Indian Journal of Clinical Anatomy and Physiology

106-107

Authors: Ayesha Anjum, Vijay Krishnan K, Praveen Patil

Background: Obesity has emerged as a major health problem in past few decades, in developing countries like India. It is found to affect the lung functions significantly. This study was designed to study the correlation of PEFR with BMI. Methods: Sixty male volunteers were analyzed in the study. They were classified into obese (BMI> or =30) and non-obese (BMI<30). Subjects were grouped into two groups, age 25-32 years in one group and age 33-45years in another group. PEFR was measured using Wrights Mini peak flow meter. Data was analyzed using unpaired t test. Results: There was no significant difference in PEFR values, with respect to BMI, in young age group. However it was found that, PEFR was inversely related to BMI, as age advances. Conclusion: This study concludes that PEFR is inversely related to BMI as age increases, and obesity is an important risk factor for reduced airflow or lung functions.

113-116

Authors: Bhanu R, Vinutha Shankar MS, Karthiyanee Kutty

Background: Diabetes Mellitus Type 2 is a very common disease worldwide. ‘Quality of life’ evaluation is an important measure for chronic disease management. Yoga and meditation are potential interventions as their use has been associated with a variety of physical and mental health benefits. Aims and Objectives: The aim was to investigate the influence of integrated approach of yoga on quality of living of diabetics by using Quality of life instrument for Indian diabetes patients (QOLID) questionnaire. Materials and Methods: In the month of July 2011, all known diabetics aged 40 years and above, coming to SVYASA AROGYADHAMA for Yoga therapy, willing to volunteer for the study and who understood English were included in the yoga group after taking written informed consent. All diabetics (n=31) who were enrolled in the study underwent Integrated Approach to yoga Therapy (IAYT) and were assessed on the first day and again after one week of yoga practice at Arogyadhama with Quality of life instrument for Indian diabetes patients (QOLID) questionnaire. Data thus obtained was analyzed using paired t-test. Institutional Ethical clearance was obtained for the study. Results: The quality of living of diabetics significantly improved after yoga intervention with mean±SD (77.40±7.17) as compared to before yoga intervention (72.54±7.27) with p value < 0.001 with minor variations in diabetics with various complications. Conclusion: Short term integrated yoga practices can improve quality of living of diabetics and play a vital role in the management of diabetes.

120-124

Authors: Deepa Bhat, Pushpalatha K.

Background & Objectives: Anatomy is the foundation stone of medical education upon which knowledge is built over time. Tutorials are a part of curriculum along with routine dissection and practical in teaching anatomy. A conventional tutorial lacks active learning habits among students. Knowledge explosion demands the students to inculcate self-directed learning habits from the beginning of medical education. Peer assisted tutorials is one such strategy to imbibe self-directed learning culture. Methodology: The study was conducted on regular tutorial batch of 25 students in 2 groups (group A & B) with 2 topics (brachial plexus & mammary gland) by cross over method. Pre and post test was administered followed by immediate feedback questionnaire. Results: The study revealed improvement in post test scores of both group but statistically significant in study groups. There was significant improvement in comparison of post test scores between study and control wings of group A (brachial plexus) but not in group B (mammary gland). The questionnaire revealed peer learning was active, interactive which fostered in depth understanding of subject in a non-threatening learning environment. Interpretation & Conclusion: The benefits and drawbacks of the innovation are discussed and compared with earlier studies. Peer learning supports the saying “to teach is to learn twice” which is evident from this study.

139-144

Authors: Rajkumar, Satyendra Kumar, Pankaj Sonaukiya

Aim: The aim of our study is - To assess whether parameter as serum testosterone can be used to predict the pathological stage of the disease. To determine whether serum testosterone can be used as prognostic marker for the carcinoma prostate. To evaluate the efficacy of serum testosterone as a rapid tool in the diagnosis and prognosis of prostate carcinoma. Materials and Methods: A total of 30 patients of carcinoma prostate as a case and 30 patients of BPH as a control. Clinical staging done by CT/MRI. Pathological staging done after radical prostectomy. Serum, testosterone analyzed by radioimmunoassay. Statistical analysis was done using statistical software SPSS version 10.0. Data was found to be normally distributed. Statistical analysis was performed using student’s ‘t’ test with statistical significance at <0.05. Results: All patients included in this study were in age group of 50-80 years. Mean age of patients was 66.60 + 8.06 years. Mean PSA for all patients was 26.49 + 12.34 ng/ml. Minimum PSA was 8 ng/ml and maximum 89 ng/ml. 40% patients have serum testosterone > 400 ng/dl and 30% patients have serum testosterone < 200 ng/dl. Remaining 30% have serum testosterone in between 200-399 ng/dl. Mean preoperative serum testosterone level in study group were 315.30±49.66 ng/ml and in control group the mean preoperative serum testosterone level were 369.83±51.12 ng/dl. The mean serum testosterone concentration is lower in carcinoma prostate patients as compared to the BPH patients. The mean difference in both the group were statistically significant (p=0.018). In organ confined disease, the mean preoperative serum testosterone level were 411.14±11.50 ng/ml and in non organ confined disease the mean preoperative serum testosterone level were 329.33±71.57 ng/dl. The mean serum testosterone level is lower in non organ confined as compared to the organ confined disease. The mean difference in both organ and non organ confined disease were statistically significant (p=0.008). Conclusion: We conclude that patients with carcinoma prostate have statistically significant correlation between pretreatment total testosterone level and pathological stage. In our study total testosterone emerged as an independent predictor of extraprostatic disease We also analyzed patients with carcinoma prostate have low serum testosterone level as compared to BHP patients. Keywords: Prostate; prostatic neoplasm; prostatectomy; testosterone

155-160

Authors: abita Yograj, Geetika Gupta, Mumtaz, Anjali Nadir Bhat, Rajiv Kumar Gupta.

The autonomic nervous system is a division of peripheral nervous system that controls automated body functions like heart rate, blood pressure, digestion and metabolism. Women have been seen to have lower cardiovascular risk and this is believed to be because of the regulatory influence of oestrogen on autonomic nervous system. The current study was conducted on 326 healthy medical students, 163 each of both sexes, in age group of 19 to 25 years, divided into Group-1 (males) and Group-2 (females). The parameters recorded and tests used were pulse rate, standing to lying ratio, 30:15 ratio, valsalva ratio and expiratory-inspiratory ratio for assessment of parasympathetic activity and pulse rate, blood pressure, orthostasis, cold pressor test, mental arithmetic test and corrected QT interval for assessment of sympathetic activity. Our findings show that young adult females have lower parasympathetic activity as compared to males of the same age group, who have a higher sympathetic activity.

163-166

Authors: Sanjay Kumar, Kunal, D.K. Jha, Shipra Das.

Background: Medical university examinations are known to cause mental stress. Stress can lead to changes in the normal functioning of the human body. Objectives: This study was done among the 1st professional MBBS students of SMIMS to determine the effect of university examination on vitals and differential leucocyte count (DLC). Material and Methods: 100 students, 26 male and 74 female, aged 18 to 21 years, were randomly assessed before and during their 1st professional university examination. Total of 13 Students suffering from fever, hypertension and on long term medication were excluded. 87 students were subjected to clinical check-up (Blood Pressure & Heart Rate) and estimation of DLC by staining the blood smear with Leishman’s Stain. Results: Data were analyzed and compared with pre-examination results. 85% students were having significant increase in neutrophil count, heart rate and systolic blood pressure. However, Eosinophil, Lymphocytes and Monocytes counts were found to be decreased. Conclusion: Examinations in medical school are stressful enough to produce changes in heart rate, blood pressure and differential leucocytes counts although all the students were in good health status. Key Words: Stress, Examination, DLC, Blood Pressure, Heart Rate

173-176

Authors: Syeda Samina, Saima Aziz.

Diabetes is a long term disease with variable clinical manifestations and progression. Diabetic patients, if undiagnosed or inadequately treated, develop multiple chronic complications leading to irreversible disability and death. The present study was conducted at Osmania Medical College, Hyderabad during the year 2014-2015. The study was carried out in 50 Type-2 diabetic patients in the age group of 40-70 years with duration of diabetes ranging from 6 months to 20 years. Control Group consists of 50 normal individuals who matched with diabetes in age, sex and socio economic condition as far as possible. Mean heart rate and arterial pressure was higher among diabetics compared with normal people but it was statistically not significant (p>0.05). In 50 Diabetic patients, the mean P-R interval is 0.136 with standard deviation of 0.124 which is shorter than normal people and the mean Q-T interval of Diabetic patients was found to be 0.4053 with standard deviation of 0.0228 which is prolonged, both of the ECG changes were statistically significant (p<0.05). In diabetic patients, there is increased need for regular health checkups especially of the cardiovascular system to prevent complications. Keywords: Diabetes mellitus, Cardiovascular changes, Heart rate, Mean arterial pressure, P-R interval, Q-T interval

182-185

Authors: Sujatha B., Pradeepa M.

Background and Objectives: Diabetes mellitus represents a spectrum of metabolic disorders which has become a major health challenge worldwide. Impaired glucose tolerance (IGT) forms a grey area between diabetes mellitus and normal individuals. IGT has a greater risk of developing future diabetes. To explore the prevalence of IGT in normal healthy individuals, to find correlation between IGT and BMI and family history. Materials and Methods: About 100 randomly selected subjects of middle aged group 25-45 years of both sexes were selected. Exclusion criteria include hypertension, diabetes oral contraceptives pill users, thyroid disorders, smokers and alcoholics. Oral glucose tolerance test (GTT) was done in all subjects. If 2-hour post glucose concentration was between 140- 199mg%, then the person was labelled as IGT. Variables such as Height, Weight, body mass index and family history were also taken. All the data were analyzed using chi-square, Fischer’s exact and two tailed Pearson correlation. Results: The prevalence of IGT was 16%. Age specific prevalence in subjects below 35 years was 7% and above 35 years was 9%. Interpretation and Conclusion: The prevalence of IGT was 16%. Subjects with positive family history and BMI had positive correlation with IGT. But there was no age specific prevalence between two selected groups. Key words: Diabetes mellitus, Body mass index, Impaired glucose tolerance

189-194

Authors: Sumathi P, N. Neelambikai.

Introduction: Petrol/ Diesel vapour generates pollutants like hydrocarbons, oxides of nitrogen, carbon and particulate matter. Occupational exposure to petrol/ diesel vapours have been shown to affect the functioning of different systems of the body. Hence the present study aims to evaluate the pulmonary functions in petrol-pump workers. Aim: Aim of the present study is to evaluate the pulmonary functions in petrol-pump workers and to compare their Pulmonary function tests (PFTs) with that of age and sex matched controls. Methodology: Study group- Fifty healthy, non-smoker petrol-pump workers in the age group of 18-40 years. Control group-Fifty age and sex matched healthy nonsmokers. The pulmonary function tests Forced vital capacity (FVC) and Vital capacity (VC) were carried out by using computerized spirometer. The parameters Peak Expiratory Flow Rate (PEFR (L/S)) Forced Expiratory Flow (FEF25&75%(L/S), Peak Inspiratory Flow (PIF(L/S), Forced Vital Capacity (FVC(L) Forced Expiratory Volume in first second (FEV1(L)), Forced Expiratory Volume percentage(FEV1%), Forced inspiratory vital capacity (FIVC(L)), Vital capacity (VC(L)), Expiratory reserve volume (ERV(L)) were compared between the two groups. Results: The PFTs of petrol pump workers were significantly decreased as compared to controls. The female workers and controls had significantly lower PFT than their respective male counterparts. The male petrol pump workers with more than 5 years of exposure had significantly decreased PFT. Discussion: The decreased lung functions in petrol-pump workers may be attributed to their exposure to the volatile organic compounds like Benzene, pollutants like Lead, CO, CO2, Nitrogen oxides, Sulphur oxides ,Hydrocarbons and unburned carbon particles for more than six months, for at least 10 hours per day. The comparatively increased PFTs in males than females may be attributed to the greater inspiratory muscle strength, more number of alveoli per unit area, larger alveoli and greater compliance in males. Decreased PFT in workers with more than five years of service indicate that the decrements in pulmonary functions are worsened by increased years of exposure. Key words: Petrol pump workers, Pulmonary function tests, Years of exposure, Gender variation

200-204

Authors: Farisa Khatoon, Farah Bahmed, Nazeema Khatoon.

Background: Chronic hyperglycemia in diabetes mellitus causes damage to various organs, particularly eyes, kidneys, nerves, heart, and the blood vessels. Visual defects in diabetics occurs due to both vascular and metabolic abnormalities which can affect retina, optic nerve and visual pathway. Change in Visual evoked potential (VEP) response occurs in diabetic patients much earlier than development of overt retinopathy and these changes correlate with duration of disease. Aim of this study was to determine the subtle functional changes in the retina of diabetic eye with the help of VEP before diabetic retinopathy sets in. In the current study comparison between amplitudes, latency P100 of VEP in type 2 diabetes mellitus with that of healthy controls was done. Method: Cross sectional study using 100 controls and 100 diabetic patients was carried out in the department of Physiology Deccan college of Medical Sciences, Hyderabad. Statistical analysis was done using SPSS software. Result: Significant association was obtained between duration of diabetes mellitus and P100 latency. Conclusion: VEP can be used as a very useful electrophysiological indicator of early subtle functional changes of retina in diabetes mellitus. Keywords: Diabetes mellitus, Visual evoked potential, P100 latency, P100 amplitud

209-212

Authors: Harish Gaikwad, Rajneesh Pandey.

Introduction: The level of division of the ulnar nerve into superficial and deep branches is of great clinical importance inulnar nerve entrapment at the wrist. This knowledge is significant during the surgical procedure of Guyon's canal release of the ulnar nerve and decompression of the deep motor branch. Objective: To measure the level of division of the ulnar nerve into superficial and deep branches. Materials and Methods: The study was done on sixty seven formalin fixed forearms. The division of the ulnar nerve into superficial and deep was traced. The level of division was measured using a divider from the radial styloid process. Results: In the present study mean level of division of the ulnar nerve into superficial and deep branches was 40 mm in 32 specimens of the left side and 42 mm in 35 specimens of the right side. The maximum percentage of the level of division of ulnar nerve was found in the range of 31 to 40 mm of the left side and on the right side maximum percentage was found in the range of 41 to 50 mm. Conclusion: The mean level of division of the ulnar nerve into superficial and deep branches is variable and is approximately 40 mm from the radial styloid process which would be helpful during the surgical decompression of the deep motor branch. Key words: Superficial and deep terminal branches of the ulnar nerve, Radial styloid process, Ulnar wrist pain, Guyon’s canal syndrome

217-229

Authors: Nandanwar RA, Wahane AM, Dange NS.

Age of union of epiphysis is an predominant purpose method of age determination which is a elaborate undertaking for medico legal person. Nevertheless, this age varies with racial, geographic, climatic and quite a lot of other factors. Be trained of quite a lot of textual content books in Anatomy and Radiology displays a obtrusive discrepancy as regards the a long time at which the distinct epiphyses fuse with the respective diaphyses in long bones. These variations have urged want of separate average of ossification for separate regions. This leads us to be taught ages of epiphyseal union around elbow joint, a rarely studied joint. Study was once carried out in total eighty healthful subjects having ages from 13 to 23 years and size of dwelling in Bastar more than 10 years. Chronological age upto the day of examination used to be decided and A-P view of right elbow joint used to be taken in each case. From this radiographs age of union of epiphyses round elbow joint is decided and when compared with the opposite authors from different states of India and in addition with other nations and located to fluctuate substantially. Keywords: Epiphysis, Elbow joint, Radius, Humerus

234-238

Authors: Shalini Sharma, Mukesh Kumar, Hitender Kumar, Manjeet Singh, Vivek Sharma.

Background and Objectives: Increase in arterial stiffness with age and/or disease increases risk for cardiovascular events such as myocardial infarction and stroke. The brain is a high flow organ, particularly susceptible to hemodynamic pulsatility. Diabetes is a group of chronic diseases characterized by hyperglycemia. The injurious effects of hyperglycemia are classified into macrovascular complications (coronary artery disease, peripheral arterial disease, and stroke) and microvascular complications (diabetic nephropathy, neuropathy, and retinopathy). It is important for physicians to understand the relationship between diabetes and vascular disease. Thus, this study was undertaken to test the hypothesis that elevated blood glucose levels in diabetes mellitus increases arterial stiffness, which further leads to increase in carotid pressure/flow pulsatility and CBFv pulsatility. Methods: Fifty six (56) patients with type 2 DM and 60 age-matched healthy volunteers were prospectively enrolled. Arterial stiffness was measured using non-invasive PC based cardiovascular risk analysis system (Periscope TM). The TCD examination was performed by using Trans-Cranial Doppler. Results: CFPWV of diabetic group showed significantly higher mean values (Group 1=931.00±215.98cms, Group 2=1241±152.03 cms) than control subjects (758±151.82 cms). CFPWV was significantly (p<0.05) increased among two diabetic groups. Glycosylated Hemoglobin was most significantly correlated to CFPWV (r=1.00, p<0.05) followed by weak correlation between CFPWV and PI (r=0.2, p>0.05). Conclusion: Type 2 Diabetes Mellitus (T2DM) increases carotid artery stiffness and pressure pulsatility index, without affecting cerebral blood flow pulsatility. This study depicts TCD findings of diabetes related cerebral hemodynamic changes and suggest that the PI reflects microangiopathic changes of cerebral vessels. Keywords: Carotid-femoral pulse-wave velocity, Diabetes mellitus, Glycosylated Hemoglobin, Pulsatility index, Trans Cranial Doppler

243-247

Authors: Mahima Shrivastava, Rajendra Kumar Mathur, Vineet Dhaneria, Samata Goyal

Background: The word dermatoglyphics means writing on the skin. This includes ridge patterns on skin of palms, digits and soles. Finger patterns are definitely constitutional in nature. Both finger and palm prints give clue to various pathological conditions in human being. Material and methods: The present dermatoglyphic study was conducted on fifty males and fifty females in the age group of 18-60 years, diagnosed as bipolar disorder cases, who attended the psychiatric outdoor or were admitted in the wards of psychiatric department, Jawahar Lal Nehru Hospital, Ajmer, Rajasthan. Results: The Total Finger Ridge Count (TFRC) and a-b ridge counts were found to be decreased in the bipolar diseased group. The mean ‘atd’ angle on both the hands considered together is found to be greater in the bipolar cases compared to the normal i.e. 90.22º in males and 92.46º in females bipolar cases compared to the control with mean angle 80.46º and 82.46º respectively in males and females (in males p= 0.0001, in females p= 0.0002). The frequency of whorls were increased in patients compared to the controls (p<0.001). Conclusion: Dermatoglyphics, a non-invasive method, could serve as a screening indicator for the follow up of individuals in threatened families. The study was aimed at establishing a correlation between occurance of bipolar affective disorder and the dermatoglyphics of hand which depends on genetic factors. On the basis of probability, one can correlate the dermatoglyphic pattern to bipolar disorder. Keywords: Dermatoglyphics, Bipolar Disorder, TFRC, a-b ridge count, atd angle