ABSTRACT
Background: Prediabetes is the preceding stage of diabetes which puts an individual to induce complications same as that of diabetes; hence, it should be treated to prevent its progression to diabetes and other consequences. However, there is very less literature about impact of home-based physical therapy on glycemic control and quality of life in Indian prediabetic population. Aims and Objectives: The aims of this study were to evaluate whether the home-based physical therapy shows effect on glycemic control and individual’s quality of life after a 3-month intervention. Materials and Methods: The study was conducted on 55 individuals who were diagnosed with prediabetes (36 males and 19 females) on basis of HbA1c level ranging from 5.7% to 6.4%. A 12-week exercise protocol was made which includes warm up exercises, main exercise program (aerobic and strengthening training), and cool down exercises along with dietary changes. SF-36 and HbA1c level is taken at baseline and at the end of 12 weeks for quality of life and glycemic control measures in participants, respectively. Results: The difference in HbA1c levels before and after treatment was found to be statistically significant. The HbA1c levels after the 3-month intervention showed significant reduction (P < 0.008) along with significant difference in all domain of SF-36 except in domain 3 (role limitation due to emotional problem) and domain 6 (social functioning). Conclusion: The home-based physical therapy program is effective in glycemic control and quality of life in adults with prediabetes.
ABSTRACT
Background: Providing immediate feedback to students has shown improvement in students’ knowledge, understanding, and confidence as it helps in identifying lacunae and loopholes in learning process. Despite the usefulness of feedback, common complaint from students is that they usually do not receive feedback immediately in their learning process. We also face similar situation with our students in institute. The aim of this study was to find out effect of giving immediate feedback and explore the views of medical students on immediate feedback during formative assessment. Aims and Objectives: The aims of this study were to evaluate the effect of immediate feedback on the medical students’ learning in medical education. Materials and Methods: The study was conducted in Department of Physiology, GMERS Medical College, Valsad on 183 students of 1st MBBS after ethical approval. Two types of modules were prepared on using “Hot Potatoes” software version 6.3. Module-1: Test 1 without feedback: consist of 20 MCQs and Module-2: Test 2 with feedback: consist of 20 MCQs, provide immediate feedback for each option of MCQ. Two modules were given one by one on WhatsApp group on mobile phone. Reflection writing and feedback from students were taken after that. Results: The qualitative data collected provided important information about the immediate feedback. Feedback responses of students on the questionnaire were analyzed using Likert scale. The Likert scale values were in strongly agree/agree part for Module-2 (with feedback). The students believed that immediate feedback was very helpful in clearing concepts, finding out lacunae, improvement in confidence, and self-learning. An excellent way for self-assessment and improved their deeper understanding of content areas. The students enjoyed innovative way of learning compared to conventional learning. Conclusion: Immediate feedback using this type of feedback modules should be implemented to improve students’ knowledge, understanding, memory, and confidence and can be used as self-directed learning tool.
ABSTRACT
Background: Lockdown measures are being implemented in several parts of the world to control the spread of novel coronavirus. This unprecedented crisis has significantly affected the lives of people in different ways. Aim: To understand the experiences and vulnerability to mental health problems during lockdown among the Indian population during COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted using an online survey form circulated through various social media platforms from April 12 to May 3, 2020 containing self-reported questionnaires to collect lockdown related experiences and scales to assess anxiety (GAD-7) and depression (PHQ-9). A convenience sampling method was used. Results: 442 valid responses were received from different states of India. Statistical analysis revealed that one-third of the respondents suffered from some form of anxiety and depression during a lockdown. Less than 10% of them had severe levels of symptoms. The majority were males aged 18-45 years and private sector employees. Delivering essential services was involved with significant anxiety and depression. Availability of food and daily essentials was the most common problem. Difficulty in availing medicines and financial crisis were significant predictors of anxiety and depression. Worsening of interpersonal relationships was associated with higher levels of anxiety and depression. Conclusions: The study concluded that experiences during the lockdown and associated psychological outcomes are important factors to consider and appropriate preventive measures to be taken in case of any future lockdowns.
ABSTRACT
Background: The common cause of mortality in India is related to complications of cardiovascular disease which has direct relation with the hyperlipidemia, diabetes mellitus, and hypertension. Rosuvastatin more efficacious than other statins in lesser dosage and having good safety profile. Aim and Objective: The present study was undertaken to evaluate the safety, efficacy of rosuvastatin 10 mg daily dose versus alternate day dose in hyperlipidemia patients. Materials and Methods: A total of 50 individuals with hyperlipidemia were selected in this prospective open label research. Patients were grouped as Group D with rosuvastatin daily dose and Group A with alternate day dose. Fasting plasma lipid profile was assessed in both groups on the 1st, 4th, and 6th weeks. Results: There is significant reduction in total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and elevation of high-density lipoprotein (HDL) after 4 weeks and 6 weeks of the treatment in both the groups compared to baseline. The mean percentage reduction of total cholesterol was by 24% and 21.60% (P < 0.05) in Group D and Group A, respectively. The mean percentage reduction of LDL-C was by 33.50% and 31% (P < 0.05) Group D and Group A, respectively. The mean percentage improvement of HDL-cholesterol was by 19.89% and 17.09% (P < 0.05) in Group D and Group A, respectively. The mean percentage of reduction of TG was by 36.70% and 41.33% (P < 0.05) Group D and Group A. Conclusion: Rosuvastatin 10 mg on alternate days had the same efficacy in lowering cholesterol levels as taking it every day, also it may be a cost-effective alternative without sacrificing therapeutic benefits or side effects.
ABSTRACT
Background: The increasing prevalence of type 2 diabetes mellitus (T2DM) and its complications pose a challenge to healthcare systems today, with a paucity of research examining the impact of T2DM on gustatory functions, especially in India. Aim and Objective: The objective of this study was to assess gustatory function in T2DM patients with good glycemic control and a disease duration ?5 years and compare it with the findings in normal individuals. Materials and Methods: This was a cross-sectional study with a sample size of 40, including patients and controls, aged 25–50 years. The Institute’s Ethics Committee clearance was taken, and written informed consent was obtained from the subjects. The evaluation of gustatory function was done using the triple drop test. Different concentrations of tastants were presented to the subjects. Scoring was done on the identification of increasing concentrations from “5” to “1.” Results: Taste scores for sweet, salty, sour, and bitter tastants were lesser in diabetic patients. This was statistically significant (P < 0.05). Conclusion: Taste impairment seems to affect diabetic patients relative to healthy controls. This could be an indication of central diabetic neuropathy. Hypogeusia in type 2 diabetic patients may influence the choice of nutrients such as an increased preference for sweet-tasting or salty foods, thus imposing health risks and affecting the quality of life.
ABSTRACT
Lipid-lowering therapy plays a crucial role in reducing adverse cardiovascular (CV) events in patients with established atherosclerotic cardiovascular disease (ASCVD) and familial hypercholesterolemia. Lifestyle interventions along with high-intensity statin therapy are the first-line management strategy followed by ezetimibe. Only about 20–30% of patients who are on maximally tolerated statins reach recommended low-density lipoprotein cholesterol (LDL-C) goals. Several factors contribute to the problem, including adherence issues, prescription of less than high-intensity statin therapy, and de-escalation of statin dosages, but in patients with very high baseline LDL-C levels, including those with familial hypercholesterolemia and those who are intolerant to statins, it is critical to expand our arsenal of LDL-C-lowering medications. Moreover, in the extreme risk group of patients with an LDL-C goal of ?30 mg/dL according to the Lipid Association of India (LAI) risk stratification algorithm, there is a significant residual risk requiring the addition of non-statin drugs to achieve LAI recommended targets. This makes bempedoic acid a welcome addition to the existing non-statin therapies such as ezetimibe, bile acid sequestrants, and PCSK9 inhibitors. A low frequency of muscle-related side effects, minimal drug interactions, a significant reduction in high-sensitivity C-reactive protein (hsCRP), and a lower incidence of new-onset or worsening diabetes make it a useful adjunct for LDL-C lowering. However, the CV outcomes trial results are still pending. In this LAI consensus document, we discuss the pharmacology, indications, contraindications, advantages, and evidence-based recommendations for the use of bempedoic acid in clinical practice.
ABSTRACT
Despite a high prevalence of common mental health concerns, especially among young adults, majority of them do not seek professional help. This study explored perceived barriers and enablers of professional help-seeking for common mental health concerns among distressed non-treatment seeking young adults in the urban Indian context. The study utilized an explanatory sequential mixed methods design. A brief survey was conducted with distressed non-treatment seeking young adults (N=37) to assess their current distress level, duration, perceived severity, effect on functioning, self-help methods, past treatment history, inclination to seek help and barriers to professional help-seeking. Semi-structured interviews were conducted with a sub-sample of 10 participants to explore their perceived barriers and potential enablers of professional help-seeking. Quantitative data were analyzed using descriptive statistics and interviews using thematic analysis. The survey revealed significant distress for 75.7% (N=28) of the total sample. Out of these, 25% were either not inclined or had practical constraints to seek help. The mean score for inclination to seek help was highest for partner/friend (4.7). Qualitative findings have been discussed under personal and general barriers and enablers. This is the first study to highlight the complex interplay of barriers and enablers of professional help-seeking among distressed non-treatment seeking young adults in the urban Indian context. There is an urgent need to incorporate the factors that hinder and facilitate professional help-seeking while devising help-seeking interventions to reduce the treatment gap.
ABSTRACT
The non-enzymatic antioxidant system protects blood components from oxidative damage and/or injury. Herein, plasma non-enzymatic antioxidant capacity after acute strenuous swimming exercise (Exe) and exercise until exhaustion (Exh) was measured in rats. The experiments were carried out in never exposed (Nex) and pre-exposed (Pex) groups. The Nex group did not undergo any previous training before the acute strenuous swimming test and the Pex group was submitted to daily swimming for 10 min in the first week and 15 min per day in the second week before testing. Plasma glucose, lactate, and pyruvate were measured and plasma total protein sulfhydryl groups (thiol), trolox equivalent antioxidant capacity (TEAC), ferric reducing ability of plasma (FRAP), and total radical-trapping antioxidant parameter (TRAP) levels were evaluated. There were marked increases in plasma lactate concentrations (Nex-Control 1.31±0.20 vs NexExe 4.16±0.39 vs NexExh 7.19±0.67) and in thiol (Nex-Control 271.9±5.6 vs NexExh 314.7±5.7), TEAC (Nex-Control 786.4±60.2 vs NexExh 1027.7±58.2), FRAP (Nex-Control 309.2±17.7 vs NexExh 413.4±24.3), and TRAP (Nex-Control 0.50±0.15 vs NexExh 2.6±0.32) levels after acute swimming and/or exhaustion. Also, there were increased plasma lactate concentrations (Pex-Control 1.39±0.15 vs PexExe 5.22±0.91 vs PexExh 10.07±0.49), thiol (Pex-Control 252.9±8.2 vs PexExh 284.6±6.7), FRAP (Pex-Control 296.5±15.4 vs PexExh 445.7±45.6), and TRAP (Pex-Control 1.8±0.1 vs PexExh 4.6±0.2) levels after acute swimming and/or exhaustion. Lactate showed the highest percent of elevation in the Nex and Pex groups. In conclusion, plasma lactate may contribute to plasma antioxidant defenses, and the TRAP assay is the most sensitive assay for assessing plasma non-antioxidant capacity after strenuous exercise.
ABSTRACT
Imperata cylindrica is a common grass with little known medicinal properties. The underground part (comprising rhizome with roots) is used by the Mizo people for the treatment of microbial and intestinal worm infections. To understand the chemical and pharmacological properties of the plant part, a methanol extract was prepared in a Soxhlet apparatus, and the extract was concentrated using a vacuum rotary evaporator. Chemical analysis was done using gas chromatography-mass spectrometry. Antibacterial activity was tested by Kirby–Bauer test and antiparasitic activity by survival test in vitro. Fourteen volatile compounds were detected; out of which the most abundant were n-hexadecanoic acid and (Z)-18-octadec-9-enolide. Some compounds detected including 2-methoxy-4-vinylphenol, 6-methylenebicyclo [3.2.0] hept-3-en-2-one and phenol,2,4-bis (1,1-dimethylethyl) are already known biologically active compounds. The plant extract was effective against all bacteria tested that included Gram-negative bacteria such as Pseudomonas aeruginosa and Klebsiella pneumoniae, and a Gram-positive bacterium Bacillus subtilis. It was also effective against two avian intestinal worms such as the tapeworm Raillietina echinobothrida and the roundworm Ascaridia galli. These findings reveal the importance of this plant as a source of therapeutic compounds.
ABSTRACT
Background: Hypertensive disorders of pregnancy are a multifactorial disease with oxidative stress also contributing to the etiopathogenesis. Assessment of maternal and neonatal oxidative stress may provide insight into early identification of at-risk mothers and neonates and timely intervention to reduce morbidity and mortality associated with hypertensive disorders. Objective: The objective of the study was to evaluate whether there occurs a reflection of oxidative stress in neonates born to hypertensive mothers. Materials and Methods: A total of 100 pregnant women of which 50 were normotensive and 50 were pre-eclamptic were tested for serum uric acid and serum malondialdehyde (MDA) in maternal blood and cord blood of their newborns. Our observations were subjected to statistical analysis Mean ± standard deviation calculated. Comparison is done by student t-test. Relationship between parameters was evaluated by Pearson’s correlation. Results: Increased levels of serum uric acid and MDA were found in maternal and cord blood in hypertensive pregnancies, indicative of oxidative stress. However, cord blood MDA and uric acid levels were lower than the corresponding maternal blood levels. Conclusion: Our study findings suggest that oxidative stress in hypertensive mothers is reflected in their neonates.
ABSTRACT
Background & objectives: Chikungunya virus (CHIKV), a mosquito-borne arthritogenic virus causes infections ranging from febrile illness to debilitating polyarthralgia in humans. Re-emergence of the virus has affected millions of people in Africa and Asia since 2004. During the outbreak, a new lineage of the virus has evolved as an adaptation for enhanced replication and transmission by Aedes albopictus mosquito. A study was designed to compare the susceptibility of four vertebrate cell lines, namely Vero E6 (African green monkey kidney), BHK-21 (Baby hamster kidney), RD (human rhabdomyosarcoma), A-549 (human alveolar basal epithelial cell) and C6/36 (Ae. albopictus) to Asian genotype and two lineages of East, Central and South African (E1:A226 and E1:A226V) of CHIKV. Methods: One-step growth kinetics of different CHIKV strains was carried out in the above five cell lines to determine the growth kinetics and virus yield. Virus titre was determined by 50 per cent tissue culture infectious dose assay and titres were calculated by the Reed and Muench formula. Growth and virus yield of the three strains in Ae. aegypti mosquitoes was studied by intrathoracic inoculation and virus titration in Vero E6 cell line. Results: Virus titration showed Vero E6, C6/36 and BHK-21 cell lines are high virus yielding with all the three lineages while RD and A-549 yielded low virus titres. C6/36 cell line was the most sensitive and yielded the maximum titre. Ae. aegypti mosquitoes, when inoculated with high titre virus, yielded an almost equal growth with the three strains while rapid growth of E1:A226V and Asian strain was observed with 1 log virus. Interpretation & conclusions: C6/36 cell line was found to be the most sensitive and high yielding for CHIKV irrespective of lineages while Vero E6 and BHK-21 cell lines yielded high titres and may find application for vaccine/diagnostic development. Infection of Ae. aegypti mosquitoes with the three CHIKV strains gave almost identical pattern of growth.
ABSTRACT
Purpose: The objective of this review is to estimate the prevalence of refractive errors, uncorrected refractive error (URE), and uncorrected presbyopia in adults aged ?30 years in India. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. A detailed literature search was performed to include all studies published from India from the year 1990 using the Cochrane Library, Medline, and Embase. Refractive error was defined by >0.50 D ametropia. URE was defined by presenting visual acuity (PVA) worse than 6/18 improving with pinhole or spectacle correction, and uncorrected presbyopia by near vision Results: Fifteen studies were included from South India, one each from Western and Central India, and one study covered 15 states across India. The prevalence of RE of at least 0.50 D of spherical equivalent ametropia was 53.1% [(95% confidence interval (CI): 37.2–68.5), of which myopia and hyperopia was 27.7% and 22.9%, respectively. The prevalence of URE was 10.2% (95% CI: 6.9–14.8), but heterogeneity in these estimates was very high. The prevalence of uncorrected presbyopia was 33% (95% CI: 19.1–51.0). Conclusion: This review highlights the magnitude of refractive errors among adults in India. More studies are needed using standard methods in regions where there is a lack of information on UREs. Programs delivering spectacles for adults in India will need to primarily focus on reading glasses to correct presbyopia along with spectacles for hyperopia and myopia.
ABSTRACT
Background: Systemic lupus erythematosus is a systemic auto immune connective tissue disease that can affect any part of the body. The disease has no direct reference in Ayurvedic texts. Considering the symptomatology, it can be compared with Upadrava of Vatarakta. Methodology: In this study, 3 patients (age group between 15– 60 yrs) diagnosed SLE with the help of ACR criteria after assessing both objective and subjective parameters have undergone the prescribed classical Ayurvedic treatments, in both IP and OP level to evaluate its effect in the functional improvement. The study period was totally 57 days which included 21 days each at inpatient and outpatient basis and 15 days of follow up. Initially Sathaila Shastika Pinda Sweda was done for first 7 days followed by Takradhara for another 7 days. Consecutively Abhyanga with Pinda taila and Thalam with Amalaki were done for next 7 days. Then treatment was done on OP basis with internal medicines. Result: Results shows that the prescribed Ayurvedic treatments helped to control the progressive signs and symptoms. The quality of life and range of movements of the affected joints improved. Major difference showing a good improvement in carrying out the day today life activities was noted. Conclusion: Traditional Ashtavaidyan Ayurveda therapy is found effective in controlling the progressive symptoms of patients and improvement in functional ability of the patients with SLE. More over there was no adverse drug reaction recorded during as well there was significant change observed in liver and renal function tests. This indicates that the therapy is safe without producing any complication or side effects.
ABSTRACT
Primary percutaneous coronary intervention is the current standard of care in ST elevation myocardial infarction (STEMI). However, large thrombus is an independent predictor for stent thrombosis and major adverse cardiac events in patients undergoing primary angioplasty for STEMI. Here we report a series of STEMI patients with large thrombus burden treated successfully with low dose intracoronary thrombolysis. There was prompt and early ST resolution. There was improvement in thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade postlysis in all patients. Majority had recanalised infarct related coronary artery thus obviating the need for stenting. There was no inhospital or 1 month mortality or bleeding events. Hence intracoronary thrombolysis is an option in patients with large thrombus burden.
ABSTRACT
Anemia is a major public health problem globally. Due to loss of 42.2 million disability-adjusted life years (DALYs) in 2011, Iron-deficiency anemia (IDA) was ranked among the top three major causes of disability in the world (1,2). IDA is responsible for at least 50% of anemia and is highly prevalent in India especially among women, children below 5 years, and adolescent girls (3) perhaps due to increased needs, insufficient dietary supplies, poor intervention coverage etc (4). Anemic girls will grow up to anemic mothers and in turn give birth to anemic children. Childhood anemia can have long term consequences. IDA has been associated with developmental deficits, impaired memory and neurodevelopment, diminished physical function, depression, fatigue, loss of vitality, preterm delivery, and lower infant birth weight (5–10). These, effects attributable to anemia remain invisible but are substantial (11), as it has serious health and economic costs and may hinder nation’s development. Therefore, effective and safe interventions are urgently needed across the lifecycle. The issue has attracted global attention and for the first time targets have been suggested like reducing the proportion of anemia among women of reproductive age (WRA) by 50% by 2025 in comparison to the baseline year 2011 (12). This is likely to add impetus to global efforts in reducing anemia and monitor the progress towards it.
ABSTRACT
Anemia is highly prevalent disease of global concern. Childhood anemia can result in irreversible damage to brain and affect cognitive, intellectual, and pyscho-motor development. In pregnant women, it is a significant contributor to adverse maternal outcome (1–4). In 2011, alone it was responsible for loss of 42 million Disability adjusted life years and among the top three causes of disability worldwide (5). In an attempt to address this huge public health problem, guidelines have been issued by various leading international organizations and targets have been set to monitor progress towards its control. One such indicator is 50% reduction of anemia in women in reproductive age group (WRA) between 2011 and 2025 (6). This makes it necessary to carry out huge population-based anemia prevalence surveys repeatedly, to measure the progress and guide policy makers in carrying out specific interventions needed to reduce its prevalence.
ABSTRACT
Background: The cancer breast is most common malignancy among the rural as well as urban women in India. This study aimed at to correlate tumor size by clinical breast examination (CBE), mammogram and post-operative histopathology examination (HPE) early breast cancer. Methods: The present prospective clinical study was conducted during sept- 2014 to september 2016 among 60 patients of breast cancer in a tertiary care hospital, Andhra Pradesh, India. All these patients were subjected to Clinical examination and mammography pre-operatively and post-operatively, to histopathology examination. All patients with age more than 18 years and less than 70 years, with early breast cancers were included. Results: About 18 (30%) of the patients belonged to 51 – 60 years, 17 (28.3%) to 41 – 50 years, 14 (23.3%) to above 61 years and 11 (18.3%) to 31 – 40 years. Mean age was 51.65±10.79 years. Cancers were more common in the left breast 37 (61.7%) compared to right 23 (38.3%). Tumor was most commonly seen in the upper outer quadrant 35 (58.3%).There was a moderate positive correlation between CBE and HPE (r = 0.674, P 0.000), thus the best predictor of tumor size was CBE next to HPE. Mammography had comparatively lesser correlation with HPE (r = 0.473, P 0.000). The correlation between CBE and Mammogram was also good (r = 0.619, P 0.000). Conclusion: Clinical Breast Examination is in good agreement with Histopathological examination of breast carcinoma, compared to mammogram. Though CBE might not be confirmatory, it can be used for screening of breast cancers to some extent, especially in low socio-economic situations as in India since mammography is a costly procedure
ABSTRACT
The aim of this study was to investigate the effect of lactatemia elevation and glycemia reduction on strenuous swimming performance in fasted rats. Three rats were placed in a swimming tank at the same time. The first rat was removed immediately (control group) and the remaining ones were submitted to a strenuous swimming session. After the second rat was exhausted (Exh group), the third one was immediately removed from the water (Exe group). According to the period of time required for exhaustion, the rats were divided into four groups: low performance (3-7 min), low-intermediary performance (8-12 min), high-intermediary performance (13-17 min), and high performance (18-22 min). All rats were removed from the swimming tanks and immediately killed by decapitation for blood collection or anesthetized for liver perfusion experiments. Blood glucose, lactate, and pyruvate concentrations, blood lactate/pyruvate ratio, and liver lactate uptake and its conversion to glucose were evaluated. Exhaustion in low and low-intermediary performance were better associated with higher lactate/pyruvate ratio. On the other hand, exhaustion in high-intermediary and high performance was better associated with hypoglycemia. Lactate uptake and glucose production from lactate in livers from the Exe and Exh groups were maintained. We concluded that there is a time sequence in the participation of lactate/pyruvate ratio and hypoglycemia in performance during an acute strenuous swimming section in fasted rats. The liver had an important participation in preventing hyperlactatemia and hypoglycemia during swimming through lactate uptake and its conversion to glucose.
Subject(s)
Animals , Male , Rats , Hypoglycemia/physiopathology , Lactic Acid/blood , Liver/physiopathology , Pyruvic Acid/blood , Swimming/physiology , Blood Glucose/analysis , Fasting/physiology , Hypoglycemia/blood , Hypoglycemia/metabolism , Perfusion , Physical Conditioning, Animal/physiology , Rats, Wistar , Time FactorsABSTRACT
The aim of this study was to evaluate the effect of expiratory positive airway pressure (EPAP) on heart rate variability (HRV) indices at rest and during 6-min walk test (6MWT) in chronic obstructive pulmonary disease (COPD) patients. Fifteen moderate to severe COPD patients were randomized and evaluated with and without (Non-EPAP) a 5 cmH2O EPAP device. Respiratory rate (RR) was collected at rest (5 min), during the 6MWT (5 min), and at recovery (5 min). Indices of HRV were computed in the time domain, in the frequency domain, and nonlinear analysis. For EPAP and Non-EPAP during the 6MWT, we found an increased mean heart rate (HR) (P=0.001; P=0.001) while mean RR (P=0.001; P=0.015) and RR tri index decreased (P=0.006; P=0.028). Peripheral oxygen saturation (P=0.019) increased at rest only in the EPAP group. In EPAP, correlations were found between forced expiratory volume in 1 s (FEV1) and low frequency (LF) sympathetic tonus (P=0.05; r=-0.49), FEV1 and high frequency (HF) parasympathetic tonus at rest (P=0.05; r=0.49), lactate at rest and LF during the 6MWT (P=0.02; r=-0.57), and lactate at rest and HF during 6MWT (P=0.02; r=0.56). Through a linear regression model, we found that lactate at rest explained 27% of the alterations of LF during 6MWT. The use of 5 cmH2O EPAP improved autonomic cardiac modulation and its complexity at rest in COPD patients. Although it did not influence the performance of the 6MWT, the EPAP device caused alterations in resting lactate concentration with an effect on sympatho-vagal control during the test.
Subject(s)
Humans , Male , Middle Aged , Autonomic Nervous System/physiopathology , Forced Expiratory Volume/physiology , Heart Rate/physiology , Pulmonary Disease, Chronic Obstructive/physiopathology , Rest/physiology , Walk Test/methods , Cross-Over Studies , Cross-Sectional Studies , Lactic Acid/metabolism , Respiratory Rate/physiology , Severity of Illness IndexABSTRACT
Aims & Objectives: To compare the occurrence of hyponatremia in the patients receiving two different Tricyclic Antidepressants (TCAs)–Amitriptyline and Imipramine Methodology: Fifty OPD patients attendingthe Psychiatry outpatient clinic of Mahatma Gandhi Institute of Medical Sciences, Sewagram having diagnosis of Depressive episode as per DSM-IV-TR criteria were included in the study. Patients with normalserum sodium levels before treatment with antidepressant were included in the study. Repeat serum Sodium levels were done after one month of being on treatment. EPI Info-6 software was used to analyze the data. Results: Average serum sodium concentrations of the patients receiving different TCAs before treatment were 139.4+2.45 (Mean+SD). Out of the 44% patients who developed hyponatremia, 45.45% were amongst the Imipramine group and 54.54% were amongst the Amitriptyline group. Although of mild severity only, hyponatremia was more in patients receiving Amitriptyline compared to those receiving Imipramine. Conclusion: Patients receiving Amitriptyline have fairly more chance of developing hyponatremiathan Imipramine receiving patients. Hence precaution should be observed while using TCA group of antidepressants.