Hormones released during stress have a negative metabolic effect in skeletal muscle. Stress can induce earlier decline in muscle strength which will eventually lead to fall and fracture. Therefore, stress should be viewed as an independent risk factor for disability and other co morbid conditions.
Background: Pediatricians often encounter children with heart murmurs during routine follow up visits or while assessment of intercurrent illness. Clinical differentiation between pathologic and innocent murmurs would be important. It is important to identify those children who need further evaluation. The aim of the study was to evaluate whether Nadas criteria can be applied as a screening test to decide on further workup.Methods: This was a prospective descriptive study done in Government T. D. Medical College, Alappuzha over a period of 12 months from July 2013 to June 2014. All children in the age group one month to 12 years, attending the outpatient department were screened for presence of murmur of grade 2 and more. They were further evaluated carefully. They were also studied for association of variables like maternal age, birthweight, dysmorphism and family history of heart disease. Nadas criteria was then applied to the study population. A score of 2 and 1 were given to major and minor criteria respectively.Results: 3070 children were screened. 150 children were detected to have murmur of grade2 and more.66 children were detected to have a structural heart disease by an echo study.74% of the study population in the age group <1 year had a heart disease.8 out of 78 children with a Nadas score of 1 and 10 out of 24 with a score of 2 had a heart disease. All with a score 3 and more had congenital heart disease (CHD).Conclusions: Nadas criteria can be used as screening test with a sensitivity of 87% and specificity of 83%.
An adequate antioxidant reserve which is usually present in a vegetarian diet is associated with higher life expectancy. On the other hand habitual consumption of fish is associated with lower risk of cardiovascular diseases which is attributed to the polyunsaturated fatty acids (PUFA) present in it. However the PUFA are readily susceptible to oxidation leading to the formation of free radicals which is known to be involved in the causation of several diseases.The oxidant-antioxidant status of 23 vegetarians and 22 fish eaters was studied by determining the plasma lipid peroxides measured as malondialdehyde (MDA) and the antioxidants, viz. glutathione (GSH), ascorbic acid, ceruloplasmin and uric acid.Results show that the ascorbic acid values were significantly higher in vegetarians. In addition, MDA correlated negatively with ascorbic acid only in vegetarians. However, correlation of MDA with glutathione showed a significant negative correlation only in fish eaters. There was no statistically significant difference in the MDA, GSH, ceruloplasmin and uric acid levels. The mechanism behind these findings are not clear and needs to be explored.
Habitual consumption of moderate amounts of fish is associated with reduced mortality from coronary heart disease. However the beneficial effects offish enriched diet seem contradictory, due to the susceptibility of the PUFAs in them to oxidation. It is also acclaimed that vegetarians in general, have a lower serum total cholesterol and LDL-cholesterol and a better antioxidant status. This contradiction was the basis for the study, where the validity of the above finding was tested in a general population consuming a vegetarian or predominantly fish diet as a regular dietary habit. The oxidant status and the lipid profile of 23 vegetarians and 22 fish eaters was studied by estimating the plasma lipid peroxides measured as malondialdehyde (MDA) and the lipid parameters viz. Total Cholesterol (TC), HDL-Cholesterol (HDL-C) and tdglyceddes (TG). Statistical analysis was carded out to compare the MDA values and the lipemic status between the two groups. MDA was also correlated with the various lipid indices among the study groups. None of the compared and correlated values was statistically significant, although certain altered trends were seen. From this study, it may be concluded that oxidant status and lipid profile does not vary significantly in the two groups, suggesting that neither a vegetarian diet nor a fish diet has a definite benefit over the other.
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