Role of neck circumference in measuring obesity in healthy adults

Background: Visceral fat or intra-abdominal fat is the adipose tissue surrounding mesenteries and omentum. This has been linked to lifestyle diseases like heart diseases, arthritis, stroke and even cancer. At present we have three tools to measure visceral fat area (VFA) – Bio impedance analysis, Magnetic resonance analyser and DEXA scan. Neck circumference measurement is a simple, easy to do and a quantifiable method of measuring visceral fat. Aim & Objective: This study aims to find correlation of visceral body fat with Neck Circumference (NC) and Body Mass Index. Methodology: A cross sectional study was carried out in a medical college of western Maharashtra, wherein 290 healthy males (>18 years) were selected by simple random sampling over a period of 7 months from (February 2018 – August 2018). Data was analyzed using SPSS version 20.0. Visceral body fat was measured using Body Space 720 and neck circumference using measuring tape. Results: We found a significant association between neck circumference and VFA. There is a strong association between NC of >35cm and VFA >100cm2. NC can be useful in field settings as it can be used easily by health care workers in predicting risk of lifestyle diseases.

Correlation of Foot Bimalleolar Angle and Ultrasonography in Assessing the Severity of Club Foot in Neonates Treated by the Ponseti Method

@#Introduction: Correlation of Pirani score and foot bimalleolar (FBM) angle has been used in few studies but correlation of FBM angle with ultrasonography has never been evaluated so they are being correlated in assessing the severity of clubfoot in neonates treated by Ponseti method. Material and Methods: Thirty-two feet with congenital talipes equinovarus (CTEV) deformity in neonates were prospectively treated by the Ponseti method. FBM angle and ultrasound parameters were measured three times i.e. at the time of initial presentation, at four weeks of treatment and at completion of treatment. The feet were divided according to the Pirani score in groups: one (0-2.0), two (2.5-4) and three (4.5-6). Correlation between FBM angle and ultrasound parameters were evaluated using Pearson correlation/regression. Results: Correlation between FBM angle and ultrasound parameters were statistically significant (p-value < 0.05). Conclusion: Ultrasound has the potential to accurately depict the pathoanatomy in clubfoot. FBM angle and ultrasound are objective methods to assess the severity of clubfoot. FBM angle and ultrasonography correlated in severity of deformity and correction achieved along the course of treatment.

Cardiodepressant activity of 90% alcoholic extract of Terminalia arjuna and its probable mechanism of action.

Background: Terminalia arjuna is being used in various cardiovascular diseases as cardiotonic, diuretic & in hypercholesterolemia. Studies conflict each other for its mechanism of action. This study aims to investigate effect of 90% alcoholic extract of Terminalia arjuna on in vitro isolated rabbit’s heart & to find its probable mechanism of action. Objective: To study the preliminary pharmacological effects of 90% alcoholic extract of Terminalia arjuna in-vitro on isolated heart, coronary blood flow, and to study its probable mechanism of action. Material & Methods: Effect of Terminalia arjuna was observed on heart rate, coronary blood flow, amplitude on in vitro isolated perfused rabbit’s heart mounted on langendorff apparatus & further cholinergic & adrenergic blockers were used to study the mechanism of action. Six experiments were conducted for each parameter & data was analysed using Student’s t test. Results: Terminalia arjuna causes mean percentage decrease of 7.26%, 9.31% & 20.51% in heart rate, decrease of 10.34%, 16.64%, 20.51% in coronary blood flow & decrease of 15.11%, 12.61%, 11.65% in amplitude at 25μg, 50μg & 100μg doses respectively. The decrease in heart rate, coronary blood flow & amplitude persists even after cholinergic & adrenergic blockers suggesting that cholinergic & adrenergic receptors are not involved in mechanism of Terminalia arjuna. Conclusion: Terminalia arjuna cardiodepressant effect does not involve cholinergic & adrenergic receptors.

Background noise in healthy volunteers--a consideration in adverse drug reaction studies.

In adverse drug reaction studies proper control over 'Back ground noise' is to be maintained to avoid erroneous conclusions to be drawn for adverse drug effects. Healthy volunteers, not taking any medication, were surveyed by a questionnaire to obtain data on the occurrence of any symptoms, often ascribed to side effects of drugs. Only 62 subjects out of a total of 236 (26.27%) stated experiencing none of these symptoms during the previous 3 days. The remaining subjects reported some symptoms, with an median number of symptoms experienced per person being 2; the most common being fatigue; headache, inability to concentrate and excessive sleepiness.

Long term performance of dual chamber pacemakers.

Records of 98 patients who had dual chamber pacemakers implanted at our institution and had a follow up for at least 6 months (range 6-90 months, mean 47.8 months) were analysed for long term performance of the pacemakers. There were 78 males and 20 females in the age range of 14 to 81 (mean 51.1 +/- 13.6) years. The mode of pacing was VDD in 12, DVI in 9 and DDD in 77 patients. Atrial malsensing was seen in 15 (16.7%) cases and generally occurred within the first week of implantation. Atrial lead dislodgement occurred in 4 cases (4.1%). Most of the problems related to atrial lead could be managed conservatively and re-operation was performed in only 4 cases. Other problems encountered on follow up included cross talk in one, endless loop tachycardia in 4, and pulse generator pocket erosion or infection in 4 (4.1%) patients. There were two instances of ventricular undersensing and one instance of insulation failure in the ventricular lead. A total of 16 patients underwent elective replacement of pulse generator 53-84 months (mean 66.3) following the initial implants. It is concluded that the incidence of pacemaker malfunction and other problems with dual chamber pacemaker implantation are not high; and most cases can be managed by conservative measures such as reprogramming.

Comparison of atrial and VVI pacing modes in symptomatic sinus node dysfunction without associated tachyarrhythmias.

The natural course of patients with symptomatic sinus node dysfunction who did not have associated tachyarrhythmias before pacemaker implantation was compared after VVI and atrial pacemaker implantation. Between April 1981 and June 1989, forty-seven such patients (mean age 52 + 13 years) received VVI pacemakers and forty patients (mean age 54 + 13 years) received AAI or DDD pacemakers. Baseline clinical characteristics and severity of sinus node dysfunction were comparable in the two groups. Over a follow up of 10 to 96 months (mean 49.2 + 26 months), 11 (23.4%) VVI patients were in functional class II or more compared to 2 (5%) atrially paced patients (p less than 0.01). Other complication rates were also higher in the VVI group as compared to AAI group viz. atrial fibrillation (21.2% vs 2.5% p less than 0.01) and stroke (10.6% vs 2.5%) though the number of deaths (14.9% vs 10%) was not significantly different in the two groups. Two patients in atrial paced group and one patient in VVI group developed first degree heart block. There was no incidence of second or third degree heart block. Transient loss of atrial sensing occurred in 3 patients and atrial lead displacement in 2 cases, but overall incidence of lead related problems was low and comparable in both groups. Thus atrial pacing is superior to ventricular pacing in sinus node dysfunction and risk of developing high grade atrioventricular block on follow up is low.