Metabolic Syndrome in Hypothyroid Patients.

Thyroid functions affect metabolic syndrome (MetS) parameters including blood pressure, fasting plasma glucose, serum triglycerides and HDL-Cholesterol. But the relationship between MetS and thyroid functions is yet to be identified clearly. Metabolic syndrome is a state in which most features of hypothyroidism can be seen. The aim of the present study was to investigate the frequency of MetS in hypothyroid patients. Thirty one patients with overt hypothyroidism, 32 patients with subclinical hypothyroidism (SCH) and 58 euthyroid controls were enrolled in this study. NCEP-ATP III criteria was used to diagnose metabolic syndrome. Majority of the participants were in the age group of 30-40 years. Body mass index and waist circumference, blood pressure, fasting plasma glucose and serum triglycerides were found to be higher in hypothyroid patients compared to that of euthyroid controls (p<0.001). On the other hand serum HDL-C was found to be significantly lower in hypothyroid patients compared to that of euthyroid controls (p<0.001). Prevalence of MetS was 82.5% in the hypothyroid group and 27.6% in eythyroid controls (p<0.001). No significant difference was found between SCH (81.3%) and overt hypothyroid (86.7%) groups in respect to prevalence of MetS (p<0.05). The findings of the study suggest a need to investigate the presence of hypothyroidism during the management of MetS patients.

Blood Lipid Profile in Acute Coronary Syndrome and Chronic Stable Angina Patients.

This study was designed to compare the blood lipid profile and conventional cardiovascular risk factors in patients with acute coronary syndrome (ACS) and chronic stable angina (CSA). A total of 110 patients, 55 of which were of ACS and 55 with chronic stable angina (CSA) who underwent coronary angiography in the Department of Cardiology, BSMMU, Dhaka were enrolled for the study. Lipid profile and age, sex, diabetes mellitus, hypertension, hyperlipidemia, smoking habit, family history of premature coronary artery diseases (CAD) of the patients were recorded and compared. Mean±SD age of the studied patients was 52.2±10 years. Prevalence of diabetes mellitus (p<0.05) and hypertension (p <0.05) was significantly higher in patients with CSA than that with ACS. Frequency of hyperlipidemia, smoking habit and family history of CAD was similar between groups. Patients with CSA had significantly higher triple vessel diseases (TVD) (p < 0.001) and significantly lower high-density lipoprotein cholesterol (HDLc) (p < 0.05) compared to that of patients with ACS. ACS patients had significantly higher single vessel diseases (SVD) (p <0.001) compared to that of CSA but the distribution of low-density lipoprotein cholesterol (LDLc), total cholesterol and triglycerides were variable between groups. This study showed that CSA patients had substantially higher frequency of having some CVD risk factors with alteration in certain lipid profile parameters and higher number of triple vessels disease than patients with ACS. This might aid in selecting appropriate criteria for angiographic evaluation and better management of patients with coronary artery diseases.

Serum Homocysteine Level in Type 2 Diabetes Mellitus with Peripheral Arterial.

Peripheral arterial disease is a macrovascular complication of type 2 diabetes mellitus. Hyper-homocysteinemia is found to be associated with peripheral arterial disease. Homocysteine induced endothelial-cell injury is mediated by hydrogen peroxide. Hydrogen peroxide exposes the underlying matrix and smooth muscle cells of the arteries which, in turn, proliferate and promote the activation of platelets and leukocytes. The present study was carried out in the Department of Biochemistry, Dhaka Medical College, Dhaka from July 2010 to June 2011 to observe the association of hyperhomocysteinemia with peripheral arterial disease in type 2 diabetes mellitus. A total of 100 subjects (50 cases and 50 controls) were selected by purposive sampling from Bangladesh Institute of Health sciences (BIHS) and BIRDEM Hospital, Dhaka. Subjects having ankle brachial index <0.9 were considered as cases and those having ankle brachial index 0.9 were considered as controls. Subjects with absent peripheral pulses or nonrecordable ankle brachial index were considered as ankle brachial index <0.9. All study subjects were normotensive, normolipidemic and non- smoker. The study showed a higher level of homocysteine (μmol/L) in cases when compared with that of controls (15.95±1.80 vs. 9.31±2.11; p<0.001). In cases, males had higher proportion of arterial disease (56%) than females. Other variables (age and body mass index) showed no significant difference between two groups.

A Study of Serum Zinc level in Cirrhosis of Liver.

Cirrhosis is a consequence of chronic liver diseases. Zinc is a micronutrient that plays an important role in the function of liver. This cross-sectional study was carried out in the Department of Biochemistry, Dhaka Medical College, from July 2010 to June 2011 to observe the association of serum zinc level with liver cirrhosis. A total of 100 adults, both males and females with age range of 18-60 years, of which 50 were healthy subjects and 50 adult hospitalised cirrhotic patients were selected purposively for the study according to selection crieteria. Fasting serum zinc level was measured with atomic absorption spectrophotometer. Serum zinc level was found to be low in 72% patients. Mean ±SD of serum zinc levels (μg/L) were 610.32 ± 169.60 and 827.66 ± 267.32 in cases and controls respectively. In cirrhotic patients serum zinc level was significantly lower than that of healthy controls (P<0.001). Though, it is difficult to draw any definite conclusion from this study, because of reduced level serum of zinc found in cirrhotics, Zn may be supplemented to them with a hope of better treatment response.

Serum and Erythrocyte Magnesium levels in Offsprings of Essential Hypertensive Parents.

Hypertension is an important public health challenge worldwide, 95% of which are primary or essential hypertension, where the exact causes are not known. It has been thought that magnesium level has an association with hypertension and plays role in the pathogenesis of essential hypertension. Several evidences suggested that decreased magnesium level may be a significant modifiable risk factor for developing essential hypertension. To explore the relationship between serum and erythrocyte magnesium level with blood pressure, this case control study was carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), during the year 2006. Thirty offsprings of essential hypertensive parents were taken as cases and 30 age and sex-matched offsprings of normotensive parents were taken as controls. Serum & erythrocyte magnesium were measured by colorimetric Calmagite method. Significantly lower serum magnesium level (mg/dl) was found in cases than that of controls (1.90±0.210 vs 2.13±0.366, p<0.01) and erythrocyte magnesium (mg/dl) was also found to be lower in cases when compared with that of controls (4.46±0.699 vs 5.43±0.775, p<0.001). Mean systolic and diastolic blood pressure were found to be significantly higher (p<0.01) in cases as compared to controls. Though it is difficult to draw any definite conclusion, it may be assumed that, a hereditary predisposition to hypertension may be related to magnesium metabolism and magnesium deficiency might have a role in the future development of hypertension in the offsprings of essential hypertensive parents.

Role of Serum Total PSA (Prostate Specific Antigen) and Free to Total PSA Ratio in the Diagnosis of Carcinoma Prostate.

The objective of the study was to evaluate and compare the role of total and free/total ratio of serum prostate specific antigen level in diagnosing carcinoma prostate. A cross sectional study was conducted at the Department of Biochemistry, Dhaka Medical College (DMC) with collaboration of the Department of Urology, Dhaka Medical College Hospital (DMCH), Dhaka from July 2008 to June 2009. This study was carried out on 60 patients above 50 years of age who attended the Department of Urology, Dhaka Medical College Hospital, complaining of irritative or obstructive lower urinary tract symptoms (LUTS) suspected as clinically benign prostatic hyperplasia (BPH) or cancer prostate. It was aimed to assess the role of total and free/total ratio of serum PSA in diagnosis of BPH and carcinoma prostate with reference to histological diagnosis. All the cases were evaluated by history, physical examination including digital rectal examination, serum prostate specific antigen level, transabdominal/ trans-rectal ultra- sonogram. From all patients, blood sample were collected before digital rectal examination or any per urethral manipulation. Final diagnosis was obtained by histo-pathological examination, specimen being obtained by perrectal biopsy with biopsy-gun. Histopathological examination detected prostate cancer in 20 out of 60 patient and 17 of these Cap 20 have a total PSA 4 ng/ml and only 3 have total PSA 4 ng/ml. 18 of these 20 have free to total ratio 0.16 and 02 have f/t ratio 0.16. Among 60 patients, 40 patients were detected BPH on histopathological diagnosis. 20 of these BPH patient have tPSA 4 ng/ml and 20 of BPH have tPSA 4 ng/ml. 38 of 40 BPH patient have f/t ratio>0.16 and 2 of 40 patient are f/t ratio 0.16. Receiver operating characteristic analysis indicated a threshold f/t ratio 0.16 was optimum discriminatory level. The sensitivity of total serum PSA (at cut off value of>4 ng/ml) in correctly differentiating prostatic carcinoma of those who have the condition is 85%, while the specificity of the test in correctly detecting those who do not have the disease is 50%. The PPV is 45.9%, NPV is 87% and accuracy is 61.7%. The sensitivity of free/total serum PSA (at cut off value of 0.16 ng/ml) in correctly differentiating prostatic carcinoma from BPH is 90%, while the specificity of the test in correctly detecting those who do not have prostatic carcinoma is 95%. The PPV of the test is 90% and the NPV of the test is 95%. The overall accuracy of the test is 93.3%. This study showed significant difference of total and free/total ratio of serum prostate specific antigen (PSA) in differentiating benign prostatic hyperplasia (BPH) from carcinoma prostate. Receiver operating characteristic curves showed advantage for the f/t PSA ratio when compared with total PSA in detecting prostate cancer. From the study it may be concluded that total and f/t ratio of prostate specific antigen (PSA) is a useful marker in diagnosis of carcinoma prostate. Free/total ratio is more accurate than total PSA.

Cystatin C: A Better Predictor of Kidney Function in Diabetic Patients .

Serum cystatin C is a new promising marker of renal function. The aim of this study was to analyze serum cystatin C as a better predictor of renal function in diabetic nephropathy. In 60 diagnosed diabetic patients, serum cystatin C and serum creatinine were assessed. Glomerular filtration rate was estimated based on the cystatin C concentration according to Cockcroft- Gault formula and based on serum creatinine concentration according to Larsson formula. DTPA-GFR (Diethylenetriamene pentaacetate Renogram) was done as reference standard. The cross tabulation of DTPA-GFR was done with eGFR- creatinine and eGFRcystatin C. The calculated sensitivity, specificity and accuracy of eGFR- creatinine were 85%, 87.2% and 85% respectively. The eGFR- cystatin C showed higher sensitivity, specificity and accuracy than eGFR- creatinine in studied diabetic subjects. The cystatin C showed more significant correlation, r=0.78, p<0.001 than serum creatinine, r=0.59, p<0.001 with DTPA-GFR in diabetic patients. This study demonstrates that serum cystatin C may be used for early prediction for renal function impairment in diabetic kidney disease.

Serum Levels of Zinc and Magnesium in Newly Diagnosed Type-2 Diabetic Subjects.

Diabetes mellitus is a chronic metabolic disorder which affects carbohydrate, lipid and protein metabolism. There is a strong relation between some specific oligoelements and diabetes mellitus. The study was undertaken to determine serum levels of zinc and magnesium in 60 newly diagnosed uncomplicated type 2 diabetic (group I) and 60 healthy non-diabetic subjects (group II). Serum zinc and magnesium were estimated by Atomic Absorption Spectrophotometer (AAS). The serum zinc and magnesium levels were (72.70±8.43 μg/dl) and (1.85±0.17 mg/dl) respectively in group-1 and (75.92±8.20 μg/dl) and (2.00±0.17 mg/dl) respectively in group-11. The levels were significantly decreased in group-1. Study showed that type 2 diabetes mellitus can result in changes in zinc and magnesium levels and supplementation of both zinc and magnesium may be considered in those cases.

FVC, FEV, and FEV, FVC% in Type 2 Diabetes and Their Relationships with Duration of the Disease.

Background: Diabetes mellitus is a chronic debilitating disease affecting various organs including lungs. The magnitude of the complications of this disease is related to its duration. Objective: To observe FVC, FEV1 and FEV1/FVC% in type 2 diabetic patients and their relationship with duration of the disease. Methods: This cross-sectional study was carried out in the Department of Physiology, BSMMU, Dhaka, from July 2007 to June 2008 on 60 type 2 diabetic male patients of age 40-60 years (Group B). For comparison, 30 age and BMI matched apparently healthy non diabetic subjects (Group A) were also studied. Patients were selected from the out patient department of Bangladesh Institute of research on diabetes, endocrine and metabolic diseases. Based on duration of diabetes, diabetic patients were divided into B1 (5-10 years) and B2 (10-20 years). FVC, FEV1 and FEV1/FVC% of all the subjects were measured by a digital microspirometer . Data were analyzed by One way ANOVA test, Unpaired Student’s ‘t’ test and Pearson’s correlation coefficient test as applicable. Results: Mean of the percentage of the predicted values of FVC and FEV1, were significantly (p<0.001) lower in both those of Gr. B1and B2 than that in A and were also significantly (p<0.001) lower in Gr. B2 when compared with Gr. B1. Again, FEV1/FVC% was significantly (p<0.01)higher in Gr. B2 than those in Gr. B1 and A whereas this value was lower in Gr. B1than those of group A but it was not statistically significant. However, FVC and FEV1 showed negative and FEV1/FVC% showed positive correlations with duration of diabetes. All these correlations were statistically non significant. Conclusion: From the result of this study it can be concluded that the ventilatory function of lung may be reduced in type 2 diabetes which may be related to the duration of the disease.

Serum Zinc and Copper in Iron Deficient Adolescents.

Background: Adolescents are vulnerable to iron deficiency. Deficiency of iron may be associated with deficiency of zinc and high copper level. Objectives: To observe serum zinc and copper status in iron deficient anemic adolescents. Methods: This observational study was conducted in the Department of Physiology, BSMMU, between January and December 2007. For this, total 60 adolescents of both sexes aged 11-18 years were selected. Of them,on the basis of hemoglobin and serum Ferrtin level 15 iron deficient male adolescents (Hb<13g/dl, SF<30ìg/L) and 15 iron deficient female adolescents (Hb<11.5g/dl, SF<22ìg/L)were included into study group as group B1and B2 respectively. Age and sex matched apparently healthy 15 male and 15 female subjects without iron deficiency were taken as control(group A1, A2). Serum zinc and copper status were assessed by measuring serum zinc and copper levels by atomic absorption spectrophotometric method and | serum ferritin and serum iron levels by micro particle enzyme immunoassay method. Data were analyzed by un paired student t test. Results: In both male and female iron deficient adolescents, mean serum zinc level was significantly (p<0.01) lower and serum copper level was significantly higher(p<0.01) than those of their respective healthy control. No statistically significant differences of these values were observed between A1 vs A2 and B1 vs B2. In this study, hypozincemia and hypercupremia were observed in both male and female iron deficient adolescents Conclusion: Therefore, from this study concludes that deficiency of iron may be associated with hypozincemia and hypercupremia in anemic adolescents and the supplementation of zinc along with iron is suggested for the correction of iron deficiency anemia especially in adolescents when their metabolic demand is high.

Glucose-6-Phosphate Dehydrogenase (G6PD) Status in Neonatal Jaundice and Its Relationship with Severity of Hyperbilirubinemia.

Background: G6PD deficiency is one of the common inherited enzymatic disorder associated with high incidence of severe neonatal hyperbilirubinemia. Objectives: To observe G6PD status in male, term neonates with jaundice and its correlation with serum level of bilirubin. Methods: This cross sectional study was conducted on 90 male, term neonates with jaundice, age ranged from 3 to 12 days (Group B) in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) between July 2007 to June 2008. On the basis of total serum bilirubin (TSB) level, study group was further divided into B1(TSB <15mg/dl), B2(TSB 15-20mg/dl) and B3 (TSB>20mg/dl). For comparison age and sex matched 30 apparently healthy neonates (Group A) were also included in the study. Erythrocyte G6PD level was measured by Spectrophotometric method by using kit of Randox. Serum bilirubin level was measured by standard laboratory technique. For statistical analysis ANOVA, independent sample “t” test and Pearson’s correlation coefficient test were performed as applicable by using SPSS windows version-12. Results: In this study, erythrocyte G6PD levels were significantly lower in moderate (p<0.01) and severe (p<0.001) hyperbilirubinemic group in comparison to that of control group . However, this enzyme level was lower in mild group compared to that of control but the difference was statistically non significant. Again, this enzyme levels were significantly lower in moderate (p<0.05) and severe (p<0.01) group than that of mild group and also between severe and moderate hyperbilirubinemic group (p<0.05). In this study, G6PD enzyme deficient were found in 1(3.33%) and 6(20%) subjects of group B2 and B3 respectively. Though, percentage of the subjects with enzyme deficiency were higher in severe group ( B3 ) compared to that of moderate group( B2 ) but the difference was statistically not significant. However, no enzyme deficient patient were found in control group (A) and mild hyperbilirubinemic group (B1). Serum bilirubin level showed significant (p<0.05) positive (r=+.429) correlation with erythrocyte G6PD level in control group (A). On the other hand, this level was negatively correlated with G6PD enzyme in groups B1 (r= -.127), B2 (r=-.120) and B3( r= -.671) but significant negative correlation in group B3 (p<0.01). Conclusion: The results of the study revealed that severity of hyperbilirubinemia depends on degree of G6PD deficiency. Therefore, early detection of this enzymopathy and close surveillance of the affected neonates may be important in reducing the complications of severe hyperbilirubinemia.

Heart Rate Variability in Hyperthyroidism.

Background: Hyperthyroidism is associated with altered cardiac autonomic nervous activity (CANA). Heart Rate Variability (HRV) analysis is a promising technique to quantify CANA and therefore can be done in hyperthyroidism. Objective: To observe the HRV parameters in patients with hyperthyroidism to find out the influence of excess thyroid hormone on cardiac autonomic nervous activities. Method: The cross sectional study was carried out on 60 hyperthyroid patients (groupB)aged 30-50 years in the Department of Physiology, BSMMU, Dhaka from 1st July 2007 to 30th June 2008. Age and sex matched 20 apparently healthy euthyroids were also studied for comparison (group A). On the basis of treatment, they were further divided into group B1 consisting of 30 untreated newly diagnosed patients and group B2 consisting of 30 hyperthyroid patients treated with antithyroid drugs for at least 2 months. The patients were selected from the Out Patient Department of Endocrinology, BSMMU, Dhaka. To assess thyroid status, serum TSH and serum FT4 levels were measured by AxSym system and time domain measures of HRV such as mean R-R interval, mean heart rate, SDNN and RMSSD were assessed from 5minute(short term) ECG recording by a polygraph. For statistical analysis Mann-Whitney U test was done. Results: Mean R-R interval was significantly (P<0.001) lower but mean heart rate was significantly (P<0.001) higher in untreated patients than those of treated and euthyroids subjects. These values were found almost similar when compared between euthyroids and treated hyperthyroids. Similarly SDNN and RMSSD were significantly lower in untreated hyperthyroids than both euthyroids (P<0.001) and treated hyperthyroids (P<0.01). Conclusion: This study concluded that decreased vagal modulation on heart rate may occur in hyperthyroidism, which may be restored following adequate treatment of the disease.

Power Spectral Analysis of Heart Rate Variability in Adolescent Male Athletes.

Background: Cardiac autonomic nervous activities (CANA) deteriorate with age, obesity, sedentary life style and in various cardiac and noncardiac disease conditions. Regular physical exercise may improve CANA in health and diseases. Power spectral analysis (PSA) of Heart rate variability (HRV) is one of the most promising newer techniques to quantify CANA. Objective: To analyze HRV by Power Spectral method in order to find out the influence of regular physical exercise on CANA in male adolescent athletes. Method: This cross sectional study was carried out on 62 adolescent male athletes aged 12-18 years (group B), in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University from 1st July 2007 to 30th June 2008. For comparison, 30 age, sex, BMI and socioeconomic condition matched apparently healthy sedentary subjects (group A) were also studied. The study subjects were selected from the BKSP (Bangladesh Krira Shikka Prothistan, Savar, Dhaka) and the control from a residential school of Dhaka city.Power spectral measures of HRV including Total Power (TP), Very Low Frequency Power (VLF) Low Frequency(LF), High Frequency (HF) LF/HF were measured by a Polygraph . For statistical analysis, Idependent-Sample t-test was used. Results: Total power, HFnu power and the VLF,LF,HF were significantly (P<0.001) higher and LFnu power and the LF/HF ratio were significantly (P<0.001) lower in athletes than those of nonathletes which indicate higher cardiac parasympathetic and lower sympathetic activity in athletes. Conclusion: Cardiac Autonomic regulation with increased parasympathetic and decreased sympathetic modulation may occur with in athletes engaged with regular physical exercise.

Parasympathetic Nerve Function Status in Postmenopausal Women.

Background: In postmenopausal women, the risk of cardiovascular diseases gradually increases and alterations in autonomic nerve functions commonly affect cardiac vagal control. Objective: To observe some aspects of parasympathetic nerve function status in apparently healthy post menopausal women. Method: This cross sectional study was carried out in the Department of Physiology Bangabandhu Sheikh Mujib Medical University. In this study, 30 postmenopausal women with age 45 to 60 years were included in group B (study group) and 30 premenopausal women aged 20 to 30 years were taken in group A (control group). They were further divided into group A1(menstrual),A2(follicular), A3(luteal) according to phases of menstrual cycle during which they were studied. Serum estrogen and progesterone levels were measured in postmenopausal women and also during follicular and luteal phases in premenopausal women and were estimated by MEIA technique. To assess parasympathetic nerve function status, three noninvasive cardiovascular reflex tests such as heart rate response to valsalva maneuver, heart rate response to deep breathing and heart rate response to standing were performed in all the subjects. Data were collected by recording ECG in resting conditions. For statistical analysis, unpaired t test and multiple regression analysis was used. Results: In postmenopausal women, serum estrogen and progesterone levels were significantly (p<0.001) lower compared to those of follicular and luteal phases of premenopausal women except progesterone level during follicular phase which was though lower but not statistically significant. Heart rate response to valsalva maneuver were almost similar in all the groups.Heart rate response to deep breathing and heart rate response to standing were significantly lower in group B than those of group A1, A2 and A3 respectively. On regression analysis parasympathetic nerve function in post postmenopausal women showed significant association with estrogen level. Conclusion: From this study it may be concluded that parasympathetic nerve function was lower in postmenopausal women, which may be related to decreased level of estrogen.

FVC, FEV1 and FEV1/FVC%, In Postmenopausal Women and Their Relationship with Serum Progesterone and Estrogen Level.

Background: Exacerbation of asthma associated with worsening of lung function has been reported in women after menopause. The relationship between lung function and female sex hormones has been documented in postmenopausal women. Objective: To observe FVC, FEV1 , FEV1/FVC%, serum estrogen and progesterone levels in apparently healthy postmenopausal women to find out their interrelationships. Methods: This cross sectional study was carried out in the Department of Physiology, from 1st January 17to 31st December 2007 in BSMMU, Dhaka. 30 postmenopausal women aged 45 to 60 years and 30 premenopausal women aged 20 to 30 years during different phases of menstrual cycle were studied. FVC, FEV1and FEV1/FVC%, were measured by RMS computer based Spirometer. 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 FVC and FEV1 were significantly (p<.001) lower in postmenopausal women compared to those of follicular and luteal phases of premenopausal women. Mean serum estrogen and progesterone levels were significantly lower in postmenopausal women compared to any phases of menstrual cycle of premenopausal women. In postmenopausal women, FVC, FEV1 showed positive correlation with progesterone but negative with estrogen level.FEV1/ FVC% Showed negative correlation with both serum estrogen and progesterone level. All these correlations were statistically non significant. In premenopausal women FEV1 and FEV1/FVC% showed positive correlation and FVC showed negative correlation with serum estrogen level in follicular phase and FVC, FEV1 showed positive and FEV1/FVC% showed negative correlation with serum estrogen level in luteal phase. Again FVC, FEV1 and FEV1/FVC% showed positive correlation with serum progesterone level in follicular and luteal phases of menustrual cycle. Conclusion: The out come of this study shows FVC, FEV1 may be reduced in postmenopausal women which in turn may be associated with low progesterone and estrogen levels.

Evaluation of FVC, FEV1, FEV1/ FVC % in Patients with Chronic Arsenicosis.

Background: Arsenic toxicity from ground water contamination is highly focused public health problem in Bangladesh. Consumption of arsenic contaminated water may be associated with respiratory symptoms and can decrease lung functions along with skin lesion. Proper investigation of this problem is crucial to prevent respiratory complications in these arsenic vulnerable populations. Objectives: FVC, FEV1, FEV1/ FVC % were studied in chronic arsenicosis patients with skin lesion from arsenic exposed area to observe their lung function status. In addition, correlations of these lung function parameters with arsenic concentration in drinking water and duration of consumption were also studied in this group of population. Study design: For this, total 80 subjects age ranged from 20-50 years of both sexes were included. Among them 40 were patients of chronic arsenicosis with skin lesion and were taken in study group and age and sex matched 40 apparently healthy subjects residing in the same arsenic contaminated area but without skin lesion, were designated as control group. Methods: This study was carried out in the department of Physiology, BSMMU from July 2005 to June 2006. FVC, FEV1 and FEV1/FVC % were measured by Digital Spirometer. Arsenic level of the tubewell water was determined by Hybrid Generation Atomic Absorbance Spectrophotometer. Data were analyzed statistically by Chi- square test, Student’s unpaired “t” test and Pearson’s correlation coefficient test as applicable. Results: The mean percentage of predicted values of FVC, FEV1 in exposed non-arsenicosis subjects were within normal ranges. Again they were significantly lower in chronic arsenicosis patients. There was no significant difference in FEV1/FVC% between the two groups. FVC and FEV1 were negatively correlated with arsenic concentration in tube well water in both groups. But FEV1/FVC% was negatively correlated in exposed nonarsenicosis subjects and positively correlated in arsenicosis patients. Again, with duration of consumption of arsenic contaminated tube well water, FVC was positively and FEV1/FVC% was negatively correlated in both exposed non arsenicosis and chronic arsenicosis patients. But FEV1 was negatively correlated in non arsenicosis and positively correlated in chronic arsenicosis patients. But all the relationships were not statistically significant. Conclusion: Therefore, the result of the present study reveals that arsenicosis patients are suffering from respiratory insufficiency. In addition, populations consuming higher arsenic concentration in drinking water are at the risk of lung function impairment and ultimately may lead to respiratory disorder.

Effect of Ocimum Sanctum Linn (Tulsi) on body weight and some biochemical parameters in restraint stressed albino rats.

Background: With the increased trend of urbanization of our society, the incidence of various stress related diseases are increasing day by day. People under chronic stress often tends to seek relief through drugs, which may have side effects. But some natural supplements called adaptogen, can be more beneficial in reducing symptoms of stress. Objective: The present animal model experimental study was designed to observe the effects of restraint stress on body weight, serum ALT, AST, Glucose, Cholesterol and their modifications by Ocimum sanctum Linn (tulsi) pretreatment which is an Ayurvedic adaptogen and has a long history of therapeutic use. Study design: For this purpose, 30 albino rats aged 90 to 120 days were included in this study. Twenty rats of experimental group were further subdivided into two groups. One group consisted of 10 rats exposed to one hour restraint stress daily for 7 days and 10 rats of the second group were pretreated with tulsi for 7 days before exposure to stress in the same way. 10 non stressed , non pretreated rats were taken into control group.This study was undertaken in the laboratory of the Department of Physiology,BSMMU during the period from July 2003 to June 2004. Methods: The body weight of all control rats were recorded daily in the morning. Body weight of the experimental rats were recorded just before exposure to stress. After completing the experiment , the animals were sacrificed and blood was collected . Serum glucose, cholesterol and ALT,ASTwere determined by standard laboratory technique. Data were compared among the groups and the results were statistically analyzed using unpaired student t’ test. Results : The body weight in untreated stressed group was significantly lower (p<0.001) than those of the control group and tulsi pretreated group. Serum levels of glucose, cholesterol, aminotrasferases (ALT and AST) were significantly higher (p<0.001) in stressed group than those of control . Again in Tulsi treated group all these biochemical parameters were significantly lower (p<0.001) than those of stressed group. This restraint stress-induced changes in body weight and biochemical parameters may be due to hypophagia, altered secretion of various metabolic hormones and neurotransmitters, changes in membrane permeability & hypovolaemia resulting from stress induced secretion of corticosterone and epinephrine through hypothalamo-pituitary adrenal axis activation. Conclusion: Prevention of stress induced changes in biochemical parameter by tulsi pre treatment indicates its anti stressor effect.

Evaluation of Parasympathetic Nerve Function Status in Healthy Elderly Subjects.

Background: Autonomic control on cardiovascular activity is modified with age. Impaired autonomic nerve functions are common features of patients suffering from cardiovascular diseases particularly in old age. Objective: To observe the influence of aging process on parasympathetic nerve function. Study design: This observational study was conducted in the Department of Physiology, BSMMU, Dhaka during the period of July 2005 to June 2006. For this purpose, 60 apparently healthy elderly subjects of both sexes were selected as study group and divided into two groups-one group consisted of 30 elderly subjects with age ranged from 51-60 years and another group consisted of 30 elderly subjects with age ranged from 61-70 years. Thirty sex and BMI matched healthy adults with age ranged from 21-30 years were studied as control. Methods: Parasympathetic nerve function status of all the subjects were assessed by three simple non-invasive cardiovascular reflex tests. These were heart rate response to valsalva maneuver, heart rate response to deep breathing and heart rate response to standing (30th:15th ). For statistical analysis one way ANOVA (Post Hoc Test) and the Pearson’s correlation co-efficient tests were done. Results: Mean (± SD) of valsalva ratio were 1.50±0.23, 1.32±0.14 and 1.28±0.15; HR response to deep breathing test were 25.36±3.90, 18.82±3.35 and 15.96±3.54 beats/min; 30th:15th ratio in standing test were 1.100.06, 1.05±0.03 and 1.04±0.02 in 21- 30, 51-60 and 61-70 years age groups respectively. All the 3 parameters were significantly lower in both elderly groups compared to that of control adults (p<0.001) Again, HR response to deep breathing was significantly lower in 61-70 years age group compared to that of 51-60 years age group. Valsalva ratio and 30th:15th ratio were also lower in 61-70 years age group than that of 51-60 years group but the differences were not statistically significant. All the 3 parameters were negatively correlated with age which were statistically significant. Conclusion: From this study it may concluded that aging process substantially impaired cardiovascular parasympathetic nerve functions.

Relationship of Forced Vital Capacity (FVC), Forced Expiratory Volume in First Second (FEV1)and FEV1/FVC% with Plasma Progesterone Level during Different Phases of Normal Menstrual Cycle.

The present study was carried out to observe the correlation of some lung function parameters with the endogenous plasma progesterone level during different phases of menstrual cycle. The study was conducted on 30 healthy young female volunteers with age range of 20-25 years in the department of Physiology of BSMMU, Dhaka, during July 2005- June 2006. All the subjects were studied in 3 phases of menstrual cycle for 2 consecutive cycles. FVC, FEV1 , FEV1/FVC% for assessing lung function and plasma Progesterone level during each phase of menstrual cycle were measured by a portable spirometer and by ELIZA method in auto analyzer respectively. Comparison of the values between different phases were done by paired ‘t’ test considering menstrual phase data as baseline due to negligible amount of progesterone detected in this phase. Correlation of FVC , FEV1 and FEV1/FVC%with Progesterone level in each 3 phases were analyzed by Pearson’s correlation– coefficient test. Plasma progesterone level was much higher during luteal phase compared to those of follicular phases of both cycles (24.54ng/ml vs1.41 ng/ml; 26.56 ng/ml vs. 1.48 ng/ml). Both FVC and FEV1 were significantly higher (p<0.001) during luteal phase than those of follicular phases in both the cycles. FVC, FEV1 and FEV1/FVC%were positively correlated with plasma progesterone level but these relationships had failed to show any statistical significance. Similar to others, this study also observed increased ventilation and high endogenous progesterone level during luteal phase. Therefore increased ventilation might be related to high progesterone level during luteal phase owing to increased inspiratory muscle endurance and bronchial relaxation effect.