Indian Journal of Clinical Anatomy and Physiology

430-433

Authors: Arun Kumar. B*,Nirmala N

Introduction: Hypertension is a major health hazard which at a later stage might lead onto various cardiovascular complications. Prehypertension is a precursor of Stage-I hypertension. Thus, the present study was done to assess the sympathetic activity in normotensive, prehypertensive and hypertensive individuals. Aims and Objectives: To compare the differences in sympathetic activity in normotensive, prehypertensive and hypertensive individuals. Materials and Methods: The study was conducted on 30 normotensive, 30 prehypertensive and 30 hypertensive subjects. Autonomic function tests were recorded using the instrument Physiopac-PP4, Medicaid system, Chandigarh. The following sympathetic function tests were performed: 1. Blood pressure response to standing, 2. Cold pressor test, 3. Isometric handgrip test. Results: Our findings on hypertensives showed that there is sympathetic dysfunction and on prehypertensives showed that there is sympathetic overactivity. Conclusion: Autonomic function tests can be used as a routine screening test to predict the future risk of hypertension at an earlier stage and also for a better prognosis during treatment.

439-442

Authors: Deepa HS*

This study evaluated the effects ofacute-intense exercise on visual and auditory reaction time. Materials and Methods: Study included 40 males in the age group of 18- 22 years. Participant’s blood pressure and resting heart rate was measured using the sphygmomanometer and Pulse Ox (heart rate monitor), respectfully. Pulse Ox was placed on non-dominant index finger of the participant. PC 1000 reaction timer was used for the measurement of VRT for red, blue & green light & ART. After the baseline measurements, subject started to exercise on the stationary bike till heart rate was doubled and subject maintained exercise for 5 more minutes. Immediately after the exercise, post exercise heart rate & post exercise blood pressure were measured, & VRT for all 3 colours& ART were retested. Results were analysed statistically using Wilcox paired‘t’ test comparing pre & post exercise measurements. Results: The mean values of VRT for red, blue & green & ART was faster after exercise when compared to before exercise values & the difference was statistically significant. There was significant increase in heart rate & systolic BP & decrease in diastolic blood pressure after exercise compared to baseline values. Conclusion: Results of the study can be associated to many people in improving their health in everyday life especially athletes & senior citizens.

449-453

Authors: Chaitra B. R*,Anitha M. R,Tarakeshwari R,Shailendranath M. S

Introduction: Tendon transfer restores balance to the hand which has lost its power due to tendon or muscle destruction. There are various factors which are taken into account while selecting a graft for reconstructive surgeries such as availability, length, expendability of graft tendon. The purpose of this study is to correlate the surface measurement of upper limb and lower limb using anatomical landmarks and underlying tendon lengths used for grafting. This will provide an idea for estimation of underlying donor tendon lengths by easily measured surface measurements of upper and lower limbs. Materials and Methods: The study was conducted on 30 cadaveric upper and lower limbs collected in the department of anatomy, AIMS&RC, Devanahalli, Bengaluru. Lengths of commonly harvested tendons used for grafting were measured. In upper limb, tendons of palmaris longus, extensor digiti minimi and extensor indices were selected. In lower limb, tendons of plantaris and extensor digitorum longus of 2nd toe were selected. Surface measurement of upper limb and lower limbs were measured using bony land marks. Correlation between surface measurement of limbs and lengths of underlying tendons used for grafting were analyzed. By using, the univariate least square regression model, tendon multiplier is generated for each tendon, which gives the tendon length in donors by using the surface measurements of upper and lower limbs. Results: Mean tendon lengths of palmaris longus is 15.53±4.7 cm, extensor digiti minimi is 19.7±1.9 cm, extensor indices is 19.1±1.2 cm, plantaris is 35.97±2.7 cm and extensor digitorum longus of second toe is 27.93±2.9 cm. Tendon multiplier for the tendon of palmaris longus is 0.66, for extensor digiti minimi is 0.53, for extensor indices is 0.31, for plantaris is 0.91 and extensor digitorum longus is 0.51. Mean surface measurement of upper limb is 27.5±2.31 cm and lower limb is 37.43± 2.6 cm. Conclusion: While selecting tendons for graft, length of donor tendon is a limiting variable. Using the easily available surface measurements, surgeons may be able to better estimate the underlying tendon lengths available for grafting.

457-460

Authors: Anand Jagannath Reddy,Rakhi Milind More*

There are several methods of reconstruction for lower human jaw, but the most common and safest is using plates and screws. The size of the lower jaw bone varies from person to person, therefore plates and screws are available in different sizes.1 A critical buccal bone thickness of 2 mm is recommended to prevent vertical resorption. A minimum bone thickness of 6 mm would be required for successful placement of a standard-sized ±4-mm-diameter implant.2 In the present study Mandibular Body Thickness (MBT) was studied in 110 dry mandibles to evaluate the ideal length of dental implants used during the corrective procedures on the mandibular alveolar process. All the mandibles in our study had adequate bone thickness needed for implant placement without traumatizing the sublingual artery.

464-467

Authors: Sureka ,Abeetha S*,Brinda S,Ganesh M,Poovarajan

Introduction: There are various stressors that a student will encounter during their initial college days and our focus is to assess if gender and BMI have any effect on the stress and anxiety experienced by students. Materials and Methods: The questionnaire based study was conducted in a private medical college. 172 students doing their paramedical course participated in the study. Anxiety and stress were assessed using Generalised Anxiety Disorder (GAD-7) and Cohens stress scale. BMI was calculated using anthropometric data. Results: The prevalence of low, moderate and high stress among students was 15.7%, 34.3% and 50.0% respectively. Similarly 29.1% students showed mild anxiety, 36% and 34.9% had moderate and severe anxiety. 57% females showed high stress. Anxiety values was similar among both genders. There was no association between stress and BMI. But underweight students showed more anxiety than others. Discussion: Study shows a wide prevalence of stress and anxiety among students. BMI also acts as a contributing factor for stress. Priority must be given for psychosocial well being of students as it reflects in their academic excellence and social behavior.

474-477

Authors: Suresh Nayak B,Ajit Thakur*,Gayathri L,Prithvi Nayak

Introduction: Globally, 1 billion people are suffering with deficiency or insufficiency of vitamin D. Vitamin D deficiency is also associated with metabolic disorders. This study evaluates Vitamin D levels in prediabetes, T2DM patients and its correlation with HbA1c. Materials and Methods: This study was done in Department of Physiology in association with Department of Endocrinology, JNU Institute of Medical Sciences & Research Center, Jaipur. A total of 155 subjected were enrolled into the study. They were divided into three groups, 65 age and gender matched healthy subjects were taken as group I (controls) (HbA1c: 5.5 to 6.5 %), 45 prediabetic subjects were taken as group II (HbA1c: 6.5 to 7.5 %) and 45 T2DM subjects were taken as group III (HbA1c: >7.5%). Age of the study subjects was 45 to 65 years. Serum sample was used for the estimation of random sugar (GOD-POD method) by using ERBA chemistry analyzer, vitamin D by ELISA method, using mini VIDAS and EDTA sample for HbA1c by using BIORAD D10. Results: In this study, random blood sugar and HbA1c levels were significantly elevated in pre diabetic (group II), T2DM (group III) subjects compared with controls (group I). Significant reduction was observed in prediabetic, T2DM subjects compared to controls in respect to vitamin D levels. Negative correlation was observed between HbA1c and vitamin D. Conclusion: In conclusion, the results of this study showed, significant reduction and negative correlation between serum vitamin D levels and HbA1c in prediabetic and T2DM patients. This study results indicates that there may be need to screen pre diabetic and T2DM patients with poor glycemic control for Vitamin D status.

483-487

Authors: P S. L. Saravanan,S Anu*,V Mathava Kumar

Introduction: It is a known fact that elderly males have a faster reaction time than females, and females exhibit greater pain sensitivity than males. Results on body core temperature between genders are inconsistent. Alternate Nostril Breathing (ANB) exercises were known to modulate the autonomic nervous system. The present study was done to find whether such differences between elderly males and females on pain sensitivity, body temperature and reaction time still persisted after ANB exercises. Objectives: 1. To measure the pain sensitivity, body temperature and reaction time in elderly males and females; 2: To compare the effects of 30 minutes of ANB exercises on all these parameters between elderly males and females. Materials and Methods: 30 elderly males (n=14) and females (n=16) with a mean age of 70.3 years participated in the study. Pain sensitivity was measured with digital algometer, temperature with clinical thermometer and reaction time with choice time apparatus before and immediately after ANB exercises. Results: A significant decrease (<0.001) in all the three parameters was observed after ANB exercises in both genders. No significant difference was observed between elderly males and females on pain sensitivity, body temperature and reaction time to red light, green light &click sound except for tone (<0.019). Conclusion: Reaction time became faster; pain sensitivity and temperature decreased immediately after ANB exercise and this could be due to the balancing effect of the autonomic nervous system. No difference existed between genders after ANB except for tone.

491-496

Authors: Jugal Kishore Bajpai,Deepak Kumar Das*,Sunil Kumar,Praveen Kumar K,Sudhir Modala Volume : 5

Introduction: Left ventricular hypertrophy (LVH) is an important predictor of mortality and morbidity in hypertension, leading to hypertensive heart disease (HHD). Left ventricular mass (LVM), therefore, chiefly determines the geometrical reorientation of LV in hypertensives and these geometrical patterns are useful determinant of severity and prognosis of congestive heart failure (CHF). Studies on the geometrical assessment of LV in hypertensive patients involving large number of patients are limited in India. 2-D Echocardiography, is a non-invasive, cost effective, and a gold standard technique in the early detection of LV hypertrophy in hypertensive patients. Aims and Objectives: To determines the structural and functional integrity of LV in accordance with the variability of the LV geometry and function in recently detected hypertensive patients by 2D- Echocardiography and Colour Doppler. Material and Methods: 2D-Echocardiography and colour Doppler was done in 1000 randomly selected patients in OPD with accidently detected hypertension. LV geometrical patterns were determined by using Echocardiographic parameters chiefly left ventricular mass (LVM), left ventricular mass index to the power 2.7 of ht. (LVMI) and relative wall thickness (RWT) were recorded according to American society of Echocardiography convention (ACE). Results and Observations: Four patterns of LV geometry were noted i.e. concentric hypertrophy (CH) (22.9%), eccentric hypertrophy (EH) (9.7%), and concentric remodeling (CR) (50%) and normal geometry (NG) (17.4%). In this study, we observed that patients with concentric hypertrophy were significantly (<0> LV systolic function was significantly lower in patients with eccentric hypertrophy and some degree of diastolic dysfunction was present in abnormal geometry. Conclusion: The study determines that if there are regular screenings of the high blood pressure, then early steps can be taken to detect the establishment of LV hypertrophy.

501-507

Authors: Mehandi Vinayak Mahajan,Kalpana R*

Introduction: e-learning is a relatively new phenomenon where currently the educators and students are grappling with the idea of its implementation and adaptation. With the speedy development of ICT and relative exposure of students to it, this study examines students’ perceptions about e-learning which would help in a newer teaching learning experiences on the campus. Materials and Methods: A quantitative approach with a structured questionnaire (18 close and 5 open ended) were used for data collection and it was presented to 150 respondents (2nd year M.B.BS) of age group 19-21yrs of different socioeconomic and demographic backgrounds. Results and Discussion: 90% students used internet daily. 78% Male [M] and 92% Female [F] respondents have an idea about e-learning, while 92.5% of them indicated their interest to further guidance. 88%M and 79 F students claim to not have any e-learning facilities on campus. 58% M and 49%F use various forms like emails, chat, blogs, video conferencing, WhatsApp to communicate with their faculties. 98% agree to find e-learning useful and 86% M and 94% F are motivated to use it. 81%M and 88% F find e-learning to be of interactive mode and 74% M with 83% F agree about its cost effectivity. Implementing e-learning would improve performance in 99% students with 74% M and 53% F indicating better understanding of the course. 75% believe that they will have ready access to e-learning courses while other don't due to lack of constant supply of internet. 38% agree e-learning is disadvantages as it will replace faculties as they are comfortable with the traditional teaching style, while 26% disagree. 58% M and 64% F think student will skip traditional classes while 39% M and 35% F would be distracted. 86%M and 92% F disagree with adapting difficulties on implementing newer e-learning modules and tools while the others agree due lack of training. Students gave suggestions to start blogs, online discussions, online submission of home work, and video assisted training for clinical work. Conclusion: The study clearly depicts that e-learning has its benefits from a student's perspective and it will have a positive influence on their performance with better understanding of their courses. Thus for at least the following few years, the university needs come out with e-learning tools and modules for a better teaching -learning experience make a positive impact on the students career.

515-518

Authors: Mohd Yusuf*,R B. Kamal,Manish Bajpai,Kavita Chawla,Piyush Saxena

Aim: The aim of the study was to compare the predictive values of VO2max determined by two sub-maximal exercise tests: Bruce sub-maximal exercise test and Treadmill jogging test and to find correlation between these two tests. Materials and Methods: One hundred twenty five apparently healthy male subjects 18-25 years underwent first three stages of the original Bruce protocol in one session and exercise according to Treadmill jogging test in another session in randomised order. VO2max was calculated by using appropriate regression equation. Results: VO2max values from two tests (t test) revealed similar mean values of VO2max between the two tests (47.06 ± 2.74 vs. 47.20 ± 2.27, t=0.64; p=0.649) i.e. not differed statistically. Concordance correlation coefficient showed an insignificant (p>0.05) concordance between the two tests (r=0.020, 95% CI=-0.152 to 0.191) with low precision (p=0.021) but with high bias correction factor (Cb=0.98). Conclusion: In conclusion we can say that these two tests are comparable in terms of mean values of VO2max. Poor correlation coefficient between the two tests should be subjected to further study with subjects having wider age range and wide range in VO2max values.

525-529

Authors: Pravin R Rathod,Santhi P Rathod*

An extensive review of the literature has revealed a limited pedicle study of the sacrum in Indian population. The present study analyses a very significant variation in the values, as regards the racial/ regional differences. Our study cover morphometric details of the 1st pedicle of sacrum for pedicle screw placement. We intend to study for safe entry of pedicle screw including finding the screw depth in Navi Mumbai population. Boucher in 1959 was the first to use pedicle screws. There has been an almost continuous development in the field of spinal instrumentation by various surgeons. Materials and Methods: The study was done on 30 dry human sacra and 30 cadaver sacral bones which were collected from Department of Anatomy, M.G.M. Medical College, and Terna medical college. Result: No significant difference in posterior pedicle height was seen in both genders. Anteroposterior length and width were higher on both sides in males. Anteroposterior length of alae on both sides in both genders were of almost of equal thickness. Conclusion: Our study brings forth valuable data from a population of Navi Mumbai, which can be of use for operating surgeons and interventionists. Our study revealed racial and regional variation with a comparison to other country studies.

535-539

Authors: P Kumudha,K P. Sangeetha*

Introduction: Endocrine abnormalities are very common in CKD and among them thyroid dysfunction is most commonly occurring in CRF patients. Hyperthyroidism, hypothyroidism & euthyroid state have all been reported by various workers but hypothyroidism incidence was found to be more common. Aim: To assess the prevalence of alteration of thyroid physiology among patients chronic renal failure patients and to correlate between the thyroid hormone levels and the severity of chronic kidney disease. Materials and Methods: A cross-sectional observational study was conducted at our hospital for a period of one year. A total of 73 patients with chronic renal failure were included in the study. A detailed clinical history and clinical examination was conducted with preference to thyroid and renal diseases. Serum fT3, fT4 and TSH were measured using standard technique. Results: Majority of the study subjects were in stage V (end stage renal disease) CRF followed by stage IV CRF and only 5 – 8% of the subjects were in stage 1 and stage II CRF. The thyroid profile of our study subjects showed hypothyroidism was present in 43.8% of the CRF patients and in that majority of them had low T3 levels, followed by low T4 levels (36.9%) and an increased TSH levels (19.1%). The correlation between the T3, T4 levels and the various stages of CRF had shown a strong negative correlation, as the stages of CRF increases the number of patients with reduced T3 and T4 levels were found to be increasing and this was found to be statistically significant (p<.05), whereas there was no statistically significant positive correlation seen between the stages of CRF and the TSH levels (p>.05). Conclusion: Alteration of thyroid physiology among CRF patients found to be increasingly common and so thyroid screening should be made mandate for all patients with CKD.

546-552

Authors: Smriti Rastogi,Shah Mohd. Abbas Waseem*,Rubeena Bano

Introduction: Anaemia is multi factorial with widespread negative consequences on health. It is more common in developing countries. It has a negative influence on the social and economic development of country. Materials and Methods: This study included 211 anaemic and 174 non anaemic subjects. Age, gender, socio economic status, dietary habits and education was enquired about and haematological parameters were analysed. Data was analysed using appropriate tests. Results: 54.8% patients attending OPD’s were found to be anaemic. It was higher in females (65%) than males (41.2%). As per WHO classification mild, moderate and severe anaemia was present in 54.98%, 37.91% and 7.11% subjects respectively. 63.99% anaemic subjects belonged to upper to middle class and 36.01% belonged to lower middle and lower class. Anaemia was higher in subjects belonging to middle to lower classes and those belonging to low education class like high school to illiterate class. Not much difference was found on the basis of dietary preferences. However the percentage of anaemic subjects with mixed dietary habits was slightly higher. Conclusion: On the basis of study it may be concluded that amongst OPD patient’s gender, socioeconomic status and education play role directly or indirectly in anaemia.

559-563

Authors: T V. Ramani*,M Pratyusha,S Saritha

Introduction: The name of pancreas derives from the Greek’ word. The pancreas involves in diseases like diabetes mellitus and pancreatic cancer. It is contains Endocrine cells or Islets of Langerhans that secrete insulin, glucagon and somatostatin, which regulate blood glucose levels.1 The exocrine pancreatic acini secretes pancreatic enzymes and alpha fetoprotein which change the expression level during development and influences development and differentiation of pancreas.2 Endocrine disease causes diabetes which affects at least 200 million people worldwide, and this number is to be doubled by 2025.1 The exocrine part leads to pancreatic cancer causing about 65,000 deaths in European countries which is virtually incurable. Aims: The purpose of the current study was to investigate microanatomy (Histogenesis) of Pancreas in aborted fresh human foetuses without any congenital abnormality. So the present study was conducted to know the development of acini and islets and their clinical correlation. Materials and Methods: Foetuses aged between 12 to 40 weeks of gestational age and they were collected from Obstetrics and Gynaecology department of Kamineni Institute of Medical Sciences, Narkatpally, Nalgonda (Dt), Telangana, (India) and Kamineni Academy of Medical Sciences and Research centre, L.B. Nagar, Hyderabad. The histogenic procedures were employed at all gestational ages and were discussed with the available literature because various studies have proved that the islets of pancreas are necessary for the transplantation of pancreas, but very few studies showed the importance of pancreatic acini. Results and Conclusion: In the early weeks (12-18 weeks) the parenchyma forms primitive tubules with small lobes and lobules of acini and small spherical islets. As the age advances (18-24 weeks) the size and number of Islets are increased with encapsulation and proliferation of acinar cells. To conclude, at the age of 18-24 weeks the fetal pancreas is suitable for organ transplantation in patients with diabetes mellitus and pancreatic cancer.