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   Table of Contents - Current issue
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October-December 2017
Volume 4 | Issue 4
Page Nos. 163-215

Online since Monday, January 29, 2018

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EDITORIAL  

Transition from prediabetes to diabetes is preventable Highly accessed article p. 163
Gopal Krushna Pal, Nivedita Nanda
DOI:10.4103/ijcep.ijcep_2_18  
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REVIEW ARTICLES Top

The development of social and educational mobility of students using effective functioning of the educational units p. 166
Lygina Marina
DOI:10.4103/ijcep.ijcep_50_17  
The mobility in education is nothing but the cross border studies applied on teachers and students as well as educational training institutions. There are number of reasons for using educational mobility in different countries. The educational units or an institution plays very significant role in the development of social and educational mobility of students. The migrants should understand the educational functions, activities, and other activities of migrated country; therefore, the educational institutions should conduct frequent training programs for migrants. The effective training mainly depends on different social problems; hence, it is required to have program to solve such social problems effectively. This can be possible only through the effective functioning of educational units. In the present study, we have focused on the Russian educational units, in which the professional training is required to develop the social and educational motility of migrants.
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REVIEW ARTICLE Top

Assessment of subclinical derangement of cardiovascular autonomic regulation in stable asthmatic patients p. 170
Rajesh Gupta, Anupama Gupta, Navneet Kumar Kaushik, Rajat Chabbra, Sushma Sood
DOI:10.4103/ijcep.ijcep_54_17  
Background and Aim: Autonomic nervous system(ANS) is linked to asthma. The ANS controls several aspects of airway function. It was planned to assess the autonomic cardiovascular regulation in stable asthmatic patients by short-term heart rate variability(HRV) analysis. Methods: The present study was conducted in the Department of Respiratory Medicine in collaboration with the Department of Physiology, Pt. B.D.S PGIMS, Rohtak in a total of eighty subjects/patients with comparable age, sex, weight, and height. Two groups with forty subjects/patients in each were formed as follows: Group1: stable asthmatics and Group2: nonasthmatics(controls). Electrocardiography and HRV of the participants were measured using digitalized polyrite-D as per the standard protocol. Results: Frequency domain parameters showed statistically significant difference between two groups. Low frequency(LF)(nu) was(48.9±17.8vs. 53.3±16.9) significantly less(P<0.05), while high frequency(HF)(nu) significantly more(41.4±15.19vs. 38.3±1.2) in Group1 as compared to Group2. LF/HF (1.2±0.6vs. 1.39±0.78) ratio was decreased significantly(P<0.05) in Group1. Conclusion: An overall reduced HRV(sympathetic activity) and deranged sympathovagal balance with vagal dominance(decreased LF, increased HF) in stable asthmatics. Hence, HRV could serve as a potential noninvasive tool to assess autonomic cardiovascular regulation in asthmatics.
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ORIGINAL ARTICLES Top

Muscle calcium regulation from reducing hypokinetic and gravity effects using chronic antiorthostatic sleeping and chronic periodic fluid redistribution p. 174
Kostas K Kakuris, Yuri N Yaroshenko, Sergei K Denogratov, Nikolay H Neofitov
DOI:10.4103/ijcep.ijcep_52_17  
Background and Aim: Chronic periodic fluid redistribution(CPFR) and chronic antiorthostatic sleeping(CAOS) counteracting diminished muscular activity(hypokinesia[HK]) and earth gravity effects contribute to vascular volume and electrolyte regulation. We hypothesized that CPFR and CAOS counteracting gravity compression effects and HK could affect muscle calcium(Ca++). We therefore studied the potential clinical benefits of CPFR and CAOS on muscle calcium. Methods: Studies were conducted on 40male volunteers. They were equally divided into four groups: active control subjects(ACS), hypokinetic subjects(HKS), CAOS control subjects(CAOSCS), and CAOS hypokinetic subjects(CAOSHS). We measured Ca++ in the muscle, plasma, urine, and feces during a preexperimental period of 390days and an experimental period of 364days. Results: In the CAOSHS group, muscle Ca++ increased(P<0.05) and plasma Ca++ and Ca++ losses decreased(P<0.05) compared to the HKS group. Muscle Ca++ increased more and Ca++ losses decrease more in a higher than a lower degree of CAOS position or higher than lower fluid shift to the head. In the HKS group without treatment of CPFR and CAOS, muscle Ca++ decreased(P<0.05) and plasma Ca++ and Ca++ losses increased(P<0.05) compared to the ACS, CAOSHS, and CAOSCS groups and the values at the preexperimental period. In the CAOSCS group, muscle Ca++ and plasma Ca++ and Ca++ losses did not change compared to the ACS group, and muscle Ca++ did not increase and plasma Ca++ and Ca++ losses did not decrease as in the CAOSHS group. Muscle Ca++, plasma Ca++, and Ca++ losses did not alter in the ACS group compared to their values at preexperimental period. All treated participants experience the need to urinate during the early preorthostatic and orthostatic position. Excretion of urine was(P<0.05) higher in orthostatic position than in CAOS position and(P<0.05) higher with lower fluid shift to the head than with higher fluid shift to the head. The participants were not experience blood pressure and heart rate changes in orthostatic position. Conclusion: The study provides evidence that muscle Ca++ increases from CPFR and CAOS, suggesting a potential benefit of muscle Ca++ regulation with treatment of CPFR and CAOS via chronically applied periodic and progressive fluid volume expansion.
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Association of prehypertension status with cardiovascular risks in subclinical hypothyroidism p. 182
Gopalakrishna Jayakrishnan, Gopal Krushna Pal, Sadishkumar Kamalanathan, Pravati Pal, Allampalli Sirisha, Nivedita Nanda
DOI:10.4103/ijcep.ijcep_1_18  
Background and Aim: Although attenuated baroreflex sensitivity (BRS)is known to promote cardiovascular(CV) risk, its status in subclinical hypothyroidism(SCH) has not been reported. Furthermore, the link of sympathovagal imbalance(SVI) to CV risk in SCH has not been reported. This study aimed to assess the association of BRS to hypertension status and CV risk in SCH. Methods: SCH patients(n=32) and controls(n=32) were recruited for the study. Body mass index, basal heart rate(HR), systolic blood pressure(BP), diastolic BP, BRS, autonomic function tests, HR variability(HRV), high-sensitive C-reactive protein, lipid profile, and atherogenic index were measured. Prediction of prehypertension status by BRS was assessed. Results: There was significant decrease in BRS, increased sympathetic and decreased parasympathetic reactivity, decreased HRV and high-density lipoprotein, and significant increase in all other lipid parameters, in SCH compared to controls. Asignificant association was found between BRS and low-frequency to high-frequency ratio in SCH group. BRS had a significant prediction of prehypertension status. Conclusion: SVI and decreased BRS were observed in SCH group that was linked to SVI. Reduced BRS that contributes to prehypertension status predisposes to subclinical hypothyroids to CV risks.
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Study of moisture content on various skin sites in different seasons in Indian population p. 190
Krutika Patel, Prachi Chetankumar Gajjar, Hita Hemant Mehta, Hemant Mehta, Jayesh Solanki
DOI:10.4103/ijcep.ijcep_3_18  
Background and Aim: Skin moisture reflects the health and good functionality of the skin, so analysis of variation in skin moisture in baseline individuals may be useful. Results and interpretations of this kind of studies may be useful for the management of common cutaneous disorders associated with decreased skin surface moisture and in the field of cosmetology. Therefore, in the present study, we aimed to measure the variations in skin moisture level with regard to different seasons and skin sites in both genders of healthy Indian volunteers. Methods: Study was conducted on 600(100 in each season) healthy Indian volunteers of age between 5 and 75years. Skin moisture level was measured on the forehead, right ocular region, right cheek, right arm, and right palm by digital moisture monitor instrument from skin care company. The measurements were performed for one particular day of different seasons. All readings were measured in percentage. On the day of study, all individuals were placed in controlled environment. Results: Moisture level was found to be decreased in aging skin. Results varied with sites showing higher moisture in the right palm and lowest in the ocular region. Males were hydrated better than females, and temporal variation without uniform pattern was seen. Most differences were small and insignificant. Conclusion: Variation in moisture content will be helpful in quantitative evaluation of absorption, and action of various topical drugs and vehicles in normal individuals. It is also helpful in the field of cosmetology and developing new skin care product which may normalize skin physiology in diseased state.
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A new method for assessing coronal alignment of the tibial component in total knee arthroplasty with an intramedullary rod p. 195
Aykut Sigirci
DOI:10.4103/ijcep.ijcep_59_17  
Background and Aim: Total knee arthroplasty(TKA) is the primary operative treatment for advanced knee osteoarthritis. Proper positioning of the femoral and tibial components is very important because malpositioning can cause undesirable results, such as implant loosening and persistent pain, and can compromise implant survival. Methods: Atotal of 200patients who underwent unilateral TKA were evaluated for their coronal tibial alignments. GroupA included the last 100patients operated on before use of the technique described here, and GroupB included the first 100patients operated on after its implementation. The checking technique involved using an intramedullary rod to help assess the coronal alignment of the tibial components. If the measured angle between the tibial plateau surface and the intramedullary rod was not within 90° ±3°, then adjustment cuts were indicated to create an ideal tibial plateau surface. Results: GroupB had a significantly lower rate of tibial coronal malalignment than GroupA(5% vs. 28%, respectively; P <0.05). Tibial plateau cuts of 17patients were adjusted with this method in GroupB, and the final coronal position of tibial plateaus were in the ideal limits(90±3). Conclusion: The intramedullary rod checking method is a simple and effective technique for arthroplasty surgeons to assess final tibial component coronal alignment during TKA.
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Optimum volume of water to be added to the leishman stain while preparing a blood smear Highly accessed article p. 198
Himel Mondal, Shaikat Mondal, Amit Pal
DOI:10.4103/ijcep.ijcep_53_17  
Background and Aim: During blood smear preparation, Leishman stain is first added to the slide for fixation. Then, aqueous fluid (e.g., distilled water[DW] and buffered water) is added and mixed with the stain. Different books suggest different amount of aqueous fluid to add with the stain. With this background, the aim of this study was to compare the quality of staining of blood smears stained by Leishman stain with different amount of DW. Methods: Atotal of 4 glass slides, with blood smear were stained by Leishman stain with different amount of DW–half the amount, equal the amount, 1½ times the amount, and double the amount of stain. After washing and drying, these blood films were seen under microscope, and the quality of staining was rated by 10 observers on 10-point scale. Scores for smears were compared by one-way ANOVA in Microsoft Excel 2010. Results: The mean score for blood film stained with half DW was 7.5±0.71, double DW was 7.9±0.74, 1½ times DW was 7.7±0.67, and double DW was 7.6±0.52. There was no difference in mean score(P=0.58) among the films when tested by ANOVA. Conclusion: There was no difference in quality of staining among smears stained by Leishman stain with different amount of DW. Hence, any volume of DW ranging from half the amount to double the amount of stain may be suggested for staining. However, half the amount may be avoided due to chances of stain precipitation.
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Efficacy of a short-term yoga-based lifestyle intervention in improving cognition in overweight/obese subjects p. 202
Dipti Magan, Raj Kumar Yadav, Manju Mehta
DOI:10.4103/ijcep.ijcep_46_17  
Background and Aim: The present report was designed to evaluate the efficacy of a short-term yoga-based lifestyle intervention in modifying cognitive functions and brain activity during cognitive tasks in overweight/obese patients. Methods: A total of (n = 12) Overweight/Obese patients and (n = 9) healthy controls who attended a short-term yoga-based lifestyle intervention program were recruited for the study. Anthropometric parameters include height, weight, body mass index(BMI), and systolic and diastolic blood pressure; different cognitive domains include Controlled Oral Word Association Test,Symbol Digit Modalities Test, Verbal n-back Test, and Forward/backward digit span; self-report measures include the Freiburg Mindfulness Inventory and Centre for epidemiologic studies for depression scale and electroencephalography(EEG) activity during different cognitive tasks were carried out twice, i.e.day 1(baseline) and day 14(end of intervention). Results: Significant(P<0.05) improvement was observed for weight, BMI, mindfulness scores, n-back test, and total attention span following lifestyle intervention for overweight/obese patients. Furthermore, EEG activity showed significant(P<0.05) increase in alpha, beta, and theta absolute power at the end of intervention. Parameters for control group remained comparable at day 14 versus day 1. Conclusion: Findings suggest that a short-term yoga-based lifestyle intervention may significantly improve cognitive functions and brain activity in overweight/obese patients.
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Fingerprint pattern and blood groups in twins p. 207
Ganesh Shenoy Panchmal, Fawaz Pullishery, Sabin Siddique, Vanishree Shirodian, Vardharaj Venkat Ramaiah
DOI:10.4103/ijcep.ijcep_51_17  
Background and Aim: Inherent genetic diversity and other random processes that affect growing embryo are the main factors responsible for the distinguishing nature of physical characteristics of a person. The focus of this study is to quantitatively determine the similarity of fingerprint pattern and blood groups in identical twins as well as in nonidentical twins. Methods: Atotal of 24 pairs of identical twins and 33 pairs of nonidentical twins were selected for the study. The fingerprints of the thumb, index, middle, ring, and little fingers of both hands of 57 pairs of twins were scanned. Due to differences in paper quality and degradation of the print over time, several of these fingerprints are of poor quality, and we selected only 51 pairs. The blood groups of the study population were identified using ABO System of Blood Grouping. Results: The results showed that “Arch” type was the most common type of fingerprint pattern present in both identical(42.04%) and nonidentical twins(53.10%). The Loop type was 26.59% and 22.24% in identical and nonidentical twins, respectively. Conclusion: All the identical twins shared the same blood group as their respective cotwin except one pair where they had a different type of B+and O+. The similarity in fingerprint pattern among identical twins were very high than nonidentical twins, and it was statistically significant. Rh+blood type was the common blood group in twins than Rh−.
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SHORT COMMUNICATION Top

Evaluation of brainstem dysfunction in primary headache using the blink reflex p. 211
Arun Singh, Deepika Joshi, Ranveer Yadav, Abhishek Pathak, Rameshwar Nath Chaurasia, Vijay Nath Mishra, Garima Gupta
DOI:10.4103/ijcep.ijcep_47_17  
Analysis of the blink reflex(BR) is a simple noninvasive method to evaluate the nociceptive brainstem pathways which are implicated in the pathogenesis of primary headaches. In the study, 75patients of primary headaches were evaluated with the BR in the interictal period. There were 51patients of migraine(GroupI), 16patients of tension-type headache(GroupII), 8patients of cluster headache(GroupIII), and 70 were control patients(Group IV) at a tertiary care referral center. All were subjected to a thorough clinical examination and were then evaluated with the BR. Significantly prolonged R2i and R2c were found in all study groups as compared to controls. An intergroup comparison with the controls revealed significantly prolonged R2i and R2c in the migraine and TTH group but not in the cluster headache group. Thus, abnormalities in the BR were found even in the headache-free periods in patients with primary headaches, thus implicating persistent sensitization of central brainstem nociceptive pathways. The nonsignificance in cluster headache could be due to small sample size.
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NEWS AND VIEWS Top

News p. 214
Nivedita Nanda
DOI:10.4103/2348-8832.224164  
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