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BackgroundCommon neurological syndrome (migraine without aura) is more common among women than men. Migraine is among the top 20 causes of disability. Menstruation is known to be a powerful trigger for migraine, and so is stress, but the presentation of headache is similar in both. Also, women are more vulnerable to stress as well as migraine, and this makes a complex relationship of menstruation, stress, and migraine.ObjectiveThis study was done to understand the association of hormonal fluctuation in menstruation and stress with common migraine.Materials and methodsA cross-sectional comparative study was conducted in 40 young adult females, of whom 20 participants were cases of migraine without aura (18–35 years old), and the remaining 20 participants were age-matched controls. The study was done in Maulana Azad Medical College, New Delhi. Study participants were selected on the basis of International Headache Society (ICHD-IIA1.1) (2004) classification. Study participants with neurological disorders, chronic diseases, and disease suggestive of any hormonal disturbances were excluded. Clinically diagnosed migraine cases were asked to maintain a headache diary and to fill in the Depression Anxiety Stress Scales questionnaire. Biochemical assessment of hormonal status for thyroid-stimulating hormone, triiodothyronine, thyroxine, estrogen, follicle-stimulating hormone, luteinizing hormone, and prolactin was also done on the second day of their menstrual cycle. We used the Mann–Whitney U test to compare hormonal levels and the χ2 test to compare anxiety- or depression-related stress among the migraine and nonmigraine groups.ResultsSignificantly higher values of prolactin were observed in cases (mean ± standard deviation, 152.7 mIU/L±30.5) compared to controls (76.1 mIU/L±8.7), with a P-value <0.001. There was no statistically significant difference observed in levels of thyroid-stimulating hormone (P=0.081), estrogen (P=0.086), luteinizing hormone (P=0.091), or follicle-stimulating hormone (P=0.478). Also, anxiety with stress or depression with stress was significantly higher among the migraine group than the controls (P=0.002). Odds of any stress in migraine were higher in the migraine group than in the nonmigraine group (odds ratio 12, 95% confidence interval 2.7–53.33).ConclusionMigraine, particularly without aura, in women is mainly associated with stress-related anxiety or depression, and are more susceptible to stress in the premenstrual period.
BackgroundLearning style is an individual’s natural or habitual pattern of acquiring and processing information in learning situations. Different sensory modalities are used by different types of medical students for assimilating the knowledge and information. Currently, the usage of electronic tools for teaching is widespread that can influence learning styles.MethodsThe purpose of this study was to know the pattern of learners among first- and second-year medical students from different institutions in India. For this purpose, we have used latest English Version 7.0 of the Visual-Aural-Read/write-Kinesthetic.ResultsAnalysis was carried out using the IBM SPSS Version 21 software. Numerical variables were summarized by mean and SD or median and IQR as appropriate. Differences in scores among Visual-Aural-Read/write-Kinesthetic-learning styles were tested by Friedman’s test with post hoc pair wise comparison. Pattern of learning styles was different, and it was statistically significant (P<0.001). In this study, aural (median score 6) and kinesthetic (median score 6) styles were preferred. Pair-wise comparisons revealed that each style was different from each other except kinesthetic and aural.ConclusionResults of the study suggest that to improve learning, one should try to use multimodal styles with special emphasis given to auditory and kinesthetic modes especially among first professionals in medical education during digitization.
Context: Meditation is very useful to relieve stress via hypothalamo-pituitory axis. Meditation is considered to be useful to relieve stress and cardio-respiratory health. Aims: To compare the effect of meditation on autonomic function including heart rate variability (HRV) over a period of 3 months of meditation. Settings and Design: Longitudinal study conducted at Physiology Department, AIIMS Bhopal. Methods and Materials: Thirty healthy volunteers doing meditation were evaluated for autonomic function using autonomic function test battery (Ewing's battery) and HRV using Power lab (Ad instrument) and digital electrocardiograph (MARKS). Statistical Analysis Used: Statistical analysis was done using statistical software. Wilcoxon signed rank test was used. Results: Significant change was seen in Valsalva ratio and lying to standing 30:15 ratio. There was no significant change in other parameters studied with 3 months of meditation. Conclusions: Three months of meditation does not have any significant effect on major parameters of autonomic functions.
In this case, we describe a newborn that presented on the first day of life with diffuse, bilateral coronary artery dilatation, in the absence of intrauterine hypoxia or other identifiable causes of coronary artery ectasia. The infant's symptoms followed an acute course before spontaneously recovering. Kawasaki disease, though relatively rare in neonates, may present in this population in the absence of classical criteria. If untreated, the cardiac sequelae of this disease can be serious. Through this case, where spontaneously remitting coronary dilatation is the paramount finding, we entertain the possibility that this may represent the earliest known presentation of Kawasaki disease.
BackgroundDiabetes mellitus causes microvascular complications in the eyes and kidneys as well as the nervous system, among other parts of the body. Lungs are a potential target organ for diabetic microvascular complications and remain the least researched among diabetic patients. The aim of this study was to explore whether there is any difference in pulmonary functions in patients with diabetes mellitus compared to those without. MethodologyA comparative cross-sectional study was conducted on 50 participants each with and without type II diabetes mellitus. Pulmonary function parameters, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1 as a percentage of FVC in percentage (FEV1%), peak expiratory flow rate in L/second (PEFR), forced expiratory flow rate in L/second in 25% of FVC (FEF25%), forced expiratory flow rate in L/second in 50% of FVC (FEF50%), forced expiratory flow rate in L/second in 75% of FVC (FEF75%), forced expiratory flow rate during 25-75% of expiration (FEF25-75%), and maximal voluntary ventilation (MVV), of both groups were analyzed using the NDD Large True Flow (Easy One) spirometer (NDD Meditechnik AG., Switzerland). A fully automated chemistry analyzer and linear chromatography were used for glycemic control measurements. ResultsAll pulmonary function test parameter values were lower in participants with diabetes mellitus compared to those without, except FEV1% and PEFR, which indicates a mixed pattern of lung dysfunction. FVC had a significant negative correlation with the duration of diabetes (r = -0.299, p = 0.034). ConclusionsType II diabetes mellitus patients had significant dysfunction in pulmonary functions with early involvement of restrictive parameters which can be monitored/diagnosed by regularly following up patients by measuring pulmonary functions, and, hence, can be taken care of.
Background: The ongoing pandemic of coronavirus disease 2019 (COVID-19) has negatively impacted respiratory health worldwide. The severity of the disease varies considerably, and patients may present with bronchitis, pneumonia, and acute respiratory distress syndrome. This study aims to quantify the parameters of the pulmonary function test (PFT) with regard to the severity of COVID-19 and understand the pattern of PFT in reference to the status of selected morbidities and body mass index.Materials and methods: This is a hospital-based, comparative, cross-sectional study. A total of 255 COVID-19 survivors underwent clinical assessment, a PFT, and a 6-minute walk test. Participants were divided into mild, moderate, and severe disease groups. The parameters were compared between these groups. The PFT and 6-minute walk tests were conducted using an NDD Digital computerized spirometer (NDD Meditechnik AG., Switzerland) and a fingertip pulse oximeter (Hasely Inc., India), respectively.Results: All PFT parameters showed significant differential distribution among the severity groups (p<0.001) except for forced expiratory volume in 1 s/ forced vital capacity (FEV 1 /FVC) and forced expiratory flow (FEF) during 25%-75% expiration and peak expiratory flow (PEF). Among severe category participants forced vital capacity (FVC), forced expiratory volume in one second (FEV 1 ), and FEV 1 /FVC, were significantly reduced as compared to mild and moderate. Severity was significantly affected by age >50 years. Severe category participants were seen in 31% of normal, 58% of pre-obese, and 53% of obese participants; however, this difference was insignificant. A significant reduction in SPO2 on the 6-minute walk test was observed in severely sick participants.Conclusions: COVID-19 is associated with a mixed pattern of spirometry. Poor prognosis is associated with older age, obesity, and multimorbidity.
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