A study on the left ventricular hypertrophy among the patients of chronic kidney disease stage third to five

Background: In Chronic kidney Disease (CKD) a significant risk factor for mortality is Cardiovascular disease (CVD) and the most prevalent cardiovascular risk factor is left ventricular hypertrophy (LVH). Anemia, hypertension and volume overload are risk factors for LVH in CKD. So, the present was aimed at comparing the risk factors between CKD with and without LVH.Methods: A cross sectional study carried out over a 2 year period in Department Nephrology and General Medicine OPD, MIMS, Vizianagaram, Andhra Pradesh. A total of 120 patients are included in this study and divided in to CKD stage III to V based on estimated GFR. Based on 2D echocardiography data CKD cases are further divided in to CKD with LVH and CKD without LVH.Results: The Left ventricular mass index was significant higher in CKD with LVH (128.89±19.28) when compared with CKD without LVH (108.20±10.28). The left ventricular mass index was noted in more number in stage V of CKD. It is also observed that the left ventricular mass index was negatively correlated with haemoglobin and eGFR and was positively correlated with systolic blood pressure and serum NT-proBNP.Conclusions: Present study finding suggested that the incidence of LVH is higher in CKD patients. LVH was positively correlated with hypertension and NT-proBNP and negatively correlated with anemia and estimated GFR

Evaluation of lung function among the Indian elite female weightlifters

Background: Spirometry is an essential tool to evaluate lung function of health and disease. Adaptability of lung and chest among athletes can be assessed by lung function test (LFT). The quest of our study was to evaluate the lung function (LF) of highly trained Indian female weighting athletes, and intended to appraise the adaptation of LF among trained elite athletes.Methods: Top ranked Indian female professional weightlifters (study group, n=6) were recruited for this study. Three out of the six weightlifters were from top ten world ranking of 6th, 7th and 9th. Age matched controls (control group, n=6) were selected for this study. Maximum voluntary ventilation (MVV), vital capacity (VC), forced vital capacity (FVC), percentage of forced expiratory volume in first second (FEV1%) and ratio of forced expiratory volume in first second and forced vital capacity (FEV1/FVC%) have been evaluated as per the ATS/ERS guidelines.Results: Statistically higher significant values of VC and FVC were noted in study group, where as other values (MVV, FEV1% and FEV1/FVC%) found no significant difference between two groups.Conclusions: Power, strength and explosiveness of the skeletal muscles are vital domains in weightlifting sport. Weightlifting is such a sport doesn’t require much ventilatory efforts during training as well as competition. This study clueing that physiological adaptation/ improvement of the pulmonary function (PF) depends on the type of the sport being engaged by the athletes

Study of prescribing pattern of antihypertensive drugs in diabetic patients in a tertiary care centre, Vizianagaram, India

Background: Diabetes mellitus (DM) and Hypertension (HTN) are the two major chronic disorders frequently coexisting, with increased incidence with age. HTN is about twice as common in patients with DM. Prescribing pattern are powerful tools to ascertain the role of drugs in society. There are many variations in prescribing patterns of antihypertensive drugs in patients with HTN and DM. Since these patients requires lifelong treatment it has enormously increased the burden of patients particularly in developing countries like India. Physician needs to be more concerned while choosing drugs for the patients with HTN and DM. In a tertiary care hospital, there is a real need for drug utilization study to determine the appropriate, more safe and effective patterns of drug therapy among diabetic hypertensive patients.Methods: A Cross sectional observational study was conducted in Maharajah’s Institute of Medical Sciences from December 2016 to May 2018. A total of 360 prescriptions of the patients with hypertension and coexisting diabetes were analyzed. The prescriptions prescribed to these patients were collected, assessed and the following parameters were noted. The treatment pattern of different group of drugs for HTN with co-existing DM was evaluated. The intended work was divided into three steps: Step 1: To collect the prescriptions of hypertensive patients with DM. Step 2: To separate the prescriptions prescribing anti hypertensive Drugs. Step 3: To statistically analyze the prescriptions. Relevant information was recorded in a structured proforma & data was evaluated.Results: In this study it was found that 36% of the patients were in the age group of 51-60 years with female preponderance among diabetic hypertensive patients. 77% of patients were treated with single antihypertensive drug and 23% of patients were treated with antihypertensive drug combinations. In monotherapy, telmisartan was most commonly prescribed. In combination therapy, amlodipine and telmisartan followed by amlodipine and atenolol were used.Conclusions: In this study monotherapy was preferred compared to combination therapy and adherence to the JNC 7 guidelines was good except in case of usage of diuretics

Status of vitamin D, lipid profile and carotid artery intima media thickness in patients with chronic kidney disease stage III to V

Background: Chronic Kidney Disease (CKD) is characterized by irreversible sclerosis and loss of nephrons. The renal mass progressively declines over a prolonged period, depending on the underlying etiology. In CKD the most common feature is hypovitaminosis D which alter the vascular smooth muscle cell proliferation and reprogram the osteoblastic changes, finally leading to increase arterial wall thickness.Methods: A cross sectional study carried out over a 2-year period in Department Nephrology and General Medicine OPD, MIMS, Vizianagaram, Andhra Pradesh, India. 120 in which 60 are normal healthy individuals and 60 are CKD patients with stage 3 to 5. In all the participants serum creatinine, blood urea, serum triglycerides serum total cholesterol, HDL cholesterol estimated and serum 25 OH vitamin D are estimated.Results: The diagnostic criteria for CKD like blood urea, serum creatinine and eGFR were significantly higher in CKD when compared to control. In the present study, systolic and diastolic blood pressure was significantly increased in CKD compared with control. The Carotid Intima Media Thickness (CIMT) both left and right side were significant higher in CKD when compared with control. There is a significantly decreased levels of serum vitamin D in CKD (14.53 ng/mL±6.88) when compared with control (28.87 ng/mL±6.28).Conclusions: Present study finding suggested that there is a raised value of CIMT in CKD patients. High triglycerides, cholesterol and decreased HDL and declined vitamin D low hemoglobin, decreased eGFR, increased systolic blood pressure, raised CIMT value were found to be significantly increased in CKD patients

Level of physical activity, determinants and barriers to motivate physical activities among south Indian diabetic patients: a prospective, questionnaire based study

Background: Several clinical trials have been reported that sedentary lifestyle modification including physical activity (PA) and weight loss significantly alters the sort-term as well as long-term incidence of diabetes. The present study explored the level of physical activity and its barriers among south Indian naïve patients who are attending the tertiary care teaching hospital.Methods: A prospective observational, questionnaire-based study. Patients with diabetes (both Type-1 and 2) who were attended diabetic clinic in the Department of General Medicine, Maharaja Institute of Medical Sciences (MIMS), Vijayanagaram, Andhra Pradesh, India was selected and recruited. Demographic data, clinical data were collected from the study participants. International Physical Activity questionnaire was used to determine each patient level of physical activity (PA). Physical activity is graded into low (3000 MET).Results: A total of 300 subjects were completed the entire study. Majority (62.7%) of the patients were suffering from Type-2 diabetes mellitus. Both male and female study subjects had low physical activity (70.5% and 74.1%) and moderate PA was seen in only one thirds of the patients. Patients with low physical activity had low glycaemic control compared to patients who were involved in moderate PA. Moderate PA patients had adequate glycaemic control (65.9 vs 34.1%, P <0.001). A total of 42.0% of subjects were suffering from one of the joint pains and friction joints, due to the following reason subjects were not involved in the PA.Conclusions: Low level of physical activity was observed in the study population, which is a risk factor for several micro-vascular complications over a period of time. It is very important to address the barriers of PA and vigorous counselling is needed which directs towards increasing PA

Pair Trawling vs. Otter Trawling: An evaluation of efficiency along the Southwest Coast of India

In Karnataka, the trawling industry contributes significantly to fish landings. Though conventional otter trawlers account for the majority of trawl landings in the state, pair/bull trawling, which is prohibited, also during the post-monsoon season. There are no published reports on the specifications of the gear used or the changes operation, in the region over the last few years. A comparison of pair/ bull trawls and mid-water finfish otter trawls operating off the coast of Karnataka was conducted. The specifications for the gears were gathered from the gear fabrication units in Mangalore and Malpe. The pair trawl’s head rope (HR) measured 183–293 m in length, while the finfish otter trawl’s HR measured 99–110 m. The pair trawls had a mouth opening that was between 2.9–4.06 times that of the mid-water finfish otter trawls. Trawlers operating along the Karnataka coast conducted both pair and otter trawling during the same cruise, depending on the circumstances. The study indicates that the catch rate was significantly higher in pair trawls than in otter trawls. The average drag produced by pair trawls was calculated to be 6.74 tonnes at a speed of 3.0 kn, while the drag produced by otter trawls was only 2.28 tonnes at the same speed. The result of the study indicates that while the high fuel consumption of a pair trawling unit may negate some of the profits, the overall profit margin of the unit remains high during pair trawling, enticing fishermen to engage in clandestine pair trawling.Capping engine power, regulating gear size and operation and enforcing legal mesh sizes through stringent “monitoring, control and surveillance†mechanisms mitigate the negative impacts of pair trawling

Comparative determination of HIV-1 co-receptor tropism by Enhanced Sensitivity Trofile, gp120 V3-loop RNA and DNA genotyping

BACKGROUND: Trofile is the prospectively validated HIV-1 tropism assay. Its use is limited by high costs, long turn-around time, and inability to test patients with very low or undetectable viremia. We aimed at assessing the efficiency of population genotypic assays based on gp120 V3-loop sequencing for the determination of tropism in plasma viral RNA and in whole-blood viral DNA. Contemporary and follow-up plasma and whole-blood samples from patients undergoing tropism testing via the enhanced sensitivity Trofile (ESTA) were collected. Clinical and clonal geno2pheno[coreceptor] (G2P) models at 10% and at optimised 5.7% false positive rate cutoff were evaluated using viral DNA and RNA samples, compared against each other and ESTA, using Cohen's kappa, phylogenetic analysis, and area under the receiver operating characteristic (AUROC). RESULTS: Both clinical and clonal G2P (with different false positive rates) showed good performances in predicting the ESTA outcome (for V3 RNA-based clinical G2P at 10% false positive rate AUROC = 0.83, sensitivity = 90%, specificity = 75%). The rate of agreement between DNA- and RNA-based clinical G2P was fair (kappa = 0.74, p < 0.0001), and DNA-based clinical G2P accurately predicted the plasma ESTA (AUROC = 0.86). Significant differences in the viral populations were detected when comparing inter/intra patient diversity of viral DNA with RNA sequences. CONCLUSIONS: Plasma HIV RNA or whole-blood HIV DNA V3-loop sequencing interpreted with clinical G2P is cheap and can be a good surrogate for ESTA. Although there may be differences among viral RNA and DNA populations in the same host, DNA-based G2P may be used as an indication of viral tropism in patients with undetectable plasma viremia

Efficacy of customised foot orthoses in the treatment of achilles tendinopathy : study protocol for a randomised trial

BACKGROUND: Achilles tendinopathy is a common condition that can cause marked pain and disability. Numerous non-surgical treatments have been proposed for the treatment of this condition, but many of these treatments have a poor or non-existent evidence base. The exception to this is eccentric calf muscle exercises, which have become a standard non-surgical intervention for Achilles tendinopathy. Foot orthoses have also been advocated as a treatment for Achilles tendinopathy, but the long-term efficacy of foot orthoses for this condition is unknown. This manuscript describes the design of a randomised trial to evaluate the efficacy of customised foot orthoses to reduce pain and improve function in people with Achilles tendinopathy. METHODS: One hundred and forty community-dwelling men and women aged 18 to 55 years with Achilles tendinopathy (who satisfy inclusion and exclusion criteria) will be recruited. Participants will be randomised, using a computer-generated random number sequence, to either a control group (sham foot orthoses made from compressible ethylene vinyl acetate foam) or an experimental group (customised foot orthoses made from semi-rigid polypropylene). Both groups will be prescribed a calf muscle eccentric exercise program, however, the primary difference between the groups will be that the experimental group receive customised foot orthoses, while the control group receive sham foot orthoses. The participants will be instructed to perform eccentric exercises 2 times per day, 7 days per week, for 12 weeks. The primary outcome measure will be the total score of the Victorian Institute of Sport Assessment - Achilles (VISA-A) questionnaire. The secondary outcome measures will be participant perception of treatment effect, comfort of the foot orthoses, use of co-interventions, frequency and severity of adverse events, level of physical activity and health-related quality of life (assessed using the Short-Form-36 questionnaire - Version two). Data will be collected at baseline, then at 1, 3, 6 and 12 months. Data will be analysed using the intention to treat principle. DISCUSSION: This study is the first randomised trial to evaluate the long-term efficacy of customised foot orthoses for the treatment of Achilles tendinopathy. The study has been pragmatically designed to ensure that the study findings are generalisable to clinical practice. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry Number: ACTRN12609000829213

Not Available

Not AvailableEconomic viability or economic efficiency is equally an important aspect in fishing industry in addition to technical efficiency. Even if a fishing unit is technically efficient but economically not viable, it is not considered suitable for long running. Reduction in fleet size of mechanised trawlers since 2000 might be associated with the decreased economic viability of trawl units which would be resulted in termination of the units. An estimation of capital investment and annual expenditure, details of elements of each type of cost and a comparison of all these among different size category are the results described. Role of fuel cost in operational cost is also portrayed.Through the study, it is proved that capital cost and other annual expenditure are in linear relationship with the size of trawler. The capital investment of mechanised trawlers in Kerala found to be ranged from 0.45 to 13.74 million rupees depending on the size. Comparing the components of capital investment of wooden and steel trawlers, cost of vessel is the major contributor in steel vessels but in wooden trawlers, it is contributing less compared to trawl nets and accessories. Annual fixed cost of mechanised trawlers in Kerala ranged from 0.3 to 2.5 million rupees. It is higher in large and very large trawlers and decreasing with respect to size of the trawler. The contribution of trawlers towards insurance found to be negligible as Matsyafed is giving insurance to fishing vessels at a very low cost ranging from 250 to 350 rupees. Operational cost, which is the most significant economic factor in case of trawlers found to increasing with size of trawlers depending on the rate of fuel consumption. Annual operational cost of trawlers in Kerala ranged from 1.21 to 14.52 million rupees during the study period. Among the components of operational cost, fuel cost found to be major contributor followed by fishermen share, repair and maintenance cost and other remaining costs. Operational cost found to be the major contributor in total annual cost of mechanised trawlers contributing 73 to 85% depending on their size.Not Availabl