1. | PREVALENCE AND PROGNOSTIC SIGNIFICANCE OF RESISTANT HYPERTENSION IN DIALYSIS AND NON DIALYSIS CKD PATIENTS |
| Vejendla Aparna Sushmi, Marturu Pavan Sai Teja, Nuthalapati Amani,Kanagala Jyothirmai, D.Rispa |
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To evaluate the risk of morbidity and hospitalization of patients with resistant hypertension. To assess the progression of CKD to ESRD and cardiovascular co- morbidities with resistant hypertension. Background: In CKD and ESRD, uncontrolled hypertension is a major risk factor, but no study has properly investigated the role of RH. Methods: We prospectively studied 187 patients and out of which 24 patients were excluded from the study due to insufficient data (or) patients who are not interested to share the data. In remaining patients of 163, 81patients were ESRD and undergo dialysis periodically are categorized into one group, and 82 patients were CKD are categorized into another group Endpoints of survival analysis were renal (end-stage renal disease or death) and cardiovascular events (fatal and nonfatal cardiovascular event). RESULTS: A total of 163 patients were included in study in which 74.8% (n=121) of the patients were male. Majority of the patients 54.6% (n=89) were in age-group of 40-59 years and the mean age was 47.2 years.. In the dialysis patients (66) males are having normal hypertension and (47) males are having resistant hypertension (11) females are having normal hypertension and (8) females are having resistant hypertension. In the non-dialytic CKD patients (54) males are having normal hypertension and (9) males are having resistant hypertension; (9) females are having normal hypertension and (6) females are having resistant hypertension. About 50% of patients had CKD of unknown etiology. Diabetes mellitus accounted for 38.03% (n=62) of the cases. Patients having glomerulonephritis accounts for 30.6% (n=50). Whereas hypertension in 85.8 % (n=140), adpkd in 11.04% (n=18). About 37% (n =3) of the patients were on thrice weekly dialysis and 61.7% (n =50) were on twice-weekly dialysis. CAD accounts 0.08% (n=7) in non-dialysis, whereas in dialysis 0.13% (n=11)LVD accounts 0.045% in non-dialysis, 0.25 in dialysis patients. 17.8 %, 66.2 %of pts having resistant hypertension in CKD, Dialysis respectively. Conclusions: In conclusion, we found that individuals with CKD and RH as well as ESRD with RH were at higher risk for coronary heart disease mortality and incident stroke. In this study, the presence of CKD did not appear to amplify the risks for the occurrence of these 2 disease entities associated with RH, whereas progression of CKD to ESRD is rapid. But the presence of ESRD may amplify the risk for the of cardiovascular co morbidities with RH but no evidence of enhancing the lethality of cardiovascular disease.
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2. | EPLERENONE IN THE MANAGEMENT OF CARDIOVASCULAR DISEASES: AN OBSERVATIONAL STUDY |
| K L Nagarani, K V S L Prasanna, P Mounika, T Chandana Madhuri, SK Faizan Ali |
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The aim of the study is to identify the effectiveness of EPLERENONE in the treatment of cardio vascular diseases. Materials and methods: 60 patients were included in our study. Those patients who meet the study criteria will be enrolled in to the study. Relevant data such as demographics details, risk factors, past medical history, drug name, dose, route, frequency, duration of therapy, total pills per day was collected from profile form of the patient and by patient interview. Complete follow up should be done within 6 months by interviewing during their review or by phone calls. Statistical consideration: All the raw data was collected , entered in excel sheet 2007 in windows 7 version, the statistical analysis was done in SPSS 16.0 software by an appropriate statistical methods using One-sample T test for knowing the significant p-value <0.005(confidence interval 95%). Results: Among 60 patients, 60% of patients are with IHD, 73.30% patients are with HTN, 23.30% are with DCMP, and 3.30% are with cardiac arrhythmias. The study shows that there is a significance decrease in Systolic BP when compared with before treatment i.e. 20.16±6.344mmHg and a significance decrease in Diastolic BP when compared with before treatment i.e. 9.00±4.002 mmHg. During therapy the heart rate was improved to 87.40+14.346 which is found to be statistically significant (p<0.05). After 2 months of treatment the dysfunctions are left with only 10% of systolic, 16.6% of diastolic & 10% of both dysfunctions. The patient with severe, moderate and mild EF was improved by the treatment. Conclusion: In our study we observed that eplerenone was safe and effective in treating patients with both acute and chronic cardiovascular diseases. The patient clinical and functional status was improved by his clinical manifestations, 6MWT, Echo and ECG changes and also improved ejection fraction by avoiding further exacerbation of condition, without occurrence of adverse effects. The monotherapy of eplerenone is as effective as polytherapy and the improvement of medication adherence was due to the patient counselling.
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3. | A REVIEW ON USE OF FIRST LINE ANTI TUBERCULOSIS DRUGS IN SPECIAL SITUATION AND THEIR CLINICAL COMPLICATIONS |
| Geervani PG, Raja Nandini K, Vaishnavi M, Chaitanya Srinivas B |
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Anti-Tubercular drugs are the class of drugs used to treat Tuberculosis. The main aim of tuberculosis treatment is treat to the patient and reduce the transmission of Mycobacterium tuberculosis in healthy individuals. Tuberculosis treatment cause possible adverse drug reactions in the patient .In this we briefly review the mechanism of action, adverse drug reactions, Drug-Drug and Drug-food interactions and their use in specific individual.
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