiver in the decision making process concerning volume expansion. Markers of cardiac preload have been shown to lack sensitivity and specificity for predicting volume responsiveness. Minimally invasive haemodynamic devices provide the clinician with dynamic markers of volume responsiveness. In mechanically ventilated patients, the magnitude of respiratory changes in stroke volume or its surrogates has been proposed to detect volume responsiveness. Accordingly, respiratory variations of arterial pulse pressure, of arterial pulse contour-derived stroke volume, of Doppler aortic blood velocity or flow, have been reported as excellent predictors of the haemodynamic response to fluid loading provided that the patient does not exhibit any triggering efforts or arrhythmias. The response to passive leg raising manoeuvre by an increase in pulse pressure or in aortic blood flow also suggests that the patient is volume responsive, even in cases of spontaneous breathing activity or arrhythmias.
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Background/aims The association between the development of cystoid macular oedema (CMO) following uneventful cataract surgery and prostaglandin analogue (PGA) therapy has not been fully determined. The study aim was to investigate...
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Background/aims The association between the development of cystoid macular oedema (CMO) following uneventful cataract surgery and prostaglandin analogue (PGA) therapy has not been fully determined. The study aim was to investigate whether discontinuation of PGA therapy following uneventful cataract surgery affected the incidence of postoperative CMO. Methods A prospective randomised controlled trial of 62 eyes of 62 participants with ocular hypertension (OH) or primary open angle glaucoma (POAG) treated with PGAs prior to cataract surgery. Participants were randomised to continue with PGA therapy after cataract surgery (CPGA) (n=31) or to discontinue PGA therapy (n=31). The primary outcome measure was the development of CMO at 1-month postoperatively, determined by a masked observer assessment of optical coherence tomography scans. The secondary outcome measure was change from baseline intraocular pressure (IOP). Results The incidence of CMO was identical in both groups at 12.9% (4 of 31 eyes) at the 1-month postoperative visit (OR 1.000; 95% CI 0.227 to 4.415). At 1-month postoperatively, the IOP was significantly lower in the CPGA group compared with baseline IOP. Conclusion Continuation of PGA therapy following uneventful cataract surgery in eyes with normal macular morphology did not increase the incidence of CMO. Continuation of PGA therapy significantly reduced IOP at 1-month postoperatively suggesting that, when indicated, it might be beneficial to continue PGA therapy in patients with POAG or OH after uneventful cataract surgery in the absence of other risk factors for developing CMO.
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