Diabetic: A Comparative Study

Background and Objectives: Type II diabetes mellitus (DM) is particularly common medical disorder and is leading cause of morbidity worldwide. The complication of DM is due to micro or macro vascular damage. The presence of an extensive microvascular circulation and abundant connective tissue in the lungs raises the possibility that lung tissue may be a target organ in diabetic patients and thus pulmonary function test can be affected by DM. This study was designed to compare pulmonary function test between Type II diabetic and non-diabetic individuals; and, with the duration of DM.Material and Methods: This cross sectional comparative study was conducted at King Edward Medical University, Lahore Pakistan. Total sample consist of 91 diabetic and 91 non-diabetic grouped as group A and group B. FEV1, FVC, FEV1/FVC ratio, and PEFR were compared within two groups and with the duration of DM.Results: Total 182 sample with mean age 53.1±5.90 years, with 91(50%) male and 91(50%) female. Group A and B had 91(50%) sample each. Mean value of FVC, FEV1 and PEFR showed statistically significant difference among the both group. Mean of FVC decreases significantly with the increasing duration of DM; although, is not significant with FEV1, FEV1/FVC ratio, and PEFR.Conclusion: Diabetic group showed significantly impaired pulmonary functions test as FEV1, FVC, and PEFR as compare to non-diabetic group.

Kapalbhati changes cardiovascular parameters

Background and Objectives: Kapalbhati is among one of the cleansing act (shatkarma) in yogic philosophy. It is one of the popular Pranayama which has several benefits. It is highly recommended for those who have to do great deal of study and need a clean, clear mind. This study was conducted among nursing students at Janaki medical college, Janakpur, Nepal.Material and Methods: This analytical study was conducted among PCL Nursing students of Janaki Medical College, Janakpurdham, Nepal. Total 40 nursing student who gave consent and performed Kapalbhati correctly were included in the study. A detailed demographic profile with a structured questionnaire and observational checklist was filled for data collection. HR, SBP, DBP were the cardiac parameters taken. Those parameters were taken before, during, immediately after and after 1 minute, 2 minutes, 3 minutes and 5 minutes Pranayama. The data were entered in SPSS and Statistical analysis was done using version 20.Results: As in usual exercises, the HR, SBP and DBP increases significantly during Kapalbhati session but immediate post effect was surprisingly significantly fall in those parameters when compared with the value during exercises. The basal (pre-Kapalbhati) mean HR, SBP and DBP were 88.25 ± 9.02, 111.43 ± 11.28 and 73.9 ± 7.70 which increases upto 133.58 ± 35.70, 89.63 ± 23.31 and 118.55 ± 19.08 respectively during exercises and fall immediately after exercises value being 114.48 ± 21.94, 76.43 ± 15.34 and 88.6 ± 17.25 respectively.Conclusion: There is no significant difference between pre and post value of HR, SBP and DBP as in other study. There is significant rise between Pre-value and during-value of all parameters and significant fall of all parameters if compared between during-value and post-value.

Study on use of Indigenous herbal product by diabetic patient visiting diabetic centre in Nepal

Background and Objectives: Diabetes Mellitus (DM) is a chronic disease worldwide. With increasing trends towards sedentary lifestyle, the prevalence of diabetes mellitus is increasing in urban region of Nepal too. Material and Methods: A quantitative descriptive study was conducted for a period of two months. One-to-one structured interviews were taken to fill the structured questionnaire prepared after proper literature review from the patients attending a diabetic clinic in Lalitpur. The questionnaire  includes the socio-demographic details, lifestyle and questionnaires related to patients’ perception and use of herbal remedies/product. Relevant information was also obtained from the patient medical files. Statistical analysis was performed by using SPSS version 20. Results: Out of total population about 30 % of people were using the indigenous product for their treatment along with allopathic medication. Among them, 17 were male and 14 were female. Various indigenous herbal products were used by the patients. Among them fenugreek, aloe Vera, bitter guard, bottle guard, black berry are the common one. The frequencies of using these products are in fig 4.4. The total percentage of patient using fen ugreek is 42%, Aleo-Vera 35%, Bittergaurd 29% and very few participants were using Bottle guard, Neem, and Hibiscus and Guava leaf too.Conclusion: Participants have good faith on use of indigenous herbal products and are using it. Fenugreeks, Aloe-Vera, Bittergourd, Neem, Bottle gourd, Hibiscus and Guava leaf are commonly used. But no consistent data regarding fixed dose or method of preparation of such product was found. So, further researches are needed to confirm the effectiveness of those indigenous products.

Chandra Anuloma Viloma Pranayama modifies Cardiorespiratory Functions

Background and Objectives: In recent years, there has been considerable interest in scientific research on yoga, especially on Pranayama. Nostril breathing exercises including Alternate nostril breathing, Left nostril breathing and right nostril breathing exercises is getting attention in the east and in the west. Left nostril breathing exercises is also called Chandra Nadisuddhi Pranayama or Chandra anulomaa vilomaa Pranayama (CAV). Very few have carried out research on Chandra Anuloma Viloma Pranayama (CAV). This study was carried out to see the effects of CAV on experienced yoga practitioners and naïves.Material and Methods: The study consisted of 36 subjects divided into two groups, first group consist of 26 medical students who were naïve and the next group consist of 10 yoga practitioners. All the subjects performed 12 rounds of Chandra Nadisuddhi Pranayama in each session for 24 days. Variables were entered into SPSS Program and were analyzed.Results: This study depicts fall in Pulse rate, respiratory rate, systolic blood pressure and Diastolic blood pressure after CAV Pranayama in both Naïves and Yoga practitioners. But the significant drop was observed in SBP only (at p < 0.05) among Naives and in all parameters except respiratory rate among Yoga Practitioners.Conclusion: The effect of the Chandra Anuloma Viloma (CAV) in this study was more eminent in the yoga practitioners than in the naïve group.

Chitta, The Mind-stuff as a Cognitive Apparatus: Model of mind and process of cognition as in Yogasutra of Patanjali

Background and Objectives: Medical sciences have developed tremendously but yet it has to understand the brain, mind, consciousness and cognition process. In this article, authors have made an attempt to present a process of cognition with a model of mind explained in yoga sutra of Patanjali. Material and Methods: Understanding the mind with the modern scientific tools is often difficult. Here an attempt has been made to understand mind with the help of various literature in yoga especially in yoga sutra of patanjali, a valid text of yoga. Hermeneutical approach, a method used in qualitative method of inquiry is used for this study. Reading, re-reading the texts and finding the meaning out of the text is the process used. Results: A model of mind has been proposed as finding of the study. This model of mind has a ‘chitta’ (Mind stuff) as a cognitive apparatus and important component for cognition. ‘Chitta’ interacts with the external manifested world (Prakriti). ‘Chitta’ has Mana, Buddhi and Ego as Antakahrana (internal organ) and ‘Indriyas’ (Five Gyanendriyas and Five Karmaindriyas) as external organ. This concept of mind and cognition works for the plane of ‘chitta-vritti’ state where vrittis are the external world. But YSP also talks about next plane of cognition which is beyond the scope of this study. Conclusion: A cognitive model explaining the concept of mind forms a major finding of this research. This finding may initiate future researches in the field of understanding the mental processing and acts as links between ancient wisdom of yoga and modern concept on mind and cognition and how they can complement each other. This model of concept of mind can also be used as concept for psychological counseling and psychological therapy.

Antenatal diagnosis of achondroplasia.

We report a interesting case of antenatal diagnosis of achondrpoplasia in a young multigravida who presented with term pregnancy for routine ultrasound assessment which revealed a single, live intrauterine fetus with a discrepancy between femur length (FL) and biparietal diameter (BPD), narrowing of the interpeduncular distance. The diagnosis of achondroplasia was made with a sonological skeletal survey and findings were correlated with radiological skeletal survey after the baby was delivered.

Myositis ossificans traumatica of the left masseter muscle presenting as soft tissue mass: a case report.

Myositis ossificans is a rare disease in which manifests as heterotopic bone formation within a muscle and is rarely found in the head or neck regions, including the masticator muscle. It should be considered as a differential diagnosis in patients of trauma with severe limitation of jaw opening. Panoramic radiographs and axial and coronal computed tomography (CT) scans can effectively delineate the calcified mass. Other imaging studies that may be helpful include magnetic resonance imaging (MRI), bone scans, and ultrasound.

Perception and knowledge about HIV/AIDS among Nepalese adolescent

Background and Objectives: Nepal is confronted with increasing incidence of HIV among adolescents. There is need to ensure, these people have correct knowledge for HIV prevention. Hence, this study was carried out to assess the perception and knowledge of adolescents regarding HIV/AIDS and to identify the areas of misconception that might serve as an important target of educational intervention. Methodology: A self designed questionnaire regarding knowledge and perception about HIV/AIDS was distributed to the students of secondary school who attended the heath assessment program organized by Kist Medical College. Submitted questionnaires were analyzed and tabulated to find out the existing knowledge and attitude of the participants. Results: Knowledge regarding HIV/AIDS was satisfactory. Seventy-nine percentage of female and 64% male agreed to care for HIV/AIDS patients. However there were still misconceptions about transmission. Sixty-two percentages thought that contraceptive pills prevent HIV transmission. Thirty two percent thought that mosquito can transmit HIV, 21 % replied that sharing of utensils, and towels etc can transmit HIV. Forty five percentage of the participants thought that someone who looks healthy cannot transmit HIV. Conclusion: Perception regarding HIV/AIDS was satisfactory. Some areas of misconception was detected which can be overcome with proper educational interventions.

Distribution of ABO and Rh blood groups in Nepalese medical students

Background and Objectives: The distribution of ABO and Rh blood groups vary from population to population. With an interest of finding out rare blood group in Nepalese population, we studied the blood group distribution was studied in five different medical colleges in Nepal. Material and Methods: Capillary Blood sample were taken to determine blood group of of 2208 twenty two hundred and eight Nepalese students from five different medical colleges, viz. Manipal College of medical sciences, Pokhara; Nepalgunj Medical College, Chisapani, Banke ; College of Medical sciences, Bharatpur, Chitwan; Kist Medical College, Lalitpur and Janaki Medical College, Janakpur were recorded. Slide test method was used to determine the blood group of the subjects. Results: In our study subjects, 28.17% were blood group A, 30.17% were blood group B, 34.87% were blood group O and 6.79% were blood group AB. Similarly, 95.38% were Rh +ve and 4.62% were Rh –ve. The blood group distribution patterns in male and female were different. Conclusion: This result demonstrates that AB blood group is the most rare blood group among the studied Nepalese population, followed by group A, B and O.

Physiology of nostril breathing exercises and its probable relation with nostril and cerebral dominance: A theoretical research on literature

This article discuss about scientific basis of benefits of practicing slow pranayama, especially alternate nostril breathing pranayama. It explains the basis of benefit of alternate nostril breathing exercises and its probable relation with nasal cycle, cerebral dominance and autonomic nervous system. The airflow through one nostril is greater than next at any point of time which later switches to another. This is called nasal cycle. The nasal cycle lasts from 30 minutes to 2-3 hours. The nasal cycle occurs naturally. This nasal cycle is related with the cerebral dominance. When one nostril is dominant, the contra lateral hemisphere is active. The right nostril breathing leads to increased sympathetic activity while left nostril breathing decreases sympathetic activity and increases parasympathetic tone. So it has been speculated that these three phenomenon viz. nasal cycle, cerebral dominance and autonomic activities are correlated. This review also suggests that practicing alternate nostril breathing (Nadisodhan pranayma) regularly keeps the two hemispheres active and balances the sympathetic and parasympathetic activities in the body. Sympathetic or parasympathetic activity alternates automatically in our body which is important for our survival. Due to our hectic and stressful life, this naturally occurring alternate breathing cycle gets disrupted and we suffer from different ailments. These ailments are due to imbalance of autonomic nervous system which can be resolved by practicing alternate nostril breathing, the Nadisodhan pranayama. It’s just like returning back to nature.

Magnesium induced vascular relaxation and role of Calcium-dependent K+ Channels

Background and objectives: Magnesium is established as a neuro-protective agent and now also known as a vasodilator. It has been known for treating vasospasm following subarachnoid hemorrhage. However, its action mechanism in cerebral vascular relaxation is not clear. Potassium channels play a pivotal role in the relaxation of smooth muscle cells. To investigate their role in magnesium-induced relaxation of basilar smooth muscle cells, we examined the effect of magnesium on potassium channels using the patch clamp technique on cells from rabbit basilar artery. Material and Methods: Fresh smooth muscle cells were isolated from the basilar artery by enzyme treatment. Whole cell current recording was done using patch-clamp technique. Appropriate bath solution was used to have potassium current. The effect of Magnesium was observed and to identify the potassium (K+) channel involved in the magnesium-induced currents, different potassium channel blockers were used. Results: Magnesium increased the step pulse-induced outward K+ currents by more than fortyfive percent over control level (p<0.01). The outward K+ current was decreased significantly by application of tetraethylammonium, a non-specific K+ channel blocker, and by iberiotoxin, a largeconductance Ca2+-activated K+ (BKCa) channel blocker, but was not inhibited by glibenclamide an ATP-sensitive K+ (KATP) channel blocker. Magnesium failed to increase the outward K+ currents in the presence of IBX. Conclusion: These results demonstrate that calcium dependent pottassium (BKCa) channels has role in magnesium induced vascular relaxation in rabbit basilar smooth muscle cells and needs to be worked out for human.

Emphysematous Pyelonephritis: Radiological Perspective.

Emphysematous pyelonephritis (EPN) is an acute necrotizing parenchymal and perirenal infection and is caused by gas-forming organisms. Diabetes mellitus and ureteric obstruction are the predisposing factors for EPN. Computerized tomography (CT) scan is the modality of choice in diagnosing the disease, determining the extent of infection and helps in management. We report a case of emphysematous pyelonephritis in 52 years old man with emphasis on plain radiographic and CT scan findings.

Assessment of some pulmonary parameters and cardiorespiratory fitness status in Nepalese medical students.

Some pulmonary function tests along with cardio respiratory fitness test were performed to assess the health status of the young (19-21 years) non-smokers Nepalese medical students. Results revealed that the vital capacity was 3.46 liters and 2.40 liters among the boys and girls respectively. PEFR was found to be 597.98 l/min among the boys and 456.53 l/min among the girls. Likewise, VO2 max among the boys and girls were 54.32 ml/kg/min and 44.88 ml/kg/min respectively. It was evident from the result that the health status of the Nepalese medical students ill the present study group was fairly well. It might be due to their health awareness, balanced-nutritious diet and the habits of occasional physical exercise.

Effect of alternate nostril breathing exercise on cardiorespiratory functions.

Pranayama (breathing exercise), one of the yogic techniques can produce different physiological responses in healthy individuals. The responses of Alternate Nostril Breathing (ANB) the Nadisudhi Pranayama on some cardio-respiratory functions were investigated in healthy young adults. The subjects performed ANB exercise (15 minutes everyday in the morning) for four weeks. Cardio-respiratory parameters were recorded before and after 4-weeks training period. A significant increment in Peak expiratory flow rate (PEFR L/min) and Pulse pressure (PP) was noted. Although Systolic blood pressure (SBP) was decreased insignificantly, the decrease in pulse rate (PR), respiratory rate (RR), diastolic blood pressure (DBP) were significant. Results indicate that regular practice of ANB (Nadisudhi) increases parasympathetic activity.