Background: The benefits of optimum blood pressure (BP) control in patients with diabetes exceed the benefits of glycaemic control and extend to the prevention of both macro-vascular and micro-vascular complications in patients suffering from both hypertension and diabetes mellitus. Aims & Objective: To investigate the utilization patterns of anti-hypertensive drugs and to evaluate blood pressure (BP) control among diabetic-hypertensive patients with and without reduced renal function. Material and Methods: A prospective, observational study carried out at medicine department of SBKS Medical College and Research Centre, Piparia. The pattern of use of antihypertensive drugs in 50 hypertensive-diabetic patients was evaluated in correlation with its renal function and BP control achieved was compared in patients with and without reduced renal function. Results: Total 63 antihypertensive medication episodes were prescribed for 50 patients. Out of which 76% patients were receiving 1 drug, 22% receiving 2 drugs and 2% receiving 3 drugs of different antihypertensive class. Most patients were receiving Angiotensin-Converting-Enzyme-Inhibitors (ACE-I)/Angiotensin-Receptor-Blockers (ARBs) (60%), followed by CCBs (24%), beta-blockers (20%), and diuretics (16%). Patients on monotherapy were mostly receiving ACE-I/ARB (65.78%). Beta blockers were more commonly prescribed in patients with reduced renal function (p=0.005). BP control was achieved in 63.15% patients in monotherapy and 33.33% in polytherapy group. Control of systolic and diastolic BP was significantly higher in patients without reduced renal function than patients with reduced renal function (p<0.05). Conclusion: There was suboptimum use of combination therapy among diabetic-hypertensive patients in general and specifically in developing countries as reflected by control achieved in systolic and diastolic BP which requires concern of all healthcare professionals.
Introduction. Thrombocytopenia is frequently noticed with P. falciparum malaria but is less reported and studied with P. vivax. Materials and Methods. The study was conducted in the Department of Medicine, SBKS MI & RC, Pipariya. We included patients who were diagnosed with vivax malaria. The data regarding their clinical and hematological profile was collected and analysed. Result. A total of 66 patients were included. 42 (63%) had platelet count <100000/mm3. Mean platelet count was 1,18,650, range being 8000/mm3–6,10,000/mm3. Amongst those with thrombocytopenia, 16 (38.09%) had anemia, 14 (33.33%) had serum creatinine >1.2 gm/dL, 15 (35.71%) had jaundice (s. bilirubin > 1.2), 2 (4.76%) had altered sensorium, 6 (14.28%) had ARDS, 2 needed ventilator support, and 1 expired. Amongst those with normal platelet count, 5 (20.83%) had anemia and 1 had jaundice whereas none had elevated s. creatinine, altered sensorium, or lung involvement. Conclusion. Thrombocytopenia is now being seen more commonly with vivax malaria. Patients with platelet count <1 lac/cumm have more severe disease.
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