Analysis of heart rate variability

No abstract is availabl

Motor Neuropathy in Hypothyroidism: Clinical and Electrophysiological Findings

Background: Hypothyroidism is a clinical condition associated with low levels of thyroid hormones with raised TSH. Peripheral neuropathy may be associated with hypothyroidism which usually develops insidiously over a long period of time due to irregular taking of drugs or lack of thyroid hormone replacement. Objectives: The present study was done to evaluate the clinical and electro-physiological findings in hypothyroid patients in order to evaluate the neuromuscular dysfunction as well as motor neuropathy. Method: In this study, 70 subjects with the age range from 20 to 50 years of both sexes were included of whom 40 hypothyroids were taken in study group (B) with the duration of 6 months to 5 years and 30 healthy euthyroid subjects were taken as control (Group A). On the basis of their TSH level, group B was further divided into group B1 with TSH level <60 MIU /L (less severe) and group B2 with TSH >60 MIU /L (severe group). The d latency and NCV for motor nerve function were measured by NCV machine in median and ulnar nerve for upper limb and in common peroneal nerve for lower limb. TT3, TT4 were measured by RIA and TSH by IRMA method. All these parameters were measured on the day 1 (one) of their first visit. Data were analysed statistically by ANOVA and Z test. Result: Both TT3, TT4 levels were significantly (P<0.01) lower in hypothyroids in comparison to those of control. Diminished or absence of most of the deep tendon reflexes were found in all the hypothyroids. Most of the patients (67.5%) showed significantly higher (P <0.01) motor distal latencies (MDL) with lower (P> 0.001) conduction velocities (MNCV) and all these changes were more marked in group B2. Conclusion: So, the study revealed that motor neuropathy may be a consequence of hypothyroidism.DOI: 10.3329/bsmmuj.v1i1.3692 Key Words: Hypothyroidism; neuropathy; electrophysiology BSMMU J 2008; 1(1): 15-1

Magnesium enrichment of skim milk : a thesis presented in partial fulfilment of the requirements for the degree of Master of Food Technology at Massey University, Auckland, New Zealand

The following Figures were removed for copyright reasons but may be accessed via their sources: Fig 2.2 (=Dalgleish et al., 2004, Fig 3 & Fig 4); 2.4 (=Gaucheron, 2011, Fig 1); 2.5 (=Broyard & Gaucheron, 2015, Fig 1); 2.8 (=Pesic et al., 2012, Fig 6A). Composite Fig 2.3 remains for purposes of clarity.Effective magnesium enrichment of dairy products depends on the amount of magnesium salt added and the nature of its distribution between the serum and micellar phases. Thus, this study firstly aimed to profile the magnesium distribution in skim milk as a function of pH (pH 5.50 to 7.20), preheating temperatures (20 to 80 ± 1 °C) and concentration of added magnesium chloride (0 to 40 mmol L-1). The second aim was to investigate the rheological properties of magnesium-induced skim milk gels as a function of different concentrations of magnesium chloride (0 to 20 mmol L-1) added to heated skim milk. The total concentration of magnesium in skim milk and serum was determined using a complexometric titration (EDTA titration) and the EDTA results were validated by atomic absorption spectroscopy (AAS). The measurement of ionic magnesium (Mg2+) in milk is of importance for understanding the bioavailability of magnesium-enriched dairy products. Hence, the concentration of ionic magnesium (Mg2+) in the serum phase was measured using a novel magnesium fluorescence dye (Magnesium 510 probe). In all the samples, a reduction in the pH increased the total soluble magnesium and ionic magnesium (Mg2+) concentrations in the serum phase, regardless of whether magnesium chloride (15 mmol L-1) was added or not to skim milk at 20 ± 1 °C. At pH 5.50, more than 92% magnesium was found in the serum phase for both added (15 mmol L-1) and no added magnesium chloride samples. The concentration of magnesium in the serum phase remained unchanged as the preheating temperature was increased from 20 to 80 ± 1 °C. The addition of magnesium chloride to skim milk reduced the milk pH and increased the ionic magnesium (Mg2+) and total soluble magnesium concentration in the serum phase at 20 ± 1 °C. The pH values are important for new magnesium-enriched dairy products as the distribution of added magnesium chloride in the serum phase was different dependent on pH adjustment between the pH 6.50 and natural pH 6.70. Rheological measurements using cone and plate geometry at constant strain showed that the addition of 5 mmol L-1 magnesium chloride induced the gelation of skim milk after 22 min of heating at 80 °C in the rheometer. The time and temperature for reaching the gelation in skim milk depended on preheating and concentration of added magnesium chloride. A higher concentration of added magnesium chloride achieved gelation at a lower temperature in the rheometer. With the magnesium-induced gels, G’ values obtained were found to increase with increasing concentrations of added magnesium chloride (0 to 20 mmol L-1), increasing holding times (10 to 60 min) and increasing heating temperatures (70 to 80 °C). Compared with samples with 5 mmol L-1 magnesium chloride, those with 15 mmol L-1 magnesium chloride showed a more rapid increase in G’. The G’ value obtained with 15 mmol L-1 magnesium chloride was 15.01 Pa at 80 °C during 10 min of holding and cooling to 20 °C rapidly increased the final G’ value to 81.44 Pa. In contrast, the addition of 5 mmol L-1 magnesium chloride resulted in the formation of a weak gel with a final G’ value of 6.87 Pa after cooling to 20 °C. The oscillation stress of milk gels also increased with increasing magnesium chloride concentration, heating temperatures and holding times in the rheometer. Preheating significantly (P < 0.05) affected the strength of magnesium-induced skim milk gels. The addition of 20 mmol L-1 magnesium chloride to preheated skim milk followed by heating at 85 °C then cooling to 20 °C formed strong skim milk gels. In parallel, samples with no added magnesium chloride did not undergo gelation. In conclusion, the distribution of magnesium was influenced by pH and magnesium concentration added and the strength of magnesium-induced gels was influenced by magnesium concentration added, preheating and the heating time and temperature in the rheometer. The technology of making magnesium-induced skim milk gels can be exploited commercially for the formation of non-fermented dairy products supplemented with magnesium

Red Blood Cell Fragility and Reticulocyte Count in Hemolytic Anemic Patients with and Without G-6PD Enzyme Deficiency

Background: Erythrocyte G-6PD enzyme deficiency is an important cause of Hemolytic anemia with consequent increasein reticulocyte count. Objective: To assess the osmotic fragility of RBC status and reticulocyte count in G-6PD enzymedeficient patients with hemolytic anemia in order to find their hemolytic status. Methods: The cross sectional study wascarried out in the Department of Physiology, BSMMU, Dhaka from July 2002 to June 2003 to observe the osmotic fragilityof RBC status and reticulocyte count in patients with hemolytic anemia. For this, total number of 50 hemolytic anemicpatients (Group-B) with age ranged from 5 to 30 years of both sexes were studied. Among them, 25 were without G-6PDdeficient hemolytic anemia (group-B1) and 25 were hemolytic anemia with G-6PD enzyme deficiency (group-B1). Age&amp; sex matched 30 apparently healthy subjects with normal blood G-6PD level were included to observe the baseline data(Group-A) and also for comparison. All the subjects were selected from Out Patient Department of Hematology,Bangabandhu Sheikh Mujib Medical University (BSSMU), Dhaka. Blood erythrocyte G-6PD enzyme level, osmoticfragility of RBC &amp; reticulocyte count were measured by standard laboratory techniques. Analysis of data was done byunpaired Student 't' test. Result: Mean starting &amp; completing points of hemolysis of RBC were significantly higher inGroup B2 vs Group A and also with Group B1 and similar higher levels of these values were also observed in Group B1than those of Group A, but the differences between them were not statistically significant. Reticulocyte count wassignificantly higher in Group-B2 vs Group B1 and also with Group A and similar higher levels of this values were alsoobserved in Group B1 vs Group A which was also statistically significant. Conclusion: From this study, it may beconcluded that, increased hemolysis of RBC with higher reticulocyte count occur in G-6PD deficient hemolytic anemicpatients which may be due to membrane defect.Key words: Osmotic fragility; Reticulocyte count; G-6PD enzyme; Hemolytic anemia.DOI: 10.3329/bsmmuj.v3i1.5510BSMMU J 2010; 3(1): 23-2

Red Blood Cell Fragility and Reticulocyte Count in Hemolytic Anemic Patients with and Without G-6PD Enzyme Deficiency

Background: Erythrocyte G-6PD enzyme deficiency is an important cause of Hemolytic anemia with consequent increase in reticulocyte count. Objective: To assess the osmotic fragility of RBC status and reticulocyte count in G-6PD enzyme deficient patients with hemolytic anemia in order to find their hemolytic status. Methods: The cross sectional study was carried out in the Department of Physiology, BSMMU, Dhaka from July 2002 to June 2003 to observe the osmotic fragility of RBC status and reticulocyte count in patients with hemolytic anemia. For this, total number of 50 hemolytic anemic patients (Group-B) with age ranged from 5 to 30 years of both sexes were studied. Among them, 25 were without G-6PD deficient hemolytic anemia (group-B1) and 25 were hemolytic anemia with G-6PD enzyme deficiency (group-B1). Age & sex matched 30 apparently healthy subjects with normal blood G-6PD level were included to observe the baseline data (Group-A) and also for comparison. All the subjects were selected from Out Patient Department of Hematology, Bangabandhu Sheikh Mujib Medical University (BSSMU), Dhaka. Blood erythrocyte G-6PD enzyme level, osmotic fragility of RBC & reticulocyte count were measured by standard laboratory techniques. Analysis of data was done by unpaired Student 't' test. Result: Mean starting & completing points of hemolysis of RBC were significantly higher in Group B2 vs Group A and also with Group B1 and similar higher levels of these values were also observed in Group B1 than those of Group A, but the differences between them were not statistically significant. Reticulocyte count was significantly higher in Group-B2 vs Group B1 and also with Group A and similar higher levels of this values were also observed in Group B1 vs Group A which was also statistically significant. Conclusion: From this study, it may be concluded that, increased hemolysis of RBC with higher reticulocyte count occur in G-6PD deficient hemolytic anemic patients which may be due to membrane defect. Key words: Osmotic fragility; Reticulocyte count; G-6PD enzyme; Hemolytic anemia. DOI: 10.3329/bsmmuj.v3i1.5510 BSMMU J 2010; 3(1): 23-2

Effects of Oral Supplementation of Vitamin E on Fragility of RBC in Hemolytic Anemic Patients with G6PD Deficiency

Background: Vitamin E has role in maintaining the integrity of red cell membrane by preventing oxidation of polyunsaturated fatty acids and thereby protects cells from oxidative stress- induced lysis in G6PD deficiency, which can be reflected by changes in osmotic fragility of RBC and some absolute values like MCV, MCH &amp; MCHC. Objective: To observe the effects of vitamin E supplementation on fragility of RBC in order to evaluate role of this antioxidant vitamin in reducing chronic hemolysis in G6PD deficient patients. Methods: For this, a total number of 102 subjects with age ranged from 5 to 40 years of both sexes were included in the study. Among them 68 were G6PD enzyme deficient patients, of whom 34 were in supplemented group (study group) and 34 were in non-supplemented group (control group). The supplemented group received vitamin E supplementation for 60 consecutive days at a dose of 800 IU/day for adult and 400 IU/day for children &lt; 12 years (in a divided dose i,e. 4 times daily). Age and sex matched 34 apparently healthy subjects with normal blood G6PD level were taken to observe the base line data (healthy control) and also for comparison. All the G6PD deficient patients were selected from Out Patient Department (OPD) of Hematology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of July 2005 to June 2006 and all the healthy subjects were selected from personal contact. Blood G6PD level, osmotic fragility of RBC were measured by standard techniques and MCV, MCH, and MCHC were obtained by calculation. All the parameters were measured on day 1 (one) of their first visit and also were on day 60 in deficient group. Data were compared among the deficient groups, also in supplemented group just before and after supplementation. Analysis of data was done by appropriate statistical method. Results: Mean starting and completing points of osmotic fragility of RBC were significantly higher but MCV, MCH, MCHC were significantly lower in patients suffering from hemolytic anemia due to G6PD deficiency in comparison to those of the healthy control. After supplementation with vitamin E starting and completing points of osmotic fragility of RBC were significantly decreased whereas, MCV, MCH, MCHC were significantly increased towards those of healthy control in supplemented group of patients in comparison to those of their pre-supplemented (day-1) and non-supplemented groups both on day 1 and day 60. Conclusion: From this study it may be concluded that, disturbances of some of the hematological parameter like higher osmotic fragility of RBC and lower MCV, MCH, MCHC occur in G6PD deficient hemolytic anemic patients, which returned towards normal after supplementation of vitamin E, which clearly indicates the role of this anti-oxidant vitamin in maintaining red cell membrane integrity and thereby decreases the rate of hemolysis in this group of patients. So, vitamin E can be supplemented along with other drugs for better management of the patients. Key words: Osmotic fragility, G6PD, hemolytic anemia, vitamin E.DOI: 10.3329/bsmmuj.v1i1.3688 BSMMU J 2008; 1(1): 6-1

Study of Glucose-6-phosphate Dehydrogenase (G6PD) Status in Preeclampsia

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the common enzymopathy and may be one of the risk factor for complicated pregnancy. Objectives: To measure erythrocyte G6PD level in pregnant women with preeclampsia in order to observe this enzyme status and also to measure Hb, TC of RBC, serum bilirubin, reticulocyte count to observe hemolytic status. In addition, to correlate this enzyme level with all these hematological parameters in order to find out any relationships among them. Methods: This cross sectional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from January to December 2008. For this, 30 pregnant women with preeclampsia, age ranged from 20 to 34 years during their third trimester (&gt;24th weeks) were studied (group B). They were selected from the Obstetric and Gynae Out Patient Department (OPD) of BSMMU and Bangladesh Medical College Hospital (BMCH) of Dhaka City. For comparison age matched 30 apparently normal pregnant women of the same gestational age (control group - group A) were also studied. They were selected by personal contact. Erythrocyte G6PD level was measured by Spectrophotometric method using kit of Randox. Serum bilirubin, hemoglobin concentration, total count of RBC and reticulocyte count were measured by standard laboratory techniques. For statistical analysis ANOVA, independent sample t test, Chi-square test and Pearson's correlation coefficient test were performed by using SPSS for windows version-12 as applicable. Results: In this study, erythrocyte G6PD level was significantly lower in preeclampsia in comparison to that of control but their percentages of involvement was not statistically significant. In addition, hemoglobin concentration and RBC count were significantly lower and serum bilirubin and reticulicyte count were significantly higher in the study group than those of control group. On the other hand, erythrocyte G6PD level was positively correlated with hemoglobin concentration and total count of RBC while negatively correlated with serum bilirubin and reticulocyte count and all these relationships were statistically significant in the study group. Conclusion: Therefore, this study revealed that presence of G6PD deficiency associated with hemolysis in preeclampsia may act as a contributory factor for the development of this complicated pregnancy. Key words: G6PD; preeclampsia DOI: 10.3329/bsmmuj.v2i2.4758 BSMMU J 2009; 2(2): 56-6

Electrophysiological Changes of Sensory Nerves in Patients with Type-2 Diabetes Mellitus of Different Duration

Background: Peripheral neuropathy is a common complication of diabetes mellitus. Among the diabetic neuropathiessymmetrical sensory polyneuropathy is the most common one. Abnormalities of sensory nerve conduction are featuresof diabetic nerve damage. Significant association has been found between electrophysiological parameters of sensorynerves and duration of metabolic derangement in patients with diabetic neuropathy. Objectives: The present study wasdesigned to characterize nerve conduction abnormalities of sensory nerves in subjects with type 2 diabetes mellitus ofdifferent duration and also to assess whether duration of diabetes has any influence on the sensory nerve function.Methods: Forty-four type 2 diabetic subjects were included in two groups:- Group B1 consisted of 23 diabetic subjectshaving duration of diabetes for 5-10 years (shorter duration) and Group B2 consisted of 21 diabetic subjects havingduration of diabetes for 10-15 years (longer duration). Twenty-five age and BMI matched healthy subjects withoutfamily history of diabetes were included as Group A (control) subjects. Sensory nerve conduction velocities, actionpotential amplitudes and latencies of ulnar and sural nerves were measured by a standard NCV-EMG equipment. Result:No significant changes in sensory nerve conduction parameters were observed in the group of diabetic subjects havingshorter duration of diabetes. In the diabetic group with relatively longer duration of diabetes some of the sensory nerveconduction parameters were affected. Among them S SNAP and S NCV were significantly (P&lt;0.01 and &lt;0.05 respectively)reduced in diabetic group with relatively longer duration of diabetes. Conclusion: The results of the study indicated thatneuronal dysfunction for sensory nerves appears after a prolonged exposure to hyperglycemia; there may also be somegenetic and biochemical basis (other than hyperglycemia) for early sensory sparing in type 2 diabetic population ofBangladesh.DOI: 10.3329/bsmmuj.v3i1.5507BSMMU J 2010; 3(1): 9-1

Electrophysiological Changes of Sensory Nerves in Patients with Type-2 Diabetes Mellitus of Different Duration

Background: Peripheral neuropathy is a common complication of diabetes mellitus. Among the diabetic neuropathies symmetrical sensory polyneuropathy is the most common one. Abnormalities of sensory nerve conduction are features of diabetic nerve damage. Significant association has been found between electrophysiological parameters of sensory nerves and duration of metabolic derangement in patients with diabetic neuropathy. Objectives: The present study was designed to characterize nerve conduction abnormalities of sensory nerves in subjects with type 2 diabetes mellitus of different duration and also to assess whether duration of diabetes has any influence on the sensory nerve function. Methods: Forty-four type 2 diabetic subjects were included in two groups:- Group B1 consisted of 23 diabetic subjects having duration of diabetes for 5-10 years (shorter duration) and Group B2 consisted of 21 diabetic subjects having duration of diabetes for 10-15 years (longer duration). Twenty-five age and BMI matched healthy subjects without family history of diabetes were included as Group A (control) subjects. Sensory nerve conduction velocities, action potential amplitudes and latencies of ulnar and sural nerves were measured by a standard NCV-EMG equipment. Result: No significant changes in sensory nerve conduction parameters were observed in the group of diabetic subjects having shorter duration of diabetes. In the diabetic group with relatively longer duration of diabetes some of the sensory nerve conduction parameters were affected. Among them S SNAP and S NCV were significantly (P<0.01 and <0.05 respectively) reduced in diabetic group with relatively longer duration of diabetes. Conclusion: The results of the study indicated that neuronal dysfunction for sensory nerves appears after a prolonged exposure to hyperglycemia; there may also be some genetic and biochemical basis (other than hyperglycemia) for early sensory sparing in type 2 diabetic population of Bangladesh. DOI: 10.3329/bsmmuj.v3i1.5507 BSMMU J 2010; 3(1): 9-1