a b s t r a c tBackground: Isolated diastolic hypertension (IDH) is a largely unrecognized subtype of

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Background:Metabolic syndrome (MetS) is a constellation of high blood pressure, hyperglycemia, obesity, and dyslipidemia. Its presence makes the patient more prone for cardiovascular events. Its prevalence has been documented as 11%–41%. The present study was undertaken to find out the demographic profile of the MetS in Kanpur region of northern India.Materials and Methods:This is a hospital based, cross-sectional study with adequate sample size.Results:Out of the randomly selected 420 patients (232 males and 188 females), 172 cases (61 males and 111 females) were found to have MeTS adopting the National Cholesterol Education Program Adult Treatment Panel III criteria. The overall prevalence of MeTS was found to be 40.9% (26.2% of total males and 59% of total females). Among the 172 cases of MeTS, females were more than males (64.5% vs. 35.4%). Maximum numbers of MeTS cases were in the age range of 50–59 years (55/172 = 31.9%) followed by 40–49 years (50/172 = 29%), >60 years (35/172 = 20.3%), 30–39 years (30/172 = 17.4%), and <30 years (2/172 = 1.1%). In the total study population of 420 cases, hyperglycemia was the most common (29.2%) and hyperglycemia, obesity, and high triglyceride were significantly higher prevalence in females. Among the participants of 111 cases of MeTS, hyperglycemia was the most common (71.5%) and high blood pressure, and low high density lipoprotein was significantly higher among males.Conclusion:The prevalence of MetS was more than 40% and its prevalence in <40 years age group is rapidly increasing. Its high time to be more active physically, before fatal cardiovascular events.

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For eradication of rheumatic fever (RF)/rheumatic heart disease (RHD), we must have a simplified diagnosis, and a treatment which is painless, easily available and safe; prophylaxis must be painless, safe, easily available, readily administered, and comprising a weekly oral single dose.Arati's regime for management of RF/RHD (ARMOR) consists of diagnosis and management of RF/RHD in today's context in a very easy and simplified way.ARMOR criteria: Arthritis or arthralgia with typical features suggestive of RF, carditis or cardiac involvement, typical of RF or RHD, and echocardiographic evidence of rheumatic heart valve involvement should essentially be the criteria to diagnose RF and RHD with high specificity and sensitivity.With regard to treatment of RF/RHD, we need a drug which is highly efficacious against Group A Beta Hemolytic Streptococcus (GABHS), which is the causative agent for primary prevention and treatment and secondary prophylaxis.The best drug discovered, to date, for GABHS is azithromycin.ARMOR for primary prevention, treatment and secondary prophylaxis of RF/RHD is as follows:Azithromycin must be given in a dose of 500 mg 1 tablet daily for 5 days, followed by 1 tablet once a week for 1 year.Penicillin for treatment and prophylaxis must be given up due to its lack of availability, side effects, risk of anaphylaxis, parenteral preparation, hazards of administration, need for sensitivity test each time, etc. and replaced by azithromycin.

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The standard and age-old treatment of RF/ RHD is a single injection of Benzathine Penicillin G given intramuscular after sensitivity test in a dose of 1.2 million units. For secondary prophylaxis, this is followed by Injection Benzathine Penicillin given intramuscular, each time after sensitivity test, after every 21 days (3weeks), in the same dose of 1.2 million units. The treatment and prophylaxis of RF/ RHD has never seriously been reviewed in the light of newer drugs discovered for GAS (Group A Streptococcus) after Penicillin. All the other drugs mentioned above are oral forms which could never be an alternative to Benzathine Penicillin due to the daily dose required, except for Azithromycin which has a long half-life and several other pharmacological properties which make it an ideal drug for treatment and prophylaxis of RF/ RHD. Benzathine Penicillin G is in use for past 60 years due to convenience of dosing, its undoubted efficacy in eradication of the GABHS, and the low cost. But the scene is changed now.JNGMC Vol. 12 No. 2 December 2014, Page: 42-45

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