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Definition of hypertension

*Hypertension is defined as levels of office systolic BP >140 mmHg and levels of diastolic BP >90mmHg.

Classification of blood pressure

*BP Should be classified according to office BP as optimal,normal, high-normal or grades 1-3 hypertension.

Office blood pressure

SBP(mmHg) Optimal <120, Normal<120-129,High normal<130-139

DBP(mmHg)Optimal<80,Normal<80-84,High normal<85-89

Abbreviations:SBP,systolic blood pressure; DBP,diastolic blood pressure.

Definitions of hypertension grades.

Hypertension

SBP (mmHg):Grade 1-140-159,Grade 2-160-179,Grade 3->180

DBP(mmHg):Grade 2-90-99,Grade-100-109,Grade->110

DIAGNOSTIC ASPECTS

Blood pressure measurement

*BP may be measured either in the doctor’s office or at Home.

*An important consideration is the BP should be measured carefully by means of a validated device.

BP measuring device

Accurate LED Sphygmomanometer

Paramed manual blood pressure cuff with carring case and Sthethoscope.

Automatic Blood pressure monitor. (Omron,Diamond,Dr Morepen bp monitor,Omron Complete ECG Machine+BP moniter )

• Vitamin D was termed as “D” because it was the fourth vitamin
  known. Chief source of vitamin D is endogenous vitamin D
  synthesis in the skin.
  • Approximately 80-90% of vitamin D is derived from sunlight,
  whereas only minor amounts of vitamin D is from dietary
  sources.
  • Vitamin D is not an actual vitamin but a secosteroid hormone
  produced in the skin from 7-dehydrocholesterol after exposure
  to sunlight UVB radiation.
  • Identification of the vitamin D receptor (VDR) in almost all
  human cells, suggests a role in extra skeletal diseases

AVERAGE DAILY RECOMMENDED AMOUNT OF VITAMIN D
Life Stage Avg. daily recommended amount
(IU)
Birth –13 years 400
Teens 14 –70 years 600
Adults
71years & older 800
Pregnant & breastfeeding women 800

LEVELS OF VITAMIN D & STATUS
Levels of Vitamin-D Status
<20 ng/mL Deficient
20–29 ng/ml Insufficient
30–50 ng/mL Optimal Range

conversion formula : 1ng/ml = 2.496 nmol/l

Dehydration is a lack of total body water that disrupts metabolic processes.

It occurs when free water loss exceeds intake, often resulting from excessive, health conditions

Inadequate consumption of water.

Dehydration can cause hypernatremia (High Levels of Sodium ions in blood.)

Chronic dehydration can cause kidney stones as well as the development of chronic kidney problems.

Causes-Loss of body water.

symptoms –(polyuria-Excessive urination more than normal)

Increased thirst, tiredness, decreased urine, dizziness, headaches and confusion.

Complications -Low blood volume shock, urinary tract infection, Kidney stones, heatstroke.

Treatment-Correction of dehydrated state is accomplished by the replenishment of necessary water

And electrolytes ORS and electrolytes drink with vitamin c provide quick relief.

COCONUT WATER

ELECTRAL

WALYTE ORS

ORS L (Electrolyte drink with vitamin C)

ENERZAL

FRUCTOLYTE.

SALINE.

What is NLEM 2022

Ans.   Means national list of essential medicines, published by ministry of health & family welfare. This includes list of molecules (drugs) which are brought under price control.

What is DPCO

Ans.   Drug price control order empowers the National Pharmaceutical Pricing Authority (NPPA) to regulate essential drugs. As per the new DPCO all strengths & dosages specified in NLEM will be under price control.

What is scheduled formulation?

Ans.   Means any formulation, included in NLEM list. Formulation is a medicine made out of or containing one or more drugs with or without any excipient for internal or external use.

What is the method of calculation of pricing of scheduled formulation?

Ans.   Sum of prices to retailer of all the brands and generic versions of the medicine having market share more than or equal to 1 % of total market turnover on the basic of MAT(Moving Annual Total) /

Total number of such brands and generic version of the medicines. Ceiling price = P (s) X ( 1+M/100)

P(s) = Avg. price to retailer for the same strength and dosage of the medicine (As calculated above)

M = % margin to retailer and its value = 16

How prices of schedule formulation can be revised?

Ans. Government shall revise the selling prices of scheduled formulations as per the annual whole sale price index (WPI) for preceding calendar year on or before 1^st April of every year.

WPI – Wholesale price index means annual whole sale price index of all commodities as announced by the department of industrial policy & promotion, Govt of India from time to time.

What is the impact of DPCO on Indian Pharma Industry?

    Ans.        No. of leading brands with high MRP must reduce their prices significant