EVALUATION OF SERUM NITRIC OXIDE IN ESSENTIAL HYPERTENSION AND ITS CORRELATION WITH SEVERITY OF DISEASE

ABSTRACTObjective: Hypertension is the most common cardiovascular disease and one of the most important public health concerns all over the world. Primaryor essential hypertension is the major form of arterial hypertension without any definitive cause. It results from increase vascular tone and resistancewhich may be confined to the lower level of endothelial derived relaxing factor such as nitric oxide (NO). Hence, the objective of this study is to findout whether any correlation exists between the concentrations of serum NO (nitrite) and essential hypertensive patients categorized according to theJoint National Committee 7 classification.Methods: We selected age- and sex-matched 24 healthy individuals as controls and 35 essential hypertensive patients as cases. Out of 35 cases, 24were included in stage 1 and 11 in stage 2 of essential hypertension. We estimated serum NO levels in study groups basing on the principle of Griessreaction.Results: We observed reduction in mean serum NO level in cases which was statistically highly significant as compared to controls (8.14±0.33 vs.13.53±0.38 µmol/L, p<0.001) and also in stage 2 patients when compared with stage 1 patients (5.97±0.31 vs. 9.15±0.28 µmol/L, p<0.001). Inhypertensive patients, serum NO showed a highly significant inverse correlation to both systolic (r=−0.89, p<0.001) as well as diastolic (r=−0.64,p<0.001) blood pressure.Conclusion: Thus, we can conclude that lower level of serum NO can be an important causative factor in the progress of essential hypertension.Keywords: Essential hypertension, Endothelial-derived relaxing factor, Nitric oxide, Joint National Committee 7

Perinatal Outcomes in Premature Placental Calcification and the Association of a Color Doppler Study: Report from a Tertiary Care Hospital in Eastern India

Introduction: Placental calcification, identified before the 36th week of gestational age, is known as premature placental calcification (PPC). PPC could be a clue for the poor fetal outcome. However, its association with adverse perinatal outcomes is yet to be confirmed. Objective: The primary objective was to determine and compare the perinatal outcomes in pregnancies with and without documented premature placental calcification. Methodology: The present study was a prospective cohort study performed from October 2017 to September 2019. We consecutively enrolled 494 antenatal women who presented to our antenatal OPD after taking consent to participate in our study. Transabdominal sonographies were conducted between 28–36 weeks of gestation to document placental maturity. We compared maternal and fetal outcomes between those who were identified with grade III placental calcification (n = 140) and those without grade III placental calcification (n = 354). Results: The incidence of preeclampsia, at least one abnormal Doppler index, obstetrics cholestasis, placental abruption, and FGR (fetal growth restriction) pregnancies were significantly higher in the group premature placental calcification. We also found a significantly increased incidence of Low APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) scores, NICU (Neonatal Intensive Care Unit) Admission, Abnormal CTG (cardiotocography), meconium-stained liquor, and low birth weight babies in those with grade III placental calcification. Conclusion: Clinicians should be aware of documenting placental grading while performing ultrasonography during 28 to 36 weeks. Ultrasonographically, the absence of PPC can define a subcategory of low-risk pregnant populations which probably need no referral to specialized centers and can be managed in these settings