Circadian variations in melatonin and cortisol in patients with cervical spinal cord injury.

PURPOSE: In cervical spinal cord injury (CSCI), afferent and efferent circuits that influence the basal production of melatonin and cortisol may be disrupted and hence disrupt the basal functions of human physiology. Therefore, the aim of this study was to assess circadian changes, if any, in serum cortisol and melatonin in patients with CSCI. METHODS: Serum levels of cortisol and melatonin were measured at 6-h intervals of the day (0600, 1200, 1800 and 0000 hours) in 22 CSCI patients, as well as 22 healthy controls. RESULTS: Significantly higher melatonin levels were observed in the patient group in morning hours, whereas a significantly lower level of melatonin was found during the night time in the patient group than in the control group. Moreover, significantly higher values were obtained in the evening and night time serum cortisol levels among the patients compared with controls. Further, when the mean values of cortisol throughout the day were tested among patient and control groups similar circadian rhythm was found. The only difference being that serum cortisol declined much more in controls in evening and night samples as compared with CSCI patients. CONCLUSION: We conclude that circadian variations exist in the circulating levels of serum cortisol and melatonin in patients with CSCI. Low levels of melatonin secretion during night may contribute to the pervasive sleep disruption and increased pain perception.

Diabetes mellitus with pulmonary tuberculosis--a double trouble.

Diabetic patients are often at a higher risk for developing several types of infections and infection does alter the handling of glucose by tissues. Pulmonary infections in diabetics are characterised by alteration in host defence, in entire body and in the lung locally as well as in the function of respiratory epithelium and ciliary motility. Association between diabetes mellitus and pulmonary tuberculosis is well established, while the prevalence of tuberculosis is increased 4-5 times more among diabetics. Impairment of host defence plays an important role for changing the clinical, radiological and bacteriological presentation in diabetic patients. It is also reported by the various studies that hyperglycaemia favours the growth of tuberculosis bacilli. So the severity of tuberculosis appears more cirtical with the degree of hyperglycaemia and host defence activity. This overlap between the diabetic and tuberculosis epidemics could adversely affect global tuberculosis control efforts.

Association of salivary cortisol with chronomics of 24 hours ambulatory blood pressure/heart rate among night shift workers.

Recent studies indicate a circadian rhythm in blood pressure and heart rate and its association with various neurotransmitters. In the present study, we examine the circadian nature of blood pressure/heart rate and salivary cortisol in night shift workers and whether these circadian changes produced by night shifts are reversible. Sixteen healthy nurses of both genders, aged 20-40 years, performing day and night shift duties, were randomly selected out of 22 who volunteered for this study. Ambulatory blood pressure monitoring was done in all the subjects and salivary cortisol levels were analyzed during both day and night shift duties. There were clinically significant changes in the Acrophase of blood pressure and cortisol levels, indicating ecphasia (odd timing of systolic blood pressure) individually during night as well as day shifts. However, this pattern was statistically not significant. A reverse pattern of Acrophase was observed in 8 out of 16 subjects when they were posted on day shift. No significant change was found in midline estimating statistics of rhythm (MESOR) of blood pressure values. Changes in Double amplitude (Predictable change) were observed in 8 subjects during night shifts as well as in 7 subjects during day shifts. However, the pattern was not similar and night workers had an altered circadian pattern in the night as well as during day shifts. Changes in Double amplitude, Acrophase and Salivary cortisol were found during night as well as day shifts but these changes were not statistically significant (p > 0.05) due to incomplete recovery during day shifts (changes again seen when they came back to day shifts). Salivary cortisol levels were lowest in early morning, increased at midnight and further increased in the afternoon during night shifts along with ecphasia. It is possible that nurses working the night shift felt more tired due to the altered circadian cycle.

Effect of yogic practices on lipid profile and body fat composition in patients of coronary artery disease.

OBJECTIVES: To observe the effect of regular yogic practices and self-discipline in reducing body fat and elevated lipids in CAD patients. METHOD: In this study one hundred seventy (170) subjects, of both sexes having coronary artery disease were randomly selected form Department of Cardiology. Subjects were divided in to two groups randomly in yoga group and in non-yoga group, eighty five (85) in each group. Out of these (170 subjects), one hundred fifty four (154) completed the study protocol. TIME LINE: The yogic intervention consisted of 35-40 min/day, five days in a week till six months in the Department of Physiology CSMMU UP Lucknow. Body fat testing and estimation of lipid profile were done of the both groups at zero time and after six months of yogic intervention in yoga group and without yogic intervention in non yoga group. RESULTS: In present study, BMI (p<0.04), fat % (p<0.0002), fat free mass (p<0.04), SBP (p<0.002), DBP (p<0.009), heart rate (p<0.0001), total cholesterol (p<0.0001), triglycerides (p<0.0001), HDL (p<0.0001) and low density lipoprotein (p<0.04) were changed significantly. CONCLUSION: Reduction of SBP, DBP, heart rate, body fat%, total cholesterol, triglycerides and LDL after regular yogic practices is beneficial for cardiac and hypertensive patients. Therefore yogic practices included in this study are helpful for the patients of coronary artery disease.

Circadian pattern of blood pressure in normal pregnancy and preeclampsia.

UNLABELLED: AIMS #ENTITYSTARTX00026; OBJECTIVE: To find out the circadian pattern of blood pressure in normotensive pregnant women and in women with preeclampsia. METHOD: A cross-sectional prospective observational case control study. Blood pressure was sampled in thirty-five normotensive pregnant women (control) and thirty five preeclamptic women (study group) by using non-invasive automatic ambulatory blood pressure monitoring machine for 72 h. RESULTS: Blood pressure (BP) was not constant over 24 h period and it oscillated from time to time in control group. BP was maximum during early part of afternoon. However, in preeclampsia besides quantitative increase in BP, circadian BP oscillations were less pronounced and in around 50% subjects BP was maximum during evening and night hours. CONCLUSION: Both systolic and diastolic BP showed definite reproducible circadian pattern in both preeclamptic and normotensive pregnant women. This pattern both quantitatively and qualitatively was different in preeclamptic women. Standardized 24 h BP monitoring allows quantitative and qualitative evaluation of hypertensive status and is important for timing and dosing of antihypertensive medications.

Nasal spirometery.

Nasal obstruction is a common symptom which is difficult to quantify clinically. Rhinomanometry, Acoustic Rhinometry and Forced Oscillation methods are available for estimating nasal resistance but, these require sophisticated machines. Because of limited availability of these techniques, this potential physiological measure has not been tapped fully for research and clinical purposes. Here, we describe the use of pulmonary spirometer with little modification for quantification of nasal flow. Nasal inspiratory and expiratory flow rates along with oral inspiratory and expiratory flow rates are used to derive different nasal resistance indices. This way of reporting nasal resistance is not new but, the data for these variables is currently not available in published literature. The reproducibility of nasal flow rates were tested as variation after one day and the interclass coefficient for inspiratory and expiratory nasal flow rates were found to be with in acceptable limits. Thus, nasal spirometery is able to describe the nasal resistance in a reliable manner and may be used to quantify nasal obstruction in pathological condition and also to study the physiological phenomenon like nasal cycle.

Circadian rhythm of peak expiratory flow rate in healthy north Indian men.

Peak expiratory flow rate (PEFR) variability follows a specific pattern in asthmatics as well as in healthy individuals. There is scarcity of data for Indian healthy subjects. The PEFR (L/min.) was measured with Wright's portable peak flow meter at 05:00, 8:00, 11:00, 14:00, 17:00, 20:00 and 23:00 hours in 42 healthy, non-smoking adults of age group between 18-26 years. The variability of PEFR revealed a circadian pattern. PEFR levels tend to increase from morning at 5:00 hours till evening at 17:00 hours, with peak PEFR in evening at 17:00 hours, after which there was a progressive fall in PEFR levels, till morning 5:00 hours. This study provides the preliminary reference data of circadian pattern of PEFR in healthy individuals.

Sympathetic hyperactivity in patients of bronchial asthma.

The bronchoconstricting and bronchodilating divisions of the autonomic nervous system control airway caliber of lungs. Parasympathetic hyperactivity in asthmatics eventuates in broncho-constriction. Sympathetic activity increases to combat this but fails to control bronchoconstriction due to negligible innervations of the airway smooth muscles although it causes vasoconstriction of blood vessels. In this study the effects of autonomic function test for sympathetic division were seen on selected patients and controls. Our results indicate sympathetic hyperactivity or an increased alpha-adrenergic input in asthmatics.

Improvement in oxidative status with yogic breathing in young healthy males.

The modern living lifestyle is known to produce various physical and psychological stresses and subject the individual to produce oxidative stresses as well. The aim of this study has been to assess the effect of yogic breathing exercises (pranayama) on the oxidatives stress. The study group consisted of 30 young male volunteers, trained for the purpose of this study and an equal number of controls were used. The free radicals and Super oxide dismutase levels were measured before the study and at the end of the study. The free radicals were decreased significantly in the study group but the SOD was increased insignificantly as compared to the control group. Yogic breathing exercises not only help in relieving the stresses of life but also improve the antioxidant status of the individual. An improvement in the antioxidant status is helpful in preventing many pathological processes that are known with impaired antioxidant system of body.

Examination stress in medical student: a study.

The present study was conducted on 40 male and 10 female students appearing for the 1st MBBS examination. Two readings of pulse rate, blood pressure and electro cardiogram were taken viz 6 months (control) and 10 minutes prior to the examination. A significant increase was seen in the pulse rate and blood pressure readings before the examination as compared to the control readings. However, no significant change was observed in electro cardiographic recordings.

Effect of extrusion processing on the nutritional quality of protein in rice-legume blends.

The effect of extrusion processing using Wenger X-5 extruder on the quality of products of rice-legume (75:25) blends was investigated. The products were palatable and had a good texture. The nutritional quality of protein in the extrudates was significantly improved. The protein efficiency ratio values of rice-soybean, rice-bengal gram and rice-black gram products were: 2.25, 2.30 and 2.28 as compared to 2.10, 1.89 and 1.98 for the respective raw blends. Extrusion processing reduced the phytates in the products to the extent of 20.3 to 26.8%.