Stakeholder Analysis for Hypertension Management in the Context of the Indian Public Health System.

Background: Hypertension (HTN) portends a significant public health burden in India and calls for multi-stakeholder action.

Objectives: We aimed to analyze the role of key stakeholder constituencies implicated in managing HTN across different levels of care within the public health system in India, alongside the enablers and barriers for effective program implementation.

Methods: We reviewed 45 articles and policy documents, and 17 consenting stakeholder representatives scored the stakeholder constituencies for "power," "position" and "interest.

Antithrombotic Management in Ischemic Stroke with Essential Thrombocythemia: Current Evidence and Dilemmas.

Thrombotic diseases like ischemic stroke are common complications of essential thrombocythemia (ET) due to abnormal megakaryopoiesis and platelet dysfunction. Ischemic stroke in ET can occur as a result of both cerebral arterial and venous thrombosis. Management of ET is aimed at preventing vascular complications including thrombosis.

Disease Activity in Spondyloarthropathy: Does it affect Vascular Health?

Background: Chronic inflammation in spondyloarthropathy (SpA) is associated with accelerated atherosclerotic cardiovascular disease (CVD). Flow mediated vasodilatation (FMD) and carotid intima-media thickness (cIMT) detects endothelial dysfunction and subclinical atherosclerosis respectively, responsible for atherosclerotic CVD.

Objective: We aimed to examine the association of disease activity in SpA with surrogate markers of CVD, i.

Haemolytic anaemia as first manifestation of Wilson's disease: a report of two cases.

Wilson's disease can have different manifestations like jaundice, cirrhosis of liver, extrapyramidal symptoms and dementia. Haemolytic anaemia may occur but it is commonly associated with florid manifestation of liver disease. Sometimes, liver cell necrosis can release huge free copper ions in blood, giving rise to oxidant damage to erythrocytes.

Generalised hyperpigmentation in vitamin B12 deficiency.

In developing countries like India, nutritional deficiencies are prevalent and hyperpigmentation due to protein energy malnutrition, zinc deficiency and pellagra are common. Indian women, especially vegetarian are prone to vitamin B12 deficiency. Vitamin B12 deficiency can present as anaemia, neurological defect, gastrointestinal symptoms or dementia.

Hyperventilation of pregnancy presenting with flaccid quadriparesis due to hypokalaemia secondary to respiratory alkalosis.

Hyperventilation in pregnancy is a cause of chronic respiratory alkalosis. Alkalosis either metabolic or respiratory may cause intracellular shift of potassium ions that may lead to hypokalaemia. However, the resultant hypokalaemia in respiratory alkalosis is usually mild and does not cause much clinical features.

Congenital giant right atrium in an elderly woman.

Enlargement of right atrium is usually secondary to pulmonary hypertension due to valvular heart diseases or obstructive pulmonary disorders, atrial septal defect, tricuspid atresia or stenosis, pulmonary stenosis, primary pulmonary hypertension, Ebstein's anomaly. Congenital enlargement of right atrium is rare and it commonly presents in children. Our patient presented with congenital giant right atrium at 65 years of age, other cardiac diseases being excluded.