iosr-JDMS   Volume-11 ~ Issue-6

Abstract: Background: One of major contributing factors for the growing burden of cardiovascular disorders is increasing prevalence of hypertension and involvement of younger people. Despite its high prevalence in the population, hypertension in women has received less attention than hypertension in men. The primary objective of this study was to assess the sociodemographic and clinical profile of young female hypertensives. Methodology: This was a cross sectional study carried out in the Cardiology OPD of a tertiary care hospital in Kolkata, West Bengal. Six forty six young female hypertensives patients (aged between 20 to <40 years) were interviewed and their blood pressure was measured. Results: The mean systolic blood pressure and mean diastolic blood pressure was 144.1± 24.6 mmHg and 79.9± 12.4 mmHg respectively. Newly detected hypertensives were 21.4%, out of which 39.1% were stage 1 hypertensives and 60.9% were stage 2.Conclusion: Though men are more commonly affected by hypertension, a significant number of females are also affected. By modification of lifestyle, diets, regular exercise and by use of appropriate drugs at right time, majority of hypertensive cases in females specially in the young age group of below 40 years can be controlled and thus major complications can be prevented. Keywords: Hypertensives, young females, clinicosocial profile

[1] National Cardiovascular Disease Database, Sticker No: SE / 04 / 233208, www.whoindia.org(accessed on July 10,2011)

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[6]. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: Page 11-12, www.nhlbi.nih.gov(accessed on July 10, 2011)

[7]. Pickering TG. Ambulatory monitoring and the definition of hypertension. J Hypertens 1992; 10: 401–409.

[8]. Myers MG, Reeves RA. White coat effect in treated hypertensive patients: sex differences. J Hum Hypertens 1995; 9: 729–733.

[9]. Hanes DS. Strategies for the treatment of hypertension in postmenopausal women. J Clin Hypertens 1999;1:62–71.

[10]. Hickson Stacey, Miles Karen, McDonnell Barry, Yasmina , Cockcroft John, Wilkinson Ian, McEniery Carmel. Use of the oral contraceptive pill is associated with increased large artery stiffness in young women: The ENIGMA Study. Journal of Hypertension 2011; 29 (6): 1155–59

Abstract: Central Venous Cannulation is a routine procedure done in the Operation Theatre and the Intensive Care Unit. Malpositioning is a very common occurance with the regular anatomical landmark technique. As the central venous catheters are essential in various critical care scenarios, hence any misplacement can hamper its purpose. Here we have three cases where in we saw the migration of the Right Subclavian Vein Catheter into the Ipsilateral Internal Jugular Vein, Contralateral Subclavian Vein and into the Ipsilateral External Jugular Vein radiologically. Hence a thorough knowledge of normal and variant anatomy is required for the proper positioning of Central Venous Catheters. Also radiological techniques like ultrasound guided cannulation may avoid inadverdent arterial puncture but may not be able to avoid malpositioning.

Keywords: Central Venous Catheter, Malposition, Right Subclavian Vein.

[1]. Samar Harris and Harris V. K. Naina. Central Venous Catheterisation – Subclavian Vein. N Engl J Med 2008; 358: 1758 – 1760.
[2]. Ashutosh Chauhan. Malpositioning of Central Venous Catheter: Two Case Reports. Indian Journal of Anaesthesia 2008; 52: 337 – 9.
[3]. Muhm M et al. Malposition of central venous catheters. Incidence, management and preventive practices.Wien Klin Wochenschr. 1997 Jun 6; 109(11): 400 – 5.
[4]. Pikwer A, Baath L, Davidson B, Perstoft I, Akeson J. The incidence and risk of central venous catheter malpositioning: a prospective cohort study in 1619 patients.Anaesth Intensive Care. 2008 Jan; 36(1): 30 – 7.
Chapters in Books:
[5]. Jonathan Chantler. Applied Anatomy of the central vein. Helen Hamilton and Andy Bodenham (Ed.) Central venous Catheters(A John Wiley & Sons, Ltd, Publication 2009):14 – 34.
[6]. Robert E. Kuminsky. Complications of Central Venous Catheterization. Journal of the American College of Surgeons April 2007; 204(4): 681 – 696.

Abstract: 47 consecutive cases of fracture neck femur in patients older than 70 years were managed by cemented hemiarthroplasty with Austin Moore prosthesis at a tertiary care teaching hospital with the objectives of studying the short come outcome and to compare the results with standard studies using uncemented Austin Moore prosthesis, to determine if cementing the prosthesis improves clinical outcome. Patients who were available for follow up for a minimum of two years have been included in this study. Short term functional outcome was analyzed using the Harris hip scoring system. 44 patients were available for follow up at the end of study period. The patients were in the age group of 72 to 93 years with the mean age of 78.2 years. 59% of the patients were females with 88.6% of all cases sustaining the fracture following a trivial trauma. The functional outcome using the Harris hip score was excellent in 43.5%, good in 38.4%, fair in 11.3% and poor in 6.8% of the cases. There was no case of bone cement implantation syndrome. Hemiarthroplasty with Austin Moore prosthesis is a good option in elderly patients with limited physical demands and mobility. Cementing the prosthesis can achieve better control of thigh pain, improves mobility, allows early mobilization and lesser use of walking aids. The use of cement does not increase perioperative mortality or morbidity in patients without severe cardiopulmonary compromise.

Keywords: Bone cement, Femoral neck fracture, Frail elderly, Hemiarthroplasty, Prosthesis implantation

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[4]. Ioro R, Schwartz B, Macaulay W, Teeney SM, Healey WL, York S. Surgical treatment of displaced femoral neck fractures in the elderly: a survey of the American Association of Hip and Knee Surgeons. J Arthroplasty 2006; 21(8):1124-1133.
[5]. Swiontowski MF. Intracapsular fractures of the hip. J Bone Joint Surg Am 1994;76-A:129-138
[6]. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: Treatment by mould arthroplasty. An end result study using a new method of result evaluation. J Bone Joint Surg Am 1969;51-A:737-755
[7]. Duncan CP, Masri BA. Fracture of the femur after hip replacement. Inst Course Lect 1995; 44: 293
[8]. Dorr L, Faugere M, Mackel A et al. Structural and cellular assessment of bone quality of proximal femur. Bone 1993; 14: 231-42
[9]. Sharif KM, Parker MJ. Austin Moore hemiarthroplasty: technical aspects and their effects on outcome in patients with fractures of the neck of femur. Injury 2002; 33: 419-22.

Abstract: Objective: Normal Thyroid hormone level is essential in maintaining the normal fetal development. The objective of the study was to evaluate the thyroid hormone levels among healthy non-pregnant women with normotensive pregnant women and women with preeclampsia. Materials and methods: In these prospective study 90 women in the age group of 19 – 36 are divided into 3 groups consisting of 30 healthy non-pregnant women, 30 healthy normotensive pregnant women and 30 pregnant women with preeclampsia and evaluated for thyroid profile. Results: Serum TT4 and TT3 levels in normotensive pregnant women and preeclamptic women were significantly higher compared to the levels in non-pregnant women. In comparison to the normotensive pregnant women, women with preeclampsia had a non significantly higher TT4 level and significantly lower TT3. In preeclamptic women serum FT4 was marginally raised than in normotensive pregnant subjects but was significantly raised than in nonpregnant subjects. The FT3 level was significantly lower in preeclamptic women than in normotensive pregnant women compared to nonpregnant subjects. TSH levels were significantly higher in both preeclamptic and normotensive pregnant women. Conclusion: The main finding of our study indicates that there is a state of hypothyroidism in normal pregnancy and in preeclampsia and so raised serum TSH occurs. Detection of any changes in thyroid profile in preeclampsia may of health in preventing the development of preeclampsia.

Key Words: Pregnancy, Preeclampsia, T3, T4, TSH

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[4] Solomon, C.G and Seely, E.W.: Brief review: Hypertension in pregnangcy : A manifestation of the insulin resistance syndrome ? Hypertension, 37 ; 232-239, 2001.
[5] Kumar, A., Ghosh, B.K and Murthy, N.S.: Maternal thyroid hormonal status in preeclampsia, Indian J.Med. Sci., 59, 57-63, 2005.
[6] Qublan, H.S., Al-Kaisi, I.J., Hindawi, I.M., Hiasat, M.S., Awamleh, I and Hamaideh, A.H., et al.: Severe preeclampsia and maternal thyroid function. J. Obstet. Gynaecol., 23, 244-246, 2003.