International Journal of Clinical and Experimental Physiology

Vagus Nerve Stimulation Could be an Adjunctive Therapy in the Management of Moderate to Severe Gestational Diabetes Mellitus

Gopal Krushna Pal, Manoharan Renugasundari — Tue, 11 Jul 2023 10:18:28 +0000

Gestational Diabetes Mellitus (GDM) is any degree of glucose intolerance with onset or first recognition during pregnancy. In the past ten years, the prevalence of GDM has increased to nearly 20%, making it likely that one in every five pregnant women will have GDM. Prevalence of GDM is 17.8% in urban, 13.8% in semi urban and 9.9% in rural India. Due to lifestyle, Indian women are at 11-fold increased risk of GDM. Obesity or being overweight is increasing in young girls which increases the risk for GDM. In 90% cases, GDM disappears after delivery, but 50% of women may develop diabetes in 5-10 years. Increased blood glucose diagnosed in the 1st trimester increases the risk of congenital malformation. Elevated glucose levels during pregnancy raises the likelihood of having a big size fetus, which requires delivery usually by caesarean section. Later, type 2 diabetes and cardiovascular disease develop in women with GDM. Additionally, it raises the infants' risk of macrosomia and subsequent obesity or diabetes.[1] Women with GDM are additionally bound to have recurrent GDM in ensuing pregnancies. In antenatal care programs, the need to concentrate on its prevention, early detection, medical management, and lifestyle changes is highlighted by the high prevalence of GDM even in low-income populations. Though mild GDM is treated mostly by nutrition therapy (Diet Management), moderate to severe GDM requires insulin therapy. Usually, insulin therapy in the later part of pregnancy is not very effective due to various reasons including sociocultural factors. Read more...

Neural Control of Renal Function in Hypertension and Health

Avinash Thakare, Rajay Bharshankar, Pooja Salkar — Tue, 11 Jul 2023 10:30:05 +0000

The body fluid volume and composition regulation are vital for homeostasis. The renal system is destined to perform the feat of ECF volume and composition regulation along with excretory function. The prime intersystem communication between the kidneys, the CNS and cardiovascular system is for ensuring the optimal blood flow and supply of the essential nutrients to each and every cell and tissues of the body. The renal system is under the control of sympathetic division of autonomic nervous system which through its afferent and efferent nerves ensure the body fluid volume regulation. The long-term hormonal mechanisms are also essential part of this regulation as does the short-term neural mechanism. The interaction between renal afferent and efferent sympathetic innervation is deciding the optimum levels of renal function effected through the nervous control The aim of this review article is to appraise, use and apply the information available through published reports to elaborate, delineate, explore on major knowledge building and to address the definite role of renal sympathetic nerves in the function of kidneys in health and disease. With obvious limitations in studying the role of renal nerve activity in hypertensive humans, the underlying mechanism studied in experimental animal model could shed more light on the disease pathogenesis and the evidences obtained so far can be applied in understanding the underlying mechanism in humans as well.

Clinicopathological Features of Patients with Bladder Cancer in a Hospital Unit in Yazd, Iran

Tue, 11 Jul 2023 10:35:53 +0000

Background and Aim: Bladder cancer is the tenth most common cancer in the world and the fourteenth cause of death in the world. The aim of this study is to investigate the clinical and pathological characteristics of patients with bladder cancer. Methods: Patients diagnosed with bladder tumor from 2014 to 2021 were selected. Clinical characteristics including size, location, morphology, stage and grade of tumor and demographic information including age, sex and smoking were extracted from patients' files. The survival rate of the patient until the study time or until death was recorded. Results: The results showed that the average age of the patients was 61 years and the male to female ratio was 4.4. The prevalence of smoking (45%) and opium (36.4%) was observed. The most common location of the tumor was the right side of the bladder (43.6%) and the left side (37.7%), and the most common histopathology observed was transitional cell carcinoma (84.4%). The follow-up results of the patients showed that 18% died due to the disease and 4.9% died due to another cause. 23.6% continued to live despite the disease and 36% showed no signs of disease during the follow-up period. Conclusion: The results showed that regular follow-up of patients and accurate recording of their information, as well as improving uropathology skills can help increase insight into bladder cancer in the future.

Low Vitamin D Status is Linked to Cardiovascular Risk in Newly Diagnosed Type 2 Diabetes Mellitus

Tue, 11 Jul 2023 00:00:00 +0000

Background and Aim: Vitamin D is linked to the prevalence and severity of cardiac autonomic neuropathy in Type 2 Diabetes Mellitus (T2DM). Autonomic dysfunctions are evident in newly diagnosed T2DM subjects. However, the association of Vitamin D level with autonomic dysfunction in newly diagnosed T2DM remains unclear. To study the relationship between Vitamin D status and cardiovascular autonomic function in newly diagnosed T2DM. Methods: One group descriptive study with 47 newly diagnosed T2DM patients (mean age 39±4 years, with 23 males and 24 females), recruited based on American Diabetes Association (ADA) criteria in outpatient clinic of Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India. Cardiovascular autonomic functions including heart rate variability, baroreflex sensitivity and other conventional autonomic function tests were measured. The level of 25-hydroxy Vitamin D[25(OH)D] was measured using chemiluminescence assay technique. Results: The mean serum 25(OH)D concentration was 17.49±7.10, and all patients had Low Vitamin D levels (<30 ng/mL). There were significant negative correlations of Vitamin D level with basal HR (P=0.006), LF(nu) (P=0.010), LF-HF ratio (P=0.023); and positive correlations with BRS (P=0.007), HF(nu) (P<0.001) and TP (P=0.002). Conclusion: There was decrease in Vitamin D level in all subjects and it showed association with markers of sympathovagal imbalance. This might increase the cardiovascular risk in them.

Effects of Pueraria Radix isoflavone (PRI) extract on osteoporosis in ovariectomized rats

Rihyang Pak, Cholgyu Choe, Kyongjin Ma — Tue, 11 Jul 2023 10:53:00 +0000

Background and Aim: Cessation of ovarian function is a major cause of postmenopausal osteoporosis. Ovariectomized rats and dogs have been used extensively in osteoporosis models. This study examined the effect of Pueraria Radix isoflavone extract not only on Bone Mineral Density (BMD) but also on bone strength using bone formation and resorption markers in ovariectomized rats as an osteoporosis model. Methods: The model of Ovariectomized (OVX) rats induced by ovariectomy as previously described and the effect of isoflavone extract was evaluated through the measurement of BMD, the strength of the distal femoral metaphysis and the levels of urinary deoxypyridinoline and serum osteocalcin. Results: In rat administrated with isoflavone extract (only 90 mg/kg) for 12 weeks, BMD was significantly increased, while the doses of 60 and 90 mg/kg decreased urinary deoxypyridinoline and serum osteocalcin to normal level and elevated the strength of the distal femoral metaphysis. Conclusion: These results suggested that Pueraria Radix isoflavone may be a useful traditional medicine for osteoporosis due to stimulated bone resorption.

Effects of Onion extract on Ulcerative Colitis in Rats

Gyonghui Rim, Songchan Han, Chunmok Rim — Tue, 11 Jul 2023 11:10:07 +0000

Background and Aim: The purpose of the present study is to provide a basis for the use of onion as a therapeutic agent for Ulcerative Colitis (UC). Methods: The rat’s model of UC induced by acetic acid administration intrarectally as previously described and the effect of onion extract was evaluated through the measurement of colonic biometrics, colonic Myeloperoxidase (MPO) activity and serum Lactate Dehydrogenase (LDH) activity in this model. Results: In rat treated with onion (300mg/kg, orally) colonic biometrics including weight and length at the 5th day after acetic acid administration was significantly improved. Colonic MPO activity was significantly decreased in onion extract group, while that in UC group significantly increased compared to control. LDH activity in serum was significantly elevated in UC group, but the administration of onion extract improved it. Conclusion: Our results suggest that onion used in the present study has potential for the treatment of UC.

Plummer-Vinson Syndrome: A Rare Cause of Dysphagia in Children

Syed Ahmed Zaki, Preeti Shanbag — Tue, 11 Jul 2023 11:15:39 +0000

Plummer-Vinson Syndrome (PVS) or Paterson-Brown-Kelly syndrome is characterized by the classical triad of iron deficiency anemia, esophageal webs and dysphagia. PVS is commonly found in women of middle age especially in the fourth and fifth decade of life and is rarely reported in children. We report a case of a 4-year-old girl who had a classic presentation of PVS. Early diagnosis is of utmost importance for better prognosis as PVS is a precancerous condition with high malignant potential. Mainstay of management is correction of anemia by iron supplementation. Majority of the cases iron repletion improves the dysphagia. In some cases; esophageal dilatation is used to provide symptomatic relief.

News and Views

Manjulata . — Tue, 11 Jul 2023 11:21:35 +0000

Cardiovascular Diseases (CVDs) are the leading cause of death globally representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke with over three quarters taking place in the low and middle socio-economic countries.[1] It constitutes 38% of the total premature death due to non-communicable disease.[1] Surgery, such as Coronary Artery Bypass Grafting (CABG) or Percutaneous Coronary Intervention (PCI), is often effective in treating the underlying blockages or narrowing of arteries in Ischemic Heart Disease (IHD). However, it is important to understand that surgery alone may not be sufficient to improve the Activity of Daily Living (ADL) in individuals with IHD. Older patients more frequently undergo cardiac surgery for improving rather than quantitating quality of life.[2] Post cardiac surgery is associated with many complications which may be multi factorial. Pulmonary and neurological complications due to Procedure/anaesthesia/ both, are the most common. Among the pulmonary complications atelectasis (32-72%) and pleural effusion (24-63%) are the most common.[3] Among the neurological dysfunction, postoperative cognitive dysfunction due to surgery is the most common.[4] Postoperative cognitive impairment affects between 10–40% of patients in the sixth postoperative week following cardiac surgery. Only around 45% of patients fully recover from cognitive impairment after 1 year post cardiac surgery.[5] A cognitive or mental decline can also lead to impaired ADL's.[6] Apart from medications, structured cardiac rehabilitation program is often recommended after surgery or other interventions for ischemic heart disease. These programs provide supervised exercise training, education on heart-healthy living, counselling, and support to help individuals regain their strength, manage symptoms, and improve ADL. The addition of yoga-based relaxation to conventional post-CABG cardiac rehabilitation helps in better management of risk factors in those with abnormal baseline values and may help in preventing recurrence.[7]. Read more...