Archive for December, 2011

Pain – a glimpse of its history, recent understanding, types and pharmacotherapy

Abstract Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. For more than a century, views on the nature of pain sensation have been dominated by three major theories – the Specificity theory by Frey, the Intensivity theory by Goldscheider and the Gate-Control theory by Melzack and Wall.  There are various types of somatic and visceral nociceptors that can activate a somatic or visceral pain pathway. Neurochemical reactions at the site of injury activate the nociceptors which initiate an afferent impulse that enters the spinal cord, traverses specific ascending spinal tracts and reaches cerebral centers for interpretation. Nociceptive information is transmitted from the spinal cord to the thalamus and cerebral cortex along five ascending pathways. The intensity of pain sensation can be modulated at the periphery, the spinal cord, midbrain, and cerebral cortex,  by various mechanisms such as the Gate control theory, neurotransmitter substances such as enkephalin and endorphins, and descending pain modulatory systems.  This article summarizes the theories of pain, somatic and visceral pain, its pathways, viscero-somatic convergence, neurotransmitters of pain, pain syndromes and therapeutic modalities used for pain control.

COMPARISON OF CARDIAC AUTONOMIC ACTIVITY AND BMI IN DIFFERENT PHASES OF MENSTRUAL CYCLE USING HEART RATE VARIABILITY

ABSTRACT: Aim:  The aim of this experiment was to compare the cardiac autonomic activity and BMI in the different phases of menstrual cycle using Heart rate variability. Context Heart rate variability (HRV) in women has been related independently to endogenous sex hormones, hormone replacement therapy, menopause, menstrual cycle, body mass index (BMI), and physical conditioning .It has become a popular non invasive tool for assessing the activities of autonomic nervous system.  Objectives: The aim of this experiment was to compare the cardiac autonomic activity and BMI in the different phases of menstrual cycle using Heart rate variability Design: Prospective comparative study during one menstrual cycle. Study setting A total of 54 female students  were  selected. The selected students were divided into two Group I (BMI < 20) and Group II (BMI >20) the ECG recording   were taken  during  the   3 phases of menstrual  cycle. The analog ECG signal were conveyed through an A/D converter to PC and were analyzed .The frequency domain analysis was done in which the LF,HF  and LF/HF components were studied. Results: In   group II (BMI>20)) there was a significant increase in the LF/HF ratio in the luteal phase of menstrual cycle when compared to other phases of the menstrual cycle. In group I (BMI < 20) there was no statistically significant difference in LF/HF ratio in the three phases . Conclusion: Woman  between  16-25  years  having  less  BMI  had  more  parasympathetic  activity  than those  with  greater  BMI.  In women   with greater BMI cardiac autonomic activity   had a predominant sympathetic profile. 

Resting B.P. and Cold Pressor Test in Policemen in Dhule City

ABSTRACT: Background: Present study was carried out on 135 policemen of Dhule city who came voluntarily as subjects for the project. Aim: To find level of cardio vascular status.  Objective: To measure Resting B.P., response to stress by cold presser test. Material: 135 policemen who came voluntarily as subjects for the project. Setting and Design: It was a cross sectional study. Out of 135 policemen 18 were between 20-30 years age, 41 were between 31-40 years age, 55 between 41 to 50 years age and 21 were between 51 to 60 years age. Method: Resting B.P measured using mercury sphygmomanometer, Response to stress using Cold presser test. Results: were tabulated based on age groups.  It was found that prevalence of Hypertension was 24.44% Associated risk factors such as obesity i.e.(BMI>25kg/m2.) was 37.03%,cold presser test abnormal in 47.40%,  Indicating vulnerability of this population to cardiac disorders. Conclusion: The background of increase obesity&stressful life adds burden on cardiovascular system leading to increase prevalence of cardio- vascular disorders in policemen compared to general population

ABSTRACT  OBJECTIVE: To measure the blood pressure and heart rate responses at various intensities, in three trimesters of pregnancy to the sustained isometric exercises, by handgrip dynamometry and comparing the results with the controls.   MATERIALS AND METHODS:  subjects – 20 healthy pregnant women, Controls – 20 non-pregnant healthy women. Subjects were followed for three trimesters. Blood pressure and heart rate were evaluated with handgrip dynamometer at Rest, 20% and 30% intensities of maximum voluntary contraction and Post Exercise. Blood pressure and Heart rate were recorded with the help of Sphygmomanometer, Stethoscope, and ECG machine. RESULTS: Blood pressure and heart rate increased more during sustained handgrip exercise in Subjects than the Controls. At rest and during static exercise blood pressure reduced in First, Second and increased in Third trimesters, compared to controls. At rest and during static exercise heart rate increased in First, Second trimesters and Third trimester displayed steady levels when compared to the controls. Maximum voluntary contraction in the Controls was higher than the Subjects. CONCLUSION: Sustained isometric exercise produces an increase in hemodynamics during different trimesters of pregnancy.   

Dynamic lung profile in sugarcane industry workers

ABSTRACT   Context: Airway diseases are commonly encountered with people exposed to dust constantly, which over a period of time may affect lung function. Objective: To study the lung function profile in asymptomatic sugarcane industry workers to find out airway diseases if any, and their correlation with duration of exposure to the dust. Design: The pulmonary function tests were studied with MEDSPIROR, in age matched sugar factory male workers exposed to sugarcane dust (n=95), and normal healthy controls (n=100) from Marathwada region of Maharashtra, during years 2009 to 2010.  The cases and controls were chosen upon detailed history. Cases and controls were divided in 3 groups namely 15 to 25 years, 26 to 35 years and more than 35 years to study various parameters like FVC, PEFR, FEF 25 – 75, FEV1 % & MVV among cases compared with age matched controls. Another distribution was done according to the duration of exposure amongst the cases 1-4 years n=48, 5 – 9 years n-25 and > 9 years n=22. Main outcome of the study: Lung functions were found to be reduced in all cases as indicated by different parameters of PFT .  Results: A highly significant decrease in FVC and PEFR in all age groups, even MVV and FEF 25 – 75 showed a highly significant decline in first two groups and a significant decline in the third. There was a non significant increase in FEV1 % in the first two groups whereas a non-significant decline in cases above 35 years when compared with age matched controls. There was a highly significant decline in FVC amongst the cases when compared with increasing duration of exposure, although other parameters also showed a non significant decline. Conclusion: It may be concluded that the decline in PFT parameters in all the age groups is suggestive of restrictive and obstructive changes and with predominance of parenchymatous lesions when exposed to mouldy bagasse for longer duration

ABSTRACT Background : Dyslipidemia in chronic renal insufficiency is one of the factors contributing to atherosclerosis and cardiovascular abnormalities. Changes in lipid status and their relation to severity of the disease is an active area of research, both in predialysis chronic kidney disease (CKD) patients and in patients on maintenance hemodialysis (HD).Aim and objectives: we have undertaken this study with a view of analyzing the abnormal lipid profile pattern including Lipoprotein(a) or Lp(a), total cholesterol, triglycerides, Low Density Lipoprotein(LDL) and High Density Lipoprotein(HDL), in all stages of predialysis CKD patients and their correlation with GFR. we have also attempted to study the abnormal lipoprotein metabolism in patients on maintenance hemodialysis (CKD stage V). Materials and methods: A total of 100 non diabetic subjects were further divided into 4 subgroups based on the GFR. Group1 comprising of healthy controls, group 2 of stage I and II CKD patients, group 3 of stage III and IV CKD patients and group 4 of stage V CKD patients on hemodialysis. Fasting blood samples were collected and analyzed for Lp(a), total cholesterol, triglycerides and HDL levels. LDL,GFR and BMI were the calculated parameters. GFR was calculated using MDRD formula and LDL by Freidwald’s formula. Statistical analysis: Statistical analysis was performed using SPSS version 16. One-way analysis of variance (ANOVA) and Pearson’s Correlation co-efficient and Regression equation were done.   Results: There is an increase in serum Lp(a) levels in all stages of CKD patients but significant increase is seen in groups 3 and 4 patients compared to that of the control group 1 (P<0.01). There is a significant rise in serum triglyceride levels in group 3 patients from that of the controls (P<0.01). There is a decrease in total cholesterol levels in group 4 patients compared to the controls (P<0.01).On comparison of serum LDL levels of controls with the other 3 groups, there is a significant elevation in groups 3 and 4 patients (P<0.01). There is no significant change in the serum HDL levels among the 4 groups. A negative significant correlation has been observed between Lp(a) and GFR. Conclusion: The abnormal lipoprotein pattern especially Lp(a) seen in chronic renal failure patients may start early and progress with the declining renal function. These dysregulated lipoproteins may contribute to atherosclerosis and cardiovascular disorders which is the leading cause of death in these patients.