Indian Journal of Physiology and Pharmacology
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Item Carbamazepine-induced hypersensitivity pneumonitis in a patient with neuromyelitis optica: A case report(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2022-03) Khan, Furqan Mohd. Akram; Dave, Dhaval; Rohatgi, Shalesh; Nirhale, Satish; Rao, Prajwal; Naphade, Pravin; Kotaru, V. V. Sravya; Gupta, Sahil; Gupta, Advait; Dubey, PrashantA 36-year-old female with serum anti-aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (NMOSD) on carbamazepine (CBZ) therapy for paroxysmal tonic spasms (PTS) developed Type 1 respiratory failure. High-resolution computed tomography chest showed diffuse ground-glass opacities in both lungs predominantly in bilateral perihilar region sparing subpleural regions and predominantly upper lobes with a smooth interlobular septal thickening. A transbronchial lung biopsy was consistent with hypersensitivity pneumonitis and following withdrawal of the CBZ and treatment with steroids her respiratory symptoms resolved. After stopping CBZ, PTS recurred, which was successfully treated with lacosamide. This is the first described biopsy-proven case of CBZ-induced hypersensitivity pneumonitis in the NMOSD patient.Item A cross-sectional study on clinical correlates of post-stroke depression in a tertiary health-care system of India(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2022-03) Samantray, S; Sahoo, SK; Mohapatra, H.Objectives: The aim of our study is to determine the relation of the type of stroke and site of lesion and medical comorbidities such as diabetes and hypertension with the severity of depression, HAM-D scores as well as age and gender of these patients. Materials and Methods: The present study was a hospital-based cross-sectional study conducted over 2 months that included 61 patients from neurology OPD of IMS and SUM Hospital, Bhubaneswar. Purposive sampling was done. The patients fulfilling the inclusion and exclusion criteria were first assessed using a semi-structured questionnaire to obtain the sociodemographic data. Clinical psychiatric evaluation and detailed mental state examination were done. Based on the clinical findings and using ICD 10-DCR criteria, the 61 patients with CVA were segregated as depressive and non-depressive categories. HAM-A and HAM-D scales were applied on both the groups. MRI findings done at the time of the attack were obtained. Further research is needed to identify the mechanisms of depression and why antidepressants lead to improved physical and cognitive recovery and decreased mortality. Results: Age of onset, gender, type of stroke and hemispherical involvement do not show any correlation with PSD. However, we found that the HAM-D scores were much higher in PSD patients with lacunar lesions as compared to non-depressive post stroke patients. Conclusion: Lacunar lesions may be involved in the psychopathology of depressive illness among stroke survivors. This could help us predict the occurrence of depressive illness among stroke patients with lacunar lesions. HAM-D and HAM-A may be used to detect anxiety and depressive symptoms among these patients.Item Postural dysautonomia in response to head-up tilt in a military pilot aspirant: Aeromedical considerations(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-06) Ghosh, G; Sinha, B; Swamy, S.Intolerance to orthostasis encompasses a group of responses on assumption of upright posture. One such response is postural dysautonomia. One of the types of postural dysautonomia is postural orthostatic tachycardia syndrome, which is characterised by an increase in heart rate of more than 30 bpm without hypotension along with other features of dysautonomia on attaining an erect posture, either actively or passively. This paper brings out a case of postural dysautonomia in a pilot aspirant in response to Head-up tilt (HUT) test. A 23-year-old female military pilot aspirant reported for evaluation of Syncope and Air Sickness. She gave a history of solitary episode of loss of consciousness on ground while preparing for an early morning sortie. She was diagnosed with a case of neurocardiogenic syncope and was put back to flying training. Subsequently, after about 2 months, she developed features of air sickness while flying and also could not tolerate preliminary motion sickness desensitisation at her unit. A thorough medical evaluation failed to reveal any neurocardiological abnormality. Before commencing the air sickness desensitisation protocol at the Institute of Aerospace Medicine, she was subjected to HUT during which she developed signs and symptoms suggestive of postural dysautonomia. A test retest assessment with repeat HUT and passive standing test revealed similar responses.Item Orexin-A levels in reproductive age group women and its association with body mass index(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2022-03) Jain, S; Gupta, V; Goel, A; Gupta, V.Objectives: Orexins are hypothalamic neuropeptides, which are involved in feeding behaviour, sleep-wakefulness, and neuroendocrine homeostasis in the body. The study was conducted with the aim to estimate the serum orexin levels in reproductive age group (RAG) women and to determine the association of serum orexin levels with body mass index (BMI) in females of RAG. Materials and Methods: One hundred and forty apparently healthy women of RAG (20–40 years) were randomly selected. Fasting serum orexin levels were measured using ELISA and BMI was calculated in women based on their height and weight. Results: Serum orexin levels were significantly higher in women with BMI ? 25 kg/m2 (P = 0.035) as compared to women with BMI < 25 kg/m2 . Conclusion: In the present study, BMI correlated significantly with mean serum orexin levels. However, serum orexin levels did not correlate with the age of women.Item A study of outcome in COVID-19 patients receiving casirivimab-imdevimab(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-06) Kulkarni, P; Chintale, KN; Bhattacharya, M; Kulkarni, M; Chape, S.Objectives: In December 2019, coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China, as a respiratory tract infection causing symptoms, such as fever, chills, dry cough, fatigue, and shortness of breath. Despite the low mortality rate of COVID-19, patients with comorbidities such as hypertension, cardiovascular disease, and diabetes mellitus seem to be prone to more severe symptoms and to a higher mortality rate than others. Such patients are shown to benefit from usage of monoclonal antibodies. Casirivimab-imdevimab is a cocktail made up of two non-competing, neutralizing human immunoglobulin G1 antibodies that target the receptor binding domain of the severe acute respiratory syndrome coronavirus 2 spike protein and block viral entry into human cells. We assessed the clinical profile and outcome of 42 patients who received the antibody cocktail. Materials and Methods: Casirivimab-imdevimab was administered to COVID-positive patients with mild severity. Forty-two patients who satisfied the inclusion criteria received casirivimab-imdevimab and were included in the study. Demographic and clinical data were tabulated in Microsoft Excel and statistics were run in OpenEpi software. Results: No adverse reactions were seen in any of the patients. Among the 42 patients, there were no deaths. Twentytwo (52.3%) patients improved, while 20 (47.6%) worsened after receiving the antibody cocktail. Out of 21 (50%) patients who did not have any comorbidity, 13 (30.9%) worsened after receiving the drug and 8 (19%) improved, while among those with comorbidities, 7 (16.6%) worsened and 14 (33.3%) improved (P < 0.05). Thirteen (30.9%) unvaccinated patients improved, while 14 (33.3%) worsened, whereas 6 (14.2%) fully vaccinated patients improved while only 2 (4.7%) worsened. Among the patients who were administered the cocktail within 5 days of onset of symptoms, 12 (28.5%) improved and 10 (23.8%) worsened, whereas among those who received the drug between 6 and 10 days of symptom onset, ten improved, and ten worsened. There was no statistically significant association between vaccination status and outcome, and infusion interval and outcome in these patients. Conclusion: None of the 42 patients developed any reaction to casirivimab-imdevimab. There were no deaths in the study population. About 52.3% of the patients improved and 47.6% worsened after receiving the cocktail. About 33.3% of the comorbid patients improved. There was no statistically significant association between vaccination status and outcome, and infusion interval and outcome in these patients.Item Exponential modelling of heart rate recovery after a maximal exercise(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-06) Joseph, A; Kanthakumar, P; Tharion, E.Objectives: Heart rate recovery (HRR) after exercise is clinically important as a predictor of mortality. In addition, HRR is an indicator of cardiac autonomic activity, since increased vagal activity and diminished sympathetic activity return the heart rate to resting conditions after exercise. The previous attempts to model HRR using polynomial, first-order and second-order modelling have produced mixed results. In this study, we hypothesised that the double-exponential fit would model the HRR more accurately than the single-exponential fit as it would capture the activity of both autonomic arms responsible for heart rate decay and investigated the outcome of these two models on the HRR data following a maximal exercise. Materials and Methods: Exponential curve fitting was done on a set of previously published data from our laboratory. The HRR data were acquired from 40 male participants (19–38 years) after a maximal treadmill exercise. The normalised HRR data from a 5-min time window from maximal heart rate were fitted using single and double-exponential curves, to obtain, respectively, the time constants Tau and, Tau 1 and Tau 2. The goodness-of-fit of the model was assessed with Chi-square values computed for each participant data set with both models. Considering that Chi-square of zero is a perfect fit, and therefore, smaller Chi-square values indicate a better fit than larger values, we computed the difference in the Chi-square values (??2 ) between the models by subtracting the Chi-square value of the double-exponential fit from the Chi-square value of the singleexponential fit. This was based on the premise that if the calculated ??2 is positive, it would indicate a better fit with double-exponential than single-exponential decay model. The data are presented as mean ± standard deviation. Comparisons were made with Student’s t-test. Results: Data from four participants were excluded for technical reasons. The Tau of the single-exponential fit was 65.50 ± 12.13 s, while Tau 1 and Tau 2 of the double-exponential fit were 43.75 ± 18.96 s and 120.30 ± 91.32 s, respectively, the Tau 1 value being significantly lower than the Tau 2 value (P < 0.0001). Remarkably among the 36 participants, the difference in the Chi-square value was positive (127.2 ± 171.04) in 22 subjects and zero or marginally negative (?0.17 ± 0.31) in 14 subjects. Conclusion: Our results indicate that the double-exponential model fitted the HRR data better than the single-exponential model in almost two-thirds (61%) of our study population. In the remaining participants, the goodness-of-fit was nearly equivalent for both fits with no evidence of superior modelling with the singleexponential fit. Our data show that while the single-exponential fit is sufficient for modelling the HRR of 14 subjects, it was less efficient for fitting the data of most participants. In comparison, the double-exponential curve fit effectively modelled 100% of our study population. Given our findings, we conclude that the doubleexponential model is more inclusive and better represented the HRR data of our study population than the singleexponential model.Item Transition to online teaching during COVID-19 pandemic: Perspective of higher education teachers from India(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-06) Khaliq, N; Ahmed, SF; Geelani, S; Khaliq, F.Objectives: This cross-sectional, anonymous and questionnaire-based study was undertaken to analyse online teaching experiences during COVID-19 lockdown in higher education from teachers’ perspectives. This was thought to help in improving long-distance education. Materials and Methods: An online survey was conducted to collect both quantitative and qualitative data from higher education teachers. Results: Benefits identified by online teachers indicate that distance education can cater to a large group and helps the students to access educational resources. Major challenges faced were internet connectivity (78.80%), increased workloads (68.80%) and lack of personal communication with students (84%). They believed that the online mode of teaching is the only alternative for students in such an extraordinary situation. It can be valuable for additional discussions but cannot replace traditional offline teaching. Conclusion: Suggestions pointed toward providing internet facilities and electronic databases to students and the necessity of faculty development programmes.Item Evaluation of an association between maternal prenatal psychological stress and insulin resistance during pregnancy and postpartum(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-06) Kishan, A; Shetty, PK; Moodithaya, SS.Objectives: Various physiological mechanisms counteract insulin resistance (IR) during normal pregnancy. Psychological stress is a known, independent risk factor for developing IR. Pregnancy-specific psychological stress may cause IR and increase the risk of overt diabetes. Hence, the study aims to evaluate maternal psychological stress using multiple stress markers and their association with changes in IR during pregnancy and postpartum. Materials and Methods: Anthropometric measurements such as height, weight and skinfold thickness were measured using standard techniques. The stress markers were assessed using perceived stress scales (K10 questionnaire), a physiological marker of stress (Heart rate variability [HRV] measures) and biochemical stress markers (Saliva, hair cortisol levels). IR was estimated using homeostasis model assessment-estimated IR (HOMA-IR). The association of stress markers with IR was studied among fifty healthy pregnant women during pregnancy and postpartum. Results: The psychological stress scores and saliva cortisol were significantly higher during pregnancy than postpartum (P = 0.000). A comparison of cardiac autonomic function as assessed by HRV measures shows that high frequency in normalised units (HFnu) was significantly higher during the postnatal period than in the prenatal period (P = 0.000). High frequency (HF) spectral power in absolute units was also significantly higher (P = 0.002) in the postpartum period (2612.30 ± 432.24) when compared with the prenatal period (1446.10 ± 299.15). Low frequency in normalised units (LFnu), low frequency (LF)/HF ratio was significantly higher during the prenatal period than in the postnatal period (P = 0.000). As assessed by HOMA-IR values, IR was significantly higher during the prenatal period than postpartum (P = 0.04). There was a significant positive correlation between prenatal psychological stress scores, HRV parameters (LFnu, LF/HF) and postnatal IR. Conclusion: Pregnancy is associated with higher psychological stress levels and IR than postpartum. Furthermore, the maternal cardiac autonomic marker could predict postnatal IR among healthy pregnant women.Item Effect of mobile phone radiofrequency electromagnetic radiations on oxidative stress and feeding behaviour in Sprague Dawley (SD) rats(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-06) Pagadala, P; Shankar, MSV; Sumathi, M E.Objectives: Radiofrequency electromagnetic radiation (RF-EMR) from mobile phones is known to produce a stress response because of its effect on hypothalamus. Mobile phones have become an integral part of our lives with increasing usage not only in terms of number of users but also increase in talk time. The present study aimed to study the effect of mobile phone radiofrequency electromagnetic radiations on oxidative stress and feeding behaviour assessment in Sprague Dawley (SD) rats. Materials and Methods: Twelve male SD rats of 10–12 weeks old, weighing 180–220 g, were housed and allowed to acclimatise in a room with 12:12 h light-dark cycle with ad libitum amount of food and reverse osmosis (RO) water before the start of the study. Then, rats were divided into control and RF-EMR exposed groups, and everyday feed intake and body weight were measured. At the end of the study period, blood sample was collected through retro orbital puncture for biochemical investigations. Results: The present study showed significant increase in malondialdehyde and serum corticosterone levels and decrease feeding behaviour in rats exposed to RF-EMR in rats exposed to RF-EMR. Conclusion: This study proves that mobile RF-EMR causes oxidative stress and oxidative damage leading to decreased feeding behaviour in SD rats.Item Nerve conduction study in young children suffering from cerebral palsy(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-06) Basak, Indrani; Pandey, Ratna; Tiwari, Anil Kumar; Prasad, Rajniti; Mandal, Maloy B.; Bhagat, Priyanka; Singh, Tej BaliObjectives: Cerebral palsy (CP) is a motor impairment syndrome leading to disorders of movement and posture. Screening of electrophysiological parameters Hoffman reflex (H-reflex and nerve conduction velocities) becomes a necessary for the early detection and management of the disease. The study aimed to assess the various electrophysiological parameters of nerve conduction velocity in CP and age-matched normal children. Matrials and Methods: The present cross-sectional study was performed between children suffering from CP and healthy control. A total of 27 children of 12–24 months of age of either sex were examined. Among them, six children were normal (with age match), seven were diagnosed with spastic CP and remaining 14 children were diagnosed with hypotonic CP The electrophysiological parameters were recorded in the right lower limb (posterior tibial nerve-soleus muscle) of all children. Results: In electrophysiological parameters, H-reflex latency in secs values was significantly decreased in all CP children. The maximum amplitudes of reflexly excitable motor neurons (Hmax) (mV) and Hmax/maximum amplitude of motor response ratio in the gastrocnemius-soleus muscle were significantly increased in spastic CPas compared to control. H-reflex conduction velocity (HRCV) was significantly higher than motor nerve conduction velocity (MNCV) in hypotonic CP children. Conclusion: The electrophysiological parameters were altered in spastic CP children. The electrophysiological parameters in hypotonic CP were within range, indicating they did not suppress the neuronal motor pool. However, HRCV was significantly more than MNCV in hypotonic CP, suggesting some myelination process defect/white matter injury in motor neurons. We concluded that the electrophysiological parameters of the nerve conduction study are a reliable test for the assessment of tone of muscles in children. Thus, it may help in the early initiation of the treatment and therapies in CP children.Item Tocilizumab fails survival benefit in severe COVID-19 – A retrospective cohort study(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2022-03) Arjun; Ranka, R; Panda, PK.Objectives: Anti-interleukin-6 monoclonal antibody, tocilizumab, has produced mixed results in clinical trials for effectiveness against coronavirus disease 2019 (COVID-19). We conducted a retrospective cohort study to compare outcomes at 28 days of a cohort of patients with severe COVID-19 treated with tocilizumab and standard care, with those receiving standard care only. Materials and Methods: In this record-based retrospective cohort study, patients hospitalised with COVID-19 were classified into non-severe and severe disease as per institutional protocol. One cohort received tocilizumab with standard care and the second cohort received only standard care. Few patients also received high-dose steroids as ‘pulse’ steroids on initial clinical deterioration. Data were collected for the treatment given including oxygen interface, steroids, antimicrobials, duration of hospital stay in survivors, requirement of mechanical ventilation, and day of intubation from symptom onset. The primary outcome was to compare the all-cause mortality between the two groups. The effect of pulse steroid therapy on all-cause mortality was studied in the secondary outcome. Results: There was statistically significant mortality in the tocilizumab cohort as compared to standard care alone (HR 2.43, 95% CI 1.54–3.89). The need for mechanical ventilation was more in the tocilizumab cohort (85% vs. 18%, P < 0.001). Tocilizumab cohort had a delay in the day of intubation by a mean of 2.29 days from the day of symptom onset (P < 0.05). Pulse steroid administration showed increased all-cause mortality (HR 1.94, 95% CI 1.18–3.20) and risk of mechanical ventilation. Conclusion: Tocilizumab cohort showed higher mortality and need for mechanical ventilation in our study which contrasts the result of a few previous trials. Our study warrants the need for future clinical trials on this subject to ensure better treatment strategies in upcoming COVID-19 waves.Item A quasi-experimental study to compare the acquisition of basic clinical skills in novice medical students taught by George and Doto’s five-step method compared to those taught by the traditional approach (SODOTO)(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2022-03) Paralikar, S; Shah, C; Kapoor, A; Parmar, U.Objectives: The aim of this study was to compare the acquisition of basic clinical skills by George and Doto’s five step method compared to the Traditional SODOTO approach, and to ascertain the perception of the students regarding these diverse methods. Materials and Methods: Fifty-four 2nd MBBS 1st semester students posted in the Department of Medicine at GMERS, Gotri, were enrolled for the study. After teaching the theory, both groups were taught per abdomen (P/A) examination and respiratory system (R/S) examination – one system by the five-step method and the other by the SODOTO approach. Skill acquisition was tested by pre-validated checklists. Finally, feedback was collected on the perception of students using a pre-validated questionnaire. The data were analysed using GraphPad. Results: There was an average 20% improvement (P < 0.001) in the group taught by the five-step method compared to the one taught by the traditional approach (P/A – 45.14/60 [5.64] vs. 57.86/60 [1.83] [Group B vs. Group A]) (R/S examination – 26.17/40 [6.65] vs. 34.79/40 [3.56] [Group A vs. Group B]). Conclusion: George and Doto’s five-step method has been found to be more effective than the traditional SODOTO approach.Item Correlation of body mass index with handgrip strength and blood pressure indices among young adults(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-06) Salim, S; Davy, CR.Objectives: Hand grip strength (HGS) is an important quantitative measure to evaluate the overall muscle strength of an individual. It is affected by factors such as age, sex, body mass index (BMI) and cardiovascular risk factors such as obesity and hypertension. This study aims to find out the correlation of BMI with HGS and blood pressure indices among young adults. Materials and Methods: Three hundred and eighty-two medical students between the age group of 18–20 years with no history of systemic illness, musculoskeletal disorder, hand pain or deformity were selected. Informed consent was obtained. Biodata and anthropometric measurements were documented in a proforma. HGS and endurance of the dominant hand were measured using a hand-held dynamometer. Blood pressure was recorded using a mercury sphygmomanometer. Data on BMI was sub grouped into underweight, normal weight, overweight and obese participants to compare the HGS among them. Results: There was a statistically significant negative correlation between BMI and HGS (r = ?0.513; P < 0.01), BMI and grip strength ratio (r = ?0.750; P < 0.01), and between BMI and handgrip endurance (r = ?0.359; P < 0.01). Statistically significant decrease in HGS was found among underweight (29.36 ± 7.01), overweight (26.18 ± 5.45) and obese participants (20.48 ± 3.12) with Kruskal–Wallis value ?2 = 14.231. Furthermore, a statistically significant positive correlation was found between BMI and systolic blood pressure (r = 0.603; P < 0.01), BMI and diastolic blood pressure (r = 0.514; P < 0.01), BMI and pulse pressure (r = 0.228; P < 0.01) and between BMI and mean arterial pressure (r = 0.572; P < 0.01). Conclusion: BMI was found to be negatively correlated with HGS and positively correlated with blood pressure indices. This can influence the compatibility of medical students with the physical and emotional stress of course. Determinants such as grip span, hand span, skeletal muscle bulk, and arm and calf muscle circumference are to be considered for further research to improve the endurance of young adults.Item Trait emotional intelligence as predictor of psychological health in undergraduate medical students: A hierarchical multiple regression approach(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-03) Jain, P; Jain, P.Objectives: Trait emotional intelligence (TEI) is a key personality construct by which an individual recognizes, understands, expresses and regulates emotions in self and others to adapt to environments or achieve one’s goals. TEI skills are modifiable and have a potential to significantly influence psychological health (PH) of a person. The aims of current work were to evaluate relationship between TEI and PH of medical students and to explore the incremental validity of TEI to predict psychological distress beyond sociodemographic and educational factors in them. Materials and Methods: One hundred and thirty-two medical students (mean age 18.02 years) participated in this cross-sectional study. TEI and PH were assessed using TEI questionnaire short form (TEIQue-sf) and depression, anxiety and stress scale (DASS-21), respectively. Hierarchical multiple regression analysis was carried out to determine if scores on TEIQue-sf added significantly to the prediction of psychological symptoms in medical students. Results: There was a significant negative association (r = ?0.57, P < 0.001) between TEIQue-sf and DASS-21 scores. Hierarchical regression analyses revealed that after controlling for sociodemographic and educational variables, TEIQue-sf scores explained a statistically significant increment of variance (P < 0.001) in DASS-21 scores. TEI emerged as best predictor of psychological distress of medical students followed by educational factors. However, sociodemographic profile as an attribute failed to demonstrate significant capacity to predict PH of our participants. Conclusion: Our results indicate that TEI is a robust and unique predictor of better PH and plays a positive role in promoting psychological well-beingItem A correlation study of arterial stiffness, cardiac autonomic neuropathy and lipid profile in type 2 diabetes mellitus patients(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-03) Kar, M; Priyadarsini, N; Behera, KK.Objectives: Micro and macrovasculopathy are common complications of undertreated or undiagnosed type 2 diabetes mellitus (T2DM) patients. One of the underlying factors of macrovasculopathy is arterial stiffness, which may lead to cardiovascular and cerebrovascular diseases. Understandably, diabetic micro and macrovasculopathy affect vital functions, which may affect the well-being of the individual. However, few studies have attempted to determine arterial stiffness, cardiac autonomic neuropathy (CAN) and lipid profile separately in South Asian population and examined its associations with T2DM. Moreover, there is a need to understand the mechanistic links among cardiovascular risk factors. This forms the basis of the present study. Materials and Methods: T2DM patients of 53–62 years and age- and gender-matched healthy control subjects were recruited in the cross-sectional and observational study (n = 30 each, eight women). Anthropometric measurements, physiological parameters such as resting heart rate, peripheral blood pressure (PBP), central blood pressure (CBP), augmentation index% (AIx%), brachial-ankle pulse wave velocity and lead II ECG for analysis of heart rate variability parameters were recorded after obtaining the consent of the study participants. The lipid profile and fasting blood glucose were also analysed. Results: Peripheral systolic blood pressure was significantly higher (P = 0.05) in T2DM patients. Dyslipidaemia was evident in T2DM patients. Atherogenic index of plasma (AIP) was also significantly higher in T2DM patients. Correlation analysis revealed a positive association between AIx% with PBP and CBP as well as between AIP index and central systolic blood pressure, serum triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) levels. AIP index was found to be negatively associated with HF (nu). Serum TG, high-density lipoprotein cholesterol (HDL-C) levels and AIP index have emerged as significant independent predictors of T2DM vasculopathy by multiple regression analysis. Conclusion: In the present study, atherogenic dyslipidaemia was observed in T2DM patients in combination with increased serum levels of TG, VLDL-C and decreased serum levels of HDL-C. Moreover, AIP index, a predictor cardiovascular risk, was found to be significantly higher in T2DM patients. Dyslipidaemia was found to be associated with dysregulation of autonomic nervous system in those patients. A positive association between noninvasive, surrogate markers of arterial stiffness with PBP and CBP indicates that enhanced arterial stiffness may elevate systemic arterial pressure. Therefore, early screening of T2DM patients for the estimation of serum lipid profile, arterial stiffness and cardiac autonomic neuropathy may be performed to unravel diabetic vasculopathy.Item Efficacy and safety of Saroglitazar and Fenofibrate in the treatment of diabetic dyslipidaemia: A pilot study(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-03) Gahlot, R; Kumar, S; Garg, S; Chawla, S; Kalra, BS.Objectives: Diabetic dyslipidaemia (DD) is characterised by hypertriglyceridaemia and elevated or normal levels of low-density lipoprotein cholesterol and decreased levels of high-density lipoprotein cholesterol with Type 2 diabetes mellitus. Statins and anti-diabetic medication are coprescribed for optimal control. Materials and Methods: The objective of the study was to compare the safety and efficacy of Saroglitazar 4-mg and Fenofibrate 200 mg in combination with low dose Atorvastatin (10 mg) in patients with DD. Run-in period of 4 weeks for life-style and diet modification followed by 12 weeks of treatment with saroglitazar or fenofibrate and low dose of atorvastatin was followed. Primary outcome of this study was an absolute change in serum triglyceride level at baseline and end of treatment period (12 weeks). Secondary outcome was changed from baseline lipid profile, fasting blood glucose and glycosylated haemoglobin (HbA1c) at the end of treatment period. Safety assessment was also done during the duration of study. Results: Forty patients of DD were randomly divided into two groups. One group received Saroglitazar 4 mg along with Atorvastatin 10 mg. Patients in second group received Fenofibrate 200 mg along with Atorvastatin 10 mg. Improvement in deranged lipid levels in both the groups was observed and this difference in improvement statistically was not found to be significant. We also observed that Saroglitazar significantly improves glycaemic profile by decreasing fasting blood sugar levels and HbA1c (P = 0.01, P < 0.01). Adverse events reported during this study were mild and none of the patients reported serious adverse events. Conclusion: Saroglitazar could be a potential drug to control both hyperglycaemia and dyslipidaemia in patients with DD.Item Effect of 12-week sports intervention programme on physical fitness and sports performance in individuals with spinal cord injury(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-03) Agarwal, B; Parab, SD; Amberkar, O; Mullerpatan, R.Objectives: Inactivity in individuals with spinal cord injury (SCI) results in low physical fitness, cardiopulmonary endurance and poor quality of life. Sports participation is known to enhance physical fitness. Therefore, the present study evaluated effect of a structured, 12-week MGM Sports Intervention for Sports Intervention Program for SCI (SPISI) on physical fitness and throw-ball performance in individuals with SCI. Materials and Methods: The study was conducted at MGM School of Physiotherapy and Spinal Cord Injury Rehabilitation centre in Navi Mumbai, India. Following ethical approval, 15 individuals with SCI (80% males and 20% females mean age 33.1 ± 7.2 years) were recruited. Upper-extremity explosive power (medicine-ball-throw), agility (t-test), cardiorespiratory endurance (incremental shuttle wheelchair propulsion test) and ball-throwing capacity (maximal-pass test) were evaluated pre- and post-12-week sports intervention programme (SPISI). The protocol involved strength training of upper extremity training at 50% 1 repetition maximum and participation in throw-ball sport. Results: Following training, increase in upper extremity explosive power (11%), cardiopulmonary endurance (5%), agility (8%) and ball-throwing capacity in distance (7%) (P < 0.05) was observed. The large effect size was observed for sports performance (maximal-pass test distance-Cohen’s d 1.261), moderate for cardiorespiratory endurance (incremental wheelchair propulsion test distance Cohen’s d 0.517) and upper extremity explosive power (medicine-ball throw distance 0.593). Increment in all outcome variables was greater than minimal clinically important difference. Conclusion: Sports intervention programme (SPISI) for 12 weeks brought about minimal clinically important difference in upper-extremity explosive power, agility, cardiorespiratory endurance and sport-specific performance and should be included as an integral component of rehabilitation of individuals with SCI.Item Rutin forestalls dysregulated cardiac bioenergetics in bisphenol A and dibutyl phthalate-exposed rats through PPAR? and AMPK modulation(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-06) Oluranti, OI; Alabi, BA; Michael, OS; Ojo, AO; Akande, AC.Objectives: Proper cardiac function is greatly dependent on adequate supply and metabolism of energy substrates. Environmental pollutants exposure including plasticizers can trigger adverse cardiac metabolic events. This study was designed to investigate the ameliorative effect of rutin (Rt) on dysregulated cardiac energy metabolism in plasticizer-exposed rats. Materials and Methods: Forty-two rats were randomised into seven groups (n = 6): Control (0.1% dimethyl sulfoxide), bisphenol A (BPA, 25 mg/kg, p.o), dibutyl phthalate (DBP, 25 mg/kg, p.o), BPA + Rt 25 mg/kg, Rt 50 mg/kg, DBP + Rt (25 mg/kg, Rt 50 mg/kg), BPA + DBP and BPA + DBP + Rt, daily for 21 days. Results: BPA and DBP exposure increased plasma glucose, reduced insulin, and increased plasma and cardiac free fatty-acid. Cardiac glucose-6-phosphate level, hexokinase and pyruvate dehydrogenase activities increased in DBP while BPA reduced these variables. Cardiac glucose transporter-4 expression was reduced in BPA group, while cardiac peroxisome proliferator-activated receptor-alpha (PPAR?) and AMP-activated protein kinase (AMPK) expression increased in BPA and DBP-treated rats. However, Rt administration prevents impaired cardiac bioenergetics and glucometabolic regulation. Conclusion: Summarily, Rt improves BPA and DBP-impaired cardiac bioenergetics through PPAR? and AMPK modulation.Item Protective effects of the ethanolic fenugreek seeds extract and its potentiation with nitric oxide modulators in adjuvant induced changes in arthritic index, proinflammatory/anti-inflammatory cytokines imbalance and oxidative stress markers in rats(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2022-03) Kamal, P; Pal, R; Nath, R; Sachan, AK.Objectives: The current study was designed to evaluate protective role of the ethanolic fenugreek seed extract (FSE) and potentiating its effects with nitric oxide (NO) modulators in experimental arthritis and its comparison with the standard drug methotrexate. Materials and Methods: The FSE was prepared using standard procedures. Fifty-four male Wistar rats were equally distributed into nine groups of six animals in each group. Rheumatoid arthritis was induced by administration of complete Freund’s adjuvant (CFA) in sub-plantar region of rt. hind paw. FSE alone and with L-arginine or N?-Nitro-L-arginine methyl ester hydrochloride (L-NAME) were administered on day 10 of CFA inoculation, i.p. Animals were evaluated for arthritic parameters, cytokines and oxidative stress markers estimation. Statistics: The data were analysed by two-way ANOVA followed by Newman Keul’s post hoc test for inter group analysis by GraphPad Prism 6.0 and P < 0.05 was taken as significant. Results: Adjuvant inoculated rat shows significant increase in arthritic and inflammatory parameters as well as oxidative stress biomarkers in serum, paw homogenates and joint synovial fluid. CFA inoculation significantly decreased anti-inflammatory cytokine-10 and SOD activity. These adjuvant-induced arthritic changes were significantly attenuated by ethanolic FSE administration from 10 to 28 days. These results are comparable to standard drug methotrexate. NO modulators further potentiated protective effects of FSE when given in combination. These results were more prominent when ethanolic seed extract was given with iNOS inhibitor, L-NAME. Conclusion: These findings suggest that FSE shows protective effects in CFA induced arthritic changes that may be mediated through pro-inflammatory/anti-inflammatory cytokines imbalance and it is associated with modulation of oxidative stress and NO-signalling.Item Implementation of the online learning management system ‘Moodle’ as a blended approach to online teaching(Scientific Scholar on behalf of Association of Physiologists and Pharmacologists of India, 2023-03) Goyal, S; Khaliq, F; Vaney, N.Objectives: Web-based learning is becoming a newly accepted standard in education, more so with COVID-19 pandemic. To use technology to redesign learning experiences, a blend of synchronous and asynchronous approaches was used wherein the routine lectures through MS Teams (synchronous) were integrated with an online learning management system (LMS), ‘Moodle’ (modular object-oriented dynamic learning environment) based, four-quadrant approach (asynchronous). We aimed to determine the student’s engagement, performance and perception of the new online LMS. Materials and Methods: All 170 students of the 1st year MBBS of batch 2020 were enrolled in the course. A module was developed for teaching ‘Physiology of Vision’ with this blended approach. Along with routine online lectures through Microsoft Teams, supplementary materials in the form of multimedia presentations and additional links to useful websites were provided through online LMS. The online activity of students was recorded and assessments were done. A feedback form was filled out by students at the end of the course. Results: A significant positive correlation of examination scores with individual student’s activity logs and significantly better scores in top Moodle users along with significantly higher marks in Moodle-based modules than in other modules confirmed the value of Moodle in improving student performance. Overall feedback from students was clearly in favour of implementing Moodle as a complementary tool to traditional teaching. Conclusion: Moodle improved the quality of learning. It developed interest and motivation among students and has a positive impact on academic outcomes.