Study of Cardiovascular Autonomic Dysfunction in Type II Diabetes Mellitus.

Autonomic neuropathy is a common complication of diabetes mellitus which may affect major systems like cardiovascular system that may cause early death in diabetics. In our study attempt was made to asses different cardiovascular autonomic function parameters like change of blood pressure from supine to standing posture (postural BP changes) and ratio of longest and shortest R-R interval during deep expiration and inspiration respectively (E/I ratio) on ECG in type 2 diabetics and age sex matched non diabetic controls. Level of fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1C) were also measured in the same subjects. Diabetics were subdivided into <5 years and >5 years groups. Findings were compared between diabetics and the controls and also between the subgroups of diabetics. Correlation between glycaemic control , duration of disease and autonomic function parameters were tested. We found, a significant difference in postural BP changes and E/I ratios between diabetics and the controls, no significant correlation could be found out between glycaemic control or duration of disease and autonomic function parameters. Therefore, our study concludes that diabetes may lead to autonomic dysfunction that may cause postural hypotension and altered E/I ratio irrespective of the duration of disease and glycemic control.

Level of Maternal Awareness Amongst Mothers who had Undergone Elective C/S.

Caesarian section (C/S) is a very common obstetric procedure. It had many advantages and disadvantages. In this age of consumer awareness, patient has to give an informed consent before the procedure – means merits and demerits of the procedure shall be known to the patient. She also has the right to choose between different procedures, type of incision and anesthesia, where possible. We have studied that status amongst 100 such patients, only 7% of them being illiterate, who had undergone elective C/S in SNP Hospital, a two tier hospital of Kolkata. The result was shocking. 65% of the mothers did not have any idea regarding the procedure they are undergoing. 1/3rd of the patients even did not know why they are having C/S. None of them was given any choice regarding anesthesia and only 9% regarding incision. A detail of the study is presented.

Association of Obesity and Leptin with Insulin Resistance in Type 2 Diabetes Mellitus in Indian Population.

Obesity and diabetes mellitus are two modern epidemics. But their interrelationship is debated. Here we explored the probable association among obesity, leptin and insulin resistance in type 2 diabetes mellitus. 60 recent onset (<5 years) diabetics and age-sex matched 33 non diabetic controls were assessed for physical and chemical parameters like Body Mass Index, abdominal circumference, waist/hip ratio, fasting blood glucose, insulin and leptin. Degree of insulin resistance was calculated by HOMAIR method (Homeostatic Model Assessment). All the physical parameters showed positive correlation with leptin and the HOMA-IR score, strength of association being highest between insulin resistance and abdominal circumference. Leptin and insulin resistance showed no correlation. Findings were lower in controls. Study concluded that, obesity mainly central type might be responsible for insulin resistance in type 2 diabetes mellitus where as leptin, a potential marker for obesity, may not. This perhaps points towards the multifactorial causation of insulin resistance in type 2 diabetes mellitus.

Auditory evaluation of the microcephalic children with brain stem evoked response audiometry (BERA).

Microcephaly implies a reduced occipito-frontal circumference (< 2 Standard Deviation of normal) and therefore a small brain size, which is usually associated with different neurodeficit. Intactness of the auditory pathway in microcephalic as well as normal children was assessed by Brain stem Evoked Response Audiometry (BERA) to locate the exact site of lesion resulting in the auditory impairment, so that appropriate early rehabilitative measures can be taken. The study revealed that absolute peak latency of wave V, inter peak latencies of III–V and I–V were significantly higher (P- value <0.05 in each case) in microcephalics than the normal children. Auditory impairment in microcephaly is a common neurodeficit that can be authentically assessed by BERA. The hearing impairment in microcephalics is mostly due to insufficiency of central components of auditory pathway at the level of brainstem, function of peripheral structures being almost within normal limit.

Assessment of nerve conduction in evaluation of radiculopathy among chronic low back pain patients without clinical neurodeficit.

The diagnostic evaluation of chronic low back pain (CLBP) is difficult, as its primary causes are multiple. Clinical, radiological and electrophysiological findings are of limited value in diagnosing radiculopathy as the cause of CLBP in early cases. Current study was undertaken on 50 controls and 50 CLBP patients without clinical neurological deficit to evaluate the potential of nerve conduction studies, particularly H-reflex study for diagnosis of radiculopathy in these cases. We observed that routine nerve conductions in CLBP without clinical neurodeficit showed no significant differences; whereas all the H-reflex parameters, H-threshold, H latency, H amplitude and H/M ratio were significantly different when compared with that of control (P value <0.0001 in each case). We concluded that subclinical cases might not have only partial conduction block but also secondary axonal loss due to compression of nerve roots. We further suggest inclusion of Soleus H-reflex study in evaluation of radiculopathy among early CLBP cases without clinical neurodeficit.

Correlation among routine semen parameters, sperm viabilty and malondialdehyde levels in human subjects with different fertility potential.

Percentage of viable sperms has good potential to reflect male fertilizing potential. In the present study, an attempt was made to find out the percentage of viable sperms in normal and abnormal ejaculates and influence of reactive oxygen species in affecting the viability of sperm. Malondialdehyde (MDA) in seminal plasma of normal and abnormal ejaculates was measured by Thiobarbituric Acid method and percentage of viable sperms was assessed by Eosin-Nigrosin staining. The results revealed that the abnormal semen samples have significantly lower number of viable spermatozoa (59.06±9.63% vs. 68.33±5.46%, P<0.05) and higher levels of MDA (2.53±0.66 vs. 1.66±0.37 nmol/ml, P<0.05) as compared to normal. A significant negative correlation was found between seminal MDA level and sperm viability. Based on the results obtained from the present study, we suggest that viability of sperm is an authentic parameter to assess male fertility potential and it can be affected significantly by oxidative stress.