Early Detection of Right Ventricular Dysfunction in Chronic Obstructive Pulmonary Disease by Echocardiography.

OBJECTIVE: This study is designed to investigate the effects of pulmonary arterial hypertension on RV systolic and diastolic functions in cases of COPD and to correlate RV systolic and diastolic functions with pulmonary arterial pressure. MATERIALS AND METHODS: 100 patients admitted in various medical wards of tertiary care Hospital and a primary care hospital with stable chronic obstructive pulmonary disease persons with age and sex-matched. 35 age and sex matched person without any associated and known disease were taken as control subjects. Selection of cases has been made on basis of detailed history, thorough clinical examination, electrocardiography, chest x-ray, pulmonary function tests. OBSERVATION: RV Systolic function (RVEF and RVWT) are significantly abnormal in patients of stable compensated COPD and they are significantly correlated with PAP(p< 0.002). RV diastolic function i.e., E/A ratio and PFR are altered in 60%(n-60) of patients of COPD studied against control subjects and significantly correlated with PAP(p< 0.002). CONCLUSION: Echocardiography is a non invasive method to detect changes of right ventricular dysfunctions in early stages with very good significant sensitivity and specificity.

Abnormalities in the thyroid function tests as surrogate marker of advancing HIV infection in infected adults.

OBJECTIVE: To study thyroid function tests in patients infected with human immunodeficiency virus (HIV) infection at various stages of the illness and to correlate the results with the disease progression. METHODS: In a prevalence study of 50 HIV infected patients at various stages of illness thyroid function tests consisting of free-thyroxin (FT-4), free tri-iodothyronine (FT-3), and serum thyroid stimulating hormone (s. TSH) were done. Subjects belonged to both sexes and all subjects were newly diagnosed HIV+ patients and were not receiving antiretroviral therapy (ART) when enrolled in the study. Patients were studied in two groups: Group-1 had 25 patients having AIDS and Group-2 had 25 patients who were HIV+ but were not having AIDS as per 1993 revised CDC classification for HIV infection in adolescents and adults. The results were statistically analyzed and correlation of abnormalities in thyroid function tests with the disease progression was studied. RESULTS: Out of 50 cases, thyroid function abnormalities were observed in substantial number of patients. Nine (18%) patients had FT-3 levels below the normal range, ten (20%) patients had decreased FT-4 levels and twelve (24%) patients had s. TSH levels above the normal range. When the results were statistically analyzed for the 50 patients enrolled in our study using Pearson's correlation coefficient, there was a direct correlation between CD4 count and FT3 and FT4 values (r = 0.357 with p < 0.05; r = 0.650 with p < 0.05 respectively). There was an inverse correlation of CD4 counts with serum TSH levels (r = -0.470 with p < 0.050). CONCLUSION: Thyroid dysfunction is frequent in HIV infection and with progression of disease there is a primary hypothyroid like stage that occurs in patients with HIV infection. FT3 /FT4/serum TSH can be used as a surrogate marker of the progression of the disease.

Pulmonary haemorrhage syndrome associated with dengue haemorrhagic fever.

Dengue fever is a major public health problem in India. Dengue haemorrhagic fever (DHF), a more serious form of disease, occurs when a person previously infected with dengue is reinfected with a different serotype. Besides common manifestations pleural effusion, pneumonitis, haemoptysis and pulmonary haemorrhage have rarely been seen. We report a case of 30 years old male, who developed pulmonary haemorrhage, haemoptysis requiring blood transfusion. Serology was consistent with the diagnosis of dengue haemorrhagic fever.

The effects of dextroamphetamine on kinesthetic figural aftereffects.

The effect of dextroamphetamine, primarily a central stimulant, on kinesthetic figural aftereffects (KFAEs) was examined. The subjects were selected after preliminary testing with the Eysenck Personality Inventory and were classified into three groups: extraverts, ambiverts, and introverts. d-Amphetamine was used at three dose levels and a control group was included for purposes of comparison. The 3 X 4 randomized block design was replicated ten times. KFAEs were measured under two sets of conditions, i.e., before and after the induction experience. The results support the following conclusions: (1) neither personality grouping nor drug treatment during preinduction trials significantly affected KFAE; (2) both types of variables were, however, significantly related to behavior during the postinduction trials; (3) the extraverted subjects showed larger KFAEs than ambiverted and introverted subjects under placebo condition; (4) the extent of KFAE was reduced in extraverted and enhanced in introverted subjects under the influence of the drug; (5) there were significant interactions between the drug treatments and personality variables in effects on KFAE.

Caffeine differentially affects kinesthetic aftereffect in high and low impulsives.

The effects of caffeine on kinesthetic aftereffect (KAE) were examined. Following a between-subjects design, high and low impulsive male postgraduate students were administered placebo and four doses of caffeine (1, 2, 3 and 4 mg/kg body weight) in a laboratory situation. A double blind procedure was adopted for drug administration. The study supports the following conclusions: (1) caffeine reduces KAE in high impulsive subjects; (2) the larger dose of caffeine (4 mg/kg) enhances KAE in low impulsive subjects; (3) caffeine produces profound effects on the performance of high impulsives; (4) caffeine leads to different dose-response trends in the two groups.

Serum, CSF, RBC & urinary levels of magnesium & calcium in idiopathic generalised tonic clonic seizures.

Serum, cerebrospinal fluid (CSF) and urinary levels of magnesium and calcium and RBC magnesium levels were studied in 100 patients of idiopathic generalised tonic clonic seizures and 95 healthy controls matched for age and sex. There was a significant reduction in serum, CSF and RBC magnesium levels and a rise in serum and CSF calcium levels in epileptic patients. The 24 h urinary excretion of calcium and magnesium in the epileptics did not differ from controls. Post ictal (within 24 h of seizure) serum and CSF magnesium levels were significantly lower and calcium levels significantly higher as compared to inter ictal levels (4 wk after seizure). There was no correlation between serum magnesium, serum calcium and CSF calcium levels and the frequency, control or duration of fits. Low CSF magnesium levels correlated with increased frequency, poor control and longer duration of fits. Patients with status epilepticus and those in the EEG abnormalities had low CSF magnesium levels.

Extraversion and reinforcement in verbal operant conditioning.

The present investigation was designed to study the relationship between extraversion and modes of reinforcement in verbal operant conditioning. A 4 X 3 randomized block design was replicated ten times. Eighty graduate and post-graduate male students were individually subjected to the standard Taffel conditioning procedure. When the numbers of conditioned responses produced by introverts and extraverts were compared, it was found that: (1) under negative reinforcement ('bad' and electric shock), with both the female and male experimenters, and under positive reinforcement ('good') with the male experimenter, the introverts' score was the higher of the two; (2) under positive reinforcement ('good') with the female experimenter, the extraverts' score was higher than that of the introverts.

Dextroamphetamine and individual susceptibility to reinforcement in verbal operant conditioning.

The present investigation was designed to study the relationships between extraversion, d-amphetamine and modes of reinforcement in verbal operant conditioning. A factorial design involving two levels of extraversion (extraverts and introverts), two reinforcement conditions ('good' and 'electric shock') and three treatments (placebo and two doses, 7.5 and 12.5 mg, of d-amphetamine) with repeated measures on the last factor was used. Sixty postgraduate female students were individually subjected to Taffel's verbal conditioning procedure. The study supported the following conclusions: (1) under the placebo condition, the extraverted subjects condition better with the rewarding reinforcer while the introverted subjects condition better with the punishing reinforcer; (2) under the influence of d-amphetamine, the extraverted subjects condition better with the punishing reinforcer while the conditioning scores of introverted subjects decrease with the punishing reinforcer but are not influenced with the rewarding reinforcer.

Impulsivity/sociability and reinforcement in verbal operant conditioning.

The present investigation was designed to study the relationship between impulsivity/sociability and modes of reinforcement in verbal operant conditioning. Two 2x3 randomized block designs, one each for impulsivity and sociability, were replicated ten times. One hundred and twenty undergraduate female students (60 for impulsivity and 60 for sociability) were individually subjected to Taffel's verbal conditioning procedure. When the conditioning scores of high and low scorers on the impulsivity and sociability scales were compared, it was found that under rewarding conditions ('good' and 'buzzer' in respect of sociability and 'good' in respect of impulsivity) the high scorers' score and under punishing conditions ('electric shock') the low scorers' score was the higher of the two. The study also revealed that the high scorers (on the impulsivity scale) conditioned more under rewarding conditions while the low scorers (both on the impulsivity and sociability scales) conditioned more under punishing ones.

Evaluation of communication skills of physicians about asthma.

OBJECTIVE: Communication skills in medical practice are important. To assess the communication skills of physicians about asthma, we undertook this study. METHODS: One thousand four hundred and twenty one physicians attending the annual conference of association of physicians of India volunteered to participate in the study. They were divided into three categories. 'Teachers' group 1, (n = 131), 'Clinicians', group 2, (n = 951) and 'Students' group 3, (n = 339). Questionnaire containing ten most frequently asked questions by asthmatic patients were given to the physicians. A panel of three patients assessed the replies of these question and graded them as 'Convincing', 'Just convincing' and 'Not convincing'. RESULTS: Replies of only 2% of physicians were graded as convincing, 15.6% just convincing and 82.4 as not convincing. Among group 1 none gave a convincing reply while replies of 2.2% of group 2 and 2.4% of group 3 were graded as convincing. The difference in results was not significant statistically on comparing the three groups (p > 0.1). CONCLUSIONS: Communication skills are the integral part of patient care and management. Our study demonstrated lack of effective communication skills among physicians.

Cerebrospinal fluid free N-acetyl neuraminic acid levels--a diagnostic and prognostic test in meningitis.

Cerebrospinal fluid (CSF) free N-acetyl neuraminic acid (NANA) levels were estimated in 20 cases each of pyogenic and tubercular meningitis (TBM) and 10 controls. The levels of free NANA were significantly high (P less than 0.001) in pyogenic and partially treated pyogenic meningitis when compared to TBM. The CSF free NANA levels had direct correlation with severity of the disease, CSF sugar and protein levels in pyogenic meningitis. The CSF free NANA can even be a prognostic criterion in management of pyogenic meningitis. Higher the levels, poorer the prognosis.

Lipid profile in rheumatoid arthritis and its relation to disease activity.

AIM OF THE STUDY: To ascertain whether--1. Serum lipids are altered in rheumatoid arthritis (RA) patients and 2. Disease activity has any role in altering lipid profile. METHODOLOGY: Lipid profiles of 25 RA cases were compared with age and sex matched controls. RESULTS: Serum triglycerides (STG) and total cholesterol (TC) were found to be significantly lower in RA patients. In patients with very active disease, activity index (AI) > 80, STG, TC and low-density lipoprotein (LDL-C) were significantly lower as compared to controls. For TG 'r' value of -0.483 indicated negative correlation between disease activity and TG values, though the correlation is not significant (p > 0.05). For TC 'r' value (-0.0551) indicates negative correlation between disease activity and serum TC.

Patient's perception towards quality nursing care.

BACKGROUND: Quality nursing care remains an important role for patients because nurses are involved in almost every aspect of client's care in hospital. Nurses interact with patients more often than any other health care personnel in a hospital. Patients express their requirements in terms of what they need, want, prefer, expect and demand with respect to the nursing service they receive. The main objective of this study was to identify the Patient's Perception towards Quality Nursing Care. METHODS: A descriptive quantitative and qualitative research design was adopted; study areas were Bir-hospital and Tribhuvan University Teaching Hospital (TUTH). Non probability purposive sampling technique with semi structured interview questionnaire including Likert Scale was used to collect the data. Descriptive and inferential statistics were used for analysis. RESULTS: Overall perception of respondents about nursing care (nurses' behavior, safety and security and admission procedure) is positive as 182 (91%) perceived positively, whereas 18 (9%) perceived negatively (not positive). There is no significant difference of perception in relation to total nursing care by sex, education and occupation status of the respondents as highest percentage of respondents had positive perception. CONCLUSIONS: It can be concluded that most of the respondents showed positive attitude towards quality nursing care in both hospitals.