Knowledge, awareness, and risk prevention among hepatitis patients attending a tertiary care hospital in Delhi

Introduction: People living with chronic viral hepatitis in India often lack awareness on risk factors and prevention. Moreover, due to fear of stigma and discrimination, they often delay appropriate and timely treatment, resulting in chronic treatment and impoverishment. The objective of this study is to assess knowledge, awareness, and prevention regarding risk factors among viral hepatitis-infected patients attending a super-specialty hospital in Delhi. Material and Methods: Data were collected from 389 patients using systematically random sampling using a pretested, structured interview schedule from patients attending Institute of Liver and Biliary Sciences, New Delhi. Results: Findings revealed that 90.7% of the respondents believed that hepatitis B virus/hepatitis C virus (HBV/HCV) can be transmitted through sexual contact with a person who is infected, 94.3% said that it can be transmitted by transfusion of infected blood, 90% reported that it can be spread from infected mother to child during child birth, 93.8% responded that it can be transmitted if a person uses a razor, pierced ear ring, needle, or syringe used by an infected person, 83% believed that HBV/HCV can cause cancer in 90% of the respondents in long run, and more than 35% believed that HBV/HCV is curable. Results also show that 7.2% of the respondents have been vaccinated for HBV infection in the past, 20.8% of the respondents have screened their families for hepatitis B infections, and 77.9% of the respondents have received antiviral medications. Conclusion: HBV/HCV-infected patients had less knowledge about various facts regarding disease and continue to experience emotional disturbances, stigma, and discrimination.

Nerve Entrapment In The Osseoaponeurotic Tunnel Mimicking Struther’s Ligament Associated With Superficial Brachial Artery: An Embryological Error

Introduction: Coracobrachialis muscle is well known for its morphological variations. Anatomical variation ofcoracobrachialis near its insertion can cause compression of median nerve and brachial artery by mimickingstruther’s ligament. Our aim of the study was to examine and record the variations in origin and insertion ofcoracobrachialis muscle and to see their relationship with the median nerve and brachial artery.Methodology: During routine dissection for undergraduate students in KFMSR, 64 upper limbs were dissectedand observed for any variations in origin and insertion of Coracobrachialis muscle.Results: Of the 64 upper limbs dissected, we noted that in one cadaver, there were two heads of origin forcoracobrachialis muscle and there was also a variation in the insertion as abnormal slips, which were attachedto antebrachial fascia. The blood supply to this muscle was from the muscular branches of superficial brachialartery.Conclusion: The knowledge of this type of variations is important for surgeons, radiologists, neurologists andphysiotherapists for proper decision making during surgical considerations and injuries around elbow joint.Neurovascular structures like median nerve and superficial brachial artery may be compressed by the abnormalslips of coracobrachialis close to insertion.

Insulin sensitivity and cardiac autonomic function in young male practitioners of yoga.

BACKGROUND: While yoga is thought to reduce the risk of chronic non-communicable diseases such as diabetes, there are no studies on insulin sensitivity in long term practitioners of yoga. We assessed insulin sensitivity and cardiac autonomic function in long term practitioners of yoga. METHODS: Fifteen healthy, young, male practitioners of yoga were compared with 15 young, healthy males who did not practice yoga matched for body-mass index. Fasting insulin sensitivity was measured in the fasting state by the hyperinsulinaemic-euglycaemic clamp. RESULTS: There were no significant differences between the groups in their anthropometry or body composition. However, the fasting plasma insulin was significantly lower in the yoga group. The yoga group was also more insulin sensitive (yoga 7.82 [2.29] v. control 4.86 [11.97] (mg/[kg.min])/(microU/ml), p < 0.001). While the body weight and waist circumference were negatively correlated with glucose disposal rate in the controls, there were no similar correlations in the yoga group. The yoga group had significantly higher low-frequency power and lower normalized high-frequency power. CONCLUSION: Long term yoga practice (for 1 year or more) is associated with increased insulin sensitivity and attenuates the negative relationship between body weight or waist circumference and insulin sensitivity.

Measurement of 24 h energy expenditure in male tuberculosis patients.

BACKGROUND & OBJECTIVES: The total daily energy expenditure in patients with infectious disease is presumed to be high because of an increase in the basal metabolic rate (BMR), a reason for the weight loss observed in these patients. A reduction in daily physical activity, which may reduce the total daily energy expenditure. The aim of this study was to measure the free living total daily energy expenditure and physical activity of newly diagnosed hospitalized patients with tuberculosis using the labelled bicarbonate method. METHODS: In 6 healthy volunteers and 6 patients with newly diagnosed tuberculosis, 13C labelled bicarbonate method was used to measure free living total daily energy expenditure and physical activity. The 13C sodium bicarbonate (NaH13CO3) tracer was infused intravenously over a 48 h period and breath samples collected at regular intervals to estimate expired 13CO2. RESULTS: The patients had a 14 per cent increase in their BMR although they were not febrile at the time of measurement. However, their total daily energy expenditure was lower than that of the controls (mean value of 8.3 and 10.3 mJ/day respectively) and their physical activity level was also lower (mean 1.4 and 1.6 units respectively). INTERPRETATION & CONCLUSION: The total daily energy expenditure of afebrile patients with newly diagnosed tuberculosis is not higher than that of sedentary controls, despite an increased basal metabolic rate. It is possible that the observed weight loss in patients with tuberculosis is due to a reduced energy intake linked to anorexia associated with the disease. These findings may have relevance in nutritional treatment of chronic infections.

Bicarbonate kinetics in Indian males.

Measurement of rates of in vivo substrate oxidation such as that of glucose, fatty acids and amino acids, are based on tracer (14C or 13C) data, and often depend on the isotopic content of expired CO2. The recovery of tracer-labelled CO 2 generated from the oxidation of 13C labelled substrates may not be 100% over short term. This can lead to underestimation of oxidation rate of substrates, and consequently a correction for the incomplete recovery of tracer has to be applied by the determination of the recovery of 13CO2 in the breath during tracer bicarbonate infusions. We have studied the recovery of tracer-labelled bicarbonate using a bolus administration model, and further characterized kinetics of bicarbonate using a three-compartment model, to assess which compartmental fluxes changed during the change from a fasted state to fed state. Recovery of bicarbonate was lower at 69% and 67% (fasted and fed state) than the value of 71% and 74% found during earlier longer term of continuous infusions. During feeding, there was a 20-fold increase in the flux of bicarbonate between the central compartment and the compartment that was equivalent to the viscera. This study shows that the difference between the fasted and fed state recovery of tracer bicarbonate similar to that obtained with continuous infusions, and that bicarbonate fluxes show large changes between different compartments in the body depending on metabolic state.