Effect of '61-points relaxation technique' on stress parameters in premenstrual syndrome.

Premenstrual Syndrome is a psychoneuroendocrine stress related disorder and more than 300 treatment modalities for PMS show that the existing remedies have not provided satisfactory help to relieve PMS. 61-points relaxation exercise (61-PR), a relatively less known hatha yoga technique, is a successful means of stress relaxation and is expected to relieve PMS as well. The present study was conducted on 50 clinically healthy women volunteers who were in their reproductive age group and in their premenstrual period, from which a control group (n = 20) and a PMS group (n = 30) based on the symptoms were identified. In both groups basal heart rate (HR/min), systolic (SBP; mmHg) and diastolic blood pressure (DBP; mmHg), electromyogram (EMG; mV), electrodermal galvanic activity (EDG; microv), respiratory rate (RR/min) and peripheral temperature (T; degrees F) were recorded and the subjects were taken through a guided 61-PR. The symptoms and parameters were re-recorded after the 61-PR. In control group, the basal HR was 82.06 +/- 8.07, SBP 111.95 +/- 8.23, DBP 76.8 +/- 6.42, EMG 4.08 +/- 2.99, EDG 9.77 +/- 3.29, RR 15.60 +/- 3.77 and T was 97.86 +/- 0.63. After 10 minutes of 61-PR, HR (77.27 +/-10.85, P < 0.05), SBP (107.35 +/- 7.41, P < 0.05), DBP (75.25 +/-7.57, P < 0.05), EMG (2.07 +/- 1.90, P < 0.05), EDG (8.06 +/- 2.87, P < 0.05), RR (16.00 +/- 4.12, P < 0.05) fell significantly and T (97.97 +/- 0.64, P > 0.05) rose significantly. In the PMS group, the basal HR was 90.61 +/- 8.46, SBP 122.5 +/- 11.52, DBP 83.53 +/- 8.26, EMG 5.79 +/-2.75, EDG 13.14 +/- 6.54, RR 19.13 +/- 3.76 and T was 93.43 -/+ 5.29. After 10 minutes of 61-PR, HR (75.58 +/- 10.11, P < 0.0001), SBP (114.53 +/- 9.70, p < 0.0001), DBP (77.46 +/- 8.68, P < 0.0001), EMG (2.56 +/- 1.77, P < 0.0001), EDG (10.64 +/- 5.72, P < 0.0001), and RR (16.13 +/- 3.76, P < 0.0001) declined to a much greater extent and T (93.49 +/- 5.28, P < 0.0001) rose more significantly. These results suggest a reduction in sympathetic activity by 61-PR, also the high basal sympathetic tone present in subjects of PMS group due to stress is considerably reduced by relaxation. 61-PR is effective in providing relief from PMS and may be a useful adjuvant to medical therapy of PMS and other stress disorders.

Salt preference: age and sex related variability.

Salt preference was assessed in 60 adults of 18-21 yrs of age (30 males and 30 females) and in 60 children of 7-12 yrs of age (30 boys and 30 girls). Subjects rated the preference on Likert scale for popcorns of five salt concentrations (OM, 1M, 2M, 3M and +3M). Statistical analysis using Two way ANOVA revealed statistically significant effect of age and sex on salt preference (F4,100 = 15.027, P < 0.01) and One Way ANOVA revealed statistically significant sex difference in salt preference of adults (F4,50 = 16.26, P < 0.01) but no statistically significant sex difference in salt preference of children (F4,50 = 4.08, P > 0.05). Dietary experiences during development and more physical activity in children may be responsible for higher salt preference in children while finding no sex variability in children favours the role of sex hormones in salt preference of male and females.

Arginine vasopressin as a neurotransmitter in brain.

Arginine vasopressin (AVP) which exerts diverse biological effects in mammals is no more restricted to the posterior pituitary. Neurons containing AVP are seen in many other areas and in CNS vasopressinergic neurons are identified from the neocortex to the spinal cord. With the characterization of three different types of vasopressin receptor subtypes V1a, V1b and V2 responsible for its actions, their cloning and identification in different areas--especially in the brain many more hitherto unknown functions of AVP in brain has come to light. Added to this is the recently available specific vasopressin receptor antagonists. At present AVP seems to be involved in memory retrieval, learning, circadian time keeping, modulating the actions of area postrema and many other functions in brain. In the suprachiasmatic nuclei (SCN)--the biological clock--an area of the brain where the role of VP is still not very clear, VP is found to participate not only in transmitting the circadian rhythms to the rest of the brain but also serves the function of synchronizing and amplifying the pacemaker output of SCN. AVP can act not only as a neurotransmitter but also can stimulate the production of chemicals/neurotransmitters and thereby act as a mediator. It may be concluded that there is a central vasopressinergic system which participates in a variety of physiological and behavioral functions of brain.

Assessment of pulmonary functions in young adults--three cross-sectional studies.

This study reports the results of 3 cross-sectional surveys and demonstrates a birth cohort effect for pulmonary functions in students admitted to our Institute in 1974, 1986 and 1991. Improvement in height, weight and haemoglobin of students was accompanied with improvement in ventilatory (FVC, FEV1/FVC%,FEF25-75%) as well as diffusion functions (TLCO(SB), Dm, VC), specially in Group 2 and 3. Study of some vital statistics of state of Haryana from 1974 to 1992 significantly visualizes this period as period of green revolution and industrialization of the state. These quantitative indices are responsible for improvement of physical parameters and pulmonary functions of younger subjects. It is concluded that in view of the expected improvement in socio-economical status of developing countries and health of their individuals, physical and functional norms reported by different laboratories must be periodically reviewed.

Pulmonary functions in healthy females of Haryana.

Pulmonary functions including lung volumes and pulmonary diffusing capacity were assessed in 137 healthy female subjects, 18-52 years of age. The results were analysed by age-wise division of subjects in six groups. It was observed that there were wide variations in pulmonary function values from one individual to another depending upon age and height of the subjects. Majority of ventilatory functions attained maximum values by the age of 25 years while diffusion functions improved upto 35 years of age. Pulmonary functions showed better correlation with age and height as compared to weight. Taking into consideration age and height of subjects, regression equations for different pulmonary functions have been derived for female subjects.

Ventilatory lung function tests in school children of 6-13 years.

Spirometry was performed in 186 healthy school children, 6-13 years of age, selected from urban population of Rohtak city (India), to derive the regression equation for prediction of normal value of ventilatory lung function in this age group. Values of lung functions in the present study are well comparable to other North Indian studies and Western reports, but higher than the South Indian children. Lung functions have shown better linear correlation with age and height as compared to weight. Comparison of ventilatory function tests in boys and girls showed statistically higher FVC, FEV1, PEFR, FEF25% and MVV in boys, while FEF50% FEF75% and FEF75-85% were statistically higher in girls in different age groups. No specific pattern of variation in lung function tests was observed with sex. Regression equations for different ventilatory functions have been derived for either sex with the best possible combination of physical parameters.

Comparison of single breath and steady state methods for measurement of lung transfer factor for CO in normal subjects and smokers.

Pulmonary diffusing capacity (lung transfer factor for carbon monoxide) has been assessed by the single breath (TLCOSB) and steady state (TLCOSS) techniques in well matched 90 females, 31 non-smoker and 29 smoker males, 18-50 years of age. Both TLCOSB and TLCOSS are significantly lower in females compared to non-smoker males (P < 0.001). Tobacco smoking statistically significantly reduces TLCOSB as well as TLCOSS in smokers as compared to non-smokers. There is a statistically significant correlation of age with TLCOSS and TLCOSB in all the three groups (r = -0.702, -0.360 and 0.300 for TLCOSB and r = -0.481, -0.355 and 0.380 for TLCOSS in non-smoker males, smoker males and females respectively). TLCOSB is 30.43 +/- 4.89, 27.29 +/- 4.54 and 26.13 +/- 3.60 ml/mmHg/min, while TLCOSS is 19.47 +/- 5.26, 16.69 +/- 3.27 and 18.24 +/- 3.78 ml/mm/Hg/min in non-smoker males, smoker males and females respectively. A fairly good correlation between the TLCOSB and TLCOSS in male, both non-smoker and smoker, as well as the female subjects was observed. TLCOSS is lower than TLCOSB in all the three groups. Even in smokers of moderate intensity both of these tests are influenced to a nearly similar extent.

Cardiovascular response to orthostatic stress following cold challenge in diabetics.

Cardiovascular responses to cold pressor test (CPT) followed by orthostatic stress were investigated in diabetics and in control subjects. The test was performed by immersing the left hand (up to wrist joint) in water at 8 degrees C for 2 minutes. The blood pressure (BP) and heart rate (HR) were recorded immediately after removal of hand from water in recumbent state and then in erect posture. The orthostatic stress (without cold exposure) caused postural hypotension in diabetics, while in control subjects BP (both systolic and diastolic) increased on attaining erect posture. CPT alone increased HR, systolic blood pressure (SBP) and diastolic blood pressure (DBP) in control as well as in diabetics. In control subjects when CPT was followed by orthostatic stress, a marked statistically significant further increase in HR but fall in SBP was observed, though the increase in DBP was not significant. On the other hand statistically significant increase in HR, and decrease in SBP, DBP were observed in diabetic subjects. These impairments in cardiovascular responses are confirmative of autonomic neuropathy in diabetic subjects.

Transfer lung factor for Co (TLCO) and its components (DM & VC) in flour mill workers.

Tlco, Kco (Tlco/Va), Va, Vc and Dm were measured in 25 flour mill workers (non-smoker 9, smoker 16) and 50 healthy control subjects (25 non-smoker, 25 smoker) of similar anthropometric parameters and socio-economic status. Tlco (P < 0.05) was decreased significantly and rest of the parameters were decreased insignificantly in flour mill workers as compared to control subjects. In non-smoker flour mill workers none of the parameters altered significantly as compared to non-smoker control subjects. Statistically significant reduction was seen in smoker workers only in Tlco (P < 0.05) and its component Dm (P < 0.05) as compared to smoker control subjects. Further it has been observed that less duration of flour dust exposure (< 5 years) in all flour mill workers and smoker flour mill workers caused negligible fall in Tlco, whereas longer duration of flour dust exposure (> 5 years) in both the groups caused highly significant fall in Tlco (P < 0.01) which was contributed to by highly significant fall in Dm (P < 0.001).

Effect of treatment on pulmonary functions in chronic severe anaemia.

Pulmonary functions were measured in 15 patients with severe chronic anaemia (haemoglobin level < 5 g/dl). The measurements were repeated after correction of anaemia (Hb > 10 g/dl). Twenty age and sex matched, asymptomatic, non-smoker subjects served as controls. There was 80-100% improvement in various lung functions after correction of anaemia. Effort dependent parameters, viz FVC, ERV, IC, MVV were low in anaemic patients which improved with the rise of haemoglobin. The TLCO, DM, VC, KCO were not significantly influenced during anaemic state. FEV1, PEFR, RV/TLC were essentially normal. We conclude that the observed changes produced in lung functions during anaemic state are fully reversible after its correction.

Effect of growth on lung transfer factor and its components.

Measurement of lung transfer factor for CO (TLCO) and its constituent components, viz. diffusion capacity across alveolar capillary membrane (Dm) and instant pulmonary capillary blood volume (Vc) were undertaken in 120 healthy non-smoker males by single breath technique. All the three parameters (TLCO, Dm, Vc) showed direct negative correlation with age. While TLCO and Dm showed a significant direct positive correlation with height, there was no correlation between VC and height. The degree of correlation increased when both age and height were used together than either of them alone for prediction of TLCO120. The prediction formulae (TLCO120 = 3.8 + 21 H (m)-0.308 A) using both age and height has regression value (R) of 0.6479 (p < 0.001).

Lung transfer components in hyperthyroidism.

Pulmonary functions were studied in twenty hyperthyroid non smoker patients. Their FVC, PEFR and MVV were significantly lowered while FEV1/FVC% and EFR25-75% were normal. Amongst the diffusion functions, Tlco, Dm and VA were reduced and VC increased, though these changes were not statistically significant. After the achievement of euthyroid state, statistically significant increase was seen in FVC, PEFR, MVV, Tlco120, Dm and VA with significant decrease in Vc from the basal levels. FEV1/FVC% and EFR25-75% were not affected. These observations suggest that the principal abnormalities in pulmonary functions in the hyperthyroid state are increased pulmonary capillary blood volume and respiratory myopathy, which are reversed as euthyroid state is achieved.

Effect of salbutamol on pulmonary diffusion functions in asymptomatic smokers.

Pulmonary functions including transfer factor for CO and its components (TIco, Dm, Vc) were studied in 45 asymptomatic subjects (25 smokers, 20 non smokers) using single breath technique. Ventilatory functions of smokers were significantly reduced; these improved significantly after salbutamol inhalation but most still remained lower than in non smokers. VA and Dm were marginally higher while Vc was significantly reduced in smokers. Their TIco1(20) was influenced only insignificantly. However, after salbutamol, both Dm and Vc were significantly lowered, resulting in further reduction (p 0.01) of TIco120 in smokers. The effect of salbutamol in non smokers was insignificant.

Effect of cold challenge on alveolar capillary blood volume in normal individuals.

The effect of immersion of both the hands and the feet in water at 10 degrees C on lung transfer factor for carbon monoxide (Tlco) and on pulmonary capillary blood volume (Vc) was investigated in 20 normal young adult males immediately, 60 min and 120 min after the end of the cold challenge. Vc was significantly reduced immediately and the reduction was aggravated at 60 min. Tlco was significantly reduced only at 60 min. All the values returned to baseline at 120 min. It is concluded that the cold-induced changes in Tlco and Vc are physiological responses and not unique to patients with Raynaud's phenomenon as suggested by some workers.

Autonomic reflexes in borderline hypertensives.

Autonomic reflexes were studied in 53 patients with borderline hypertension (BLH) and 25 normotensives. BLH patients had higher basal heart rate. With 2 minutes of sustained head-up passive tilt of 50 degrees or 75 degrees, the rise in heart rate was comparable in both groups but the rise in blood pressure was significantly more in the BLH group. The rise in systolic pressure with Valsalva manoeuvre as well as with sustained hand grip was significantly higher in BLH patients. The postural tachycardia index and Valsalva index were significantly lower in BLH patients probably due to higher basal heart rate.

Diurnal variations in lung transfer factor and its components.

Serial measurements of transfer factor of lung and its constituent components along with FVC and EFR25-75% were undertaken in 20 healthy nonsmoker adult males thrice on the same day. All the lung transfer components decreased as the day advanced, though reduction was statistically significant for Tlco and VA only. These changes were present in association with reduction in FVC and EFR25.75% indicating that patency of airways influences diffusion function of lung. Variations during the day are less than 7.4% and are hence unlikely to influence their diagnostic value, but serial estimation of these functions should preferably be carried out at the same time specially in the morning when these values are maximum.

Response of lung transfer components to grades of smoking.

Pulmonary functions were studied in 50 healthy, asymptomatic, 20 to 47 years, male smokers along with 50 healthy non-smokers matched for age, height, socio-economic status and physical activity. Smokers consumed 2-30 cigarettes per day with duration of smoking ranging from 2 to 26 years. In smokers FEF, V75. PEF and MVV were significantly reduced whereas FRC was increased significantly. Pulmonary diffusion function as assessed by TLCO showed significant reduction. While Vc showed progressive decrease with increasing duration and quantity of smoking, DM increased in the beginning but gradually declined later. TLCO showed a better negative correlation with quantity than with duration of smoking even when the effect of other factors was excluded. Decrease in TLCO is probably due to bronchoconstriction and reflex vasospasm of pulmonary vasculature. Co-efficient of diffusion KCO was also decreased in smokers.

Ventilatory and diffusion studies in smoker and non smoker flour-mill workers.

Various pulmonary function tests, FVC, FEV1/FVC%, PEFR, EFR25-75, MVV and Tlco were measured in 25 asymptomatic male flour mill workers and 50 healthy subjects not working at flour mill, to assess the effect of flour dust on lungs. All the subjects of different groups were well matched in their anthropometeric parameters and socio economic status. In smoker flour mill workers significant reduction was present in both ventilatory and diffusion functions of lungs, which was more pronounced in subjects who consumed larger quantity of tobacco and were exposed to flour dust for longer duration. On the other hand deterioration of pulmonary functions in non smoker flour mill workers was found to be statistically not significant. The relative strength of both the parameters viz tobacco and flour dust for impairment of pulmonary functions is discussed for being a pointer to further studies.

Pulmonary diffusion capacity for Co at varying alveolar oxygen tensions and different alveolar volumes.

In six healthy nonsmoker volunteers pulmonary diffusion capacity for Co (DLCO) was determined by single breath holding technique. Multiple measurements of DLCO were taken with PAO2 from 70 to 610 mm Hg, out of which at least 10 tests were performed between 100 to 140 mm Hg. A wide and non uniform inverse relationship was found between DLCO and PAO2 from 70 to 610 mm Hg. In narrow range of 100-140 mm Hg, a highly significant linear negative correlation was found. To find out corrected DLCO at PAO2 120 mm Hg, expressed as DLCO120, a correction factor of 0.45% for each mm Hg change in PAO2 should be applied to measured DLCO inversely. By regulating inspiratory volume, DLCO was studied at different alveolar volumes and there was a direct positive correlation between them. DLCO should be measured at maximum alveolar volume, as with one percent fall in VA there is 0.69% decrease in DLCO. This new method of expressing DLCO as DLCO120 at maximal effective alveolar volume will be more useful in studying the effects of factors affecting DLCO and for interlaboratory comparison.