A comparative study of pre and post prandial blood pressure recordings on normotensives and hypertensives on treatment

Background: The aim of the study was to study pre and post prandial BP recordings in normotensives and hypertensives on treatment above the age of 18 years.Methods: The study will be conducted on 50 normotensives and 50 hypertensives on treatment admitted to our hospital over a period of 3 months. The patients are randomly selected and the details of duration and antihypertensive are noted. Both systolic and diastolic blood pressure is measured in supine position of the right arm using digital electronic blood pressure monitor. BP recordings are taken 30 min before and 30 min after meals. Then fall in BP is recorded.Results: From this study we found that the mean systolic and diastolic blood pressure is higher in hypertensives than normotensive patients. The study was statistically significant which was found by paired t test. The post prandial fall in BP was significantly higher in hypertensives than normotensive patients. Probably hypertensives had reduced cardiac sympathetic tone which caused postprandial hypotension more than normotensive patients.Conclusions: Apart from pharmacological treatment, poor housing condition and illiteracy of the parents of these patients need to be addressed

Tinnitus and vertigo in chronic kidney disease patients: an observational study at tertiary care centre

Background: Chronic kidney disease is characterized by the progressive and irreversible loss of kidney function over a period of months and years. Due to antigenic similarity, the cochlea and kidney have similar physiological mechanisms namely active transport of fluid and electrolytes achieved by stria vascularis in the cochlea and glomeruli in the kidney. Objective was to inspect the relation between hemodialysis and development of tinnitus and vertigo in CKD patients.Methods: Prospective observational study conducted at Srinivas Institute of medical science, Mangalore, 88 patients were enrolled in this study.Results: Out of 88 patients studied 09 patients (10.22%) complain of tinnitus, 12 patients (13.63%) complain of vertigo, 48 patients (54.54%) had both tinnitus and vertigo, and the remaining 19 patients (21.59%) didn’t develop any tinnitus or vertigo symptoms. The pure tone audiometry results in these individuals were indicative of inner ear pathology. The statistical analysis was done using SPSS 22.Conclusions: Vertigo and tinnitus are common with haemodialysis in patients with chronic kidney disease as 78.40% were affected with either tinnitus or vertigo or with both

Efficacy of biofeedback in treatment of migraine

Background: Migraine is characterized by increased excitability of CNS. Biofeedback is a non-invasive, non-pharmacologic therapeutic technique, which helps patients control stress response by deep breathing,visualization and medication. The aim of the study was to compare efficacy of conventional therapy, biofeedback and combination of pharmacotherapy with biofeedback. Methods: This is a randomized study conducted for period of 2 years from April 2020 to May 2022 in Srinivas Institute of Medical Science and Research Centre, Mukka, Surathkal. 100 patients who were diagnosed with migraine between 18 and 60 years of age were included in the study after ruling out other primary causes of headache. Patients<18 years of age >60 years of age, with known comorbidities that can precipitate headache and on treatment for any other condition were excluded from the study. They were randomly assigned to groups for receiving conventional therapy, biofeedback therapy and combination of pharmacotherapy and biofeedback. 35 patients were allotted to group which received conventional therapy, 35 were assigned to the group that received combination of biofeedback and pharmacotherapy and 30 patients were allotted to the group that received biofeedback alone. Results: Among 100 migraine patients 58 were females and 42 were males. 62 of them were in the age group of 30 to 40 years of age. 66 patients belonged to moderate to severe category of migraine. Out of 35 patients who received conventional therapy 21 (57.4%) reported improvement in quality of life, whereas 26 out of 35 (74.28%) who received combination of biofeedback and pharmacotherapy reported reduction in severity and frequency of headaches with better quality of life compared to 13 patients out of 30 who received biofeedback alone (43.3%). Conclusions: Patients who received combination of biofeedback and pharmacotherapy had best outcome (74.28%) compared to the ones who received biofeedback (43.3%) or conventional therapy (57.4%) alone.

Incidence of ventilator associated pneumonia in tracheostomised and non tracheostomised patients

Background: Pneumonia is the most common hospital acquired infection in the intensive care unit. One of the causes for hospital acquired pneumonia is ventilator associated pneumonia. Tracheostomy is known to prevent occurrence of ventilator associated pneumonia as it decreases the respiratory dead space, assists in better clearance of secretions and prevents chances of aspiration. Generally, tracheostomy is done after 2 weeks of endotracheal intubation to prevent tracheal complications. The aim of this study is to identify the incidence of ventilator associated pneumonia in tracheostomised and non tracheostomised patients and to see if early tracheostomy can prevent development of ventilator associated pneumonia.Methods: The study was conducted at a tertiary care hospital during a period of four years. 100 patients who were on mechanical ventilation for more than 7 days where taken up for the study. APACHE 4 scoring system was used. The incidence of Ventilator associated pneumonia in tracheostomised and non tracheostomised patients was studied.Results: In our study the total incidence of VAP was 44 %. In our study out of the 42 patients who had undergone tracheostomy 13 (30.95%) patients had ventilator associated pneumonia. Among the non-tracheostomised patients 31 (53.44%) out of 58 patients developed ventilator associated pneumonia. In our study the incidence of ventilator associated pneumonia was much lesser (12%) in patients who underwent tracheostomy in the period 7 to 10 days after mechanical ventilation, whereas in those who underwent tracheostomy after 11 days incidence of ventilator associated pneumonia was much higher.Conclusions: Our study showed that the incidence of ventilator associated pneumonia was much higher among non tracheostomised patients compared to patients who underwent tracheostomy. Hence patients undergoing earlier tracheostomy had a clear advantage than those undergoing tracheostomy late or non tracheostomised patients in preventing ventilator associated pneumonia

Cardiovascular changes in patients presenting with vertigo

Background: The term dizziness often used to refer to a host of complaints which present in a similar manner. Of these vertigo is the most common. A thorough knowledge of cardiovascular changes that occur in subjects presenting with peripheral vertigo will help the treating medical practioner to promptly identify the cause of symptoms and prevent any confusion that may alter the course of treatment. The aim of this study to identify the changes in cardiovascular parameters that occur in patients with vertigo.Methods: Study was conducted at a tertiary care hospital during a period of two years during which 100 subjects where studied. Of these 50 where healthy adults which was taken as control group. Remaining 50 subjects where those who were admitted to hospital with a diagnosis of peripheral vertigo and termed as case group. Cardiovascular parameters where accessed in terms of pulse rate, rhythm, blood pressure and ECG Recordings among both the groups taken in static position and with 30 degree head tilt backwards and 45 degree angulation on either sides as is done during Dix-Hallpike’s maneuver immediately, after 3 minutes and 10 minutes of positioning the patient.Results: The study showed that there is no significant change in cardiovascular parameters in patients with vertigo when compared with healthy individuals in static position. Immediately following change in position of head there is sudden fall in pulse as well as blood pressure which then gradually comes back to baseline levels in healthy individuals. When there is a labyrinthine dysfunction in those who have hyper active labyrinth the pulse rate and Blood pressure increases sharply immediately after change in position then gradually comes back to baseline level. In hypo active labyrinth the pulse rate and blood pressure falls marginally compared to normal individuals and in dead labyrinths there is a significant fall in pulse rate and blood pressure immediately following change in position which then gradually reverts back to normal.Conclusions: From our study it is quite clear that there are considerable changes in cardiac parameters in patients presenting vertigo which should be kept in mind while evaluating the patients to prevent misdiagnosis. The study also proves a close coordination between vestibular system and central cardiovascular regulatory mechanisms during positional changes to maintain hemodynamic stability.

Role of nanotechnology in the management of indoor fungi

Fungi are ubiquitous in the environment and seek to colonize and grow on diverse materials as part of their life cycle. They constitute complex biofilms on surfaces and deteriorate the indoor air quality even under adverse conditions. They adapt well to changing humidity and temperature conditions, resuming their growth in minutes. Their vital activity generates a large number of pollutants that contribute to bioaerosols, which generate major health problems. The reports published in last few decades pointed out that contaminated environments play an important role in the transmission of infections, especially in hospitals. Advances in the field of nanotechnology have resulted in different and diverse applications. Antimicrobial nanomaterials have been found to be eco‐friendly alternatives to be applied in functional paint and coatings. These ?smart? surfaces could face at nanoscale level the approaching of propagules to avoid their attachment, which is the first stage in biofilm development. In this sense, several nanomaterials, including metal, non‐metal, and hybrids, have been discussed in relation to their antifungal activity in this chapter.Fil: Gámez Espinosa, Erasmo Junior. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigaciones en Tecnología de Pinturas. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigaciones en Tecnología de Pinturas; ArgentinaFil: Barberia Roque, Leyanet. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigaciones en Tecnología de Pinturas. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigaciones en Tecnología de Pinturas; ArgentinaFil: Bellotti, Natalia. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigaciones en Tecnología de Pinturas. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigaciones en Tecnología de Pinturas; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; Argentin