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Jalal S, Sofi FA, Abass SM, Alai MS, Bhat MA, Rather HA, Lone NA, Siddiqi MA. Effect of amlodipine and lisinopril on microalbuminuria in patients with essential hypertension: A prospective study. Indian J Nephrol 2010; 20:15-20. [PMID: 20535265 PMCID: PMC2878405 DOI: 10.4103/0971-4065.62090] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Microalbuminuria can be present in 25-100% of patients with essential hypertension and is associated with increased incidence of cardiovascular events. Our goal was to evaluate the effect of a commonly used calcium channel blocker, amlodipine, and an angiotensin converting enzyme inhibitor, lisinopril on urinary albumin excretion in patients with mild to moderate essential hypertension. We screened 324 patients with essential hypertension for microalbuminuria and documented it in 120 patients. These 120 patients with microalbuminuria were randomly divided into two groups of 60 each, matched for age, sex, arterial pressure, creatinine clearance, and urinary albumin excretion so as to receive amlodipine or lisinopril. We prospectively measured their urinary albumin excretion and creatinine clearance prior to treatment and, four and eight weeks after treatment with amlodipine or lisinopril. Mean arterial pressure (mean +/- SD) at baseline, after four weeks, and after eight weeks was 113.01 +/- 4.38,104.93 +/- 3.12, and 98.89 +/- 1.75 mmHg (P < 0.0000); and 114.13 +/- 7.11, 106.52 +/- 3.50, and 100.89 +/- 2.80 mmHg (P < 0.0000) in amlodipine and lisinopril groups, respectively. Urinary albumin excretion (mean +/- SEM) at baseline, after four, and after eight weeks was 79.30 +/- 3.74, 62.03 +/- 3.61, and 52.02 +/- 3.05 (P < 0.0000); and 73.96 +/- 4.10, 72.39 +/- 3.74, 66.12 +/- 3.94 (P = 0.1742) in lisinopril and amlodipine groups, respectively. Lisinopril but not amlodipine, reduced the urinary albumin excretion significantly despite their similar antihypertensive efficacy. The clinical and prognostic significance of these observations need to be established.
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Affiliation(s)
- S. Jalal
- Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India
| | - F. A. Sofi
- Department of Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India
| | - S. M. Abass
- Department of Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India
| | - M. S. Alai
- Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India
| | - M. A. Bhat
- Department of Nephrology, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India
| | - H. A. Rather
- Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India
| | - N. A. Lone
- Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India
| | - M. A. Siddiqi
- Department of Immunology and Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India
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Tabish A, Lone NA, Afzal WM, Salam A. The incidence and severity of injury in children hospitalised for traumatic brain injury in Kashmir. Injury 2006; 37:410-5. [PMID: 16569405 DOI: 10.1016/j.injury.2006.01.039] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2005] [Revised: 01/24/2006] [Accepted: 01/26/2006] [Indexed: 02/02/2023]
Abstract
A large number of people experience traumatic brain injury each year, often with severe consequences. This is a public health problem that requires ongoing surveillance to follow trends in the incidence, risk factors, causes, and outcomes of these injuries. In 2003, a prospective study of all children below 15 years admitted to hospitals with a diagnosis of head injury was conducted in the Accident & Emergency Department of Sher-e-Kashmir Institute of Medical Sciences, Srinagar (India) to determine the incidence and severity of accidental head injury among children and the circumstances of injury. The highest incidence of head injury was seen at ages 6-10 years. Head injury rates were higher in males than in females. The leading causes include falls and motor vehicle accidents. More than 50% falls occurred in the age group of 4-6 years. Ninety per cent patients, who recovered, were discharged within 16-24 h after admission. Lack of supervision, non-implementation of safety measures and poor implementation of traffic rules leads to many injuries. The ability of the health care system to deal with increasing trauma in Jammu & Kashmir is limited. Nevertheless, prevention can be low cost strategy to overcome this problem. The results of epidemiological studies are affected by factors like demography, geographic region and socioeconomic status. This study emphasizes the need for intensified effort for prevention, minimising risk factors, strict legislative measures, observing traffic rules, implementation of safety measures, establishing appropriate trauma care at district level, adult supervision, and creating awareness.
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Affiliation(s)
- Amin Tabish
- Department of Accident & Emergency, Sher-e-Kashmir Institute of Medical Sciences, Srinagar, India.
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Khan KA, Jalal S, Jan VM, Lone GM, Jan R, Alai MS, Iqbal K, Tramboo NA, Lone NA, Rather HA, Dar MA. Pulmonary function profile in chronic congestive heart failure and the effect of ipratropium bromide. Indian Heart J 2000; 52:297-300. [PMID: 10976150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Twenty-five symptomatic patients of chronic heart failure were subjected to spirometry to detect abnormalities of pulmonary function and to assess the effect of ipratropium bromide in reversing or minimising these abnormalities. All the patients exhibited abnormal pulmonary function manifesting as obstructive (15/25) or restrictive (10/25) ventilatory defect. There was overall improvement in lung functions with ipratropium bromide especially in those with obstructive ventilatory defects and mostly comprised of smokers. Forced expiratory volume in one second increased by 47.7 percent (p < 0.02), forced expiratory volume in one second/forced vital capacity ratio by 14.1 percent (p < 0.001) and maximal voluntary ventilation by 40.6 percent (p < 0.05) in these patients. It is concluded that ipratropium bromide can prove as a promising adjunctive therapeutic intervention in improving quality of life in patients of chronic congestive heart failure who are incapacitated by dyspnoea and have clearly documented ventilatory defects.
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Affiliation(s)
- K A Khan
- Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar
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Zargar AH, Bashir MI, Wani AI, Laway BA, Masoodi SR, Lone NA, Jalal S. Reversible complete heart block in Grave's disease. J Assoc Physicians India 1999; 47:1120-1. [PMID: 10862330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- A H Zargar
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir
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Jalal S, Rather HA, Khan KA, Jan VM, Alai MS, Lone NA, Dar MA, Iqbal K, Tramboo NA. The role of myoglobin in early detection of acute myocardial infarction. J Assoc Physicians India 1999; 47:846. [PMID: 10778646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Jalal S, Alai MS, Khan KA, Jan VM, Rather HA, Iqbal K, Tramboo NA, Lone NA, Dar MA, Hayat A, Abbas SM. Silent myocardial ischemia and cardiac autonomic neuropathy in diabetics. J Assoc Physicians India 1999; 47:767-9. [PMID: 10778618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE To evaluate the association of silent myocardial ischemia (SMI) with cardiac autonomic neuropathy in asymptomatic diabetic patients. MATERIAL AND METHODS Two hundred asymptomatic patients of diabetes mellitus were assessed for evidence of cardiac autonomic neuropathy. Of these, 30 (15 males, 15 females; mean age 44.7 +/- 8.8 years) were found to have cardiac autonomic neuropathy. Thirty (30) age and sex matched diabetic patients (mean age 42.4 +/- 7.6 years) who had no evidence autonomic neuropathy were included in the study as control group. Both the groups of patients were evaluated for SMI by 24 hour ambulatory electrocardiographic (ECG) monitoring. RESULTS Incidence of SMI was significantly higher in patients with autonomic neuropathy 12/30 (40%) compared to those without 3/30 (10%) p < 0.001. Duration of diabetes was more (13 +/- 1.59 years) in patients with autonomic neuropathy compared to the control group (8.66 +/- 1.55 years) p < 0.001. Serum cholesterol and triglyceride levels were significantly higher in patients with autonomic neuropathy in comparison to control group < 0.05 and < 0.01, respectively. There was no difference in the pattern of SMI in the two groups (p = N.S). CONCLUSION Cardiac autonomic neuropathy predisposes patients with diabetes mellitus to SMI. Twenty four hour ambulatory ECG monitoring provides useful diagnostic information in early detection and evaluation of SMI in asymptomatic diabetic patients.
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Affiliation(s)
- S Jalal
- Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar
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Jalal S, Khan KA, Alai MS, Jan V, Iqbal K, Tramboo NA, Rather HA, Lone NA, Dar MA. Clinical spectrum of infective endocarditis: 15 years experience. Indian Heart J 1998; 50:516-9. [PMID: 10052275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Four hundred and sixty-six patients (277 males, 189 females; mean age 23.2 years) diagnosed as cases of infective endocarditis during the past 15 years were retrospectively analysed. Two-thirds of patients belonged to the 15 to 35 years age group. The most common predisposing cardiac lesion was rheumatic heart disease seen in 73.4 percent patients. Mitral valve prolapse and right-sided endocarditis were infrequent, seen in four patients each. Blood culture positivity was 28.7 percent in adults and 61 percent in children. Commonest organism isolated was staphylococcus aureus in adults (39.3%) and streptococcus viridans in children (48%). Salmonella typhi was detected in 17 patients and showed excellent response to ciprofloxacin and gentamycin. Overall mortality was 13.9 percent and resistant heart failure was the leading cause of death. Our study presents the clinical spectrum of infective endocarditis and highlights the comparison with western studies.
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Affiliation(s)
- S Jalal
- Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar
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