Cardiovascular Status in Newly Detected Chronic Kidney Disease Patients

Objective: Cardiovascular disease is one of the leading causes of morbidity and mortality among chronic kidney disease patients. This study aims to assess the cardiovascular status of newly detected chronic kidney disease patients in northern India. Methods: All the patients who attended renal OPD were reviewed (for one year). Patients with elevated blood urea and serum creatinine levels with confirmed medical renal disease on USG were included in the study. Any history of previous renal disease/failure, rheumatoid arthritis, documented connective tissue disorders, liver disorders, malignancy, pregnancy, hypertension, diabetes mellitus, smoking, were excluded from the current study. Total of 42 newly detected CKD patients was included in the study. Their ECG and echocardiography were performed. Results: ECG analysis revealed no rhythm or ischemic disease but 27 out of the 42 patients (64.29%) showed mild to moderate left ventricular hypertrophy. The echocardiographic examination confirmed the hypertrophy diagnosis in 61.9% of patients. Conclusion: Newly diagnosed CKD patients even without previous history of cardiovascular symptoms may be present with advanced cardiovascular abnormalities. Cardiovascular and kidney diseases may have a common cause and together result in a very poor prognosis. Thus screening, early diagnosis, and treatment of these risk factors must become a priority.

Implementation and Evaluation of Priming as a Teaching-learning Tool for Enhancing Physiology Learning Among Medical Undergraduates

Background: It has been observed over the years that despite the best efforts of the teachers in reinforcingkey concepts in their lectures, the outcome in terms of students’ performance is not commensurate withthe efforts, especially when the students in question are mediocre. Our study focusses on a teachinginnovation that is more student-centric (active) than teacher-centric.Objectives: To demonstrate the benefits of priming students before delivering formal (didactic) lecture onkey concepts.Methods: Students were randomly divided in two groups (A and B). Both the groups were primed on differenttopics with an open-book MCQ based test, before didactic lectures. This was followed by didactic lectureson these topics and subsequent MCQ based assessment of both the groups, where one group serving asa control for the other and vice-versa. Marks obtained were compared between the groups using MannWhitney U test. Questionnaire was also administered to elicit their views on the method.Results: The mean marks scored by “Group A” primed on Nerve-Muscle topics (17.08±1.85) were significantlyhigher (p=0.0037) than the marks scored by the unprimed group (15.94±1.82). Improvement was observedin “Group B” primed on Blood-Immunity topics also but was statistically non-significant. (17.28±1.73 Vs16.74±1.81, p=0.1351). The students’ declared the ‘self-priming ‘process as an effective way of learning,which helped in better orientation during class-room lectures.Conclusion: The study proves the combination of student-centric priming model and didactic lecture assuperior to the conventional, teacher-centric method alone.

Management of insomnia: current trends.

Insomnia is one of the most commonly occurring sleep disorders worldwide.1 With increased prevalence of insomnia the demand of the people seeking pharmacological treatment for this disease is continuously increasing. Numerous options are currently available for its treatment and with our increased understanding of the neurophysiological factors involved in the insomnia continuous research is being conducted to seek newer pharmacological treatments. Recent advancement in treatment of insomnia is the introduction of non-benzodiazepine hypnotic medications such as zaleplon, zolpidem, and eszopiclone. Ramelteon, a melatonin agonist, is also helpful for sleep initiation diffi culties. Tri-cyclic antidepressants have long been used for insomnia but use has been limited by unwanted anticholinergic side-effects. A hypocretin/orexin antagonist MK-4035 is presently in clinical trials. Serotonin antagonists and inverse agonists are being investigated for their usefulness in insomnia; newer research examining other mechanisms of action suggest that agents which modulate the histaminergic, serotonergic, melontonergic, and hypocretin/ orexin and perhaps gamma-aminobutyric acid B systems could play a promising role in management of insomnia

Effect of calcium channel blockers on the serum levels of thyroid hormone.

Background: The effect of the calcium channel blockers on the cardiovascular system is implemented judiciously in different conditions related to cardiovascular system such as angina pectoris, hypertension, and in cardiac arrhythmias but the aspect that deals with the impact of blockade of calcium channels in other systems like endocrine system remains eclipsed. These effects generally go unnoticed and the present study was formulated to elucidate the serum T3, T4, TSH levels after administration of calcium channel blockers and to observe the resultant side effect on the endocrine glands, if any by this commonly used group of drugs. Methods: The study was conducted on male albino rabbits, they were divided in three groups of ten each and each group received one of the calcium channel blockers- Verapamil, Diltiazem and Nifedipine for three months. At the end of each month the serum T3, T4, TSH levels were evaluated by chemiluminisence. Results: It was found that on continuous daily administration of calcium channel blockers there was a gradual fall in levels of T3 and T4 with rise in TSH levels in comparison to the control value taken before initiating the drug therapy. Conclusion: These findings could have potential clinical implications and this study proposes the importance of blood thyroid hormone level follow up in the long-term calcium channel blocker therapy.