Does swine flu (H1N1) always show the clinical features?

Swine flu (H1N1) infection has clinical features like seasonal flu in it’s early stage. However, patients show the devastating symptoms at the progressive stage of viral pathogenesis inside the body. The neurological symptoms are shocking in the advanced stage. Recently, it is shown that some H1N1 patients have negative symptoms, revealing no clinical features all around it’s pathogenesis period. One report from Japanese high school students’ survey suggest that 20% of students and teachers infected with swine flu displayed no symptoms. Then, antibody testing confirmed the positive for H1N1 for those symptomless students. It is known that H1N1 flu possesses rapid replication capacity inside the body after primary pathogenesis; however, rapid multiplication might be one reason to show symptoms among some patients and/or it might be due to person to person physiological variations. The obvious mechanism is yet to be studied. Therefore, ‘clinical screening’ might be a good option for symptomless patients.

Do we overlook ‘white coat hypertension’?

Sometime, to determine ‘clinical hypertension’ is a troublesome task for the physicians. It is said that atleast several consecutive measures should be taken to determine ‘clinical hypertension’ at both office and home. Home monitoring of blood pressure is differed from office monitoring, should be problematic one and to determine the final interpretation. Therefore, it is important to consider about ‘white coat hypertension’, revealing a rise in blood pressure at physician’s office or clinic. There should be certain mechanism; however, it is known that anxiety is responsible for the rise in blood pressure in the office, demonstrating ‘white coat hypertension’. Now, the question is to determine the fundamental measurement procedure to establish blood pressure measure among normal subjects and patients. It is known, the morbidity is higher among sustained hypertensive patients than white coat hypertensive patients; however, there is higher morbidity among the white coat hypertensive patients than clinically normotensive patients. So, it is necessary to consider this ‘white coat hypertension’ among normal population. Therefore, this suggests, home-monitoring of blood pressure is suitable to determine ‘clinical hypertension’ after considering different predisposing factors.