Archive for the ‘ Physiology ’ Category

Changes desired by medical students in current medical education and evaluation

ABSTRACT

Objective: The aim of education is to change the attitude. Thus, it has to be aimed at the minds of the students. Therefore, taking account of students’ opinion about the educational strategies, scheduling of syllabus as well as evaluation methodology is valuable. The feedback obtained from the students, therefore, would be essential to bridge the gap between the teaching schedule and ability of the students to learn. Therefore, a feedback was obtained from the students of Government Medical College, Miraj (GMCM) regarding their perceptions of the current medical educational program and the changes desired.
Materials and Methods: A questionnaire was given to 300 MBBS students of GMCM. It consisted of questions regarding teaching methods, teaching schedule, course duration of I MBBS, method of evaluation, student-teacher relationship and responsibilities of students, and the changes desired in the current system of education and evaluation.
Results: Student’s opinion was calculated in terms of percentage for different options.
Conclusion: Most students feel that the teaching schedule is too exhaustive and sometimes be provided for assimilation of what is learned. Furthermore, current education is knowledge oriented rather than being clinically oriented. There should be integrated teaching for basic sciences. Lectures should contain essential syllabus and lecture duration should be 45 min. Students learn better with discussions. There should be special education for poor performers, but strict evaluation of skills achieved by the students is desired. The evaluation should be objectively structured and more emphasis be given to practical examinations and viva. Furthermore, medical students be taught communication skills.

Ultradian rhythm variations in frequency domain indices of heart rate variability in healthy young adults

ABSTRACT

Background: Heart rate variability (HRV) is a non-invasive recording of the sympathovagal interaction modulating cardiovascular function. Analysis of HRV has been used to evaluate cardiac autonomic tone. There are different autonomic tones at different times of the day infl uenced by daily activities, stress, and environment. The study was done to observe the effect of time of day on sympathovagal balance in healthy young adults using frequency domain indices of HRV.
Aim and Objective: The aim was to fi nd out the ultradian rhythm variation (morning and evening) in frequency domain indices of HRV in healthy young adults.
Materials and Methods: A total of 100 healthy subjects (50 males and 50 females) in the age group of 18-25 years were included in the study. They were screened by history and physical examination to exclude cardiovascular and any abnormalities.
Methodology: Short term HRV (Lead II electrocardiography [ECG] for 5 min) was done by using standardized neuroperfect electromyography 2000 (with installed HRV software) machine. For each and every subject two recordings were done, – one in the morning between 9 and 10 AM before starting the daily activities of the day and one in the evening between 3 and 4 PM at the end of the day.
Result: The results were statistically analyzed by using Students t-test. Comparison of frequency domains low frequency (LF), high frequency (HF), LF/HF ratio between morning and evening sessions for the same individual were carried out. LF was increased in the evening session when compared to the morning session and the difference is statistically signifi cant (P < 0.0001). HF was decreased in the evening session when compared to the morning session and the difference is not statistically signifi cant (P = 0.2745). LF/HF ratio also increased in the evening session when compared to the morning session and the difference is statistically signifi cant (P < 0.0001).
Conclusion: There exists a signifi cant difference in LF and LF/HF ratio between morning and evening recordings. It is concluded that time of the day has a signifi cant impact on cardiac autonomic tone.

STUDY OF PULMONARY FUNCTION TESTS IN TRAFFIC POLICEMEN EXPOSED TO AUTOMOBILE POLLUTION IN BANGALORE CITY

ABSTRACT

Background: There is a higher risk of developing acute or chronic respiratory disease in individuals who are exposed to automobile pollution. Hence a study was undertaken with a view to investigate the effect of automobile pollution on pulmonary function parameters
in Traffic policemen, so that the potential health risks in these subjects can be minimised by early identification of abnormalities in PFT parameters. Periodic retesting can detect pulmonary disease in the earliest stages when corrective measures are more likely to be beneficial.

ABSTRACT

Effect of shavasana training on cardiovascular response to exercise in young healthy volunteers.
Background and objective: The effect of physical training on cardiovascular response to exercise is a well known concept. But there are limited studies done on the effect of yoga training on cardiovascular response to exercise. Yogic techniques in general and shavasana in particular are known to combat stressful situations. Therefore in the present study, the effect of shavasana on cardiovascular response to exercise was performed on young healthy volunteers.
Methods: A total of 40 young healthy male volunteers aged between 17–20 years of first year MBBS were selected from Mysore Medical College and Research Institute, Mysore. Basal HR, Basal BP and Basal RPP was recorded before Shavasana training and after Shavasana training. Shavasana training was given for 30 minutes daily for 3 months duration by a yoga teacher. Cardiovascular response to exercise (Heart rate, blood pressure, rate pressure product) using Harvard step test are recorded before shavasana training and after shavasana training.
Results: Results were analysed and statistically treated paired ‘t’ test was applied between pre shavasana¸ and post shavasana values. It was found that there was reduction in basal HR, BP and RPP after shavasana training. And also after three months of shavasana
training, exercise induced changes in these parameters were significantly reduced except DBP. Overall, the study suggested that there was probable increase in parasympathetic activity and decrease in sympathetic activity.
Interpretation and conclusion: The findings of the present study shows that practice of shavasana may probably shift autonomic equilibrium towards parasympathetic dominance leading to milder cardiovascular work to exercise. This physiological change could be a suitable clinical application for individuals with coronary artery disease.

EVALUATION OF CHEST PAIN IN THE MIDDLE AGED BY RATE PRESSURE PRODUCT ANALYSIS

ABSTRACT

Background: Coronary artery disease (CAD) results from imbalance between oxygen supply and demand of the heart. Myocardial oxygen consumption (MVO ) is a good 2 indicator of the response of the coronary circulation to increased myocardial oxygen demand. Direct measurement of MVO is difficult in routine clinical 2 practice but it can be easily calculated by indirect methods like Rate Pressure Product (RPP) analysis. The internal myocardial work performed is represented by RPP and external myocardial work performed is generally expressed as stages of exercise.

Objective of the study: The objective of this study was to study rate pressure product in middle aged with non specific chest pain to isotonic exercise.

Materials and Methods: This is a retrospective cross sectional study carried out in the Department of Medicine, JSS Hospital, Mysore. The study group comprised of 43 patients in the age group of 40-50 years with a history of nonspecific chest pain but normotensive, nondiabetic and with normal resting ECG. Standard Bruce protocol was followed. The patients were divided into two groups – Group A (35 patients with typical angina) and Group B (8 patients with atypical angina). Statistical analysis was done using SPSS version 16.

Results: Mean RPP was decreased in patients with atypical angina (Group B) compared to patients with typical angina (Group A) (p < 0.05).

DOPPLER MONITORING OF THYROID BLOOD FLOW BEFORE AND AFTER YOGASANAS

ABSTRACT

Background : Hypothyroidism is one of the commonest of all endocrine illnesses .Medical therapy in the form of oral thyroid tablets can cause harmful effects if the dosage is not carefully regulated and the patient also has to be on tablets lifelong. Yogasanas are considered to be the best remedy to activate the thyroid gland. The thyroid specific asanas are considered to increase the flow of fresh oxygenated blood to the thyroid, which in turn can activate the thyroid gland. The aim of our study is to find out the role of yogasanas in increasing the blood flow to the thyroid gland.

Materials and methods: We evaluated this by measuring the Peak Systolic Velocity and Resistive Index in the inferior thyroid artery using colour Doppler ultrasound in 40 female medical students (age 17-19 yrs) before and after 3months of yoga training.

Conclusion : Increased mean PSV ( P value < 0.0001)and decreased RI showed that the yogasanas are effective in increasing the blood flow to the thyroid gland. Increase in flow may be due to the inverted postures attracting more blood towards the head and neck and also due to increased secretion of TSH from pituitary. Regular practice of yogasanas is suggested for hypothyroid patients to correct the hormonal imbalance as well as for normal individuals to maintain thyroxine level of blood.

BHASTRIKA PRANAYAMA: A LONGITUDINAL STUDY OF ITS EFFECT ON BLOOD PRESSURE, HEART RATE,MEP & PEFR OF HEALTHY YOUNG STUDENTS

ABSTRACT

Background: Pranayama has a very important role in the yogic system of exercises for keeping sound health. Bhastrika Pranayama imitates the action of the ‘Bhastika’ or ‘bellows’ & fans the internal fire, heating the physical & subtle bodies. The most important physiological effects of Bhastrika is on the brain & heart. It stimulates the circulation of cerebral fluid & increases the compression
& decompression upon brain, creating a rhythmic massage. There is a lack of study on particular discipline and hence the present study has been undertaken to examine the effects of bhastrika pranayama on the HR, BP, MEP & PEFR.

Aim: To determine the effects of Bhastrika pranayama on
Blood Pressure, Heart Rate, MEP & PEFR. Materials & Methods: The study was conducted on 50 medical students (age: 18-25 yrs). BP, HR, MEP & PEFR were recorded using standard instrument before & after
the pranayama. Paired ‘t’ test was applied to obtain the statistical significance.
Conclusion: Bhastrika pranayama is found effective in decreasing BP and increasing HR immediately. Significant increase in pulmonary parameters like MEP and PEFR was found. It suggests that practice of pranayama helps in improvement of cardiopulmonary functions.

THE EFFECT OF ALCOHOL CONSUMPTION ON SERUM URIC ACID LEVEL

ABSTRACT

BACKGROUND : Association between alcoholism and hyperuricemia has been suggested. Very few studies are done correlating the quantity of alcohol consumed with serum uric acid (UA) level. As alcoholism is also associated with end organ damage, it will be interesting to see correlation between quantity of alcohol consumption, serum UA levels and end organ damage markers(serum
creatinine, SGOT, SGPT), so that some light can be thrown on understanding the mechanism of hyperuricemia in alcoholics.
METHODS : Sample: 30 light, 27 moderate, 30 heavy alcoholic male subjects and 30 age matched non alcoholics of age between 30 & 60 years. Details about amount, type&frequency of alcohol intake and dietwere gathered by history given by subjects. Blood samples
were collected within 24 hours of last drink and serum UA, serum bilirubin, SGPT&SGOTwere estimated.
RESULTS : Consistent and very significant (P<0.0001) increase in serum UA with increasing quantity of alcohol consumption was observed. Serum creatinine showed positive correlation with quantity of alcohol intake that is significant (P<0.001) only in heavy alcoholics. Positive correlation between serum UA and serum creatinine observed was significant (P<0.001) only in moderate and heavy alcoholics. Correlation between serum UA and SGOT was positive and significant (<0.05) only in heavy alcoholics.
CONCLUSION : Regular moderate alcohol consumption promotes hyperuricemia because of increased urate production by accelerating hepatic breakdown of ATP and decreased urate excretion by conversion to lactic acid. Along with these, renal impairment causing decreased urate excretion and hepatic impairment affecting urate metabolism may be involved in the mechanism of hyperuricemia associated with heavy alcoholism. Regular alcohol consumption in any amount promotes hyperuricemia.

PATTERN REVERSAL VISUAL EVOKED POTENTIALS IN HYPOTHYROID FEMALES

ABSTRACT

Background: Hypothyroidism is a common medical condition in the general population. Most commonly affects females. Hypothyroidism is a multi organ endocrine disorder which also involves neuromuscular system. The symptoms are generalized initially. The neurologic signs appear after months to years. The neuromuscular symptomspresent in 30 – 80%of patients with hypothyroidism. Visual Evoked Potentials (VEPs) are electrical potential difference recorded from the scalp in response to visual stimuli. It is a simple, non- invasive electro physiological test.
Aim: To evaluate the conduction in optic pathway (CNS), potentials recorded from the scalp in response to visual stimuli on pattern
reversal checker board. Objective: To use VEP as a tool to assess the conduction of optic pathway in hypothyroid females and to compare with the controls.
Materials and methods: The sample size is 30. The study design is a cross sectional study. VEP recording was done in Neurophysiology Laboratory of Research Wing using RMS EMG EP Marc II POLYRITE. The left and right eye tested separately in all subjects by giving mono ocular stimulation. The important parameter of VEP, the wave latency P 100 was measured. The statistical analysis was done by Student unpaired ‘t’ test using SPSS software 15 version.
Results: There was statistically significant prolongation of latency P 100 wave of VEP in the study group compared to the control group.
Discussion: In hypothyroidismmentation is slow and cerebrospinal fluid protein is elevated. They affect mitochondrial oxidative
activity, synthesis, degradation of proteins and sensitivity of tissues to catecholamines and hence demyelination occurs due to oxidative damage tomyelin membrane and oligodendroglial cells. Thyroid hormone affects myelination. The demyelination results in delay in nerve conduction responsible for prolonged latency P 100.
Conclusion: The electro physiological studies would be useful in the diagnosis of asymptomatic polyneuropathy in hypothyroid patients before they present complications clinically.

ABSTRACT

Background : Obesity has become a worldwide epidemic .Regional body fat distribution, with abdominal fat accumulation, irrespective of total body fat quantity, as assessed by body mass index may represent a major independent risk factor for several conditions, especially metabolic and cardiovascular diseases. This study was aimed to evaluate the better predictor for non alcoholic fatty liver disease by correlating waist circumference and body mass index (BMI) with serum liver enzymes (SGPT& SGOT).
MATERIALS & METHOD: 180 apparently healthy subjects attending master health check up clinic in Sri Ramachandra Medical Centrewere enrolled in this study. Alcoholics, smokers, subjects with known cases of diabetes, hypertension, hypertriglyceridemia, thyroid disorders, liver disorders under treatment & on oral contraceptives and drugs which could alter liver enzymes levels were excluded from the study. Structured questionnaire applied. Anthropometric measurements were taken.
Results: Waist circumference correlated significantly with SGPT with p value = 0.036, r value = 0.156.BMI did not show any significant correlation with SGPT with p value = 0.104, r value = 0.122.
Conclusion: Our study showed a significant positive correlation between waist circumference and serum liver enzyme- SGPT a marker of non alcoholic fatty liver disease (NAFLD). Body mass index (BMI) did not correlate significantly with serum liver enzyme-SGPT indicating waist circumference a better indicator than Body mass index in predicting non alcoholic fatty liver disease a component ofmetabolic syndrome.

STATUS OF RESPIRATORY PERFORMANCE IN RESIDENTIAL SCHOOL CHILDREN COMPARED TO NON-RESIDENTIAL SCHOOL CHILDREN

ABSTRACT

Objective: To compare the effect of regular physical exercise on respiratory performance among Residential and Non-Residential school children.

Material &Methods : The present study was designed on healthy respiratory symptom free children of a Residential Sainik (100) and Non-Residential (100) school children (aged 12-16 yrs) of Bijapur, to evaluate pulmonary functions. Pulmonary functions (Vt, ERV, VC, FVC, FEV1) were recorded by spirometry, PEFR by Peak flowmeter andMEPby Modified Black’s Apparatus.

Results : We found statistically significant higher values (p=0.000) of Breath Holding Time (BHT in secs), 40mmHg Endurance test(ENDT in secs), Tidal Volume (Vt in ml), Expiratory Reserve Volume (ERV in ml), Vital Capacity (VC in ml), Forced Vital Capacity (FVC in ml), Forced expiratory Volume at 1 second (FEV 1%), Peak Expiratory Flow Rate (PEFR in L/min) and Maximal Expiratory Pressure (MEP in mmHg) in Residential Sainik school children compared to Non-Residential school children.

Conclusion: Our study shows that possibly, regular physical exercise increases the pulmonary functions in Residential school children compared to Non-Residential school children.

EFFECTIVE USE OF E-LEARNING IN BASIC MEDICAL SCIENCES

ABSTRACT

Thoughtfully selected technology offers multi dimensional learning for novice medical students. Presently, almost all Indian medical schools have traditional, teacher centered classrooms, without or with minimal use of e-learning technology. The article explores the efficacy of using E-learning in medical education, especially in teaching basic medical subjects like anatomy, physiology and biochemistry to first year medical students.

The students engaged in E-learning activities will be able to construct their own knowledge through self directed learning. Eventually performance of the students may increase by implementation of E-learning at various medical colleges in India. The MBBS-Phase I students can be benefitted by using advanced E – learning technologies, like power point presentations, video demonstrations and video recording of classroom teaching as well, which are made available to students even after the lecture classes via E-learning portal through intranet facilities.

The incredible rapid growth of information in medical sciences should be paralleled by appropriate educational technology, without which efficient teaching in medical schools likely would not be possible. E-learning will be of great help to the slow learners in Indian medical schools, who are in significant number, since student’s admission to MBBS course is not purely on merit basis in most of our colleges. The issue of e-learning needs to be eaddressed since this mode of teaching, used too little in many of our medical schools, is the future of the initial or continuing medical education.

Cad Risk And Effect Of Yoga In Young, Healthy Males

ABSTRACT

National Cholesterol Education Program (NCEP) guidelines recommend cholesterol screening as early as 20yrs. It also suggests that Risk ratio of > 3.5 is considered as risk forCAD(coronary artery disease).to know the lipid levels in young, healthy individuals, assess risk of CAD among them. (ii) to know  the effect of yoga on lipid profiles and its effect onCAD.Twenty five young healthy males of 18-25 years were selected for the study and they underwent Yoga practice for six months. Total  Cholesterol (TC), Triglycerides (TG), High density lipoprotein cholesterol (HDL), Low density lipoprotein cholesterol (LDL), Very low density Lipoprotein Cholesterol (VLDL) were measured and “risk ratio” (TC/HDL)was calculated.The risk ratio of >3.5 is noted in our subjects before practice of yoga. Significant reduction in TC, TG, VLDL, LDL, and significant increase in HDL is observed in this study. The risk ratio after practice of Yoga reduced significantly.Our study suggests that there is a risk of CAD even in the younger age group as noted fromthe risk ratio >3.5 as per NCEP guidelines and the risk of CAD is reduced by regular practice of yoga as is evident fromthe reduced risk ratio.

ABSTRACT

Focussing on diabetes a worldwide epidemic, we used visual and auditory reaction time as a  tool to detect neuropathy a common complication of diabetes in earlier stages so thatwe could prevent further damage to nerves.Subjectswere enrolled based on detailed questionnaire and informed consent was obtained .The studywas conducted at Salem in themonth of July 2010 which included 40 Type 2 diabetic subjects froma private hospital in Salem. The mean age of diabetic subjectswas 47.8 years.Cases; AGE 40-49 Years, Duration of diabetes less than 10 years,HBA1C value less than 7.5%.Alcoholics, diabetes with complication, subjects with auditory and visual disturbances. PC1000Hz Reaction timer was used to measure auditory and visual reaction  time.Pearson correlation was applied for two groups.The auditory reaction time showed linear correlation with HBA1C with r value = 0.406. The visual reaction time showed linear correlation with HBA1C with r value = 0.2OO.Auditory and visual reaction time correlated
linearly with glycosylated haemoglobin. It could be because of the neuropathic changes in diabetes. This can be routinely applied to monitor neuropathic changes and its prognosis with glycemic status. This device measures pshycomotor response of the  ndividual.

ABSTRACT

Pranayama is a yogic technique in which breathing is controlled voluntarily. There are various types of pranayama. Previous studies have been conducted on the effects of certain combined practice of yoga. The present study however is under taken to ascertain whether pranava pranayama alone has any effect on the ventilatory lung functions, which depends on strength of
respiratorymusclesandcomplianceof lungs. The study was done to know whether there is any change in pulmonary functions in subjects practicing pranava pranayama,andinsubjectsnotpracticingpranavapranayama.Test group consisted of 40 student volunteers of RamaKrishna institute ofmoral and  spiritual education, Mysore of aged between 18 to 28years.They practiced  ranava pranayama for 30minutes daily for 16 weeks. While performing pranava pranayama the subject breaths deeply during
which the lungs inflate&deflate to fullest possible extent and there is strengthening of respiratory muscles. Hence there is increase in Pulmonary functions

A simple imaging method for demonstrating red cell sizes to life sciences students

ABSTRACT

The red cell sizes are described in the scale of micrometers. For a novice it is difficult to imagine the cell size. Measuring cell size requires the use of advanced instruments whichmandates use of trained personnel. Sixty peripheral blood smearswere photographed using a microscope camera. The images were stored in a computer. The retrieved images were measured offline
using the software. Two independent observers recorded the red cell sizes on both randomly selected and tagged red cells of each slide. The mean red cell width of the tagged red cells as measured by the first and second observer was 7.70-7.82 (±0.61μ) and 7.71-7.76 (±0.61μ) respectively. The measured red cell width ranges between 7.49-7.67 (±0.54μ) and 7.34-7.44 (±0.60μ) in untagged red cells for both the observers. The intraclass correlation coefficient for inter rater&intra rater reliability is 0.956 (observer 1) and 0.944 (observer 2) for tagged red cell width and 0.723 (observer 1) and 0.730 (observer2) foruntaggedredcell width. Computer based image analysismethod to determine red cell size, provides an accurate and reliable measurement, which is simple and cost effective. This method can be used to demonstrate measurement of red cell width to life-sciences students in the setting of hematology practical.

 


      

ABSTRACT

Looking at the effects of insulin deficiency on carbohydrate and lipid metabolism, diabetes mellitus is now being called more a disease of lipid metabolism than carbohydrate metabolism. A cross-sectional study was conducted during March 2005 to March 2006 to study the glycosylated haemoglobin (HbA1c) and lipid levels in normal adults and with type -2 diabetes mellitus and its
relation to glycaemic control. Comparison of  lipid levels was made between group of diabetic patients and the normals. The lipid fractions i.e.Total cholesterol, triglycerides, and low-density lipoprotein levels of poorly controlled diabetic (HbA1c > 8 %), were respectively higher (p<0.001), (p<0.01) and (p<0.001) than those of the control group. Later the lipid levels decreased drastically with glycaemic control (p>0.05, p>0.05 and p<0.05 respectively). Increased levels of low-density lipoprotein may be a contributory factor to the high risk of atherosclerosis induced coronary artery disease observed in diabetes mellitus patients. Reduction of blood glucose levels is likely to reduce low density lipoprotein levels and the  risk of complication, with the lowest risk being in
those with glycosylated hemoglobin values in the normal range i.e. less than 8.0%.

Do hypertensives have tendency for lesser hemoglobin concentration?

ABSTRACT

The prevalence of Hypertension is increasing at an alarming rate worldwide.Hypertension is now considered as an ‘Urban
syndrome’. Major causes of hypertensive pattern are increasing work stress, strict deadlines and high expectations among
corporate population. High blood pressure affects many systems of the body and can alter various hematological parameters.
The present study was undertaken to compare the arterial blood pressure (BP) and blood hemoglobin (Hb) concentration in
software professionals. Male software professionals (74 in number) of Infosys software company, Mangalore, Karnataka,
India in the age group of 21–45 years were divided into two groups based on their BP recordings. 21 were normotensives
and 53 hypertensives. Their BP was recorded in supine position (JNC 7 Criteria) and Hb was estimated by Drabkin’s
spectrophotometric method. The relation between BP and Hb concentrations were analyzed statistically. The mean age of
normotensives and hypertensive group were 27.62±5.24 and 28.53 ± 6.25 years respectively.The mean BP of normotensives and
hypertensives were 124±16.03/80±11.16 and 142±16.09/96±11.10mmHg respectively. The mean Hb of normotensives and
hypertensives were 16.15±0.92 and 13.08±0.91gm% respectively. When this association was analyzed, results revealed that Hb
was significantly lower in hypertensive group (p=0.001, Unpaired T test).