Introduction Dexmedetomidine is a highly selective α2-adrenoceptor agonist with sedative, anxiolytic and analgesic properties that has minimal effects on respiratory drive. Its sedative and hypotensive effects are mediated via central α2A and imidazoline type 1 receptors while activation of peripheral α2B–adrenoceptors result in an increase in arterial blood pressure and systemic vascular resistance (SVR). In this randomized, prospective, clinical study we attempted to quantify the short-term hemodynamic effects resulting from a rapid IV bolus administration of dexmedetomidine in pediatric cardiac transplant patients. Methods Twelve patients, aged ≤10 years of age, weighing ≤40kg, presenting for routine surveillance of right and left heart cardiac catheterization after cardiac transplantation were enrolled. After an inhaled or IV induction, the tracheas were intubated and anesthesia was maintained with 1 minimum alveolar concentration of isoflurane in room air, fentanyl (1mcg/kg) and rocuronium (1mg/kg). At the completion of the planned cardiac catheterization, 100% oxygen was administered. After recording a set of baseline values that included heart rate (HR), systolic blood pressure, diastolic blood pressure, central venous pressure, systolic pulmonary artery pressure, diastolic pulmonary artery pressure, pulmonary artery wedge pressure and thermodilution-based cardiac output, a rapid IV dexmedetomidine bolus of either 0.25mcg/kg or 0.5mcg/kg was administered over 5 seconds. The hemodynamic measurements were repeated at 1 min and 5 mins. Results There were 6 patients in each group. Investigation suggested that systolic blood pressure, diastolic blood pressure, systolic pulmonary artery pressure, diastolic pulmonary artery pressure, pulmonary artery wedge pressure and systemic vascular resistance all increased at 1 minute after rapid IV bolus for both doses, and decreased significantly to near baseline for both doses by 5 minutes. The transient increase in pressures was more pronounced in the systemic system than in the pulmonary system. In the systemic system there was a larger percent increase in the diastolic pressures than the systolic pressures. Cardiac output, CVP and pulmonary vascular resistance did not change significantly. HR decreased at 1 min for both doses and was, within the 0.5 mcg/kg group, the only hemodynamic variable still changed from baseline at the 5 min time point Conclusion Rapid IV bolus administration of dexmedetomidine in this small sample of children having undergone heart transplants was clinically well tolerated, although it resulted in a transient but significant increase in systemic and pulmonary pressure and a decrease in HR. In the systemic system there is a larger percent increase in the diastolic pressures than the systolic pressures, and furthermore these transient increases in pressures were more pronounced in the systemic system than in the pulmonary system.

Obesity and cardiovascular risks are closely associated. Hypertension is the most common and early complication of obesity. Obesity is measured with different parameters like Body Mass Index, Waist to Hip Ratio etc. In the present study we have tried to link parameters of obesity with hypertension. We have found that in hypertensive middle aged Indian males diastolic blood pressure showed a better correlation with Waist to Hip Ratio rather than with Body Mass Index.

Type 2 Diabetes Mellitus (D.M.) is a leading cause of morbidity and mortality in developing countries like India. It comprises of a group of common metabolic disorders and is characterized by a state of chronic hyperglycaemia due to a defective production or action of insulin.The rising prevalence of type 2 D.M. is closely associated with industrialization and socio-economic development. The recent World Health Organization report suggests that over 19% of the world's diabetic population currently resides in India. This translates to over 35 million diabetic subjects and this number is projected to increase to nearly 80 million by 2030.Type 2 diabetes, which was a disease of the middle-aged and the elderly previously, has recently escalated in all the age groups and is now being identified in the younger age groups. It is of great concern as to how to prevent this "new epidemic" from destroying the future generations which include adolescents and children, especially in high-risk populations.Unfortunately, more than 50% of the diabetic patients in India remain unaware of their diabetic status, which increases the risk of the development of diabetic complications in them. This underscores the need for mass awareness and screening programmes to detect diabetes at an early stage. For this purpose, we have used a simplified Indian Diabetes Risk Score (IDRS) [1] for the prediction of diabetes in undergraduate medical students. IDRS requires answers to three simple questions and a waist measurement.In our study [2], we found that among 126 students, 8%, 79% and 13% were in high, moderate and low risk groups respectively for the development of type 2 D.M. This underscores the need for further investigations to detect diabetes at an early stage and to overcome the disease burden of diabetes in the future.Environmental factors play a key role in the development of type 2 diabetes. Globalization and industrialization lead to an increase in the prevalence of obesity and the metabolic syndrome in adults and particularly, in children. The main causes are -increasing urbanization, nutrition transition and reduced physical activity.Most of the children who develop type 2 diabetes have a family history of type 2 diabetes. It was found that 45-80% children had a parent with type 2 diabetes [3]. Upto 60%-90% of the youth who develop diabetes have acanthosis nigricans, a thickening and hyper pigmentation of the skin at the neck and the flexural areas, which is due to insulin resistance. This manifestation is common at younger ages than at adulthood and so it can be used as a marker for the youth [4] who are at risk for type 2 diabetes.The available data on the long-term complications of type 2 diabetes such as nephropathy microalbuminuria, hypertension, dyslipidaemia, atherosclerosis, polycystic ovarian syndrome and poor blood glucose control [5,6]. In young people underscores the severity of the disease. The persistence of obesity interferes with the patients' response to the treatment and it exacerbates the comorbidities .This ...