Nutritional and Functional Status as a Predictor of Short-Term Mortality in Hospitalized Elderly Patients in a Tertiary Care Hospital.

Context Elderly people are at a high risk of malnutrition leading to poor outcomes and quality of life. Aims We aimed to find an association between the nutritional and functional status of hospitalized elderly patients and the three-month all-cause mortality among them. Settings and design A cross-sectional study was carried out at a tertiary care hospital in North India from July 2018 to December 2019. Methods and material A total of 177 patients were recruited for the study, and their demographic and clinical data were collected on a preformed questionnaire. Comorbidity, nutritional status, functional status, and depression were calculated using the Charlson Comorbidity Index (CCI), Mini Nutritional Assessment (MNA) form, Katz Index of Independence in Activities of Daily Living (Katz ADL), and Geriatric Depression Scale (GDS), respectively. Statistical analysis A Chi-square test was used to find the association between different qualitative variables. A regression model was used to find out the odds for mortality. Statistical significance was set at p<0.05. Results According to the MNA score, 49.7% (88) were at risk of malnutrition, and 22.6%(40) were malnourished. Malnutrition, Charlson Comorbidity Index, and the functional status of the patients were found to be associated with three-month mortality, with a p value of 0.005, 0.017, and 0.021, respectively. On regression analysis, malnutrition (odds ratio (OR): 3.796; 95% confidence interval (CI): 1.178-12.234; p=0.025) and the functional status (OR: 3.160; 95% CI: 1.256-7.952; p=0.015) of the study participants were found to have higher odds for three-month all-cause mortality. Conclusions Nutritional status and ADL assessed at the time of discharge are good prognostic markers of health outcomes in the elderly population. Key message ADL and nutritional assessment at admission and discharge should be routinely incorporated in the geriatric assessment of hospitalized patients to triage and prognosticate.

Stroke Characteristics as Predictors of New-onset Seizure in Patients with Acute Ischemic Stroke.

INTRODUCTION: The current guidelines on diagnosis and management of new-onset seizures in stroke are not well defined, especially in the Indian setting. Our study aims at providing insight into the hospital prevalence risk of new-onset seizures following ischemic stroke and to correlate seizure risk with the characteristics of stroke and other clinical parameters. METHODS: A total of 127 patients were analyzed for the study where we assessed the clinical severity and the imaging severity of stroke using the National Institute of Health Stroke Scale (NIHSS) score and Alberta Stroke Program Early CT (ASPECT) score, respectively. Seizure-related variables including semiology, timing, and details of antiepileptic drugs (AEDs) were assessed under the domain of early and late poststroke seizures (PSSs). All patients were followed for 6 months for the seizure recurrence and change in Barthel index. In statistical analysis, quantitative variables were compared using the independent t-test/Mann-Whitney U test, and qualitative variables were correlated using Chi-square test/Fisher's exact test. Univariate and multivariate logistic regression was used to find out the significant risk factors of acute symptomatic seizure. RESULTS: The mean age of the study population was 59.72 years (±14.77), with a male predominance (60.63%). About 78.74% of the cases had an NIHSS score more than or equal to 6.24% had posterior circulation strokes and the rest had anterior circulation strokes. A cortical location of infarct was observed in 62.2% of cases and a subcortical location in 61.4% of cases. The prevalence of early PSSs observed in our study was 10.6%. Of those, 80% had generalized seizures, 13.3% had focal seizures, and 6.67% had focal seizures with secondary generalizations. No patient in the study group had late-onset seizures. Total leukocyte count, serum protein levels, serum uric acid levels, and erythrocyte sedimentation rate (ESR) values were associated with early seizures (p<0.05). Patients with early seizures were found to have a longer hospital stay (8 vs 6 days with p<0.05). In the Trial of Org 10,172 in Acute Stroke Treatment (TOAST) etiological classification, an acute stroke of undetermined etiology was found to have a significant association with the occurrence of early seizure in both univariate and multivariate analysis [p = 0.030; odds ratio (OR) 4.735 (1.160-22.576)]. There was no difference in change in the Barthel index among the two groups. CONCLUSION: There was no recurrence of seizures in those who defaulted for AED and one patient had a seizure even on AED. Prophylactic AEDs in stroke patients based on stroke characteristics could not be ascertained, but the sample size was small. Knowing the fact that antiepileptics cause sedation and increase the chance of aspiration, continuing AEDs in patients who develop acute symptomatic seizures should be judged judiciously.

Immunoporosis: Role of Innate Immune Cells in Osteoporosis.

Osteoporosis or porous bone disorder is the result of an imbalance in an otherwise highly balanced physiological process known as 'bone remodeling'. The immune system is intricately involved in bone physiology as well as pathologies. Inflammatory diseases are often correlated with osteoporosis. Inflammatory mediators such as reactive oxygen species (ROS), and pro-inflammatory cytokines and chemokines directly or indirectly act on the bone cells and play a role in the pathogenesis of osteoporosis. Recently, Srivastava et al. (Srivastava RK, Dar HY, Mishra PK. Immunoporosis: Immunology of Osteoporosis-Role of T Cells. Frontiers in immunology. 2018;9:657) have coined the term "immunoporosis" to emphasize the role of immune cells in the pathology of osteoporosis. Accumulated pieces of evidence suggest both innate and adaptive immune cells contribute to osteoporosis. However, innate cells are the major effectors of inflammation. They sense various triggers to inflammation such as pathogen-associated molecular patterns (PAMPs), damage-associated molecular patterns (DAMPs), cellular stress, etc., thus producing pro-inflammatory mediators that play a critical role in the pathogenesis of osteoporosis. In this review, we have discussed the role of the innate immune cells in great detail and divided these cells into different sections in a systemic manner. In the beginning, we talked about cells of the myeloid lineage, including macrophages, monocytes, and dendritic cells. This group of cells explicitly influences the skeletal system by the action of production of pro-inflammatory cytokines and can transdifferentiate into osteoclast. Other cells of the myeloid lineage, such as neutrophils, eosinophils, and mast cells, largely impact osteoporosis via the production of pro-inflammatory cytokines. Further, we talked about the cells of the lymphoid lineage, including natural killer cells and innate lymphoid cells, which share innate-like properties and play a role in osteoporosis. In addition to various innate immune cells, we also discussed the impact of classical pro-inflammatory cytokines on osteoporosis. We also highlighted the studies regarding the impact of physiological and metabolic changes in the body, which results in chronic inflammatory conditions such as ageing, ultimately triggering osteoporosis.

Correlation of Serum Nitric Oxide (NO) with Glasgow Coma Scale (GCS) in Acute Ischemic Stroke Patient: A Study in North India.

Nitric oxide (NO) is one of the key players in the pathogenesis of ischemic stroke. Limited reports are available about the serum level of NO and their correlation with Glasgow Coma Scale (GCS) score in acute (<24 h) ischemic stroke (AIS) patients. A hospital based, cross sectional study was done in North Indian population to find out correlation of serum NO and GCS in AIS patients. 50 patients of AIS and 25 healthy controls were chosen for the study. Serum NO level was measured by ELISA and GCS scores were assessed by a neurologist. Pearson correlation coefficients were analyzed to look for the relationship between NO and GCS. Statistically highly significant elevation in mean serum NO level was observed in cases as compared to controls (p < 0.01). A negative correlation of NO levels with neurological score of GCS r (48) = -0.144, p > 0.05 was seen. This indicates oxidative stress in acute ischemic stroke may be the result of imbalance in oxidant/antioxidant homeostasis.

Age-Wise Association of Carotid Intima Media Thickness in Ischemic Stroke.

BACKGROUND: Ischemic stroke is often a sequel of atherosclerotic risk factors. Carotid intima-media thickness (CIMT) is a surrogate marker of early atherosclerotic changes. PURPOSE: It was hypothesized that CIMT is associated with ischemic stroke in adults across all ages. METHODS: A case control study was performed on 163 diagnosed cases of first-time ischemic stroke and age-(±1 SD) and gender-matched healthy control attendants reporting at a tertiary care hospital. Data were collected on atherosclerotic risk factors for ischemic stroke. CIMT from both the carotids was measured using carotid vascular Doppler. The demographic profile and CIMT with atherosclerotic risk factors of cases and controls across different age groups were compared using unpaired t test if they passed the test of normality, else the Mann-Whitney test was used. OR for vascular risk factors for the development of stroke was calculated. The relationship of CIMT to atherosclerotic risk factors was analyzed by using Spearman correlation and regression analysis. The level of significance was set at 0.05. RESULTS: Age-specific value of CIMT was significantly higher in stroke cases than in age-matched controls across all age groups. Right CIMT, along with the history of hypertension (HTN; OR 2.3), are important risk factors for ischemic stroke in the younger age group (20-40 years). With increasing age along with the history of HTN and right CIMT (OR >7), presence of plaque (OR 6.3) and daily smoking (OR 5.1) are also significant risk factors. CIMT is significantly related to the daily alcohol and smoking intake and the presence of plaques. Right CIMT is positively related to increasing age in normal population (R2 = 0.041; p < 0.001). CONCLUSIONS: Right CIMT and comorbid HTN are significant risk factors associated with the development of ischemic stroke across all adult age groups.

Blood pressure reduction following accumulated physical activity in prehypertensive.

CONTEXT: Accumulated moderate physical activity (PA) for 30 min in a day is the only recommended treatment of prehypertension. OBJECTIVE: We investigated autonomic modulation as a possible mechanism for the decrease in blood pressure (BP) during the rest periods in each 10 min session of PA. DESIGN SETTING AND PARTICIPANTS: We conducted a single-blind randomized multi-arm control trial on 40 prehypertensive (pre-HT) young male adults. METHODS: Participants were randomly divided by using random number table into four groups. Control (no intervention); Group 1 (walking at 50% of predicted VO2 peak); Group 2 (walking at 60% of predicted VO2 peak); Group 3 (walking at 70% of predicted VO2 peak). BP, heart rate variability (HRV), and heart rate recovery 1 min (HRR 1 min) were measured at baseline and during the rest period after each session of 10 min over 30 min of accumulated physical activity (PAcumm). RESULTS: Significant diastolic BP (DBP) reduction (P < 0.001) was observed during the rest period after each session of PAcumm in intervention groups. An average reduction in DBP was more in pre-HT undertaking PAcumm at 70% of predicted VO2 Peak. Decrease in the mean value of low-frequency (LF) and LF/high-frequency ratio was observed following PAcumm in all intervention groups irrespective of the intensity of PA. No significant association of reduction of BP with HRV and HRR 1 s was observed. CONCLUSION: Reduction in BP was observed during the rest period after each 10 min session of PAcumm irrespective of the intensity of PA. Autonomic modulation does not seem to be the possible mechanism for the reduction in BP during the sessions.

Arterial Compliance and Autonomic Functions in Adult Male Smokers.

INTRODUCTION: Smoking is known to augment sympathetic activity and may lead to increased arterial stiffness. Several studies have reported association of increased sympathetic activity and arterial stiffness to cardiovascular risks among smokers. Pulse Wave Velocity (PWV) of peripheral arteries, instead of aorta can be used as a non-invasive indicator of arterial stiffness. AIM: To measure non-invasively, the autonomic functions and peripheral arterial stiffness in smokers, and to find out whether the aforementioned factors are modified by the level of physical activity in these smokers. MATERIALS AND METHODS: This cross-sectional analytical study was conducted in the Department of Physiology, HIMS, Dehradun, over a period of 12 months (2013-2014) on 100 adult males (20-40 years); 50 smokers and 50 non-smokers. The parameters analysed include relevant anthropometric and cardiovascular parameters, Pulse Wave Velocity (PWV), sustained Hand Grip Test (HGT) and Heart Rate Variability (HRV) domains. Data interpretation and analysis was carried out using SPSS 17.0. Comparison of the above mentioned parameters amongst groups was done with unpaired t-test. The relationship of pack-years & physical activity with vascular functions was assessed by Pearson's correlation. Interaction of various grades of smoking and physical activity with Cardiovascular System (CVS) parameters was assessed by one-way ANOVA. RESULTS: Smokers had higher values of PWV (5.7±0.5m/s) as compared to non-smokers (4.8±0.4m/s) (p<0.001). ΔDBP during HGT was lower (7±3.18mmHg) among smokers as compared to non-smokers (19.4±3.5mmHg) (p<0.001). Smoking (pack-years) was positively related to PWV (r= .03) but showed a weak negative relationship with change in Diastolic Blood Pressure (ΔDBP) (r= -0.084, p=0.56) showing that, more the frequency of smoking, the more was arterial stiffening and the lesser was the sympathetic response to the HGT. The smokers had significantly higher sympathetic activity; Low Frequency (LF) & Low Frequency: High Frequency ratio (LF: HF) (p<.001) whereas High Frequency (HF) was significantly lower (p<.001) showing a decline in parasympathetic activity. CONCLUSION: Smokers demonstrated higher peripheral PWV and higher intrinsic sympathetic activity and this increase in intrinsic sympathetic activity may lead to increased arterial stiffness. Interaction of autonomic function and PWV with levels of physical activity and grades of smoking showed no significant differences, suggesting the fact that increased physical activity or reduced smoking may not have any effect on the endothelial dysfunction or CVS morbidity caused by smoking.

Assessment of Anthropometric Indices, Salt Intake and Physical Activity in the Aetiology of Prehypertension.

INTRODUCTION: Globally, prehypertension is responsible for approximately 62% of cardiovascular and 49% of ischemic heart disease (IHD) episodes. Current data from the Indian subcontinent suggests that prevalence of prehypertension was 47% amongst young urban residents. Considering its serious prognosis, the current study was undertaken to assess risk factors such as for cardiovascular diseases in prehypertensives adult males in Uttarakhand region. MATERIALS AND METHODS: This cross-sectional analytical study was conducted in the Department of Physiology, HIMS, Dehradun, over a period of 12 months. Volunteers (20-40 years) were divided into two groups; Group I (Controls): normotensives and Group II (Cases): prehypertensives based on JNC VII classification. RESULTS: Exercise capacity, determined by peak VO2 consumption was significantly lower in prehypertensive group than the normotensive group (p<0.001). Daily salt intake of pre-hypertensives was significantly greater than the normotensive subjects (p<0.001). Multiple Linear Regression analysis revealed that average baseline SBP increases by 0.34 mmHg for every 1 kg increase in weight and average baseline DBP increases by 0.25 mmHg for every 1 year increase in age. CONCLUSION: Exercise capacity was found decreased in pre-hypertensives and they have high daily salt intake. Also, weight and age emerged as independent risk factors for SBP and DBP respectively.

Pattern Reversal Visual Evoked Potential and Cognitive Functions in Subclinical Hypothyroid Subjects.

BACKGROUND: Central nervous system (CNS) involvement is insidious and may occur early in subclinical hypothyroid (SCH) state which can be picked up by electrophysiological study. This study aims to record visual evoked potential (VEP), event-related latency and cognitive functions, and find their association with the levels of serum thyroid-stimulating hormone (TSH) in patients with SCH. MATERIALS AND METHODS: In this cross-sectional study, 36 adult SCH patients and an equal number of age- and sex-matched euthyroid controls were included. Pattern reversal VEP, visual reaction time (RT), digit spanning test, and AB clock test (ABCT) were done in both SCH cases and euthyroid controls. The observed values were analyzed for comparison of mean values between the groups and correlation of recorded variables with the levels of serum TSH. RESULTS: SCH cases showed a higher P100 (VEP) latency in both the right (103.2 ± 12.3 vs. 102.7 ± 6.8 ms) and left eye (101.1 ± 9.1 vs. 96.2 ± 10.7 ms) as compared to controls, but the difference was statistically insignificant. A significant delay in RT was observed on visible spectra of light in SCH cases (P < 0.001). Digit spanning score (forward and backward) in SCH cases was significantly lower than controls (P < 0.001), and a lower standardized score (<124 or <95th percentile) was significantly associated with SCH state (P = 0.027). No significant difference was observed in visuospatial domain by ABCT between both the groups although the median score was lower in SCH cases. Only digit spanning score showed a significant negative correlation with TSH levels (r = -0.4; P = 0.001). CONCLUSION: Decline in working memory and RT to visual stimuli is an evidence of the involvement of CNS in SCH. Prolonged latency in VEP may depend on the duration of SCH.

Autonomic Function Tests in Prehypertensive Young Adult Males of Uttarakhand Region.

Pre-hypertensives are at increased risk for rise in blood pressure and cardio vascular morbidities. Autonomic dysfunction is both a cause and effect of high blood pressure. Considering its serious prognosis the current study was undertaken with an aim to assess autonomic functions in pre-hypertensive young adult males. Male volunteers of 20-40 years were divided into normotensives (n=44) and clinically healthy pre-hypertensives (n=44). They were subjected to anthropometric measurements, Heart Rate variability (HRV) analysis along with Standard Isometric Handgrip Test (HGT) and Sinus arrhythmia test. Analysis showed a significant increase in sympathetic activity among prehypertensives characterized by lower rise in DBP (mmHg) in response to HGT: [11.27±3.76 mmHg vs 23.95±6.29 mmHg, (p<0.05)]. Parasympathetic activity was significantly decreased among prehypertensives (HFnu: 30.02±14.43 vs 41.62±14.91, p<0.05); E/I ratio: 1.20±0.10 vs 1.32±0.10, p<0.05). Sympathovagal balance showed prominent sympathetic activity (2.85±1.78 vs 1.75±0.98; (p<0.01) among prehypertensives. Salt intake among prehypertensives was significantly higher than normotensives (21.2±1.2 gm/day vs 9.0±0.5 gm/day: P<0.001). Conclusion: Autonomic dysfunction is evident in prehypertensives with an enhanced sympathetic activity, decreased parasympathetic activity and an altered sympathovagal balance in prehypertensives, salt intake was found on a higher side. Thus lifestyle changes in the form of balanced diet and moderate exercise may be advised to attenuate the risk progression of prehypertension to hypertension.

Gender correlation of stress levels and sources of stress among first year students in a medical college.

Medical courses in India are very demanding for the students thus making career in medical education very stressful. The study was designed to determine the prevalence of stress levels in 100 first year medical students and to explore the sources of stress & it's relationship across the male and female students. Demographic information and Qualitative data from investigator tailored Medical Student Stress Questionnaire (MSSQ) by self rating under supervision of investigators were subjected to a thematic analysis. Stress perceived was more in males students (82.2%) as compared to females (61.8%) and their MSSQ index score was significantly different (U=985; P=0.02). Moderate to high academic stress was present among 79% of students more so in males with the academic domain score significantly different from that of females (U=883; P=0.007). Females perceived more stress in inter personal domain (12.7%) with the score significantly different from males (U=953.5; P=0.02). Group and Teaching stress was equally present in males and females.

Dolichos biflorus Linn. ameliorates diabetic complications in streptozotocin induced diabetic rats.

BACKGROUND: Horsegram (Dolichos biflorus Linn.) is a known antilithiatic, hypolipedemic and has free radical scavenging activity and increased production of reactive oxygen species play a role in pathophysiological mechanisms that trigger diabetic complications. AIM: To see the effect of daily oral feeding of D.biflorous on nephropathy and retinopathy in streptozotocin (STZ) induced-diabetic rats. MATERIALS AND METHODS: A total of 24 healthy rats were randomly grouped into controls, diabetic and diabetic on Dolichos. Diabetes was induced by a single dose of STZ (55 mg/kg) and animals were given prepared food and water ad libitum. Dolichos was orally given at 300 mg/kg/day to rats in diabetic on Dolichos group for next 30 days. Fasting blood glucose levels was monitored at beginning and at the end of the experiment while assessment of serum creatinine levels and histopathological study of kidney and retina was carried only at the end of the experiment. Statistical differences between groups were analyzed using analysis of variance followed by, Bonferroni test as posthoc test. RESULTS: Results indicated improvement in serum creatinine levels and reduced glomerular sclerosing and Bowman's space with interstitial alterations and significantly reduced renal hypertrophy in diabetic rat son Dolichos diabetic rats (P < 0.001). Retinal layers showed inconsistent improvement in the width of the neuronal layers and decreased vacuolization of plexiform layers and retinal vessel density. CONCLUSION: D. biflorus at doses of 300 mg/kg/day for 30 days resulted in gradual but significant decreased diabetic nephropathy.

Effect of mobile usage on serum melatonin levels among medical students.

Exposure to extremely low frequency (ELF) electromagnetic radiations from mobile phones may affect the circadian rhythm of melatonin in mobile users. The study was designed with objective to evaluate the influence of mobile phone on circadian rhythm of melatonin and to find the association if any between the hours of mobile usage with serum melatonin levels. All the volunteers medical students using mobiles for > 2 hrs/day were included in high users group and volunteers who used mobile for ≤ 2 hrs where included in low users group. Both high and low users volunteers were sampled three times in the same day (Morning-3-4 am, Noon 1-2 pm, Evening-5-6 pm) for estimation of serum melatonin levels: Comparsion of sernum melatonin levels in high users and low users were done by Mann Whitney "U" Test. Reduced morning melatonin levels (3-4 am) was observed in high users (> 2 hrs/day) i.e high users had a disturbed melatonin circadian rhythm.There was a negative correlation between melatonin secretion and hours of mobile usages.

Effect of Dolichos biflorus on blood sugar and lipids in diabetic rats.

Diabetes mellitus is a chronic disease characterized by hyperglycemia and dyslipidemia, which leads to severe morbid complications. In view of the effectiveness of conventional herbal adjutants the present study was taken to assess the anti-diabetic and anti-lipidemic effect of Dolichos biflorus. 32 healthy albino rats of either sex were randomly divided into 4 equal groups (I-IV) each having 8 rats. Group I, control rats received only vehicular fluid while Group II received only Dolichos biflorus for the experimental period of 30 days. Diabetes was induced in Group II and Group IV rats by single intravenous dose of STZ and confirmed on 3rd day with fasting blood sugar (FBS) more than 250 mg/dl. Group III diabetic rats, received vehicular fluid while Group IV diabetic rats received Dolichos biflorus in single dose of 300 mg/kg body weight/day intra-gastrically up to the experimental period of 30 days. FBS levels were assessed on 1st, 8th, 15th, 22nd and 30th day. On last day overnight fasted rats were sacrificed for drawing the sample for lipid profile from beating heart and harvested for pancreatic tissue histology. Data obtained showed that FBS levels were decreased significantly when Dolichos biflorus was given to diabetic rats from mean +/- SD values 362 +/- 63.36 to 118 +/- 38.55 with p value < 001. S cholesterol and S. triglyceride levels were also decreased significantly with P value < 001. It was concluded that Dolichos biflorus has anti-diabetic and anti-lipidemic effect at daily oral dose and can be used as an adjuvant for management of diabetes mellitus and its associated complications.

Effects of curcumin on the gastric emptying of albino rats.

Curcumin (diferuloylmethane), a polyphenol, is an active principle of the perennial herb Curcuma longa commonly known as turmeric. Turmeric (CURCUMA LONGA L.) is a medicinal plant extensively used in Ayurveda, Unani, and Siddha medicine as a home remedy for various diseases including biliary diseases, cough, hepatic diseases, wound healing. However studies on the effect of curcumin on the gastric emptying are nearly nonexistent. It is hypothesized that curcumin may have an effect on gastric emptying. For this reason the present study was aimed to study the effect of curcumin on gastric emptying. Rats were divided into 5 groups (Group I - Group V), based on the time interval between administration of curcumin/vehicular fluid to administration of barium sulphate (Group I - 1 hr, Group II - 8 hrs, Group III - 16 hrs, Group IV - 24 hrs, Group V - 48 hrs). Each group was further divided into two subgroups, Group A (control) and Group B (experimental), containing 6 rats each. Rats in experimental group were administered curcumin intragastrically, in the dose of 1 gm/kg body weight, suspended in normal saline (0.9% NaCl). The controls were given vehicular fluid intragastrically, in volume equal to the experimental animals. It was observed that there was a decrease in the gastric emptying in all the experimental groups.

Clinical validation of aneroid sphygmomanometer.

Recent concerns about the mercury toxicity and its ill effects on the environment and health has led to widespread use of aneroid manometers. Present study was conducted to analyse whether this change would lead to any systematic shift in measured blood pressure or consistency of blood pressure measurement in clinical setting. The clinical accuracy of the Welch Allyn aneroid sphygmomanometer model 7670-04 was studied against the mercury sphygmomanometer on 83 volunteers from Dehradun. Two blood pressure reading of each study subject was recorded with pretested instruments (aneroid and mercury sphygmomanometer). Data analysis showed the difference of means between the reading of two devices against mean of the observer reading for both systolic (-3.62 +/- 4.88) and diastolic (-2.36 +/- 3.77) blood pressure were not statistically different. The corresponding values of the SBP and DBP from both the instruments showed significant correlation. Regression analysis of mercury versus aneroid showed regression line (Y = 9.52 + 0.95X for SBP, Y = 0.36 + 0.96X for DBP) significantly different from line of equality (P < 0.001). The study has demonstrated that the aneroid device (model: 7670-04) achieved grade B performance according to the British Hypertensive Society criteria.

Adiposity: determinant of peak expiratory flow rate in young Indian adults male.

BACKGROUND: Although several factors such as respiratory muscle strength, lung compliance, resistance to airflow, and even obesity affect the lung functions, the nature of relationship with markers of adiposity is not clear. We hypothesised that central pattern of fat distribution is a significant predictor of decreased peak expiratory flow rate (PEFR). The present study was designed with the aim to examine the effects of adiposity on PEFR in males. METHODS: One hundred young healthy male volunteers were analysed in the study. They were classified into non-obese, and obese groups based on body mass index (BMI) (obese > or = 30 Kg/m2 and non-obese < 30 Kg/m2). The PEFR was measured by using Wright's peak flow meter. Data was analysed using unpaired 't' test for statistical significance of differences between the non-obese and the obese, stratified into age groups of 20 to 30 years and 30 to 40 years. A partial correlation adjusted to age, height and BMI followed by regression analysis was conducted using adiposity markers as a predictor of PEFR. RESULTS: The model adjusted to age, height, weight and BMI revealed waist hip ratio (WHR) as the only parameter which shows significant variance in PEFR with a Pearson's r=-0.59, F (1, 100)=12.23, p=0.04. The resulting linear regression equation is y=-388.72xWHR+850.68. CONCLUSIONS: Our findings suggest that obesity itself and especially the pattern of body fat distribution have independent effects on PEFR. These results suggest that abdominal adiposity, measured as WHR, is a better predictor of expiratory flow than weight or BMI.

Effect of gender on correlation of anaemia with body mass index in medical students.

Nutritional anemia exists globally and cuts across all the sections of the population. Adolescent being formative years in life are more susceptible to nutritional anemia. Considerable changes in growth pattern, lifestyle, dietary habits & behavior are likely to influence the hemoglobin levels among male and females of high income group. Study was done to assess the level of anemia among medical students and it's relation to Body mass index (BMI) among medical students. 200 healthy medical students at the Himalayan Institute of Medical Sciences belonging to both the sexes were taken in the study. Following consent anthropometry was conducted using standard protocol. Body Mass Index of >/= 18.5 kg/m2 is used to define undernutrition. Hemoglobin was estimated in gram %. Statistical analyses was done using mean .Standard deviation, Student's t test, and was studied for effect of gender on correlation of anemia with BMI. 8% of the students of MBBS were found to be anemic (Hb <12 g%) with none of the boys having hemoglobin <12 g% .15.5% under nutrition was observed in the medical students with (25.75%) of girls having a BMI of <18.5 kg/m2. A negative association of hemoglobin was found with nutritional status (BMI) (r = -0.59; P = 0.24) in over weight and obese females students. Nutritional anemia and under nutrition exist among female medical students who are literate, and have free access to the nutritive diet in a good healthy environment.

Effects of vincristine on the bile flow in male albino rats.

Bile secretion is an important function served by the liver. The microtubular system integrity plays a key role in hepatic transport and excretion of several of bile constituents including phospholipids & cholesterol as well as detoxified xenobiotics. Furthermore, an alteration in bile secretion has been proposed as an important cause of enteritis, also a complication of microtubular inhibitors like Vincristine (VCR) that may occur following treatment as an anti cancer drug. The study aims to study the effects of microtubule inhibitor VCR on bile flow and bile composition in rats. For this purpose, male albino rats were studied. One group of five rats was infused with single IV dose of VCR (@1 mg/kg and the other received equal volume of IV vehicular fluid. For bile samples, animals were cannulated, bile flow examined at different time intervals before and after drug administration. Biliary composition studied at second hour post i/v administration. Single dose VCR treatment showed significant rise in the baseline excretion of bile in animals studied during first 2 hrs, although, there was a mild reduction in the biliary flow rate after few hours. Biliary total cholesterol was decreased and cation concentrations increased significantly in the second hour post VCR. The results indicate that the exposure of rats to VCR induces early alterations in biliary secretion. This study may prove useful for the purpose of understanding enteritis in patients undergoing chemotherapy.

A study on substance abuse among school going male adolescents of Doiwala Block, District Dehradun.

Adolescent boys are recognized as a vulnerable group to substance abuse. The present study has the objective to study the biosocial profile and habit pattern of substance abusers. The study was conducted on 511 male adolescents, students of 10 th to 12 th class from the four intermediate schools of the Doiwala block of Dehradun district. 46.9% students accepted substance abuse. In 75.5% cases, friends were providing the substances. 80.2% substance abusers expressed their desire to quit the habit. The study is indicative of need for developing a supportive environment involving both parents and teachers so that adolescent can decide and sustain with the right choices for healthy life.