Normative data of Ankle brachial pressure Index and Toe brachial index in normal healthy male adult using fully automated vascular Doppler.

Context: Peripheral vascular disease affects some 12%-14% of the general population, and the majority of people with the disease are asymptomatic. Risk factors for it are smoking, diabetes mellitus, hyperlipidemia, hypertension, obesity, and syndrome X. The Ankle Brachial Pressure Index (ABPI) is one of the screening noninvasive methods for the diagnosis of peripheral vascular disease. Assessment is performed by fully automated vascular Doppler, which is considered to be accurate; however, normative data are limited. Aims: To measure the normative data of ABPI and Toe brachial index (TBI) in a healthy adult. Settings and Design: A cross-sectional study done in male (n = 59) volunteers in the age group of 18 to 50 years of age group. Methods and Material: Smartdop XT fully automatic Doppler-14 ports (Hadeco, Japan) was used to measure ABPI and Toe brachial index (TBI). Statistical analysis used: Normative value (Mean, SD, Range) was calculated using Systac 13 software. Results: Right-side Ankle Brachial Pressure Index (ABPI) and left-side ABPI at the posterior tibial artery (PT) were 1.061 ± 0.098, and 1.105 ± 0.139, respectively. Right-side ABPI and left-side ABPI at the dorsal pedis artery were 0.86 ± 0.129 and 0.86 ± 0.115. Right-side toe Brachial Pressure Index (TBPI) and left-side ABPI was 0.85 ± 0.185 and 0.822 ± 0.2, respectively. Conclusions: ABPI index of more than 0.9 may be considered normal in the male population in Bhopal; however, we recommend further Multicentric trials across the Indian population.

Effectiveness of Semmes Weinstein 10 gm monofilament in diabetic peripheral neuropathy taking nerve conduction and autonomic function study as reference tests.

Context: Diabetic peripheral neuropathy (DPN) if detected early can reduce the burden on the health system and prevent the development of diabetic foot ulcers and amputation. Aim: To study the effectiveness of Semmes Weinstein 10 gm monofilament in detecting DPN taking nerve conduction studies (NCS) and autonomic function testing (AFT) as reference tests. Settings and Design: Observational and comparative cross-sectional study conducted in the Physiology department AIIMS, Bhopal in collaboration with the Medicine department of the institute. Methods and Material: A total of 72 diagnosed type-2 diabetes mellitus patients were examined using Semmes Weinstein 10 gm monofilament, DPN was confirmed using NCS (Nihon Kohden Neuropack XI machine) and autonomic neuropathy was confirmed using AFT (Ewing's battery and Power lab) with heart rate variability (HRV). Diagnostic value of Semmes Weinstein 10 gm monofilament taking NCS and AFT as reference test was calculated. Statistical Analysis Used: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were calculated using the standard formula. Results: Sensitivity, specificity, PPV, and NPV using monofilament are 69.23%, 20%, 69.23% and 20% respectively taking NCS as reference test and 70.59%, 0, 92.30%, and 0 respectively taking AFT as reference test. Conclusions: Semmes Weinstein 10 gm monofilament is not the ideal screening test for the diagnosis of DPN. Sole clinical use of monofilament should be discouraged.

Effect of head down tilt on heart rate variability.

CONTEXT: Sirshasan is supposed to increase blood flow to the brain and considered to be beneficial for intellectual function, however mastering these techniques may be difficult. AIMS: To see the effect of headstand using a tilt table on heart rate variability (HRV). SETTINGS AND DESIGN: A cross-sectional study that was done on 26 healthy volunteers. METHODS AND MATERIAL: HRV was assessed in the supine position and 30° head tilt position for 5 min. HRV recording was done on the power lab (AD Instruments P Ltd, Castle Hill Australia). The tilt table used was Medica Podium, New Delhi, HLT-200. STATISTICAL ANALYSIS USED: Paired t-test. RESULTS: All the HRV parameters showed non-significant change except low-frequency parameters which showed significant change during head tilt. CONCLUSIONS: Headstand to a 30° using tilt table cause a decrease in the autonomic activity which is mainly because of decrease in sympathetic activity.

Neurophysiological parameters of sensory perception and cognition among different modalities of learners.

INTRODUCTION: Different types of learners based on sensory modalities are observed. Cognition or physiological alterations in the sensory pathways might play its role in different modalities of visual, auditory, read and write, and kinesthetic learners which are based on different sensory modalities of perception. OBJECTIVE: The objective of this study is to ascertain an objective parameter (neurophysiological parameters) for the classification of learners based on their preferred sensory modality. MATERIALS AND METHODS: An experimental cross-sectional study was conducted among 100 medical students. Learners were classified into visual, auditory, read-write, and kinesthetic learners based on the interpretation drawn on the basis of the VARK questionnaire. Sensory-evoked potentials (SEPs), including pattern shift visual (PSVEPs), brain stem auditory (BAEPs), short-latency somatosensory (SSEP), and event-related potentials (P300) were measured. SEPs measured in microvolts were recorded from the scalp with the help of active and reference electrodes. Multiple responses to sensory stimuli (using NIHON KOHDEN Corporation Neuropack X1, Tokyo, Japan) were recored and averaged using the computerized signal averging technique. RESULTS: No statistically significant difference was observed in conduction velocities (in terms of latency and amplitude) of SEP among different type of learners, except latency N145 wave form in VEP (P < 0.05). A characteristic pattern of minimal comparative latency was observed among the majority of visual learners. Similary, P300 has shown a characteristic pattern of decreased comparative latency among majority of read and write learners. CONCLUSION: Study findings suggested that among existing teaching and learning modalities, visual modalities were observed faster but to retain it in memory and for abstract thinking, students should utilize read and writing skills which are lacking in the era of digitalization and overuse of electronic devices.

Effect of meditation on autonomic function in healthy individuals: A longitudinal study.

CONTEXT: Meditation is very useful to relieve stress via hypothalamo-pituitory axis. Meditation is considered to be useful to relieve stress and cardio-respiratory health. AIMS: To compare the effect of meditation on autonomic function including heart rate variability (HRV) over a period of 3 months of meditation. SETTINGS AND DESIGN: Longitudinal study conducted at Physiology Department, AIIMS Bhopal. METHODS AND MATERIALS: Thirty healthy volunteers doing meditation were evaluated for autonomic function using autonomic function test battery (Ewing's battery) and HRV using Power lab (Ad instrument) and digital electrocardiograph (MARKS). STATISTICAL ANALYSIS USED: Statistical analysis was done using statistical software. Wilcoxon signed rank test was used. RESULTS: Significant change was seen in Valsalva ratio and lying to standing 30:15 ratio. There was no significant change in other parameters studied with 3 months of meditation. CONCLUSIONS: Three months of meditation does not have any significant effect on major parameters of autonomic functions.