Effect of yoga on blood glucose levels in patients with type 2 diabetes mellitus.

INTRODUCTION: In view of people embracing sedentary life style, and the effectiveness of treatment becoming less, the role of regular exercise especially 'yoga' seems to be a beneficial and economical adjuvant in the management of the Type 2 diabetes mellitus (T2DM). OBJECTIVES: To assess the beneficial effects of yoga on blood glucose levels in normal and T2DM volunteers. MATERIALS AND METHODS: A prospective case-control study was conducted in the Department of Physiology and Diabetic clinic of a tertiary care teaching hospital over period of two years. The study subjects consisted of 30 male diabetic patients attending diabetic clinic and 30 non-diabetic male volunteers constituted control group. The patients in the age group of 36 to 55 years with T2DM of at least one year duration and those on diabetic diet and oral hypoglycemic agents were included in the study group. The age matched healthy male volunteers who had come to join yoga training at yoga centre were included in the control group. All the participants were trained by yoga experts and subjected to regular practice under supervision for six months. In all the participants fasting (FBS) and post-prandial blood sugar (PPBS) was estimated before, during (at three months) and after (six months) yoga training. Paired Student t-test was used to estimate difference in means calculated before and after yoga training in a same group. A p-value of <0.05 was considered as statistically significant. RESULTS: The distribution of age, mean height and mean weight among both the groups were comparable. The reduction in mean values of FBS and PPBS at the end of six months was highly significant (p <0.001) in both the groups when compared with the mean values before and during (three months) yoga practice. The reduction in these values at three months during yoga was highly significant in T2DM group when compared with mean values before yoga (p <0.001), but it was insignificant (p<0.05) in control group. CONCLUSION: The results of the present study demonstrated that the yoga is effective in reducing the blood glucose levels in patients with T2DM.

Inadvertent cannulation of the left internal thoracic vein during central vein catheter insertion.

The left internal thoracic vein was accidentally cannulated during an attempt to establish central vein catheterization through left internal jugular vein. The surgeon found this during left internal mammary artery dissection and it needed to be repositioned.

Glucose control lowers the risk of wound infection in diabetics after open heart operations.

BACKGROUND: Elevated blood glucose levels in the postoperative period are associated with an increased risk of deep wound infection in diabetic individuals undergoing open heart operations at Providence St. Vincent Hospital. METHODS: Of 8,910 patients who underwent cardiac operations between 1987 and 1993, 1,585 (18%) were diabetic. The rate of deep sternal wound infections in diabetic patients was 1.7%, versus 0.4% for nondiabetics. Nine hundred ninety patients had their operation before implementation of the protocol and 595 after implementation. Charts of all diabetic patients were reviewed. Mean blood glucose levels were calculated from documented results of finger-stick glucometer testing. RESULTS: Thirty-three diabetic patients suffered 35 deep wound infections: 27 sternal (1.7%) and eight at the donor site (0.5%). Infected diabetic patients had a higher mean blood glucose level through the first 2 postoperative days than noninfected patients (208 +/- 7.1 versus 190 +/- 0.8 mg/dL; p < 0.003) and had a greater body mass index (31.5 +/- 1.4 versus 28.6 +/- 0.1 kg/m2; p < 0.05). Multivariable logistic regression showed that mean blood glucose level for the first 2 days (p = 0.002), obesity (p < 0.002), and use of the internal mammary artery (p < 0.02) were all independent predictors of deep wound infection. Institution of a protocol of postoperative continuous intravenous insulin to maintain blood glucose level less than 200 mg/dL was begun in September 1991. This protocol resulted in a decrease in blood glucose levels for the first 2 postoperative days and a concomitant decrease in the proportion of patients with deep wound infections, from 2.4% (24/990) to 1.5% (9/595) (p < 0.02). CONCLUSIONS: The incidence of deep wound infection in diabetic patients was reduced after implementation of a protocol to maintain mean blood glucose level less than 200 mg/dL in the immediate postoperative period.

Byssinosis in a Bombay textile mill.

BACKGROUND: Till a national campaign against dust-related lung diseases was launched by a voluntary agency in Ahmedabad in 1992, government records for the 150-year-old textile industry showed no cases of byssinosis--the disabling occupational disease caused by cotton dust. The worldwide incidence of byssinosis among workers in the dusty sections of textile mills is nearly 40%. We assessed the prevalence of byssinosis in a Bombay mill so that the Employees State Insurance Scheme would start conducting medical checks in all the 55 textile mills in Bombay and officially recognize the disease. METHODS: The study was conducted under the auspices of the Occupational Health and Safety Centre, a voluntary organization. Textile workers were called to a camp conducted over 3 nights and 3 days. We asked them to answer a questionnaire and tested their lung function using a Wright's ventilometer. The diagnosis of byssinosis was made if there was a feeling of chest tightness on exposure to cotton dust, and if the FEV1 was less than 60% of the expected result or the FEV1/FVC was less than 75%. RESULTS: Of the total 1075 workers in the mill only 273 came to the camp; 54 (30%) of the 179 individuals working in the dusty sections of the mill had byssinosis. In the non-dusty departments, 16 (17%) out of the 94 workers were affected. Among those working for less than 10 years in textile mills, 24% had byssinosis and among those working for more than 30 years, 45% had the disease. CONCLUSION: We found a prevalence of byssinosis among textile workers which is similar to that reported worldwide. The disease affected those who worked in both the dusty and non-dusty sections of the mill. There are an estimated 40,000 affected workers in Bombay and we suggest that the disease be recognized by the Employees State Insurance Scheme, and that the textile mill workers be compensated if they are affected by byssinosis.

Tetralogy of Fallot: intracardiac repair in 840 subjects.

Since 1967, when the first intracardiac repair was performed in this centre, until 1991, 840 symptomatic subjects with tetralogy of Fallot have undergone corrective surgery. Cardiac catheterization and angiocardiography were carried out in all patients. Cardinal findings on the clinical status of these subjects are outlined. A substantial number of patients (244; 29.0%) were > 15 years of age. Historically, a transannular pericardial gusset has been utilized in 578 (68.8%), and in 423 (93.0%) during the past decade. The incidence of residual interventricular septal defects has been 0.68% and occurrence of complete heart block after surgery 0.4%. Death occurred in 86 patients (10.2%) within 30 days of operation and later in 40 subjects (4.8%). Long-term results have been excellent with good haemodynamic status in > 90% of subjects in the follow-up period. Associated features including absent pulmonary valve, absent left pulmonary artery, and previous palliative shunts did not alter the outcome; however, a raised haematocrit (> 0.65) was associated with an increased mortality rate.