ABSTRACT
Aim The aim of this study was to determine the effect of moderate aerobic exercise on heart rate variability (HRV) in obese adults with type 2 diabetes. Methods Forty-one obese adults with type 2 diabetes participated in this study. Anthropometric and metabolic parameters were measured, and resting electrocardiogram (ECG) for the HRV analysis at spontaneous respiration was recorded for 5 min in supine position before and after six months of supervised aerobic training given thrice-a-week. Results The mean age, body mass index (BMI), and duration of diabetes of the study population were 44.1 ± 4.5 years, 30.94 ± 1.36 kg/m2, and 16.3 ± 2.7 years, respectively. In time domain variables, standard deviation of all RR intervals (SDNN), the square root of the mean of the sum of the squares of differences between adjacent RR intervals (RMSSD) and percentage of consecutive RR intervals that differ by more than 50 ms (pNN50) were significantly increased after exercise. In frequency domain variables, high frequency (HF) (ms2) and HF (nu) were significantly increased while low frequency (LF) (ms2) and LF/HF ratio were significantly decreased after exercise. But LF (nu) was unaffected after exercise. Conclusion This study suggests that thrice-a-week moderate intensity aerobic exercise for six months improves cardiac rhythm regulation as measured by HRV in obese adults with type 2 diabetes
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Background: Angiomatous nasal polyp (ANP) is a rare interesting clinical entity cause diagnostic dilemma by presenting either gradually progressive or sometimes in acute fashion with sign and symptoms suggestive of malignancy. Objective: To study the varied clinical symptoms, growth pattern and spectrum of radiological, histomorphological features. Methods: Here we studied 10 cases diagnosed with this entity and characterized the histomorhological features. We have also discussed clinical presentations and radiological features of this disease as described in the literature. Results: ANP have a prominent component of dilated capillary-type blood vessels with intraluminal thrombosis- infarction with compromise of their blood supply and extensive accumulation of extravascular stromal, perivascular pools of eosinophilic, congo red -negative pseudoamyloid- like material. Conclusion: Angiomatous nasal polyp is although benign does at times mimics malignancy causing radiologically evident surrounding bone erosion / destruction. Preoperative radiological diagnosis helpful in avoiding extensive surgery but final diagnosis is usually made by histopathological examination.
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Background: The aim of the study was to find out the correlation between pretherapeutic clinical and radiological staging of carcinoma larynx. Methods: This was a prospective cross sectional study carried out in department of ENT at Government Medical College & Dr. Susheela Tiwari government hospital, Haldwani during the period of September 2015 to 2016. 50 adult patients (mainly 4th, 5th, 6th,7th decade) having complaints of hoarseness, throat pain, neck mass etc were subjected to clinical evaluation.. Provisional clinical diagnosis of laryngeal mass was made followed by diagnostic rigid 90 degree laryngoscopy in OPD setting. It was followed by FNAC in cases of lymph node swelling. Radiological evaluation was done using CECT scan neck and MRI ( if required). Biopsy of suspected cases (malignant) was done under local or general anesthesia. Pretherapeutic clinical staging was done in patients diagnosed with carcinoma. Using information from CT and MRI pretherapeutic radiological staging was done and these patients were included in the study. Patients having benign neoplasm, lymphoma, recurrent malignant disease and those having undergone radiotherapy were excluded from the study. Comparison between pretherapeutic clinical and radiological staging of carcinoma larynx was done and its impact on treatment options was analyzed during follow up of patients. Results: It was observed in the present study that Carcinoma larynx is a male dominant disease mainly seen in elderly age group with mean age group of 65years consuming alcohol along with habit of smoking. Maximum number of cases were of supraglottic malignancy followed by involvement of glottis with no case of subglottic malignancy. In the present study we found that 32% of cases showed upstaging with CT scan, as a result of deep tumor extent undetectable at clinical examination.Conclusion:Clinical or endoscopic evaluation fails to identify invasion of the laryngeal framework and of extralaryngeal soft tissues in a high percentage of cases. An additional radiologic examination, either CT or MR imaging, is essential in most laryngeal carcinomas for the correct pretherapeutic staging and proper treatment.
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Background: Evaluation of a patient with chronic rhinosinusitis also requires proper radiological examination apart from otolaryngological examination and diagnostic nasal endoscopy. Various anatomical variations can be seen on CT Scan of nose and paranasal sinuses. Methods: This was a prospective cross sectional study carried out in department of ENT at Government Medical College &Dr. Susheela Tiwari government hospital, Haldwani during the period of October 2014 to October 2015. 30 adults patients of Chronic rhinosinusitis diagnosed clinically by revised task force criteria were included in the study. Acute rhinosinusitis, benign and malignant nasal and paranasal disease, previously operated for sinonasal pathology and facio-maxillary trauma were excluded from the study. After clinical diagnosis all patient underwent non contrast CT scan of nose and paranasal sinuses. The study reviewed coronal, sagittal and axial view in bony windows of all CT scan films. Anatomical variations were noted and their correlation with chronic rhinosinusitis was discussed. Results: Of the 30 patients of the study group, 28 (93.33 %) with DNS, 10 (33.33%) with concha bullosa, 8 (26.66%) with enlarged bulla, 6 (20%) with agger nasi, 2 (6.66%) with onodi cell were found. Conclusion: Anatomical variations are common in the osteomeatal complex. Deviated nasal septum was the most common anatomical variation encountered in our study followed by concha bullosa and enlarged ethmoidal bulla.