Pulmonary function changes in asymptomatic smokers - a community survey in Udupi, Karnataka, India

Background: Smoking has been labeled the most important preventable cause of a respiratory disease and its effects in a smoker are well established. A better understanding on the pulmonary function impairments in an asymptomatic smoker is the need of the hour. Objective: To study the pulmonary function changes in asymptomatic smokers and non- smokers and to establish the dose -effect relationship amongst asymptomatic smokers.Methods: A cross sectional survey was conducted in Udupi district of Karnataka, India. 140 men aged between 20 to 45 years with a BMI ranging from 18.5 to 29.9 Kg2 /m was enrolled in to the study. 70 subjects were asymptomatic smokers and the other 70 were non-smokers. Outcomes measured were standard spirometric measures for pulmonary function and symptoms like breathlessness, cough and sputum using a Breathlessness Cough Sputum scale.Results: The mean age (mean ± SD) of non-smokers and asymptomatic smokers enrolled was 34.7±5 and 33.8±5 years respectively. The mean smoking dose amongst the asymptomatic smokers was 15.74±5.5 pack years. FEV1 amongst the asymptomatic smokers showed a negative correlation with smoking dose (p<0.05) and there was a significant difference in FEV1, FVC, PEFR, MVV and FEF 25- 75 % (p<0.001) amongst the asymptomatic smokers and non-smokers.Conclusions: Asymptomatic smokers showed low values of pulmonary function parameters compared to those in non-smokers

Work related musculoskeletal disorders among medical laboratory professionals: a narrative review

Work related musculoskeletal disorders are common health problem and increasing cause of disability. Laboratory professionals are unique group of healthcare professionals who play an essential part in diagnosis and therapy planning and often their work is associated with potential health hazards. Objective of current study was to review literature on prevalence of work-related musculoskeletal disorders among medical laboratory professionals. Electronic databases and bibliographies were searched and identified papers evaluated against inclusion criteria. The searching strategy uncovered 13 reports. Total 7 studies were included for the review. A high degree of heterogeneity among studies was observed. The overall prevalence’s ranges from 40-60%. With neck being more prevalent 18-78%. However additional high quality studies are required in this area

C-reactive protein and coronary heart disease - risk marker or risk factor?

Cardiovascular diseases are gaining a dubious distinction of becoming the leading cause of death. Thus, the search for new risk markers and risk factors of cardiovascular disease continue, in an attempt to predict the risk of cardiovascular events with greater precision. Of all the risk markers available, high sensitivity C-reactive Protein (hsCRP) is considered to be the most robust tool with test characteristics desirable and conducive for clinical use. Pharmacological intervention trials were successful in reducing hsCRP in individuals with elevated levels, following which its status as a therapeutic target has taken a big leap. Numerous pharmacologic and non-pharmacologic interventions are presently being investigated for their efficacy in reducing this inflammatory marker. This review discusses the stability of hsCRP, factors affecting the concentration, independent predictive ability as compared to the traditional risk factors and its role in atherogenesis

Analysis of time-domain indices, frequency domain measures of heart rate variability derived from ECG waveform and pulse-wave-related HRV among overweight individuals: an observational study [version 1; peer review: 2 approved]

Background: Research on the compatibility of time domain indices, frequency domain measurements of heart rate variability obtained from electrocardiogram (ECG) waveforms, and pulse wave signal (pulse rate variability; PRV) features is ongoing. The promising marker of cardiac autonomic function is heart rate variability. Recent research has looked at various other physiological markers, leading to the emergence of pulse rate variability. The pulse wave signal can be studied for variations to understand better changes in arterial stiffness and compliance, which are key indicators of cardiovascular health. Methods: 35 healthy overweight people were included. The Lead II electrocardiogram (ECG) signal was transmitted through an analog-to-digital converter (PowerLab 8/35 software, AD Instruments Pty. Ltd., New South Wales, Australia). This signal was utilized to compute Heart Rate Variability (HRV) and was sampled at a rate of 1024 Hz. The same AD equipment was also used to capture a pulse signal simultaneously. The right index finger was used as the recording site for the pulse signal using photoplethysmography (PPG) technology. Results: The participants' demographic data show that the mean age was 23.14 + 5.27 years, the mean weight was 73.68 +  7.40 kg, the mean body fat percentage was 32.23  +  5.30, and the mean visceral fat percentage was 4.60  +  2.0. The findings revealed no noticeable difference between the median values of heart rate variability (HRV) and PRV. Additionally, a strong correlation was observed between HRV and PRV. However, poor agreement was observed in the measurement of PRV and HRV. Conclusion: All indices of HRV showed a greater correlation with PRV. However, the level of agreement between HRV and PRV measurement was poor. Hence, HRV cannot be replaced with PRV and vice-versa

Kinetics and kinematics of diabetic foot in type 2 diabetes mellitus with and without peripheral neuropathy: a systematic review and meta-analysis.

Diabetes mellitus patients are at increased risk of developing diabetic foot with peripheral neuropathy, vascular and musculoskeletal complications. Problems develop with a relatively high risk of infection, gangrene and amputation. In addition, altered plantar pressure distribution is an important etiopathogenic risk factor for the development of foot ulcers. The purpose of this systematic review is to understand the biomechanical changes involved through studies of foot kinematic and kinetic in type 2 diabetes mellitus. Scientific articles were identified using electronic databases including Science Direct, CINAHL, Springer Link, Medline, Web of Science, and Pubmed. The selection of articles to include in the systematic review was narrorwed after reading the full text, focusing on studies that used experimental designs relating to the biomechanics of diabetic foot. The meta-analysis report on gait velocity (neuropathy = 128 and non-diabetes = 131) showed that there was a significantly lower gait velocity in neuropathy participants compared to non-diabetes age-matched participants at a high effect level (-0.09, 95% CI -0.13 to 0.05; p < 0.0001). Regarding knee-joint flexion range, there was a significant difference between neuropathy and non-diabetes groups (4.75, 95% CI, -7.53 to 1.97, p = 0.0008). The systematic review found significant differences in kinematic and kinetic variables among diabetic with neuropathy, diabetic without neuropathy and non-diabetic individuals. The review also found that the sample sizes used in some studies were not statistically significant enough contribute reliably to the meta-analysis, so further studies with higher sample sizes are required

A MUSCULOSKELETAL INJURY PROFILE OF ATHLETES AT A NATIONAL INTER-UNIVERSITY ATHLETIC MEET IN MANIPAL, KARNATAKA, INDIA

ABSTRAC

Effect of balance strategies on fall risk in type 2 diabetes mellitus with peripheral neuropathy: a systematic review and meta-analysis

Individuals with type 2 diabetes mellitus with peripheral neuropathy are at a high risk of developing unsteadiness and falls. This systematic review and meta-analysis evaluated the effect of balance strategies on fall risk in these conditions. Records from six electronic databases were reviewed. Only randomized control trials focusing on balance strategies and outcomes linked to fall risk were included. Preferred reporting items for systematic reviews and meta-analyses guidelines were followed. Of 2,373 studies, 8 were in-cluded. Risk-of-bias analysis showed that 6 were of good quality, 1 was fair, and 1 was of poor. Meta-analysis of 4 outcome measures was conducted. A meta-analysis of the Berg balance scale (MD 1.08, 95% CI 0.42, 3.19), the functional reach test in centimeters (MD 3.82, 95% CI 0.82, 6.83), the timed up and go test in seconds (MD −1.41, 95% CI −2.14, −0.69), and the one-leg stance test in seconds (right eye open: MD 7.86, 95% CI 1.97, 13.94; left eye open: MD 6.14, 95% CI 2.64, 9.64; right eye closed: MD 2.45, 95% CI 0.61, 4.28; and left eye closed: MD 1.80, 95% CI 0.86, 2.75) It suggested that balance strategies improve fall risk in diabetic neuropathy. The meta-analysis also showed low to very low evidence of a large effect on all the outcomes. The findings of this review show that balance strategies positively influence balancing abilities and reduce fall risk in type 2 diabetes mellitus with peripheral neuropathy

Structured exercise program on Foot Biomechanics & Insulin Resistance among people living with type 2 diabetes with and without peripheral neuropathy

Background: The biomechanical changes in foot among people with type 2 diabetes mellitus often leads to various foot complications which could further add to diabetes related morbidity &amp; mortality. These changes could be seen due to musculoskeletal factor like reduction in intrinsic foot muscle strength, tightness of lower limb muscles, postural changes, etc. Aim: To design and determine the efficacy of a structured exercise program on foot kinetics and kinematics among type 2 participants Materials and methods: A total of 35 participants with type 2 diabetes (n=15, type 2 diabetes mellitus without neuropathy and n=20, type 2 diabetes with peripheral neuropathy) were recruited. All participants were screened clinically &amp; biochemically and given a set of structured exercise program, three times a week for 12weeks along with standard medical care. Results: The mean age of the participants was 56&plusmn;10.5 (Non neuropathy) 62.3&plusmn;7.35 (Neuropathy) years, mean duration of diabetes was 8.7&plusmn;8.95 (Non neuropathy), 10.97&plusmn;8 (Neuropathy) years, mean Body mass index was 26.54&plusmn; 4.83(Non neuropathy), 24.39&plusmn;3.58 (Neuropathy), Significant differences have been observed in kinetic and kinematic variables. Conclusion: The present study shows that the structured exercise protocol is very effective in improving the biomechanics of foot in people with type 2 diabetes with and without neuropathy. It could help to correct the structure and function of the foot and eventually could reduce the risk of foot complications like diabetic foot ulcers