Validity of a Novel Research-Grade Physical Activity and Sleep Monitor for Continuous Remote Patient Monitoring.

In the midst of the COVID-19 pandemic, Remote Patient Monitoring technologies are highly important for clinicians and researchers. These connected-health technologies enable monitoring of patients and facilitate remote clinical trial research while reducing the potential for the spread of the novel coronavirus. There is a growing requirement for monitoring of the full 24 h spectrum of behaviours with a single research-grade sensor. This research describes a free-living and supervised protocol comparison study of the Verisense inertial measurement unit to assess physical activity and sleep parameters and compares it with the Actiwatch 2 actigraph. Fifteen adults (11 males, 23.4 ± 3.4 years and 4 females, 29 ± 12.6 years) wore both monitors for 2 consecutive days and nights in the free-living study while twelve adults (11 males, 23.4 ± 3.4 years and 1 female, 22 ± 0 years) wore both monitors for the duration of a gym-based supervised protocol study. Agreement of physical activity epoch-by-epoch data with activity classification of sedentary, light and moderate-to-vigorous activity and sleep metrics were evaluated using Spearman's rank-order correlation coefficients and Bland-Altman plots. For all activity, Verisense showed high agreement for both free-living and supervised protocol of r = 0.85 and r = 0.78, respectively. For physical activity classification, Verisense showed high agreement of sedentary activity of r = 0.72 for free-living but low agreement of r = 0.36 for supervised protocol; low agreement of light activity of r = 0.42 for free-living and negligible agreement of r = -0.04 for supervised protocol; and moderate agreement of moderate-to-vigorous activity of r = 0.52 for free-living with low agreement of r = 0.49 for supervised protocol. For sleep metrics, Verisense showed moderate agreement for sleep time and total sleep time of r = 0.66 and 0.54, respectively, but demonstrated high agreement for determination of wake time of r = 0.83. Overall, our results showed moderate-high agreement of Verisense with Actiwatch 2 for assessing epoch-by-epoch physical activity and sleep, but a lack of agreement for activity classifications. Future validation work of Verisense for activity cut-point potentially holds promise for 24 h continuous remote patient monitoring.

Effect of Oral Contraceptive Pills on the Blood Serum Enzymes and DNA Damage in Lymphocytes Among Users.

The continuous use of synthetic hormones as contraceptive pill or hormonal replacement therapy among women is increasing day by day. The widespread use of different formulations as oral contraceptives by women throughout their reproductive cycle has given rise to a serious concern for studying the effects of oral contraceptives on enzymatic profile and DNA damage in peripheral blood lymphocytes among users. The present study was carried out on women taking oral contraceptives. The study was based on the questionnaire having the information of reproductive history, fasting, age, health, nature of menstrual cycle, bleeding and other disease. The profile of the blood serum enzymes i.e. alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), lactate dehydrogenase (LDH), aminotransferases (SGOT and SGPT), serum proteins (albumin and globulin) and DNA damage in lymphocytes was studied among users and non-users. The results of the present study suggest that OCs not only effects enzymatic activity but also results in DNA damage that may vary with the duration of using oral contraceptives. A significant increase in LDH, GGT, SGPT, SGOT, globulin and decrease in ALP as well as albumin was found among users as compared to non-users. The observed DNA damage was more in users as compared to non-users. Hormonal contraceptives seem to exert DNA damage and also have significant effects on blood serum enzymes.

Correlation between bone mineral density and oxidative stress in postmenopausal women.

BACKGROUND: Postmenopausal osteoporosis affects large fraction of elderly women. Oxidative stress (OS) appears to be involved in its pathogenesis. The scarcity of human studies focusing on the correlation between bone mineral density (BMD) and OS in postmenopausal women has prompted us to study on this issue. MATERIALS AND METHODS: We conducted a cross sectional study in 95 subjects, between 21-65 years of age, including postmenopausal osteoporotic females (n = 35), healthy postmenopausal females (n = 30) and healthy females in reproductive age group (n = 30). We measured serum antioxidant activity of superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx), and total antioxidant power (TAP). BMD was obtained at lumbar spine and femur neck by dual-energy X-ray absorptiometry scan. Osteoporosis was considered when subjects had a BMD of 2.5 standard deviations or more below the mean value for young adults. RESULTS: Serum GPx, SOD, catalase and TAP level were found significantly lower in osteoporotic postmenopausal group as compared to healthy postmenopausal women and women in healthy reproductive age group healthy reproductive women (P < 0.005). but correlation between BMD and serum antioxidants were not found to be statistically significant (P > 0.005). CONCLUSION: These findings support that oxidative stress plays an important role in pathogenesis of postmenopausal osteoporosis. We did not find any significant association between BMD and serum level of antioxidants (P > 0.05). The failure to detect this association does not preclude the role of OS in osteoporosis because OS is complex and dynamic process.

Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility.

AIMS AND OBJECTIVES: The aim was to study the prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility. MATERIALS AND METHODS: A total of 95 infertile women were investigated for thyroid stimulating hormone (TSH). Infertile women with clinical/subclinical hypothyroidism were given thyroxine ranges from 25 to 150 µg. RESULTS: Of 95 infertile women, 53.7% were hypothyroid (TSH > 4.6 µIU/ml). After the treatment with thyroxine, 33.3% of subclinical hypothyroid women conceived within 6 weeks to 2-year period. The mean time to conception was 14.56 ± 4.83 months. CONCLUSION: Thyroid profile should be done in infertility work up. Women with normal TSH levels who are positive for thyroid antibodies should also be treated with levothyroxine.

Correlation between serum neuron specific enolase and functional neurological outcome in patients of acute ischemic stroke.

CONTEXT: The use of biomarkers to predict stroke prognosis is gaining particular attention nowadays. Neuron specific enolase (NSE), which is a dimeric isoenzyme of the glycolytic enzyme enolase and is found mainly in the neurons is one such biomarker. AIMS: This study was carried out on patients of acute ischemic stroke with the aims to determine the correlation between NSE levels on the day of admission with infarct volume, stroke severity, and functional neurological outcome on day 30. MATERIALS AND METHODS: Seventy five patients of acute ischemic stroke admitted in the Department of Medicine were included in the study. Levels of NSE were determined on day 1 using the human NSE ELISA kit (Alpha Diagnostic International Texas 78244, USA). Volume of infarct was measured by computed tomography (CT) scan using the preinstalled software Syngo (version A40A) of Siemen's medical solutions (Forchheim, Germany). Stroke severity at admission was assessed using Glasgow coma scale (GCS) and functional neurological outcome was assessed using modified Rankin scale (mRS) on day 30. STATISTICAL ANALYSIS USED: Statistical analysis was performed using the SPSS software for windows version 15.0 (SPSS). RESULTS: A positive correlation was found between concentration of NSE on day 1 and infarct volume determined by CT scan (r = 0.955, P < 0.001). A strong negative correlation was found between GCS at presentation and concentration of NSE on day 1 (r = -0.806, P < 0.001). There was a positive correlation between NSE levels at day 1 and functional neurological outcome assessed by mRS at day 30 (r = 0.744, P < 0.001). CONCLUSIONS: Serum levels of NSE in first few days of ischemic stroke can serve as a useful marker to predict stroke severity and early functional outcome. However, larger studies with serial estimation of NSE are needed to establish these observations more firmly.

Plasma adiponectin levels in women with polycystic ovary syndrome: impact of metformin treatment in a case-control study.

OBJECTIVE: An interaction between adiponectin, steroid synthesis or action and measures of insulin resistance (IR) have been reported in the pathogenesis of polycystic ovary syndrome (PCOS). The present study was done to determine plasma adiponectin concentration (PAC) in women with and without PCOS and to assess its correlation to the hormonal and metabolic parameters including measures of IR. The effect of Metformin for 6 months in PCOS was also evaluated. PATIENTS: In total, 72 selected women were classified as follows: 17 obese (body mass index (BMI))>25 kg/m(2) with PCOS; 19 normal weight (BMI) 18-22.9 kg/m(2) with PCOS; 17 obese (BMI)>25 kg/m(2) without PCOS and 19 normal weight (BMI) 18-22.9 kg/m(2) without PCOS. INTERVENTIONS: Blood samples were collected from all women with PCOS between 0800 and 1100 h, after an overnight fast. MAIN OUTCOME MEASURES: Serum level of LH, FSH, TSH, total T4, testerosterone, 17-α-hydroxyprogesterone (17OHP), DHEAS, insulin, adiponectin and glucose. Measures of IR included fasting serum insulin (FSI), glucose-to-insulin ratio, and homeostasis model assessment (HOMA). RESULT AND CONCLUSION: Waist-hip ratio (WHR), insulin, and HOMA index were significantly higher in the lower adiponectin group than in the higher adiponectin group. By using stepwise multiple regression analysis, in model 1 (including BMI, FSI, fasting plasma glucose (FPG) with other variables such serum as testerosterone and DHEAS), the weight and contributions from other variables, namely FSI and FPG were significant independent determinants of fasting PAC (adjusted r(2)=0.66); and in model 2 (including BMI, HOMA, FPG only as an index of IR with other variables such as serum testerosterone and DHEAS), BMI, and HOMA were significant independent determinants of fasting PAC (adjusted r(2)=0.59). FPG, HOMA index and FSI were significantly lower after Metformin treatment in both obese and non-obese PCOS while adiponectin levels increased significantly.

Ovarian steroid cell tumour: correlation of histopathology with clinicopathologic features.

Ovarian steroid cell tumours (not otherwise specified) are rare neoplasms of the ovary and are classified under lipid cell tumours. Their diagnosis can be considered as one of exclusion. Histopathologically, the tumour should carefully be evaluated for microscopic features of malignancy, but it is essential for the clinician and the pathologist to remember that in these tumours, pathologically benign histomorphology does not exclude the possibility of clinically malignant behaviour. Our case study focuses on the comparative findings in a postmenopausal female diagnosed with an ovarian steroid tumour (not otherwise specified). A careful correlation between clinical and surgical evaluation and microscopic analysis is necessary, as is a regular followup.

Evaluation of serum erythropoeitin response to anaemia in macroalbuminurics of diabetic and non-diabetic etiologies.

This case-control study was undertaken in 75 subjects categorized into 3 equal groups (A: diabetic subjects with macroalbuminuria, B: non-diabetic subjects with macroalbuminuria and C; control subjects). Serum erythropoietin (EPO) was estimated and analyzed in relation to hemoglobin levels in the three groups. The Pearson's coefficient (r) for hemoglobin and log natural EPO was significant for groups A (0.01), B (0.05) and C (0.01). Linear regression analysis of hemoglobin and log natural EPO showed significant differences between the study and control groups; however no significant difference could be demonstrated amongst the study groups. Hence, it was concluded that an inadequate EPO production occurs in renal failure, which accounts for the anaemia and diabetes does not confer an additional discrepancy in this mechanism over non-diabetic macroalbuminuria.

ST-deviation, C-reactive protein and CPK-MB as mortality predictors in acute myocardial infarction.

Prognosis varies widely in patients with acute coronary syndromes because of the heterogeneous nature of this condition. Successful outcome depends upon early risk stratification and an early decision regarding the approach of management of these patients. We studied 120 patients admitted with acute myocardial infarction, who were subsequently divided into two groups based on their final outcome (improvement or expiry). C-reactive protein and CPK-MB were quantitatively estimated at the time of hospital admission. Also, the number of ECG leads showing ST deviation and its sum was calculated and correlated with the biochemical markers. Differences in these variables were analysed between the two groups of patients. Significant differences were found in the mean levels of CRP, CPK-MB, the number of ECG leads with ST deviation and its sum between the two groups. Also, significant correlation was found between the levels of biochemical markers and the sum of ST deviation at admission in all patients of acute myocardial infarction.