Antinociceptive and Anti-inflammatory Effects of Combined Administration of a-tocopherol and Diclofenac.

Background: Nonsteroidal anti-inflammatory drugs such as diclofenac are used for relief of pain and inflammation, but frequently cause gastrointestinal complications. This study aimed to explore that combination of diclofenac and α-tocopherol (αT) are better analgesic as well as anti-inflammatory agent than that of diclofenac alone. Objective: To assess the effects of combination of diclofenac with α-tocopherol on pain and inflammation. Methods: This prospective experimental study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka between January to December 2013. For this purpose, 15 male Long Evans rats were studied. On the basis of vitamin and drug administrations, the rats were divided into three (3) groups (5 rats in each). Control group received normal saline, one experimental group received diclofenac sodium (DS) at a dose of 10 mg/kg/body weight, and another experimental group received combination of DS with αT at a dose of 10 mg/kg/body weight and 500mg/kg/body weight, respectively. All the groups received single dose and equal volume (1 ml) through intraperitoneal route 1 hour before the test. Just one hour after administrations, they were subjected to formalin test followed by formalin induced paw edema test. The data were statistically analyzed by ANOVA followed by Bonferroni Post Hoc test. Results: Combined administration of DS and αT significantly (p<0.001) lowered the variables for nociceptive pain, central analgesic activity, inflammatory pain and inflammation than individual intervention of DS. Conclusion: From this study it may be concluded that, combined administration of diclofenac sodium and ±-tocopherol were more effective in lowering pain and inflammation than individual administration of diclofenac.

Effects of Pulmonary Rehabilitation on Exercise Tolerance in Patients with COPD.

Background: Pulmonary rehabilitation (PR) is known to be therapeutically useful for COPD patients. Objective: To evaluate the effects of combination of breathing exercises (pursed lip breathing and diaphragmatic breathing) and lower extremity endurance training (LEET) as part of PR program on six minute walk distance (6MWD), on oxygen saturation (SpO2%), on the level of dyspnea and fatigue in patients with moderate stable COPD. Methods: This prospective study was conducted in the Department of Physiology, BSMMU, Dhaka from July 2010 to June 2011 on 116 male stable moderate COPD patients aged 50 to 65 years. They were enrolled from the out patient department (OPD) of the Department of Medicine of BSMMU and NIDCH Dhaka. 56 patients without PR constituted control group and experimental group included 60 patients intervened with PR. The experimental patients were advised to perform the PR program for 30 minutes duration per session at home twice daily, for consecutive 60 days along with the standard drug treatment of COPD. The control patients were advised to continue their standard drug treatment alone for consecutive 60 days. For the assessment of exercise tolerance, 6MWD, SpO2%, the level of dyspnea and fatigue of all subjects were recorded on day 0 and day 60 for both the groups. SpO2% was recorded by portable Pulse Oximeter and the level of dyspnea as well as fatigue were recorded by Modified Borg Scale. Statistical analysis was done by independent sample ‘t’ test and paired sample ‘t’ test. Results: Significant improvement were observed in 6MWD, SpO2%, the level of dyspnea and fatigue in patients who performed PR program. In addition, significant improvement in these parameters were observed after completing PR program compared to the beginning of the intervention. Conclusion: The study concludes that regular exercise of all components of PR program significantly improve exercise tolerance in COPD patients.

Effects of Pulmonary Rehabilitation on Lung Functions In Patients with COPD.

Background: The importance of pulmonary rehabilitation (PR) as a therapeutic measure for COPD patients is well known. Objective: To evaluate the effects of PR program by pursed lip breathing (PLB) and diaphragmatic breathing (DB) on FVC, FEV1, FEV1/FVC ratio in male patients with moderate stable COPD. Methods: This prospective study was conducted in the Department of Physiology, BSMMU, Dhaka from July 2010 to June 2011 on 116 male stable moderate COPD patients aged 50 to 65 years. They were enrolled from the out patient department of the Department of Medicine of BSMMU and NIDCH Dhaka. They were grouped as control (56 patients without PR) and experimental (60 patients with PR). The experimental patients were advised to perform PR program for 30 minutes duration per session at home twice daily, for consecutive 60 days along with the standard drug treatment of COPD. On the contrary, the control patients were advised to continue their standard drug treatment alone for consecutive 60 days. For the assessment of spirometric lung function status, FVC, FEV1, FEV1/FVC ratio of all subjects were recorded on day 0 and day 60 for both the group by a portable digital MicroDL Spirometer and the statistical analysis was done by independent sample ‘t’ test and paired Student’s ‘t’ test. Results: FVC and FEV1 value were significantly increased in comparison to the control patients after 60 days of follow up. On the other hand, post exercise value of FEV1/FVC ratio was decreased but it was not statistically significant. Conclusion: The study reveals improvement of lung functions with this sort of combination of PR program in stable COPD patients.

Assessment of Some Aspects of Cardiovascular Function Status in Male Patients with Stable COPD.

Background: COPD is a preventable and treatable disease with some important extra pulmonary effects, which may contribute to the severity of this disease. Among these extra pulmonary ailments cardiovascular disorders are noteworthy. Although its silent involvement is known, but little attention paid to this major comorbidity while treating COPD patients. Objective: to assess rate, systolic blood pressure (SBP) and peak systolic velocity (PSV) of blood flow to observe the cardiovascular function status in stable COPD patients Methods: This cross-sectional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during 2010. For this purpose 60 (sixty) male, smoker (5 to 10 pack years) patients of stable COPD (FEV1/FVC% <0.70; FEV1 e” 80%; without any exacerbation for last 4 weeks) were randomly selected from the Out Patient Department of the Department of Cardiology, BSMMU and also from a private clinic in Dhaka city. On the basis of spirometric findings, 30 mild (group B1) and 30 moderate stage (group B2) of COPD patients with age 35-45 years were included in the study. In addition, 30 age and BMI matched apparently healthy male persons were studied as control (group A). For assessment of cardiovascular function, pulse rate, SBP and PSV were measured. PSV of blood flow in distal part of the right brachial artery in arm was measured by Color Doppler ultrasonography. For statistical analysis, Independent sample t-test and Pearson’s Correlation Coefficient test were used. Results: Significantly (p<0.001) higher mean pulse rate and SBP were observed in moderate stage of COPD patients than those of control and mild stage. PSV was significantly (p<0.001) higher in both stages than those of the control as well as in moderate stage to that of the mild COPD. In addition, SBP and PSV were negatively correlated with FEV1 in moderate stage which was statistically significant (p<0.01). Conclusion: This study suggests that, cardiovascular status may be altered in stable COPD and this alteration is inversely related to the severity of the disease.

Micronutrient Deficiency in Severe Preeclampsia.

Background:. Micronutrient such as calcium, magnesium and zinc deficiency are associated with preeclampsia. Objective: To observe serum calcium, magnesium and zinc levels in severe preeclamptic women. Methods: This cross sectional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka from July 2009 to June 2010. 60 cases of preeclampsia, aged 18-39 years and >20th weeks of pregnancy were included in the study group. They were further sub divided into group B1 (30 mild preeclampsia) and group B2 (30 severe preeclampsia). Age and gestational period matched 30 normotensive pregnant women (Group A) were also studied as control. All the preeclamptic women were selected from the Obstetric and Gynaecology in and out patient Department of BSMMU and Dhaka Medical College Hospital. Serum calcium and magnesium was measured by colorimetric and serum zinc was measured by spectrophotometric method. For statistical analysis one way ANOVA, independent sample t test and ÷2 test were used. Results: The mean serum calcium, magnesium and zinc levels were significantly (p<0.001) lower in both group of preeclampsia than normotensive pregnant women. Again serum calcium and zinc levels were significantly lower (P<0.05) in severe preeclampsia compared to mild preeclampsia whereas serum magnesium levels were found almost similar in both group of preeclampsia (P>0.05). Again in this study, 40% mild, 73.3 % severe preeclamptic women and 20% normotensive pregnant women had hypocalcaemia. 36.7% mild, 30.0% severe preeclamptic women and 3.3% normotensive pregnant women had hypomagnesaemia and 6.7% mild, 20 % severe preeclamptic women and no normotensive pregnant women had hypozincemia. Conclusion: This study may conclude that micronutrient deficiency may be one of the risk factor of preeclampsia and increases the risk of its severity. Therefore early detection and supplementation to treat this deficiency may reduce the incidence of preeclampsia.

Relationship Of FEF25-75, Pefr And SVC With Estrogen And Progesterone Level In Postmenopausal Women.

Background: Deterioration of lung function is common in women after menopause, which may be related to very low estrogen and progesterone level. Objective: To observe FEF25-75, PEFR and SVC (slow vital capacity) values in apparently healthy postmenopausal women to find out their relationships with serum estrogen and progesterone. Methods: This study was carried out in the Department of Physiology in BSMMU, Dhaka in the year 2007. 30 healthy postmenopausal women aged 45 to 60 years and 30 healthy premenopausal women aged 20 to 30 years during their different phases of menstrual cycle were studied. Postmenopausal women were residents of Dhaka city and premenopausal subjects were medical students. FEF25-75, PEFR and SVC of all subjects were measured by a digital micro spirometer. Their estrogen and progesterone levels were estimated by Micro particle Enzyme Immunoassay (MEIA) method. Data were analyzed by Pearson’s correlation coefficient test, one way ANOVA and unpaired‘t’ test Results: The mean percentage of predicted values of FEF25-75 and PEFR were lower in postmenopausal women compared to those of follicular and luteal phases of premenopausal women but it was not significant. Measured values of SVC was Significantly (p<.001) lower in postmenopausal women compared to those of follicular and luteal phases of premenopausal women. Again Mean serum estrogen and progesterone levels were significantly (p<.001) lower in post menopausal women compared to those of follicular and luteal phases of premenopausal women. In post menopausal women, FEF25-75 was positively, PEFR and SVC were negatively correlated with progesterone level. PEFR and SVC showed positive correlattion and FEF25-75 showed negative correlation with serum estrogen level. All these correlations were statistically non significant. In premenopausal women FEF25-75 and PEFR showed positive correlation and SVC showed negative correlation with serum progesterone level. The relationships were statistically significant in luteal phase but nonsignificant in follicular phase. FEF25-75 ,PEFR and SVC were positively correlated with serum estrogen level in luteal phase but FEF25-75 and PEFR negatively correlated and SVC positively correlated with estrogen level in follicular phase. Conclusion: The outcome of this study shows FEF25-75 , PEFR and SVC may be reduced in postmenopausal women which in turn may be associated with their low progesterone and estrogen levels.

Time Domain Measures Of Heart Rate Variability In Heavy Workers.

Background: Physical inactivity and low resting heart rate variability (HRV) are associated with increased incidence of coronary heart disease. Heavy physical activity is associated with higher heart rate variability and reduces the risk of coronary heart disease Objective: To assess some time domain measures of HRV in order to compare Cardiac Autonomic Function between sedentary and heavy workers. Methods: This cross sectional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University between 1st July 2008 to 30th June 2009 on 30 apparently healthy heavy workers aged 28-50 years from low socioeconomic condition (study group). For comparison 30 age, sex, BMI and socioeconomic status matched apparently healthy sedentary subjects (group A) were also studied. The study subjects were selected among rickshaw-pullers living in the slum areas nearby BSMMU, Dhaka and the controls were from fourth class employee of BSMMU, Dhaka. Heart Rate Variability were assessed by a Polygraph. Several time domain measures of HRV such as mean R-R interval, mean HR, SDNN, RMSSD were analyzed. For statistical analysis, Independent-Samples t-test, and Pearson’s correlation coefficient tests were done as applicable. Results: Resting mean heart rate (P<0.01), SDNN (P<0.01) and RMSSD (P<0.001) were significantly lower but mean R-R interval (P<0.001) was significantly higher in heavy workers than those of sedentary control. The mean R-R interval (P<0.05) showed significant positive correlation in heavy workers but significant negative correlation in sedentary workers with BMI. Conclusion: Cardiac autonomic nerve function status may be higher with parasympathetic dominance by increased physical activity.

Effects of Vitamin E Supplementation on Reducing Chronic Hemolysis in Glucose 6 Phosphate Dehydrogenase (G6PD) Deficiency.

Background: Vitamin E works within the cell membrane as an antioxidant and may prevent destruction of RBC in G6PD deficient hemolytic anemia, which can be reflected by changes in peripheral blood film. Objective: To observe the role of vitamin E supplementation on restoring normal cell types in peripheral blood film in order to evaluate the role of this antioxidant vitamin in reducing chronic hemolysis in G6PD deficient patients. Method: Total 102 subjects, age range from 5-40 years of both sexes were included in the study. Among them 68 were G6PD enzyme deficient patients, of whom 34 were in non-supplemented group (Group B) and 34 were in supplemented group (Group C). Both group B and C were divided into Group B1 and C1 (on day 1 ) and also into B2 and C2 (on day 60) respectively. Supplemented group received vitamin E supplementation for 60 consecutive days (800 IU/day for adult and 400 IU/day for children in a divided dose i,e. 4 times daily). Age and sex matched 34 apparently healthy subjects with normal G6PD level (Group A) were also taken to observe baseline data. Determination of Erythrocyte G6PD level and preparation of peripheral blood film were done on day 1 for all groups and also on day 60 in deficient groups. Results: Percentage of subjects with presence of some abnormal red cells in peripheral blood film was significantly higher in patients of hemolytic anemia with G6PD deficiency in comparison to that of healthy control. After supplementation with vitamin E (i,e. on day-60) this percentage was significantly decreased towards those of healthy control in their supplemented group in comparison to that of pre-supplemented (day-1) and nonsupplemented groups. Conclusion: Some abnormal red cells may be found in peripheral blood film of G6PD deficient patients, improvement of which occur following vitamin E supplementation, and thereby indicates role of this antioxidant vitamin in reducing the rate of hemolysis.

FVC, FEV1 and FEV1 / FVC % in Hypothyroid Female and their Relationships with Thyroid Hormones.

Background: Hypothyroidism is a common hormonal disorder affecting various organs including lungs. It may be associated with respiratory symptoms and can decrease lung function. Objective: To observe FVC, FEV1 and FEV1 / FVC % in hypothyroid female patients. Methods: This crosssectional study was carried out in the Department of Physiology, BSMMU, Dhaka, from 1st July 2008 to 30th June 2009 on 60 hypothyroid female patients of 30-50 years age (Group B). For comparison, 30 age and BMI matched apparently healthy subjects (Group A) were also studied. Based on receiving treatment, hypothyroid patients were divided into B1 (untreated patients on their 1st day of diagnosis) and B2 (patients treated for at least 12-18 months). They were selected from the Out Patient Department of Endocrinology wing of department of Medicine, BSMMU, Dhaka. Serum TSH and FT4 levels were measured by Microparticle Enzyme Immunoassay (MEIA) principle in AxSYM system. The FVC, FEV1, FEV1/FVC%, of all the subjects were measured by a digital MicroDL spirometer. Data were analyzed by One way ANOVA test, Independent sample t- test and Pearson’s correlation coefficient test. Results: The mean percentage of predicted values of all the lung function variables in healthy female subjects and treated hypothyroids were within normal ranges. However, all of them were lower in untreated hypothyroids in comparison to those of control and treated hypothyroids.FVC and FEV1 showed statistically significant (p<0.001) difference and FEV1/FVC% showed non significant difference . In addition, all the ventilatory variables had negative correlation with serum TSH level and positive correlation with serum FT4 level and these relationships were statistically significant in control (p<0.001) and treated hypothyroids (p<0.01). Conclusion: This study reveals that lung function may be lower in untreated hypothyrod patients and correlated with thyroid hormones. Treatment of hypothyroids may reverse this changes..

Power Spectral Analysis of Heart Rate Variability in Hypertensive Male.

Background: Essential hypertension is associated with altered cardiovascular autonomic nerve function. Heart Rate Variability (HRV) analysis is an important tool for quantitative measurement of autonomic nerve activity. Objective: To assess the cardiac autonomic nerve function status in essential hypertension by analyzing power spectral measures of heart rate variability. Methods: This cross sectional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University between July 2008 and June 2009. Sixty male hypertensive patients with age range 40-60 years (group B) were enrolled from the Out Patient Department of Cardiology,BSMMU, Dhaka. Thirty age and sex matched apparently healthy normotensive subjects (group A) were studied as control, Hypertensive patients were further divided into group B1 consisting of 30 untreated patients on their 1st day of diagnosis and group B2 consisting of 30 patients under antihypertensive therapy. Power Spectral measures of Heart Rate Variability (HRV) such as total power, low frequency (LF) and high frequency power(HF) LH/HF ratio were assessed by a digital Polygraph. For statistical analysis , Independent sample t-test, One-way ANOVA test and Pearson’s correlation coefficient test were done as applicable. Results: Mean TP,LF,HF and HF norm was significantly (p<0.001) lower and LF/HF ratio and LF norm were significantly (p<0.001) higher in both untreated and treated hypertensive patients compared to those of normotensive subjects. Again, significant differences of LF norm and HF norm and LF/HF ratio were found between the two hypertensive groups. The LF/HF ratio and LF norm were positively and HF norm was negatively correlated with SBP and DBP in both the hypertensive groups. However, all these findings were more marked in untreated hypertensive patients than those of treated group. Conclusion: Sympathovagal balance in hypertensive patients is towards higher sympathetic and lower vagal modulation and effective treatment of the patients can return the balance towards normal.

Power Spectral Analysis of Heart Rate Variability In Hypothyroidism.

Background: Hypothyroidism is one of the common clinical problems with high incidence in women particularly in older age. It has profound effect on metabolic processes in almost all tissue of the body and heart is particularly sensitive to thyroid hormone action. Power spectral analysis (PSA)is useful to determine the cardiac autonomic regulation by assessing sympathovagal balance. Objectives: To assess the cardiac autonomic nervous activity by power spectral analysis of heart rate variability in patients with hypothyroidism.Method: This cross sectional study was carried out in the Department of Physiology, Banghabandhu Sheikh Mujib Medical University from 1st July 2008 to 30th June 2009 on 60 female patients of 30-50 years with hypothyroidism (group B). For comparison, 30 age sex matched apparently healthy euthyroid subjects (group A) were also studied. Based on treatment, hypothyroid patients were divided into B1 (patients on their 1st day of diagnosis, before starting of treatment) and B2 (patients with medication for 12-18 months). The patients were selected from the Out Patients Department of Endocrinology, BSMMU. Serum TSH and FT4 levels of all subjects were measured by AxSYM system. To perform power spectral analysis of HRV Total Power(TP), Low Frequency(LF),High Frequency(HF),LF norms (nu),HF norms (nu) and LF/HF ratio were assessed by a Polyrite. For statistical analysis of data, Independent Sample t test, One Way ANOVA and Pearson’s correlation coefficient test were done as applicable.Results: The mean serum TSH(38.16 vs2.18;2.04) was significantly higher and FT4(5.12vs 15.13; 15.08) was significantly lower(p<0.001) in group B1 than those of group A and B2.The mean values of all the spectral parameters of HRV in euthyroid subjects were within normal range. In untreated hypothyroid patients the mean values of TP ( 77.11vs2702.87;2683.73), HF power(56.68 vs 342.02; 437.34) HF nu( 24.79 vs 36.35;34.55) were found significantly (p<0.001) lower LF/HF(1.7±0.3,3.16±.84 and 1.93±.58) and LF nu(75.32 vs 63.71, and 65.90) were significantly (p<0.001) higher and in comparison to both euthyroids and treated patients. Conclusion: Alteration in cardiac autonomic nervous activity characterized by reduced vagal modulation and higher sympathetic activity may occur in the hypothyroid patients..

Sympathetic Nerve Function Status in Postmenopausal Women.

Background: Postmenopausal women usually suffer from increased incidence of cardiovascular diseases than premenopausal women. Alterations in autonomic nerve functions often develop in this group of women that commonly affect cardiac vagal control and usually associated with sympathetic hyperactivity. Objectives: To observe the sympathetic nerve function status in postmenopausal women and their relationships with serum estrogen level. Methods: This cross sectional study was carried out in the Department of Physiology, BSMMU, Dhaka from 1st January to 31st December 2007. A total number of 60 apparently healthy subjects of whom 30 were postmenopausal women with age ranged from 45-60 years(group B) and 30 were premenopausal women with age ranged from 20-30 years (group A) were enrolled. Premenopausal women were studied during follicular phase of menstrual cycle.Two simple autonomic nerve function tests, rise of diastolic blood pressure (DBP) during hand grip and fall of systolic blood pressure (SBP) on standing were done to assess sympathetic activity and serum estrogen level was measured in both the groups. Data were analysed by unpaired t test and Pearson correlation coefficient test. Results: Mean resting SBP and DBP were significantly higher (p<0.001) in postmenopausal women than premenopausal women. The mean value of estrogen was significantly (p<0.001) lower in group B (postmenopause) than those in group A (premenopause). Fall in systolic blood pressure after standing was significantly (p<0.001) higher and rise in diastolic blood pressure after sustained handgrip was significantly (p<0.001) lower in postmenopausal women than those in premenopausal women during their follicular phase of menstrual cycle. Again, rise in diastolic blood pressure after sustained handgrip and fall in systolic blood pressure after standing showed (p>0.05) negative correlation with estrogen level in the postmenopausal women which was statistically not significant. In addition, regression analysis further revealed significant association of sympathetic activity with estrogen level and age in postmenopausal women. Conclusion: From this study it can be concluded that sympathetic activity is higher in postmenopausal women, which may be related to their low estrogen level and age as well.

Sympathetic Nerve Function Status in Obesity.

Background: Obesity is an important and independent risk factor for cardiovascular morbidity and mortality. High incidence of cardiac autonomic nerve dysfunction has been noted in obese subjects who are at increased risk for sudden death Objective: To study the relationship between sympathetic nerve function and obesity. Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University between July 2006 to June 2007 and 40 apparently healthy obese subjects aged18-40 years of both sexes with BMI > 25 kg/m2 in study group. Age and sex matched 40 apparently healthy nonobese subjects with BMI range of 18.5-22.9 kg/m2 were also included for comparison (Control). Two noninvasive cardiovascular reflex tests like blood pressure response to sustained handgrip and blood pressure response to standing were done to assess sympathetic nerve function status. Unpaired Student’s ‘t’ test and Pearson correlation coefficient test were used for statistical analysis. Results: Mean values of resting heart rate, resting systolic and diastolic blood pressure were significantly(p<0.05) higher and both the sympathetic nerve function parameters(BP response to hand grip and BP response to standing) were significantly (p>0.05) lower in obese compared to those of non obese control subjects. Again, BP response to hand grip were negatively and BP response to standing were positively correlated with BMI in all subjects. These correlations are statistically significant(p<0.05). Conclusion: The results of this study revealed that sympathetic nerve function may be reduced in obesity.

Relationship of Thyroid Hormones with Heart Rate Variability.

Background: Altered thyroid functions are associated with variation in autonomic regulation of cardiovascular activity. Cardiac Autonomic Nervous Activity (CANA) can be assessed quantitatively by analysis of Heart Rate Variability (HRV). Objective: To observe the relationship between CANA with altered TSH and FT4. Methods: This cross sectional study was carried out in the Department of Physiology, BSMMU, Dhaka between1st July 2007 and 30th June 2008 on 60 patients with excess thyroid hormone (group B, aged 30-50 years). Based on treatment, 30 untreated newly diagnosed patients were designated as group B1 and 30 patients under treatment with antithyroid drugs for at least 2 months were included into group B2 in order to observe the effect of treatment. All these patients were selected from the Out Patient Department of Endocrinology wing of Department of Medicine, BSMMU, Dhaka. Sociodemographically matched 20 apparently healthy euthyroid persons were selected for comparison (group A). To confirm thyroid status, serum TSH and serum FT4 levels were measured by AxSym system and some of the spectral HRV parameters i.e.mean R-R interval, mean heart rate, variance, LF n.u, HF n.u and LF/HF ratio were assessed by recordings of ECG for 5 minute (short term) with a polyrite. For statistical analysis Pearson’s correlation coefficient (r) test was used. Results: With serum TSH level, the LF n.u. power and LF/HF ratio showed significant (p<0.05) positive correlations but HF n.u. power showed significant (p<0.05) negative correlation in group B1. But these three parameters showed non significant correlations with TSH in the other two groups (A, B2). Similarly with serum TSH level, variance and mean R-R interval showed negative and mean HR showed positive correlation in group B1. In group A, all these parameters were positively correlated whereas in groupB2, RR interval and variance were positively and mean HR was negatively correlated. All these correlations were statistically non significant. With serum FT4 levels, mean R-R and HF n.u. were negatively and mean heart rate, LFnu, LF/HF were positively correlated in all three groups but variance showed positive in group A and negative correlation in B1 and B2. All these correlations were statistically non significant. Conclusion: From this study it can be concluded that changes in autonomic nervous regulation are related to altered serum level of TSH and FT4 in hyperthyroids.

PEFR and FEF25-75 in type 2 diabetes mellitus and their relationships with its duration.

Background: Diabetes mellitus is a major public health problem with increasing incidence worldwide and long term complications of various organs including lungs. The magnitude of the complications of this disease is related to its duration. Objective: To observe PEFR and FEF25-75 in type 2 diabetic male and their relationship with duration of the disease. Methods: This cross sectional study was carried out in the Department of Physiology, BSMMU, Dhaka, from 1st July 2007 to 30th June 2008 on 60 type 2 diabetic, non smoker, male of 40-60 years old. For comparison, 30 age, BMI and socioeconomic status matched apparently healthy non diabetic subjects were also studied. Based on the duration of disease, diabetic patients were divided into B1 (5-10 years) and B2 (10-20 years). PEFR and FEF25-75 of all the subjects were measured by an electronic spirometer. Data were analyzed by One way ANOVA, Unpaired Student’s ‘t’ and Pearson’s correlation coefficient tests. Results: The mean percentage of predicted values of PEFR and FEF25-75 in non diabetic male were within normal ranges. But, both the parameters were significantly (p<0.001) lower in both the groups of type 2 diabetic male compared to those of non diabetic male. Again, the PEFR and FEF25-75 were lower in the patients of longer duration compared to those of shorter duration but the differences were not significant. However, PEFR was negatively correlated and FEF25-75 was positively correlated with shorter duration of diabetes and the relationships were nonsignificant. On the other hand, both the parameters were negatively correlated with longer duration of diabetes while only PEFR showed significant (p<0.01) relationship. Conclusion: The PEFR and FEF25-75 may be lower in type 2 diabetic male, which are inversely related to the duration of the disease.