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

Interdisciplinary Approach for Salvaging a Carious Multirooted teeth: A Case Report

Hemisection denotes sectioning of root with its accompanying crown portion of molars.The outcomes is predictable and success rates are high. In this case report a 29 year old male patient with severe class-III furcation involvement of mandibular molar, which was treated with hemisection and restoration followed by fixed prosthodontic prosthesis

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

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

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

Patient education for individuals with Interstitial Lung Disease: A scoping review. [version 1; peer review: 1 approved, 2 approved with reservations]

Objectives Interstitial Lung Disease (ILD) is a severe and rapidly progressing disease with a high fatality rate. Patient education (PE) has been demonstrated to promote long-term adherence to exercise and lifestyle improvements by assisting patients in developing self-management techniques. Our scoping review's goal was to chart out the prevailing level of research about the content, processes, and effectiveness of PE for patients with ILD. Methods The relevant databases were searched using the rules provided by Arksey and O'Malley in 2005 and the Joanna Briggs Institute reviewers' manual 2015: an approach for JBI scoping reviews. Individuals with ILD, published in English between the years of inception and 2020, and describing PE administered by various healthcare practitioners were among the 355 studies found and reviewed. Thirteen studies met these criteria. Results PE delivery process, delivery techniques, quality of life assessments, common PE themes, and healthcare professional participation were all recognized and cataloged. Conclusion Despite the fact that healthcare professionals (physicians, nurses, and physiotherapists) provide PE to patients with ILD regularly, the PE provided varies greatly (contents of PE, process of delivery and delivery techniques). During the scoping review, a significant variation in the themes was addressed. They could not provide any evidence-based specific recommendations for all healthcare practitioners due to the studies' heterogeneity and lack of effectiveness measures

Photo-stimulatory effect of low energy helium-neon laser irradiation on excisional diabetic wound healing dynamics in wistar rats

<b>Background:</b> Generally, the significances of laser photo stimulation are now accepted, but the laser light facilitates wound healing and tissue repair remains poorly understood. <b> Aims:</b> We have examined the hypothesis that the laser photo stimulation can enhance the collagen production in diabetic wounds using the excision wound model in the Wistar rat model. <b> Methods:</b> The circular wounds were created on the dorsum of the back of the animals. The animals were divided into two groups. The study group (N = 24) wound was treated with 632.8 nm He-Ne laser at a dose of 3-9J/cm² for 5 days a week until the wounds healed completely. The control group was sham irradiated. <b> Result:</b> A significant increase in the hydroxyproline content and reduction in the wound size were observed in the study group. The pro-healing actions seem to be due to increased collagen deposition as well as better alignment and maturation. <b> Conclusion:</b> The biochemical analysis and clinical observation suggested that 3-6 J/cm² laser photo stimulation facilitates the tissue repair process by accelerating collagen production in diabetic wound healing

The accuracy of 10 g monofilament use for clinical screening of diabetes peripheral neuropathy among Indian population.

ObjectiveThe purpose of this study was to test the diagnostic accuracy of the 10g monofilament to screen for diabetic peripheral neuropathy (DPN) in India. The study further assessed the effect of physical activity, footwear use, and occupation on the outcome.MethodsNon-probabilistic purposive sampling was used to recruit patients with T2DM to assess the diagnostic utility of the 10 g monofilament. 160 participants were recruited divided into 4 groups. Each group consisted of 40 participants with 20 under each category described as "Physical Worker Vs Non- physical worker" (n = 40), "Barefoot Vs Footwear" (n = 40), "Use of Slipper at Home Vs No-slippers use at home" (n = 40), "Agriculture Vs Non- agriculture" (n = 40). 10 g monofilament was used to detect the presence of protective sensation towards screening of DPN against biothesiometer (Vibration Pressure Threshold).ResultsThe area under the ROC (receiver operating characteristic) curve was 0.6 for identifying DPN using the 10 g monofilament. Physical work (p = 0.04), footwear (p = 0.04), slipper use at home (p = 0.02) and occupation (p = 0.02) impacted on the diagnostic utility of the 10g monofilament.ConclusionsThis study shows that the 10 g monofilament has limited accuracy for detecting DPN in the Indian population and this is further affected by occupation, socioeconomic and religious practice