Effect of body mass index on cardiorespiratory parameters among medical students: a cross-sectional study.

BACKGROUND: Obesity is a global crisis due to its significant contribution to mortality and morbidity. This study discovered an association between body mass index (BMI) with pulmonary function tests (PFTs) and aerobic capacity (VO2 max) in medical students of Zydus Medical College and Hospital, Dahod, Gujarat. AIM: The study aimed to determine the effect of obesity on cardiopulmonary health of medical students. OBJECTIVES: The study objectives were as follows: 1. To compare PFT parameters and VO2 max between obese and non-obese students. 2. To study the correlation of BMI with PFTs and VO2 max. MATERIAL AND METHODS: BMI was calculated with the formula BMI = weight/height2. PFTs were assessed with computerized spirometry. Aerobic capacity was calculated with Astrand 6-minute Cycle Test. Statistical analysis was done with unpaired t-test. RESULTS: This study found a significant difference in forced vital capacity (FVC), forced expiratory volume in 1 minute (FEV1), slow vital capacity (SVC), maximum ventilatory volume (MVV), and VO2 max between obese and non-obese students (P<0.05). There was a positive correlation between BMI and forced mid-expiratory flow (FEF25-75), peak expiratory flow rate (PEFR), MVV, SVC, expiratory reserve volume (ERV), and MVV and negative correlation with FVC, FEV1, lung age, and VO2 max in non-obese students. There was also a positive correlation between BMI and PEFR, SVC, FVC, FEV1, lung age, MVV, ERV, and a negative correlation with FEF25-75 and VO2 max in obese students. CONCLUSION: As BMI is inversely related to cardiopulmonary function, students having high BMI can be motivated toward a healthy lifestyle.

The anatomy, movement, and functions of human sperm tail: an evolving mystery.

Sperms have attracted attention of many researchers since it was discovered by Antonie van Leeuwenhoek in 1677. Though a small cell, its every part has complex structure and different function to play in carrying life. Sperm tail is most complicated structure with more than 1000 proteins involved in its functioning. With the advent of three-dimensional microscopes, many studies are undergoing to understand exact mechanism of sperm tail movement. Most recent studies have shown that sperms move by spinning rather than swimming. Each subunit of tail, including axonemal, peri-axonemal structures, plays essential roles in sperm motility, capacitation, hyperactivation, fertilization. Furthermore, over 2300 genes are involved in spermatogenesis. A number of genetic mutations have been linked with abnormal sperm flagellar development leading to motility defects and male infertility. It was found that 6% of male infertility cases are related to genetic causes, and 4% of couples undergoing intracytoplasmic sperm injection for male subfertility have chromosomal abnormalities. Hence, an understanding of sperm tail development and genes associated with its normal functioning can help in better diagnosis of male infertility and its management. There is still a lot that needs to be discovered about genes, proteins contributing to normal human sperm tail development, movement, and role in male fertility. Sperm tail has complex anatomy, with surrounding axoneme having 9 + 2 microtubules arrangement along its entire length and peri-axonemal structures that contribute in sperm motility and fertilization. In future sperm tail-associated genes, proteins and subunits can be used as markers of male fertility.

Physiology to Disease Transmission of Respiratory Tract Infection: A Narrative Review.

INTRODUCTION: In the current scenario of the COVID 19 pandemic, the protective reflexes, namely sneeze and cough, have received great importance. However, it is not in terms of protection but in terms of the spread of infection. The present review tries to bring out the correlation between the physiology of sneeze and cough, taking into consideration the various receptors that initiate the two reflexes, then correlating it with the formation of expelled droplets and the significance of various aspects of droplets that lead to the spread of infection. MATERIAL AND METHODS: For the compilation of the present review, we searched the terms "Physiology of cough", "Physiology of sneeze", "droplets", "aerosols" and "Aerosols in COVID 19". The above-mentioned terms were extensively searched on PubMed, Google Scholar, and google search engine. After reviewing the various available material, the most significant research has been considered for this review. CONCLUSION: Through this review, we conclude that there are various factors responsible for the initiation of sneeze and cough, but in the case of infection, it is mainly the inflammatory reaction that directly stimulates the receptors to produce the reflex outburst air. As the flow of air during expiration is turbulent, it causes damage to the Epithelial Lining Fluid present in the respiratory conduit. In addition, it gets admixed with the saliva in the oropharynx and oral cavity and mucus in the nose to form droplets of various sizes. Large droplets settle close and are responsible for droplet and fomite transmission, but the smaller droplets remain suspended in the air and travel farther distances to cause airborne transmission. The spread of droplet cloud in sneezing may range to 6m or more as compared to cough; hence the concept of 1m to 2m of social distancing does not hold reliable if the patient is sneezing.

Maternal serum uric acid and calcium as predictors of hypertensive disorder of pregnancy: A case control study.

OBJECTIVES: Compare serum uric acid and calcium levels among normotensive and hypertensive pregnant women, to compare maternal and perinatal outcomes in two groups. MATERIALS AND METHODS: Prospective case control study was conducted after ethical approval in Obstetrics and Gynaecology department of rural tertiary care centre of Northern India, over seven months. Total 220 antenatal women ≥34 weeks of gestation with 110 cases having hypertensive disorder of pregnancy and 110 controls with normal blood pressure were compared for maternal uric acid and calcium levels and maternal, perinatal outcomes. RESULTS: Mean ± SD values of uric acid and calcium in control group was 4.42 ± 1.42 mg/dl and 8.94 ± 0.6 mg/dl, whereas in cases they were 6.8 ± 2.72 mg/dl and 8.61 ± 0.78 mg/dl (p < 0.05). Induced labour followed by lower segment caesarean section was the most common mode of delivery in hypertensive cases, whereas, in controls, the majority had spontaneous onset of labour and delivered vaginally (p < 0.05). Hypertensive women with higher uric acid and lower calcium had adverse perinatal outcome as compared to controls (p < 0.05). Mean ± SD of neonatal birth weight in controls was 2.81 ± 0.295 Kg and in cases 2.56 ± 0.421 Kg. Neonatal birth weight was significantly associated with maternal uric acid than calcium in hypertensive women. Cases with hyperuricemia and low calcium levels had adverse overall outcome as compared to controls. CONCLUSION: Maternal hyperuricemia and hypocalcaemia was associated with adverse maternal, perinatal outcomes in women with hypertensive disorder of pregnancy as compared to healthy normotensive women.

Cell-Free Fetal DNA: A Novel Biomarker for Early Prediction of Pre-eclampsia and Other Obstetric Complications.

Hypertensive disorder of pregnancy, especially Pre-eclampsia is one of the major causes of increased maternal and perinatal morbidity and mortality all over the world. Early prediction of pre-eclampsia is the need of modern obstetrics, as this can timely prevent the progress of disease as well as related fetal and maternal morbidity and mortality. In addition to the screening of fetal aneuploidies, Rhesus-D status, fetal sex, single gene disorders, the cell-free fetal Deoxyribonucleic acid (DNA) quantification has emerged as a promising biomarker for the prediction of pre-eclampsia. Hence, its use can help in the early prediction of hypertensive disorders of pregnancy, especially pre-eclampsia even before the appearance of symptoms. Furthermore, in future, it can also help in the determination of the complete DNA sequence of every gene of the fetus. The present review focuses on recent literature concerning the use of cell-free fetal DNA in early prediction of preeclampsia as well as for non-invasive prenatal genetic screening of fetus for various disorders. Methods: The recent literature related to cell-free fetal DNA was searched from numerous English language journals and published peer-reviewed articles on Pubmed, Google Scholar, MEDLINE and various government agencies till 2016.

Reactive oxygen species in seminal plasma as a cause of male infertility.

Male factor is responsible for 40-50% of infertility cases, contributing equally as a female factor. Oxidative stress has now emerged as one of the major causes of unexplained male infertility, as it leads to increased risk of deoxyribonucleic acid (DNA) fragmentation, decreased sperm motility, concentration and abnormal morphology. Though a certain amount of reactive oxygen species (ROS) activity is essential for normal functioning of sperms, an excess lead to pathological effects on semen parameters, ultimately resulting in male sub-fertility or infertility. Furthermore, oxidative stress affected sperm cells with damaged DNA result in increased risk of birth defects, neuropsychiatric problems and cancers in off-springs of such fathers due to increased risk of de-novo mutations in the germline and post-fertilization. Hence, present review helps in highlighting the facts about ROS, their production, physiological functions and pathological effects on sperm dysfunction and DNA damage, leading to male infertility. The literature regarding male infertility and role of ROS was searched from various peer-reviewed printed and online articles indexed in PubMed, MEDLINE, SCOPUS, EMBASE, etc. and from various governmental organizations till Jan 2018.

Impact of maternal serum uric acid on perinatal outcome in women with hypertensive disorders of pregnancy: A prospective study.

INTRODUCTION: Worldwide hypertensive disorder of pregnancy is major cause of maternal and perinatal morbidity, mortality. AIM: To study impact of maternal serum uric acid on perinatal outcome in women with hypertensive disorder of pregnancy. METHODOLOGY: Present study was conducted in Obstetrics and Gynecology Department of rural tertiary care centre of Northern India over seven months (October 2016-May 2017). Total 110 pregnant women >-34weeks with hypertensive disorder of pregnancy were divided into three groups; Gestational hypertension (n = 35), Pre-eclampsia (n = 49), Eclampsia (n = 26). Maternal serum uric acid and its co-relation with perinatal outcome were assessed in each group. RESULTS: Of total 111 babies delivered to women with hypertensive disorder of pregnancy, 52 (46.85%) were preterm and 59 (53.15%) term. Of these; 43 (38.74%) were born healthy (APGAR > 7), 31 (27.93%) suffered minimal respiratory distress, 14 (12.61%) severe birth asphyxia and required ventilator support, of which two died, 19 (17.12%) babies died in utero and 4 (3.60%) were still births. Mean neonatal birth weight in all three groups was 2.956 ±â€¯0.273 kg, 2.475 ±â€¯0.324 kg and 2.177 ±â€¯0.282 kg respectively. Mean serum uric acid in gestational hypertension women with healthy foetuses was 5.16 ±â€¯1.74 mg/dl and with distressed foetuses was 6.52 ±â€¯2.31 mg/dl, in pre-eclampsia it was 5.3 ±â€¯1.44 mg/dl and 7.29 ±â€¯2.63 mg/dl and in eclamptic women 5.7 ±â€¯0 mg/dl and 8.83 ±â€¯2.96 mg/dl respectively. CONCLUSION: Adverse perinatal outcome was maximum in eclampsia group, followed by pre-eclampsia and lastly in gestational hypertension. Hence, higher maternal serum uric acid was associated with poor perinatal outcome (p < .05).

Trends of male factor infertility, an important cause of infertility: A review of literature.

Infertility and problems of impaired fecundity have been a concern through ages and is also a significant clinical problem today, which affects 8-12% of couples worldwide. Of all infertility cases, approximately 40-50% is due to "male factor" infertility and as many as 2% of all men will exhibit suboptimal sperm parameters. It may be one or a combination of low sperm concentration, poor sperm motility, or abnormal morphology. The rates of infertility in less industrialized nations are markedly higher and infectious diseases are responsible for a greater proportion of infertility. The present literature will help in knowing the trends of male factor infertility in developing nations like India and to find out in future, various factors that may be responsible for male infertility.

Type 2 diabetes mellitus affects male fertility potential.

OBJECTIVE: Diabetes is a syndrome that affects all the physiological systems of the body, therefore this study was undertaken to compare the seminogram parameters in diabetics and non-diabetics. STUDY DESIGN: The study was carried out at Male Infertility and Reproductive Physiology unit in the Department of Physiology, MGIMS, Sevagram, Wardha. 25 normozoospermic subjects with type 2 diabetes and 25 normozoospermic non diabetic subjects were recruited in the study. The semen samples were analyzed for sperm concentration, motility and morphology. RESULTS: In diabetic group the sperm concentration was 24.6 millions/ml with the motility of 52.3% and normal morphology 31.5%, while in non-diabetic group the sperm concentration was 42.7 millions/ml with 63.1% motility and 47.2% normal morphology. CONCLUSION: Thus our observations indicate that there is a detrimental effect of type 2 diabetes mellitus on semen parameters.