To evaluate the effect of yoga on moderate degree hypertension and lipid profile.

Yoga is a practice consisting of gentle stretching, breath control and mind-body intervention. So we aimed at yoga practice on blood pressure and lipid profile. Methods: Carried out at Dept of Cardiology, Owaisi Hospital and research centre. After taking written informed consent, we selected 60 Patients (30 females and 30 males) age 40 years to 60 years who attended our programs with moderate hypertension who is volunteered to participate in the study. They were trained in asanas (postures), Pranayama (breathing exercise) and relaxation techniques for 6 months. Blood pressure, Serum total cholesterol, LDL, VLDL, HDL cholesterol and total triglycerides were measured at the beginning (baseline, day 0) and at the end of the study (after 6 months). Results: The systolic blood pressure came down from 164.0+ 1.9 to 140+1.9 mmHg, Diastolic blood pressure 96+0.8 to 82+0.6 mmHg, pulse rate declined from 85+1.2 to 77 + 0.7 per min, the TC concentration decreased significantly from 200+ 6.5 to 170+ 3.6 mg/dl (p< 0.001) the LDL reduced from 166+ 4.2 to 148+3.7 mg/dl (p<0.001) and the triglycerides showed a significant decrease from 189+10.3 to 166+8.6 mg/dl (p<0.001), while the HDL cholesterol showed a marked increase from 39+1.4 to 46+1.2 mg/dl (p<0.05). Conclusion: The results conclude that the Yoga practice in patients with moderate degree hypertension leads to decrease in blood pressure and lipid profile within the period of 6 months.

Effect of sleep deprivation on blood glucose and vital data.

Background: The shift work affects human health and performance by disrupting circadian rhythms and by causing numerous alterations in human behaviour. We have taken night shift workers as they were sleep deprived people, comparing with the same variables in same persons during day shift work, to assess, how sleep deprivation (night shift work) impacts on persons health. So we decided to study the effect of sleep deprivation on blood glucose and vital data. Method: 58 normal healthy male volunteers aged ranging from 25 to 45 years were selected from Madras cement factory Limited and tested for Fasting Blood Glucose, Pulse Rate, Respiratory Rate, Temperature, Systolic Blood Pressure, Diastolic Blood Pressure before and After Sleep Deprivation. Results: Mean Fasting Blood Glucose levels after sleep deprivation, when compared to mean fasting Glucose levels after normal sleep is significantly increased (P value < 0.05). The mean Temperature after sleep deprivation, when compared to mean Temperature after normal sleep is significantly decreased (P value < 0.05). The mean Systolic Blood Pressure after sleep deprivation when compared to mean Systolic Blood Pressure after normal sleep is significantly Raised (P value < 0.05)The mean Diastolic Blood Pressure, mean respiratory rate and mean pulse rate after sleep deprivation was not significant (P value > 0.05). Conclusion: This study concludes that sleep deprivation play a role to increase blood glucose levels and blood pressure.The results suggest that sleep deprivation play a role in the etiology of hypertension and diabetes mellitus.

To evaluate the involvement of autonomic nervous system during pre and post menstrual phases in young women.

Background: During reproductive life, Women undergo many types of behavioural and hormonal changes, which influence various functions of body. ANS provides physiological adaptive background for these changes. The main aim of this study is to carry out autonomic function tests during various phases of menstrual cycle. Method: Different Methods were used to evaluate sympathetic and Parasympathetic activity. This study was carried out in two different phases of menstrual cycle viz. premenstrual phase (late luteal phase-LL) and post menstrual phase (early follicular phase –EF). Results: The autonomic function tests and heart rate variables were recorded and data was tabulated for Statistical evaluation with student paired “t” test. P 0.05 was considered as statistically significant. The tests for sympathetic activity were compared during pre and post menstrual phases. It was observed that pulse rate, blood pressure and cold pressor test were statistically more significant (p<0.01), while orthostatic variation in arterial blood pressure was statistically significant (p<0.05) in premenstrual phase as compared to post menstrual phase of menstrual cycle. For parasympathetic activity it was observed that heart rate response, expiratory: inspiratory ratio and valsalva ratio were statistically not significant (p>0.05) in both pre and post menstrual phases of menstrual cycle. Conclusion: In this study the responses to various sympathetic tests were significantly altered in premenstrual phase as compare to that of postmenstrual phase, reflecting the significant increase in the sympathetic activity. These changes may be due to gonadal steroids imbalance during post menstrual phase (EF) and premenstrual phase (LL) of menstrual cycle which in turn affects HPA axis and ANS significantly. Significant increased sympathetic activity responses indicate an augmented stress system.

Seroprevalence of chlamydial infection in patients attending STD.

Background: Chlamydial disease has the major scourges of humans. In women severe, sometimes irreversible complications usually present as the first symptom of genital infection. Though contemporary diagnostic methods are reliable for identifying infections there are economic and acceptance issues surrounding certain intervention strategies involving frequent community wide screening for early detection and for mass treatment. So we aimed at the Chlamydial infections in the community. Method: The study population was 150 cases out of which 100 cases were symptomatic patients who are attending STD clinic and 50 were control group. We selected ELISA test by the patella Chlamydia IgG ELISA kit supplied by BIO-RAD agencies, Hyderabad for detecting Chlamydia IgG antibodies after the Ethical Committee approval. Results: The test results were tabulated. Out of 100 test sera collected for chlamydial infections with variety of clinical symptoms, 12 patients have shown seropositivity, 20.83% belongs to the age group of 21-25 years, 17.64 % of them are belongs to rural group,14.18% are females and 16.66% of patients suffers with syphilis. Conclusion: Present study concludes that 12 cases were positive for chlamydial infection. Majority of the patients belong to the age group of 21-25 years and least incidence was seen among the age group less than 20 years and females were affected more than males. Distribution of chlamydial infection was more in rural area than urban and was found to be syphilis than other STD cases.

Involvement of autonomic nervous system in isometric handgrip in healthy young subject.

Background: HRV can be considered a relatively simple, noninvasive and sensitive method for studying autonomic modulation, purpose of the present study was to determine whether readily measured blood pressure (BP) indices and responses to autonomic reflex tests could be used as surrogates of short-term heart rate variability. Different Methods were used to evaluate sympathetic and Parasympathetic activity. Results: The autonomic function tests and heart rate variables were recorded and data was tabulated for Statistical evaluation. A two tailed P value less than or equal to 0.05 (5%) were considered statistically significant. Heart Rate Variability in Male Mean R-R interval and SDNN of time domain analysis were highly significant on comparing supine to standing (P<0.001),Similarly LF, HF power, Total Power and LFnu of frequency domain analysis were highly significant on comparing supine to standing (P<0.001) and in Females also it is same. Conclusion : Considering the results our data indicate a decrease in HRV that seems to be expressions of a reduction in autonomic modulation in postural change from supine to standing erect both in male and female subjects. The findings suggestive of a shift in cardiac autonomic regulation towards sympathetic activation in response to real life stressors which also includes the decrease in parasympathetic modulation and no significant correlation between readily measured blood pressure indices to heart rate variables in both male and female groups, we suggest that mean heart rate, SBP, DBP and RPP cannot be used as surrogates of HRV. However, observations need to be made in healthy subjects belonging to various age groups and in patients with conditions known to be associated with autonomic deregulation.

Assessment of autonomic function in epileptic patients

To use spectral analysis to assess the autonomic activity of epileptic patients compared with normal patients, and to assess the clinical usefulness of the applied methods of signal processing. Forty-eight patients with generalized tonic-clonic seizures and who were not taking any medications, and 48 age and gender matched controls participated in this study from July to September 2007 at Johns Hopkins Hospital, Baltimore, Maryland, and the Medical Center, Cookeville, Tennessee, United States of America. All subjects consented to participate in the research prior to their inclusion in the study, and the local ethics committee approved the study protocol. The study design was to measure peripheral blood flow [PBF] and respiration signals as well as the heart rate variability [HRV] signals derived from the ECG during supine and standing positions. The results clearly indicate that in patients with epilepsy, the coherence values are less than in the control group in both low frequency and high frequency bands at coherence spectra between HRV and PBF as well as HRV and respiration in both the supine and standing position. Autopower and coherence spectra analysis for patients with epilepsy compared to normal subjects seems useful in the assessment of autonomic function for epileptic patients. Further studies are needed using other tests and methods of signal analysis

clinicopathologic patterns of prostatic diseases and prostate cancer in Saudi patients

To determine the clinicopathologic patterns of prostatic diseases in Saudi patients, with special emphasis on prostate cancer [PCa]. The records of patients who underwent histopathological examinations of their prostatic specimens in King Abdulaziz University Medical City and King Faisal Specialist Hospital, Jeddah, Kingdom of Saudi Arabia, between June 2003 and June 2008 were reviewed retrospectively. The age, indications for biopsy, histological diagnosis, and Gleason grading of cancer patients, were studied. The study included 330 patients aged 37-100 years [median=68]. Specimens included 233 transrectal ultrasound [TRUS] biopsies, 85 transurethral resection of the prostate [TURP], 8 simple prostatectomies, 3 radical prostatectomies, and one radical cystoprostatectomy. Indications for TRUS guided biopsy in PCa patients were elevated prostate specific antigen [PSA] [85.2%], abnormal digital rectal examination [5.5%] or both [9.3%]. Prostate specific antigen values <4 ng/ml were found in 13.6% of PCa patients. Among others, adenocarcinoma was found in 28.5%, benign prostatic hyperplasia [BPH] alone in 43.3%, BPH with inflammation in 20.3% and inflammation alone in 4.2%. In specimens of TURP or simple prostatectomy for apparently benign disease, incidental PCa was detected in 14/93 [15%]. The Gleason sum of >/= 6 was found in 92.8% of patients. The incidence of prostate cancer in Saudi Arabia is low compared to the western countries. However, incidental PCa detected in presumed benign disease appears to be rising. Further future studies addressing this issue are needed to confirm the potential rising trend, and its possible etiology. Our findings support the recommendations to lower the PSA cutoff value for prostatic biopsy to 2.5 rather than 4ng/ml

Incidence and epidemiology of cerebral venous thrombosis

Cerebral venous sinus thrombosis is a disorder whose epidemiology has changed over the past few decades. It is no longer regarded as a uniformly fatal disease. CVST is not a rare disorder. It may have a differential geographic distribution with a higher incidence in the Asian world. It is a disease of neonates, younger women and men, often a hypercoagulable state, either acquired [eg cancer] or a genetic prothrombotic condition may be present. Outcome is not uniformly dismal and prognostic criteria that detect patients with a poor outcome have become available from prospective studies. There is a paucity of well designed large scale epidemiologic studies focused on venous thrombosis from regions where it is relatively frequent [South Asia, Middle East]. The newer epidemiologic data derived from a Caucasian database; suggest a better overall prognosis, younger age at distribution than arterial stroke

Pathophysiology of cerebral venous thrombosis - an overview

Cerebral venous sinus thrombosis is a disorder with a unique pathophysiology which needs to be described.A Medline search of all articles detailing pathophysiology of CVST was done, using keywords: cerebral venous thrombosis and pathophysiology. In addition, major texts were reviewed for additional references. The pathophysiology of CVST depends on two interconnected events, local signs due to venous infarct, e.g. hemiparesis and global signs due to raised ICP from an obstructed venous system - papilloedema and isolated intracranial hypertension being one of them. Pathophysiology of CVST is diverse and makes it easier to understand the diversity of clinical presentations

Thrombolytic therapy in cerebral venous sinus thrombosis

The use of thrombolytic agents to rapidly lyse the clot has emerged as a therapeutic modality, in concert with interventional neuroradiologic approaches to deliver the agent locally at the site of thrombosis.There are no randomized, double blind, placebo, controlled trials to support thrombolysis as a first line therapy in patients with cerebral venous sinus thrombosis compared to standard therapy using anticoagulation with weight based dose adjusted unfractionated Heparin. Numerous case reports and a single non randomized trial have shown that it is comparatively safe and may rescue patients who are deteriorating despite anticoagulation with unfractionated Heparin. Consideration must be given to the use of thrombolysis in this group. This is an approach that must be restricted to centers with considerable experience in neurointerventional therapy

Heparin in the treatment of cerebral venous thrombosis

Cerebral venous thrombosis [CVT] is a potentially life-threatening condition requiring rapid diagnosis and urgent treatment. Heparin anticoagulation is the time-honoured treatment, and is advocated in all cases of CVT, irrespective of etiology or presence of haemorrhage. The supportive evidence is largely observational; data from randomized placebo-controlled trials shows a nonsignificant trend favouring heparin. Current practice is to begin heparin [unfractionated or low-molecular weight] immediately on confirmation of the diagnosis. Newer anti-thrombotic agents such as ximelagatran may offer advantages over heparin and need to be investigated in the treatment of CVT

Complications associated with cerebral venous thrombosis

Although CVT is associated with a good outcome in the majority of cases, it may be complicated by numerous unique and sometimes rare complications. The purpose of this review is to discuss the acute and chronic complications of CVT in greater detail. Awareness may lead to a more aggressive approach in those in which these complications are anticipated and perhaps avoided. The complications of CVT may be temporally divided into those unique to the acute stage and those that are associated with the chronic stage of CVT. They are venous infarction and haemorrhage, subarachnoid haemorrhage, a rapid progression and pulmonary embolism. In the chronic stages of CVT, one may encounter dural AV - fistula, progressive psychiatric disease, residual epilepsy and recurrence. Cerebral venous sinus thrombosis is associated with unique acute and chronic complications, some of them may be avoidable e.g. pulmonary embolism. The chronic complications are rare but are potentially treatable e.g. dural AVFistula nidus obliteration with intervention

Isolated deep venous thrombosis - case series, literature review and long term follow up

Cerebral Venous Sinus thrombosis may rarely be isolated to a cortical vein or to the deep venous system. When the deep venous system is involved, prognosis is generally poor. In addition, long term follow up is not reported. We conducted a retrospective review of all patients admitted to a major tertiary care center, with the diagnosis of isolated deep venous thrombosis. Two patients were identified with isolated involvement of the deep venous system, they are reviewed in detail with long term follow up. Two young South Asian women in their thirties with rapid onset of neurologic signs and symptoms are reported. Even when one patient required intubation and mechanical ventilation for stupor, both had excellent neurologic recovery. Over 6 years of follow up there has been no recurrence. In spite of stupor at presentation, complete recovery is possible without long term recurrence

Sigmoid volvulus complicating pregnancy.

Sigmoid volvulus complicating pregnancy is an extremely rare complication with fewer than 76 cases reported in literature. We report a case of sigmoid volvulus complicating pregnancy. The sigmoid colon was resected and Hartman's colostomy was performed. The patient had a successful recovery. Aggressive resuscitation followed by early surgical intervention should be undertaken to reduce maternal and fetal morbidity and mortality.

Multiple births in a hospital setting

This study was conducted in Sir Ganga Ram Hospital, Lahore to study the pattern of multiple births in routine hospital deliveries, associated neonatal mortality and morbidity, and the extent of any association between multiple births and assisted conception or drugs used for sub fertility. To this end 100 mothers with multiple gestations were seen and scrutinized for risk factors like maternal age and parity, maternal height, previous twin gestation, and exposure to exogenous gonadotrophins. Similarly the neonates were assessed for gestational age, infra uterine growth retardation, asphyxia, narcotizing enterocolitis, and congenital abnormalities. The major outcome was that a higher incidence of twinning was seen in a younger maternal age group; with history of previous twin gestations; and with increasing parity

Cellular immune response in acute hepatitis B leading to chronic carrier state

Immunological studies among jaundiced patients revealed significant changes in T-helper and T-suppressor cells among chronic HBV cases from the acute and control groups. The chronic cases revealed a highly significant decrease in interleukin-2R expression but their low interferon-gamma values were statistically nonsignificant from the control group. The acute cases recorded the highest interleukin-2R and interferon-gamma values. Lymphocyte blastogenesis assay in response to different mitogens and antigens produced two groups: responders [acute cases] and nonresponders [chronic cases]. The responders revealed more intact specific and nonspecific cellular immune responses. Neither group differed with regard to their proliferative response to HBsAg, but vigorous response to HBcAg was a significant feature of the responders

Outcome of pregnancies in diabetic mothers: a descriptive study

Data of 50 diabetic mothers and their new borns collected from two hospitals over a period of twelve months was studied. 23[46%] of the mothers had gestational diabetes; 17[34%] were in White's class B, and the rest were in classes A, C and D. Out of 50 newborns, 25[50%] of the newborns had macrosomia. Among macrosomic babies, 11 were from class B and 8 from gestational diabetics. Six new borns had hypoglycemia, six had hypocalcemia, seven were jaundiced, two babies had congenital malformations, whereas 6 died. In conclusion, most of the mothers had gestation diabetes but macrosomia and Caesarean section rate were higher in infants of class B mothers

Epidemiology and prognosis of acute renal failure in children

One hundred and thirty three children with nonsurgical forms of acute renal failure [ARF] were admitted during a six-month period [January to June, 1991] to the Department of Paediatrics, Mayo Hospital, Lahore; they comprised 1.8% of the hospitalised children. Newborns and infants constituted 69% of the patients. Acute diarrhoea [53%], sepsis [21%], and haemolytic uraemic syndrome [8%] were the leading causes of ARF. The case fatality rate was 23.3%, with septicaemia as the major cause [48%] of death. Four patients [3%] developed chronic renal failure. Good prognosis indicators were prerenal oliguria versus renal oliguria, based on history, and low fractional excretion of sodium [< 1%] and renal failure index [< 1]; oliguria of less than seven days; unclouded sensorium; and early dialysis at the onset of complications

Role of serological tests in diagnosis of brucellosis

The present study included one hundred and ninety nine cases. They were divided into two main groups, namely group of brucellosis [n= 99] and infectious group other than brucellosis [n= 80], in addition, there were twenty normal subjects [control group]. Every subject was subjected to thorough clinical and serological evaluations before and two weeks after therapy. In comparison of culture positive cases of brucellosis group [n= 60] with subgroups of infectious group other than brucellosis, namely, typhoid [n= 20], T.B. [n= 20], rheumatic fever [n= 20] and U.T. infection [n= 20] and control group [n= 20], the sensitivity for both IgG and IgM was 100%, with 96% specificity of the first and 62% of the second immunoglobulin. From the above data, it can be concluded that ELISA was rapid, sensitive, reliable and specific test for diagnosis of human brucellosis