An epidemiological study of obesity in Shimla Town.

A cross sectional study of 888 randomly selected subjects in Shimla town was done to determine prevalence of obesity, its relation to age and physical activity. The prevalence of obesity was 21.5% using cut off levels of BMI 25. The prevalence of obesity rose significantly with age. Obesity was less in those having moderate physical activity as compared to those with low and high activity. Primary prevention is required to tackle this disease risk factor through health education focussing on promotion of moderate regular physical activity.

Complications of treadmill testing.

Complications occurring in 2,400 treadmill tests are reported, out of which 2107 (87.8%) were on males and 292 (12.2%) on females. The total number of patients with complications was 29 (1.2%) and the types were: acute MI in 2, ventricular tachycardia (sustained) in 3, nonsustained in 7 with ventricular couplets in 3 patients, atrial tachyarrhythmias in four of AVNRT in 2, EAT in 2, SVT with abberancy in 1, SVT (undifferentiated) in 3, bradyarrhythmias in form of sinus bradycardia in 4, hypotension in 4 and AV block in 2. There were no deaths. Only 8 (0.33%) patients required treatment-2 each of acute MI, sustained VT, AVNRT and hypotension, though only 4 of them were hospitalised (2 each of acute MI and VT) and subsequently discharged. Highest incidence of complications was seen in post MI patients (2.01%) followed by those with typical anginal pain (1.9%) and they had more serious problems in form of MI and sustained VT. 55.17% patients with complications were positive for provocative ischaemia as compared to 22.75% positivity in the total. Although 14 (38.2%) patients developed complications at workload of 4-6 METS but 2 achieved load of 10 METS also. Complications were seen mostly during exercise and also during recovery only.

Clinical profile of stroke in relation to glycaemic status of patients.

Present study was undertaken in fifty consecutive patients of acute stroke to assess the role of glycemic status on clinical profile of stroke. Majority of patients (76%) were in age group of 41-70 years. The patients were classified into four groups: euglycemics (33), known diabetics (8), newly diagnosed diabetics (6) and stress hyperglycemics (3). Diabetics as well as stress hyperglycemics had higher prevalence of larger sized severe haemorrhagic stroke with poor outcome and there was positive correlation between them.

Plasma lipoproteins in cortical and lacunar infarction.

Plasma lipoproteins in 30 patients of cortical infarction and 20 patients of lacunar infarction were estimated to study the relation of plasma lipids to the risk for ischaemic stroke by comparing clinical and biochemical characteristics of survivors. No significant differences were observed in the concentrations of total cholesterol, triglycerides, low density lipoproteins, very low density lipoproteins in both the groups. However patients with lacunar infarction had higher concentrations of high density lipoproteins as compared to patients with cortical infarction. These data suggest that previously demonstrated differences in HDL concentration between patients with ischaemic stroke and control subjects without stroke may be true for patients with cortical infarction but not for patients of lacunar infarction.

A study of nerve conduction velocity in patients on diphenylhydantoin therapy.

Peripheral nerve conduction studies were performed in 30 epileptics, treated with DPH and results were compared with age and sex matched controls. There was significant reduction in the amplitude of sensory nerve action potential of median (26.65 +/- 14.71 mu v) and superficial radial nerve (25.65 +/- 10.08 mu v) (p < 0.001) in DPH treated group as compared to controls, (median nerve 42.64 +/- 15.93 uv and superficial radial nerve 40.72 +/- 24.74 mu v). The results suggest that DPH causes a subclinical distal axonal neuropathy in therapeutic dosage.

Japanese B encephalitis with neurocysticercosis.

A case of Japanese encephalitis (JE) with multiple calcified lesions suggestive of calcified neurocysticercosis on CT scan of the head is reported. The presence of nonenhancing calcified lesions and rising antibody titres for JE differentiated it from acute encephalitis neurocysticercosis. Post mortem studies indicate that neurocysticercosis predisposes to fatal JE infection. The present report is of an association of the two diseases which did not result in a fatal outcome.

Role of aluminium in sporadic motor neuron disease.

In an attempt to ascertain the role of aluminium in sporadic motor neuron disease (MND), trace metals were estimated in blood, plasma and cerebrospinal fluid (CSF) of 38 patients of sporadic MND and 30 controls by direct current plasma emission spectrophotometry. CSF aluminium levels (20.76 +/- 4.38 micrograms/dl) were significantly higher (P less than 0.05) in those patients of MND who presented as progressive bulbar palsy (PBP) as compared to the other subtypes of MND (amyotrophic lateral sclerosis = 7.71 +/- 2.01 micrograms/dl; progressive muscular atrophy = 10.01 +/- 2.41 micrograms/dl) and controls (11.63 +/- 2.82 micrograms/dl). Aluminium may be important in the etiopathogenesis of a subgroup of sporadic MND.

Q-T interval changes in acute transmural myocardial infarction.

The serial Q-T interval changes were studied in 29 survivors of acute transmural anteroseptal (11 patients), extensive anterior (10 patients), and inferior (8 patients) myocardial infarctions admitted 4 to 48 hours after the acute episode. Q-T prolongation evidenced by abnormal Q-T ratio was a constant and almost universal feature detected in 28 (97.06%) patients. The maximum Q-T prolongation was observed on an average about 36 hours after the onset of acute episode. Patients with anterior myocardial infarction had significantly higher Q-T ratios than inferior myocardial infarction group. There was a rapid decline towards normal in anteroseptal and inferior myocardial infarction groups in which it settled during initial six days, whereas, in extensive anterior myocardial infarction group, it took a longer time beyond six days to settle. The normalization of Q-T interval did not correspond to settling down of the elevated ST segment. Patients having ventricular tachyarrhythmias (VT and frequent VPBS) (14) had significantly higher Q-T ratios than those without arrhythmias. Further, the Q-T ratio was significantly higher in patients with VT (4) than in those with frequent VPBs (10). Alterations in Q-T ratio were not related to severity or extent of infarction and occurrence of heart failure. It is concluded that prolongation of electrical systole (Q-T interval) is a constant phenomenon after acute transmural myocardial infarction, magnitude and time course of its alterations being related to location of infarct and its electrical complications. It does not seem to have any correlation with mechanical complications of infarction.(ABSTRACT TRUNCATED AT 250 WORDS)