Thyroid hormone levels in highlanders- a comparison between residents of two altitudes in Nepal.

BACKGROUND: The endocrine changes related to altitude adaptation in human have attracted physiologists around the globe for long. A number of high altitude studies to detect the physiological changes have been performed now and then. But, the study to see the hormonal changes to compare populations residing at different high altitudes is a scarce. Hence, we have performed a study in native populations of different high altitude comparing changes in thyroid hormones in western Nepal. The Jharkot population included in this study is at altitude of 3760 m and Jomsom population at 2800 m height from sea bed. OBJECTIVE: The study is to compare changes in thyroid hormones at two different high altitude natives. METHODS: To compare thyroid status between high altitude natives at two different altitudes a cross sectional study is performed by random sampling method. The blood sample was collected in a vacutainer from fifty eight individuals after obtaining the informed consent of participants. The blood collected from antecubital vein was centrifuged in an hour and the serum obtained was used for biochemical analysis of free triiodothyronine, free thyroxine and thyroid stimulating hormone. RESULTS: Mean free thyroxine (fT4) of Jharkot population is significantly larger (p = 0.001) than Jomsom population. Mean thyroid stimulating hormone (TSH) with p = 0.597, does not indicate the difference between this two population. There is no significant difference between mean free triiodothyronine (fT3) of Jharkot and Jomsom population (p = 0.345). CONCLUSION: The rise in free thyroid hormone at high altitude is not dependent on the thyroid stimulating hormone released from anterior pituitary. The rise in free thyroxine is found at higher altitude and no difference in fT3 level is detected in population studied at high altitudes.

Effect of sub-maximal exercise stress on cold pressor pain: a gender based study.

BACKGROUND: Analgesic effect of exercise is a well established fact; however available reports are contradictory on gender differences in pain perception following exercise stress test. OBJECTIVE: The current study is prospectively designed to evaluate and compare the effect of acute bout of sub-maximal exercise stress on cold pressor pain in normal adult males and females. METHOD: The experimental study design involved healthy adults (n= 41); females (n = 18) and males (n=23) aged between 18 to 25 years and included them into four sets of experiments: SET I (Control), "resting blood pressure, radial pulse and respiratory rate were recorded after 15 minutes of complete supine relaxation. SET II (Cold Pressor Pain Test): Pain Threshold, Pain Tolerance, and Pain Duration in seconds were taken. SET III (Exercise Stress Test): Sub-maximal exercise of 70 to 75% of maximum predicted heart rate was given for 6 minutes. SET IV (Cold Pressor Pain Test immediately after Exercise Stress Test): At 0 minute of recovery again the pain parameters; Pain Threshold, Pain Tolerance, and Pain Duration in seconds were taken. SET I, SET II were performed in order on the first day and SET III and SET IV on the second day to ensure only a single Cold Pressor Pain Test is performed in each day. RESULT: The data (Mean ± SD) analysis showed significant increased in pain threshold (males: 14.36 ± 10.6 Vs 21.47 ± 13 seconds, p< 0.001, females: 14.1 ± 11.5 Vs 23.81 ± 20.22 seconds, p<0.001) and pain tolerance time (males: 41.3 ± 19.31 Vs 54.1 ± 21.7 seconds, p<0.001) in both sexes after 6 min of acute bout of sub-maximal exercise stress test with comparable age, BMI and baseline resting values of pain parameters and pulse rate and blood pressure. The percentage increment pain tolerance time following the exercise stress in female is higher than male (78.6 Vs 68.9%). CONCLUSION: The result suggests that pain sensation decreases immediately after a brief period of exercise challenge irrespective of gender, and the analgesic effect of the acute bout of exercise in terms of pain tolerant time is more enhanced in females than males.

Variations of body physique in Santhals: an Indian tribe.

In order to assess sex differences in body physique in Santhals, a cross sectional sample of 800 adult Santhals (400 males and 400 females) was collected from West Bengal (India) using multistage cluster random sampling. The present study aims to explore the body physique of Santhals of West Bengal, where both males and females do backbreaking labor work. This type of research is rare in tribal communities, especially in India. Anthropometric Somatotyping, the method forwarded by Heath and Carter, is followed in the present study, which is a technique of rating human body physique and composition through anthropometric measurements. The results suggest that the Santhal males and females are predominately Mesomorphic in their body physique. Mean somatotype of Santhal males and females are 1.98-4.81-3.98 and 3.16-5.43-3.17 respectively. Variation among Santhal females is more than males in terms of their body physique. Males in general are linear and muscular, whereas females are lean to fatty, but muscular.

Waist circumference and waist-hip ratio as predictors of type 2 diabetes mellitus in the Nepalese population of Kavre District.

The objective of the present study was to find out WHR and WC as predictor of Type 2 DM in the population of Kavre district of Nepal. Sixty-five "known type 2 diabetic" and Thirty-five "self-reported non-diabetic" subjects above thirty years of age were included in the present study. Height, Weight, Waist Circumference and Hip Circumference were recorded for every subject. BMI and WHR were calculated by the standard formula. The data was analyzed using SPSS Evaluation Version 15.0 and STATA Special Edition Version 8.2. Our results showed that the optimal cut-off values for WHR, WC. BMI and age in female are 0.87, 0.85 cms, 21.40 kg/m2 and 40 years respectively and for male the respective values are 0.96, 0.87 cms, 23.63 kg/m2 and 44 years. In female, age (82.9%) is the strongest predictor followed by WHR (78.1%), WC (70.2%) and least for BMI (55.0%) whereas for male WC (87.0%) is the strongest followed by WHR (81.6%), BMI (68.5%) and least: for age (6.4.6%) using Receiver Operating Characteristic (ROC) curves. Optimum sensitivity and specificity obtained from the ROC curves corresponded to these cutoff values and area under curve for their predictive ability. The current study showed that the WC and WHR are the best predictors of type 2 DM in both male and female population of Kavre district.

Appropriate body mass index cut-off point in relation to type 2 diabetes mellitus in the population of Kavre district.

OBJECTIVE: The objective of the present study was to find out the appropriate BMI cut-off point in relation to type 2 diabetes mellitus (DM) in the population of Kavre district of Nepal. MATERIALS AND METHODS: Thirty-five "known type 2 diabetic" and Thirty-five "self-reported non-diabetic" subjects above thirty years of age were included in the present study. Height and weight were recorded for every subject. BMI was calculated by the standard formula. The data was analyzed using SPSS Version 11.5. RESULTS: Our results showed that the reference BMI range for both diabetic male (23.26 +/- 6.88 kg/m(2)) and diabetic female (22.51 +/- 6.28 kg/m(2)) subjects were within normal BMI range according to WHO. Odds ratio showed an irregular pattern at different BMI ranges indicating the risk of having diabetes did not increase constantly. Comparison of number and percentage of both diabetic and non-diabetic male and female subjects according to various recommended normal BMI categories showed gradual reduction in percentage of both diabetic and non-diabetic male and female subjects that were within normal ranges from BMI category 18.5-24.9 kg/m(2) to BMI category 18.5-21.9 kg/m(2). The BMI cut-off point was found 22 kg/m(2) using Receiver Operating Characteristic (ROC) curves. CONCLUSION: The appropriate BMI cut-off point for both men and women was found 22 kg/m(2) in the population of Kavre district of Nepal.

Sonographic presentation of uterine sex cord-stromal tumor.

A 24-year-old woman presented with continuous vaginal bleeding and anemia. Pelvic sonography demonstrated an enlarged uterus measuring 8.9 x 4.9 x 4.7 cm and a mass within the endometrial cavity measuring 3.0 x 1.8 cm. The mass appeared to be polypoid and echogenic, contained a small cyst, and was suggestive of a polyp. The patient underwent total vaginal hysterectomy. Pathologic examination revealed a uterine sex cord-stromal tumor. To our knowledge, the sonographic features of uterine sex cord-stromal tumor have not been previously reported. The sonographic appearance mimicked that of a polyp.

Respiratory adaptation to high altitude in adolescent Bod girls of the Western Himalayas.

The impact of high-altitude environment was studied on respiratory functions and body measurements in adolescent Bod girls of Ladakh, Jammu and Kashmir, India. Data were collected on 133 high-altitude and 141 low-altitude Bod girls in the age range 12-18 years. Lung functions were, age to age, higher in high-altitude girls than their coeval lowlanders. This has been explained as an adaptation to the stress of low atmospheric pressure at high altitude. This response is similar to the one observed in growing Bod boys living in the same area (Malik and Singh 1979, 1984). High-altitude girls were shorter and lighter, the difference was more pronounced in weight and especially after 14 years of age.

Biomechanical evaluation of lift postures in adult Koli female labourers.

Three lift-postures, back straight and knees bent, back bent and knees straight and squatting were evaluated biomechanically based on data from 100 Koli female labourers, when lifting loads from the floor to hold them at knee height. The maximum weight was lifted with the back bent and the knees straight which is a posture commonly used by Indian labourers for lifting a load. Squatting (a posture used by Indians for performing household chores) produced the least physical strain in terms of moment and moment ratio (moment per kilogramme of load lifted). Consequently, squatting was found to be the best posture for lifting a load, specifically for the Indian labourers who are accustomed to squatting when working.

Anthropometric somatotype of Bod girls: A comparison of high and low altitude populations.

The high altitude environment is known to influence the morphophysiology of man in a variety of ways. Its possible impact on somatotype of adolescent girls has not been investigated so far. For this purpose 348 female Bods, from 10 to 18 years old, have been somatotyped from high altitude (n = 176) of Ladakh (3,534 m) and low altitude (n = 172) of Kullu Valley (1,500-2,200 m). The results of the study reveal greater mesomorphy and ectomorphy in the high altitude Bod girls than in ethnically similar low altitude Bod girls of comparable age. The study has accorded the differences in the somatotypes to the high altitude stresses. Striking similarities in boys and girls in terms of higher mesomorphy and ectomorphy in the highlander Bods than the coeval lowlanders confirm the hypothesis that the high altitude environment influences the somatotype components.

The attitudes of medical students to the objective structured practical examination.

The objective structured practical examination (OSPE) together with the classical practical examination (CPE) form the basis for evaluation of laboratory teaching at the All India Institute of Medical Sciences, New Delhi. Students' attitudes to OSPE and CPE were assessed by preparing a questionnaire containing 32 item statements on Likert's 5-point scale (LS) and 11 bipolar adjectives on Osgood's 7-point Semantic Differential Scale (OSDS). The questionnaire was administered to 50 medical undergraduates before their final examination. Forty-two (84%) students responded to the questionnaire. The LS showed high internal consistency and validity. Attitude scoring on LS and OSDS revealed a high degree of correlation. The majority of students showed a positive attitude to OSPE, and high-rank students had a greater intensity of positive attitude. OSPE was rated as a reliable, effective, useful, interesting and challenging examination, although considered taxing, mentally and physically. The students preferred a combination of OSPE and CPE as in the present system to a complete change-over to the OSPE. The item analysis of the questionnaire is discussed.

Objective structured practical examination: a new concept in assessment of laboratory exercises in preclinical sciences.

The objective structured practical examination (OSPE) was used as an objective instrument for assessment of laboratory exercises in preclinical sciences, particularly physiology. It was adapted from the objective structured clinical examination (OSCE). The OSPE was administered to two consecutive classes in conjunction with the conventional examination in which the candidate is expected to perform a given experiment. The scores of the students in the two components of the examination were used to compare the OSPE with the conventional examination and to evaluate the new instrument of assessment. The OSPE appears to be a reliable device with a good capacity for discriminating between different categories of students. It is better in these respects than the conventional practical examination. Moreover, it has scope for being structured in such a way that all the objectives of laboratory teaching can be tested and each aspect can be assigned the desired weightage.

Effect of natural background radiation on dermatoglyphic traits.

Long term exposure to natural background radiation could cause gross abnormalities in individuals and at the population level. Studies conducted on the coastal Kerala population which is known to be receiving fifteen times the normal permissible dose of radiation support this. This study aims at understanding the deviations, if any, in the normal human variation as a result of such high natural radiation. A detailed quantitative and qualitative dermatoglyphic study was done on two communities i.e. Hindus and Christians, living separately in the radiation area. The significant differences were observed between control and exposed groups with regard to d-t ridge count, distances c-t and angle atd. The susceptibility of the axial triradius to environmental distrubances is discussed.

Lung function in highlander Bods of Ladakh.

A cross-sectional sample of 221 male Bods, 11 to 19 years, from Leh, Ladakh, was studied to determine some biological responses to the environment. The higher forced vital capacity and increased association between chest measurements and respiratory function as well as increased chest dimensions of the Bods resemble the findings on highland Peruvians. These differences from lowland Bods and Indians may partially be attributable to low oxygen pressure in higher areas. However, the contributing effect of factors, viz. varying activity levels and genetics, cannot be dismissed.

Ventilatory capacity among highland Bods: a possible adaptive mechanism at high altitude.

Ventilatory capacity (forced vital capacity, forced expiratory volume and maximal voluntary ventilation) among Highland Bods (3514 m altitude) was higher than in an ethnically similar population residing at a lower altitude in Kulu Valley (1500--2200 m). Increased ventilatory capacity appears to have developed among native highlanders as a consequence of a biological response to high altitude. Numerous factors such as low oxygen pressure, increased work-load and minimal air pollution may explain these findings.

Growth trends among male Bods of Ladakh--a high altitude population.

A random sample of 274 native male Bods of Ladakh ranging in age from 11 to 19 years, living in Leh (Ladakh) at mean altitude of 3,514 metres, was studied. The pattern of growth of this sample was compared with the sea level Indians. The results indicate that: (1) The so called adolescent spurt is not well defined among Bod highlanders. (2) Bods grow faster than plain dwelling Indians and are taller and heavier at the age of 19 years. (3) The highlanders exhibit greater chest circumference than the lowland norms. This finding, similar to those among Andean natives, supports high altitude hypoxia's role in human growth and morphology.