Journal of Bangladesh Society of Physiologist

Relationship between serum ferritin and parathyroid function in adult male patients with transfusion dependent thalassemia

SFH Urmi — 2022-12-27

Background: Thalassemia is a genetic disorder of defective hemoglobin synthesis. In transfusion dependent thalassemia (TDT), iron overload is caused by repeated blood transfusion for a long time. This increased iron is deposited in body tissue and may lead to endocrine dysfunction.

Objective: To evaluate the relationship between serum ferritin and parathyroid dysfunction in adult male patients with TDT.

Methods: It was a cross sectional study which was conducted from March 2018 to February 2019 in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. For this study, 35 TDT male patients aged 18 to 40 year, were considered as study group and 35 age and sex matched apparently healthy subjects were considered as control group. The outpatient department of Hematology and Transfusion Medicine was the point of collection of study group. Parathyroid function was assessed by plasma intact para thyroid hormone (iPTH), serum total calcium and serum inorganic phosphate. Plasma iPTH and serum ferritin levels were estimated by Electrochemiluminescence Immunoassay method using automated analyzer. Serum total calcium and serum inorganic phosphate levels were estimated by colorimetric method using automated analyzer. Independent sample t test and Pearson’s correlation coefficient (r) test were applied for statistical analysis using SPSS version 16.

Results: In this study, serum ferritin level was significantly (p <0.001) higher in patients with TDT than that of healthy control. Correlation analysis showed negative correlation of serum ferritin with plasma iPTH and serum corrected calcium and positive correlation with serum inorganic phosphate in patients with TDT. Among them correlation with serum corrected calcium and inorganic phosphate were statistically significant (p <0.05).

Conclusion: This study concluded that TDT may be associated with elevated iron status which is inversely related with parathyroid function.

J Bangladesh Soc Physiol. 2022, June; 17(1): 1-5

Effect of physical exercise on non-linear parameters of heart rate variability in Chronic Obstructive Pulmonary Disease

Syeda Fadia Tasnim — 2022-12-27

Background: Chronic Obstructive Pulmonary Disease (COPD) is associated with autonomic nerve dysfunction. Nonlinear methods of heart rate variability (HRV) analysis have been gaining interest as a method of detecting changes in cardiac autonomic nerve function. Regular practice of physical exercise may cause improvement of this impaired autonomic nerve function.

Objectives: To assess the effect of physical exercise on nonlinear measures of HRV analysis in male patients with COPD.

Methods: This prospective interventional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka in 2018 on 60 diagnosed male COPD patients aged 40-75 years with disease duration of at least 5 years selected from the Department of Respiratory Medicine, BSMMU, Dhaka. Thirty patients underwent physical exercise (walking for 30 minute and pursed lip and diaphragmatic breathing 10 minuts)for 3 months in addition to standard treatment. Thirty (30) patients received only standard treatment for 3 months. For comparison, 30 age matched apparently healthy males were also enrolled. HRV data of all patients were recorded before and after 3 months of follow up. HRV data of healthy controls were recorded once at baseline. For assessing autonomic dysfunction, nonlinear parameters of HRV were recorded by Power Lab 8/35. For statistical analysis, paired sample t-test and independent sample t-test were done as applicable.

Results: SD1, SD2 and SD1/ SD2 were found significantly lower in COPD patients compared to healthy controls at baseline. After 3 months of physical exercise, significant increment of these parameters occurred with a trend of improvement in cardiac autonomic nerve function in these patients.

Conclusion: This study concluded that physical exercise can improve cardiac autonomic nerve dysfunction function in COPD patients.

J Bangladesh Soc Physiol. 2022, June; 17(1): 6-13

Serum Calcium, Magnesium and Creactive protein levels in female Metabolic Syndrome patients

Sumaiya Mohammad — 2022-12-27

Background: Metabolic syndrome (Mets) is a risk factor for cardiovascular, chronic lung, liver and kidney diseases. Hypercalcaemia, hypomagnesaemia and elevated C-reactive protein (CRP) produce various complications such as cardiac arrythmia, renal stones, atherosclerosis, Diabetes Mellitus, Obesity etc. Some researchers suggested that hypercalcaemia, hypomagnesaemia and elevated CRP occur in Metabolic syndrome patients.

Objectives: To measure serum calcium, magnesium and CRP levels in Metabolic syndrome patients.

Methods: This cross sectional study was conducted from March 2019 to July 2020 in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University(BSMMU), Shahbag, Dhaka. For this study, 30 female metabolic syndrome patients aged 25 to 45 year, from the Outpatient department of Endocrinology of BSMMU were selected. For comparison, 30 age and gender matched apparently healthy female subjects were control. Serum calcium and magnesium were measured by Colorimetric method and serum CRP was measured by Immunoturbidimetric method. Independent sample‘t’ test was performed for serum calcium and Mann-Whitney U test was performed for serum magnesium and CRP.

Results: Mean serum calcium (p £0.05 and median value of serum CRP (p £0.01) were significantly higher, median value of serum magnesium was lower (p>0.05) but not significant in Metabolic syndrome patients than that of control.

Conclusion: This study may conclude that elevated serum calcium and CRP levels are associated with metabolic syndrome patients.

J Bangladesh Soc Physiol. 2022, June; 17(1): 14-20

Vitamin D3 supplementation on lung functions and exercise tolerance in D3 deficient asthma COPD overlap syndrome patients - A randomized controlled trial

Naznin Sultana — 2022-12-27

Background: Vitamin D3 supplementation showed significant improvement in lung functions and exercise tolerance in both of asthma and COPD patients.

Objectives: To evaluate the effects of vitamin D3 supplementation on lung functions and exercise tolerance in D3 deficient, stable patients with ACO.

Methods: A double blinded randomized placebo controlled trial was carried out on 60 (sixty) D3 deficient [serum 25-hydroxycholecalciferol, 25(OH)D<30 ng/ml], male, smoker, stable ACO patients of age 40 to 80 year, selected according to selection criteria. After the final selection, all the patients were randomly allocated as ‘Study’ (n=30) or ‘Control’ (n=30) and their baseline spirometric lung functions (FVC, FEV1, FEV1/FVC ratio, PEFR, FEF25-75) and exercise tolerance represented by 6Minute Walk Distance (6MWD), peripheral capillary oxygen saturation (SpO2) at rest, SpO2 after 6MWT, dyspnea scale and fatigue scale variables were measured. All the ‘Study’ patients received 80,000 IU (2 oral capsules) of vitamin D3 per week for first 13 weeks. Subsequently, according to their serum 25(OH)D or calcium, they got 40,000 IU (1 oral capsule) of D3 per 1 week or per 2 weeks or per 6 weeks or no further supplementation, for following 13 weeks. Whereas, all the ‘Control’ patients received two oral capsules of placebo weekly for consecutive 26 weeks. After 26 weeks of follow up, spirometric lung functions and exercise tolerance variables were again measured and compared with their corresponding baseline value. Data were analyzed by independent and paired sample t test, where p£0.05 was accepted as significant.

Results: There was significant improvement in 6MWD (p<0.05), SpO2 after 6MWT (p<0.001), dyspnea scale (p<0.001) and fatigue scale (p<0.001), in patients with vitamin D3 supplementation in comparison to those of placebo on 26th week of follow up. However, there was no improvement in ventilatory variables in the D3 supplemented group in comparison to those of placebo group.

Conclusion: The present study reveals that vitamin D3 supplementation improves exercise tolerance but not ventilatory variables in vitamin D3 deficient stable ACO patients. Further multi centered trials with different dose as well as duration schedule on both male and female ACO patients are recommended.

J Bangladesh Soc Physiol. 2022, June; 17(1): 21-33

Myocardial salvaging effect of turmeric (Curcuma longa) on experimentally induced myocardial injury in rats

Sharmin Nahar — 2022-12-27

Background: In Ayurveda turmeric (Curcuma longa) has been used for cardioprotection. Experimentally induced myocardial injury is clinically similar to human myocardial infarction.

Objective: The study was designed to assess the myocardial salvagingeffect of turmeric (Curcuma longa) on experimentally induced myocardial injury in rats.

Methods: This experimental study was carried out in the Department of Physiology, Dhaka Medical College, Dhaka during 2015. Total twenty eight (28) Wistar albino male rats (aged 13±1 weeks; 125±25 gm) were randomly grouped into NS (normal control group), ISO (isoproterenol treated control group),Tm+ISO (turmeric pretreated and isoproterenol treated group) and Am+ISO (amlodipine pretreated and isoproterenol treated group). All the rats were sacrificed on 10th day of experimentation. . Blood samples were collected. Serum carduac troponin I (cTnI) level was estimated by AxSYM methodand serum malondialdehyde (MDA) level was estimated byspectrophotometric method.For statistical analysis, one way ANOVA followed by Bonferroni post hoc test was done by using SPSS 22.0 version.

Results: The mean serum cTnI and MDA level was significantly (P<0.001) higher in ISO in comparison to all other rats of different groups. Whereas, the mean serum cTnI level was lower in Tm+ISO and Am+ISO in comparison to that of ISO which were statistically significant (P<0.05). Again, mean serum MDA level was significantly lower in Tm+ISO(P<0.05) and Am+ISO(P<0.001) in comparison to that of ISO.However, there were no significant differences between Tm+ISO and Am+ISO.

Conclusion: The results of the study concluded that turmeric has myocardial salvaging effect on experimentally induced myocardial injury inrats.

J Bangladesh Soc Physiol. 2022, June; 17(1): 34-40

Relationship of vitamin B12, folic acid and homocysteine level with time domain measures of heart rate variability in female Metabolic Syndrome

Khaleda Akter — 2022-12-27

Background: Metabolic syndrome (MetS) is a major risk factor for cardiac mortality and morbidity. Hyperhomocysteinemia and folic acid are related with MetS. Both MetS and hyperhomocysteinemia adversely affect heart rate variability (HRV).

Objectives: To assess the relationship of vitamin B12, folic acid and homocysteine levels with HRV in female MetS patients.

Methods: This cross sectional study was carried out on 40 female MetS patients of 25-45 years of age. Forty apparently healthy female with similar age were control. Chemiluminescent immunoassay measured serum vitamin B12, folic acid, homocysteine level and time domain parameters of HRV were recorded by Powerlab 8/35, AD instruments, Australia. Independent sample ‘t’ test and pearson correlation coefficient test was used for statistical analysis

Results: In this study, all the time domain HRV variables ( Standard deviation of all RR intervals-SDRR, Coefficient variation of RR interval-CVRR, The square root of mean squared difference of RR intervals-RMSSD and Number of R-R interval differing >50ms from adjacent intervals divided by the total number of all R-R intervals-pRR50%) were significantly lower (p<0.05) in MetS patients compared to control. But correlation analysis showed only the folic acid level was significantly negatively correlated (p<0.05) with SDRR, CVRR, RMSSD and pRR50%.

Conclusion: The result of this study showed inverse relation of low HRV with low serum folic acid levels in female MetS patients.

J Bangladesh Soc Physiol. 2022, June; 17(1): 41-48

Analysis of different levels of cognitive domain in undergraduate written short answer questions in Physiology: A descriptive study in Bangladesh

Jawairia Rajwana — 2022-12-27

Background: Teaching-learning and assessment of Physiology should be more organized because it builds the foundation for clinical science. A written question sheet on Physiology can be claimed ideal when it can assess the competence at different levels of cognitive domain of student’s learning.

Objectives: The aim of the present study is to find out the prevalence of questions addressing different levels of cognitive domain in the first professional MBBS written examination on Physiology.

Methods: This descriptive and retrospective type of study was conducted in the Department of Physiology, BSMMU, Dhaka, during the period of March 2020 to February 2021. A total 67 Short Answer Question(SAQ) sheets in the first professional MBBS examinations of the last five years of four public universities of Bangladesh were analyzed following revised Bloom’s Taxonomy. The frequency percent of questions addressing six levels of cognitive domain was manually calculated.

Results: ‘Question-segments’ assessing remember level were greater than 80%, Whereas, ‘questionsegments’ assessing understand, apply and analyze level ranged between 11-13%,0.25-0.95% and 0.11-0.67% respectively in all the universities. No ‘question-segment’ was found addressing evaluate and create level of cognitive domain.

Conclusion: From the results of this study, it may be suggested that there is almost absence of questions for assessment of student’s higher order thinking ability and most of the questions used, assessed the lowest level of cognition process in the first professional MBBS written examination on Physiology under four public universities of Bangladesh.

J Bangladesh Soc Physiol. 2022, June; 17(1): 49-55

Effect of slow breathing exercise on heart rate variability in tension-type headache female patients: A time domain analysis

Shahanur Rahman — 2022-12-27

Background: Tension-type headache (TTH), the most frequently occurring primary headache is associated with autonomic dysfunction. Time domain analysis of heart rate variability (HRV) is a popular tool to detect changes in cardiac autonomic nerve function (CANF) in TTH patients. Slow breathing exercise (SBE) can significantly improve HRV in patients with cardiovascular disorders.

Objective: To observe the effect of SBE on HRV by time domain analysis in TTH female patients.

Methods: This quasi-experimental study was conducted from March 2021 to February 2022 in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka on 60 female TTH patients aged 20-45 years. Thirty patients performed SBE every morning and evening for 30 minutes in addition to receiving conventional treatment and 30 patients continued only conventional treatment without any exercise for 90 days. Thirty age, sex and BMI matched apparently healthy control were enrolled who did not perform SBE or any other exercise. All subjects were assessed at baseline and also after 90 days. Time domain HRV parameters were recorded by Power Lab 8/35 AD Instruments, Australia. One way ANOVA followed by post-hoc test and Paired sample t-test were performed for statistical analysis and p<0.05 was considered as statistical significance.

Results: Mean heart rate (HR) was significantly higher (p<0.001) and SDRR (Standard deviation of all RR interval); CVRR (Coefficient variation of RR interval); SDSD (Standard deviation of successive RR interval differences between adjacent RR intervals); RMSSD (Square root of mean of squared differences of successive RR interval) and pRR50% (Proportion of RR interval with duration > 50ms) were significantly lower (p<0.001) in TTH female patients compared to control at baseline. Significant decrement of mean HR (p<0.001) and increment of all other time domain parameters (p<0.001) was observed after 90 days of SBE. Again, significantly decreased SDRR, CVRR, SDSD, RMSSD and pRR50% (p<0.001, p<0.01) was observed in the patients who did not perform SBE.

Conclusion: SBE may effectively improve cardiac autonomic dysfunction in TTH female patients.

J Bangladesh Soc Physiol. 2022, June; 17(1): 56-63