Direct ways of establishing reference intervals for analytes are time-consuming and costly. Bhattacharya analysis is an indirect way to mathematically derive reference intervals from the results of analytes in a hospital database and is practically a simple and inexpensive alternative to direct methods. Data of serum uric acid, magnesium, and plasma homocysteine levels measured in the department of clinical biochemistry over 3 years were extracted from the hospital database along with the age, gender, and location of the patients. Bhattacharya analysis was performed by identifying underlying Gaussian distribution within the non-Gaussian distribution of the patient data by log transformation of the distribution of the data. Reference intervals for each of the analytes were calculated from the identified Gaussian distribution. The reference interval for serum uric acid was 1.49–8.97 mg/dL in men and 2.13–6.14 in women, serum magnesium in adults was 1.19–3.21 mg/dL, and plasma homocysteine in adults was 4.6–21 μg/dL. Using Bhattacharya analysis, we were able to derive reference intervals for analytes from our hospital data.
{"title":"Determination of Reference Interval for Serum Homocysteine, Magnesium, and Uric Acid from Tertiary Care Hospital Data By the Bhattacharya Method","authors":"Monica Peter, Arunachalam Vijaya Bhaskar, Videeta Avinash Kamble, Gaikwad Abhishek Lazaras, Pamela Christudoss, Joe Varghese, Padmanaban Venkatesan","doi":"10.4103/cmi.cmi_108_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_108_23","url":null,"abstract":"\u0000 \u0000 \u0000 Direct ways of establishing reference intervals for analytes are time-consuming and costly. Bhattacharya analysis is an indirect way to mathematically derive reference intervals from the results of analytes in a hospital database and is practically a simple and inexpensive alternative to direct methods.\u0000 \u0000 \u0000 \u0000 Data of serum uric acid, magnesium, and plasma homocysteine levels measured in the department of clinical biochemistry over 3 years were extracted from the hospital database along with the age, gender, and location of the patients. Bhattacharya analysis was performed by identifying underlying Gaussian distribution within the non-Gaussian distribution of the patient data by log transformation of the distribution of the data. Reference intervals for each of the analytes were calculated from the identified Gaussian distribution.\u0000 \u0000 \u0000 \u0000 The reference interval for serum uric acid was 1.49–8.97 mg/dL in men and 2.13–6.14 in women, serum magnesium in adults was 1.19–3.21 mg/dL, and plasma homocysteine in adults was 4.6–21 μg/dL.\u0000 \u0000 \u0000 \u0000 Using Bhattacharya analysis, we were able to derive reference intervals for analytes from our hospital data.\u0000","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782755","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}
Anurag Gola, Ambarish Das, Amar B. Gumataj, S. Amirdhavarshini, J. Venkatachalam
Artificial intelligence (AI) has emerged as a revolutionary mechanism in the field of science and technology. The role of AI in scientific research is becoming broader day by day. While AI is making processes easier and smoother, it is also raising concerns among researchers regarding its ethical utility. Besides, the decision-making process of AI remains a black box for research scholars. This review seeks to provide a comprehensive overview of the utilization of AI-based tools in medical research, along with an exploration of the associated challenges. The search strategy involved querying PubMed using keywords such as “Artificial intelligence,” “machine learning,” and “medical research” to identify relevant literature. The significance of AI in research is inevitable. Researchers need to accept the fact that AI will soon be an integral part of research, at the same time, the current limitations of AI need to be alleviated so that it will be embraced by the scientific community.
{"title":"Artificial Intelligence and Its Role in Medical Research","authors":"Anurag Gola, Ambarish Das, Amar B. Gumataj, S. Amirdhavarshini, J. Venkatachalam","doi":"10.4103/cmi.cmi_147_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_147_23","url":null,"abstract":"\u0000 Artificial intelligence (AI) has emerged as a revolutionary mechanism in the field of science and technology. The role of AI in scientific research is becoming broader day by day. While AI is making processes easier and smoother, it is also raising concerns among researchers regarding its ethical utility. Besides, the decision-making process of AI remains a black box for research scholars. This review seeks to provide a comprehensive overview of the utilization of AI-based tools in medical research, along with an exploration of the associated challenges. The search strategy involved querying PubMed using keywords such as “Artificial intelligence,” “machine learning,” and “medical research” to identify relevant literature. The significance of AI in research is inevitable. Researchers need to accept the fact that AI will soon be an integral part of research, at the same time, the current limitations of AI need to be alleviated so that it will be embraced by the scientific community.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140796433","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}
Background: During the COVID-19 pandemic, medical students and health-care professionals faced significant challenges, which had a negative impact on their mental health. Aims: This study aimed to assess the mental health of male and female undergraduate medical students and the psychological effects of the COVID-19 pandemic. Participants and the Methodologies: After receiving institutional ethical clearance and the informed consent of the participants, this study was carried out on 591 medical students from a peripheral medical college in West Bengal during the first and second waves of the COVID-19 pandemic. At intervals of 6 months, two surveys were conducted. The Depression Anxiety and Stress Scale-21 and Impact of Event Scale–Revised scale scores were evaluated in the Google Forms surveys. Using the t-test and the Chi-square test, the parameters of the two groups of students were compared. Results: On the initial assessment, neither group received a score that was significantly different from the other. Female students had significantly higher anxiety scores than male students on the second assessment. During the second pandemic wave, there was a significant gender difference in anxiety and stress levels (P = 0.001), with females experiencing higher levels of anxiety and stress. Conclusions: During the second wave of the COVID-19 pandemic, female undergraduate medical students had higher stress and anxiety levels than their male counterparts, according to the current study. Therefore, it is possible to draw the conclusion that the spread of the pandemic had a greater negative impact on the mental health of female undergraduate students.
{"title":"A study to compare the mental health status and psychological impact of the COVID-19 pandemic on male and female undergraduate medical students","authors":"Shouvik Das, A. Chaudhuri","doi":"10.4103/cmi.cmi_12_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_12_23","url":null,"abstract":"Background: During the COVID-19 pandemic, medical students and health-care professionals faced significant challenges, which had a negative impact on their mental health. Aims: This study aimed to assess the mental health of male and female undergraduate medical students and the psychological effects of the COVID-19 pandemic. Participants and the Methodologies: After receiving institutional ethical clearance and the informed consent of the participants, this study was carried out on 591 medical students from a peripheral medical college in West Bengal during the first and second waves of the COVID-19 pandemic. At intervals of 6 months, two surveys were conducted. The Depression Anxiety and Stress Scale-21 and Impact of Event Scale–Revised scale scores were evaluated in the Google Forms surveys. Using the t-test and the Chi-square test, the parameters of the two groups of students were compared. Results: On the initial assessment, neither group received a score that was significantly different from the other. Female students had significantly higher anxiety scores than male students on the second assessment. During the second pandemic wave, there was a significant gender difference in anxiety and stress levels (P = 0.001), with females experiencing higher levels of anxiety and stress. Conclusions: During the second wave of the COVID-19 pandemic, female undergraduate medical students had higher stress and anxiety levels than their male counterparts, according to the current study. Therefore, it is possible to draw the conclusion that the spread of the pandemic had a greater negative impact on the mental health of female undergraduate students.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81200266","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 case of Immune Thrombocytopenic Purpura (ITP) presented as an unusual case of post- operative hemorrhage. Our patient had presented for an elective laparoscopic total extraperitoneal repair for an inguinal hernia. He had undergone the procedure with no procedural or immediate post- operative complications. On post- op day 1, our patient had developed tachycardia with hypotension with clinical examination revealing signs of pallor with petechiae and ecchymosis. A complete blood count revealed thrombocytopenia with normocytic anemia while coagulation parameters were normal. Serum biochemistries did not reveal any renal failure or elevated lactate dehydrogenase. A computer- tomography with angiography revealed features supportive of a hemoperitoneum. Our patient was first stabilized with transfusion and vasopressor support. Evaluation with bone marrow analysis revealed features suggestive of ITP while secondary workup remained negative. Our patient was managed with dexamethasone pulse followed by maintenance steroids, following which there was an incremental response of the platelet count.
{"title":"Immune thrombocytopenic purpura: A rare case of postoperative thrombocytopenia","authors":"V. Thomas, S. Rao","doi":"10.4103/cmi.cmi_126_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_126_22","url":null,"abstract":"A case of Immune Thrombocytopenic Purpura (ITP) presented as an unusual case of post- operative hemorrhage. Our patient had presented for an elective laparoscopic total extraperitoneal repair for an inguinal hernia. He had undergone the procedure with no procedural or immediate post- operative complications. On post- op day 1, our patient had developed tachycardia with hypotension with clinical examination revealing signs of pallor with petechiae and ecchymosis. A complete blood count revealed thrombocytopenia with normocytic anemia while coagulation parameters were normal. Serum biochemistries did not reveal any renal failure or elevated lactate dehydrogenase. A computer- tomography with angiography revealed features supportive of a hemoperitoneum. Our patient was first stabilized with transfusion and vasopressor support. Evaluation with bone marrow analysis revealed features suggestive of ITP while secondary workup remained negative. Our patient was managed with dexamethasone pulse followed by maintenance steroids, following which there was an incremental response of the platelet count.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88631869","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}
Background: Entering medical professional courses is stressful to students in general and more so in a profession like nursing. Identifying the most effective methods of coping strategies with psychiatric distress may help to reduce mental health issues. This study was conducted to estimate the levels of psychiatric distress, anxiety, depression, and suicidal ideation, and their correlation with coping responses among undergraduate nursing students. Methodology and Participants: Sixty-eight 1st-year BSC nursing students participated in the study. The students were surveyed online using Google Forms. Participants had to fill up five scales: General Health Questionnaire (GHQ-28); Coping response inventory; State-Trait Anxiety Inventory (STAI); Beck Depression Inventory (BDI); and Adult Suicidal Ideation Questionnaire (ASIQ). Results: Thirty-nine students (57.35%) were found to be facing psychiatric distress (GHQ-28 Score >4). Sixteen (23.5%) had moderate depression and 13 (19.1%) had severe depression scores. Psychiatric distress scores were positively correlated with Depression, Anxiety, and Suicidal Ideation scores. A positive correlation was also found between suicidal ideation and anxiety and depression. A significant positive correlation was found between emotional discharge and acceptance/resignation (coping strategies) and GHQ, STAI, BDI, and ASIQ Scores. Positive reappraisal (PR), seeking guidance and support (SG), and problem-solving were the three coping strategies that had negative correlations with psychiatric distress, state anxiety, and suicidal ideation. Conclusion: Psychiatric distress increased depression levels, anxiety as well as suicidal ideation. Emotional discharge was identified as the most commonly used coping response. PR, SG, and problem-solving were the three most effective coping strategies which helped in reducing perceived stress levels.
{"title":"A study of the impact of psychiatric distress on coping responses and the levels of anxiety, depression, and suicidal ideation among undergraduate nursing students","authors":"Debayan Bhattacharya, A. Chaudhuri","doi":"10.4103/cmi.cmi_123_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_123_22","url":null,"abstract":"Background: Entering medical professional courses is stressful to students in general and more so in a profession like nursing. Identifying the most effective methods of coping strategies with psychiatric distress may help to reduce mental health issues. This study was conducted to estimate the levels of psychiatric distress, anxiety, depression, and suicidal ideation, and their correlation with coping responses among undergraduate nursing students. Methodology and Participants: Sixty-eight 1st-year BSC nursing students participated in the study. The students were surveyed online using Google Forms. Participants had to fill up five scales: General Health Questionnaire (GHQ-28); Coping response inventory; State-Trait Anxiety Inventory (STAI); Beck Depression Inventory (BDI); and Adult Suicidal Ideation Questionnaire (ASIQ). Results: Thirty-nine students (57.35%) were found to be facing psychiatric distress (GHQ-28 Score >4). Sixteen (23.5%) had moderate depression and 13 (19.1%) had severe depression scores. Psychiatric distress scores were positively correlated with Depression, Anxiety, and Suicidal Ideation scores. A positive correlation was also found between suicidal ideation and anxiety and depression. A significant positive correlation was found between emotional discharge and acceptance/resignation (coping strategies) and GHQ, STAI, BDI, and ASIQ Scores. Positive reappraisal (PR), seeking guidance and support (SG), and problem-solving were the three coping strategies that had negative correlations with psychiatric distress, state anxiety, and suicidal ideation. Conclusion: Psychiatric distress increased depression levels, anxiety as well as suicidal ideation. Emotional discharge was identified as the most commonly used coping response. PR, SG, and problem-solving were the three most effective coping strategies which helped in reducing perceived stress levels.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85538063","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":"The changing contours of health care","authors":"S. Chandy","doi":"10.4103/cmi.cmi_59_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_59_23","url":null,"abstract":"","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90471179","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}
Sirshendu Chaudhuri, Bhuswami Saibindu, A. Nirupama, Aniruddh Gaurang, V. Agiwal
Background: Self-care practices in diabetes are deemed as one of the mainstays of management, but often poorly practiced by people with diabetes. Aim: The study describes self-care practices among adult diabetics registered with a primary health-care setup. Methods: This was a community-based cross-sectional study based out of the Ramaiahguda primary health center in Vikarabad town of Telangana. Informed consent was taken from all participants before the commencement of the study. All eligible candidates were approached for the study. The seven domains of the “American Association of Diabetes Educators measures of outcome” were taken as the base for assessment of self-care practices among the participants. Results: The mean (standard deviation [SD]) age of the 155 study participants was 50.8 years (SD 12.4 years). Among the various components of self-care, drug adherence, glucose monitoring, and diet modifications were regular as per the advice. Comparatively, healthy coping, risk reduction, and problem solving are the areas where the participants had a major scope to improve. The median self-care score of the participants was 15.25 (interquartile range 14.5–16.25) ranging from 0.25 to 18.0. 86 (55.5%) participants had good self-care scores, and 69 (44.5%) participants had moderate self-care scores. Conclusions: The observations from our study point toward a lack of understanding and in-depth evaluation of the effectiveness of diabetic self-care practices, which may in turn be one of the factors affecting compliance to such practices among the diseased population.
{"title":"Self-Care practices in diabetes: A community-based cross-sectional study in Vikarabad, Telangana","authors":"Sirshendu Chaudhuri, Bhuswami Saibindu, A. Nirupama, Aniruddh Gaurang, V. Agiwal","doi":"10.4103/cmi.cmi_5_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_5_23","url":null,"abstract":"Background: Self-care practices in diabetes are deemed as one of the mainstays of management, but often poorly practiced by people with diabetes. Aim: The study describes self-care practices among adult diabetics registered with a primary health-care setup. Methods: This was a community-based cross-sectional study based out of the Ramaiahguda primary health center in Vikarabad town of Telangana. Informed consent was taken from all participants before the commencement of the study. All eligible candidates were approached for the study. The seven domains of the “American Association of Diabetes Educators measures of outcome” were taken as the base for assessment of self-care practices among the participants. Results: The mean (standard deviation [SD]) age of the 155 study participants was 50.8 years (SD 12.4 years). Among the various components of self-care, drug adherence, glucose monitoring, and diet modifications were regular as per the advice. Comparatively, healthy coping, risk reduction, and problem solving are the areas where the participants had a major scope to improve. The median self-care score of the participants was 15.25 (interquartile range 14.5–16.25) ranging from 0.25 to 18.0. 86 (55.5%) participants had good self-care scores, and 69 (44.5%) participants had moderate self-care scores. Conclusions: The observations from our study point toward a lack of understanding and in-depth evaluation of the effectiveness of diabetic self-care practices, which may in turn be one of the factors affecting compliance to such practices among the diseased population.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88182768","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}
S. Sheetal, Persis George, Timothy Varghese, Vintu Fernandez
Hyperosmolar hyperglycemic state (HHS) is a medical emergency, characterized by hyperosmolarity, hyperglycemia, and intravascular volume depletion, in the absence of ketosis. The spectrum of neurological manifestations in HHS is diverse, ranging from mild encephalopathy to coma. The common neurological presentations of HHS include encephalopathy, seizures, and hyperkinetic movement disorders. Stroke-like presentation of HHS is less reported. We report the case of an elderly female, with uncontrolled type 2 diabetes mellitus, who presented with left hemiplegia and, on evaluation, she was diagnosed to have HHS. As she was a chronic kidney disease patient, this case posed challenges in fluid management, which forms the corner stone of HHS management, along with insulin administration. She was discharged at the end of 1 week, with a complete resolution of her neurological deficit.
{"title":"Hyperosmolar hyperglycemic state as a stroke mimic","authors":"S. Sheetal, Persis George, Timothy Varghese, Vintu Fernandez","doi":"10.4103/cmi.cmi_10_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_10_23","url":null,"abstract":"Hyperosmolar hyperglycemic state (HHS) is a medical emergency, characterized by hyperosmolarity, hyperglycemia, and intravascular volume depletion, in the absence of ketosis. The spectrum of neurological manifestations in HHS is diverse, ranging from mild encephalopathy to coma. The common neurological presentations of HHS include encephalopathy, seizures, and hyperkinetic movement disorders. Stroke-like presentation of HHS is less reported. We report the case of an elderly female, with uncontrolled type 2 diabetes mellitus, who presented with left hemiplegia and, on evaluation, she was diagnosed to have HHS. As she was a chronic kidney disease patient, this case posed challenges in fluid management, which forms the corner stone of HHS management, along with insulin administration. She was discharged at the end of 1 week, with a complete resolution of her neurological deficit.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82772208","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}
Sirshendu Chatterjee, Subhadeep Patra, Kaberi De, P. Panda
Background: The sex hormones, estrogen, and progesterone, as well as the gonadotropins, luteinizing hormone, and follicle-stimulating hormone produced from the anterior pituitary, govern the three stages of the menstrual cycle: menstrual, follicular, and luteal. Hormone fluctuations cause changes in autonomic function. There have been relatively few studies that show autonomic function modification throughout various periods of the menstrual cycle. Aim and Objectives: The current study was undertaken to investigate the difference in mean parasympathetic autonomic characteristics between the proliferative and secretory stages of the menstrual cycle. Materials and Methods: A total of 120 healthy young adult female volunteers were recruited among Kalinga Institute of Medical Sciences, Kalinga Institute of Nursing Sciences, and Kalinga Institute of Dental Sciences students. The study eliminated 20 students who were in the bleeding phase of their cycle. The electrocardiogram was captured, and parasympathetic parameters were determined using the fully automated CANWin instrument in the Department of Physiology. The data of the abovementioned parameters were compiled, tabulated, and entered into Microsoft Excel 2013 and statistically analyzed using STATA software 15.1. Results: The subjects' mean ages, heights, and weights were 18.9 ± 0.70 years, 156.6 ± 5.25 cm, and 53.7 ± 8.63 kg, respectively. The mean resting heart rate in the secretory phase was substantially greater than in the proliferative phase, indicating sympathetic dominance. The 30:15 ratio between proliferative and secretory stages. The mean E: I ratio calculated from the slow deep breathing maneuver reveals a statistically significant difference between the proliferative and secretory phases. Conclusion: During the secretory phase, there is a considerable rise in parasympathetic activity among the individuals in the current study. Changes in parasympathetic activity throughout the follicular and secretory stages of the menstrual cycle may be caused by fluctuations in estrogen and progesterone levels.
{"title":"A study of parasympathetic autonomic function in different phases of the menstrual cycle among young adult females","authors":"Sirshendu Chatterjee, Subhadeep Patra, Kaberi De, P. Panda","doi":"10.4103/cmi.cmi_82_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_82_22","url":null,"abstract":"Background: The sex hormones, estrogen, and progesterone, as well as the gonadotropins, luteinizing hormone, and follicle-stimulating hormone produced from the anterior pituitary, govern the three stages of the menstrual cycle: menstrual, follicular, and luteal. Hormone fluctuations cause changes in autonomic function. There have been relatively few studies that show autonomic function modification throughout various periods of the menstrual cycle. Aim and Objectives: The current study was undertaken to investigate the difference in mean parasympathetic autonomic characteristics between the proliferative and secretory stages of the menstrual cycle. Materials and Methods: A total of 120 healthy young adult female volunteers were recruited among Kalinga Institute of Medical Sciences, Kalinga Institute of Nursing Sciences, and Kalinga Institute of Dental Sciences students. The study eliminated 20 students who were in the bleeding phase of their cycle. The electrocardiogram was captured, and parasympathetic parameters were determined using the fully automated CANWin instrument in the Department of Physiology. The data of the abovementioned parameters were compiled, tabulated, and entered into Microsoft Excel 2013 and statistically analyzed using STATA software 15.1. Results: The subjects' mean ages, heights, and weights were 18.9 ± 0.70 years, 156.6 ± 5.25 cm, and 53.7 ± 8.63 kg, respectively. The mean resting heart rate in the secretory phase was substantially greater than in the proliferative phase, indicating sympathetic dominance. The 30:15 ratio between proliferative and secretory stages. The mean E: I ratio calculated from the slow deep breathing maneuver reveals a statistically significant difference between the proliferative and secretory phases. Conclusion: During the secretory phase, there is a considerable rise in parasympathetic activity among the individuals in the current study. Changes in parasympathetic activity throughout the follicular and secretory stages of the menstrual cycle may be caused by fluctuations in estrogen and progesterone levels.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80518226","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}
Background: In pacemaker recipients with preserved left ventricular ejection fraction, there is scant evidence regarding the effect of single-chamber pacing on left ventricular systolic function. The objective of the study was to assess the echocardiographic progression of pacemaker patients with preserved left ventricular ejection fraction at the baseline in relation to the level of right ventricular pacing and indication for pacing. Methodology: The clinical and diagnostic data from 200 patients who had undergone pacemaker implantation during 2018–2019 were analyzed. Of 200 patients, 32 patients were not included in the study in view of their baseline ejection fraction being <55% in 22 patients, loss to follow-up in six patients, and owing to four patients dying during the study. At admission and after a year of follow-up, the patient's biodata, indications for pacemaker insertion, pacing percentage and echocardiographic parameters, and treatment profile were recorded. Results: A total of 168 patients (48.2% of males and 51.8% of females) were implanted with single-chamber permanent pacemaker. By 1 year, the mean ejection fraction, which was 61.47%, had significantly dropped to 50%. Mitral annular tissue velocity diastolic (E/e′) increased significantly (>4%) after 1 year compared to the baseline. By 1 year, there has been a significant (>10%) change from the baseline in the transannular plane systolic excursion parameter. The left ventricular systolic dysfunction happened in a greater degree in patients with advanced conduction disease compared to those who had sinus node dysfunction. Conclusion: Clinically significant left ventricle dysfunction and right ventricle dysfunction developed in a large number of pacemaker recipients with normal left ventricular function at the baseline.
{"title":"Evaluation of left ventricular dysfunction after single-chamber pacemaker implantation in patients with normal left ventricular function in a tertiary care institution in South India: An observational study","authors":"Hariharan Narasaiyan, N. Swaminathan","doi":"10.4103/cmi.cmi_3_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_3_23","url":null,"abstract":"Background: In pacemaker recipients with preserved left ventricular ejection fraction, there is scant evidence regarding the effect of single-chamber pacing on left ventricular systolic function. The objective of the study was to assess the echocardiographic progression of pacemaker patients with preserved left ventricular ejection fraction at the baseline in relation to the level of right ventricular pacing and indication for pacing. Methodology: The clinical and diagnostic data from 200 patients who had undergone pacemaker implantation during 2018–2019 were analyzed. Of 200 patients, 32 patients were not included in the study in view of their baseline ejection fraction being <55% in 22 patients, loss to follow-up in six patients, and owing to four patients dying during the study. At admission and after a year of follow-up, the patient's biodata, indications for pacemaker insertion, pacing percentage and echocardiographic parameters, and treatment profile were recorded. Results: A total of 168 patients (48.2% of males and 51.8% of females) were implanted with single-chamber permanent pacemaker. By 1 year, the mean ejection fraction, which was 61.47%, had significantly dropped to 50%. Mitral annular tissue velocity diastolic (E/e′) increased significantly (>4%) after 1 year compared to the baseline. By 1 year, there has been a significant (>10%) change from the baseline in the transannular plane systolic excursion parameter. The left ventricular systolic dysfunction happened in a greater degree in patients with advanced conduction disease compared to those who had sinus node dysfunction. Conclusion: Clinically significant left ventricle dysfunction and right ventricle dysfunction developed in a large number of pacemaker recipients with normal left ventricular function at the baseline.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83376504","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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