Cardiovascular risk factors, geriatrics, nutrition and chronic obstructive pulmonary disease Research Papers (original) (raw)

This study was performed to asses and establishes the prevalence of Polypharmacy in geriatric population in the Medicine ward of Rajah Muthaiya Medical College and Hospital, Annamalai University, during one year from January 2013 to January 2014. Demographic analyses of this prospective study revealed that out of 520 patients, 342 (65.76%) were males and 178 (34.23%) were females. All the collected prescriptions were scrutinized for Polypharmacy and were categorized as minor Polypharmacy -concurrent use of ≤ 5 drugs; and major Polypharmacy -concurrent use of > 5 drugs. Out of 502 Prescriptions 61(11.73%) prescriptions were minor Polypharmacy and 457(88.26%) prescriptions were major Polypharmacy. The maximum patients were in the age group of 60-64 (38.84%) range lead to a significant increase in the number of medications. The most common diseases associated systems were Cardiovascular system 147 (28.26 %) patients, and followed by Respiratory system 103(19.80%). Our results show that there is a higher prevalence of Polypharmacy among the males than females. The length of hospital stay of geriatric patients is increase in major Polypharmacy compare with minor Polypharmacy. The prevalence of cardiovascular drugs and respiratory drugs were often involved in Polypharmacy among geriatric patients. Polypharmacy is very common among geriatric patient and health care professional’s interventions to improve the optimal use of medication in geriatric could lead to reduction in the drug related problems associated with Polypharmacy.

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- Geriatrics, Drugs And Addiction, Elderly Falls (Geriatrics), Drug Designing

In this work modelling and control of Perfusion system is presented. The Perfusion system simultaneously
controls the partial pressures during Extra Corporeal Membrane Oxygenation (ECMO) support. The
main Problem in ECMO system is exchange of Blood Gases in the Artificial Lung (Oxygenator).It is a
highly Nonlinear Process comprising time-varying parameters, and varying time delays, it is currently
being controlled manually by trained Perfusionist. The new control strategy implemented here has a
feedback linearization routine with time-delay compensation for the Partial pressuresof Oxygen and
Carbon dioxide. The controllers were tuned robustly and tested in simulations with a detailed artificial
Lung (Oxygenator) model in Cardiopulmonary bypass conditions. This Automatic control strategy is
proposed to improve the patient’s safety by fast control reference tracking and good disturbance rejection
under varying conditions.

Cardiovascular Disease (CVD) is the leading cause of death in both developed and developing countries. While it is relatively easy to identify those who are obviously at high risk and those at the lowest risk for CVD, it is often the large group of individuals with what appears to be modestly abnormal risk factors who contributes most to the burden of CVD. This is where estimation of CVD risk is necessary. Many tools for risk assessment have been devised. All these risk scores have their own inherent advantages and disadvantages. Furthermore, they may also not be directly applicable to a local population. Ideally, each country should have its own risk score that takes into account other factors as well. In the interim, it is worthwhile to be familiar with one of these scores, select one that is most appropriate for your patient and discuss treatment options based on the estimated risk.

- by Yook C Chia
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- Primary Care, Cardiovascular disease, Pain Management, Hypertension

The role of vitamin D in the regulation of bone metabolism has been well established. However, in recent years, many studies have demonstrated that its role extends far beyond bone health. Growing evidence has shown a strong association between vitamin D deficiency and hypertension, metabolic syndrome, diabetes mellitus and atherosclerosis. The mechanisms by which vitamin D exerts its cardiovascular protective effects are still not completely understood, but there is evidence that it participates in the regulation of renin-angiotensin system and the mechanisms of insulin sensitivity and activity of inflammatory cytokines, besides its direct cardiovascular actions. In this review, several studies linking vitamin D deficiency with cardiometabolic risk as well as small randomized trials that have evaluated the cardiovascular effects of its supplementation are presented. However, large randomized placebo-controlled studies are still needed before we can definitively establish the role of vitamin D supplementation in the prevention and control of cardiovascular disease.

The renin-angiotensin-aldosterone system (RAAS) blockers have been widely used in chronic kidney disease patients undergoing hemodialysis; however, whether RAAS blockers have beneficial effects for cardiovascular disease in those patients has not been fully defined. This review focuses on the effects of RAAS blockers in chronic kidney disease undergoing hemodialysis for cardiovascular disease.

- by Yoshiyuki Morishita and +1
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- Cardiovascular disease, Risk factors for cardiovascular diseases, Aldosterone, Renin Angiotensin Aldosterone System

Background: Development of pulmonary vascular disease (PVD)
has been considered a risk factor in the long-term course of ASD
(atrial septal defect). Lung biopsy remains the gold standard to
confirm the degree of severity in pulmonary vascular disease in
patients with isolated ASD.
Objective: To determine the effect on natural course on
pulmonary vascular diseases in isolated ASD patients at high
altitude .To assess the histological degree of pulmonary vascular
diseases in isolated ASD patients.
Material and Methods: This study was carried in the Department
of Cardiovascular and Thoracic Surgery Sher-i-Kashmir Institute
of Medical Sciences between 1st September 2010 to 31st November
2012.Patients with isolated ASD was included in the study.
Isolated ASD Patients. Ostium secundum (OS) type. Patients
residing at more than 3,500ft above sea-level. All patients were
subjected to cardiac cath prior to surgery. Pulmonary vascular
resistance was calculated in all patients. Lung Biopsy (which was
taken during repair of ASD before patient was put on cardio
pulmonary bypass) was sent for histopathological examination.
Histopathological examination of the specimen was done by a
single histopathologist. Severity of the pulmonary vascular disease
was assigned a Score between 1 - 4.
Results: histopathological score of one was seen in none whereas
5.6% of the patients (n=2) had a histopathological score of 2; 44.4
% (n=8) had a histological score of 3 and 50% (n=9) had a
histological score of 4. Most of our patients (94.4%; n=17) had a
higher histopathological score of 3 & 4.
Conclusion: No formal study has been conducted so far to analyze
the effect of high altitude on pulmonary vascular disease in Atrial
Septal defect. All of our patients had established pulmonary
vascular changes at the time of presentation. Severity of the
pulmonary vascular disease as proved by histopathological scoring and Cath data was quite high. This is in contrast with
those residing at low altitude as reported in the literature.
Therefore, it seems that high altitude has a strong bearing on the
natural course of the disease, its complications and outcome after
surgery.