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   Table of Contents - Current issue
Coverpage
April-June 2017
Volume 4 | Issue 2
Page Nos. 55-108

Online since Monday, July 17, 2017

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EDITORIAL  

The message of international yoga day p. 55
Gopal Krushna Pal
DOI:10.4103/ijcep.ijcep_31_17  
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REVIEW ARTICLE Top

Cardioprotective effects of angiotensin converting Enzyme II p. 57
Leta Melaku, Andualem Mossie
DOI:10.4103/ijcep.ijcep_17_17  
To circumvent the major threats of low blood volume and low blood pressure, animals need powerful mechanisms for salt and water conservation, which is renin–angiotensin system (RAS). Activation of RAS is therefore a useful response in many demanding situations. However, an increased activity of the RAS, especially in combination with other cardiovascular risk factors, may lead to a cascade of deleterious effects such as hypertension, atherosclerosis, myocardial remodeling, heart failure, ischemic stroke, and diabetes mellitus. Many of these pathophysiological actions of angiotensin II (Ang II) may still be viewed as being homeostatic in principle but harmful if carried to excess. Numerous experimental studies have indicated that angiotensin-converting enzyme II (ACE II) efficiently hydrolyzes the potent vasoconstrictor Ang II to Ang 1–7. Thus, the axis formed by ACE II/Ang 1–7/Mas appears to represent an endogenous counter-regulatory pathway within the RAS, the actions of which are in opposition to the vasoconstrictor/proliferative arm of the RAS consisting of ACE, Ang II, and Ang II Type 1 receptor (AT1R). Although most of the well-known cardiovascular and renal effects of RAS are attributed to ACE, an important enzyme in the generation of Ang II, much less is known about the functions of ACE II. This review summarizes recently published data on the basic properties of ACE II and Ang 1–7 and a summary of the evidence from experimental and clinical studies of various pathological conditions related to the biological roles of ACE II/Ang 1–7/Mas in the heart.
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ORIGINAL ARTICLES Top

A comparative study of the effect of ambient air pollution on ventilatory function tests in urban and rural population p. 69
Veeanna Hoovinahole Bhadranna, Christofer Thomas
DOI:10.4103/ijcep.ijcep_24_17  
Background and Aim: The particulate matter (PM10) is considered as the criteria parameter for assessing the quality of air that we respire as it is known to produce a significant impairment in ventilatory functions leading to respiratory diseases including bronchial asthma and chronic obstructive pulmonary disease. The aim of this study was to compare the lung function status in an urban population residing in an area with high ambient air pollutant with rural population with minimal concentration of air pollutant in their working environment. Methods: A cross sectional study was conducted with 144 exposed subjects and 148 control subjects. A computerised spirometer was used to assess the ventilatory function parameters. Ventilatory parameters like FVC, FEV1, FEV1/FVC, PEFR, FEF25, FEF50, FEF75, MVV was taken into consideration for the preset study which was also analysed with respect to the control and study group as well as with respect to the age group of the study subjects. Monitoring the concentration of the ambient air pollutants was done by the air monitoring stations of the Karnataka state pollution control board. Statistical analysis was done using SPSS package. Results: There was no significant differences in the anthropometric parameters of both study and control group. The results showed that the ventilatory function test of the urban study group was markedly declined when compared with the control group which was statistically significant. It was also found that the mean values of parameters like FVC, FEV1, PFF, FEV1/FVC%, FEF25-75%, V max 25%, 50%, 75% was statistically different in <30 years and >30 years among study and control group.Conclusion: Considering the fact that all the subjects participated in the study are from the same ethnic origin, residing at same altitude and non smokers, the significant reduction in the lung function parameters in the exposed group could be only due to the their exposure to the air pollutants.
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Evaluation of anthropometric profile in obesity in nigerian females during pregnancy p. 75
WB Vidona, Aduema Wadioni, SN Okeke
DOI:10.4103/ijcep.ijcep_25_17  
Background and Aim: Excess body fat deposition is known to be unhealthy. There have been controversies on defined anthropometric parameters for the assessment of obesity during pregnancy. This is because certain cut-off values relating to it are influenced by age, sex, ethnicity, and trimesters of pregnancy. This study is aimed at investigating the use of anthropometric parameters to measure obesity and determine its prevalence in the different trimesters of pregnancy. Methods: The research is a prospective study of 460 pregnant women in the sample proportion of 110, 110, and 240 in the 1st, 2nd, and 3rd trimesters, respectively, chosen randomly from antenatal clinic of the Rivers State Primary Health care centre, Rumuepirikom, Obio-Akpor, Rivers State. Measurements of height, weight, waist circumference (WC), and hip circumference were obtained. Body mass index (BMI) was calculated from values of height and weight. Waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) were also calculated from waist and hiP values. Results: The result showed a BMI prevalence of 3.6%, 7.3%, and 0.8%; WC prevalence of 15.5%, 15.5%, and 3%; WHR prevalence of 43.6%, 35.5%, and 14.2%; WHtR prevalence of 56.4%, 51.8%, and 40% all in the 1st, 2nd, and 3rd trimesters, respectively. A negative linear correlation was shown between the other indices and BMI as an independent variable in 1st trimester with value (r = −0.015) against a (r = 0.085 and 0.165) in WC and WHtR, respectively. There was an association among the other anthropometric indices against BMI with no statistically significant difference at the level of 95% (P < 0.05). Conclusion: The results of this study are therefore recommended as a guide for clinical judgment in preventive and therapeutic health care services on obesity.
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Association of prehypertension status with sympathovagal imbalance in young first-degree relatives of Type 2 diabetics in Indian population is linked to body mass index p. 82
Gopal Krushna Pal, Pravati Pal, Balasubramanian Suchitra, Allampalli Sirisha, Nivedita Nanda
DOI:10.4103/ijcep.ijcep_34_17  
Background and Aim: As reports indicate that autonomic imbalance and hypertension in first-degree relatives (FDR) of type 2 diabetics predispose them to cardiovascular (CV) risks, in the present study, we have assessed contribution of body mass index (BMI) to sympathovagal imbalance (SVI) and prehypertension status in these patients. Methods: BMI, basal heart rate (BHR), blood pressure (BP), prehypertension status, rate pressure product (RPP), and spectral indices of heart rate variability (HRV) were reordered and analyzed in FDR of type 2 diabetics (Study group, n = 63) and in individuals with no family history of diabetes (Control group, n = 87). Results: BMI and low-frequency-high-frequency (LF-HF), the ratio of LF to HF power (LF-HF ratio) of HRV, a sensitive marker of SVI was significantly increased (P < 0.001) in the study group compared to control group. The SVI in the study group was due to concomitant sympathetic activation (increased LF) and vagal inhibition (decreased HF). In the study group, BMI was significantly correlated with LF-HF ratio, BHR, BP, and RPP. Multiple regression analysis demonstrated an independent contribution of BMI to prehypertension status and bivariate logistic regression revealed significant prediction of prehypertension status by LF-HF and BMI in the study group. Conclusion: BMI is more in FDR of type 2 diabetics and SVI in the form of increased sympathetic and decreased parasympathetic activity is present in them. Increased resting heart rate, elevated prehypertension status, decreased HRV, and increased RPP in these participants make them vulnerable to CV risks. BMI in these participants could be the link between SVI, prehypertension, and CV risks.
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Effect of physical activity and parameters of body stature and body composition on respiratory muscle strength in healthy young males: An observational study p. 87
Bhakti P Gadhavi, Jayesh Dalpatbhai Solanki, Hemant B Mehta, Amit H Makwana, Chinmay J Shah, Pradnya A Gokhale
DOI:10.4103/ijcep.ijcep_22_17  
Background and Aim: Obesity and physical inactivity affect respiratory functioning adversely. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) measure the strength of respiratory muscles. We studied the MIP and MEP in nonathletic young males in relation to adiposity and physical activity. Methods: We conducted a cross-sectional study on a consecutive sample of sixty young apparently healthy nonathletic males. Body mass index (BMI) and body composition were measured by Omron Karada Scan by tetra poplar bio-electrical impedance. We measured MIP and MEP by Ultima PFX real-time diffusion (RTD) (Medgraphic diagnostic company, USA), Breezesuite software, flow volume calibration, and guidelines laid by the American Thoracic Society. Results were analyzed further by comparing the actual value against the predicted value among the three patterns of subgrouping based on BMI, visceral fat (VF), and physical activity. Statistical significance was set at P< 0.05. Results: The study group had a mean age of 21 years, mean BMI of 22.5, and nearly half with BMI <22.5 and half were physically active. Better profile of body composition was present in males with BMI <22.5, VF <10%, and physical activity. MIP and MEP of the study participants were significantly lower than the predicted values, significantly better with physical activity and better without statistical significance with BMI or VF controlled. MIP and MEP correlated negatively but insignificantly with most other test parameters. Conclusion: Maximal respiratory pressures of young nonathletic males were less than predicted, more so with physical inactivity than adiposity. This indicates the importance of exercise and moderate physical activity to strengthen the respiratory muscle for optimal maximum respiration.
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Assessment of acute bronchodilator response in participants with or without airway obstruction in a tertiary care Hospital of West Bengal p. 92
Joyashree Banerjee, Ashmita Sengupta, Aloke Kumar Sinhababu, Anilbaran Singhamahapatra, Pranab Kumar Dey
DOI:10.4103/ijcep.ijcep_27_17  
Background and Aim: Acute bronchodilator response (BDR) during spirometry is very common in clinical studies. The response varies in different groups of participants. The aim of this study was to analyze the distribution of BDR in participants with or without airway obstruction. Methods: A retrospective analytical study of the spirometry results was undertaken. The spirometric values were analyzed for the present study. Among them, 1024 test results were included in our study. The values were estimated by an electronic spirometer, model-RMS Helios-702 in the Department of Physiology, R. G. Kar Medical College, Kolkata on 3200 participants. Results: Acute BDR was higher in chronic obstructive pulmonary disease (COPD) participants (45.4%) compared to other participants. Reversibility test was positive in 41.2% of asthma, 31% of allergic rhinitis, 32% of chronic cough, and 13.6% in apparently healthy participants. Conclusion: A good percentage of positive BDR is found not only in COPD and asthma but also in allergic rhinitis, chronic cough, apparently healthy participants which indicate its wider utility.
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Effects of diets containing black-eyed beans and serotonin precursors on neuromuscular coordination in experimental mice p. 97
Aduema Wadioni, DI Izunwanne, AK Amah
DOI:10.4103/ijcep.ijcep_7_17  
Background and Aim: Black-eyed beans contain the neurotransmitter serotonin and its precursor, 5-hydroxytryptophan (5-HTP) which is known to have neurobehavioral effects on neuromuscular coordination. Therefore, the aim of this study was to find whether long-term consumption uncooked bean diet has effects on some neurobehavioral parameters notably; neuromuscular coordination using Swiss white mice as experimental animals. Methods: Thirty CD1 mice were randomly assigned into three groups, namely, control, uncooked beans diet (50% w/w), and serotonin precursor (5-HTP) diet (0.2 mg/50 g w/w) for 30 days. All the mice had access to clean drinking water ad libitum. Before the neurobehavioral parameters were assessed, the LD50of the beans and that of the serotonin precursor (5-HTP) was determined. Serotonin concentration was measured in beans using gas chromatography analysis. Neuromuscular coordination was investigated alongside food and water intake and body weight change. The involvement of serotonin pathway was investigated using the set of mice administered serotonin precursor for comparison with the beans diet-fed mice. Beam walking was used to assess neuromuscular coordination. Results: The results showed that beans and 5-HTP-fed mice showed better neuromuscular coordination when compared to control. This is because, decreased frequency of foot slips and longer latency of falls indicates a higher level of maneuverability in the beam, thus indicating better neuromuscular coordination. Conclusion: Long-term consumption of uncooked beans improves neuromuscular coordination.
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Observation of various demographic, socio-economic and physical factors with Sthaulya (obesity) in individuals preferring day sleep: A cross sectional survey p. 101
Akhilesh Shukla, Anupama Shukla, AS Baghel, Mahesh Vyas
DOI:10.4103/ijcep.ijcep_21_17  
Background and Aim: Obesity is associated with an increased risk of morbidity and mortality as well as reduced life expectancy. Ayurveda has emphasized that the sleep pattern of the individual is equally responsible for obesity alike food. The aim of this study is to identify the association between day sleep and Sthaulya (Obesity) among patients aged between 20 and 60 years. Methods: A cross-sectional survey study was conducted among 250 Sthaulya (obesity) patients visiting the outpatient department. Sleep pattern questionnaire was used for the survey study. Results: The survey study revealed that habit of sleeping during daytime for more than 1 h, especially just after having lunch, waking up late after 6 AM in the morning, and sleeping for more than 8 h in a day is the important factors associated with Sthaulya (obesity). Conclusion: To prevent obesity, sleep after lunch and getting-up late in the morning should be avoided.
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LETTER TO EDITOR Top

Problem-seeking learning in medical education p. 105
Sabyasachi Sircar
DOI:10.4103/ijcep.ijcep_26_17  
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NEWS AND VIEWS Top

News and Views p. 107

DOI:10.4103/2348-8832.210937  
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