Lifestyle changes are a must to prevent hypertension irrespective of guidelines indicating threshold levels

Health Care, Heart Care Foundation of India, Medicine, Social Health Community Comments Off

Uncontrolled high blood pressure can lead to heart attack or stroke and other complications

New Delhi, 13 July 2018: If the new blood pressure (BP) (hypertension) guidelines are adopted, they could increase the number of people identified as having the condition and being recommended for drug treatment, as per a new study. The American College of Cardiology (ACC) and the American Heart Association (AHA) recently released guideline recommendations for hypertension with lower blood pressure values used to define elevated blood pressure, and lower treatment thresholds, than those recommended in current guidelines.

High BP should be treated earlier with lifestyle changes and in some patients with medication – at 130/80 mm Hg rather than 140/90 – based on new ACC/AHA guidelines for the detection, prevention, management and treatment of this condition.

Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, said, “Uncontrolled high blood pressure can lead to heart attack or stroke, aneurysm, heart failure, organ malfunction, vision loss, metabolic syndrome and memory problems. The new guidelines mean that there will be more people diagnosed with hypertension. It is likely to bring an additional 15% to 20% of the Indian population in the ambit of abnormal blood pressure, including the younger generation. The guidelines are encouraging because people would start making changes to their lifestyle and diet much earlier than they would have otherwise. Those with risk factors will also get diagnosed at an early stage and take appropriate measures to control their blood pressure.”

To improve blood pressure control and reduce cardiovascular disease risk in these patients, a small percentage of them will be asked to take medications while the majority will be recommended non-pharmacological interventions with healthy lifestyle changes.

Adding further, Dr Aggarwal, who is also the Group Editor of IJCP, said, “High blood pressure imposes an up-front burden in people who know they have it and who are working to control it. It adds to worries about health. It alters what you eat and how active you are, since a low-sodium diet and exercise are important ways to help keep blood pressure in check. Some people need medication and may need to take one or more pills a day, which can be a costly hassle.”

Some tips from HCFI.

  • Achieve and maintain a healthy weight for your height.
  • Exercise regularly.
  • Eat a diet that is rich in fruits, vegetables, and whole grains.
  • Limit sodium intake to under 2,300 milligrams a day (one teaspoon of salt), and get plenty of potassium (at least 4,700 mg per day) from fruits and vegetables.
  • Drink alcohol in moderation, if at all.
  • Reduce stress.
  • Monitor your blood pressure regularly, and work with your doctor to keep it in a healthy range.

Neonatal sepsis is a fatal condition and can lead to mortality in infants

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India witnesses more than 50,000 infant deaths due to this condition every year

New Delhi, 09 July 2018: Hospitalized infants are at high risk of developing drug-resistant hospital-acquired infections due to a rise in bacterial resistance. The susceptibility of newborns to sepsis is compounded, as diagnosing serious bacterial infections in them is challenging and symptoms difficult to detect. About 40% of the global burden of sepsis-related neonatal deaths is in South Asia. In India alone, about 56,500 neonatal deaths every year are attributable to sepsis caused by anti-microbial resistance to drugs.

Neonatal sepsis is a systemic infection occurring in infants at ≤28 days of life and is an important cause of morbidity and mortality of newborns. Early-onset sepsis is seen in the first week of life occurs after 1 week and before 3 months of age. This condition can be attributed to bacteria such as Escherichia coli (E.coli), Listeria, and some strains of streptococcus.

In a Joint Statement, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, & Dr Akhil Saxena, Senior Paediatricians Kota said, “The immune systems in newborns are not fully developed and therefore, sepsis at this stage can be potentially life threatening. The infection is mostly passed on from the pregnant mother to the baby. However, in less common cases, it can also be picked up from the immediate environment. Most babies with such infections can recover completely with timely intervention. The more quickly an infant gets treatment, the better the outcome. In the absence of this, they can develop complications including lifelong disability. In case of infants with this condition, the normal immune system response is sent into overdrive, causing a blood condition which is potentially harmful to the baby’s health. Under such conditions, the body produces excessive white blood cells to fight the infection.

Symptoms of neonatal sepsis in infants include changes in body temperature, breathing problems, diarrhea, low blood sugar, reduced movements, reduced sucking, seizures, slow or fast heart rate, swollen belly area, vomiting, and yellow skin and whites of the eyes (jaundice).

Adding further, Dr Aggarwal, who is also the Group Editor of IJCP, said, “Complications during pregnancy and after birth can create high-risk conditions for neonatal sepsis. Infants who do not receive timely treatment can succumb to multiple organ failure. In other cases, the blood pressure may drop – what can be called a septic shock. This can be fatal if the doctor does not administer antibiotics and large quantities of intravenous fluids to flush out and fight the infection in the blood.”

Some prevention tips to avert neonatal sepsis

  • Pregnant women should maintain proper hygiene. They should be given preventive antibiotics in case of Chorioamnionitis, Group B strep colonization, or a previous baby with sepsis caused by bacteria.
  • It is important to prevent and treat infections in mothers, including HSV
  • There should be a provision of a clean place for birth.

·         The baby should be delivered within 12 to 24 hours of when the membranes break. In case of complications, a cesarean delivery should be done in women within 4 to 6 hours or sooner of membranes breaking.

Zika infections could be an unrecognized cause of miscarriages and stillbirths

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It is important to take precautionary measures especially during monsoons

New Delhi, 7th July 2018: According to a new study, pregnancy loss due to Zika infections that do not show any symptoms may be a common but unrecognized cause of miscarriages and stillbirths. Zika virus is widely known for causing children to be born with a brain abnormality called microencephaly and other malformations. Zika disease in human adults includes fever, rash, headache, joint and muscle pain, as well as red eyes. However, most are asymptomatic.

In another finding, it has been explained that India’s Zika is genetically distinct from two other pathogenic global strains — African and Asian — as it is unable to efficiently infect mosquitoes. However, if this Zika strain mutates to more efficiently infect mosquitoes, it could become a major public health problem in the future — in the same way that chikungunya re-emerged in India after years of dormancy.

Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, Heart Care Foundation of India(HCFI), said, “Just like dengue, malaria, and chikungunya, Zika is a major public health concern. Many people infected with Zika virus do not feel sick. If a mosquito bites an infected person while the virus is still in that person’s blood, it can spread the virus by biting another person. The virus can be transmitted from an infected woman to the fetus and cause microcephaly and other severe brain anomalies in infants. In adults, it can lead to Gullain-Barre syndrome, in which the body’s immune system attacks nerves, leading to several complications. There is no vaccine for Zika virus infection. Protection against mosquito bites is very important. People traveling to high-risk areas, especially pregnant women, should take protection from mosquito bites.”

Zika became a worldwide threat in 2015, when babies in Brazil were born with microcephaly. WHO had then declared it a global health emergency.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “The need of the hour is enhanced surveillance against the virus and its spread to areas within the country: community-based and at international airports and ports to track cases of acute febrile illness. While awareness needs to be created about the disease, the public needs to be reassured that there is no cause for undue concern if any cases are detected.”

On 15 May 2017, the Ministry of Health and Family Welfare-Government of India reported three laboratory-confirmed cases of Zika virus disease in Bapunagar area, Ahmedabad District, Gujarat, State, India. The routine laboratory surveillance detected a laboratory-confirmed case of Zika virus disease through RT-PCR test at BJ Medical College, Ahmedabad, Gujarat. The aetiology of this case has been further confirmed through a positive RT-PCR test and sequencing at the national reference laboratory, National Institute of Virology, Pune on 4 January 2017.  Two additional cases, have then been identified through the Acute Febrile Illness (AFI) and the Antenatal clinic (ANC) surveillance.

This report is important as it describes the first cases of Zika virus infections and provides evidence on the circulation of the virus in India. These findings suggest low level transmission of Zika virus and new cases may occur in the future. Efforts to strengthen surveillance should be maintained in order to better characterize the intensity of the viral circulation and geographical spread, and monitor Zika virus related complications.

The risk of further spread of Zika virus to areas where the competent vectors, the Aedes mosquitoes, are present is significant given the wide geographical distribution of these mosquitoes in various regions of the world.

Some tips from HCFI

• Stay inside when the Aedes are most active. They bite during the daytime, in the very early morning, and in the few hours before sunset.

•  Buildings with screens and air conditioning are safest.

• Wear shoes, long-sleeved shirts, and long pants when you go outside.

• Ensure that rooms are fitted with screens to prevent mosquitoes from entering.

• Wear bug spray or cream that contains DEET or a chemical called picaridin.

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