Heart rate variability, task load and perceived exertion associated with a long-distance military ski exercise: A pilot study

OBJECTIVES: Skiing is practiced by the security forces posted at mountain areas for patrolling, securing borders, taking up rescue missions and sometimes as recreational activities. A study was planned to assess physiological and mental stress of a military ski activity through the measurement of heart rate (HR) variability, task load and perceived exertion. MATERIALS AND METHODS: Eleven healthy Indian soldiers, trained with skiing techniques, participated in a 15 km skiing with 22 kg equipment at a predetermined snowy mountainous track. Pre- and post-exercise HR and HR variability (HRV) were recorded (bio-harness, Zephyr, USA) and questionnaires, namely NASA task load index (NASA-TLX) and Borg’s rating of perceived exertion (RPE) scale, were filled after exercise. Time and frequency domain parameters such as HR, variations between successive RR intervals (RMSSD), standard deviation of RR (SDNN) and percentage value of NN50 (pNN50), low- and high-frequency bands (LF and HF %) and LF/HF ratio were derived using Kubios software. Student’s t (paired) test was applied to compare pre- and post-exercise HRV parameters and Pearson’s correlation was applied to observe interdependencies between HRV and subjective scores. RESULTS: The findings depicted increase in post-exercise HR and decrease in overall HRV (both significant). Besides this, there was an increase in LF (significant) and LF/HF ratio (insignificant). Such response shows sympathetic dominance over parasympathetic domain of autonomic nervous system. The physical and mental stress experienced during the exercise was also expressed through high physical demand (79 out of 100) and high overall task load (total score – 77 out of 100) of the NASA-TLX and a moderately heavy RPE score (14 out of 20). CONCLUSION: The pre- and post-exercise differences in physiological variables ensured the presence of physical stress along with dominance of sympathetic nervous system. Overall task load was depicted with high subjective ratings. Carrying out skiing task in an environment infested with cold, wind chill, moderate hypoxia at a snowy and mountainous track possibly has induced the observed physiological and mental stress to the participants. Such findings are important to understand exact requirements of the mountain warfare events carried out by the forces.

Challenges Faced by People Affected with Leprosy During the COVID-19 Pandemic: A Questionnaire Based Study

This study aims to assess the continuity of medical care, the impact on disease condition and to highlight the major challenges faced by people affected by leprosy during the pandemic. Telephonic questionnaire-based survey was conducted among previously registered patients of leprosy at referral hospitals in India. Leprosy affected people aged >18 years, either on treatment or who had completed treatment with access to phone and willingness to participate were included. The questions were asked pertaining to demographic details, baseline disease characteristics and various problems faced during lockdown relating to livelihood, finances, treatment, and mental status. A total of 196 patients consented to participate in the study. Mean age of study participants was 37.31 (13.86) years, male participants (n=123, 62.7%) were more than females (n=73, 37.2%). Overall, 101 patients (51.5%) experienced exacerbation, 21 patients (10.7%) reported improvement and 74 patients (37.8%) reported no change in disease status during the pandemic. Most common difficulty faced was the procurement of medicines (115 patients, 58.6%) followed by difficulty in diagnostic testing (61 patients, 31.1%). Course of treatment was interrupted in 16 patients. Most of the patients (n=147, 75%), agreed that teleconsultation services would aid in management of their disease. The majority of patients (88.2%) were able to continue some form of treatment. Two patients (1%) tested positive for COVID-19. Nearly all patients (n=189, 96.4%) were informed regarding the risks and preventive measures related to COVID-19. Fifty percent of the patients reported deterioration in mental health due to the pandemic. The present study highlights the gaps in healthcare delivery and social inequalities along with their impact on the health, livelihood and mental status of people affected by leprosy during the current COVID-19 pandemic.

Adjuvant chemotherapy with six cycles of AC regimen versus three cycles of AC regimen followed by three cycles of Paclitaxel in node-positive breast cancer.

Context: Antracycline-Cyclophosphamide (AC) along with Paclitaxel/Docetaxel, either in combination or sequential regimens, is showing superior results than Anthracycline-containing regimens. Aims: This study was designed to determine whether adding Paclitaxel to a standard adjuvant chemotherapy regimen AC for breast cancer patients would prolong the time to recurrence and survival. Settings and Design: Randomized, prospective, open-labeled, single-institutional study. Materials and Methods: Fifty stage II breast cancer patients accruing 25 patients in each arm, treated between July 2007 and January 2010, were included in the study. Initial surgical treatment was Modified Radical Mastectomy. Systemic therapy was to have begun within 4-6 weeks of the patient's surgery. In the control arm, all the patients were treated with six cycles of adjuvant chemotherapy with AC regimen repeated at an interval of 3 weeks. For the study arm, the patients received adjuvant chemotherapy with three cycles of AC regimen followed by three cycles of Paclitaxel, repeated at an interval of 3 weeks. All the patients of both the arms received locoregional external beam radiotherapy (EBRT) after the entire course of chemotherapy. All the hormone receptor-positive patients received Tamoxifen. Statistical Analysis Used: Statistical analysis was performed using the chi-square test and the Kaplan Meier survival analysis with the log-rank (Mantel-Cox) test. Results: Adding Paclitaxel to AC resulted in a statistically significant disease-free survival. The overall survival was also improved significantly. The toxicity profile in both the arms was comparable. Conclusions: In early and node-positive breast cancer, the addition of three cycles of Paclitaxel after completion of three cycles of AC improves the disease-free and overall survival.

Renal pathological changes in poisonous snake bite.

There are more than 3000 species of snakes in the world but only about 350 are venomous. With approximately 10000 deaths occurring annually in India, a large proportion of snake bites occur when people work barefoot in the fields or while walking at night or early morning through fields or along roads. Although, nearly all snakes with medical relevance can induce nephropathy, leading to Acute Renal Failure (ARF), it is unusual except with bites by Russell‟s Viper, E. Carinatus and members of the genera Crotalus and Bothrops. In India, ARF is mostly associated with Russell‟s Viper and E. Carinatus bites. The incidence of ARF following Russell‟s Viper or E. Carinatus bites is 13-32% in India. A histopathological study was conducted on renal autopsy specimens from those subjects who were admitted to IPGME&R and SNP Hospital, Kolkata as a result of development of acute renal failure following poisonous snake bite. Acute tubular necrosis (100%) and Acute cortical necrosis (25%) were the most significant renal histopathological changes. Glomerular lesions were also present in 30% of cases.

A comparative study of regression of jaundice in patients of malaria and acute viral hepatitis.

BACKGROUND & OBJECTIVES: Jaundice is one of the common manifestations of severe malaria in adults. The purpose of this study is to compare the pattern of clinical and biochemical parameters such as serum bilirubin and liver enzyme levels in patients of malaria with jaundice and acute viral hepatitis. METHODOLOGY: The present study was conducted on 34 patients of malaria with jaundice and 15 patients of acute viral hepatitis. Estimation of serum bilirubin, aspartate amino transferase (AST), alanine amino transferase (ALT) and alkaline phosphatase was done daily using standard procedures in malaria patients and weekly in acute viral hepatitis patients. RESULTS: Mean level of serum bilirubin on first day in malaria and acute viral hepatitis patients was 7.07 +/- 3.94 and 10.38 +/- 7.87 mg%, whereas on Day 8 it was 1.19 +/- 1.43 and 7.88 +/- 7.02 mg% respectively. Mean level of AST on Day 1 in malaria and acute viral hepatitis patients was 158.47 +/- 120.35 and 1418.6 +/- 834.11 IU/L, whereas on Day 8 it was 41 +/- 28.33 and 775.3 +/- 399.01 IU/L respectively. Mean level of ALT on Day 1 in malaria and acute viral hepatitis patients was 220.14 +/- 145.61 and 1666.67 +/- 1112.77 IU/L, whereas on Day 8 it was 50.85 +/- 37.31 and 823.8 +/- 475.06 IU/L respectively. Mean level of serum alkaline phosphatase on Day 1 in malaria and acute viral hepatitis patients was 394.74 +/- 267.78 and 513.4 +/- 324.7 IU/L, whereas on Day 8 it was 84.76 +/- 68.50 and 369.27 +/- 207.75 IU/L respectively. INTERPRETATION & CONCLUSION: We observed that resolution of jaundice in malaria took 1-2 weeks in contrast 6 to 8 weeks in viral hepatitis. This difference in duration was statistically significant. Thus, jaundice not resolving in 1-2 weeks time in a patient of malaria requires serious consideration for presence of other concomitant diseases including viral hepatitis.

Oesophageal web--a case report.

A case of posterior oesophageal web in an 18-year-old girl is being presented, in view of its rarity. The diagnosis could be established only after thoracotomy and exploration of the oesophagus. The clinical profile along with possible theories of aetiology are discussed and a brief review of literature is made.

Growth, CO2 exchange rate and dry matter partitioning in mungbean (Vigna radiata L.) grown under elevated CO2.

This study was conducted to determine the effects of anticipated future level of CO2 on growth and dry matter partitioning of mungbean (Vigna radiata). Plants were grown from seedlings to maturity inside the open top chamber under amhient CO2 (350 +/- 25 microL L(-1)) and elevated CO2 (600 +/- 50 microL L(-1)) at Indian Agricultural Research Institute, New Delhi (India). Plants were harvested at 20, 35 and 50 days after germination. Mungbean plants grown under elevated CO2 concentration resulted in greater photosynthetic rate on a leaflet area basis and no acclimation in photosynthesis was recorded due to high CO2. Plants grown under CO, enrichmcnt were taller and attained greater leaf area along with more dry matter than ambient CO2 grown plants at all growth stages. Response to high CO, depends upon the growth stage of the plant and it was more at early growth stages compared to maturity stages. The high CO2 grown mungbean plants also exhibited increased root growth along with stem and leaves. There was a substantial increase in pod number and seed number/plant under elevated CO2 conditions. The increase in dry matter and growth of root, stem and leaves proved that CO2 enrichment of the atmosphere can stimulate photosynthetic rate which can ultimately lead to an increase in dry matter and growth.

Philosophy of medicine according to Ayurveda.

The modern, western system of medicine researches only a small group of people, it is understood that over half of the population of the world has no share in it. In India the overwhelming majority of people receive medical service from traditional practitioners, who treat their patients according to the principles of Ayurveda. Also in Sri Lanka, Bangladesh and Nepal a vast majority of the masses has been looking up to Ayurveda in its pure form or some of its variations in some form or other, for relief of various ailments. This is how Ayurveda has come to attract the attention of WHO.

Antipyretic activity of Nelumbo nucifera rhizome extract.

Antipyretic activity of methanolic extract of rhizome of N. nucifera was studied on normal body temperature and yeast induced pyrexia in rats. Yeast suspension (10 ml/kg, s.c.) increased rectal temperature after 19 hr of administration. The extract, in doses of 200, 300 or 400 mg/kg (po) produced significant dose dependent lowering of normal body temperature and yeast provoked elevation of body temperature in rats. The effect produced was comparable with the standard antipyretic drug, paracetamol (150 mg/kg, i.p.).

Fluorimetric probes of the individual and competitive binding of 1-anilinonaphthalene-8-sulfonate, eosine and fluorescene to bovine serum albumin.

Fluorescence of 1-anilinonaphthalene-8-sulfonate (ANS) is greatly enhanced on its binding to bovine serum albumin (BSA). Fluorimetric titration shows that three ANS molecules bind per BSA molecule. The enhanced fluorescence of BSA-ANS is quenched by eosine (EOS); and one EOS physically displaces one ANS bound to BSA. The enhanced fluorescence of free ANS in the hydrophobic environment of the nonionic surfactant Triton X 100 is also quenched by EOS but by an energy transfer mechanism. The dye fluorescene (FLSN) also quenches the fluorescence of BSA-bound ANS, but by the energy transfer mechanism. The binding region of ANS in BSA has been speculated.

Effect of GABA analogues on various components of maximum electroshock-induced seizures in mice.

Out of fourteen compounds reported here only four [N-valproyl GABA (V.GABA), N-phthaloyl GABA (P.GABA), gamma-phthalimido N-amyl butyramide (PGA) and gamma-phthalimido N-phenyl butyramide (PGP)] gave significant protection to all the four components of maximal electroshock-induced seizures (MES) in mice. It appeared that substitution of either amino or carboxylic or both groups of gamma-aminobutyric acid (GABA) with bulkier groups like aliphatic or aromatic carbons usually produced effective anticonvulsant GABA derivatives. V.GABA and P.GABA were the most effective anticonvulsant GABA derivatives in protecting all the components of MES-induced seizures. They were 2.3 and 1.5 times potent than sodium valproate in molar ratio, but P.GABA has low therapeutic index when compared to V.GABA. The observed anticonvulsant activity may be due to enhanced GABA concentration in the CNS. Probably, the active compound (V.GABA) crossed the blood brain barrier and hydrolysed to GABA and valproic acid to bring about its anticonvulsant action.

Spectrophotometric study of the relative affinities of teichoic acid for different metal ions.

Spectrophotometric study of the relative affinities of teichoic acid (TA) for Na+, Ca2+, Mg2+, Cd2+, Hg2+, Cu2+ and Pb2+ described on the basis of the disruption of metachromasia of dye 1,9-dimethyl methylene blue (DMMB)-polyanion (TA) system has revealed the following sequence of relative affinities of TA for these metals: Na+ < Ca2+ < or = Mg2+ < Cd2+ < Hg2+ < Cu2+ < Pb2+. Some of the metal ions particularly Pb2+ and Hg2+ have specific interactions with the dye, and induce distinct metachromatic band of the dye even in the absence of the polyanion.

Spectroscopic probe of distribution of the non-intercalating drug netropsin between DNA and heparin.

Circular dichroism has been used as a monitoring tool to probe the distribution of the non-intercalating drug netropsin (NTPS) between the two biomolecules DNA and heparin. The stoichiometry of the interaction of the individual biomolecules and the drug is determined from conductometric titrations; the titration in each case shows two breaks corresponding to two stoichiometries of interaction. Though netropsin is non-intercalating, DNA wins over heparin in binding the drug due to strong hydrogen bonding capability of NTPS in the minor grooves of DNA through its greater than NH donor groups. Potential hydrogen bond breakers like KF and urea reduce the induced dichroism of NTPS-DNA system, probably dislodging some drug from DNA through hydrogen bond breaking.

Neuropharmacology of amide derivatives of P-GABA.

Three lipophilic amide derivatives of phthaloyl-GABA (P-GABA), namely gamma-phthalimido N-amyl butyramide (PGA), gamma-phthalimido-N-hexylbutyramide (PGH) and gamma-phthalimido N-phenylbutyramide (PGP), were synthesized and evaluated for their hypnotic and anticonvulsant activities in mice. Both PGA and PGH showed moderate hypnotic activity but PGP had no such action. Picrotoxin (0.08 mg/kg) a non-specific GABA antagonist completely abolished the hypnotic action of PGA in subconvulsive doses. Bicuculline (0.04 mg/kg) a GABAA antagonist, 3-mercaptopropionic acid (6 mg/kg) a GAD inhibitor at subconvulsive doses failed to neutralise the hypnotic action of PGA. On the other hand, PGA showed significant protection only against picrotoxin-induced convulsions, but was inactive against other convulsants tested. PGP which has no hypnotic activity, and has a mild anticonvulsant action in all the models except picrotoxin. A definite correlation was observed between the brain GABA and the hypnotic activity of PGA. However the present data indicate that the hypnotic and anticonvulsant activities are mediated probably through different brain GABA-ergic mechanisms.

Transformation and regeneration of mung bean (Vigna radiata).

The procedure relied on a protocol in which shoot organogenesis was induced on cotyledons of mung bean genotypes selected for susceptibility to agrobacterium seems to work reproducibly if not efficiently. Approximately 4-5% of the shoots produced on the kanamycin selected cotyledons are transgenic based on assays on kanamycin resistance and GUS activity. This demonstrated that transformation and regeneration in mung bean are possible. However, raising the transformed plants in field condition is yet to be perfected.

Antinociceptive action of GABA-mimetic agent--N-phthaloyl GABA.

N-phthaloyl GABA (P-GABA), a nonselective GABA-ergic drug, showed positive analgesic response in four different models in mice, viz-tail immersion, tail clip, hot plate and writhing-induced by acetic acid. Antinociceptive ED50 (ip in mice) of P-GABA was lowest in tail immersion method (ED50 = 24.27, mg/kg). Though pethidine (10 mg/kg, ip) significantly potentiated the antinociceptive action of P-GABA (20 mg/kg, ip), pretreatment of naloxone (5 mg/kg, im) did not influence the same. Pretreatment with atropine (10 mg/kg, im), picrotoxin (0.08 mg/kg) and 3-mercaptopropionic acid (2 mg/kg) reduced the antinociceptive action of P-GABA significantly. But pretreatment with bicuculline (0.4 mg/kg), a specific GABA antagonist, did not reduce the antinociceptive action of P-GABA.

Induction of metachromasia and circular dichroism in the dye 1,9-dimethyl methylene blue by S. aureus wall teichoic acid.

Teichoic acid (TA) isolated from the Gram-positive bacteria Staphylococcus aureus induces blue shifted metachromasia in the dye 1,9-dimethyl methyleneblue (DMMB). Results of conductometric titrations show that DMMB binds to TA with 1:1 stoichiometry. Unlike DNA, this TA does not induce a definite metachromatic band in the dye acridine orange. S. aureus TA also induces strong circular dichroism (CD) in this dye with molar ellipticity value of the order of 10(4). This induction of CD in DMMB supports our earlier inference that TA in dilute solution at neutral pH has a helical conformation, and is not a random coil polymer.

Induction of metachromasia and circular dichroism in the dye 1,9-dimethyl methylene blue by ATP.

The theoretical prediction of induction of metachromasia [V Czikkely, H D Foersterling & H Kuhn (1970), Chem Phys Lett, 6,207] in a dye by a polyanion having only four to six anionic sites is proved experimentally, for the first time, in ATP--1.9-dimethyl methylene blue system. The findings show that ATP induces metachromasia in the dye at neutral pH, when ATP molecule remains fully charged providing four anionic sites to the dye cations. Conductometric titration shows that the dye molecules bind stoichiometrically to ATP (four dyes/ATP). However ATP at acidic pH and ADP and AMP at any pH fail to induce metachromasia. This is also the first report of induction of circular dichroism in bound dyes by ATP. Though the chiral moiety of ribose sugar in ATP may induce dichroism in the bound achiral dyes, the observed high molar ellipticity values indicate aggregation of bound dyes with twist in one sense initiated by the twisted conformation of the triphosphate chain in ATP. This inference on the state of conformation of ATP in its native environment is in agreement with that derived from PMR and spin lattice relaxation technique. It is thus interesting that the conformation of crystalline disodium ATP, as concluded from X-ray crystallography, is maintained by tetrasodium ATP in dilute aqueous solution--the native environment of ATP.