Prevalence of hypertension among the elderly Malays living in rural Malaysia

Background

We are living in an ageing world. The prevalence of hypertension which is an established risk factor for cardiovascular disease and stroke increases with age. The aim of the study was to determine the prevalence of hypertension among the elderly Malays living in rural parts of north Malaysia.

Method

This cross-sectional study was conducted among the elderly (aged ≥60) Malay residents living in 22 villages in a northwestern state called Kedah in Malaysia from 2007 to 2009. Kedah has one of the highest rates of elderly population in the country. Data was collected by trained research assistants. Besides the baseline demographic information, blood pressure was measured using standardised methods using a manual sphygmomanometer.

Results

The response rate was 97.7%. The prevalence of hypertension among the elderly in these villages was 54.5% (228), 118 (28.2%) were known to be hypertensive and were on medication and an additional 110 (26.3%) respondents were newly diagnosed. Elevated mean systolic (146.17 ± 25.23) and diastolic (89.68 ± 15.60) blood pressure was noted among the known hypertensive. There was an almost fourfold risk (OR 3.64) of having uncontrolled blood pressure among the known hypertensive on treatment. Those with malnutrition were at an almost twofold at risk of being hypertensive (OR 1.73). Binary logistics regression showed occupation (OR 1.65), marital status (OR 2.32) and body mass index (BMI) (OR 1.62) as significant predictor variables.

Conclusion

Screening the elderly for hypertension will benefit this group of people by reducing the morbidity and mortality associated with this condition     

Correlation of CD4+ T cell count with total lymphocyte count, haemoglobin and erythrocyte sedimentation rate levels in human immunodeficiency virus type-1 disease

Background: Studies in human immunodeficiency virus (HIV) infected adults have demonstrated association of total lymphocyte count (TLC) <1200/mm³ and subseqnent disease progression or mortality. The association of other surrogate makers such as haemoglobin (Hb), and erythrocyte sedimentation rate (ESR) with CD4 count and disease progression has also been suggested. This study was carried out to determine the relationship of CD4-positive T lymphocyte counts with TLC, Hb and ESR in HIV-infected individuals.Methods: The study population comprised of 215 antiretroviral treatment naive HIV-1 infected adults. The CD4 positive T cell counts, TLC, Hb and ESR of study participants were measured. Spearman's rank order correlation and Receiver Operating Characteristic were used for statistical analyses.Result: The sensitivity, specificity, positive and negative likelihood ratios for cut-off value of TLC <1200/mm³ for predicting CD4 counts <200 cells/mm³ and <350 cells/mm³ were 9.4%, 100%, not measurable and 1.1, and 6.1 %, 98.8 %, 5.13 and 0.95, respectively. The association of Hb (<10, 11, 12 g/dl and <10, 12, 14 g/dl for CD4 counts <200 cells/mm³ and <350 cells/mm³, respectively), and ESR (<10, 20 and 30 mm fall after 1 hour) with these two CD4 counts cut-off values were suboptimal.Conclusion: This study reveals the poor association of TLC, Hb, and ESR with CD4 counts in HIV infected adults, thus highlighting the need to review the utility of these surrogate markers, for predicting CD4 counts in people living with HIV/AIDS.     

A novel link between Tourette's syndrome and histaminergic signalling

l ‐Histidine decarboxylase and Tourette's syndrome Ercan‐Sencicek et al. (2010) The New England Journal of Medicine 362(20): 1901–1908     

Measuring domestic violence in human immunodeficiency virus-positive women

Background

Violence affects the lives of millions of women worldwide, in all socioeconomic classes. Violence and the fear of violence are emerging as important risk factor contributing to the vulnerability to human immunodeficiency virus (HIV) infection for women. The objective of the present cross sectional study is to compare the experiences of domestic violence between HIV-positive and HIV-negative married women seeking treatment in a tertiary care hospital.

Methods

The study is conducted in a tertiary care hospital in Pune on a randomly selected 150 married women (75 HIV-positive and 75 HIV-negative). Informed consent was obtained from all the women and also a trained counsellor was present during the process of data collection. The data was collected by interview method by taking precautions as laid down in the World Health Organization''s ethical and safety recommendations for research on domestic violence and using modified conflict tactics scale (CTS). The definition of violence followed is as per the Declaration on the Elimination of Violence against Women, adopted by the United Nations General Assembly in 1993.

Results

The percentage of women reporting domestic violence is 44.7% (95% confidence interval [CI] = 36.84–52.68). The proportion of physical, emotional and sexual violence reported is 38% (95% CI = 30.49–45.96), 24% (95% CI = 17.67–31.31), and 14.7% (95% CI = 9.66–21.02), respectively. The odds of reporting violence of all forms is significantly higher among HIV-positive women than among HIV-negative women (P<0.05). Univariate and multivariate logistic regression is carried out to examine the possible predictors of domestic violence.

Conclusion

The findings suggest high proportion of HIV-positive women report violence then HIV-negative women which must be addressed through multilevel prevention approaches.Key Words: domestic violence, human immunodeficiency virus, violence against women     

The contribution of neurocognitive situation,physical capacity and daily life activities to quality of life in childhood acute lymphoblastic leukemia survivors

Background/aim There are no extensive studies on the QL in children who completed acute lymphoblastic leukemia (ALL) treatment and currently living without any disease in Turkey. Our study aimed to analyze both the QL and the effects of physical, neurocognitive capacities on QL in childhood ALL survivors aged 7–12 years at the time of recruitment.Materials and methodsPedsQL cancer module 3.0 child and proxy report, for ages 5–7 and 8–12 years, WeeFIM scale, BOTMP Short Form, RPM, reading, writing, and mathematics assessment tools, sociodemographic information form were carried out to the children and their family.Results There was no effect of the months since the completion of therapy on pain, anxiety, cognitive problems, perceived physical appearance, and the total QL scores of children and proxy reports (p > 0.05).Children’s physical capacities were significantly worse than healthy controls and have not reached the level of healthy children even after a long time since completion of ALL therapy. There was a significant association between physical capacity and daily independent living status (p < 0.001). Reading, writing, and mathematical skills were significantly associated with the mean time off-treatment (p < 0.001), and the total score of RPM and PedsQL of those with mathematical difficulties were significantly lower than those without any difficulty (p < 0.05).ConclusionThe months after the treatment (off-treatment time) have not affected total and subunit QL scores. As motor skills difficulties will lead to low academic achievement, early recognition direct the parents for immediate intervention. lead to low academic achievement, early recognition could direct the parents for immediate intervention. Planning psychosocial support programs for physical activity and age-appropriate development of patients from the initiation of treatment will increase the QL in childhood ALL with a survival rate of 80% or more.