Inter arm blood pressure difference: an indicator of cardiovascular risk

Background: Overall prevalence of hypertension in India is 33% in urban and 25% in rural areas. For optimal health blood pressure of less than 120 mm of Hg systolic and 80mm of Hg diastolic is to be maintained. According to American heart association, inter arm BP difference of more than 20 mm of Hg systolic and 10 mmm of Hg diastolic are associated with peripheral vascular disease, vasculitis, connective tissue disorders and congenital anomalies. Though the guidelines quote that it is mandatory to examine pressure in both arms before diagnosing hypertension this system is not followed, which has led to increase in misdiagnosis of HT. The present study aims to determine the magnitude of interarm difference in young healthy individuals and to assess whether family history of HT and BMI is related to higher interarm difference.Methods: 110 normal healthy medical students both males & females are recruited for the study .after obtaining institutional ethical clearance the participants in the study are informed about the study process and detailed history obtained .after 5 min of rest BP is assessed by sphygmomanometer first in right arm & then left. Statistical analysis done using paired t test, correlation between variables done with chi square test. Results: statistically significant difference p10mm of Hg and diastolic interarm >5mm of Hg ,though this value is not statistically significant ,it shows that people with family history of hypertension is more prone to interarm BP difference.Conclusions: Interarm difference exists in norma lhealthy volunteers and interarm difference  of >10 mm of Hg systolic & >5 mm of Hg diastolic should be investigated further as these subjects are more prone to develop cardiovascular morbidities .hence we conclude that interarm difference is a sensitive noninvasive and simple method of detecting individuals prone for cardiovascular morbidities.

Variations of physiological parameters in newly detected hypothyroidism

Background: Emergence of hypothyroidism as a public health issue apart from a common clinical entity, has gained much attention nowadays. The non-specific features of hypothyroidism lead to incorrect diagnoses, inadequate treatment and complications in the future. The present study was designed to unravel the effects of hypothyroidism on physiological parameters and to highlight the importance of early diagnosis and treatment. This study was done to assess the effects of hypothyroidism on pulse rate, blood pressure and respiratory rate.Methods: This descriptive cross-sectional study was done in 60 hypothyroid patients of 18-45 years age, both males and females, who were either newly detected or on treatment for less than 6 months. Patients with history of other systemic diseases, pregnancy and hyperthyroidism were excluded. After obtaining written consent from the patients, clinical examination was done.Results: Student t-test and ANOVA were used for analysis. Physiological parameters like pulse rate, blood pressure and respiratory rate had variations in the patients and there were changes with age, gender and BMI even though they were not significant. These changes were attributed to increased arterial wall thickness and endothelial dysfunction in blood vessels.Conclusions: The patients showed changes in cardiovascular and respiratory profiles. The variations in systolic and diastolic blood pressures were significant with increase in age. Physiological parameters had variations with gender and BMI also. This proves the cardiovascular and respiratory morbidity in newly detected hypothyroidism, which emphasizes the importance of early diagnosis and treatment in them

Metacognitive awareness- evaluation and implications in medical students

Background: Medical education is at cross roads today with a mismatch between students’ expectations of their performance and the reality. This led us to explore the reason for the academic decline. During our search, we found that metacognitive awareness plays a key role in moulding the learning skills of adult learners. Hence this study was conducted to evaluate the metacognitive awareness of medical students studying in the first year of MBBS.Methods: 100 first year medical students were included in the study and metacognitive awareness inventory questionnaire, a validated tool was administered to the students. This measures metacognitive knowledge and regulation. The results were obtained, tabulated and analysed.Results: Metacognitive awareness among medical students was average. Metacognitive knowledge was found to be significantly better than regulation. On comparing the genders, we note that females have better metacognitive regulation while males score higher in metacognitive knowledge which was statistically significant.Conclusions: The findings of the present study points towards the need of introduction of metacognitive strategies in the medical curriculum with more emphasis on problem based learning in order to make our learners become independent thinkers and efficient care givers.  

The effect of waist hip ratio on the various stress types in I year Indian medical students

Background: A medical student faces tremendous academic and non-academic stress owing to the vast curriculum and inadequate time. The impact of stress results in detrimental mental and physical health which is assessed here using stress questionnaires and anthropometric parameters. Stress need not be only academic.  Hence it becomes vital to identify and target the specific and common non-academic stressors to enable the students to have a stress-free learning environment. The objective of this study was to find the inter relationship between waist hip ratio (WHR) and various stressors the student is exposed to.Methods: 97 I year medical students participated in this cross-sectional study and were administered the medical student stress questionnaire (MSSQ), a validated tool and the anthropometric measurements (waist and hip circumference, waist hip ratio, body mass index) were taken. The data was analyzed using SPSS version 22.Results: The study showed a negative correlation of WHR with all the stress parameters of which inter personal relationship stress (IRS) and teaching learning related stress (TLRS) were significant.Conclusions: Increasing the duration of I year MBBS course and helping learners acclimatize to the new study environment may help in reducing stress. Stress relaxation techniques, psychological counselling and strengthening the mentor- mentee programs along with exercise regimen may aid in the stress reduction process and facilitate physical health.

One-year clinical outcome of patients with nonvalvular atrial fibrillation: Insights from KERALA-AF registry.

BackgroundWe report patient characteristics, treatment pattern and one-year clinical outcome of nonvalvular atrial fibrillation (NVAF) from Kerala, India. This cohort forms part of Kerala Atrial Fibrillation (KERALA-AF) registry which is an ongoing large prospective study.MethodsKERALA-AF registry collected data of adults with previously or newly diagnosed atrial fibrillation (AF) during April 2016 to April 2017. A total of 3421 patients were recruited from 53 hospitals across Kerala state. We analysed one-year follow-up outcome of 2507 patients with NVAF.ResultsMean age at recruitment was 67.2 years (range 18-98) and 54.8% were males. Main co-morbidities were hypertension (61.2%), hyperlipidaemia (46.2%) and diabetes mellitus (37.2%). Major co-existing diseases were chronic kidney disease (42.1%), coronary artery disease (41.6%), and chronic heart failure (26.4%). Mean CHA2DS2-VASc score was 3.18 (SD ± 1.7) and HAS-BLED score, 1.84 (SD ± 1.3). At baseline, use of oral anticoagulants (OAC) was 38.6% and antiplatelets 32.7%. On one-month follow-up use of OAC increased to 65.8% and antiplatelets to 48.3%. One-year all-cause mortality was 16.48 and hospitalization 20.65 per 100 person years. The main causes of death were cardiovascular (75.0%), stroke (13.1%) and others (11.9%). The major causes of hospitalizations were acute coronary syndrome (35.0%), followed by arrhythmia (29.5%) and heart failure (8.4%).ConclusionsDespite high risk profile of patients in this registry, use of OAC was suboptimal, whereas antiplatelets were used in nearly half of patients. A relatively high rate of annual mortality and hospitalization was observed in patients with NVAF in Kerala AF Registry

Metacognitive awareness- evaluation and implications in medical students

Background: Medical education is at cross roads today with a mismatch between students' expectations of their performance and the reality. This led us to explore the reason for the academic decline. During our search, we found that metacognitive awareness plays a key role in moulding the learning skills of adult learners. Hence this study was conducted to evaluate the metacognitive awareness of medical students studying in the first year of MBBS. Methods: 100 first year medical students were included in the study and metacognitive awareness inventory questionnaire, a validated tool was administered to the students. This measures metacognitive knowledge and regulation. The results were obtained, tabulated and analysed. Results: Metacognitive awareness among medical students was average. Metacognitive knowledge was found to be significantly better than regulation. On comparing the genders, we note that females have better metacognitive regulation while males score higher in metacognitive knowledge which was statistically significant. Conclusions: The findings of the present study points towards the need of introduction of metacognitive strategies in the medical curriculum with more emphasis on problem based learning in order to make our learners become independent thinkers and efficient care givers. [Int J Res Med Sci 2016; 4(8.000): 3570-3575

Growth of Homogeneous Luminescent Silicon–Terbium Nanowires by One-Step Electrodeposition in Ionic Liquids

An electrodeposition method for the growth of homogeneous silicon–terbium nanowires (NWs) with green light emission is described. The method involves template-assisted electrochemical co-deposition of Si/Tb NWs with 90-nm diameter from an electrolyte bath containing Si and Tb precursors in an ionic liquid (IL). This method of deposition is advantageous over other conventional techniques as it is relatively simple and cost-effective and avoids harsh deposition conditions. The deposited NWs are of uniform dimensions with homogeneous composition incorporating 10% of Tb and exhibit intense room temperature (RT) luminescence in the visible range due to Tb emission. These results were confirmed by combining classical characterization such as scanning electron microscopy (SEM) and photoluminescence (PL) performed on an assembly of NWs with spatially resolved experiments such as transmission electron microscopy (TEM) and cathodoluminescence (CL). This electrodeposition method provides an alternative and extremely simple approach for depositing silicon-rare earth nanostructures for optical and sensing applications

Synthesis, Characterization, and Application of Silicon Wafer Functionalization with a Luminescent Tb(III) Coordination Complex

A new luminescent Tb-DOTAGA (1,4,7,10-tetraazacyclododecane-1-glutaric-4,7,10- triacetic acid) complex (TbL) was synthesized and covalently immobilized on a silicon wafer. The grafting process was monitored by means of IR and XPS spectroscopies and the optical properties of the functionalized silicon wafer (TbL@Si) were investigated by fluorescence experiments. A homemade setup was then implemented in order to follow TbL@Si optical properties in the presence of gaseous nitric oxide (NO). The prima facie results indicated that in the presence of NO, the wafer fluorescence was partially quenched. This quenching was reversible as soon as NO was pumped outside the fluorescence cell, which could be interesting for the further development of lanthanide labelled silicon wafers as gas phase sensors