Prevalence of low bone health using quantitative ultrasound in Indian women aged 41-60 years: Its association with nutrition and other related risk factors.

The purpose of this study was to find the prevalence of low bone health conditions and assess associated nutritional and other risk factors in Indian women aged 41-60 years. A total of 1,911 women participated in this cross-sectional study. Bone health was assessed using an Omnisense multisite quantitative ultrasound bone densitometer on two sites (radius and tibia). Crude prevalence of osteopenia and osteoporosis was found to be 30.09% and 19.89%, respectively. The Indian women were deficient in a majority of nutrients. Postmenopause, hysterectomy, hyperthyroid, hypothyroid, hypertension, low physical activity, low sun exposure, high stress levels, and low calcium levels were found to be independent risk factors of low bone health.

Prevalence of Type 2 Diabetes Mellitus among Urban Sikh Population of Amritsar.

CONTEXT: Type 2 Diabetes Mellitus (T2DM) refers to a group of common metabolic disorders that share the phenotype of Hyperglycemia. More than 60% of the world's population with diabetes comes from Asia. AIM: To study the prevalence of Type 2 Diabetes Mellitus among Sikh individuals living in the urban localities of Amritsar. SETTINGS AND DESIGN: The study was designed in the Faculty of Sports Medicine & Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India. The data collection was carried out in various urban localities of Amritsar. Blood samples were analyzed in the Biochemistry laboratory, whereas data analysis and article preparation was carried out in the Faculty of Sports Medicine and Physiotherapy. MATERIALS AND METHODS: Multi-stage random sampling was done with a sample size of 1089 patients. STATISTICAL ANALYSIS: The data was analyzed in Stata 11.2 software. Various tests used in the study are Mean ± SD, Pearson Chi Square Test, Students' t test and multiple logistic regression test. RESULTS: Our study showed that the prevalence rate of Type 2 Diabetes Mellitus is 23.2% with the confidence interval of 20.7-25.7. Proportionately more patients with T2DM had hypertension (46.6%). Likewise proportionately more patients, 67.5% had hypertrigylerdemia, 67.6% had low HDL levels, 59.2 % had hypercholesterolemia and 73.1% suffered from metabolic syndrome. CONCLUSIONS: Our study clearly indicates that the young Sikh adults below 40 years of age have similar high BMI, WC and WHR to that of the older adults above 40 years of age. It is necessary to adopt appropriate preventive strategies and interventions in high-risk individuals to curb the growing epidemic of diabetes. Innovative community outreach programs need to be designed and implemented to create awareness and early screening and treatment of diabetes, especially in the urban population.

Detection of aneuploidy from single fetal nucleated red blood cells using whole genome sequencing.

OBJECTIVE: The objective of the study was to detect aneuploidy in single fetal nucleated red blood cells (FNRBCs) from placental villi using whole genome amplification (WGA) and next generation sequencing. METHODS: Three single FNRBCs per sample were manually picked from villi collected from ten women undergoing elective first-trimester termination of pregnancy, and one or two cells were picked from each of four aneuploid chorionic villus samples. Following WGA and addition of adaptor and index sequences, samples were sequenced on the Illumina MiSeq. Leading and trailing 15 bases were trimmed, and reads were aligned to the human reference genome. Z-scores were calculated to determine deviation of the mean of the test from reference samples, with a score of 3 used as the threshold for classification of a particular chromosome as trisomic. RESULTS: We successfully made correct diagnoses from ten single cells isolated from villi from two cases of trisomy 21 (one case from a single cell and one from two cells), two cases of trisomy 18 (two cells each), and a case of trisomy 15 (three cells). CONCLUSION: With their faithful representation of fetal genome, diagnosis using single FNRBCs provides a definitive result compared with non-invasive prenatal testing using cell-free fetal DNA, and is a safer alternative to invasive amniocentesis.

Effect of progressive pedometer based walking intervention on quality of life and general well being among patients with type 2 diabetes.

BACKGROUND: To determine the effectiveness of two goal setting pedometer based walking program for people with type 2 diabetes, one employing supervised exercise group with pedometer and the other employing self reported group with pedometer. METHODS: A total of 102 type 2 diabetic outpatients (28 women, 74 men) between the age of 40-70 years were recruited and randomly allocated into 3 groups: supervised exercise group with pedometer (Group A), self reported exercise group with pedometer (Group B) and a control group (Group C) for 16 weeks. Subjects were asked to respond to the Audit of Diabetes Dependent Quality of Life (ADDQoL) and well being questionnaire at two occasions i.e. 0 week and after 16 weeks of intervention. Paired t test were used within the groups to compare Mean ± SD for all the parameters at baseline and at the end of 16 weeks. Differences between the groups were compared using analysis of variance (ANOVA). Statistical difference was further analyzed by Post hoc analysis using Bonferroni method. RESULTS: The item "Freedom to eat" had the highest negative impact among all the subgroups. Other domains that were adversely affected by diabetes are 'leisure activity', 'do physically', 'physical appearance', 'self confidence', 'future' and 'financial situation'. In the group A significant reduction were noted among all the items except long distance journey (p<0.05). In the group B participants experienced reduction among all the domains except long distance journey, sex life and living condition. CONCLUSION: Pedometer determined activity has the potential to improve the quality of life. Supervised Walking using a pedometer was found more effective in improving quality of life and general wellbeing for Asian Indians with type 2 diabetes. CLINICAL TRIAL REGISTRY INDIA CTRI: [CTRI/2012/10/003034].

Effect of Exercise Program and Calcium Supplements on Low Bone Mass among Young Indian Women- A Comparative Study.

PURPOSE: Low bone mass is a major health concern among young women nowadays due to sedentary lifestyle and lack of calcium rich food intake. Therefore there is an increase in the incidence of LBM among young university women so our main purpose of study was to compare effects of exercise program and calcium supplements on bone mass in young women. METHODS: This single blinded, cross sectional study included data collection in the form of SOS T-scores at distal radius for 104 young university women of mean age 22.3 years using Sunlight Omnisense Bone Sonometer 7000S. Of these, 62 women with low bone mass were included in a 3 month study but 60 subjects completed the study. They were randomly divided into 3 groups: exercise group (n=21), calcium supplementation group (n=21) and control group (n=20). All participants were evaluated pre and post protocol for T-score distal radius and midshaft tibia. RESULTS: After measuring SOS T-score of 104 subjects; we found that 60.57% had low bone mass and remaining 39.43% had normal bone mass. After 3 months, the exercise group showed significant improvement in distal radius SOS T-score (t=5.10, P<0.001), at midshaft tibia (t=3.71, P<0.001) followed by improvement in calcium group at distal radius (t=6.28, P<0.001), midshaft tibia (t=2.33, P<0.05) as compared to control group which showed a marginal increase. CONCLUSIONS: Exercise group showed more improvement in T-scores than calcium and control group. Exercise is important modifiable factor to improve bone accretion at this age and reduce risk of developing osteoporosis related debilitating conditions later in life.

Membrane proteins of human fetal primitive nucleated red blood cells.

In humans, primitive fetal nucleated red blood cells (FNRBCs) are thought to be as vital for embryonic life as their counterpart, adult red blood cells (adult RBCs) are in later-gestation fetuses and adults. Unlike adult RBCs, the identity and functions of FNRBC proteins are poorly understood owing to a scarcity of FNRBCs for proteomic investigations. The study aimed to investigate membrane proteins of this unique cell type. We present here, the first report on the membrane proteome of human primitive FNRBCs investigated by two-dimensional liquid chromatography coupled with mass-spectrometry (2D-LCMS/MS) and bioinformatics analysis. A total of 273 proteins were identified, of which 133 (48.7%) were membrane proteins. We compared our data with membrane proteins of adult RBCs to identify common, and unique, surface membrane proteins. Twelve plasma membrane proteins with transmembrane domains and eight proteins with transmembrane domains but without known sub-cellular location were identified as unique-to-FNRBCs. Except for the transferrin receptor, all other 19 unique-to-FNRBC membrane proteins have never been described in RBCs. Reverse-transcriptase PCR (RT-PCR) and immunocytochemistry validated the 2D-LCMS/MS data. Our findings provide potential surface antigens for separation of primitive FNRBCs from maternal blood for noninvasive prenatal diagnosis, and to understand the biology of these rare cells.

Cardiovascular risk factors in middle age obese Indians: a cross-sectional study on association of per cent body fat and intra-abdominal fat mass.

OBJECTIVES: To determine the association of per cent total body fat (TBF), intra-abdominal fat (IAF) mass and subcutaneous abdominal fat with cardiovascular risk factors in middle age obese Indians. DESIGN: Cross-sectional study. SETTING: Hydrostatic Laboratory, Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, India. PARTICIPANTS: 51 subjects aged 30-55 years with a body mass index value 23 and above. METHODOLOGY: In all the participants, TBF was estimated by underwater weighing machine and IAF and subcutaneous fat were measured by ultrasonography. Lipid profile was determined by a semiautomated analyser. Main outcome measures were: IAF, per cent body fat to TBF ratio, lipid profile and risk of developing cardiovascular diseases. RESULTS: IAF was found to be significantly associated with lipid variables (95% CI, p<0.01) and risk of developing cardiovascular diseases (95% CI, p≤0.05) in both male and female subjects. TBF and subcutaneous fat thickness showed no significant results (95% CI, p>0.05) with either lipid variables or risk of developing cardiovascular diseases (tables 1 and 2). IAF mass showed significant association with age (95% CI, p<0.01) and significant negative association with physical activity (95% CI, p<0.05) in male subjects (tables 3 and 4). CONCLUSION: An ultrasonic measurement of IAF is a better predictor of the risk of developing cardiovascular diseases in middle aged Indian population. In male subjects, physical activity of 5 or more days a week showed lesser amount of IAF as compared with those with physical activity <5 days a week.

Relationship of maximal aerobic capacity with predictors of cardiovascular diseases in North Indian cardiac patients.

OBJECTIVE: To determine the relationship between maximal oxygen uptake (VO2max), as determined by the Bruce protocol, and selected risk factors for cardiovascular disease (CVD) in an North Indian population. DESIGN: Cross-sectional design. SETTING: The study was carried out at Fortis Escorts Hospital, Amritsar, Punjab, India. PATIENTS: 105 CVD patients. INTERVENTIONS: All patients were subjected to a symptom-limited treadmill test and their fasting blood lipid parameters were measured. MAIN OUTCOME MEASURES: (a) Body composition; (b) blood lipid parameters; (c) haemodynamic measurement (heart rate at rest and during exercise); (d) physical activity questionnaire (perceived functional ability, physical activity score and physical activity readiness). RESULTS: VO2max was found to be negatively associated with age (r=0.192), body mass index (r=0.163), waist circumference (r=0.197), hip circumference (r=0.208) and percentage of body fat (r=0.238); positively correlated with perceived functional ability (r=0.580), physical activity readiness (r=0.534), physical activity score (r=0.784), maximum heart rate (r=0.236) and metabolic equivalents (r=0.938); and showed no association with total cholesterol (r=0.102), triglycerides (r=0.079) and high-density lipoproteins (r=0.153). CONCLUSION: VO2max was associated with body composition parameters but did not show any relation with blood lipid parameters. The most significant association was found between VO2max and the physical activity questionnaire.

Effect of Body Mass Index on work related musculoskeletal discomfort and occupational stress of computer workers in a developed ergonomic setup.

BACKGROUND: Work urgency, accuracy and demands compel the computer professionals to spend longer hours before computers without giving importance to their health, especially body weight. Increase of body weight leads to improper Body Mass Index (BMI) may aggravate work related musculoskeletal discomfort and occupational-psychosocial stress. The objective of the study was to find out the effect of BMI on work related musculoskeletal discomforts and occupational stress of computer workers in a developed ergonomic setup. METHODS: A descriptive inferential study has been taken to analyze the effect of BMI on work related musculoskeletal discomfort and occupational-psychosocial stress. A total of 100 computer workers, aged 25-35 years randomly selected on convenience from software and BPO companies in Bangalore city, India for the participation in this study. BMI was calculated by taking the ratio of the subject's height (in meter) and weight (in kilogram). Work related musculoskeletal discomfort and occupational stress of the subjects was assessed by Cornell University's musculoskeletal discomfort questionnaire (CMDQ) and occupational stress index (OSI) respectively as well as a relationship was checked with their BMI. RESULTS: A significant association (p < 0.001) was seen among high BMI subjects with their increase scores of musculoskeletal discomfort and occupational stress. CONCLUSION: From this study, it has been concluded that, there is a significant effect of BMI in increasing of work related musculoskeletal discomfort and occupational-psychosocial stress among computer workers in a developed ergonomic setup.

The influence of kinesiophobia on trunk muscle voluntary responses with pre-programmed reactions during perturbation in patients with chronic low back pain.

The purpose of this study was to examine the relation between fear of movement and perturbation induced electromyographic global trunk muscle voluntary responses with pre-programmed reactions among persons with chronic low back pain (CLBP). CLBP subjects (n = 25) were challenged to unexpected and expected perturbations on stable and unstable surfaces. 'Tampa scale for kinesiophobia - Adjusted version-13' was used to measure kinesiophobia. Regression analysis revealed significant negative correlation between kinesiophobia scores and voluntary responses of rectus abdominis (RA) for unexpected perturbations on stable (r = -0.69, 95% of CI: -0.85 to -0.40, p < 0.000, r(2) = 0.41) and unstable surfaces (r = -0.47, 95% of CI: -0.72 to -0.09, p < 0.018, r(2) = 0.29). The activity of erector spinae was not influenced by most of testing conditions in the study except task on unstable surface for expected perturbation (r = -0.593, 95% of CI: -0.8 to -0.25, p = 0.002, r(2) = 0.15). RA activity and kinesiophobia score of the CLBP population was significantly inversely associated during anteriorly directed unexpected perturbations. In our study, the significant association between fear of movement and the trunk muscle responses was differentially influenced by expected and unexpected postural demands.

Intravascular haemolysis during prolonged running on asphalt and natural grass in long and middle distance runners.

Surface features such as uneven playing surfaces, low impact absorption capacity and inappropriate friction/traction characteristics are connected with injury prevalence whereas force impact during foot strike has been suggested to be an important mechanism of intravascular haemolysis during running. We aimed to evaluate intravascular haemolysis during running and compare the effect of running on two different types of surfaces on haemolysis. We selected two surfaces (asphalt and grass) on which these athletes usually run. Participants were randomly assigned to group A (asphalt) or group B (grass) with 10 athletes in each group. Each athlete completed one hour of running at the calculated target heart rate (60-70%). Venous blood samples were collected before and immediately after running. We measured unconjugated bilirubin (UBR) (mg · dl(-1)), lactate dehydrogenase (LDH) (µ · ml(-1)), haemoglobin (g · l(-1)) and serum ferritin (ng · ml(-1)) as indicators of haemolysis. Athletes who ran on grass demonstrated an increase in the haematological parameters (UBR: P < 0.01, LDH: P < 0.05) when compared to athletes who ran on asphalt (UBR: P < 0.05, LDH: P = 0.241). Our findings indicate that intravascular haemolysis occurs significantly after prolonged running. Furthermore, we conclude that uneven grass surface results in greater haemolysis compared to asphalt road.

Firm insoles effectively reduce hemolysis in runners during long distance running - a comparative study.

BACKGROUND: Shock absorbing insoles are effective in reducing the magnitude and rate of loading of peak impact forces generated at foot strike during running, whereas the foot impact force during running has been considered to be an important cause of intravascular hemolysis in long distance runners. Objective of this study was to evaluate the intravascular hemolysis during running and compare the effect of two different types of insoles (Soft and Firm) on hemolysis. METHODS: Twenty male long and middle distance runners volunteered to participate in this study. We selected two insoles (Soft and Firm) according to their hardness level (SHORE 'A' scale). Participants were randomly assigned to the soft insole (group 1) and firm insole (group 2) group with ten athletes in each group. Each athlete completed one hour of running at the calculated target heart rate (60-70%). Venous blood samples were collected before and immediately after running. We measured unconjucated bilirubin (mg/dl), lactate dehydrogenase (µ/ml), hemoglobin (g/l) and serum ferritin (ng/ml) as indicators of hemolysis. RESULTS: Our study revealed a significant increase in the mean values of unconjucated bilirubin (P < 0.05) while running with soft insoles indicating the occurrence of hemolysis in this group of athletes. Graphical analysis revealed an inverse relationship between hardness of insoles and hemolysis for the observed values. CONCLUSION: Our results indicate that intravascular hemolysis occurs in athletes during long distance running and we conclude that addition of firm insoles effectively reduces the amount of hemolysis in runners compared to soft insoles.

Effects of Withania somnifera (Ashwagandha) and Terminalia arjuna (Arjuna) on physical performance and cardiorespiratory endurance in healthy young adults.

INTRODUCTION: Several medicinal plants have been described to be beneficial for cardiac ailments in Ayurveda like Ashwagandha and Arjuna. Ashwagandha-categorised as Rasayanas, and described to promote health and longevity and Arjuna primarily for heart ailments. coronary artery disease, heart failure, hypercholesterolemia, anginal pain and can be considered as a useful drug for coronary artery disease, hypertension and ischemic cardiomyopathy. OBJECTIVE: There are no scientific clinical studies showing effect of both these drugs on exercise performance after regular administration when given as supplements The present study was therefore designed and performed to assess the effects of Withania somnifera (Ashwagandha) and Terminalia arjuna (Arjuna) individually and as a combination on maximum velocity, average absolute and relative Power, balance, maximum oxygen consumption (VO2 max) and blood pressure in humans. MATERIALS AND METHODS: Forty normal healthy. Subjects (either sex, mean age 20.6 ± 2.5yrs and mean Body Mass Index 21.9 ± 2.2) were recruited after written informed consent was obtained. Institutional Ethics Committee permission was also obtained. Thirty participants were assigned to experimental group of which 10 received standardized root extracts of Withania somnifera, 10 received standardized bark extract of Terminalia arjuna and the rest of the 10 received standardized root extract of Withania somnifera in addition to bark extract of Terminalia arjuna both. Both the drugs were given in the form of capsules (dosage 500mg/day for both the drugs). Ten participants received placebo (capsules filled with flour). All the subjects continued the regimen for 8 weeks. All variables were assessed before and after the course of drug administration OBSERVATIONS: Our study showed that Withania somnifera increased velocity, power and VO2 max whereas Terminalia arjuna increased VO2 max and lowered resting systolic blood pressure. When given in combination, the improvement was seen in all parameters except balance and diastolic blood pressure. CONCLUSION: Withania somnifera may therefore be useful for generalized weakness and to improve speed and lower limb muscular strength and neuro-muscular co-ordination. Terminalia arjuna may prove useful to improve cardio-vascular endurance and lowering systolic blood pressure. Both drugs appear to be safe for young adults when given for mentioned dosage and duration.

Prediction equation for calculating fat mass in young Indian adults.

PURPOSE: Accurate measurement or prediction of fat mass is useful in physiology, nutrition and clinical medicine. Most predictive equations currently used to assess percentage of body fat or fat mass, using simple anthropometric measurements were derived from people in western societies and they may not be appropriate for individuals with other genotypic and phenotypic characteristics. We developed equations to predict fat mass from anthropometric measurements in young Indian adults. METHODS: Fat mass was measured in 60 females and 58 males, aged 20 to 29 yrs by using hydrostatic weighing and by simultaneous measurement of residual lung volume. Anthropometric measure included weight (kg), height (m) and 4 skinfold thickness [STs (mm)]. Sex specific linear regression model was developed with fat mass as the dependent variable and all anthropometric measures as independent variables. RESULTS: The prediction equation obtained for fat mass (kg) for males was 8.46+0.32 (weight) - 15.16 (height) + 9.54 (log of sum of 4 STs) (R2= 0. 53, SEE=3.42 kg) and - 20.22 + 0.33 (weight) + 3.44 (height) + 7.66 (log of sum of 4 STs) (R2=0.72, SEE=3.01kg) for females. CONCLUSION: A new prediction equation for the measurement of fat mass was derived and internally validated in young Indian adults using simple anthropometric measurements.

The effects of aerobic versus resistance training on cardiovascular fitness in obese sedentary females.

PURPOSE: The present study was designed to evaluate the effects of aerobic and strength training on cardiac variables such as blood pressure, heart rate (HR), and metabolic parameters like cholesterol, high density lipoprotein (HDL), triglycerides and anthropometric parameters of obese women of Punjab. METHODS: This study was performed as an experimental study, in which subjects were randomly selected. There were thirty obese women, aged between 35-45yrs with body mass index (BMI) of above 30. Subjects were grouped into control (n=10), aerobic training (n=10) and resistance training (n=10). Aerobic training was given for three days a week at 60-70% of maximum HR for 6 weeks. Resistance training (Delorme and Watkins Technique) was given for alternate days for 6 weeks. HR and blood pressure were measured before and after the exercise. Recovery HR was also measured. RESULTS: The findings of the study indicate statistically significant differences in recovery heart rate [Pre-exercise: 97.40± 5.378 (mean±standard deviation (SD)), post-exercise: 90.70±4.599, t=8.066, P<0.001] and in post-diastolic blood pressure [Pre-exercise: 85±3.265, post-exercise: 86.20±2.820, P<0.001] in aerobic training and in systolic blood pressure [Pre- and post-exercise] in both training groups (P<0.001). Significant differences were observed in very low-density lipoprotein [pre-exercise: 28.10±1.415, post-exercise: 26.86±0.760, t=5.378] and HDL [pre-exercise: 45.40±3.533, post-exercise: 53.60±3.134, t=6.318] levels in aerobic training group with P<0.001. BMI and body fat percentage showed significant improvements in both training groups. CONCLUSION: Aerobic training is more beneficial and can be used as a preventive measure in patients who are at risk of developing cardiovascular diseases due to obesity.

Effectiveness of an aerobic walking program using heart rate monitor and pedometer on the parameters of diabetes control in Asian Indians with type 2 diabetes.

AIMS: To analyze the effects of 8 weeks of aerobic walking using a heart rate monitor (HRM) and pedometer for monitoring exercise intensity on glycemic outcomes, fasting blood glucose (FBG), cardiovascular fitness and well-being in type 2 diabetes patients. METHODS: Forty adults with type 2 diabetes were randomly allocated to an 8-week supervised program of walking using heart rate monitor and pedometer (group A=20) and control group (group B=20). All outcomes were determined at baseline and after the 8-week training period. RESULTS: The exercise training program resulted in a 9.7% (P<0.05) improvement in group A. Fasting blood glucose level decreased significantly by 37% in group A (P<0.05). Body mass index (BMI) ratio decreased by 3.9% in group A and increased by 2.2% in group B. General well-being (GWB) improved by 28.8% (P<0.05) in the exercising group and there was an improvement in all parameters associated with cardiovascular health. CONCLUSION: Monitoring an exercise program using a heart rate monitor and pedometer was effective and decreased the level of HbA1c, FBG, BMI and improved general well-being. Further using HRM helped us to attribute all improvements to the exercise intensity that we used in our study.