Background: Thyroid hormones exert effects on the heart and peripheral circulation. Heart rate variability (HRV) is a good marker for identifying the cardiovascular risk in patients with hyperthyroidism. Aims and Objective: To evaluate the impact of hyperthyroidism on autonomic tone and to compare the HRV parameters in patients with hyperthyroidism and healthy volunteers. Materials and Methods: This study was conducted at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, on 30 hyperthyroid patients (cases) with average age 39.23 ± 6.91 years and 30 healthy volunteers (controls) with average age 42.13 ± 6.78 years. After obtaining the written consent from the subjects, ECG was recorded for 10 min in a computerized physiograph in lead II. Results: Statistical analysis carried out by independent Student's t-test showed a significant difference (P < 0.001) in HRV parameters of patients with hyperthyroid and healthy volunteers. Among the frequency domain measures, a decrease in high frequency (HF) in normalized units and increase in low frequency (LF) in normalized units, and in the ratio of LF to HF (LF/HF) in hyperthyroid patients was observed. Among the time domain measures, decrease in RR intervals, SDNN, RMSSD, and NN50 was observed in patients with hyperthyroid compared to those with euthyroidism. Conclusion: This study showed that individuals with hyperthyroidism had a higher sympathetic tone and a lower parasympathetic tone as compared to those with euthyroidism. Using HRV analysis, we can identify patients who are at risk for cardiac complications and early intervention can reduce mortality rates.

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Background: Non-alcoholic fatty liver disease (NAFLD) is considered as a hepatic manifestation of the metabolic syndrome. Worldwide prevalence of NAFLD is 38%. Serum uric acid level has been suggested to be associated with factors that contribute to insulin resistance and metabolic syndrome. The aim of this study is to investigate the association of serum uric acid level and body mass index (BMI) with NAFLD. Methods: This observational study was conducted in subjects, who attended the master health checkup clinic of PSG Hospitals, Coimbatore, on 50 patients with NAFLD and 50 non fatty liver subjects. NAFLD was diagnosed based on the abdominal ultrasonographic findings. BMI and serum uric acid level were also measured in all the study participants. Uric acid quartiles were categorized into four groups, and the number of subjects, who came under each group, was noted. Results: The mean BMI (kg/m²) for cases was 27.01 ± 3.53 and the same for controls was 23.91 ± 3.11. Elevated BMI was associated with an increased incidence of NAFLD with a statistical significance (p < 0.05).The mean uric acid concentration (mg/dl) for cases was 5.73 ± 1.57, and for controls was 4.69 ± 0.91. Increased serum uric acid concentration was associated with an increased incidence of NAFLD with a statistical significance (p < 0.05). Conclusion: This study showed that elevated BMI is associated with an increased incidence of NAFLD. Serum uric acid levels are significantly associated with NAFLD, and high uric acid levels showed a high incidence of NAFLD compared to low serum uric acid level.

Background:The objective of the study was to compare the efficacy between levosalbutamol and ipratropium combination over levosalbutamol nebulisation in reversing airflow obstruction and improve oxygenation, evaluated using the pulmonary asthma score, SaO2, and PEFR in mild and moderate asthma. Methods: A prospective, randomized, study was performed in RMMCH pediatric emergency department. Children between 6 and 12 years of age who presented with mild to moderate asthma exacerberations were enrolled in the study. They were randomly allocated into two different groups: one nebulised with levosalbutamol alone and another with addition of ipratropium bromide to levosalbutamol. Baseline Peak expiratory flow rate and Final absolute values or change from baseline 60-120 minutes after the inhalation are measured. Patients were evaluated using the pulmonary score. Results: After treatment there is improvement in the mean pulmonary asthma scores and PEFR percentage in A+B group than A group, but it is not statistically significant (p value >0.05). There is statistically significant improvement in pulmonary asthma score and PEFR in each of the groups after nebulisation and pulmonary asthma score has a sensitivity of 66.7% and 65.6% in diagnosing severity of asthma in relation to PEFR.

Background: The new competency based medical curriculum was introduced in India from 2019. The curriculum implementation support program (CISP) developed by medical council of India, provides the much-needed intellectual support to colleges for smooth transition from existing to the new curriculum. This study was done to assess the effectiveness of CISP program by comparing the pretest and posttest questionnaire.Methods: This retrospective cross-sectional study was conducted among 30 medical teachers in a medical college after getting Institutional Ethical committee clearance. During the CISP training program, a structured and validated questionnaire were administered, and it was evaluated and compared before and after the workshop.Results: There was a significant improvement in the knowledge of electives, meaning of curriculum, knowledge on curriculum delivery process, knowledge concepts of Miller’s pyramid, hardens integration ladder, GMER and the concepts of SLO. Though there is a significant improvement, the knowledge gained on foundation course, Miller’s pyramid and GMER are still poor (mean score <0.7).Conclusions: The CISP program serves as an effective program to bridge the inadequacies of the teaching faculty regarding the implementation of the new CBME curriculum. But not just one session will tide over all the antiquities. A repeated longitudinal structured program in between the academic hours for a short duration will be effective in improving the teaching skills of the medical teachers.