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Volume 4, Problème 3 (2015)

Rapport de cas

A Case Report of Thrombotic Microangiopathic Malignant Hypertension

Taner Basturk, Özgül Pamukcu, Yener Koc, Tamer Sakaci, Mustafa Sevinc, Tuncay Sahutoglu, Yusuf Yildirim, , Elbis Ahbap and Abdülkadir Unsal

We represented a case of malignant hypertension with thrombotic microangiopathy. There was found no finding revealing renovascular hypertension inspite of high renin and aldosterone levels. The patient responded to aldactone that was administered because of the likelihood of primary aldosteronism regarding the causes of secondary hypertension. We aimed to point out that the laboratory tests may reflect the outcomes of microangiopathic hemolytic anemia; therefore in such circumstances it may be impossible to find out the main reason of hypertension

article de recherche

Effect of Dietary Soy Protein Supplement in Dyslipidemic South Indian Population: A Randomized, Double-Blind, Placebo Controlled, Parallel-Group Trial

Natesan Chidambaram, Subramaniyam Sethupathy, Nadanam Saravanan, Toshiya Toda, Mari Mori, Yukio Yamori, Arun Kumar Garg and Arun Chockalingam

Forty subjects identified as dyslipidemic were assigned randomly to either soy powder (Soy) or red bean powder (Placebo). The soy group received daily a sachet of 18.1 g soy power containing 85 K cal and the placebo group received daily placebo sachet (23.1 g) of red bean powder containing 85.5 K cal in addition to the usual diet for four weeks. Intake of soy/placebo powder was assessed by measurement of 24-hour urinary isoflavone excretions at baseline and at the end of the intervention period. Relative to placebo, soy powder has significant effect over some Cardiovascular Disease (CVD) markers and Metabolic Syndrome (MetS) indices including abdominal circumference, triglycerides, HbA1c and insulin. These data support that the dietary consumption of soy has the property to reduce risk factors for CVD and MetS.

article de recherche

Postoperative Hypertension: Novel Opportunities in the Treatment of a Common Complication

Pasquale Sansone, Maria Caterina Pace, Maria Beatrice Passavanti, Vincenzo Pota, Alessandro Tavano and Caterina Aurilio

Acute Postoperative Hypertension (APH) is one of the most common complications detected after surgery. It is a condition associated to a great number of causes and a pathophysiology still unclear which recognizes a central role in sympathetic activation. For these reasons, an ideal agent for treating APH does not exist, but we have to choose the most appropriate therapeutic strategy based on the individual case. We have reviewed some of the most important available treatments.

Rapport de cas

Expectant Management of Severe Preeclampsia Remote From Term In A Rural Setting of Niger Delta, Nigeria: Is It Time to Define a Protocol?

Mbachu Ikechukwu Innocent, Eleje George and Osuagwu Ihechimere Kelechi

Background: Severe preeclampsia is one of the leading causes of maternal and perinatal mortality worldwide. Management of cases remote from term poses a great challenge to the caregiver and the patient. This is more pronounced in developing countries with limited resources and high premium on children. This article highlighted the challenges in the management and we presented a successfully expectant management of a case in a rural setting.

Case presentation: We presented Mrs JV, a 33 year old booked G7P1 with no living child who presented at the gestational age of 24 weeks plus 3 days with severe hypertension and proteinuria. Expectant management was instituted and pregnancy was ended via an emergency caesarean section at 29 weeks of gestation with delivery of extreme low birth baby. Both mother and baby are in good health.

Conclusion: Management of severe preeclampsia remote from term should be individualized and can be feasible in a rural setting in developing countries. Availability of tertiary health institutions in rural settings will help in the management of these patients.

article de recherche

Evaluation of Role of Serum Lipoprotein and Lipid Profile in Essential Hypertension Patients in a Tertiary Care Hospital

Arindam Sur, Tirkey BN and Mishra PK

Introduction: Hypertension is a leading cause of mortality and morbidity worldwide. It doubles the risk of cardiovascular diseases. Elevated serum lipoprotein (a) are associated with an increasing risk of cardiovascular disease in hypertensive patients. Aims and Objectives: To determine levels of serum lipoprotein (a) and lipid profile in hypertensive patients and to correlate the serum lipoprotein (a) levels with lipid parameters.

Material and Methods: Lipid profile and serum lipoprotein (a) were estimated in 68 hypertensive patients and compared with 63 age and sex matched healthy controls. Serum lipoprotein (a) was estimated by immunoturbidometric assay and lipid profile by standard biochemical methods.

Result: Serum lipoprotein (a) was found to be significantly increased (p<0.001) in hypertensive patients (36.52 ± 9.34 mg/dl) as compared to healthy individuals (17.96 ± 8.42 mg/dl). Total cholesterol, LDL, triglycerides were significantly increased (p<0.001) and HDL was significantly decreased (p<0.001) in cases compared to controls. The correlation study between serum lipoprotein (a) and lipid profile in hypertensive cases showed, that only LDLc had a significant positive correlation with lipoprotein (a).

Conclusion: Elevated lipoprotein (a) in hypertensive patients can be a independent risk factor for development of cardiovascular disease.

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