Experimental evaluation of genomic selection prediction for rust resistance in sugarcane.

The total sugarcane (Saccharum L.) production has increased worldwide; however, the rate of growth is lower compared with other major crops, mainly due to a plateauing of genetic gain. Genomic selection (GS) has proven to substantially increase the rate of genetic gain in many crops. To investigate the utility of GS in future sugarcane breeding, a field trial was conducted using 432 sugarcane clones using an augmented design with two replications. Two major diseases in sugarcane, brown and orange rust (BR and OR), were screened artificially using whorl inoculation method in the field over two crop cycles. The genotypic data were generated through target enrichment sequencing technologies. After filtering, a set of 8,825 single nucleotide polymorphic markers were used to assess the prediction accuracy of multiple GS models. Using fivefold cross-validation, we observed GS prediction accuracies for BR and OR that ranged from 0.28 to 0.43 and 0.13 to 0.29, respectively, across two crop cycles and combined cycles. The prediction ability further improved by including a known major gene for resistance to BR as a fixed effect in the GS model. It also substantially reduced the minimum number of markers and training population size required for GS. The nonparametric GS models outperformed the parametric GS suggesting that nonadditive genetic effects could contribute genomic sources underlying BR and OR. This study demonstrated that GS could potentially predict the genomic estimated breeding value for selecting the desired germplasm for sugarcane breeding for disease resistance.

Draft Genome Sequence Resource for the Orange Rust Pathogen of Sugarcane Puccinia kuehnii.

Puccinia kuehnii is an obligate biotrophic fungal pathogen that causes orange rust of sugarcane, which is prevalent in many countries around the globe. In the United States, orange rust was first detected in sugarcane in Florida in 2007 and poses a persistent and economically damaging threat to the sugarcane industry in this region. Here, we generated the first genome assemblies for two isolates of P. kuehnii (1040 and 2143) collected in Florida in 2017 from two sugarcane cultivars, CL85-1040 and CP89-2143, respectively. These two rust genome resources will be of immense value for future genomic studies, particularly further exploration of the predicted secretomes that may help define key pathogenicity determinants for this economically important pathogen.

Eight Species of Poaceae Are Hosting Different Genetic and Pathogenic Strains of Sugarcane Mosaic Virus in the Everglades Agricultural Area.

Sugarcane mosaic virus (SCMV) was detected by reverse transcription polymerase chain reaction in eight different species of the Poaceae family in the Everglades Agricultural Area (EAA) of south Florida: broadleaf signalgrass (Urochloa platyphylla), Columbus grass (Sorghum almum), goosegrass (Eleusine indica), maize (Zea mays), sorghum (Sorghum bicolor), St. Augustine grass (Stenotaphrum secundatum), southern crabgrass (Digitaria ciliaris), and sugarcane (Saccharum interspecific hybrids). Based on their coat protein (CP) gene sequence, 62 isolates of SCMV from Florida and 29 worldwide isolates representing the known genetic diversity of this virus were distributed into eight major phylogenetic groups. SCMV isolates infecting Columbus grass, maize, and sorghum in Florida formed a unique group, whereas virus isolates infecting sugarcane in the United States (Florida and Louisiana) clustered with isolates from other countries. Based on the entire genome coding region, SCMV isolates infecting sugarcane in Florida were closest to virus isolates infecting sorghum species or St. Augustine grass. Virus isolates from Columbus grass, St. Augustine grass, and sugarcane showed different virulence patterns after mechanical inoculation of Columbus grass, St. Augustine grass, and sugarcane plants, thus proving that these isolates were different pathogenic strains. Sugarcane was symptomless and tested negative for SCMV by tissue blot immunoassay after inoculation with crude sap from SCMV-infected Columbus grass, indicating that Columbus grass was not a reservoir for SCMV infecting sugarcane in the EAA. Close CP sequence identity between isolates of SCMV from Columbus grass, maize, and sorghum suggested that the same virus strain was naturally spreading between these three plants in south Florida.

Genome-wide association study of multiple yield traits in a diversity panel of polyploid sugarcane (Saccharum spp.).

Sugarcane (Saccharum spp.) is an important economic crop, contributing up to 80% of sugar and approximately 60% of biofuel globally. To meet the increased demand for sugar and biofuel supplies, it is critical to breed sugarcane cultivars with robust performance in yield traits. Therefore, dissection of causal DNA sequence variants is of great importance, as it provides genetic resources and fundamental information for crop improvement. In this study, we analyzed nine yield traits in a sugarcane diversity panel consisting of 308 accessions primarily selected from the World Collection of Sugarcane and Related Grasses. By genotyping the diversity panel via target enrichment sequencing, we identified a large number of sequence variants. Genome-wide association studies between the markers and traits were conducted, taking dosages and gene actions into consideration. In total, 217 nonredundant markers and 225 candidate genes were identified to be significantly associated with the yield traits, which can serve as a comprehensive genetic resource database for future gene identification, characterization, and selection for sugarcane improvement. We further investigated runs of homozygosity (ROH) in the sugarcane diversity panel. We characterized 282 ROHs and found that the occurrence of ROHs in the genome were nonrandom and probably under selection. The ROHs were associated with total weight and dry weight, and high ROHs resulted in a decrease in the two traits. This study suggests that genomic inbreeding has led to negative impacts on sugarcane yield.

Lack of transmission of Sugarcane yellow leaf virus in Florida from Columbus grass and sugarcane to sugarcane with aphids or mites.

Sugarcane yellow leaf virus (SCYLV), the causal agent of yellow leaf disease, naturally infects at least three plant species in Florida: sugarcane (Saccharum spp.), the weed Columbus grass (Sorghum almum) and cultivated sorghum (S. bicolor). All three hosts are also colonized by the sugarcane aphid (Melanaphis sacchari), the main vector of SCYLV worldwide. To understand the high incidence of SCYLV observed in sugarcane commercial fields and in germplasm collections, we investigated the transmission efficiency of SCYLV from sugarcane and Columbus grass to sugarcane using the sugarcane aphid and a spider mite (Oligonychus grypus) that also tested positive for SCYLV in Florida. Healthy and SCYLV-infected leaf pieces of sugarcane and Columbus grass carrying viruliferous aphids or spider mites were transferred to virus-free plants of the yellow leaf susceptible sugarcane cultivar CP96-1252. Three- and 6-months post inoculation, the 108 aphid-inoculated plants of Columbus grass and the 90 mite-inoculated plants of sugarcane tested negative for SCYLV by tissue blot immunoassay (TBIA) or reverse transcription polymerase chain reaction (RT-PCR). Similar results were obtained for 162 aphid-inoculated plants of sugarcane, except for two plants that tested positive for SCYLV by TBIA and RT-PCR. In two field experiments planted with SCYLV-free and virus-infected sugarcane (cultivar CP96-1252), only 18-28% of healthy plants became infected during a 24- to 28-month period. SCYLV prevalence in these field experiments did not differ between aphicide treated and untreated plots. Incidence of M. sacchari haplotypes in the Everglades agricultural area also indicated that the predominant haplotype that is currently colonizing sugarcane was not a vector of SCYLV in Florida. Lack of virus transmission by the spider mite suggested that this arthropod only acquired the virus when feeding on infected plants but was unable to transmit SCYLV. The current vector of SCYLV in Florida remains to be identified.

Development of an Axiom Sugarcane100K SNP array for genetic map construction and QTL identification.

KEY MESSAGE: An Axiom Sugarcane100K SNP array has been designed and successfully utilized to construct the sugarcane genetic map and to identify the QTLs associated with SCYLV resistance. To accelerate genetic studies in sugarcane, an Axiom Sugarcane100K single-nucleotide polymorphism (SNP) array was designed and customized in this study. Target enrichment sequencing 300 sugarcane accessions selected from the world collection of sugarcane and related grass species yielded more than four million SNPs, from which a total of 31,449 single-dose (SD) SNPs and 68,648 low-dosage (33,277 SD and 35,371 double dose) SNPs from two datasets, respectively, were selected and tiled on Affymetrix Axiom SNP array. Most of selected SNPs (91.77%) were located within genic regions (12,935 genes), with an average of 7.1 SNPs/gene according to sorghum gene models. This array was used to genotype 469 sugarcane clones, including one F1 population derived from the cross between Green German and IND81-146, one selfing population derived from CP80-1827, and 11 diverse sugarcane accessions as controls. Results of genotyping revealed a high polymorphic SNP rate (77.04%) among the 469 samples. Three linkage maps were constructed by using SD SNP markers, including a genetic map for Green German with 3482 SD SNP markers spanning 3336 cM, a map for IND81-146 with 1513 SD SNP markers spanning 2615 cM, and a map for CP80-1827 with 536 SD SNP markers spanning 3651 cM. Quantitative trait loci (QTL) analysis identified 18 QTLs controlling Sugarcane yellow leaf virus resistance segregating in the two mapping populations, harboring 27 disease-resistant genes. This study demonstrated the successful development and utilization of a SNP array as an efficient genetic tool for high-throughput genotyping in highly polyploid sugarcane.

Genome-Wide Association Studies Identified Resistance Loci to Orange Rust and Yellow Leaf Virus Diseases in Sugarcane (Saccharum spp.).

Sugarcane (Saccharum spp.) supplies globally ∼80% of table sugar and 60% of bioethanol. Sugarcane orange rust and Sugarcane yellow leaf virus (SCYLV) are major sugarcane diseases, causing up to 50 and 40% yield losses, respectively. Sugarcane cultivars resistant to these diseases are needed to sustain sugarcane production in several regions. Dissecting DNA sequence variants controlling disease resistance provides a valuable tool for fulfilling a breeding strategy to develop resistant cultivars. In this study, we evaluated disease reactions to orange rust and SCYLV of a sugarcane diversity panel in repeated trials. We conducted a genome-wide association study between high-density markers and disease resistance reactions. We identified 91 putative DNA markers and 82 candidate genes significantly associated with resistance to one of the two diseases. These provide an important genetic resource for finding genes and molecular markers for disease resistance. Our results emphasized the importance of utilizing a wide germplasm collection for breeding resistant sugarcane cultivars.

Evaluation of the Correlation of Magnetic Resonance Imaging and Electrodiagnostic Findings in Chronic Low Backache Patients.

BACKGROUND: Low back pain (LBP) is one of the most common medical complaints and leading cause of workforce loss in many countries. Magnetic resonance imaging (MRI) is a highly sensitive method for the detection of lesions in the spine because of its excellent imaging of anatomical detail. However, MRI does not provide information about physiological nerve function and has relatively low specificity. Electrodiagnostic (EDX) study, including needle electromyography (EMG), is a specific test to assess the physiological functions of nerve roots or peripheral nerves. The aim of the present study was to correlate the electrophysiological and MRI findings in chronic low backache patients. MATERIALS AND METHODS: Fifty patients (26 males and 24 females) with mean age 33.54 ± 8.33 years with a history of LBP of minimum 3 consecutive months were evaluated with MRI and EDX (bilateral nerve conduction study of three nerves [tibial, peroneal, and sural nerve] and bilateral EMG of three muscles [paraspinal, tibialis anterior, vastus medialis]) studies. RESULTS: Twenty-seven patients showed disc involvement on MRI and 23 MRI were normal. Mean conduction velocity was mildly decreased in tibial and sural nerves in all the patients either with normal MRI or disc involvement on MRI. In disc involvement conduction velocity, decrease was more as compared to normal MRI. About 39% patients with normal MRI and 78% patients with disc involvement showed abnormal EMG. This data represented statistically significant association of EDX study with MRI (P < 0.05). CONCLUSIONS: In patients with LBP, EDX studies are significantly more correlated with clinical data than MRI. Therefore, EMG may be a useful diagnostic tool to establish management protocols and prevent unnecessary interventions. EDX gives a better representation of physiological status of nerve and muscle, a supra added benefit which MRI lacks. However, MRI gives better visualization of anatomic parameters and structural details which may or may not be associated with chronic LBP.

Spino-pelvic radiological parameters in normal Indian population.

INTRODUCTION: There is increasing emphasis on the sagittal spino-pelvic alignment and its interpretation is of critical importance in the management of spinal disorders. A cross-sectional study of several spino-pelvic radiographic parameters was conducted to determine the physiological values of these parameters, to calculate the variations of these parameters according to epidemiological data, and to study the relationships among these parameters. MATERIAL AND METHOD: Fifty normal healthy volunteers (29 males and 21 females) with no history of back pain were selected and were subjected to standing sagittal spino-pelvic radiographs. All the measurements of various radiographic parameters were performed with use of a software program. A statistical analysis was done to study the relationships among them. RESULTS: The mean values of pelvic incidence (PI) and lumbar Lordosis Angle (LLA) were 48.52 ± 8.99 and 58.78 ± 9.51, respectively. There was statistical difference between male and female parameters in LLA, lumbo-sacral angle (LSA), sacral horizontal angle (SHA), sacral inclination angle (SIA), sacropelvic angle (PRS1), pelvisacral angle (PSA), and PI. A majority of parameters had higher values for female subjects when compared to male subjects. PI was positively correlated with LLA, pelvic angle (PA), pelvic overhang (PO), pelvic tilt (PT), sacrofemoral distance (SFD), SHA, and sacropelvic translation (SPT), which were highly significant, whereas LLA was positively correlated with SHA and SIA only. PI and LLA were both negatively correlated with PSA, pelvic thickness (PTH), and PRS1. CONCLUSIONS: This study presents the various spino-pelvic radiographic parameter values of a sample of the normal asymptomatic Indian population. There was significant difference in radiographic parameters between males and females in about half of the parameters studied in the sample. The values obtained are comparable with the values presented as normal in the literature. A comparison of the study results with data published about other populations revealed no differences in any of the pelvic parameters between the Indian, Brazilian, and Korean populations.

Identifying Quantitative Trait Loci (QTLs) and Developing Diagnostic Markers Linked to Orange Rust Resistance in Sugarcane (Saccharum spp.).

Sugarcane (Saccharum spp.) is an important economic crop, contributing up to 80% of table sugar used in the world and has become a promising feedstock for biofuel production. Sugarcane production has been threatened by many diseases, and fungicide applications for disease control have been opted out for sustainable agriculture. Orange rust is one of the major diseases impacting sugarcane production worldwide. Identifying quantitative trait loci (QTLs) and developing diagnostic markers are valuable for breeding programs to expedite release of superior sugarcane cultivars for disease control. In this study, an F1 segregating population derived from a cross between two hybrid sugarcane clones, CP95-1039 and CP88-1762, was evaluated for orange rust resistance in replicated trails. Three QTLs controlling orange rust resistance in sugarcane (qORR109, qORR4 and qORR102) were identified for the first time ever, which can explain 58, 12 and 8% of the phenotypic variation, separately. We also characterized 1,574 sugarcane putative resistance (R) genes. These sugarcane putative R genes and simple sequence repeats in the QTL intervals were further used to develop diagnostic markers for marker-assisted selection of orange rust resistance. A PCR-based Resistance gene-derived maker, G1 was developed, which showed significant association with orange rust resistance. The putative QTLs and marker developed in this study can be effectively utilized in sugarcane breeding programs to facilitate the selection process, thus contributing to the sustainable agriculture for orange rust disease control.

Assessment for Efficacy of Additional Breathing Exercises Over Improvement in Health Impairment Due to Asthma Assessed using St. George's Respiratory Questionnaire.

BACKGROUND: Breathing exercises have been described to be useful in asthma management by few researchers in the past. OBJECTIVE: To assess the efficacy of breathing exercises (Pranayamas) added to regular optimal medications in asthma patients in improving health impairment using St. George's Respiratory Questionnaire (SGRQ). METHODS: Sixty stable asthma patients (34 females) receiving optimal treatment at our institute for 3 months or more as per the Global Initiative for Asthma guidelines were included in the study. They performed seven breathing exercises under supervision at yoga center of our institute for 3 months in addition to their regular medications. SGRQ (1 month symptoms version) was used to assess the quality of life before and after breathing exercises intervention for following subsets: Symptom score, activity score, impact score, and total score to assess the efficacy of breathing exercises. RESULTS: Of 60 asthma patients, 34 were females and 26 were males, and their mean age was 25.45 ± 5.41 years. Their baseline spirometric values were as follow: Forced expiratory volume in 1 s (FEV1) - 2.492 ± 0.358 L and peak expiratory flow rate (PEFR) - 283.82 ± 51.12 L/min. The SGRQ scores after breathing exercises intervention decreased from 45.98 ± 5.61 to 38.78 ± 4.92 for symptom subset, from 15.45 ± 3.33 to 12.34 ± 2.39 for activity subset, from 17.95 ± 4.22 to 12.12 ± 3.82 for impact subset, and from 25.83 ± 8.31 to 19.20 ± 7.09 for total scores. All these reductions were statistically highly significant (P < 0.001). Decrease in symptoms, activity, and total SGRQ scores each was significantly correlated with FEV1, FEV1/forced vital capacity (FVC) ratio, and PEFR; decrease in impact score was significantly related only with FEV1/FVC ratio. CONCLUSIONS: Breathing exercises significantly decreased all component scores of SGRQ, signifying a global improvement in health impairment due to asthma; this improvement was in addition to that was achieved with optimal asthma therapy alone.

Magnetic resonance imaging of lumbar trunk parameters in chronic low backache patients and healthy population: a comparative study.

PURPOSE: The aim of this study was to evaluate the lumbar trunk parameters by MRI and investigate their association with chronic low backache. METHODS: Fifty patients (26 males and 24 females) with mean age 33.54 ± 8.33 years with a history of low back pain (LBP) of minimum 3 consecutive months constituted the study group (Group A). To match with the study group, 15 normal healthy volunteers (9 males and 6 females) with no history of back pain were selected (Group B). Both the groups were subjected to magnetic resonance imaging of lumbosacral spine and lumbar trunk parameters were calculated. RESULTS: Trunk width, depth and skin angle were comparable at L3-L4, L4-L5 and L5-S1 disc levels; significant difference with regard to disc angle of L3-L4 (p = 0.005) and L4-L5 (p = 0.02) and cross-sectional area (CSA) of disc at L4-L5 level (p = 0.01) was observed between two groups. There was a tendency of smaller CSA of paraspinal and abdominal oblique muscles in Group A patients, but the measurements were not statistically different from Group B patients. Rectus abdominis muscles showed a unique pattern of larger CSA at L3-L4 and L4-L5 disc levels and smaller CSA at L5-S1 in LBP patients. Intervertebral disc degenerative changes on MRI were observed in 27 (54 %) patients in the Group A; and none of the Group B participants showed degenerative changes. CONCLUSIONS: Tendency of smaller trunk musculature CSA may be a cause or a result of chronic LBP. A unique pattern of larger CSA at L3-L4 and L4-L5 disc levels and smaller CSA at L5-S1 of Rectus abdominis muscles is observed in LBP patients compared to healthy persons. Differences in disc angles and CSA of disc at L3-L4 and L4-L5 levels between the two groups signify that these may be the predisposing factors leading to LBP due to abnormal load/stress transmission and precipitating early degenerative changes in the disc.

Brainstem auditory evoked potential in clinical hypothyroidism.

OBJECTIVES: The association of hypothyroidism with impairment of hearing is known to occur. It may be of any kind i. e., conductive, sensorineural or mixed. The aim of this study is to assess auditory pathway by brainstem auditory evoked potential (BAEP) in newly diagnosed patients of clinical hypothyroidism and healthy sex- and age-matched controls. MATERIALS AND METHODS: The study included 25 healthy age- and sex-matched controls (Group I) and 25 patients of newly diagnosed clinical hypothyroidism (Group II). The recording was taken by using RMS EMG EP MK2 equipment. STATISTICAL ANALYSIS USED: Unpaired Student's t test. RESULTS: There was a significant increase in wave IV (5.16 ± 0.85 ms) and wave V (6.17 ± 0.89 ms) latencies of right ear BAEP of Group II in comparison to wave IV (4.66 ± 0.39 ms) and wave V (5.49 ± 0.26 ms) of Group I. Wave V of left ear BAEP of Group II was also prolonged (6 ± 0.61 ms) in comparison to Group I (5.47 ± 0.35 ms). There was a significant difference in inter-peak latencies IPL I -V (4.44 ± 0.66 ms) and IPL III -V (2.2 ± 0.5 ms) of right ear BAEP of Group II in comparison to IPL I -V (3.94 ± 0.31 ms) and IPL III -V (1.84 ± 0.34 ms) of Group I. A significant prolongation was also found of IPL I -V (4.36 ± 0.59 ms) and IPL III -V (2.2 ± 0.42 ms) of left ear BAEP of Group II in comparison to IPL I -V (3.89 ± 0.3 ms) and IPL III -V (1.85 ± 0.3 ms) of Group I. CONCLUSION: Prolongation of wave IV and V along with inter-peak latencies in BAEP of both ears suggests that central auditory pathway is affected significantly in clinical hypothyroid patients.

Brainstem evoked potential in newly diagnosed patients of subclinical hypothyroidism.

BACKGROUND: Hypothyroidism is known to be associated with impairment of hearing. The hearing impairment may be conductive, sensorineural, or mixed. AIMS: The aim is to assess the auditory pathway by brainstem auditory evoked potentials (BAEPs) in newly diagnosed patients of subclinical hypothyroidism and healthy sex- and age-matched controls. MATERIALS AND METHODS: The study included 25 healthy sex- and age-matched controls (Group I) and 25 patients of newly diagnosed subclinical hypothyroidism (Group II). The recording was taken by using RMS EMG EP MK2 equipment. The unpaired Student's t-test was used and a P value <0.05 was considered significant. RESULTS: Wave V of right ear BAEP in group II was prolonged (6 ± 0.62 ms) compared to group I (5.49 ± 0.26 ms), and wave V of left ear BAEP in group II was prolonged (5.84 ± 0.57 ms) compared to group I (5.47 ± 0.35 ms). There was no significant coefficient of correlation between wave V and inter-peak latency (IPL) I-V compared to thyroid-stimulating hormone (TSH) levels of both the ears. CONCLUSION: The prolongation of wave V in BAEPs of both ears suggests that the central auditory pathway is affected significantly in subclinical hypothyroid patients.

Spectral Parameters of HRV In Yoga Practitioners, Athletes And Sedentary Males.

Physical inactivity is an important risk factor for cardiovascular mortality and morbidity. Exercise is considered an acceptable method for improving and maintaining physical and emotional health. Although yoga is historically a spiritual discipline, a growing body of evidence supports the belief that yoga benefits physical and mental health. The objective of this study was to evaluate heart rate variability which reflects autonomic control of heart among yoga practitioners, athletes and individuals with sedentary lifestyle. The study was carried out in the departments of physiology at MAMC Agroha, Hisar and Pt. BD Sharma PGIMS Rohtak, Haryana. The study group comprised of 1200 healthy male volunteers of 16 to 55 years of age. The study group was divided into four age groups: Group A of age 16 to 25 years; Group B of age 26 to 35 years; Group C of age 36 to 45 years and Group D of age 46 to 55 years. All age groups were further divided into three categories i.e athlete (runner), yoga (yoga practitioners) and sedentary in which individuals with sedentary life style were included. The basal recording of ECG in lead II was done for 5 minutes. The Polyrite-D ECG data was used for analysis of heart rate variability by frequency domain method. Two spectral components were recorded namely high frequency (HF) component (0.15-0.4 Hz), an indicator of vagal efferent activity and low frequency (LF) component (0.04-.15 Hz), replicator of composite sympatho-vagal interplay. HF component in normalized unit was found significantly high in age group B and C in yoga practitioners and athletes as compared to sedentary individuals and in age group D significantly high in yoga practitioners as compared to athletes and sedentary individuals. Significantly decreased LF/HF ratio was found in age group B and C in yoga and athlete subjects as compared to sedentary individuals and in age group D in yoga practitioners as compared to athletes and sedentary individuals. This indicates that parasympathetic activity is substantially greater in yoga practitioners.

Study of cognitive functions in newly diagnosed cases of subclinical and clinical hypothyroidism.

INTRODUCTION: Hypothyroidism is associated with significant neurocognitive deficits because hypothyroidism prevents the brain from adequately sustaining the energy consuming processes needed for neurotransmission, memory, and other higher brain functions. Hence, the study was done to assess the cognitive functions of newly diagnosed subclinical and clinical hypothyroid patients by evoked response potential P300. MATERIALS AND METHODS: 75 patients each of newly diagnosed subclinical and clinical hypothyroid patients attending endocrinology clinic and 75 healthy age and sex matched euthyroid controls were considered for the study. P300 was recorded with Record Medicare System Polyrite, Chandigarh using auditory "oddball paradigm". The data was analyzed using ANOVA followed by post Tukey's test. RESULTS: Newly diagnosed clinical hypothyroid patients showed a significant increase in P300 latency compared to control (P < 0.05) and subclinical cases (P < 0.01) while there was no significant difference between the P300 latency of subclinical cases and control group. Also, there was no significant difference in P300 amplitude among the three groups. CONCLUSION: P300 latency in case of newly diagnosed hypothyroid clinical cases is significantly increased compared to newly diagnosed subclinical cases and control.

Pranayam for Treatment of Chronic Obstructive Pulmonary Disease: Results From a Randomized, Controlled Trial.

CONTEXT: Existing medications for chronic obstructive pulmonary disease (COPD) do not modify the long-term decline in lung functions. The increasing prevalence of COPD requires the development of interventions beyond the usual medical treatment, with a specific focus on rehabilitation. Controlled breathing (pranayam) is a specific set of respiratory exercises within yoga that has been shown to improve the resting respiratory rate, vital capacity, maximum voluntary ventilation, breath-holding time, and maximal inspiratory and expiratory pressures. OBJECTIVE: In this study, pranayam was analyzed as an adjunct treatment for medically stable individuals with moderate to severe COPD. DESIGN: The research team carried out a case control study. SETTING: This study took place at a tertiary care institution, with the participation of the departments of Physiology, Yoga and Naturopathy, and Pulmonary Medicine at Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences in Rohtak, Haryana, India. PARTICIPANTS: Participants were 50 medically stable individuals with moderate to severe COPD. INTERVENTION: Twenty-five participants in the intervention arm (IA) were trained to practice pranayam for 30 min 2 ×/d and also received the usual medical treatment. The control group also included 25 participants, and they received the usual medical treatment only, without pranayam. OUTCOME MEASURES: The COPD assessment test (CAT) score and the body-mass index, obstruction, dyspnea, exercise (BODE) capacity index were assessed at baseline and at 3 mo. The results were expressed using standard statistical methods. RESULTS: For the IA, a significant improvement occurred in the CAT score (21.2 ± 2.6-17.4 ± 2.5, P < .001) and in the impact level, which moved from high (>20) to medium (10-20) after 3 mo of practicing pranayam. The control arm (CA) showed no significant improvement in the CAT score (21.6 ± 2.7-21.4 ± 2.7). Although the IA showed a significant improvement in a 6-min walk test (6MWT) when compared to the CA, (1) the IA's forced expiratory volume in 1 sec (FEV1), which is a measure of airflow that is commonly impaired in COPD patients and which is associated with poor functional status, showed no significant improvements, and (2) the IA's BODE capacity index showed no significant improvements. CONCLUSION: The current study shows that pranayam has been demonstrated as useful for individuals with moderate to severe COPD. Significant improvements in the IA's CAT scores after 3 mo of practice suggests that pranayam can improve the subjective experience of health, disease severity, and functional status for COPD patients, without much improvement in FEV1 actually occurring and with airflow limitation not fully reversible but usually progressive. The research team concluded that pranayam is a useful adjunct treatment and can be an effective rehabilitation program for individuals with COPD.

Evaluation of spectrum of peripheral neuropathy in predialysis patients with chronic kidney disease.

INTRODUCTION: Neurological complications secondary to the uremic state, contribute largely to the morbidity and mortality in patients with renal failure. The prevalence of peripheral neuropathy remains high in advanced renal dysfunction. MATERIALS AND METHODS: The present cross-sectional study was conducted on 100 adult patients of chronic kidney disease between 18 and 75 years of age with serum creatinine greater than 2 mg/dL. Apart from routine examination and baseline investigations, detailed history was elicited pertaining to patients' neurological symptoms, and scored according to the Neurological Symptom Score. Motor nerve conduction velocity was measured from right median, ulnar, peroneal, and tibial nerves. RESULTS: It was observed that neurological symptoms increased steadily with raise in serum creatinine. The mean nerve conduction velocities (NCVs) of right median nerve, ulnar nerve, peroneal nerve, and tibial nerve were 51.34 ± 6.07, 53.04 ± 5.91, 44.72 ± 6.14, and 44.20 ± 5.17, respectively. The NCVs of all the tested nerves decreased significantly with increase in serum creatinine levels (p < 0.01): 70% of the patients had uremic polyneuropathy; 6% had asymptomatic neuropathy, 51% had symptomatic non-disabling neuropathy, while disabling neuropathy was seen in 13% of the patients. CONCLUSION: Our data suggests that NCV testing when complimented with meticulous neurological assessment can provide invaluable input. These tests apart from helping us detect neuropathy in advanced renal dysfunction; can also detect the disease in largely asymptomatic patients which avoids the necessity to order for detailed neurophysiological investigation.

A comparison of cognitive functions in non-hypoxemic chronic obstructive pulmonary disease (COPD) patients and age-matched healthy volunteers using mini-mental state examination questionnaire and event-related potential, P300 analysis.

OBJECTIVE: To assess sub-clinical cognitive dysfunctions in stable chronic obstructive pulmonary disease (COPD) patients having no hypoxemia vs. age-matched healthy volunteers using (i) an electrophysiological test: Auditory event related potential, P300 test and (ii) a questionnaire tool: Mini-mental state examination (MMSE) questionnaire. MATERIALS AND METHODS: EIGHTY MALE SUBJECTS WERE INCLUDED: 40 stable COPD patients (smoking history >20 pack years) and 40 healthy volunteers (HVs). Age, duration of illness, smoking pack years, and spirometric indices were assessed. MMSE scores were evaluated in these groups. Latency of P300 wave and amplitude of P300 wave were studied in both groups to detect P300 abnormalities in COPD group. Correlations of P300 abnormalities with patient characteristic parameters and MMSE scores were assessed. In addition, individual COPD patients having significant cognitive dysfunctions beyond cut-off value of 99(th) percentile of HVs were analyzed. RESULTS: We observed significantly prolonged P300 latency (P < 0.001) and decreased P300 amplitude (P < 0.001) in COPD group. MMSE scores were significantly reduced in COPD group (P < 0.001). 10/40 COPD patients had prolongation of P300 latency, and 27/40 COPD patients had reduced MMSE scores beyond 99(th) percentile of HV. However, we did not observe any statistically significant correlation between P300 abnormalities and patients' characteristics or MMSE scores (P > 0.05 for all). CONCLUSIONS: Our study explores cognitive dysfunctions in stable COPD patients with no hypoxemia. This study highlights the relative importance of using MMSE and P300. Cognitive dysfunctions were detected both by MMSE and P300; however, MMSE abnormalities were more frequent compared to P300 abnormalities (27/40 vs. 10/40) in COPD patients.