Effect of obesity on pulmonary function test: A comparative study

Background: Obesity is worldwide health problem, with increasing incidence and prevalence, high costs, and poor outcomes. Accumulation of adipose tissue mass is associated with respiratory abnormalities. There is a need to conduct pulmonary function tests (PFTs) among obese subjects and create awareness of the drawback of obesity as it is reversible lifestyle disorder.Aim and Objective: The aim of the study was to assess the PFT in obese adult males and females and compare the result with controls.Materials and Methods: PFTs of healthy non-obese subjects and obese but healthy subjects were compared and correlated in a tertiary medical college and hospital. Criteria for obesity were according to the WHO criteria of body mass index. The PFTs were carried out with a computerized spirometer (Med-Spiror).The data were collected, statistically analyzed, and valid conclusions were drawn. Results: There was a statistically significant decrease in the value of forced expiratory volume (FEV) 1 and FEV3. Peak expiratory flow rate in obese males and females whereas forced vital capacity and force expiratory flow 25–75% significantly decreased anly in obese male subjects.Conclusions: Obesity influences respiratory functions. The cause of this reduction of various pulmonary functions is due to the inability of the chest wall and thoracic cavity to expand which lead to a decrease in ventilatory volumes and total lung capacity.

Ecological problems of tree species in protected ecosystems of Orissa, India.

The tree layer vegetation of two protected ecosystems i.e. Similipal Biosphere Reserve (SBR) and Bhitarkanika National Park (BNP) of eastern ghat was analysed for structure, composition and diversity. With respect to the tree species composition the two protected ecosystems were differed from each other at the family, genera and species level. About 117 tree species representing 85 genera and 42 families were recorded in SBR. The average number of species per hectare was 32.5. However, a total of 29 tree species representing 22 genera and 16 families were recorded in BNP with an average number of species per hectare of 24.17. Species dominancy of the two protected areas was also different due to their difference in habitat condition. In SBR Shorea robusta was the most dominant species while in BNP Excoecaria agallocha was the most dominant species. Shannon-Wiener species diversity was 3.15 for Similipal and 2.314 for Bhitarkanika indicating that Similipal was highly diverse than Bhitarkanika. In general both the protected ecosystems of Orissa are highly rich in biodiversity and are characteristics of good ecological wealth of eastern ghat. Thus conservation and management practices are essential for the sustainability of their biodiversity.

Malarial hepatitis as a component of multiorgan failure--a bad prognostic sign.

A prospective study among the patients (n = 301) belonging to the coastal districts of Orissa having complicated falciparum malaria with multiorgan failure fulfilling modified APACHE II criteria, for a period of two years in this hospital setting was carried out with particular emphasis on hepatic involvement. There were 206 males and the rest females. Hepatic involvement in the form of raised serum bilirubin levels > or = 6 mg% and prothombin time > 4 compared to controls was found in 192 cases (63.8%). On analysis out of 192 cases predominantly conjugated hyperbilirubinaemia, mixed patterns and unconjugated hyperbilirubinaemia were seen in 115 (59.9%), 64 (33.3%) and 13 (6.8%) cases respectively. Serum bilirubin ranged from 6 to 38 mg%. Aminotransferase aspartate (AST, SGOT) and aminotransferase alkaline (ALT, SGPT) were raised almost two-fold in 98% cases of multiorgan failure with hepatic failure with mean values of 78 +/- 30.4 IU/l and 81 +/- 29.06 IU/l respectively. Nearly three-fold elevation of alkaline phosphatase was observed in 80% cases with mean (315 +/- 39.4 IU/l). Prothombin time was prolonged with mean 7 +/- 3 seconds. Serum proteins and albumin/globulin ratio were normal. There was no difference in glycaemic status over controls. In selected cases, liver histopathological study showed abnormalities in the form of Kupffer cell hyperplasia, mononuclear cell infiltration, hepatocyte necrosis, fatty changes and cholestasis. Majority of patients in multiorgan failure who died, had hepatic failure.

Randomized control trial of quinine and artesunate in complicated malaria.

OBJECTIVE: To study the comparative efficacy of the quinine and artesunate in complicated malaria in children. METHODS: All cases admitted to the Pediatrics ward of our hospital with clinical features of complicated malaria (WHO criteria) having asexual forms of P. falciparum in the peripheral smear, were included in the study. Relevant investigations were carried out for confirmation of diagnosis and to assess the prognosis. The patients were sub-grouped into 6 categories as per clinical presentations and each subgroup received alternatively either quinine or artesunate by systematic random sample method. Every odd number received quinine (Group-1) and every even number received artesunate (Group-2). 40 cases in each group were considered for the study and the data obtained were compiled and analyzed by suitable statistical tests. RESULTS: 80 children with complicated malaria enrolled in the present study, of which 48 were boys and 32 were girls. The mean age was 7.93+3.56 years. The most common presentations were fever, splenomegaly and altered sensorium. The CRT, FCT and PCT were significantly less in the artesunate group (50.4 +/- 31.49 hrs; 43.55 +/- 20.12 hrs, and 41.67 +/- 16.78 hrs respectively) as compared to the quinine group (70.15 +/- 17.56 hrs, 62.23 +/- 16.99 hrs, and 52.24 +/- 12.69 hrs respectively) ( p<0.05) No side effects were observed in the artesunate treated group. CONCLUSION: Artesunate is a much better drug than quinine in complicated malaria in terms of rapid coma resolution, fever clearance, parasite clearance and better tolerability.

Acute erythroleukemia--M6B.

Acute Erythroleukemia is a rare disorder of hematopoietic system, accounts for 1-3% of all acute leukemia and 15% of myeloid leukemia. Recently, the World Health Organisation & Society of Haematopathology proposed a change in the categorization, with M6a and M6b subgroups of the original FAB classification. Hereby we report a case of acute erythroleukemia--M6b subtype, presented with pain abdomen and vomiting. The patient died within two days. The case is being reported for its rarity and uncommon presentation.

Retroperitonial atypical lipomatous tumour--a case report.

We report a case of atypical lipomatous tumor-sclerosing type, a rare retroperitoneal soft tissue liposarcoma, presented with vague musculoskeletal symptoms. Patient was managed with complete resection of the tumor mass with adjuvant chemotherapy. The patient is doing well, with no evidence of recurrence 22 months after the treatment.

Diffuse cavernous haemangioma of the rectosigmoid with bladder involvement--a case report.

Haemangiomas of large bowel are very rare. We report extensive colonic haemangiomatosis in one young boy affecting bladder, sigmoid colon & descending colon. The patient was managed with sphincter saving operation.

Atypical presentations of falciparum malaria.

To identify the uncommon presentations of falciparum malaria in an endemic area and to assess the outcome of treatment, a study was carried out on 35 proved cases whose clinical presentations were either dominated by features other than fever or the history of fever was totally absent. Both urban and rural patients were included. Seventeen cases (48.3%) presented with features of cerebral malaria. Acute abdomen, urticaria, and unexplained shock were the other atypical presentations. Five cases (14.3%) of cerebral malaria died. We conclude that awareness of atypical presentations is important to detect cases of falciparum malaria in an endemic area. Intravenous quinine may need to be given promptly even when cerebral malaria is diagnosed empirically.