The role of motor nerve conduction: in cervical radiculopathy patients

Background: Cervical radiculopathy is the clinical description of when a nerve root in the cervical spine becomes inflamed or damaged, resulting in a change in neurological function. Neurological deficits, such as numbness, altered reflexes, or weakness, may radiate from the neck into the shoulder, arm, hand, or fingers. Patient also complains of tingling, numbness or loss of sensation along with the nerve root dermatome. It is a substantial cause of disability and morbidity, and its cost-effective evaluation and treatment are crucial so there is a definite need to establish a cost effective, reliable, and accurate means for establishing the diagnosis of cervical radiculopathy. Electrodiagnostic tests are the closest to fulfil these criteria out of which nerve conduction tests are one of the electrodiagnostic test.Methods: In this study motor nerve conduction of ulnar and median nerve done in 30 clinically proven cervical radiculopathy patientsResults: There are significant decrease in the conduction velocity of both nerve (median nerve (51.60±7.5), Ulnar nerve (50.60±5.6)) and significantly increased in the mean latency of both nerve (median nerve (6.02±2.4), ulnar nerve (5.8±1.8)).Conclusions: Authors concluded that MNC is the specific test for the diagnosis of cervical radiculopathy. At least the MNC of both nerves included in diagnostic criteria of cervical radiculopathy.

Spectral Parameters of HRV In Yoga Practitioners, Athletes And Sedentary Males.

Physical inactivity is an important risk factor for cardiovascular mortality and morbidity. Exercise is considered an acceptable method for improving and maintaining physical and emotional health. Although yoga is historically a spiritual discipline, a growing body of evidence supports the belief that yoga benefits physical and mental health. The objective of this study was to evaluate heart rate variability which reflects autonomic control of heart among yoga practitioners, athletes and individuals with sedentary lifestyle. The study was carried out in the departments of physiology at MAMC Agroha, Hisar and Pt. BD Sharma PGIMS Rohtak, Haryana. The study group comprised of 1200 healthy male volunteers of 16 to 55 years of age. The study group was divided into four age groups: Group A of age 16 to 25 years; Group B of age 26 to 35 years; Group C of age 36 to 45 years and Group D of age 46 to 55 years. All age groups were further divided into three categories i.e athlete (runner), yoga (yoga practitioners) and sedentary in which individuals with sedentary life style were included. The basal recording of ECG in lead II was done for 5 minutes. The Polyrite-D ECG data was used for analysis of heart rate variability by frequency domain method. Two spectral components were recorded namely high frequency (HF) component (0.15-0.4 Hz), an indicator of vagal efferent activity and low frequency (LF) component (0.04-.15 Hz), replicator of composite sympatho-vagal interplay. HF component in normalized unit was found significantly high in age group B and C in yoga practitioners and athletes as compared to sedentary individuals and in age group D significantly high in yoga practitioners as compared to athletes and sedentary individuals. Significantly decreased LF/HF ratio was found in age group B and C in yoga and athlete subjects as compared to sedentary individuals and in age group D in yoga practitioners as compared to athletes and sedentary individuals. This indicates that parasympathetic activity is substantially greater in yoga practitioners.

Effect of chronic exposure to biomass fuel smoke on pulmonary function test parameters.

Background: Life in a typical Indian household revolves around the cooking area, and Indian women spend much of their time there. Cooking stoves in most households are nothing more than a pit, a chulha (a U-shaped construction made from mud), or three pieces of brick. Cooking under these conditions entails high levels of exposure to cooking smoke. Aim of this study was to evaluate the effect of Chronic Exposure to Biomass Fuel Smoke on Pulmonary Function Test Parameters. Methods: 60 non-smoking women without any history of any major chronic illness in the past were selected for this study. The study group comprised of 30 rural female subjects who were chronically exposed to biomass fuel smoke combustion and 30 age matched urban female subjects exposed chronically to clean fuel combustion (Liquified Petroleum Gas–LPG) in Haryana (India). All the subjects were evaluated for pulmonary function tests by RMS Medspiror. Results: Biomass exposure index came out to be 85.68±3.69 for women cooking on biomass and LPG index was 64.17±6.97 for women cooking on LPG. This implies significant chronic exposure of women to biomass fuel smoke. The lung function parameters were significantly lesser in biomass exposed rural women [FEV1 (p<0.01), FVC (p<0.01), FEF25-75 (p<0.01), FEV1/FVC ratio (p<0.01), PEFR (p<0.01), MVV (p<0.01)] than the LPG exposed urban women. The evaluation of PFT suggested obstructive type of pulmonary disease. Conclusion: The derangement in pulmonary function parameters in women exposed to biomass smoke pollutants could be due to chronic significant exposure as suggested by high Biomass exposure Index. Inadequate ventilation in cooking area without chimney/vent also contributed to pulmonary function derangement and COPD.

Effect of gamma linolenic acid pretreatment on diabetic neuropathy in rats.

Background: The present study was planned to evaluate the preventive effects of gamma linolenic acid (GLA) on STZ induced diabetic neuropathy Methods: Streptozotocin (STZ) induced diabetic neuropathy in rats was monitored by measuring blood sugar levels, body weight, motor nerve conduction velocity (MNCV) and nociception. Forty rats were divided into 4 groups of 10 each. Group 1: control (vehicle), Group 2: STZ (50 mg/kg, i.v., single injection), Group 3: Gamma linolenic acid (50 mg/ kg, p.o., daily + STZ), Group 4: STZ + Insulin (4 units/kg, s.c., bid). Similar protocol was used for other parameters also. Results: Gamma linolenic acid pretreatment failed to reduce blood sugar levels in diabetic rats but prevented deterioration of motor nerve conduction velocity as compared to STZ diabetic rats. A significant weight gain was observed in STZ diabetic rats pretreated with GLA as compared to rats received STZ alone. Hyperalgesia induced by STZ was antagonized by GLA Conclusions: Thus gamma linolenic acid prevents the development of neuropathic changes induced by STZ in rats.

Validity of visual evoked response in measuring ethambutol induced optic neuritis in tuberculosis patients: Evaluation using receiver operating characteristic [ROC] curves

Significant vision loss can occur during treatment with Ethambutol [EB] in tuberculosis [TB] patients. Visual Evoked Response [VER] is often used to detect this subclinical visual impairment even before the appearance of symptoms. We assessed the usefulness of three VER parameters- P[100] latency, amplitude and interocular difference for the early diagnosis of ethambutol-induced optic neuritis [ON]. This study was carried out on 60 newly diagnosed adult cases of tuberculosis aged between 20-50 years who were randomly assigned into two groups of 30 each. Nonparametric Receiver Operating Characteristic [ROC] analysis was used to evaluate the validity of VER indexes. At a cut-off pint of 116 ms sensitivity for the diagnosis of ON was 77.8% and specificity was 81.1%. Results of the application of Bayes's theorem showed that 87% of the patients scoring 116 ms or higher would actually have ethambutol-induced ON and 99% of those scoring less than 116 ms would not have ON. The best area under curve [AUC] for ROCs, an index of diagnosing accuracy, was 0.91 for P[100] latency, suggesting very good accuracy. The results suggest that P[100] latency gives the best results for ON screening in ethambutol treated patients. Amplitude and interocular difference were reasonable alternatives. Measurement of P[100] latency of VER is a valuable tool which can be used more easily than clinical examination in detecting subclinical ethambutol-induced ON

Efficacy of PS-VEPS in the detection of subclinical optic neuritis following ethambutol in therapeutic dosage

Ethambutol is an antimicrobial agent used frequently to treat tuberculosis. The most commonly recognized toxic effect of ethambutol is optic neuropathy, which may sometime result in irreversible vision loss. However, early recognition not only prevents this complication, it also increases compliance of the drug. This study was carried out to assess the usefulness of pattern-shift visual evoked potentials [PS-VEPs] in the detection of sub clinical optic neuropathy in patients on ethambutol for the treatment of tuberculosis in the recommended dosage. 30 consecutive patients of tuberculosis were studied before and after two months of ethambutol therapy. Ethambutol was administered in the WHO recommended dosage of 15mg/kg of body weight. All the patients underwent pattern shift visual evoked potential tests, which check the function of the visual pathway from the retina to the occipital cortex. PS-VEP abnormalities were seen in 5 patients [16.7%],out of which prolonged latency was documented in 3 patients [10%],increased latency difference was seen in 1 patient [3.3%] and abnormal amplitude difference was reported in 1 patient [3.3%].Associated psychophysical abnormalities of visual acuity in 2 patients [6.7%] and color vision abnormality in 1 patient [3.3%] were also seen. Our study confirms that during the treatment with ethambutol, PS-VEPs may reveal a surprisingly high percentage of sub clinical optic neuritis even at dosages considered to be safe. This needs attention in terms of patient care and drug compliance