Natl Med J India
-
Hypertension is one of the most important causes of cardiovascular morbidity and mortality in the elderly. With the increase in the number of elderly in India, hypertension is likely to emerge as an important public health problem. ⋯ Our findings emphasize the public health importance of hypertension in the elderly in Kerala at present, and point to a likely increase in burden of this problem in India in the near future. A National Hypertension Programme, targeted to meet the imminent public health challenge posed by hypertension seems warranted.
-
Comparative Study
Use of the logistic organ dysfunction system to study mortality in an Indian intensive care unit.
Mortality in Indian intensive care units has not been well studied. Scoring systems are used to predict mortality of patients admitted to such units. Some scoring systems predict hospital mortality while others predict mortality in intensive care units. We used the logistic organ dysfunction system to study the hospital and intensive care unit mortalities in our intensive care unit. ⋯ Our intensive care unit mortality rate is comparable to the western hospital mortality rate. However, after transfer of patients out of the unit, the hospital mortality is higher.
-
Microcytosis is a common red cell change seen in anaemias of varied aetiology. These include iron deficiency, thalassaemia, chronic disease and sideroblastic anaemias. The microcytosis of heterozygous beta-thalassaemia needs to be distinguished from non-thalassaemic microcytosis for its role in thalassaemia control. Red cell indices derived from automated red cell analysers have been used to discriminate between microcytic patients with a high probability of thalassaemia minor from those with a low probability. There is a controversy on the choice of red cell indices to be used and the cut-off values for this distinction, because the prevalence of iron deficiency as a cause of non-thalassaemic microcytosis is variable. Since no Indian study using receiver operator characteristic (ROC) curves was available to determine the above, we conducted this study. ⋯ In countries with a high prevalence of iron deficiency, cut-off values for red cell indices should be recalculated using ROC curves.
-
While rising Caesarean section rates have been the subject of much attention and debate worldwide, there is not much information available on this rate and its potential adverse impact in India. ⋯ Our study revealed a very high rate of Caesarean section in the selected metropolitan population. On purely scientific grounds, a rate of 40% to 50% is extremely difficult to justify. Though not conclusive, the data also suggest that Caesarean section may be adversely affecting some aspects of breast-feeding. There is a need for more data and audits on Caesarean section rates in India, and a wider debate on its potential adverse impact on the health of mothers and newborns.