Comparison of the effect of recumbent body positions on dynamic lung function parameters in healthy adults

Background: Pulmonary function parameters can be altered with the change in body position. Therefore, physiological basis behind such consequent influence is essential to be understood. Pulmonary function tests are generally conducted in the erect sitting posture as it is more feasible and comfortable. However, bedridden patients are unable to do so and only few studies are found on recumbent postures. Thus, to comfort such patients in breathing, need arises to meet this requisite investigation to conclude the best recumbent body posture. Aim and Objectives: To compare and assess forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, forced expiratory flow of during 25�% expiration (FEF25�%, and peak expiratory flow rate (PEF) in the Supine, Crook-lying and Fowler抯 position. Materials and Methods: The present research was carried out on 128 healthy adults to measure FVC, FEV1, FEV1/FVC ratio, FEF25�% and PEF using a computer-based spirometer in the Supine, Crook-lying and Fowler抯 position. One-way Analysis of Variance with Tukey HSD post-hoc test was utilized between each body postures by evaluation of their mean values. Results: This study consisted of 128 subjects (males 57, females 71) with mean age of 21.62 � 1.75 years, mean weight 59.71 � 9.97 kg, mean height 164.68 � 9.30 cm and Body mass index 21.91 � 2.38 kg/m2. Fowler抯 posture showed significantly (P < 0.05) higher value in all spirometric parameters as compared to other two postures. Outcome of the study showed all spirometric parameters value- greater in the Fowler抯 posture than that of Supine or Crook-lying posture. Conclusion: The implication of this research is that it will meet the need of selection of the most suitable substitute posture for better pulmonary functioning in bedridden people.

Murder through insanity: a forensic perspective

Background: Persons with major mental illness (such as schizophrenia) may commit crime under the influence of psychopathology. Case description: A 35 year old man (accused) killed his mother (victim). An autopsy of victim’s body revealed the cause of death as ‘due to fatal injuries to the brain and neck structures.” With the support of circumstantial evidence and post-mortem report of victim, the inquest officer presented the accused in the court. On receipt of judicial reception order he was subsequently referred to the psychiatrist. The accused was diagnosed as suffering from paranoid schizophrenia and it was found that under the influence of psychosis he committed the crime. The psychotic symptoms were present before the manifestation of violent behaviour, in the form of delusions, hallucinations, and disorganized behaviour. With treatment his psychotic symptoms improved. Discussion: This case illustrates the profile of a person with major mental illness who was never treated, from a forensic perspective. Not all patients are violent; but, the risk is high. Conclusions: Early psychiatric intervention in the form of identification and management may go long way in prevention of violence committed by few patients with major mental illness. There is a need to understand the motivational factors for such violent acts which may help in effective prevention.

A Prospective Study on MBBS Student About Different Visual Aids.

Background: To enhance successful communication medical teachers are increasingly using different visual aids. Objective: To determine medical students perception of different visual aids like black board (BB), over head projector transparencies (OHPT) and, LCD and to generate recommendations for their optimal use. Methods: A questionnaire based study was carried out among first year MBBS students of Government Medical College, Kota, India. The survey was undertaken among 84 Medical students of first year MBBS of batch 2008 after exposing them to different visual aids like BB, OHPT and LCD in Physiology lectures. A few lectures were absolutely on BB, and some were on OHPT and on LCD. Few classes were taken with mixed visual aids. Students were exposed for such visual aids for one year and then they were requested to complete a questionnaire. Data were statistically analyzed by One Sample Chi-square test. Results: 55 (65.48%) students rated chalk & black board as best visual aids in understanding the topic better as compared to OHPT and LCD (P<0.01). 47 (55.95%) students have good learning experience with black board teaching and it is best mode to note down important points. 56 (66.66%) students favored LCD as more interesting and interactive visual aids (P<0.01). It also complete the lecture faster which was advantageous for 69(82.17%) students. 77 (91.66%) students wanted mixing of different visual aids (P<0.01). Mostly (75%) do not find any difficulty in switching from one mode to another. No significant gender difference was observed. Conclusion: To improve students learning medical teachers should match the lectures with preferred visual aids. It will maintain interest and enthusiasm among pupil.

Malignant transformation of plantar ulcers in leprosy.

Malignant transformation of plantar ulcers in leprosy is not uncommon. The apparent rarity of these neoplasms could be because many observed cases are not reported. To determine the extent of the problem, 133 consecutive cases of plantar ulcers seen over two years were studied clinically as well as histologically. Plantar ulcers were more common in the distal third of foot (64.67%) but malignant transformation was seen more often in plantar ulcers of proximal third of foot (64.29%). Malignant transformation was more common in plantar ulcers of long duration. Histologically, most of the lesions were benign, being instances of pseudo-epitheliomatous hyperplasia (57.89%) or atypical pseudo-epitheliomatous hyperplasia (13.53%). However, squamous cell carcinoma was observed in 10.53% cases. Thus it may be that more cases with this complication will be detected if it is borne in mind that malignant change may be encountered in such ulcers.

Hospital epidemiology of dry eye.

One hundred consecutive cases of dry eye were studied to comment upon its epidemiological aspects. The incidence of dry eye amongst ophthalmic outpatients was 0.46% with a male:female ratio of 1:1.22. Fifty seven percent of the patients were above 50 years of age. The incidence was higher amongst outdoor workers and people from rural areas with poor socioeconomic status. The influence of hot and dry climate and nutritional status on dry eye incidence is discussed.

Food habits & anthropometry of two tribes of Rajmahal hills, Bihar.

A dietary survey was conducted between August 1986 and July 1987, to investigate the various food ingredients consumed by two tribes (the Santals and the Pahariyas) residing in the villages of Rajmahal hills, of Bihar. A total of 651 families of two tribes of Sahibganj (Pakur and Rajmahal sub-divisions) and Godda districts were surveyed. Agriculture and forest products were the principal sources of income and food. Only about 12.6 per cent of the Pahariyas and 28.2 per cent Santals could afford regular meals every day for the whole year. Maize, rice, dry jawar powder and Ghangara were the staple foods of these tribes. Pulses and milk found no place in the diet of the Pahariyas. About 4.3 per cent Mals, 2.9 per cent Kumarbhags and 1.8 per cent Saurias and 7.2 per cent Santals ate fish/meat regularly. Toddy and locally distilled wines were regularly consumed by both the tribes. The amount of cereals, roots/tubers and toddy consumed by the Pahariyas was greater than that by the Santals (cereals: 82 and 64.6 per cent of the total food consumed by the Pahariyas and the Santals respectively). Similar amounts of leafy vegetables (5.1% in Santals and 4.8 to 6.8% among the Pahariyas) was consumed by these tribes. Slightly, higher quantity of non-leafy vegetables was consumed by the Santals (4.4%) than the Pahariyas (2.3% to 3.6%). Mean body weight, height, chest circumference, arm circumference and skinfold thickness etc., of the Pahariyas were significantly lower than those of the Santals.