Electro-physiological Changes in the Central Nervous System by Visual Evoked Potential in Diabetic Patients.

BACKGROUND: Increasing sedentary lifestyle in today's world has increased the prevalence of Diabetes Mellitus. Loss of vision due to diabetic retinopathy is a major public health burden. Visual evoked potential identifies the neuronal degenerative changes in chronic metabolic disorders specially Diabetes Mellitus. The study aimed at evaluating changes in visual evoked potential waves in diabetic patients. METHODS: This is a cross sectional comparative study consisting of 90 participants, out of which 60 were diabetic patients and 30 were non-diabetic control group. Among diabetic patients, 30 were without retinopathy, 10 with mild non-proliferative retinopathy, 10 with moderate non-proliferative retinopathy and 10 with severe non-proliferative retinopathy. Visually evoked potential latencies and amplitudes were compared among diabetic patients and the control group and also among individuals with different grades of retinopathy. RESULTS: Delay in P100 latency and decrease in its amplitude were statistically significant in diabetic patients. The changes in P100 latency, P100 amplitude and N75 latency were also significant in different grades of retinopathy. CONCLUSIONS: There are statistically significant changes in visually evoked potential in diabetes patients. Visual evoked potential is a useful, non-invasive investigation which can establish the central nervous system neuropathy in diabetes at an early stage of the disease. So Diabetic retinopathy can be prevented due to early detection of neuropathy by visual evoked potential test Keywords: Diabetes mellitus; diabetic retinopathy; visual evoked potential.

Comparison of Spirometric Parameters in different Postures among Young Healthy Volunteers.

BACKGROUND: Spirometry is the most common pulmonary function tests that specifically measures volume and flow of air during respiration. It helps to identify obstructive and restrictive diseases of the lungs. The alterations of the results in spirometry can happen even in normal health due to change in body postures that alter lung volumes and muscle biomechanics. So, the objective of this study is to determine the effects of change of postures mainly supine, sitting and standing on pulmonary parameters of young healthy volunteers. METHODS: A cross-sectional analytical study was conducted among young medical students of Maharajgunj Medical Campus in the department of Clinical Physiology. A total of 31 students were selected by convenient sampling technique. Pulmonary parameters: Forced Vital Capacity (FVC), Forced Expiratory Volume in 1st second (FEV1), FEV1/FVC, Peak Expiratory Flow(PEF), EF2575 were collected from spirometry. The spirometry was done in supine, sitting and standing postures and the best value of each posture was selected for the comparison and obtained data were analyzed using repeated measures ANOVA with confidence interval of 95%. RESULTS: The pulmonary parameters recorded in different postures showed that the mean of these variables comparatively increased in standing posture than others with mean FVC 3.98±0.66 L, mean FEV1 3.53±0.55L, mean FEV1/FVC 89.23±5.60%, mean PEF 8.60±1.62L/s and mean PEF2575 4.46±1.08 L/s. The mean comparisons of these pulmonary parameters in supine, sitting and standing postures showed statistically significant differences with P value < 0.05. CONCLUSIONS: The pulmonary parameters are affected by body postures. Those parameters are recorded highest during standing posture and lowest during supine posture.

Validity of Elite-HRV Smartphone Application for Measuring Heart Rate Variability Compared to Polar V800 Heart Rate Monitor.

BACKGROUND: With technological advancement, it has become very easy to obtain heart rate variability data with handy heart rate monitors as well as smartphone applications. This study was conducted to assess the validity of Elite HRV smartphone application to measure time domain heart rate variability indices at rest, in comparison to Polar V-800 heart rate monitor. METHODS: Heart rate variability data were acquired from twenty apparently healthy male medical students in supine position after simultaneously connecting Polar V800 and Elite HRV to chest-worn Polar H7 sensor. Time domain indices viz. Mean RR intervals, mean heart rate, standard deviation of normal to normal intervals and root mean square of successive differences of interval were taken for comparison. Difference, validity and agreement were assessed using students t-test, intraclass correlation coefficient and Bland Altman plot and limits of agreement. RESULTS: Students t-test showed that there was no significant difference between the data obtained from Elite HRV and Polar V-800 in all the parameters viz. mean RR intervals, mean heart rate, standard deviation of normal to normal intervals and root mean square of successive differences of interval (p>0.05). Correlation was excellent as shown by Intra-class correlation coefficient of >0.999 in all the parameters. Bland Altman analysis revealed small bias and narrow limits of agreement with all the parameters: mean heart rate [-0.003 (0.05 - 0.04)], mean RR [0.01 (-0.58 - 0.60)], standard deviation of normal to normal intervals [-0.01 (-0.32 - 0.30)] and root mean square of successive differences of interval [-0.05 (-0.89 - 0.79)]. CONCLUSIONS: Elite HRV smartphone application provided reliable time-domain heart rate variability data consistent with the data obtained from validity tested Polar V800 heart rate monitor.

An update on the epidemiology, length of stay, and cost of Kawasaki disease hospitalisation in the United States.

BACKGROUND: Kawasaki disease is an acute vasculitis of childhood and is the leading cause of acquired heart disease in the developed countries. METHODS: Data from hospital discharge records were obtained from the National Kids Inpatient Database for years 2009 and 2012. Hospitalisations by months, hospital regions, timing of admission, insurance types, and ethnicity were analysed. Length of stay and total charges were also analysed. RESULTS: There were 10,486 cases of Kawasaki disease from 12,678,005 children hospitalisation. Kawasaki disease was more common between 0 and 5 years old, in male, and in Asian. The January-March quarter had the highest rate compared to the lowest in the July-September quarter (OR=1.62, p < 0.001). Admissions on the weekend had longer length of stay [4.1 days (95 % CI: 3.97-4.31)] as compared to admissions on a weekday [3.72 days (95 % CI: 3.64-3.80), p < 0.001]. Blacks had the longest length of stay and whites had the shortest [4.33 days (95 % CI: 4.12-4.54 days) versus 3.60 days (95 % CI: 3.48-3.72 days), p < 0.001]. Coronary artery aneurysm was identified in 2.7 % of all patients with Kawasaki disease. Children with coronary artery aneurysm were hospitalised longer and had higher hospital charge. Age, admission during weekend, and the presence of coronary artery aneurysm had significant effect on the length of stay. CONCLUSIONS: This report provides the most updated epidemiological information on Kawasaki disease hospitalisation. Age, admissions during weekend, and the presence of coronary artery aneurysm are significant contributors to the length of stay.