Friday, 1 April 2016

IMJ Health : March 2016

Effect of Sports on Blood Pressure and Heart Rate Variability: An Interventional Study

Abstract Lack of sufficient physical activity is the second most important contributor to preventable deaths trailing only to tobacco use. So an interventional study was conducted on University students to study effect of sports with Blood Pressure & HRV. Comparison was made between Non exercise control group (n=31) and exercise group (n=31). Exercise group had an intervention of atleast 60 minutes of various sports of moderate to vigorous intensity daily for one year. Various variables of Blood Pressure & HRV were assessed in both the groups and compared by student unpaired 't' test. It was observed in this study that Exercise group had significantly lowered SBP, DBP, MABP. Although there was no significant difference in both the group in frequency domain of HRV but in time domain RR Intervel was significantly lowered in exercise group thanthe other group. So it can be concluded that one hour of Sports intervention significantly decreased Resting Systolic, Diastolic and Mean Arterial Blood Pressure and significantly decreased Resting Heart Rate this indicates a good interplay or modulation between parasympathetic and sympathetic nervous system. So these sports activities should be motivated in college students by including in their daily curricular activities.

Key words: Blood Pressure, Heart Rate Variability, Exercise, Sports

Click here to Download Full Paper

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Associated Sociodemographic and Clinical factors with Hypertension and Dyslipidemia in Type 2 diabetes: A Hospital Based Cross-sectional Study

Abstract Diabetes Mellitus (DM) is a chronic and progressive condition with a hereditary predisposition which is further induced by unhealthy lifestyle. It is a silent killer with cardiovascular complications being most common cause of morbidity and mortality in patients with T2DM.

Objective: To find out association of socio demographic and clinical parameters of diabetes type 2 with hypertension and dyslipidemia among Diabetes Mellitus type 2 cases aged 18 to 70 years. Methodology: A cross sectional hospital based study was conducted on 272 type 2 DM patients attending Department of Medicine in a secondary care referral hospital after taking consent.

Results: Hypertension was present in 192 (70.59%) and dyslipidemia was present in 93 (34.19%) of type 2 diabetes patients. Age, family income, presence of family history, duration of illness, type of treatment, consumption of alcohol , BMI, Hba1c level were found to be associated significantly with both hypertension and dyslipidemia in type 2 DM patients.

Key Words: Diabetes Mellitus, Hypertension, Dyslipidemia , Body mass Index

Click here to Download Full Paper

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Submental Intubation Technique for Airway during Surgery of Midfacial and Panfacial Traumatic Injuries: A Descriptive Study

AbstractSubmental intubation is a method for airway without trachiotomy. This study was conducted with the aim to evaluate the frequency, indications, and outcomes of airway management by submental intubation in maxillofacial trauma patients and comparison with tracheostomy regarding its advantages and disadvantages.40 patients with maxillofacial injuries were selected for submental intubation who required tracheostomy/ retromolar intubation in a 2 year period (2013–2015). Submental intubation permitted reduction and fixation of all the fractures without the interference of the tube during surgical procedure in all of the patients. It avoids retromolar intubation/ tracheostomy and its disadvantages.Thus,Submental intubation is a simple, safe, with low morbidity technique for operative airway management in maxillofacial trauma patients when there are fractures involving the nasal region and concomitant dental occlusion disturbances who required retromolar intubation/ tracheostomy for airway management during surgery.

Key words: Submental Intubation, Tracheostomy, Maxillofacial Trauma Cases, Midfacial and Panfacial Traumatic Injuries

Click here to Download Full Paper

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High-Dose-Rate brachytherapy (HDR-BT) with neoadjuvant chemoradiation for advanced rectal cancer

AbstractColorectal cancer is leading cancer-related public health problem. This study was conducted to determine the effect of High-Dose-Rate intraluminal brachytherapy (HDR-BT) with or without interstitial brachytherapy during neoadjuvant chemoradiation for locally advanced rectal cancer. This randomized contrial was conducted on 28 patients attended with locally advanced rectal cancer (T3, T4 or N+) treated initially with concurrent capecitabine (800 mg/m2 twice daily for 5 days per week) and pelvic external beam radiation therapy (45Gy in 25 Fractions) after one week MRI for all patients; received intraluminal HDR-BT with 4Gy x 2 Fractions with one week interval for those had gross residual disease within 1cm of rectal wall and receiveed intraluminal and interstitial brachytherapy with 4Gy x 2 Fractions with one week interval for those had gross residual disease far from 1cm of rectal wall. All patients underwent surgery within 4-8 week after completion of neoadjuvant therapy. In the control group which were not randomized, twenty-eight patients underwent neoadjuvant chemoradiation (45Gy in 25 Fraction with concurrent capecitabine 800mg/m2 twice daily for 5 days per week) followed by surgery. It was found that in HDR-BT group pathologic complete response (pCR), pathologic partial response (pPR) and pathologic response rates (pCR+pPR) based on AJCC TNM staging for colorectal cancer were %35.7, %35.7, and %71.4 respectively. The pCR, pPR, and pRR were %25, %17, and %42 in the control group respectively. pCR, pPR, and pRR were improved with HDR-BT. However, only response rate improvement was statistically significant (p=0.031). There was no a statistically significant difference in the complications between the two groups (p > 0.05). So it can be concluded that HDR intraluminal with or without interstitial brachytherapy may be an effective method of dose escalation technique in neoadjuvant chemoradiation therapy of locally advanced rectal cancer with higher response rate and manageable side effects.

Key words: HDR, Brachytherapy, Neoadjuvant, Chemoradiation, Rectal cancer

Click here to Download Full Paper

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Occupational Risk Factors of Common Psychiatric Disorders among Railway Employees: A Descriptive Study

Abstract There is a dearth of research work and scarcity of availability of data on psychiatric morbidity among railway employees in India. Present hospital based observational descriptive study was carried out at medical OPD of Central Hospital of Northern Western Railway, Jaipur with the specific aims to study occupational attributes of common psychiatric disorders. Total 450 randomly selected individuals were screened for psychiatric morbidities by using Mini-international neuropsychiatric interview-PLUS. Psychiatric diagnosis confirmed by two psychiatrists separately using the ICD, 10th revision (diagnostic and research criteria). A self designed, pre-tested & semi-structured detailed Performa was used to elicit demographical and occupational attributes. Univariate analysis was carried out initially to identify risk factors. The data was analyzed in terms of descriptive statistics, Chi-square test and stepwise binary logistic regression by using SPSS and Primer Version ‘6’. Most common diagnosed psychiatric disorders were Neurotic, stress related and somatoform disorders (28%), followed by mood disorders (25.56%). Common Psychiatric Disorders (CPD) i.e. depression, anxiety and somatoform disorders were the most common diagnosed psychiatric morbidities (49.78%). Working in rotatory shifts, perceived problems related to shift duties and stress in the working environment, work experience more than 20 years and non-executive type job were observed as the occupational risk factors for common psychiatric disorders. The present observations suggest that there is scope for psychiatric intervention for the management of perceived stress at work place, problems related to shift duties and other occupational challenges.

Key words: Common Psychiatric Disorders, Occupational Risk Factors, Shifts Duties, Medical Comorbidity

Click here to Download Full Paper

Effect of Sports on Blood Pressure and Heart Rate Variability: An Interventional Study

Abstract Lack of sufficient physical activity is the second most important contributor to preventable deaths trailing only to tobacco use. So an interventional study was conducted on University students to study effect of sports with Blood Pressure & HRV. Comparison was made between Non exercise control group (n=31) and exercise group (n=31). Exercise group had an intervention of atleast 60 minutes of various sports of moderate to vigorous intensity daily for one year. Various variables of Blood Pressure & HRV were assessed in both the groups and compared by student unpaired 't' test. It was observed in this study that Exercise group had significantly lowered SBP, DBP, MABP. Although there was no significant difference in both the group in frequency domain of HRV but in time domain RR Intervel was significantly lowered in exercise group thanthe other group. So it can be concluded that one hour of Sports intervention significantly decreased Resting Systolic, Diastolic and Mean Arterial Blood Pressure and significantly decreased Resting Heart Rate this indicates a good interplay or modulation between parasympathetic and sympathetic nervous system. So these sports activities should be motivated in college students by including in their daily curricular activities.

Key words: Blood Pressure, Heart Rate Variability, Exercise, Sports

Click here to Download Full Paper

_____________________________

Associated Sociodemographic and Clinical factors with Hypertension and Dyslipidemia in Type 2 diabetes: A Hospital Based Cross-sectional Study

Abstract Diabetes Mellitus (DM) is a chronic and progressive condition with a hereditary predisposition which is further induced by unhealthy lifestyle. It is a silent killer with cardiovascular complications being most common cause of morbidity and mortality in patients with T2DM.

Objective: To find out association of socio demographic and clinical parameters of diabetes type 2 with hypertension and dyslipidemia among Diabetes Mellitus type 2 cases aged 18 to 70 years. Methodology: A cross sectional hospital based study was conducted on 272 type 2 DM patients attending Department of Medicine in a secondary care referral hospital after taking consent.

Results: Hypertension was present in 192 (70.59%) and dyslipidemia was present in 93 (34.19%) of type 2 diabetes patients. Age, family income, presence of family history, duration of illness, type of treatment, consumption of alcohol , BMI, Hba1c level were found to be associated significantly with both hypertension and dyslipidemia in type 2 DM patients.

Key Words: Diabetes Mellitus, Hypertension, Dyslipidemia , Body mass Index

Click here to Download Full Paper

__________________________________

Submental Intubation Technique for Airway during Surgery of Midfacial and Panfacial Traumatic Injuries: A Descriptive Study

AbstractSubmental intubation is a method for airway without trachiotomy. This study was conducted with the aim to evaluate the frequency, indications, and outcomes of airway management by submental intubation in maxillofacial trauma patients and comparison with tracheostomy regarding its advantages and disadvantages.40 patients with maxillofacial injuries were selected for submental intubation who required tracheostomy/ retromolar intubation in a 2 year period (2013–2015). Submental intubation permitted reduction and fixation of all the fractures without the interference of the tube during surgical procedure in all of the patients. It avoids retromolar intubation/ tracheostomy and its disadvantages.Thus,Submental intubation is a simple, safe, with low morbidity technique for operative airway management in maxillofacial trauma patients when there are fractures involving the nasal region and concomitant dental occlusion disturbances who required retromolar intubation/ tracheostomy for airway management during surgery.

Key words: Submental Intubation, Tracheostomy, Maxillofacial Trauma Cases, Midfacial and Panfacial Traumatic Injuries

Click here to Download Full Paper

____________________________

High-Dose-Rate brachytherapy (HDR-BT) with neoadjuvant chemoradiation for advanced rectal cancer

AbstractColorectal cancer is leading cancer-related public health problem. This study was conducted to determine the effect of High-Dose-Rate intraluminal brachytherapy (HDR-BT) with or without interstitial brachytherapy during neoadjuvant chemoradiation for locally advanced rectal cancer. This randomized contrial was conducted on 28 patients attended with locally advanced rectal cancer (T3, T4 or N+) treated initially with concurrent capecitabine (800 mg/m2 twice daily for 5 days per week) and pelvic external beam radiation therapy (45Gy in 25 Fractions) after one week MRI for all patients; received intraluminal HDR-BT with 4Gy x 2 Fractions with one week interval for those had gross residual disease within 1cm of rectal wall and receiveed intraluminal and interstitial brachytherapy with 4Gy x 2 Fractions with one week interval for those had gross residual disease far from 1cm of rectal wall. All patients underwent surgery within 4-8 week after completion of neoadjuvant therapy. In the control group which were not randomized, twenty-eight patients underwent neoadjuvant chemoradiation (45Gy in 25 Fraction with concurrent capecitabine 800mg/m2 twice daily for 5 days per week) followed by surgery. It was found that in HDR-BT group pathologic complete response (pCR), pathologic partial response (pPR) and pathologic response rates (pCR+pPR) based on AJCC TNM staging for colorectal cancer were %35.7, %35.7, and %71.4 respectively. The pCR, pPR, and pRR were %25, %17, and %42 in the control group respectively. pCR, pPR, and pRR were improved with HDR-BT. However, only response rate improvement was statistically significant (p=0.031). There was no a statistically significant difference in the complications between the two groups (p > 0.05). So it can be concluded that HDR intraluminal with or without interstitial brachytherapy may be an effective method of dose escalation technique in neoadjuvant chemoradiation therapy of locally advanced rectal cancer with higher response rate and manageable side effects.

Key words: HDR, Brachytherapy, Neoadjuvant, Chemoradiation, Rectal cancer

Click here to Download Full Paper

__________________________

Occupational Risk Factors of Common Psychiatric Disorders among Railway Employees: A Descriptive Study

Abstract There is a dearth of research work and scarcity of availability of data on psychiatric morbidity among railway employees in India. Present hospital based observational descriptive study was carried out at medical OPD of Central Hospital of Northern Western Railway, Jaipur with the specific aims to study occupational attributes of common psychiatric disorders. Total 450 randomly selected individuals were screened for psychiatric morbidities by using Mini-international neuropsychiatric interview-PLUS. Psychiatric diagnosis confirmed by two psychiatrists separately using the ICD, 10th revision (diagnostic and research criteria). A self designed, pre-tested & semi-structured detailed Performa was used to elicit demographical and occupational attributes. Univariate analysis was carried out initially to identify risk factors. The data was analyzed in terms of descriptive statistics, Chi-square test and stepwise binary logistic regression by using SPSS and Primer Version ‘6’. Most common diagnosed psychiatric disorders were Neurotic, stress related and somatoform disorders (28%), followed by mood disorders (25.56%). Common Psychiatric Disorders (CPD) i.e. depression, anxiety and somatoform disorders were the most common diagnosed psychiatric morbidities (49.78%). Working in rotatory shifts, perceived problems related to shift duties and stress in the working environment, work experience more than 20 years and non-executive type job were observed as the occupational risk factors for common psychiatric disorders. The present observations suggest that there is scope for psychiatric intervention for the management of perceived stress at work place, problems related to shift duties and other occupational challenges.

Key words: Common Psychiatric Disorders, Occupational Risk Factors, Shifts Duties, Medical Comorbidity

Click here to Download Full Paper