A Comparative Study of Iron Status in Subclinical Hypothyroid and Euthyroid Subjects in a Tertiary Care Hospital.

BACKGROUND: The physiological equilibrium of the entire human body's metabolism is significantly influenced by thyroid hormones. Subclinical hypothyroidism, which is often concealed, is connected to iron deficiency anemia and various other hematological disorders. We in the current study tried to determine the prevalence and severity of iron deficiency anemia and investigate the correlation of subclinical hypothyroidism with iron deficiency. METHODS: A total of 100 subjects included in the study were divided into two groups. Group 1 included 50 cases with subclinical hypothyroidism, and Group 2 included 50 healthy age- and sex-matched controls. Hemoglobin (Hb) levels were measured within 24 hours of sample collection using a Sysmex automated cell counter (Kobe, Hyogo, Japan). Thyroid hormones (free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH)) were measured. RESULTS: Out of 50 cases, 48 (96%) have iron deficiency anemia, and 52 (104%) have subclinical hypothyroidism. Among the cases with iron deficiency anemia, 43 (86%) also have subclinical hypothyroidism. There was a negative correlation between thyrotropin (TSH) and Hb levels. Pearson's correlation coefficient "r" values were -0.86408. The serum ferritin levels of cases were decreased as compared to the healthy controls, and the difference in means for cases and controls in terms of serum ferritin is also statistically significant. CONCLUSION: The prevalence of anemia in subclinical hypothyroidism is significantly elevated, and considering the absence of significant clinical manifestations in the early stages, it is recommended to routinely conduct investigations for early detection, facilitating prompt management. Consequently, our study emphasizes that both overt and subclinical hypothyroidism should be recognized as risk factors for the development of iron deficiency anemia.

Effect of COVID-19 on Stress and Biomarkers: An Exploratory Cross-Sectional Study.

Background Anxiety and stress in COVID-19 lead to continual pro-inflammatory cytokine activity resulting in excessive inflammation. Levels of different bio indices of COVID-19 may predict clinical outcomes and the severity of COVID-19 disease and may correlate with anxiety and stress levels. Objectives To measure the level of anxiety in COVID-19 patients using the coronavirus anxiety scale (CAS) as an assessment of psychological stress. To measure the levels of blood biomarkers and biochemical and hematological markers of inflammation in COVID-19. To record and measure the indices of short-term HRV in COVID-19 patients to assess their physiological and psychological stress levels. To determine the relationship between anxiety scores, levels of laboratory indices (blood biomarkers), and HRV parameters across mild, moderate and severe cases of COVID-19. Material and method A total of 300 COVID-19 patients aged between 18 and 55 years were included. A questionnaire-based CAS was used to assess anxiety levels. Short-term HRV was recorded to measure stress. Blood biomarkers: Biochemical and hemato-cytological markers of inflammation were measured. Statistical analyses were performed using the SPSS software version 20.0. Results Anxiety and stress increased with the severity of COVID-19. A positive correlation was detected between anxiety and serum ferritin, IL-6, MCV, and MCH levels, and a negative correlation between the corona anxiety score and RBC count. The increase in the severity of COVID-19 showed elevated levels of WBC count, neutrophil%, platelet count, neutrophil/lymphocyte ratio, serum ferritin, D-dimer, C-reactive protein, procalcitonin, interleukin-6, and lactate dehydrogenase, and decreased lymphocyte and monocyte percentages. The increase in the severity of COVID-19 decreased lymphocyte, monocyte, and eosinophil counts. Conclusion The Corona Anxiety Scale and heart rate variability can be used as complementary tools to index COVID-19-related anxiety and stress. An association exists between immune dysregulation and heart rate variability, which can be used to predict the inflammatory response and prognosis of COVID-19.

Psychometric Measurement of Fertility-related Quality of Life across Gender in Primary Infertile Couples.

Background: Infertility is a crucial global public health issue that affects millions of people of reproductive age. Fertility-related stress can negatively impact infertile couples' quality of life (QoL). Aims: This study aimed to assess and compare the psychometric properties of fertility QoL between primary infertile couples' male and female partners. Settings and Design: This cross-sectional study included 114 primary infertile couples visiting the Andrology Laboratory referred from the Gynaecology and Obstetrics Department, AIIMS, Patna. Materials and Methods: Data were collected using the Fertility QoL (FertiQoL) tool, an internationally validated questionnaire to measure the reproductive QoL, demographic information and medical history. The FertiQoL questionnaire responses were recorded and analysed. Statistical Analyses Used: Statistical analyses used were performed using the SPSS 20.0 version. Descriptive statistics, Kolmogorov-Smirnov test, Cronbach's alpha and Student's independent t-tests were used. Statistical significance was set at P < 0.05. Results: In our study, the overall estimated Cronbach's α was 0.83, and males had a significantly better fertility-related QoL in all domains of the FertiQoL, such as emotional (P < 0.000), mind-body (P < 0.000), social (P < 0.004) and tolerability (P < 0.000), except relational and environmental domains, which were lower in them. However, between the groups, the relational domain was significant (0.000) and the environmental domain was non-significant (0.592). Overall, males had a significantly better total core score, total treatment score and overall total FertiQoL score, while females had lower scores. Conclusion: Amongst infertile couples, the reproductive QoL was poorer in females than in males. Our study suggests psychological counselling and mental support for females during infertility management.

Semen Quality in Males Suffering From COVID-19: A Pilot Study.

Background It is well known that some viral infections may affect male fertility. Coronavirus disease (COVID-19) can lead to multiorgan damage through the angiotensin-converting enzyme-2 receptor, abundant in testicular tissue. However, little information is available regarding the shedding of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in semen and its impact on spermatogenesis and fertility potential. We planned to investigate the presence of SARS-CoV-2 in the semen of COVID-19 males and to study the effect of COVID-19 on semen quality and sperm DNA fragmentation index. Material and method Thirty COVID-19 male patients aged 19-45 registered to AIIMS Patna hospital participated in the survey between October 2020 and April 2021. We conducted a real-time reverse transcriptase test on all the semen samples. Detailed semen analysis, including the sperm DNA Fragmentation Index, was done at first sampling that is during COVID-19. After 74 days of the first sampling, we obtained the second sampling and repeated all the above tests. Results All semen samples collected in the first and second sampling tested with real-time reverse transcription-polymerase chain reaction (RT-PCR) were negative for SARS-CoV-2. In the first sampling, semen volume, vitality, total motility, sperm concentration, total sperm count, % normal morphology, % cytoplasmic droplet, and fructose were significantly lower. In contrast, semen agglutination, % head defect, DNA Fragmentation Index, liquefaction time, semen viscosity, and leukocytes were increased. These findings were reversed at the second sampling but not to the optimum level. All these findings were statistically significant (p < 0.05 for all). Thus, COVID-19 negatively affects semen parameters, including sperm DNA fragmentation index. Conclusion Although we could not find SARS-CoV-2 in the semen, the semen quality remained poor until the second sampling. Assisted reproductive technology (ART) clinics and sperm banking facilities should consider assessing the semen of COVID-19 males and exclude men with a positive history of SARS-CoV-2 until their semen quality returns to normal.

Evaluation of Spirometric Measures and Quality of Sleep in Tuberculosis Patients and Their Non-Tuberculosis Family Caregivers.

Background and Aim Tuberculosis (TB) patients may present with depression and poor sleep as co-morbidities. This presents great challenges including the stigma of increased risk of developing TB while taking care of such patients. This study aims to determine the lung functions, quality of sleep in tuberculosis patients in comparison with non-tuberculosis (non-TB) family caregivers. Methods TB patients and their family caregivers (60 each) visiting the Directly Observed Therapy Short-course (DOTS) clinic at a tertiary care hospital were assessed for spirometric parameters and quality of sleep. Spirometry measurements were performed using a portable, computerized, pre-calibrated, electronic, dry type of machine. Pulmonary function impairment pattern and severity were assessed from spirometry results using a percentage of the predicted values of Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1). Descriptive statistics and t-tests were applied using SPSS version 19.0. p≤0.05 was considered significant. Results TB patients had a significantly more (p=0.000) sleep disturbance, daytime dysfunction, and higher mean global Pittsburgh Sleep Quality Index (PSQI) score (9.56±3.97) compared to their non-TB family caregivers (4.36±2.07). The spirometric measures were reduced in TB patients and showed significant differences in actual measures of all parameters except FVC (actual). The % predicted measures of FEV1, FEF 25%-75%, PEFR, and MVV showed significant differences in comparison to their non-TB family caregivers. Conclusions The present study shows that TB patients have a poor quality of sleep and pulmonary functions compared to their non-TB family caregivers. Health care workers need to develop systematic strategies to screen the symptoms of mental disorders in tuberculosis patients and their family caregivers to enable better management of this population.

A comparative survival analysis of high viscosity glass ionomer restorations using conventional cavity preparation and atraumatic restorative treatment technique in primary molars: A randomized clinical trial.

BACKGROUND: This randomized clinical trial (RCT) aimed to compare the 3-year survival rates of high viscosity glass ionomer restorations (HVGIC) using conventional cavity preparation and atraumatic restorative technique (ART) in primary molars. MATERIALS AND METHODS: In this RCT, 139 schoolchildren aged 6-9 years with dentinal caries in primary molars were randomly allocated to groups, i.e. the ART group and the conventional group, utilizing a random number generator. Adequate allocation concealment was done. Intervention was delivered using standard procedure and GC Fuji IX ART HVGIC was used as restorations in both the groups. Analysis was carried in 92 participants, and survival rates in both the groups were compared at 12, 24, and 36-month intervals. IBM SPSS software was utilized to analyze the time taken for the procedure and the Kaplan-Meier estimate was used to assess the survival rates. P value of 0.05 was considered statistically significant. RESULTS: The ART took longer to complete (16.48 ± 2.02 min) versus conventional rotary instrumentation (13.15 ± 1.32 min). The conventional method was slightly superior as compared to ART; excellent survival rates (i.e. >90%) were achieved in both groups at the end of 12-month follow-up with no significant differences at the end of 24 and 36 months as evident from Kaplan-Meier estimate (P = 0.255). CONCLUSION: Three-year follow-up showed that GIC restorations with ART and conventional method carried out using GC Fuji IX ART HVGIC were acceptably successful, substantiating the use of ART for the primary dentition in areas with high caries prevalence and limited access to dental care.

Effect of obesity on cardiovascular responses to submaximal treadmill exercise in adult males.

CONTEXT: Obesity is a major risk factor for chronic diseases. Abnormal changes in cardiovascular responses to exercise indicate the alteration in autonomic activity in obese. AIMS: To assess and compare the cardiovascular parameters before and after exercise among obese and nonobese adult males. SUBJECTS AND METHODS: Thirty each obese and normal-weight males between the age group 18-45 years were selected as cases and controls, respectively. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), corrected QT intervals were measured before and after submaximal treadmill exercise (QT and QTc) were done according to Bruce protocol. HR, SBP, DBP, MAP, QT, and QTc were also measured during passive recovery at 1 min and 5 min after exercise. STATISTICAL ANALYSIS USED: One-way analysis of variance and t-test were used to assess changes before and after exercise. RESULTS: Resting HR was significantly higher in obese when compared to nonobese (P < 0.05). SBP, DBP, MAP, QT, and QTc were significantly higher in obese when compared to nonobese (P < 0.001). Immediately after exercise HR, SBP, DBP, MAP, QT, and QTc were significantly higher in obese when compared to nonobese (P < 0.001) 1 min after exercise. CONCLUSIONS: Obese individuals had elevated resting cardiovascular parameters and showed increased responses to steady exercise which could be due to alteration in autonomic functions with sympathetic hyperactivity. Delayed rate of decrease in HR and BP after exercise was also observed in obese, which indicates that they are at risk of developing cardiovascular diseases.

Physical Exhaustion Induced Variations in Event-Related Potentials and Cognitive Task Performance in Young Adults.

BACKGROUND/AIMS: Physical exhaustion is not always peripheral, and it is the brain that causes the sensation of fatigue either due to decrease of metabolic resources or due to central activation process that regulates attention and performance. This study was undertaken to observe the variations in event-related potentials (ERPs) and cognitive performance after an exhausting physical exercise. METHODS: A total of 60 healthy young adult subjects were included in the study. The study was conducted in 2 phases with at least a week gap between the phases. The participants answered a Multidimensional Fatigue Inventory (MFI-20) questionnaire before and after trials in each phase to measure the induced physical exhaustion. In phase I (control trial), the ERP data were processed using P300, Standard auditory "oddball paradigm," on computerized evoked potential recorder (RMS EMG MK-2) using 10/20 system to know the engagement of attention after which participants were given to perform cognitive tasks such as "Stroop Test, Trial Making Test and Mini Mental State Examination." In Phase II (exercise trial), the participants were instructed to cycle as hard as they could, till they could not continue anymore, which was followed by recording of P300-evoked potentials and performance of cognitive tasks as in Phase I. Paired t test was used to compare between any dependent variables. RESULTS: Fatigue-related subjective measures (MFI-20) showed that both mental and physical exhaustion were significantly greater in the exercise-involved cognitive trial than in the control trial. Lower P300 latencies reflect faster reaction time; however, their response accuracies were poorer resulting in poorer cognitive performances. Participants subjected to control trial performed better in terms of higher percentage accuracy but with slow reaction time. CONCLUSION: The participants experienced more fatigue physically and mentally during the exercise that involved cognitive tasks. An apparent decrease in attention based on decreased percentage accuracy of response was evident, implying that fatigue, performance, and attention are interdependent.

Short-term acute effects of gutkha chewing on heart rate variability among young adults: A cross-sectional study.

BACKGROUND AND OBJECTIVES: An increase in the consumption of smokeless tobacco has been noticed among high school, college students, and adults. Despite the antiquity and popularity of chewing tobacco in India, its effects have not been investigated systematically in humans. The aim of this study was to investigate acute effects of gutkha chewing on heart rate variability (HRV) among healthy young adults. MATERIALS AND METHODS: A total of 60 young adult males were included in the study. Each individual was asked to chew tobacco and subjected to HRV analysis. HRV analysis using short-term electrocardiogram recording was used to measure HRV parameters before gutkha chewing and at 5, 15, and 30 min after chewing tobacco. One-way analysis of variance and paired t-test was used to assess changes over time. RESULTS: There was a significant increase in heart rate (HR) during tobacco chewing. Mean HR at baseline measured 73.0 ± 6.2 bpm. There was a rise in mean HR to 83.7 ± 9.1 bpm at 5 min during tobacco chewing and gradual reduction to baseline observed after 15 min followed by no significant change till 30 min. The normalized low-frequency power and LF/high-frequency (HF) power ratio were elevated after 5 min; however, normalized HF power was reduced after 5 min tobacco chewing. CONCLUSION: Gutkha is closely associated with traditional cardiovascular risk factors as detected by a transient enhancing sympathetic activity during tobacco chewing in the form of increased HRV parameters or an imbalance between sympathetic and parasympathetic neural activity among healthy young adults.