Computerised Spirometric Evaluation of Pulmonary Functions in Obese Hypertensive and Obese Non-Hypertensive Male Subjects; A Comparative Study

Background:Obesity has become a worldwide epidemic and is associated with impaired quality of life. It is now a major health concern in our country contributing significantly to increased morbidity and mortality, reducing life expectancy markedly among adults, and is commonly associated with hypertension. It causes mechanical obstruction of various parts of the body, including the respiratory system.Materials and Methods: A Total of three hundred (300) age and sex matched subjects were selected from those attending the Executive Health Check up OPD of kannur Medical College , which included One hundred (100) normal subjects (Group 1), One hundred (100) obese normotensive subjects (Group 2), and One hundred (100) obese hypertensive subjects (Group 3). Results:In the obese normotensive group and obese hypertensive group, statistically significant decline in FVC was seen as compared to the non-obese group. But there was no significant change in FVC between the hypertensive obese and normotensive obese groups . FEV1 showed no significant difference between regular, obese normotensive and obese hypertensive groups, although the obese groups showed a small insignificant decrease. FEV1/FVC % did not show any significant change in the three groups.  PEF did not show any significant change in the three groups.Conclusion:It can be concluded that obesity causes mechanical restriction to respiratory movements  which adversely affect pulmonary functions. Hypertension had no adverse effects on lung functions. &nbsp

Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries

Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income countries (LMICs). Remarkably, cases of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) have rarely been reported from LMICs. Aims: We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs. Methods: We report data from an international registry on CVST after COVID-19 vaccination. VITT was classified according to the Pavord criteria. We compared CVST-VITT cases from LMICs to cases from high-income countries (HICs). Results: Until August 2022, 228 CVST cases were reported, of which 63 were from LMICs (all middle-income countries [MICs]: Brazil, China, India, Iran, Mexico, Pakistan, Turkey). Of these 63, 32 (51%) met the VITT criteria, compared to 103 of 165 (62%) from HICs. Only 5 of the 32 (16%) CVST-VITT cases from MICs had definite VITT, mostly because anti-platelet factor 4 antibodies were often not tested. The median age was 26 (interquartile range [IQR] 20–37) versus 47 (IQR 32–58) years, and the proportion of women was 25 of 32 (78%) versus 77 of 103 (75%) in MICs versus HICs, respectively. Patients from MICs were diagnosed later than patients from HICs (1/32 [3%] vs. 65/103 [63%] diagnosed before May 2021). Clinical manifestations, including intracranial hemorrhage, were largely similar as was intravenous immunoglobulin use. In-hospital mortality was lower in MICs (7/31 [23%, 95% confidence interval (CI) 11–40]) than in HICs (44/102 [43%, 95% CI 34–53], p = 0.039). Conclusions: The number of CVST-VITT cases reported from LMICs was small despite the widespread use of adenoviral vaccines. Clinical manifestations and treatment of CVST-VITT cases were largely similar in MICs and HICs, while mortality was lower in patients from MICs.</p

Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19

Introduction: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men. Patients and methods: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men. Results: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28–54) vs 45 (28–56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28–79) vs 68 (30–125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19–62) vs 53 (20–92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ. Discussion and conclusions: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.</p

Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19

Introduction: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men. Patients and methods: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men. Results: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28–54) vs 45 (28–56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28–79) vs 68 (30–125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19–62) vs 53 (20–92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ. Discussion and conclusions: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.</p

An Electrophysiological Comparative of Auditory and Visual Reaction time among Diabetics and Non-Diabetics- A Case Control Study

Background: Type 2 diabetes is a pandemic; &nbsp;visual and auditory reaction time were used as &nbsp;tools to detect neuropathy a common complication of diabetes so that we could prevent further damage to nerves. Objectives: To measure and compare visual and auditory reaction time between Type -2 diabetics on oral medication and non-diabetics. Material and Methods:&nbsp; A case control study was done&nbsp; and they were enrolled based on detailed questionnaire and informed consent was obtained .The study was conducted in the month of July 2019 which included 40 Type 2 diabetic subjects from a tertiary care hospital. Visual Reaction time and Auditory reaction time were measured. PC1000Hz reaction timer was used to measure auditory and visual reaction time SPSS software (trial version 22.0) was used for analysis. Results:The mean age of type 2 diabetic subjects was 49.6 years and that of control 44.4 years cases and controls were age matched. The visual reaction times was significant with p value = .001 and for auditory reaction time p value =.001. Conclusion:Auditory and visual reaction was prolonged in type 2 diabetics on oral medication when compared with non-diabetics of same age group. This can be due to neuropathic changes in diabetes

A Prospective Study of Serum Thyroid Stimulating Hormone and Lipid Function in Post Menopausal Women

Introduction: Menopause has a direct impact on the activity of the thyroid gland. During menopause there is imbalance in the oestrogen and progesterone hormone levels that may in turn have a drastic impact on the thyroid hormone production. So, correlation between S.TSH and serum lipid profile is assessed to detect what type of alteration occurs in lipid profile.2 The chance of cardiovascular disease is more in women over age 50. The risk of atherosclerosis in women increases significantly after menopause. The risk of atherosclerosis is 3.4 times greater in post-menopausal women. Three types of lipids that have been linked to cardiovascular disease and atherosclerosis are cholesterol and its carrier proteins LDL (low density lipoprotein)and HDL(high density lipoprotein).The risk for cardiovascular disease decreases by 3 % for each 1 % reduction in serum cholesterol.Materials and Methods: This was a cross sectional observational study done for one year from January 2019 to December 2019. Two study groups were selected; forty premenopausal women in the reproductive age group and forty post-menopausal women attending medicine outpatient department with prior informed consent. Exclusion criteria were subjects with known thyroid disease and subjects having diabetes, hypertension and heart disease. Screening of all subjects for the study was done using proforma. Samples of blood were taken by phlebotomy method after an overnight fast of twelve hours using syringes and needles which are disposable. 8 ml blood was collected from ante cubital vein under aseptic precautions and transferred to bottles. Serum TSH and all parameters of lipid profile were estimated and analysed. S.TSH measured using an automated chemiluminescenceanalyser. Estimation of total cholesterol was done using cholesterol reagent set. This is based on enzymatic method. Estimation of HDL cholesterol also done by enzymatic method.Results: Serum cholesterol / HDL ratio, LDL / HDL ratio is significantly higher in post-menopausal women. In post-menopausal women, levels of TSH and serum cholesterol were found to be positively correlated and this is found to be statistically significant. In post-menopausal women, the levels of S.TSH and serum cholesterol/ HDL ratio were found to be positively correlated and this is found to be statistically significant. In post-menopausal women, the levels of S.TSH and LDL / HDL ratio were found to be positively correlated and this is found to be statistically significant.Conclusion: A statistically significant positive correlation was seen between S.TSH and serum cholesterol levels in post-menopausal women. A statistically significant positive correlation was observed between S.TSH and serum cholesterol/HDL ratio levels in post-menopausal group of women. A statistically significant positive correlation was obtained between S.TSH and LDL/HDL ratio levels in post-menopausal group of women. A statistically significant correlation was not seen between S.TSH and other parameters of lipid profile in post-menopausal group. A statistically significant correlation was not seen between S.TSH and any parameters of lipid profile in the premenopausal women