Correlates of microalbuminuria in hypertensive patients of a tertiary care teaching hospital of Central India

Background: Although the prevalence of hypertension is high in India, the relationship between micro-albuminuria and target organ damage in hypertension is not well studied. Hence this study aims to study the prevalence of micro-albuminuria in patients of hypertension and its correlation with other cardiovascular risk factors.Methods: This cross-sectional study was done in 112 essential hypertension non-diabetic patients presented at a tertiary care hospital of Madhya Pradesh, India who fulfilled inclusion criteria and exclusion criteria during a calendar year. The diagnosis of essential hypertension was made by the study physician after complete medical history, physical examination and routine biochemical analysis of blood and urine. The data was analysed using SPSS version 20 and Mann Whitney U and Chi-square test was used for quantitative and qualitative data respectively.Results: The total number of patients having micro-albuminuria was 26 and the prevalence came out to be 23.21%. The mean age of micro-albuminuric patients was less compared to non-microalbuminuric patients (p<0.05). The systolic, diastolic blood pressure and cholesterol levels were found to be higher but was statistically insignificant whereas body mass index (BMI) and duration of disease was statistically  higher (p<0.05) amongst the cases having micro-albumin in their urine.Conclusions: The prevalence of micro-albuminuria increases with the increase in duration, stages /severity of hypertension. Micro-albuminuria may be considered as a marker of adverse cardiovascular risk profile such as LVH and hyperlipidemia. High BMI, smoking and advanced stages of retinopathy are also the risk factors of micro-albuminuria.

A comparative study among clinical and non clinical medical professional’s experiences perceived stress during Covid -19 pandemic era, at tertiary health care centre in central India

Background: The COVID-19 pandemic changed the daily routines of each individual worldwide in tandem with efforts to prevent and control the transmission of COVID-19. The increasing trend of suspected and confirmed cases of COVID-19 required healthcare workers, particularly doctors, to be involved in the management of the COVID-19 pandemic such as contact tracing, diagnosis, treatment, and care of patients with COVID-19. Methodology: This is a cross sectional study has been conducted at Government Medical College and associated hospital, Datia, MP, India during April 2021 to June 2021 among doctors who did different duties in covid-19 pandemic era and comparison between clinical and non clinical specialist in terms of perceived stress. Participants surveyed by socio demographic Performa and Perceived Stress Scale [PSS-10]. Results: Study discloses significant level of stress among medical professionals invariable of gender, age and department. Clinical specialist displayed higher range of perceived stress in comparison of non clinical doctors. Conclusion: Understanding and addressing the mental health issues of health care professionals is important in terms of their efficiency and adaptability towards current scenario of Covid-19 pandemic and this is also noteworthy to identify and neutralise their rising burden of stress and promotion of positive mental health

Adult-onset Still′s disease masquerading as sepsis

This is a case of a 30-year-old female who presented with a recent 4-week history of fever with an underlying chronic illness for the last 6 years for which she got evaluated multiple times and received long treatments but did not get relieved. This time, she presented with high-grade fever and palpitation. Electrocardiogram was suggestive of supraventricular tachycardia which was immediately reverted with intravenous adenosine. She was transferred to the Intensive Care Unit for suspected sepsis. However, after a thorough diagnostic microbiologic, serologic, and immunologic workup, she was diagnosed with adult-onset Still′s disease (AOSD) and was managed with steroids and responded well to treatment. AOSD is a rare condition which could present with a variety of clinical features resembling sepsis

Changing epidemiology of poisoning in Central India: shifting poles from male farmers to young house wives

Introduction: Acute self infliction of poisoning is very common among young in developing countries. The epidemiology of poisoning changes time to time and varies region to region. In south India, organophosphorus compound poisoning has been more common as compared to Aluminium phosphide poisoning in north India. All over India males are more commonly reported to poison themselves. Poisoning in farmers has been reported more commonly than in any other profession. Madhya Pradesh is situated in central part of India, where agriculture is the predominant source of income. There is a knowledge gap in epidemiology of poisoning in this region. Methods: This is a hospital based observational type cross sectional study over nearly 2 years. Results: Out of the 550 number of study participants about 90% were younger than 40 years. Females were more common than males in all age groups. Poisoning was more common in married population in both the genders. House wives followed by unemployed students were the most vulnerable populations. Farmers constituted only about 10% of total cases. Organophosphorus compounds were the most common type of poisoning contributing to almost one fourth of the total cases followed by Zinc phosphide, Aluminium phosphide, oleander and ethylene dibromide poisoning in decreasing order. The overall mortality was 9.8% (n=54). The case fatality rates of various agro-chemicals in decreasing order were Aluminum phosphide (44.7%), ethylene dibromide (17.6%), and organophosphorus (7%). These 3 poisonings contributed to 92.5% of all deaths. Death was more common when the time lag to hospitalization was &gt; 6 hours. Conclusion: Younger age group, female sex and housewives were the most vulnerable group. The case fatality rate of various poisonings in decreasing order were Aluminum phosphide (Celphos) poisoning followed by EDB and OPC

Dissecting the treatment-naive ecosystem of human melanoma brain metastasis

Melanoma brain metastasis (MBM) frequently occurs in patients with advanced melanoma; yet, our understanding of the underlying salient biology is rudimentary. Here, we performed single-cell/nucleus RNA-seq in 22 treatment-naive MBMs and 10 extracranial melanoma metastases (ECMs) and matched spatial single-cell transcriptomics and T&nbsp;cell receptor (TCR)-seq. Cancer cells from MBM were more chromosomally unstable, adopted a neuronal-like cell state, and enriched for spatially variably expressed metabolic pathways. Key observations were validated in independent patient cohorts, patient-derived MBM/ECM xenograft models, RNA/ATAC-seq, proteomics, and multiplexed imaging. Integrated spatial analyses revealed distinct geography of putative cancer immune evasion and evidence for more abundant intra-tumoral B to plasma cell differentiation in lymphoid aggregates in MBM. MBM harbored larger fractions of monocyte-derived macrophages and dysfunctional TOX+CD8+ T&nbsp;cells with distinct expression of immune checkpoints. This work provides comprehensive insights into MBM biology and serves as a foundational resource for further discovery and therapeutic exploration