The novel coronavirus disease 2019 (COVID-19) pandemic has caused a turmoil in the health-care delivery system and challenged consumers’ sense of well-being. This study examines the evolving consumer expectations and explores the key interventions that health-care providers can employ to increase engagement with consumers and prepare organisations to cope with post-pandemic challenges. We conducted a cross-sectional survey of 715 randomly selected patients visiting three secondary diabetes care centres across Andhra Pradesh – Vijayawada, Tenali and Tirupati between December 2020 and January 2021. We collected participants demographic data and history of comorbidities. During lockdown, 59.3% of the respondents were concerned about health management, 63.9% expressed fear of contracting infections while visiting hospitals. Majority (70%) did not prefer visiting hospitals treating COVID-19 patients, while 18.3% reluctantly consider only if COVID-19 ward was kept isolated. Measures such as wearing personal protective equipment sanitisation and thermal screening and social distancing in outpatient settings/waiting areas were demanded by 89.7%, 84.5% and 60% of respondents, respectively. Concurrently, there is an increasing trend (from 2.8% to 24.9%) in teleconsultation. About 31.7% show an inclination to continue teleconsultations even after COVID-19 era with 51.7% recognising telemedicine as a time-saving option. Among interested patients (54%) with no prior experience of telemedicine, 41.5% reported concerns due to lack of technical equipment and improper training. About 23.1% were skeptical of effective personalised treatment. Sample collections at home (75.3%), home monitors (63.3%), medication delivery (47.3%) and telemedicine (31.7%) are preferred choices. On a real-time basis, participants are willing to share their health status-related data with their health-care team. Succumbing to the worldwide COVID-19 experience, both health-care providers and patients need to adopt and devise a ‘new normal’, a paradigm for addressing both health-care providers’ and patients’ requirements.
{"title":"A study of changing trends in consumer preferences and perspectives towards health-care services during the pandemic","authors":"Srikanth Medimpudi, Lucklin Medimpudi, Lakshmana Rao Ayyagari, Jeswanth Araveti, Mahesh Kadiri","doi":"10.25259/ijpp_454_2021","DOIUrl":"https://doi.org/10.25259/ijpp_454_2021","url":null,"abstract":"\u0000\u0000The novel coronavirus disease 2019 (COVID-19) pandemic has caused a turmoil in the health-care delivery system and challenged consumers’ sense of well-being. This study examines the evolving consumer expectations and explores the key interventions that health-care providers can employ to increase engagement with consumers and prepare organisations to cope with post-pandemic challenges.\u0000\u0000\u0000\u0000We conducted a cross-sectional survey of 715 randomly selected patients visiting three secondary diabetes care centres across Andhra Pradesh – Vijayawada, Tenali and Tirupati between December 2020 and January 2021. We collected participants demographic data and history of comorbidities.\u0000\u0000\u0000\u0000During lockdown, 59.3% of the respondents were concerned about health management, 63.9% expressed fear of contracting infections while visiting hospitals. Majority (70%) did not prefer visiting hospitals treating COVID-19 patients, while 18.3% reluctantly consider only if COVID-19 ward was kept isolated. Measures such as wearing personal protective equipment sanitisation and thermal screening and social distancing in outpatient settings/waiting areas were demanded by 89.7%, 84.5% and 60% of respondents, respectively. Concurrently, there is an increasing trend (from 2.8% to 24.9%) in teleconsultation. About 31.7% show an inclination to continue teleconsultations even after COVID-19 era with 51.7% recognising telemedicine as a time-saving option. Among interested patients (54%) with no prior experience of telemedicine, 41.5% reported concerns due to lack of technical equipment and improper training. About 23.1% were skeptical of effective personalised treatment. Sample collections at home (75.3%), home monitors (63.3%), medication delivery (47.3%) and telemedicine (31.7%) are preferred choices.\u0000\u0000\u0000\u0000On a real-time basis, participants are willing to share their health status-related data with their health-care team. Succumbing to the worldwide COVID-19 experience, both health-care providers and patients need to adopt and devise a ‘new normal’, a paradigm for addressing both health-care providers’ and patients’ requirements.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41785392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heart rate variability (HRV) is the beat-to-beat variation of heart rate and an important non-invasive tool to study the cardiac autonomic nervous system activity. Ischaemic heart disease (IHD) patients are often considered to have a state of sympathetic predominance. Elimination of myocardial ischaemia with percutaneous coronary intervention (PCI) could restore autonomic balance. Hence, this study aimed to evaluate HRV measures, after successful revascularisation among IHD patients. A total of 145 male IHD patients planned for coronary angiography were recruited. Fifteen minutes of electrocardiogram recording was done. Short-term HRV analyses of all the patients were acquired and time-domain indices (standard deviation of normal-to-normal intervals [SDNN], root-mean-squared differences of successive R-R intervals [rMSSD]) and frequency-domain indices (low-frequency [LF] power, high-frequency [HF] power and total power [TP]) were analysed. Before and after PCI, all measurements were made. This study included 145 male IHD patients with the mean age of 54.57 ± 10.81 years. There was a significant decrease in SDNN, rMSSD, LF, HF and TP whereas increase in LF/HF ratio following revascularisation. These changes in measures of neurocardiac regulation correlated with risk factors and medication on regression analysis. Increase in LF/HF ratio with the decrease in SDNN, rMSSD, LF, HF and TP in patients with IHD who underwent coronary intervention infers changed cardiac autonomic balance with this surgical procedure. These measures could be potentially used as prognostic measures in the future studies.
{"title":"Alterations in heart rate variability before and after percutaneous coronary intervention in patients with ischaemic heart disease","authors":"S. Seetharam, V. Ms, K. Udupa, N. Reddy, R. A","doi":"10.25259/ijpp_228_2022","DOIUrl":"https://doi.org/10.25259/ijpp_228_2022","url":null,"abstract":"\u0000\u0000Heart rate variability (HRV) is the beat-to-beat variation of heart rate and an important non-invasive tool to study the cardiac autonomic nervous system activity. Ischaemic heart disease (IHD) patients are often considered to have a state of sympathetic predominance. Elimination of myocardial ischaemia with percutaneous coronary intervention (PCI) could restore autonomic balance. Hence, this study aimed to evaluate HRV measures, after successful revascularisation among IHD patients.\u0000\u0000\u0000\u0000A total of 145 male IHD patients planned for coronary angiography were recruited. Fifteen minutes of electrocardiogram recording was done. Short-term HRV analyses of all the patients were acquired and time-domain indices (standard deviation of normal-to-normal intervals [SDNN], root-mean-squared differences of successive R-R intervals [rMSSD]) and frequency-domain indices (low-frequency [LF] power, high-frequency [HF] power and total power [TP]) were analysed. Before and after PCI, all measurements were made.\u0000\u0000\u0000\u0000This study included 145 male IHD patients with the mean age of 54.57 ± 10.81 years. There was a significant decrease in SDNN, rMSSD, LF, HF and TP whereas increase in LF/HF ratio following revascularisation. These changes in measures of neurocardiac regulation correlated with risk factors and medication on regression analysis.\u0000\u0000\u0000\u0000Increase in LF/HF ratio with the decrease in SDNN, rMSSD, LF, HF and TP in patients with IHD who underwent coronary intervention infers changed cardiac autonomic balance with this surgical procedure. These measures could be potentially used as prognostic measures in the future studies.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45412922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Tayade, Simran Kaur, Suriya Prakash Muthukrishnan, Ratna Sharma, Gaurav Saini
The map topography analysis gives an idea of temporal dynamics of electric fields, which is reference independent, making the results unambiguous. These topographic maps remain stable for 80 to 100 milliseconds, abruptly shifting to a new topographic map configuration and remains stable in that state are called the ‘functional microstates’ as described by Lehmann et al (1987). There has been no study done in the resting state eye closed and eye open conditions showing the microstate maps in healthy Indian subjects in resting eyes open and resting eyes closed condition using 128 channel EEG. So our study aim was to assess the microstates in resting eyes closed and eyes open condition. And to compare the microstate parameters such as mean duration, global explained variance (GEV) and time coverage between eyes closed and eyes open condition. A cross-sectional and observational study on 20 indian subjects (Mean age- 26.65 and (SD) - 2.78 years) was done on resting eyes closed and eyes open conditions. After EEG acquisition using 128 channel EEG machine, EEG was preprocessed and microstate analysis using CARTOOL software was performed on the EEG data. After microstate analysis four maps topography were obtained. There was statistically non-significant difference observed in microstate maps between resting eyes closed and resting eyes open condition for the all parameters i.e. mean duration, time coverage and GEV. Our findings suggests that, both eyes closed and eyes open conditions were similar to each other in terms of stability and predominance of Maps.
{"title":"EEG microstates in resting condition in young indians","authors":"P. Tayade, Simran Kaur, Suriya Prakash Muthukrishnan, Ratna Sharma, Gaurav Saini","doi":"10.25259/ijpp_44_2022","DOIUrl":"https://doi.org/10.25259/ijpp_44_2022","url":null,"abstract":"\u0000\u0000The map topography analysis gives an idea of temporal dynamics of electric fields, which is reference independent, making the results unambiguous. These topographic maps remain stable for 80 to 100 milliseconds, abruptly shifting to a new topographic map configuration and remains stable in that state are called the ‘functional microstates’ as described by Lehmann et al (1987). There has been no study done in the resting state eye closed and eye open conditions showing the microstate maps in healthy Indian subjects in resting eyes open and resting eyes closed condition using 128 channel EEG. So our study aim was to assess the microstates in resting eyes closed and eyes open condition. And to compare the microstate parameters such as mean duration, global explained variance (GEV) and time coverage between eyes closed and eyes open condition.\u0000\u0000\u0000\u0000A cross-sectional and observational study on 20 indian subjects (Mean age- 26.65 and (SD) - 2.78 years) was done on resting eyes closed and eyes open conditions. After EEG acquisition using 128 channel EEG machine, EEG was preprocessed and microstate analysis using CARTOOL software was performed on the EEG data.\u0000\u0000\u0000\u0000After microstate analysis four maps topography were obtained. There was statistically non-significant difference observed in microstate maps between resting eyes closed and resting eyes open condition for the all parameters i.e. mean duration, time coverage and GEV.\u0000\u0000\u0000\u0000Our findings suggests that, both eyes closed and eyes open conditions were similar to each other in terms of stability and predominance of Maps.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49497141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skiing is practiced by the security forces posted at mountain areas for patrolling, securing borders, taking up rescue missions and sometimes as recreational activities. A study was planned to assess physiological and mental stress of a military ski activity through the measurement of heart rate (HR) variability, task load and perceived exertion. Eleven healthy Indian soldiers, trained with skiing techniques, participated in a 15 km skiing with 22 kg equipment at a predetermined snowy mountainous track. Pre- and post-exercise HR and HR variability (HRV) were recorded (bio-harness, Zephyr, USA) and questionnaires, namely NASA task load index (NASA-TLX) and Borg’s rating of perceived exertion (RPE) scale, were filled after exercise. Time and frequency domain parameters such as HR, variations between successive RR intervals (RMSSD), standard deviation of RR (SDNN) and percentage value of NN50 (pNN50), low- and high-frequency bands (LF and HF %) and LF/HF ratio were derived using Kubios software. Student’s t (paired) test was applied to compare pre- and post-exercise HRV parameters and Pearson’s correlation was applied to observe interdependencies between HRV and subjective scores. The findings depicted increase in post-exercise HR and decrease in overall HRV (both significant). Besides this, there was an increase in LF (significant) and LF/HF ratio (insignificant). Such response shows sympathetic dominance over parasympathetic domain of autonomic nervous system. The physical and mental stress experienced during the exercise was also expressed through high physical demand (79 out of 100) and high overall task load (total score – 77 out of 100) of the NASA-TLX and a moderately heavy RPE score (14 out of 20). The pre- and post-exercise differences in physiological variables ensured the presence of physical stress along with dominance of sympathetic nervous system. Overall task load was depicted with high subjective ratings. Carrying out skiing task in an environment infested with cold, wind chill, moderate hypoxia at a snowy and mountainous track possibly has induced the observed physiological and mental stress to the participants. Such findings are important to understand exact requirements of the mountain warfare events carried out by the forces.
{"title":"Heart rate variability, task load and perceived exertion associated with a long-distance military ski exercise: A pilot study","authors":"T. Chatterjee, D. Bhattacharyya, A. Yadav, M. Pal","doi":"10.25259/ijpp_101_2022","DOIUrl":"https://doi.org/10.25259/ijpp_101_2022","url":null,"abstract":"\u0000\u0000Skiing is practiced by the security forces posted at mountain areas for patrolling, securing borders, taking up rescue missions and sometimes as recreational activities. A study was planned to assess physiological and mental stress of a military ski activity through the measurement of heart rate (HR) variability, task load and perceived exertion.\u0000\u0000\u0000\u0000Eleven healthy Indian soldiers, trained with skiing techniques, participated in a 15 km skiing with 22 kg equipment at a predetermined snowy mountainous track. Pre- and post-exercise HR and HR variability (HRV) were recorded (bio-harness, Zephyr, USA) and questionnaires, namely NASA task load index (NASA-TLX) and Borg’s rating of perceived exertion (RPE) scale, were filled after exercise. Time and frequency domain parameters such as HR, variations between successive RR intervals (RMSSD), standard deviation of RR (SDNN) and percentage value of NN50 (pNN50), low- and high-frequency bands (LF and HF %) and LF/HF ratio were derived using Kubios software. Student’s t (paired) test was applied to compare pre- and post-exercise HRV parameters and Pearson’s correlation was applied to observe interdependencies between HRV and subjective scores.\u0000\u0000\u0000\u0000The findings depicted increase in post-exercise HR and decrease in overall HRV (both significant). Besides this, there was an increase in LF (significant) and LF/HF ratio (insignificant). Such response shows sympathetic dominance over parasympathetic domain of autonomic nervous system. The physical and mental stress experienced during the exercise was also expressed through high physical demand (79 out of 100) and high overall task load (total score – 77 out of 100) of the NASA-TLX and a moderately heavy RPE score (14 out of 20).\u0000\u0000\u0000\u0000The pre- and post-exercise differences in physiological variables ensured the presence of physical stress along with dominance of sympathetic nervous system. Overall task load was depicted with high subjective ratings. Carrying out skiing task in an environment infested with cold, wind chill, moderate hypoxia at a snowy and mountainous track possibly has induced the observed physiological and mental stress to the participants. Such findings are important to understand exact requirements of the mountain warfare events carried out by the forces.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49669968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashwini Kumar, B. Sinha, Santhosh Sr, Pratibha Mishra
Military flying is a complex task and requires high level of physical fitness of aviators. Various aviation stressors such as acceleratory force, hypoxia, cold weather conditions and decompression sickness place enormous stress on human physiological systems of the aviators. Individuals with Hb <13 g/dL (males) are being placed in the lower medical category which makes them unfit to fly. The present study was undertaken to assess the implication of low haemoglobin (Hb) on exercise capacity and hypoxia tolerance. Twenty-five individuals with anaemia and 15 healthy controls participated in the study. The participants were subjected to normobaric hypoxia (NH) equivalent to an altitude of 15,000 feet. Different physiological parameters such as heart rate (HR), systolic and diastolic blood pressure (SBP and DBP), respiratory rate (fR) and arterial oxygen saturation (SpO2) were measured during NH. Participants also performed maximal aerobic capacity (VO2 max) and maximal anaerobic capacity test in bicycle ergometer. HR, SBP, DBP and fR in anaemic subjects were higher than healthy controls during NH, whereas SpO2 in anaemic subjects was lower as compared to healthy controls. Anaemic individuals had a lower VO2 max than their healthy counterparts. Critical power and anaerobic work capacity were lower in anaemic subjects than healthy controls. There is a deterioration in exercise capacity and hypoxia tolerance in individuals with low Hb levels. Adequate precaution should be exercised for permitting military aviators to fly with low Hb level.
{"title":"A simulation study to compare physiological responses to hypoxia and exercise between anaemic subjects and healthy controls","authors":"Ashwini Kumar, B. Sinha, Santhosh Sr, Pratibha Mishra","doi":"10.25259/ijpp_472_2021","DOIUrl":"https://doi.org/10.25259/ijpp_472_2021","url":null,"abstract":"\u0000\u0000Military flying is a complex task and requires high level of physical fitness of aviators. Various aviation stressors such as acceleratory force, hypoxia, cold weather conditions and decompression sickness place enormous stress on human physiological systems of the aviators. Individuals with Hb <13 g/dL (males) are being placed in the lower medical category which makes them unfit to fly. The present study was undertaken to assess the implication of low haemoglobin (Hb) on exercise capacity and hypoxia tolerance.\u0000\u0000\u0000\u0000Twenty-five individuals with anaemia and 15 healthy controls participated in the study. The participants were subjected to normobaric hypoxia (NH) equivalent to an altitude of 15,000 feet. Different physiological parameters such as heart rate (HR), systolic and diastolic blood pressure (SBP and DBP), respiratory rate (fR) and arterial oxygen saturation (SpO2) were measured during NH. Participants also performed maximal aerobic capacity (VO2 max) and maximal anaerobic capacity test in bicycle ergometer.\u0000\u0000\u0000\u0000HR, SBP, DBP and fR in anaemic subjects were higher than healthy controls during NH, whereas SpO2 in anaemic subjects was lower as compared to healthy controls. Anaemic individuals had a lower VO2 max than their healthy counterparts. Critical power and anaerobic work capacity were lower in anaemic subjects than healthy controls.\u0000\u0000\u0000\u0000There is a deterioration in exercise capacity and hypoxia tolerance in individuals with low Hb levels. Adequate precaution should be exercised for permitting military aviators to fly with low Hb level.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44539028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A functional aspect of the vascular system is defined as vascular physiology, which covers mostly cardiovascular, cerebrovascular, renovascular and pulmonary vascular systems. Most of the system functions with perfect homeostasis under the coverage of haemodynamics. This haemodynamics maintains a steady relationship between intravascular pressure (P), overall vascular resistance (R) and circulatory flow (F). To explore more unknown facts of vascular physiology further research in experimental physiology with small animals by in vivo, vascular cell line research by in vitro, applications of bioinformatics tools by in silico and clinical studies are needed.
{"title":"Vascular physiology: A bridge between health and disease","authors":"Kusal K. Das","doi":"10.25259/ijpp_414_2022","DOIUrl":"https://doi.org/10.25259/ijpp_414_2022","url":null,"abstract":"A functional aspect of the vascular system is defined as vascular physiology, which covers mostly cardiovascular, cerebrovascular, renovascular and pulmonary vascular systems. Most of the system functions with perfect homeostasis under the coverage of haemodynamics. This haemodynamics maintains a steady relationship between intravascular pressure (P), overall vascular resistance (R) and circulatory flow (F). To explore more unknown facts of vascular physiology further research in experimental physiology with small animals by in vivo, vascular cell line research by in vitro, applications of bioinformatics tools by in silico and clinical studies are needed.","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48759315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Scientific illustration made easy: A primer for prospective authors","authors":"Shival Srivastav, M. Gadhvi, A. Arvind","doi":"10.25259/ijpp_229_2022","DOIUrl":"https://doi.org/10.25259/ijpp_229_2022","url":null,"abstract":"","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47453685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asmaa Hussien Elsayed Mobarak, N. E. Sayed, Y. Maklad, S. Kenawy
The effects of early renin-angiotensin system (RAS) blockade using angiotensin-converting enzyme (ACE) inhibitor lisinopril and/or angiotensin receptor blocker valsartan on renal nephrin and vascular endothelial growth factor (VEGF)-A gene expression were investigated in diabetic-hypertensive rats. Diabetes and hypertension were induced in adult Wistar rats using streptozotocin (45 mg/kg, i.p.) and Nω-nitro-L-arginine methyl ester (60 mg/kg/12 h) for 4 consecutive days. Experimental animals were allocated into six groups (n = 6): normal control, diabetic control, diabetic-hypertensive control and lisinopril-, valsartan- and combination-treated diabetic-hypertensive groups (5 mg/kg/drug/day, p.o., for 21 days). Blood glucose, blood pressure, body weight, kidney weight to body weight ratio, serum albumin, creatinine, total protein and urea were measured and recorded every week. Nephrin and VEGF-A gene expression were measured using real-time polymerase chain reaction. Renal nephrin protein was measured using ELISA as well as nephrin immunostaining. Blood pressure was significantly decreased by all treatments (P ≤ 0.05). All treatments normalised serum albumin and urea. Serum creatinine significantly decreased, while total protein significantly increased (P ≤ 0.05). Nephrin gene expression had a non-significant decrease in diabetic-hypertensive rats, yet it was statistically increased with individual treatments (P ≤ 0.05) and normalised with combined treatment. Renal nephrin protein significantly decreased in diabetic-hypertensive rats, normalised by lisinopril and significantly increased by valsartan and combined treatments (P ≤ 0.05). VEGF-A expression significantly increased in diabetic-hypertensive rats and significantly decreased with lisinopril and valsartan monotherapy and normalised with combined treatment (P ≤ 0.05). Immunostaining of nephrin also showed an obvious increase in the case of combined treatment. Early dual blockade of RAS in diabetic-hypertensive rats protected against renal damage and improved renal nephrin and VEGF-A gene expression as well as renal nephrin protein expression.
{"title":"Effect of dual blockade of renin-angiotensin system on renal nephrin and vascular endothelial growth factor – A expression in diabetic-hypertensive rats","authors":"Asmaa Hussien Elsayed Mobarak, N. E. Sayed, Y. Maklad, S. Kenawy","doi":"10.25259/ijpp_382_2021","DOIUrl":"https://doi.org/10.25259/ijpp_382_2021","url":null,"abstract":"\u0000\u0000The effects of early renin-angiotensin system (RAS) blockade using angiotensin-converting enzyme (ACE) inhibitor lisinopril and/or angiotensin receptor blocker valsartan on renal nephrin and vascular endothelial growth factor (VEGF)-A gene expression were investigated in diabetic-hypertensive rats.\u0000\u0000\u0000\u0000Diabetes and hypertension were induced in adult Wistar rats using streptozotocin (45 mg/kg, i.p.) and Nω-nitro-L-arginine methyl ester (60 mg/kg/12 h) for 4 consecutive days. Experimental animals were allocated into six groups (n = 6): normal control, diabetic control, diabetic-hypertensive control and lisinopril-, valsartan- and combination-treated diabetic-hypertensive groups (5 mg/kg/drug/day, p.o., for 21 days). Blood glucose, blood pressure, body weight, kidney weight to body weight ratio, serum albumin, creatinine, total protein and urea were measured and recorded every week. Nephrin and VEGF-A gene expression were measured using real-time polymerase chain reaction. Renal nephrin protein was measured using ELISA as well as nephrin immunostaining.\u0000\u0000\u0000\u0000Blood pressure was significantly decreased by all treatments (P ≤ 0.05). All treatments normalised serum albumin and urea. Serum creatinine significantly decreased, while total protein significantly increased (P ≤ 0.05). Nephrin gene expression had a non-significant decrease in diabetic-hypertensive rats, yet it was statistically increased with individual treatments (P ≤ 0.05) and normalised with combined treatment. Renal nephrin protein significantly decreased in diabetic-hypertensive rats, normalised by lisinopril and significantly increased by valsartan and combined treatments (P ≤ 0.05). VEGF-A expression significantly increased in diabetic-hypertensive rats and significantly decreased with lisinopril and valsartan monotherapy and normalised with combined treatment (P ≤ 0.05). Immunostaining of nephrin also showed an obvious increase in the case of combined treatment.\u0000\u0000\u0000\u0000Early dual blockade of RAS in diabetic-hypertensive rats protected against renal damage and improved renal nephrin and VEGF-A gene expression as well as renal nephrin protein expression.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45081721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical teachers need to use different pedagogical approaches to enhance student learning. Students are exposed to the flipped classroom (FC) in addition to the other teaching approaches which may enhance the comprehension, interpretation, and analytic skills of the students. The objective of this study was to compare the test scores obtained after the FC teaching session with the test scores obtained after a traditional classroom teaching session on a topic in skeletal muscle physiology delivered to 1st-year undergraduate medical students. Twenty-one 1st-year undergraduate medical students, undergoing a musculoskeletal system module at a private medical college were involved in this study. Students in the flipped pedagogical method were required to read the notes and power-point slides provided in addition to watching the prerecorded lecture videos before class. During the class, there was a topic review session followed by a small case discussion in groups. In the traditional classroom, students were advised to attend the lectures but there were no recorded videos to watch before the session. The effectiveness of the two types of pedagogical approaches was tested through pre-test and post-test using multiple-choice questions. The students’ perception of FC was collected through a semi-structured validated questionnaire. The pre-test mean score was higher for FC (5.48 ± 1.44) when compared to the traditional classroom (3.19 ± 1.4). In our study, the scores from pre-test to post-test in a traditional classroom showed statistically significant improvement (P = 0.0014) but were not statistically significant in the FC. In the flipped pedagogical approach, the difference between mean correct responses for question number 5 (P = 0.031) in pre-test and post-test was statistically significant. There was an improvement in the mean scores in all the eight questions between pre-test and post-tests in the traditional pedagogical method of teaching. About 79.6% of students agreed that they watched all the assigned videos and 78.6% of students completed reading the assigned power-point presentation slides before coming to the FC. About 78.5% agreed to learn more topics in FC format and 78.6% of students agreed that FC was more engaging and interesting in comparison to a traditional class. Our study showed that flipped and traditional pedagogical approaches both enhance student learning.
{"title":"Flipped pedagogical approach in teaching skeletal muscle physiology for undergraduate medical students","authors":"Rekha Prabhu, Girish Prabhu","doi":"10.25259/ijpp_63_2021","DOIUrl":"https://doi.org/10.25259/ijpp_63_2021","url":null,"abstract":"\u0000\u0000Medical teachers need to use different pedagogical approaches to enhance student learning. Students are exposed to the flipped classroom (FC) in addition to the other teaching approaches which may enhance the comprehension, interpretation, and analytic skills of the students. The objective of this study was to compare the test scores obtained after the FC teaching session with the test scores obtained after a traditional classroom teaching session on a topic in skeletal muscle physiology delivered to 1st-year undergraduate medical students.\u0000\u0000\u0000\u0000Twenty-one 1st-year undergraduate medical students, undergoing a musculoskeletal system module at a private medical college were involved in this study. Students in the flipped pedagogical method were required to read the notes and power-point slides provided in addition to watching the prerecorded lecture videos before class. During the class, there was a topic review session followed by a small case discussion in groups. In the traditional classroom, students were advised to attend the lectures but there were no recorded videos to watch before the session. The effectiveness of the two types of pedagogical approaches was tested through pre-test and post-test using multiple-choice questions. The students’ perception of FC was collected through a semi-structured validated questionnaire.\u0000\u0000\u0000\u0000The pre-test mean score was higher for FC (5.48 ± 1.44) when compared to the traditional classroom (3.19 ± 1.4). In our study, the scores from pre-test to post-test in a traditional classroom showed statistically significant improvement (P = 0.0014) but were not statistically significant in the FC. In the flipped pedagogical approach, the difference between mean correct responses for question number 5 (P = 0.031) in pre-test and post-test was statistically significant. There was an improvement in the mean scores in all the eight questions between pre-test and post-tests in the traditional pedagogical method of teaching. About 79.6% of students agreed that they watched all the assigned videos and 78.6% of students completed reading the assigned power-point presentation slides before coming to the FC. About 78.5% agreed to learn more topics in FC format and 78.6% of students agreed that FC was more engaging and interesting in comparison to a traditional class.\u0000\u0000\u0000\u0000Our study showed that flipped and traditional pedagogical approaches both enhance student learning.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43167943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Pant, Rajalakshmi Rajasegaran, B. Dubashi, P. Jagadesan, S. Ganapathy
Oncology caregivers often endure a significant amount of psychosocial stress while going through the experience of caregiving for their dependents. Exposure to chronic stress disrupts the cardiac autonomic balance and increases the risk of cardiovascular events. There is a paucity of research on the association between caregiving strain and cardiac autonomic status of primary oncology caregivers. This study aimed to assess the cardiac autonomic balance and its association with the levels of perceived strain and quality of life (QOL) of primary oncology caregivers. Forty-six individuals (30 males and 16 females) who have been primary caregivers of patients under the treatment for cancer at the Regional Cancer Centre over the past 3 months–1 year were recruited in this cross-sectional study. Cardiac autonomic status was assessed by heart rate variability (HRV) technique. The level of strain perceived and QOL of the study participants were assessed using the Modified Caregiver Strain Index (MCSI) and Caregiver QOL-Cancer (CQOL-C) questionnaires, respectively. Comparison of study parameters based on MCSI scores (low strain vs. moderate-high strain) was done using the Independent Student’s t-test. Spearman rank correlation coefficient test was performed to assess the correlation between sympathovagal balance (Low frequency [LF]/high frequency [HF]) and other study parameters. Multiple linear regression analysis was performed to predict the LF/HF ratio with independent variables MCSI score and CQOL-C score. P < 0.05 was considered statistically significant. Significantly high blood pressure, LF power, LF nu (LF normalised units) and LF/HF ratio were observed among caregivers with moderate-to-high caregiving strain as compared to those with low strain levels, while significantly low HF nu (HF normalised units) and CQOL-C scores were noted among the moderate-to-high caregiving strain subgroup as compared to the low caregiving strain subgroup. LF/HF ratio revealed a significant positive correlation with the level of caregiving strain (r = 0.563, P < 0.001) and a significant negative correlation with the QOL (r = −0.489, P = 0.001) of caregivers. However, on regression analysis, the level of caregiving strain was found to be a significant predictor of autonomic dysfunction unlike the caregivers’ QOL. Increased caregiving strain is associated with cardiac autonomic imbalance in primary oncology caregivers.
{"title":"Caregiving strain is associated with cardiac autonomic imbalance in primary oncology caregivers: A cross-sectional analytical study","authors":"A. Pant, Rajalakshmi Rajasegaran, B. Dubashi, P. Jagadesan, S. Ganapathy","doi":"10.25259/ijpp_307_2022","DOIUrl":"https://doi.org/10.25259/ijpp_307_2022","url":null,"abstract":"\u0000\u0000Oncology caregivers often endure a significant amount of psychosocial stress while going through the experience of caregiving for their dependents. Exposure to chronic stress disrupts the cardiac autonomic balance and increases the risk of cardiovascular events. There is a paucity of research on the association between caregiving strain and cardiac autonomic status of primary oncology caregivers. This study aimed to assess the cardiac autonomic balance and its association with the levels of perceived strain and quality of life (QOL) of primary oncology caregivers.\u0000\u0000\u0000\u0000Forty-six individuals (30 males and 16 females) who have been primary caregivers of patients under the treatment for cancer at the Regional Cancer Centre over the past 3 months–1 year were recruited in this cross-sectional study. Cardiac autonomic status was assessed by heart rate variability (HRV) technique. The level of strain perceived and QOL of the study participants were assessed using the Modified Caregiver Strain Index (MCSI) and Caregiver QOL-Cancer (CQOL-C) questionnaires, respectively. Comparison of study parameters based on MCSI scores (low strain vs. moderate-high strain) was done using the Independent Student’s t-test. Spearman rank correlation coefficient test was performed to assess the correlation between sympathovagal balance (Low frequency [LF]/high frequency [HF]) and other study parameters. Multiple linear regression analysis was performed to predict the LF/HF ratio with independent variables MCSI score and CQOL-C score. P < 0.05 was considered statistically significant.\u0000\u0000\u0000\u0000Significantly high blood pressure, LF power, LF nu (LF normalised units) and LF/HF ratio were observed among caregivers with moderate-to-high caregiving strain as compared to those with low strain levels, while significantly low HF nu (HF normalised units) and CQOL-C scores were noted among the moderate-to-high caregiving strain subgroup as compared to the low caregiving strain subgroup. LF/HF ratio revealed a significant positive correlation with the level of caregiving strain (r = 0.563, P < 0.001) and a significant negative correlation with the QOL (r = −0.489, P = 0.001) of caregivers. However, on regression analysis, the level of caregiving strain was found to be a significant predictor of autonomic dysfunction unlike the caregivers’ QOL.\u0000\u0000\u0000\u0000Increased caregiving strain is associated with cardiac autonomic imbalance in primary oncology caregivers.\u0000","PeriodicalId":13367,"journal":{"name":"Indian journal of physiology and pharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49354949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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