Physical fitness and diabetes.

Physical fitness is an essential part of, and an important means of, ensuring and maintaining good health. Exercise is a physical activity which is designed for improvement or maintenance of physical fitness. Pursuit for fitness should be an integral aspect of one's lifestyle, and hence one should engage in regular physical activity, exercises, games, sports and martial arts. Persons living with diabetes often find it challenging to pursue a proper exercise regimen in an effective, yet safe, manner. In this communication, we suggest a strategy to kick start a physical fitness regimen that one can adhere to. This simple suggestion will be helpful not only for persons living with diabetes and other chronic diseases, but for their health care providers as well.

Diagnostic Accuracy of Somatosensory Evoked Potential and Transcranial Motor Evoked Potential in Detection of Neurological Injury in Intradural Extramedullary Spinal Cord Tumor Surgeries: A Short-Term Follow-Up Prospective Interventional Study Experience from Tertiary Care Center of India.

Objective Intraoperative neuromonitoring (IONM) is an acknowledged tool for real-time neuraxis assessment during surgery. Somatosensory evoked potential (SSEP) and transcranial motor evoked potential (MEP) are commonest deployed modalities of IONM. Role of SSEP and MEP in intradural extramedullary spinal cord tumor (IDEMSCT) surgery is not well established. The aim of this study was to evaluate sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of SSEP and transcranial MEP, in detection of intraoperative neurological injury in IDEMSCT patients as well as their postoperative limb-specific neurological improvement assessment at fixed intervals till 30 days. Materials and Methods Symptomatic patients with IDEMSCTs were selected according to the inclusion criteria of study protocol. On modified McCormick (mMC) scale, their sensory-motor deficit was assessed both preoperatively and postoperatively. Surgery was done under SSEP and MEP (transcranial) monitoring using appropriate anesthetic agents. Gross total/subtotal resection of tumor was achieved as per IONM warning alarms. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of SSEP and MEP were calculated considering postoperative neurological changes as "reference standard." Patients were followed up at postoperative day (POD) 0, 1, 7, and 30 for convalescence. Statistical Analysis With appropriate tests of significance, statistical analysis was carried out. Receiver-operating characteristic curve was used to find cutoff point of mMC for SSEP being recordable in patients with higher neurological deficit along with calculation of sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of SSEP and MEP for prediction of intraoperative neurological injury. Results Study included 32 patients. Baseline mean mMC value was 2.59. Under neuromonitoring, gross total resection of IDEMSCT was achieved in 87.5% patients. SSEP was recordable in subset of patients with mMC value less than or equal to 2 with diagnostic accuracy of 100%. MEP was recordable in all patients and it had 96.88% diagnostic accuracy. Statistically significant neurological improvement was noted at POD-7 and POD-30 follow-up. Conclusion SSEP and MEP individually carry high diagnostic accuracy in detection of intraoperative neurological injuries in patients undergoing IDEMSCT surgery. MEP continues to monitor the neuraxis, even in those subsets of patients where SSEP fails to record.

Comparison of Propofol and Ketofol on Transcranial Motor Evoked Potentials in Patients Undergoing Thoracolumbar Spine Surgery.

STUDY DESIGN: This was a double-blind randomized study. PURPOSE: The primary purpose was to compare the effects of propofol and ketofol on amplitudes and latencies of transcranial motor evoked potentials (TcMEPs) during thoracolumbar spine surgery. In addition, intraoperative hemodynamics and muscle power were compared. OVERVIEW OF LITERATURE: Propofol is commonly used during intraoperative TcMEP monitoring. However, propofol inhibits TcMEP amplitudes and causes hypotension in a dose-dependent fashion. METHODS: Amplitude and latency of TcMEPs were recorded bilaterally from the abductor pollicis brevis (APB) and abductor hallucis (AH) muscles in 38 adult American Society of Anesthesiologists I and II patients undergoing thoracolumbar spine surgery. Baseline recordings of TcMEPs in both groups were recorded under propofol infusion. Group X patients then received propofol and fentanyl (1 mcg/kg/hr), and group Y patients received ketofol and fentanyl (1 mcg/kg/hr). Bispectral index was maintained at 40-60 in both groups. Amplitude and latency were recorded at 30 minutes intervals for 2 hours. RESULTS: Propofol caused no significant changes in amplitude and latency in any muscle. In contrast, amplitude increased significantly at all time points in the bilateral APB muscles and 60, 90, and 120 minutes in the left AH muscle without changes in latency in response to ketofol. When the two groups were compared, ketofol induced significantly higher amplitudes at 60, 90, and 120 minutes in the (left) APB, at all time points in the (right) APB, and at 120 minutes in both AH muscles, compared with propofol. Blood pressures were lower and fluid and vasopressor requirements were higher in group X. Muscle power was similar between the two groups. CONCLUSIONS: Ketofol facilitates TcMEP amplitudes without affecting latency. Use of ketofol resulted in a better and more stable hemodynamic profile than did use of propofol.

Effect of Tratak (Yogic Ocular Exercises) on Intraocular Pressure in Glaucoma: An RCT.

Introduction: In healthy subjects, the intraocular pressure (IOP) is maintained by a dynamic equilibrium between continuous production of aqueous humor by ciliary bodies and continuous outflow through the two drainage pathways: trabecular meshwork and uveoscleral outflow. Here, we hypothesized that yogic ocular exercises, including extraocular muscles exercise, and modified Tratak Kriya (mTK), might reduce the IOP as well as stress and improve quality of life (QoL) in patients with glaucoma. Methodology: A parallel two-arm randomized controlled trial (RCT) was conducted in glaucoma patients (Control group and Intervention group). Control group patients were on standard medical treatment and intervention group patients practiced a Yoga-based lifestyle intervention (YBLI) for 4 weeks as add-on therapy with their standard medical treatment. All Participants were assessed at baseline day 1, day 14 (D14), and day 28 (D28). A minimum of 30 patients were recruited in each group. Results: We did not observe any statistically significant different mean IOP of right (IOP-r) or, left eyes at any time point as well as cortisol level and QoL between the two groups. However, with in intervention group, there was a reduction in IOP-r at D14 (15.54 ± 2.81 mmHg) and D28 (15.24 ± 3.1 mmHg), P = 0.006 and 0.001, respectively, compared to their baseline IOP (16.26 ± 2.98). Conclusion: Based on the present RCT, yoga-based ocular exercises practiced here cannot be recommended for management of raised IOP in glaucoma patients. Further larger studies are warranted with yoga-based interventions in patients with glaucoma. Clinical Trial Registration Number: CTRI/2016/03/006703.

Role of CTLA4 A49G polymorphism in systemic lupus erythematosus and its geographical distribution.

CTLA-4 (cytotoxic T-lymphocyte-associated protein-4) or CD152 is an inhibitory receptor expressed constitutively on CD4+ CD25+ T regulatory lymphocytes and transiently on activated CD4+ and CD8+ T lymphocytes. Its inhibitory function promotes long-lived anergy in immune cells and prevents autoimmunity. Therefore, it plays a crucial role in T cell-mediated autoimmunity, and thus in susceptibility to autoimmune diseases, including systemic lupus erythematosus (SLE). It is encoded by CTLA4 gene in humans. AtoG polymorphism at position +49 of CTLA4 gene is the only polymorphism which changes amino acid sequence from alanine to threonine in the leader sequence, which may affect the function of CTLA-4. Association of CTLA4 polymorphisms with SLE has been investigated in several reports in different ethnic populations from different countries, which have shown highly inconsistent findings. In this review, we have compiled previous studies which have reported the association of CTLA4 A49G polymorphism in SLE and its geographical distribution.

The Anthropometric Correlates for the Physiological Demand of Strength and Flexibility: A study in Young Indian Field Hockey Players.

INTRODUCTION: Optimal strength and flexibility are essential for performance enhancement and injury prevention in hockey, and anthropometry is known to influence these parameters. AIM: To find anthropometric correlates for strength and flexibility score in young Indian field hockey players. MATERIALS AND METHODS: Thirteen female and 19 male subjects volunteered for the study. Selected anthropometric variables: lengths, breadths, girths and body composition; strength and sit and reach score were measured for each subject. RESULTS: Males were taller, leaner and stronger with longer upper limbs and broader chests. With few exceptions, taller, heavier and leaner players with longer trunks and limbs, broader chest and hip, and bulkier arms and lower limbs had stronger grip, back, upper and lower limbs. Heavier and taller players with longer trunk and more percentage of body fat were more flexible. Also, the stronger players had more percentage body fat and body mass index, which might be due to the strong positive correlation of percentage body fat and body mass index with fat free mass. CONCLUSION: Anthropometric variables, especially heights, breadths and body composition, show significant correlation with strength and flexibility, and hence may serve as monitoring tool and for talent identification.

Telomerase based anticancer immunotherapy and vaccines approaches.

Telomerase is a Reverse Transcriptase that maintains the telomere length. It is absent in most somatic cells but is found in stem cells, germ cells and around 90% of cancers. It plays a crucial role in developing and maintaining cancer cells. Telomerase, a HLA class-I antigen, is able to stimulate cell mediated immune response by inducing cytotoxic T-cells. This property of telomerase is being exploited in targeting cancers by host's own immune responses; stimulated by various Human Telomerase Reverse Transcriptase (hTERT) derived vaccines. Many approaches and studies including clinical trials have shown effective anticancer responses of these vaccines, without toxicity to non cancer cells. In this article we have compiled different hTERT based anticancer immunotherapy approaches, vaccines and their performances.

Anthropometric Basis of Vertical Jump Performance: A Study in Young Indian National Players.

INTRODUCTION: Vertical Jump (VJ) is a good measure of athletic performance and occupational activities. Earlier studies reported conflicting results on anthropometric influence. AIM: To evaluate the relationship between anthropometric characteristics and VJ in national level hockey and cycling players. MATERIALS AND METHODS: Fifty four (32 males) national level hockey and cycling players of 11-21 years were the volunteers. Following standard protocols, these variables were measured: VJ, Weight (WT), Height (HT), Trochanterion-Height (TH), Sum of Skinfold Thickness (SSF), Lengths [Acromiale-Stylion (AS) and Midstylion-Dactylion (SD)], Breadths [Biacromial (AB), Biiliocristal (IB), Biepicondylar Humerus (HB) and Biepicondylar Femur (FB)], Girths [Relaxed Arm (AG), Mid Thigh (TG) and Calf (CG)], Lower Back and Hamstring Flexibility (SR), Grip [Left Hand Grip (LHG) and Right Hand Grip (RHG)] and Back Strength (BS). International Society for the Advancement of Kinanthropometry (ISAK) procedures were followed for anthropometric variables measurement. Unpaired-'t'-test was used for comparison between genders. Pearson's correlation and multiple regression analysis were used to evaluate correlates and predictors of VJ respectively. RESULTS: Males had significantly higher VJ, HT, SD, AB and BS; but lower SSF, AS and TG. VJ correlated positively with age, WT, HT, SD, TH, girths, SR and strength among males; but only with WT and LHG among females. After controlling gender, TH and LHG predicted VJ significantly with 69% of total variance. HT, SSF and BS; and LHG were the significant predictors among males and females respectively. CONCLUSION: Anthropometric and physiological variables like TH, grip, HT, skinfold and BS had major influence on VJ. The result might help in training-monitoring and player's selection.

Gender Difference in Aerobic Capacity and the Contribution by Body Composition and Haemoglobin Concentration: A Study in Young Indian National Hockey Players.

INTRODUCTION: Although gender difference in aerobic capacity is known, the contributing factors have been researched seldom. AIM: To investigate the gender gap and the contribution by percentage Body Fat (BF), Body Mass Index (BMI) and haemoglobin concentration Hb. MATERIALS AND METHODS: The study was conducted on 30 (17 males, 13 females) training status matched young hockey players. Healthy players who were playing upto national level competition were included. BW (Body Weight), BF, BMI, LBM (Lean Body Mass), rHR (restring Heart Rate), HRR (Heart Rate Recovery), Hb, a/rVO2max (absolute/relative), a/rPWC (Physical Work Capacity) and RMR (Resting Metabolic Rate) were measured and analysed. RESULTS: There was significant gender difference in the measured parameters. Difference in a/rVO2max remained significant even after controlling for BF, BMI and Hb. Multiple regression and correlation analysis revealed gender difference in VO2max/LBM was due to: BMI(31.91%)>BF(27.60%)>Hb(9.91%). BMI also significantly contributed 3.66% of VO2max/LBM variance, independent of that by gender. Difference in RMR was mainly related to LBM, BF and BMI. CONCLUSION: The study provided an understanding for gender gap in aerobic capacity. Differences in BMI & BF were one of the main reasons.

Comparison of Mustard Oil and Ghee Consumption on the History of Coronary Heart Disease in Urban Population of India.

INTRODUCTION: Coronary Heart Disease (CHD) is one of the leading causes of mortality in India, due to high consumption of mustard oil and ghee among urban population. AIM: To find out the relationship of mustard oil and ghee consumption on CHD history. MATERIALS AND METHODS: By a random cross-sectional, house-to-house survey in North India, 137 people aged between 40-80 years (70 males and 67 females) were selected by dietary history of Mustard Oil (MO) and Ghee consumption (G), but having no other CHD precipitating factor. Using food frequency questionnaire, the study population was divided into two groups based on the amount of MO and G consumption; Group A (n = 75): MO >1L/month, but G <0.5Kg/month and Group B (n = 62): MO =0.2 to 0.5L/month but G >1.25Kg/month. Serum lipid profile estimation and resting ECGs recording were done from all the subjects. RESULTS: There was no statistical significant difference in CHD history between the two groups. Mustard Oil had positive correlation with CHD history. CHD was higher by 50.9% in Group A and was independent of gender. However, the odds of CHD history were higher among males by 32.2% irrespective of the groups. CONCLUSION: The results demonstrated that CHD history was associated with higher relative consumption of mustard oil than ghee and CHD is positively correlated with increase mustard oil intake, blood level of TG, TC, LDL, VLDL, TC/HDL and LDL/HDL ratio.