Background Reducing excess body weight is important for control and management of high blood pressure (BP) in adults. Previous studies showed high prevalence of hypertension in River Nile State—north of Sudan, hence this study to establish whether obesity can be among the main risk factors and to study the prevalence of obesity related hypertension among Sudanese adults in River Nile State. Methods This was a cross sectional community-based study conducted in River Nile State, Northern Sudan from January to June 2021. Obese and overweight, aged 18 years and above and accepted to participate in the study were included in the study. Convenience sampling method was used to select the participants. Data was collected through structured questionnaire filled by the patients after taking informed consent. Anthropometric measurements were taken. Two measurements of BP were obtained. Data was analyzed using SPSS version 23.0 (IBM, Chicago, USA). Chi-square test was used to determine the associations between categorical variables while logistic regression test was used to predict the presence of hypertension among studied population. Results A total of 1,295 participants were enrolled in this study. Obesity was reported in 1,118 (86.3%) of the participants. The prevalence of hypertension among the participants was 1,027 (79.3%). Central obesity was reported in 951 (92.6%) among hypertensive patients (P<0.001). Moreover, among hypertensive patients 470 (45.8%) were obese class I, 334 (32.5%) overweight, 139 (13.5%) obese class II and 84 (8.2%) obese class III (P<0.001). Obesity, BMI are risk factor of hypertension (P<0.001). Other risk factors were age above 40 years (P<0.001), unemployment (P<0.001), low education level (P<0.001) and being married (P<0.001). Logistic regression analysis showed that increasing age [P<0.001; odds ratio (OR) =1.055; 95% confidence interval (CI): 1.041–1.068], central obesity (P<0.001; OR =5.16; 95% CI: 3.4–7.8) and high body mass index (BMI) (P<0.001; OR =3.7; 95% CI: 1.7–7.9) were associated with uncontrolled hypertension. Conclusions The study showed that the prevalence of obesity related hypertension was high. Common risk factors were age above 40 years, unemployment, and marriage. Importantly, central obesity, gross obesity and increasing age can be associated with uncontrolled BP management.
Acute Fibrinous and Organizing Pneumonia (AFOP) is a diffuse infiltrative pulmonary disease characterized by the presence of intra alveolar fibrin and organized pneumonia. It’s a rare and relatively unknown "entity" with only a few cases described. Herein, we describe the association of acute fibrinous and organizing pneumonia with excellent response to steroid therapy. We suggest that, such an association has been very rarely reported. A32 year's old Sudanese female was presented to us in ELmek Nimer university hospital complaining of fever, cough and shortness of breath for 10 days and received a full course of antibiotics without any improvement, her condition deteriorated. The initial chest radiography showed well defined inhomogeneous pacification in the upper lobe of the left lung with no air bronchogram, Computed Tomography of the chest showed a rather well defined Lt Upper lobe mass lesion closely related to the arch of the aorta. Ultrasound guided biopsy of the lung showed a histological diagnosis of acute fibrinous and organizing pneumonia. After establishing the diagnosis of fibrinous pneumonia the patient received oral steroid (prednisone 1mg/kg) for 10 days then tapering. The patient showed rapid improvement and excellent response and discharged in good condition. Chest radiography after one month showed complete resolution of the radiological finding in her previous imaging. We recommend that AFOP should be considered in the differentials of a suspected pulmonary infection unresponsive to optimal antibiotic "therapy". AFOP may present as pulmonary mass on chest X-ray and diagnosed made with biopsy and histological examination. We conclude that AFOP may be treated with "steroids" therapy.
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